Joint Pain

Vitamin D has a number of vital functions within our body. 

Recently published review suggests one more thing – supplementation may enhance athletic performance in vitamin D deficient athletes.  This review examined studies looking at physical performance and vitamin D levels and they found that some measures of physical performance were directly related to vitamin D levels in the body.  The authors of this review indicate that vitamin D may help prevent stress fractures, chronic musculoskeletal pain, respiratory tract infections (those who exercise heavily are at an increased risk) and several chronic diseases related to vitamin D deficiency.  Older adults, in particular, may benefit from adequate vitamin D levels through improved neuromuscular functioning, including better balance.

Vitamin D Deficiency
Unfortunately, vitamin D deficiency is a widespread problem, even among healthy adults.  How do you know if you are vitamin D deficient?  Get tested for 25(OH)D.  Though deficiency is commonly quantified as having a 25(OH)D concentration of <20 nanograms per milliliter (ng/mL), some scientists believe that level needs to be raised and that ideal levels may be above 50 ng/mL.  Indoor athletes – gymnasts, wrestlers, basketball players etc. need to be especially cognizant of their vitamin D levels.

Athletes should include a vitamin D supplement in their daily regimen of at least 1000 to 2000 IU of vitamin D3.  A multivitamin with just 400 IU is not enough and it can be very difficult to get enough vitamin D from food.  A liquid vitamin D3 supplement could easily be added to a daily protein shake or smoothie.

Source:  Med Sci in Sports & Exerc 2009;1102-1110.
 

LAUGH A LITTLE TO HELP PROTECT HEART, LOWER BLOOD PRESSURE

Laughter is not only an effective stress-reliever, but can be heart-healthy, according to research presented today at the American College of Sports Medicine’s 56th Annual Meeting in Seattle. Two separate studies examined the role of a good laugh as it relates to health.

One of the studies took an inverted approach to previous research on the harmful cardiovascular tolls of stress and negative mood. A small group of healthy adults were instructed to watch either a comedy or documentary film, and were monitored for carotid artery activity during the films.

Subjects who watched the comedy benefited from improved “arterial compliance,” the amount of blood that moves through the arteries at a given time. Conversely, decreased arterial compliance is often associated with high blood pressure and heart disease.

“Arterial compliance was improved for a full 24 hours after subjects watched a funny movie,” said lead researcher Jun Sugawara. “Laughing is likely not the complete solution to a healthy heart, but it appears to contribute to positive effects.”

A second study found similar results in vascular function. When another group watched either a comedy or a somber documentary, blood vessels became more dilated during the comedy. Constricted blood vessels often lead to high blood pressure. Like the first study, favorable effects on vascular function were sustained for 24 hours.

“Not only did comedies improve vascular dilation, but watching a documentary about a depressing subject was actually harmful to the blood vessels,” said Takashi Tarumi, lead researcher on the study. “These documentaries constricted blood vessels by about 18 percent.”

In addition to laughter, a significant body of evidence exists that shows exercise as a preventive mechanism against both cardiovascular disease and high blood pressure. ACSM’s Exercise is Medicine program promotes these curative and protective benefits, and encourages all patients to talk with their doctor or health care provider about their physical activity programs.

TheAmerican College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 35,000 international, national and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.


Source:  American College of Sports Medicine Press Release, May 29, 2009

There have recently been reports of Vitamin D deficiency being linked to obesity.  Just recently at the Endocrine Society’s annual meeting in Washington, D.C., it was declared that vitamin D levels may play a role in weight loss in obese patients.

Dr. Sibley from the University of Minnesota in Minneapolis conducted an investigation in 38 obese and overweight men and women testing their vitamin D levels while investigating a causal relationship between vitamin D levels and rate of weight loss.

They measured both the active and inactive levels of vitamin D before and after an eleven week weight loss program consisting of a 750 calorie per day deficit from estimated needs. On average, vitamin D levels in the study subjects were in a deficiency range.

