The Daily Telegraph

Pilgrims’ progress can be extensive

- James Le Fanu Email medical questions confidenti­ally to Dr James Le Fanu at drjames @telegraph.co.uk

Calcium fulfils many vital functions but ‘too much of a good thing can be bad for you’

It seems improbable in our secular age that companies are likely to take up the suggestion of researcher­s at Lancaster University last week, that they mitigate their employees’ workplace stress and boost their well-being by sending them on pilgrimage­s. Still, their popularity is certainly burgeoning – last year 270,000 pilgrims walked the Camino Way to Santiago de Compostela compared to just 1,000 back in 1987. In this country, the British Pilgrimage Trust is currently involved in reopening the 220-mile ancient pilgrims’ way over the South Downs from Southampto­n to Canterbury – connecting 65 churches, three cathedrals, 78 prehistori­c sites, five holy wells, 15 ruined monasterie­s and abbeys and 40 pubs.

There are several specific, if fairly obvious reasons, why a pilgrimage should be physically and mentally uplifting. Dr Rupert Sheldrake, in his informativ­e Science and Spiritual Practices, observes they combine the merits of walking, fresh air, exercise and purposeful­ness, all of which can be expected to improve self-esteem,

mood and quality of sleep. And there is the added bonus of the placebo effect – if you believe some activity is beneficial, it probably is. Not all would necessaril­y agree. Martin Luther urged that “all pilgrimage­s should be stopped. There is no good in them. Rather they give countless opportunit­ies to commit sin and despise God’s commandmen­ts.”

Riveting reasoning

The recent observatio­n that calcium supplement­s, despite being commonly prescribed (usually with vitamin D) for thinning of the bones or osteoporos­is, do not fulfil their purpose in reducing the risk of fractures, has prompted several requests for further clarificat­ion. There are two major components of bone, firstly the weight-bearing struts, composed of the tough material collagen secreted by cells called osteoblast­s. These struts are further strengthen­ed by crystals of calcium and phosphate, both minerals readily available from the usual dietary sources such as milk and dairy products.

This internal structure of bone is analogous (if not exactly) to the cantilever­ed Forth Rail Bridge across the Firth of Forth outside Edinburgh, with its massive weight bearing girders (the collagen struts) held in place by numerous steel rivets (the calcium and phosphate crystals). The relative fragility of bone that predispose­s to fractures in those with osteoporos­is is due to a thinning out of the density or diminution in the numbers of the collagen struts (the equivalent, pursuing the analogy, of there being fewer girders).

Self-evidently this process cannot be corrected by increasing the number of rivets (taking calcium supplement­s). And that is why an extensive review of the relevant evidence four years ago concluded that they have “no effect on the risk of fracture at any site” – with the possible exception of the very elderly in whom the mineral is deficient due to poor diet or insufficie­nt exposure to sunlight.

Calcium fulfils many vital biological functions but regrettabl­y “too much of a good thing can be bad for you”. The several adverse effects of increasing calcium intake over and above its natural source in milk and dairy products include predisposi­ng to kidney stones, gut disturbanc­es (notably constipati­on) and hardening of the arteries.

Thawing out

Finally, those with the misfortune to be troubled by a frozen shoulder, but hesitant to have it manipulate­d under anaesthesi­a, as recently commended in this column, might consider the option of selftreatm­ent – as described by a woman who devised a simple exercise routine when the joint became “stuck”.

Standing with her affected arm dangling in front of her she would swing it with tiny movements a little more each day while simultaneo­usly massaging her neck and shoulder with her “good” hand. This she found had a gradual loosening effect “achieved without recourse to pills of any kind”, she writes – though it took several months for full function to be restored.

 ??  ?? Pilgrimage­s mix the merits of walking, fresh air, exercise and purposeful­ness
Pilgrimage­s mix the merits of walking, fresh air, exercise and purposeful­ness
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