A study of 1,554 postmenopausal women showed that 52% of these women had suboptimal vitamin D concentrations. Most study participants were healthy, ambulatory, community-dwelling, white women who were well educated. These results underscore a need for improved physician and patient education regarding optimization of vitamin D status in the care of postmenopausal women with osteoporosis.

According to the AACE Medical Guidelines for Clinical Practice of the Prevention and Treatment of Postmenopausal Osteoporosis: 2001 Edition, with Selected Updates for 2003, general principles for all individuals, particularly children and adolescents, include a diet with adequate calcium content, good general nutrition, adequate vitamin D intake (at least 400 IU/day; as much as 800 IU/day in the elderly, regular weight-bearing exercise and no tobacco use. VitaminD is not widely available in natural food sources. It is primarily found in fish oils (including cod liver oil), some vegetables, and fortified milk, cereals, and breads. If appropriate, vitamin D supplements may be prescribed.

The AACE Fourteenth Annual Meeting and Clinical Congress will be held May 18 through May 22, at the Marriott Wardman Park Hotel in Washington , DC.

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One of the tenets of the successful "South Beach Diet" is to reduce and slow sugar absorption. In his first book, Dr. Arthur Agatston explains: "What we're concerned with here is the speed with which our bodies get at the sugars.If the body experiences a fast infusion of sugars, a lot of insulin is required. If the sugars are metabolized more slowly, the insulin is released gradually. This is a crucial difference, as far as obesity is concerned: Fast sugar is worse for you; slower is better."

Besides the implication for extra sugar being stored (as fat) rather being used effectively, Dr. Agatston notes that with large sugar infusions, the body often produces too much insulin, which then lowers the blood sugar level. When that happens, he writes, "new cravings are created, requiring more quick carbohydrate fixes."

Next steps

Wielinga again warned that any comparison between rats and humans regarding HCA have to be treated very carefully. However, he said now that it is known where HCA has an effect in rats, the next step is to try and uncover its mechanism. He said that "if we can reduce the peaks and valleys of insulin with HCA, then it might have some application in diabetes, both in slowing progression to diabetes 2 and since these people have an obesity problem, it could potentially have an additional benefit in the therapeutic field. But this is all highly speculative," Wielinga added.

Wielinga, who is moving to the Institute of Veterinary Physiology at the University of Zurich, Switzerland, said another promising area "we plan to study is HCA's affect on food intake reduction, since it is known that HCA seems to reduce some food intake in rodents."

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