According to the investigators, vitamin D levels predicted subsequent weight loss success in subjects on a weight loss diet.

“Abdominal fat specifically tended to be related to vitamin D levels with the effect being stronger with the active form of vitamin D”, Dr. Sibley reported at the meeting.

Preservation of lean body mass remained intact.

Underlying mechanisms for these results need to be studied further, but optimism is on the horizon. Dr. Sibley concluded that “If it is established that vitamin D does indeed contribute to weight loss approaches this could have a huge public health impact on the obesity epidemic”.

Findings suggest at this point that vitamin D may play a pivotal role in weight loss success rates when combined with a low calorie diet. 

Sibley added a note of caution, saying that more research is needed. "Our findings need to be followed up by the right kind of controlled clinical trial to determine if there is a role for vitamin D supplementation in helping people lose weight when they attempt to cut back on what they eat."

The study was funded by the National Institutes of Health, the University of Minnesota, and the Pennock Family Endowment at the University of Minnesota.

As always, consult your doctor before going on any kind of weight loss program.  Ask your doctor for a vitamin D blood level test to see if you are deficient.  It may be more beneficial to take a vitamin D supplement while on a diet and exercise program.

The Joy of Gardening...

By the end of the winter I am itching to get in the garden.  I've forgotten all about how much I hate to weed and my aching back after bending all day.  All I remember is the feel of the dirt and the satisfaction of planting new flowers and plants.  I can't wait to go to the nursery and carefully pick out my next addition - usually to replace the ones that didn't make it over the winter.

Gardening is a wonderful way to get outside and soak up some vitamin D from the sun and get a little exercise at the same time.  However, there are a few things us weekend warriors need to remember as we return to the great outdoors.

1.  Dress to protect. 

This is a lesson learned after tangling with blackberry bushes or re-potting a very poky pine tree.  Wear gloves, goggles and clothing as needed.  Don't stay out in the sun very long without a hat and sunscreen.  A little is OK (10 to 15 minutes) to get vitamin D, but you don't want to burn.
 

2.  Put safety first. 

Be very careful when operating tools and equipment.  Pay attention to what you are doing and others around you! I was once so excited about using my new electric powered hedge trimmer, that I forgot to pay attention to the cord itself and proceeded to chop it in half!  I tried to hide the cord in the garbage can, but my husband found it anyway.

3.  Watch our for heat-related illness.  

If you live in an area with high temperatures, make sure to work outside in the early morning or late evening when it is cooler.  Drink plenty of water and do not over exert yourself.  Running through the sprinkler occasionally feels great too.

4.  Know your limits.

If you have arthritis, use tools, benches, wagons, or anything that makes it a bit easier.  Gardening is a great way to get those joints moving and actually relieves arthritis pain.

5.  Enjoy the benefits of physical activity.

As noted above, gardening is just a great way to get physical exercise while enjoying yourself.  Active people are less likely than active people to be overweight and have many other diseases.  Start slow and gradually build up your time and intensity levels. 


For more information see http://www.cdc.gov/family/gardening/ for the complete article.

Don't forget to take your liquid glucosamine and chondroitin supplement to help with those joints while gardening.  

Do you have any great gardening stories?  I would love to hear them - send me a comment and I may post your story in by next blog post!
 

Dark skin means less Vitamin D absorbed.

Dark skin works as a natural shield against the sunlight.  Consequently, many people with darker skin are less likely to wrinkle or develop sunburn or skin cancer (though those of Asian and African decent are more likely to have advanced skin cancer by the time it is diagnosed and melanoma is frequently fatal for African Americans, Hispanic Americans and Asian Americans). 

Because their skin naturally blocks out more sunlight, people with darker skin also absorb less sunlight and therefore produce less vitamin D.  Studies show that African Americans are one group that is very likely to have low circulating levels of vitamin D.  Studies have even shown that a high percentage of African American teenage boys have low vitamin D levels.  And, as we know, teenage boys tend to eat everything in site and yet in some groups studied they still did not’t meet their vitamin D needs! 

