May is National Osteoporosis Awareness and Prevention Month. Osteoporosis is a medical condition where bones become fragile and more likely to break. Here are some startling facts from the National Osteoporosis Foundation: Osteoporosis is a major public health threat for an estimated 44 million Americans, or 55 percent of the people 50 years of age and older.

In 2005, about 293,000 Americans age 45 and over were admitted to hospitals with a fracture of the femoral neck, a common type of hip fracture. Osteoporosis was the underlying cause of most of these injuries. An average of 24 percent of hip fracture patients aged 50 and over die in the year following their fracture.

The best ways to prevent osteoporosis are to eat foods rich in calcium and vitamin D, like milk, cheese and yogurt, and engage in regular weight bearing exercise like walking, jogging or even carrying groceries, all of which build bone strength and reduce the risk of osteoporosis.

The following resources are available on our website to help you build stronger bones:

• Calcium Quiz
• MyFitness Planner
• Vitamin D: What You Need to Know about the Sunshine Vitamin

As the month of May wraps up, take some time to learn about ways to prevent osteoporosis.

Dairy Council of California

Lactose intolerance is a real and important clinical syndrome, but its true prevalence is not known, according to a report released in February by the NIH Consensus Development Conference: Lactose Intolerance and Health. Not enough data is available to estimate the prevalence of true lactose intolerance in the United States, the report stated, but it's likely the numbers are lower than those often reported.

Many individuals with real or perceived lactose intolerance avoid dairy and ingest inadequate amounts of calcium, potassium and vitamin D, which may predispose them to decreased bone accrual, osteoporosis, and other adverse health outcomes.  In data presented by Dr. Connie Weaver from Purdue University, among teenagers that exclude dairy from the diet, 100% lacked key nutrients such as calcium, vitamin D, phosphorous and potassium. Although theoretically adequate nutrients can be consumed from non-dairy sources, teenagers in our culture do not eat enough of the foods needed to get adequate amounts of these nutrients if they do not include dairy. This is especially important because peak bone mass is attained during the teenage years and if this window of opportunity is missed, bone is compromised for the remainder of life. 

In most cases, individuals experiencing lactose intolerance symptoms do not need to eliminate dairy completely. Research is clear that many people with lactose malabsorption or intolerance can, in fact, tolerate significant amounts of dairy food. There is evidence that increasing consumption of dairy foods gradually over time can improve the body’s tolerance of lactose. The following simple, evidence-based dietary strategies are a healthy approach to coping with lactose intolerance:

• Drink small amounts of milk with meals.  Consuming milk with other foods or a meal can make it easier to digest. By introducing small amounts of milk at meals, over time tolerance improves for most individuals.
• Eat yogurt. Yogurts that contain live and active cultures can make it easier for the body to digest lactose.
• Eat aged cheeses. Aged cheeses like Swiss, Parmesan, Gouda, Colby, Provolone, Cheddar, Edam, Fontina, Gruyere, Muenster and Monterey Jack have very little lactose.
• Drink lactose-free milk. Lactose-free milk is available in most local supermarkets in the dairy aisle. However, this option is more expensive and research shows in many cases is not necessary. 

I asked a colleague who has lactose intolerance if these techniques really work and she said absolutely. Her primary suggestion was to keep experimenting to find the milk and dairy foods—and the amounts—that work for you. The gradual introduction of dairy foods into the diet on a regular basis can improve the body’s ability to digest lactose. The body will slowly build up the enzyme it needs to digest the lactose.

Maureen Bligh, MA, RD
Project Manager

February is American Heart Month. According to the American Heart Association, one in three Americans has high blood pressure. A major part in preventing heart disease, which is the number one killer of American women, is maintaining healthy blood pressure. One dietary intervention health professionals commonly recommend when guiding a client with hypertension is a reduced sodium diet. However, current research shows that we should think beyond simply limiting sodium to help our clients achieve healthy blood pressure. Other factors affecting hypertension that are equally important and often overlooked include lifestyle, diet quality and intake of micronutrients such as potassium.  

Focusing on lifestyle modifications can be a simple yet very effective way to treat hypertension. You can help your clients reduce blood pressure by encouraging them to:

• Adopt the DASH eating pattern, which emphasizes low-fat dairy foods, fruits, vegetables, whole grains, fish, poultry, beans and nuts. This dietary pattern is high in fiber and potassium and low in saturated fat and cholesterol. 
• Be active. Engaging in regular physical activity helps manage weight, reduce stress and control blood pressure.
• Reduce Stress. Turning down the stress response helps the body tune in to good health.
• Limit alcohol and quit smoking.

