Dr John Briffa: Lovely bones

I recently had Radio 4 on for a bit of oral wallpaper, and pricked up my ears during an item on quangos. According to a report published by the Efficiency in Government Unit, the UK has more than 500 'quasi-autonomous, non-governmental organisations' which soak up billions of taxpayers' pounds each year but appear to offer dubious value for money. One quango rating highly in the 'useless'-stakes report is the Milk Development Council. At one point during the radio item, a representative was hard-selling the healthy attributes of milk for schoolchildren.

I was left wondering what merit there is in milking the benefits of a foodstuff that is generally taken to play an indispensable nutritional role. My experience in practice is that the belief that dairy-derived calcium is needed for the building of bone in children is firmly entrenched in our psyches. This is evidenced by the fact that, should I recommend cutting out milk or dairy products from a child's diet (usually because sensitivity to dairy foods is a frequent factor in asthma, eczema and ear infections), parents usually express concern that this may leave their child short on calcium.

This month, in a study published in the journal Pediatrics, American researchers cast a critical eye over research assessing the role of calcium and dairy products in the bone health of children and young adults. Of 37 studies, 27 found no relationship between dietary calcium or dairy-product intake and measures of bone health. Of the remaining studies, any apparent benefit was surprisingly small.

While the bone benefits of calcium may have been overstated, some calcium is essential for bone health. Good alternative sources include green leafy vegetables, such as kale and broccoli. Veggies also alkalinise the blood, which preserves the calcium content of bone. Other good sources of calcium include tinned salmon and sardines. These are also rich in vitamin D, which is vital for the formation of healthy bone. Another lifestyle factor that has a bearing on bones is exercise. Activity during adolescence has a much greater influence on measures of bone health than calcium intake.

The authors of the study conclude that the available evidence does not support the promotion of milk or dairy products as bone builders in children and adolescents. Recent evidence adds nutritional credence to the EGU's branding of the Milk Development Council as one of the UK's most useless quangos.

Nutrition news

Studies have suggested that lycopene - a member of the carotenoid family of nutrients - may help in the prevention of prostate cancer. In a recent study published in the International Journal of Cancer, prostate cancer risk was assessed in relation to lycopene, along with other carotenoid nutrients including alpha-carotene, beta-carotene, lutein and zeaxanthin. Compared to those with the lowest intakes, those with the highest intakes of lutein and zeaxanthin (combined), lycopene, alpha-carotene and beta-carotene were found to have a prostate cancer risk reduced to the tune of 98, 82, 57 and 66 per cent, respectively. Good sources of these nutrients include spinach (lutein, zeaxanthin, beta-carotene and alpha-carotene), tomato (beta-carotene and lycopene), watermelon (beta-carotene and lycopene) and citrus fruits (lutein, zeaxanthin, beta-carotene and alpha-carotene). Not surprisingly, higher intakes of these foodstuffs were also associated with a reduced prostate cancer risk. This evidence suggests that the regular consumption of deeply coloured red, orange, yellow and green fruits and vegetables (likely to be rich in carotenoid nutrients) will help to reduce prostate cancer risk in the long term.

Dear John

Do you have any advice about alternative treatments for Peyronie's disease? MS

Peyronie's disease is a condition in which a dense, fibrous plaque forms in the shaft of the penis. The erect penis tends to curve or angulate at the point of the plaque. Surgery is an option, though this can lead to some loss of penile length, and the results are unpredictable. Some doctors recommend tamoxifen, though it is not licensed for this purpose. In one study, tamoxifen was pitted against the amino acid acetyl-L-carnitine in men with Peyronie's disease over a three-month period. Acetyl-L-carnitine was significantly more effective than tamoxifen in reducing discomfort and inhibiting the progression of the disease. It was found to reduce penile curvature significantly, while tamoxifen had no benefit. The recommended dose is 1g, twice a day. It may take several months for maximum benefit to be achieved. Acetyl-L-carnitine benefits various organs, including the heart and brain, and there is no evidence that it is unsafe to take in the long term.

· If you have any issues you would like Dr Briffa to address in his column, please email him on john.briffa@observer.co.uk. Please note that Dr Briffa cannot enter into any correspondence. You can also visit www.drbriffa.com. Before following any recommendations in this column, you should consult your own medical adviser about any medical problems or special health conditions.

Thanks to guardian.co.uk who have provided this article. View the original here.


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