A nationwide study found levels considered:

Extremely low
• African Americans: 29%
• Mexican Americans: 7.5%
• Non-Hispanic whites: 2.5%

Too low for optimum health
• African Americans: 97%
• Mexican Americans: 90%
• Non-Hispanic whites: 71%

Source: National Health and Nutrition Examination Survey of more than 13,000 teens and adults from 2001 to 2004


Moral of the research story – if you are an African American and you don’t consume 3-4 glasses of milk or vitamin D fortified soy or almond milk daily, make sure you take a vitamin D supplement.  Getting enough sun can be very difficult as it takes much longer for a dark skinned individual to make enough vitamin D compared to light skin.  Vitamin D is vital for bone health and the immune system and may even help prevent some types of cancer and chronic pain.  Vitamin D supplements for children are especially important.  A liquid vitamin D supplement is the perfect way to make sure children get their vitamin D also.

Read recent article in USA Today for more information on this important topic.

Don’t let joint pain keep you from springing forward in life.

One great thing about spring is the weather.  Warmer weather can make life a lot easier on arthritic joints.  If you have arthritis (in particular the wear and tear related osteoarthritis) you will undoubtedly feel more like moving once your body and joint tissues have warmed up. 

So lets discuss a spring forward warm up plan that can reduce the twinges from your hinges during a workout. Your spring forward warm up for joint health includes
1) environmental, 2) temporal and 3) physical tips
  
1. Your joints will feel better when working out in warmer environments.  This can be accomplished by staying indoors or keeping the cooling system low, or by wearing workout gear that keeps your body well insulated (i.e. sweats and wraps).  You can also enhance your body temperature pre-activity by taking a hot shower or sitting in a Jacuzzi.

2. In terms of the best time to exercise, your joints will feel best around midday.  This will give your body a chance to naturally loosen up and warm up with your daily routine without feeling overtaxed by a full day of life tasks. 

3. Last but not least are some physical tips that can help prepare sensitive joints for various types of physical exercise. 
 
In terms of your cardio-vascular exercise, be sure to start off slowly with modest range of motion.  Gradually increase your movement range in both your upper body and lower body movements until you are working at near full range capacity.  This could take a good 10 to 15 minutes.  So for example, start your fitness walk with small steps and minimal arm swinging, as you warm up and loosen up try rolling the shoulders up, back and down while you walk.  Also add in some ball and heel walking.  By this I mean, walk on the balls of your fee for about 10 seconds followed by walking on your heels for 10 seconds.  Go back to a normal footfall and gently reach a bit further with each step.  Once you feel your overall body temperature has elevated (usually noted by a desire to take off your outer jacket) you can stop and hold a few hip and leg stretches, if those areas still feel restricted.  Keep those stretches light (8 to 10 seconds in length).  Then continue with your walk, using the best arm swing and leg stride that you can.  

Your muscle-conditioning workout should follow a similar warm up plan of action.  When performing strength training exercises always do the first set of any exercise with limited range and very light resistance.  Then for the second set you can gradually increase the range and/or resistance.  Keep in mind that strength training is important but so is joint sense.  Use resistance loads that you can safely handle for about 15 repetitions even if that means no resistance other than the weight of your body or body part. 

All stretches should start off light, never force or bounce. Once your muscles are warm they have better give therefore you get the best results from your stretches after you have completed more active exercises (i.e. walking or strength exercises).  These stretches should be held to a point of slight or mild discomfort for 10 to 30 seconds.

Progress slowly and always stay in the pain free range of motion.  If your joints are experiencing more pain or discomfort than typical two hours after a workout is over, you have probably worked too hard.  Back off a bit and don’t forget to take your joint healthy glucosamine and chondroitin supplements.     
 

Time for a bit of Arthritis Spring-Stretching.