There are many ways that you can help you clients prevent and/or manage this “silent killer.” First, stay current on the latest research. Check out our recent Health Connections Newsletter which focuses on Managing Hypertension Through a Healthy Lifestyle. Second, encourage your clients to focus on diet quality. This goes beyond focusing on limiting sodium. Try recommending the DASH eating plan. There are many resources online to help them get started. Our partners at Oregon Dairy Council have developed a user-friendly online tool to help individuals incorporate DASH into their daily food choices. Lastly, identify clients who are at high risk of developing hypertension. Risk factors include obesity, physical inactivity, high sodium intake, low potassium intake, excessive alcohol consumption and diabetes. Helping at risk individuals make healthy lifestyle changes can make a difference.

Ashley Rosales, R.D.

Project Manager

There has been a lot of discussion lately about the benefits/drawbacks of serving flavored milk in schools. Many health professionals share the view that the small amount of sugar in chocolate milk is worth the additional nutrients included in the food. It is a little known fact that nine out of ten girls and seven out of ten boys currently do not get adequate calcium in their diet. With life expectancy on the rise in the United States, osteopenia and osteoporosis have become increasing health concerns among the older Americans. And we are seeing consequences of lower bone mineral density early in life as well. Children and adolescents today are more likely to break a bone than their parents were. 
 
Dr. Robert Murray, Director of the Center for Healthy Weight and Nutrition, at Ohio State University in Columbus, Ohio recently wrote a blog post in November 2009 on the National Dairy Council, The Dairy Report blog. In it he said:

"Most nutritionists strongly recommend yogurt as a highly nutritious product for adults, particularly women. But it’s rare for adults to consume unsweetened yogurt, unadulterated by additives or sweeteners. Why is it so different for children? Most children have a taste preference for sweet that exceeds that of adults. Many prefer flavored milk to white milk. When flavored milks are withdrawn in schools, consumption falls, as we should expect. Has the avoidance of 2 teaspoons of sugar been worth the loss of protein, calcium, vitamins D, A and B12, magnesium, potassium, riboflavin and niacin? I don’t believe so. Many of the nutrients available in milk and other dairy products are on the “nutrients of concern” list in the U.S. Dietary Guidelines. Why wouldn’t we use flavored milk to help children meet the nutrient recommendations that many fall short on?"

The Dairy Council of California has the following resources to help parents, teachers and school food service personnel sort through the issues regarding flavored milk in children's diets:

• Got Flavored Milk? Clearing Up Common Misconceptions
• Fuel Your Body a flyer to share with parents and coaches
• Milk's Nutrient Contribution to School Lunch
• Parents Can Feel Good About Flavored Milk
• Adding Chocolate to Milk Doesn't Take Away Its Nine Essential Nutrients 

These references provide additional support for defending the role of flavored milk in schools: 

• Fact Sheet: Use Low-fat Milk, Cheese, and Yogurt for Healthier School Meals
• Drinking Flavored or Plain Milk Is Positively Associated with Nutrient Intake and Is Not Associated with Adverse Effects on Weight Status in US Children and Adolescents, J Am Diet Assoc. 2008;108:631-639.
• Clearing Up Confusion on the Role of Dairy in Children's Diets, AAP News, Volume 28, Number 7, June 2007. 

In some corners it is politically popular to bash sugar as the culprit that brought about the obesity crisis. The Journal of the American Dietetic Association article listed above refutes that flavored milk leads to weight gain in children. In reality, the obesity crisis is a very complex issue and will take complex rather than simple solutions to fix. We need to be sure that the solutions created to solve one problem in the end do not cause another. 
 
 
Maureen Bligh, M.A., R.D.
Project Manager
 
 

Growing older doesn’t have to lead to chronic disease, lack of energy or lack of independence. In fact, by making some small lifestyle changes today, older adults can enjoy more energy, maintain physical mobility, lower risks for certain chronic diseases and prevent bone and muscle loss associated with aging. The best way to do this is by helping your older clients make positive food and physical-activity choices every day. This can be a challenge, given that many older adults experience a loss of thirst and appetite, find meal planning to be challenge and may experience difficulty being as active as before. However, given some simple guidance, many of these challenges can be overcome.  