The warmer weather creates a positive environment for many things, in particular joint mobility.  With that in mind it may be a great time for arthritis sufferers to re-evaluate their training program and get back on track with a few daily joint healthy exercises.  Daily stretching has been recommended in particular for those with compromised joints as a treatment for joint pain.  The Aerobic and Fitness Association of American lists flexibility as one of the first fitness components to be addressed when designing a functional fitness program for those with arthritic conditions  http://www.afaa.com .

The reason why is pretty simple.  If you can’t move with good range of motion it is pretty hard to do any exercise or daily activity with proper form and alignment.  Exercising with pore alignment is a major cause of joint stress and further joint damage, thus it is important to keep joints as mobile as possible, even when limitations exist.  Below are a few stretching guidelines to follow.
 

• Always increase your body core temperature prior to holding stretch position: performing a physical warm up including light cardio-vascular or rhythmic movement can do this.  A physical warm up can be enhanced by taking a hot shower or bath prior to your session, scheduling your session toward the later and/or warmer part of the day, performing your stretches in a warm environment and/or while wearing clothing that keeps the body well insulated.

•  Ease into your stretch positions: start at a point of very mild tension, take two or three deep breaths, then try to move into a deeper stretch position, increasing the stretching sensation to a higher degree of tension (or slight discomfort).

• Never stretch to the point of pain or high discomfort: your muscles will actually reject the stretch and try to protect themselves by tensing up.

• Breath fluidly throughout all your stretches: at least 5 deep breaths per stretch.

• Repeat each stretch 2 to 3 times over.

The following includes an upper and lower body stretch series that should be done at least once every day:

The Upper Body wall Stretch:

Stand facing a wall and gently position your hands a comfortable distance above your head. Work your arms up the wall, keep your abdominals tight and lean your torso towards the wall.  Next, turn around and place your backside to the wall with your arms in a ‘T’ position (elbows bent and upper arm parallel to the floor).  Try to press your head, spine and arms against the wall.  Hold both the front and back position for 3 to 5 deep breaths.

The Lower Body chair stretch: 

Start by standing behind a sturdy chair in a lunge position.  Gently work the back leg further away from the front leg until you feel a stretch down the hip, and then press the heel towards the floor until you feel a stretch in your lower leg/ calf muscle.  Follow this up by straightening the front leg and leaning forward with your torso until you feel a stretch down the back of the front leg (keep your spine straight as you lean forward).  Switch leg positions and repeat the series

In my next article I will give you some great ideas for following up your stretch session with bone and joint health strength routines... until next time keep taking your joint protective supplements with glucosamine and chondroitin and MSM. 

It’s time to get in shape for the summer! 

When summer rolls around and you are wearing less clothing, you definitely want to feel good about yourself and your body.  Plus, you’ll want to be in shape so you can keep up with the kids at the water park, ride the waves in the ocean and go for long walks in the park.  Here are a few tips to keep you in shape this summer:

Access when you are hungry and when you are full. 
This may sound like common sense but most adults eat because the clock tells us it is time to eat or we see tasty food in front of us.  The next time you are ready to dig in, ask yourself if you are hungry or if you need food.  Then, monitor your fullness levels and save your leftovers.

Follow the 80/20 rule. 
Eat healthy about 80% of the time and allow yourself that 20% for “cheat” foods.

Enlist the help of a workout partner. 
This may mean that you grab your coworker to walk during lunch, sign up for boot camp or a personal trainer or tell your child you’ll bike with them.  Find out what works for you and get going.

Schedule your physical activity. 
Many people plan for happy hour or plan their child’s birthday.  Well, it’s time to start scheduling your date with the gym, park, walking buddy or boot camp.  When you’ve carved out the time it is harder to come up with an excuse.

Allow yourself a few slipups. 
Many people get discouraged when they forgo an entire week’s worth of workouts or they thrown in the towel when their beach trip turns into a 4-day feast.  Resolve to be a little easier on yourself and get right back on track.  Don’t dwell on what you can’t change or beat yourself up about it.