Here are a few tips to share with your older adult clients:

• Choose a mix of nutrient-rich foods every day from all the food groups to get more nutrients for fewer calories.
• Consume at least three servings of low-fat milk or milk products each day to ensure adequate intake of calcium and vitamin D.
• Make sure to eat foods high in protein with each meal and snack, such as lean meat, poultry, beans, eggs, milk, nuts and seeds.
• Stay hydrated by drinking fluids throughout the day. Water, low-fat milk, 100% fruit juice and decaffeinated tea are good choices.
• Consume foods high in fiber to help with digestive regularity, such as fruits, vegetables, whole grains, beans and nuts.
• Be active for at least 30 minutes per day doing activities that raise your heart rate, such as a water-aerobics class, dancing or walking.
• Do muscle-strengthening activities weekly. Use an elastic band or small hand weights.
• Stock up on the basics so that you always have food on hand for a healthy meal or snack.

In addition to these tips, we have also developed a new, two-sided downloadable handout, Healthier Eating & Physical Activity: Tips for Older Adults for you to use with your clients. This handout is perfect to distribute at a medical office, senior center, or even a health fair. I also suggest using this handout as an insert to our other free nutrition education booklets, such as Activity & Eating—Linking Together for Optimal Health and Fitness or The Calcium Connection—Healthy Bodies From One Generation to Another. By providing relevant and practical nutritional guidance to your older adult clients, you can help them achieve health and well-being as they age.

Ashley Rosales, R.D.

Project Manager

Soy beverages, while wholesome and nutritious, are not the nutritional equivalent of milk. Since soy beverages are naturally low in calcium (about 10 milligrams per serving), manufacturers fortify them with calcium salts to boost the calcium content. However, the amount of calcium salts added is not regulated and may vary from 80 to 500 milligrams per serving. Some soy beverages are not fortified with calcium at all. It is critical that consumers read the food label.

Even fortified soy beverages that contain the same amount of calcium as cow's milk do not provide the same health benefit due to less absorption. Creighton University researchers calculated that the body absorbs about 25 percent less calcium from a fortified soy beverage than from cow's milk. A serving of milk (8 ounces) contains about 300 milligrams of calcium. It would take 500 milligrams of calcium in an 8-ounce serving of fortified soy beverage to equal the calcium in a glass of cow's milk.

A bigger issue is the settling problem in calcium-fortified soy drinks. Most soy beverages have appreciable sedimentation of the added calcium; in other words, it settles to the bottom of the glass. A study conducted by Heaney in 2006 found that in a shaken sample, the mean calcium level was 59 percent of the value shown on the label. Unshaken samples only contained on average 31 percent of the calcium listed on the label. Very few consumers would shake a carton of soy beverage, pour out a glass and then chug it down quickly. It you set the glass aside, even for a few minutes, the calcium settles to the bottom of the glass. Reduced bioavailability and sedimentation combine to make the calcium content in soy beverages far less than in milk.   

Milk is a nutrient-rich food that provides a large number of nutrients relative to the calories consumed. Check this page to see a listing of the major nutrients in milk.

Maureen Bligh, M.A., R.D.

Project Manager

On Thursday, November 5, Dairy Council of California was recognized at the California Fit Business awards ceremony held in Sacramento. The award, established by the organization in 2003, recognizes California employers that promote healthy workplaces. In all, 71 employers were honored statewide, ranging from organizations with more than 70,000 employees to those with less than 100. Dairy Council of California received the Honorable Mention award for our outstanding commitment to promoting workplace wellness. This recognition was remarkable given this is the first year of our employee wellness program. The criteria to qualify were extremely difficult this year and many companies went unrecognized. 

Being a nutrition- and health-based organization, it was only natural to promote wellness within our workplace. Some of the key highlights of our wellness program include:

• monthly newsletters with health and physical-activity tips and recipes
• policies for healthy food and beverage choices at Dairy Council of California-sponsored meetings and events
• interactive staff competitions such as the Meals Matter Nutrition & Fitness Challenge
• opportunities for physical activity at work.

We look forward to growing our wellness program by continuing to create a healthy workplace and supporting healthy employees.
 