Take a Calcium and Vitamin D Supplement
Calcium is involved in the regulation of various enzymes that control muscle contraction, fat digestion, and metabolism.  A recent study has found that calcium plus vitamin D supplementation can increase weight loss in people with calcium deficiency.  Read more  Both are very important for optimal bone health nutrition.
 

We have had several questions recently about whether you can give the liquid glucosamine and chondroitin to a dog.  The answer is Yes!  Even though it is meant for human consumption, it can be safely given to a dog of any size and is a great treatment for joint pain that many dogs have.  However, the dosage amount depends on weight.


Serving size for dogs of liquid glucosamine and chondroitin:

0 - 40 lbs = 2 tsp (10ml) per day
41 - 80 lbs = 4 tsp (20ml) per day
>80 lbs = 2 tbsp (30ml) per day
 

I usually suggest to pour the liquid glucosamine over the dry dog food, or mix it into canned dog food.  Make sure to give it to them every day and you must continue giving it to them for best results. 

A coworker of mine had an older black lab (who has now sadly passed away) that was having a difficult time walking and going up or down stairs because of arthritis in the hips.  Canine hip displasia is a very common occurrence especially in larger dogs such as Labs, Irish Setters, German Shepherds, etc. 

After she started giving him the liquid glucosamine, he was able to get around much easier.  Although not like when he was a young dog, it helped to improve his quality of life.  It's very sad to see them not be able to do as much as when they were younger. 

Here are the signs of when glucosamine may be needed for your dog:

• Difficulty or adverse reaction to walking, playing, or going up stairs
• Falling behind you on walks
• General lethargy
• Difficulty or adverse reaction to walking, playing, or going up stairs
• Limping
• Difficulty getting up when laying down
• Signs of pain when petted or touched
• Aversive to any contacts

Spring has sprung and this means you’ll be outdoors more.  The sun is shining later and you are also probably more active!  Though your mind has turned to doing many fun things this time of year, keep managing your osteoporosis in mind and that means calcium and vitamin D.  It's never too late to start, even if you have already been diagnosed.

Calcium Citrate
If you take calcium citrate, you can take it any time of the day with or without a meal.  This is extremely beneficial because it means that you don’t have to carry your supplements with you if you are out all day long.  Calcium citrate also absorbs faster and more thoroughly than calcium carbonate.  It is the preferable form of calcium, especially for weight loss surgery patients because of its absorbability.  A liquid calcium citrate is even better.  Look for one with 1000 mg of calcium and 1000 IU of vitamin D which helps to absorb the calcium for strong bones.

Vitamin D also Important
Though we can manufacture vitamin D in our body when our skin is exposed to sunlight, many of us still don’t manufacture enough.  Sunscreen, darker skin, clothing and advanced age can all minimize how much vitamin D we produce.  That’s why it is important to ensure you are still getting enough vitamin D through food and/or supplements. 

Nutrient Rich Foods
What else can you do to ensure you are maintaining your bone mass?   Eat foods rich in soy.  Soy beans, tofu and soy protein shakes may all help build your bones.  You can also incorporate magnesium-rich foods in your diet.  Like calcium, magnesium is a mineral stored in bone tissue.  Eating nuts, spinach, oatmeal, potatoes, beans, wheat germ and avocado are all great ways to bone up on your magnesium intake. 
 

Don't let osteoarthritis get the best of you!

A little over a year ago I was told that I have mild osteoarthritis in one knee.  I wasn’t terribly surprised since this disease is so prevalent and I’ve put my knees through years of impact activity.  If you’re like me and have this degenerative joint disease, there are things you can do to ensure that it doesn’t hamper your daily life. 

Take Glucosamine and Chondroitin
Your first line of defense should be glucosamine and chondroitin sulfate.  Taken together, these supplements can help relieve some of the pain and stiffness associated with osteoarthritis. 

Next, you should consider taking omega 3 fatty acids, which can help reduce inflammation. 

Make sure you talk to your personal physician first prior to trying either of these supplements, especially if you are on blood thinners such as warfarin (Coumadin). 

Exercise
For exercise, it is important to perform range of motion exercises to keep your joints moving and avoid undue stress on specific joints (the kind of stress that can occur with repetitive motion activities such as running).  Water aerobics and other non-impact activities such as the elliptical machine and stationary bike, are excellent for people with osteoarthritis.  Personally, I like to mix up the activity I am doing to keep my body strong and my joints limber.  And, I frequently do exercises to strengthen the areas around my joints.

See Exercises

Lose Weight
Excess weight increases your risk of developing osteoarthritis and being overweight leads to greater pain and loss of mobility when you do have the disease.  Overweight people tend to be less active which leads to weak muscles and even more painful joints.  Always lose weight gradually and talk to your doctor first before starting any kind of weight loss or exercise program.

Overall, it's important to lead a healthy lifestyle in managing osteoarthritis to minimize your joint pain.  Keep it in control and it won't control your life.

For more information see www.arthritis.org

If you’ve looked into bariatric surgery (weight loss surgery) or even gone ahead and had surgery, you know some the major benefit of having surgery – these surgeries are intended to limit the amount of food you are able to take in.  By doing this, you’ll lose weight, and may do so rapidly.  While it seems like a miracle cure for obesity, weight loss surgery doesn’t come without nutrition issues that you need to be aware of and account for.

There are several new eating habits you’ll have to adapt to in order to increase your chances of weight loss success while minimizing any potential complications.  These include:
 

• Eating very small meals (and progressing over time so you can eat about 1 to 1.5 cups of food at a time)
• Eat and drink slowly
• Chew food thoroughly
• Drink liquids between meals not at meals
• Try new foods one at a time
• Take vitamin and mineral supplements especially calcium and vitamin D

Let’s take a closer look at that last recommendation.  You will need to take certain vitamin and mineral supplements for the rest of your life because your body will have a tough time absorbing certain nutrients.  Doctors recommend that you take a multivitamin-mineral supplement and calcium, iron, vitamin B-12 and vitamin D.

Now, given the fact that you will have to progress from a liquid diet to a pureed diet to soft foods and onto more normal foods (all while chewing food thoroughly and not drinking liquids while eating), you can imagine what a task it would be to take a hard vitamin or mineral supplement.  And it may be a little more than your body can handle.

For example, when it comes to calcium and vitamin D supplements, these are typically quite big in pill form.  By opting for a liquid supplement, you can take them at any time during the day (just a few teaspoons worth at most).  Many physicians recommend liquid supplements for these reasons – they are convenient and much easier for your digestive tract to handle.

When choosing a calcium supplement, make sure it has calcium citrate and not calcium carbonate.  After weight loss surgery, the body cannot absorb calcium carbonate.  Calcium citrate is water soluble and can be easily absorbed, especially in liquid form.

Liquid supplements are easier to swallow and fast absorbing.  The stomach does not have to "dissolve" the tablet or pill, making it a perfect choice for anyone who has had weight loss surgery or who has trouble swallowing pills. 

The ASMBS Guidelines for Bariatric Nutrition recommends 1500-2000mg of calcium citrate supplement per day in addition to whatever calcium you get from food.  Here is a great liquid calcium supplement with 1000 mg of elemental calcium citrate and 1000 IU of vitamin D3.  It is best to split up the dosage into 500 each time.  The body can only absorb so much at one time.

Tell us about your weight loss journey and experience with weight loss surgery and what steps you have taken to stay healthy.

This is a great resource site as well - www.obesityhelp.com

References
Gastric bypass diet: What to eat after weight-loss surgery.  Mayo Clinic. http://www.mayoclinic.com/print/gastric-bypass-diet/WT00007/METHOD=print

Schweitzer DH, Posthuma ED.  Prevention.  Prevention of vitamin and mineral deficiencies after bariatric surgery: evidence and algorithms.  Obesity Surgery 2008 18(11): 1485-1488.
 