Ashley Rosales, R.D.
Project Manager

This year, California Foundation for Ag in the Classroom held their statewide conference in Rohnert Park, California, on October 23-24th.  This was my first year attending the conference, which I found to be very informative and useful. Kicking off Friday’s activities was keynote speaker David Pegos, CDFA Assistant Secretary of Public Outreach. He shared the importance of ag literacy in his keynote address, along with providing an overview of agricultural production throughout the state. 

Many interactive workshops were offered to attendees; I chose to attend the Milk Matters! workshop, which highlighted Ag in the Classroom’s newest curriculum. During this hands-on workshop, participants performed activities that related to the many different dimensions of the dairy industry. Mandi Bottoms, Curriculum Coordinator for California Foundation for Agriculture in the Classroom, did an excellent job facilitating this workshop. Here are some of the useful resources that were provided: 

Dairy Feeds
Ultimate Efficient Recycler
Milk Matters! Discovering Dairy

After workshops were completed, participants were given the opportunity to tour local farms and businesses such as wineries, dairies, a compost operation, organic vegetable growers, flower growers and a restaurant.

I feel fortunate to have been able to participate in such an important educational event. I left with a better understanding of the challenges and opportunities facing California’s educators and farmers. This dialogue between educators and farmers will encourage future opportunities for working together to better the health of California through classroom education.

Nicolina Mulcahy

Territory Manager

More experts are weighing in on sugar consumption, and for good reason in light of the obesity epidemic. Today, the average American consumes about 22 teaspoons of sugar a day, which is 355 calories. Soft drinks and other sugar-sweetened beverages are the number-one source of added sugars in the American diet.

According to study published October 2009 in the American Journal of Clinical Nutrition, five-year-old girls that consume two or more 8-ounce servings of sweetened beverages a day were more likely to be overweight as teenagers than girls who consumed lower intakes of sweetened beverages. The authors did not find an association between milk and fruit juices and future weight status. It is important to remember that this is only one study, and previous studies have not always shown this same association. Since 1970, calorie consumption is up 24 percent from all foods, not just foods with added sugar.

Most health professionals will agree that high-nutrient foods should be included in the diet over high-sugar, low-nutrient choices. Foods with added sugars from under-consumed food groups such as whole grains (e.g., sweetened oatmeal) and milk and milk products (e.g., chocolate milk) are still a good nutritional value.

This handout can help your clients sort out their beverage choices: Put Your Beverage to the Test.
 
Maureen Bligh, M.A., R.D.

Project Manager

 In world history, salt was a sought-after commodity. Salt served as currency and established trade routes. Today, sodium intakes are linked to high blood pressure, and the committee that is currently working on the 2010 Dietary Guidelines is considering lowering the sodium recommendation for the general population. According to recent national studies, the average American consumes about 3,400 milligrams per day of sodium. This amount exceeds by over 1,000 milligrams the amount recommended in the 2005 Dietary Guidelines. If the 2010 Guidelines lower the sodium recommendations, the gap between current recommendations and consumption will widen.

Anyone can develop high blood pressure. Risk factors include obesity, physical inactivity, high salt and sodium intake, low potassium intake, excessive alcohol consumption and diabetes. Making lifestyle changes to address these risk factors generally improves blood-pressure levels.

Dietary patterns are related to overall health. Many studies have found that eating a low-fiber, high-fat diet and drinking excess alcohol increase the risk of developing disease. In contrast, eating a diet that is rich in low-fat dairy products, fruit and vegetables can promote health. Studies have shown that a diet with 3 servings of low-fat milk or milk products and high amounts of fruits and vegetables (8 – 9 servings per day) can lower blood pressure as much as some blood-pressure-lowering drugs. It is important to note that in a large clinical trial, a diet with fruits and vegetables alone (without the low-fat dairy foods) lowered blood pressure by half as much as the diet including the dairy foods.

This eating pattern was later coined the DASH (Dietary Approaches to Stop Hypertension) Eating Plan. While originally developed to study the effects of an eating pattern on the prevention and treatment of hypertension, DASH is one example of a balanced eating plan that promotes overall health. The handout DASH Study: Dietary Approaches to Stop Hypertension explains the eating plan in more detail. The website DASH Diet Eating Plan provides more specifics on how to implement the eating plan.

Maureen Bligh, M.A., R.D.

Project Manager