My coworker, who is a member of our "green committee", provided this great information I thought I should pass along:

What does it mean to go green? 
In a world where “green” is the new word it can mean a variety of things to different people.  Anyway you look at it both individuals and corporations are exploring the word green.  They call it sustainable living, green living and reducing our footprint.  Green is here to stay and more and more people are thinking, “What can I do to do my part.” 

As a company we are addressing everything from how we make our products to how we recycle and dispose of waste in our employee break rooms.  We are committed to environmental responsibility that promotes the well-being of our customers, employees and the global community.  Our liquid supplements come in a bottle, with a label and cap that can be totally recycled in most communities. 

10 Tips for Beginning the Process of Going Green:

1. Think the three R’s:  Reduce, Reuse, or Recycle.  This thought process comes into play each and every time you have something in your hand to toss in the garbage.  Can it be used for something else or by someone else, or can it be recycled before you toss it in the garbage can to later sit in a landfill. 
2. Most communities now have expanded business and curbside residential recycling programs.  These include mixed paper, newspaper, plastics, glass, cans and in some cases even yard debris and food scraps as compost.  Recycling and reuse programs are also being set up for old cell phones, computer equipment, light bulbs, paint, batteries and the list goes on. 
3. Use a site like http://earth911.com to find out where in your community you can recycle a list of different items. 
4. Use a reusable mug for your morning coffee
5. Use a portable reusable water container and stop buying bottled water
6. Bring a bag to the store to reuse instead of taking home another disposable bag to toss in the trash
7. Wash out a used pasta jar and reuse it
8. Shop for products that can be recycled when their life span is over and items that can be purchased with less overall packaging
9. Think before you print out that email or document – “Does this really need to be printed?”
10. Turn off your computer, monitor, and lights when not in use
11. Start a kitchen compost bin
12. Wash your laundry in cold water

Question #4 in the Liquid Sunshine Vitamin D Sweepstakes:

"Who is at risk for low levels of Vitamin D?"

a. Darker skinned individuals
b. Individuals over 50
c. People who live in a northern climate
d. Overweight individuals
e. All of the above

The answer is e - All of the above!  Are you one of them?  It's hard not to be.

Marie Spano, fellow blogger and Nutrition Expert wrote this great article:

Who is at risk for low vitamin D levels?

A vitamin D deficiency can occur when usual intake is lower than recommended levels over time, exposure to sunlight is limited, the kidneys cannot convert vitamin D to its active form, or absorption of vitamin D from the digestive tract is inadequate. Vitamin D deficient diets are associated with milk allergy, lactose intolerance, and strict vegetarianism.

Exclusively breast fed infants
Breast milk does not have enough vitamin D to meet an infant’s needs.  Studies indicate that breast milk only provides approximately 25 IU/L.

Darker skinned individuals
Melanin, the pigment that makes skin dark, also protects darker skin from the sunlight.  In doing this, it decreases the amount of sunlight absorbed by skin and utilized to produce vitamin D.  Studies have also found that rickets is more prevalent in immigrants from Asia, Africa and the Middle East and that African Americans are at risk for low serum levels of vitamin D.   If you have darker skin, you need to spend more time outside in the sunlight in order to produce enough vitamin D in comparison to a lighter-skinned individual’s exposure.  Keep in mind that although darker skin protects skin from the damaging effects of sun exposure, darker-skinned individuals are still at risk for skin cancer.

Older individuals
As people age, the body’s synthesis of vitamin D is decreased as is the kidney’s ability to covert vitamin D to its active hormone form.  Those who are 50 years of age or older are considered at risk for developing vitamin D deficiency.  

People exposed to little sunlight
If you live where the sun rarely shines or diligently wear sunscreen and cover up most of your body in clothing, your skin is not obtaining enough sun exposure to manufacture adequate amounts of vitamin D.

People with fat malabsorption
As a fat-soluble vitamin, vitamin D requires some dietary fat for proper absorption.  Fat malabsorption is associated with pancreatic enzyme deficiency, Crohn’s disease,
cystic fibrosis, celiac disease, surgical removal of part of the stomach or intestines, and some forms of liver disease.

Obese individuals
Obesity/excess body fat increases the risk for vitamin D deficiency.  Vitamin D is stored in fat tissue and the more fat tissue a person has the less available their vitamin D is for circulation.

In addition to the groups mentioned above, individuals with kidney disease , gastrointestinal and liver disease , and primary hyperparathyroidism are at risk for vitamin D deficiency.

Aside from bone pain and muscle weakness, there may be little indication that someone has inadequate circulating levels of vitamin D.  To learn your vitamin D levels, ask your doctor about a rapid vitamin D test that measures your blood levels of the vitamin.

Because it is difficult to get enough vitamin D from diet and sunlight, taking a supplement is recommended.  A liquid vitamin D supplement is a great way for the whole family to get the vitamin D they need without having to swallow large pills.
 

Happy Hearth Health Month!

Fats are one of the most fascinating dietary components.  Back in the 1990s we shunned them in favor of a high carbohydrate diet only to realize later that was not the healthiest approach!  When it comes to heart health there are fats we should avoid or minimize and fats we should eat. 

First the bad:  man-made trans fats and saturated fat.
If you are concerned about your cholesterol and heart health, cut down on any fat that is solid at room temperature because these raise your bad cholesterol levels (LDL).  Butter, fatty cheeses, fat on meat, higher fat dairy products etc.  And, take note that many of these types of fats are lurking in processed foods – especially pastries, pies, the icing on cake and donuts.  And, to the best extent possible, cut out man-made trans fats (found in partially hydrogenated oils).  Not only do these raise your bad cholesterol but they also lower your good cholesterol (HDL), increase systemic inflammation (which may contribute to cardiovascular disease) and they may increase belly fat!  Flip over the package of your favorite food and make sure it says 0 grams trans fat on the food label.  Then take a look at the ingredients – you shouldn't’t see “shortening” or “partially hydrogenated oils” anywhere.

Now for the good fats. 
Dig into fatty fish – salmon, mackerel, herring, halibut, lake trout, tuna steaks.  Fatty fish contain heart healthy, omega 3 fatty acids that lower triglycerides, decrease your blood pressure and decrease inflammation.  Studies show low death rates from cardiovascular disease in populations with high fish consumption.

So dig into a nice salmon fillet or tuna steak and take good care of your heart this month!

The winter months are prime time for colds and the flu.  I’ve heard people say they’d rather be sick during the winter then in the summer.  I’d rather not be sick at all!  Having previously worked at the CDC (Center for Disease Control), with constant reminders to engage in healthy behaviors, I’m well aware of how to keep my immune system healthy so I never get sick – regardless of what time of year it is.

At CDC we lined up for flu shots every November.  However, November has passed and if you didn’t get your flu shot, don’t worry about it now.  Some of the other things I learned: 

• Stay away from sick people
• Wash your hands constantly
• Don’t shake people’s hands (you can nod your head instead)
• Avoid touching your face,
• Sleep well
• Eat right
• Drink plenty of fluids
• Manage your stress
• Take nutritional supplements each day such as a multivitamin and vitamin D3

Pretty simple, right? 
It is amazing how many people forget to wash or sanitize their hands after touching a grocery store cart, machines in the gym or the bathroom door handle (use a paper towel!).  And then wonder how they got sick?  Many of us don’t get enough sleep, manage our stress or eat right either.  If you have stress management issues, try a yoga or meditation class (or better yet, delegate some of your work or duties out).  If you eat on the run at least make sure your hands are clean when you are eating.

Be sure to supplement your diet with immune boosting foods and nutritional supplements like hot tea, liquid vitamin D3  for extra immune support, vitamin C rich foods (grapefruit, oranges, strawberries; you don’t need thousands of milligrams of a vitamin C supplement) and zinc-rich foods (oysters, crab, beef, dark turkey meat, beans). 

A few simple steps will keep you healthy year-round!