With all the conflicting information about how much vitamin D you need, what is the right amount?

The answer is - it depends.  According to well-known scientists who study vitamin D, most people need at least 1,000 IU per day. For each 100 IU of vitamin D, your blood level of this vitamin will increase by about 1 ng/ml. However, this rate of increase varies among people. Those with excess body fat will likely need more to raise their vitamin D levels because it is stored in fat cells. Excess body fat means less vitamin D is available in circulation.

Age, skin color and time spent in the sun without sunscreen are also factors in the amount of a vitamin D supplement you should take each day.  Older individuals, darker skin and those who spend a lot of time indoors will need more vitamin D to keep levels in a healthy range.

Always check with your physician prior to taking any supplement. And, ask your doctor what your optimal level of vitamin D should be (and keep a record of all of your blood levels, supplements taken and changes in blood levels after supplementing). Though vitamin D levels of > 15 ng/mL or > 37.5 nmol/L are considered adequate for bone health (according to the NIH), some scientists suggest a level of 50 – 80 ng/mL as more appropriate for preventing fracture risk and even higher for overall health. The vitamin D council suggests maintaining a level of 50 – 80 ng/mL.

Have you had your vitamin D levels tested yet?  You may be surprised at how low it is, even if you live in a sunny area.  Studies have found even those who live in sunny California are vitamin D deficient.  Get your levels tested and then start taking a liquid vitamin D supplement which absorbs quickly and is perfect for the whole family!

References:
Osteoporosis International 2005: 713-6.
Vitamin D Council

 

Hug it, Tug it, Your Bones Get Stronger.  This clinically tested product can help build both muscles and bones!  

Calcium supplements are important for bone health but did you know you can also strengthen your bones with as little as 5 to 10 minutes a day using an inflatable ball similar to a beach ball---but with handles to help you "tug"?  The OsteoBall™ is just the right product for aging joints that may not be comfortable doing traditional strength training exercise.  Bone loss is site specific, which means that we lose bone mass most  rapidly in those areas of the body that are most inactive and/or immobile.  Bone stimulation is also site specific, which means that you have to contract muscles around all of the various bones and joints in your body to help protect your bones and keep you bone density up.   

This is why resistance training including isometric exercise has become a very popular recommendation for bone health. A well designed strength routine should address all of the major muscles and related joints of the body.  The problem is that some of our elderly and frail population may be afraid or unable to perform dynamic strength exercise due to losses in balance, coordination, core control and/or joint pain and discomfort.  This was the challenge that Doctor Robert Swezey of the Arthritis & Back Pain Center and Osteoporosis Prevention & Treatment Center of the Swezey Institute ran into time and time again with his patients. Doctor Swezey, M.D., F.A.C.P., F.A.C.R., F.A.A.P.M.R., is an internationally recognized leader in research and teaching in rheumatological rehabilitation.  He is also a Clinical Professor of Medicine at UCLA and is a Board Certified specialist in 3 specialty areas: Rheumatology, Physical Medicine and Rehabilitation, Internal Medicine and Osteoporosis. It was over a decade ago that he developed the OsteoBall™ to use in his clinical practice. 

The OstoBall program is based on performing a series of isometric contractions utilizing the OstoeBall™ product, which allows for by pushing and pulling exercises that often reach parts of the body that are difficult to exercise. An example of an isometric exercise is to simply press one hand as hard as you can against an immovable object, such as the wall.  By increasing and holding the tension for several seconds you can recruit muscle fibers to build strength and endurance with minimal stress to the related joints.  This is why isometric has long been used as a way to rehab joints after injury and trauma. Clinical Research done at the Swezey Institute on the OsteoBall program showed new bone mineral stimulation and improvements in muscular strength in post menopausal women after eight weeks of simple and easy to perform exercises done for 5 to 10 minutes a day.(http://www.bonefitness.com/consumer/education/research/clinical_studies/op_study.html).  

Here are some key techniques to use when performing a OsteoBall™ isometric style exercise (some of which can be done using any compressible ball):

1. If sitting or standing always start by aligning yourself in good posture (head over shoulders, chin level with the floor,  sternum lifted, abdominals pulled in).
2. Inhale as you initiate the pressing or pulling action.
3. Slowly press (or pull) against the ball, gradually building up a level of tension that you would describe as somewhat hard, hard, or very hard (a 6 to 8 on a 10 point effort scale).
4. Count out loud as you push or pull to insure proper breathing thought the contraction. Say "push 1, push 2, push 3. push 4, push 5" to help you exhale properly.
5. Make sure you maintain proper posture and alignment throughout the contraction.
6. After completing the held contraction, rest and relax the muscles your were contracting for 30 seconds to a minute and reposition the ball for another exercise (or perform a second repetition of the same exercise).
7. Try to do at least one exercise for each major muscle group and related joint area (neck, shoulders, elbow, wrists, spine, hips, knees, ankles). 
8. When you are done with a muscle group feel free to stretch the area contracted.

10 exercises, 10 minutes, 10 great reasons to recommend this workout for those with bone or joint limitations:  Easy to do isometric exercises allow you to create the right amount of tension without any weights or bands to worry about dropping or breaking.  

• The 10 exercises are clearly printed on the inflatable ball, insuring you hit each major muscle group and related joint area.
• Handle straps on the ball allow for easy positioning of the ball for various exercises as well as pulling contractions.
• The soft surface of the ball allows for a gentle progression into the compression contractions.
• The 10 base exercises can be done from a standing, seated and even a bed rest position (for those who are less or non ambulatory).
• Each exercise only takes 5 second to complete.
• Isometric exercises allow you to strengthen muscles without moving joints that may be painful or have limited range of motion
• The resistance progression is build in, because as you get stronger you simply push or pull harder.
• Stronger muscles lead to better life function and less risk for falls.
• Stronger bones and muscles help reduce the chance of breaks and joint degeneration

Research has shown that one of the best ways to build strong bones is to start in your youth (www.ncsf.org/pdf/ceu/Establishing-Peak-Bone-Mass.pdf). 

Young athletes that participated in strength and weight bearing and impact activities had higher peak bone density in their mid to late twenties (which is when we hit our peak) and thus had a higher base to fall back on (no pun intended) as they aged.  Bone density is primarily the amount of calcium measured in a specific region of the bone, such as the vertebrae in the spine. A higher bond density means a higher overall bone mass and stronger bones.

Loss of Bone Density
As we age there is a natural attrition in bone mass and density.  The cells that build new bone can no longer keep up with those that break it down and reabsorb it into the body.  When this condition accelerates due to hormonal changes (i.e. menopause), unhealthy lifestyle choices (i.e. smoking and heavy drinking), inactivity and inadequate nutrition it can lead to condition known as osteoporosis, which literally means brittle, porous bone.  This silent but serious condition can lead to bone degeneration and breaks which may be difficult to recover from.  Falls and the related bone breaks are a leading cause of hospitalization in the elderly.  

Multiple studies have shown that aerobics, weight bearing, and resistance exercises can all help maintain or increase BMD in postmenopausal women (Bonaiuti D, Shea B, Iovine R, et al. (2002). "Exercise for preventing and treating osteoporosis in postmenopausal women". Cochrane database of systematic reviews (Online) (3): CD000333). Some of the studies are mixed on whether a person can increase bone density once they have hit their later years, but there is substantial evidence that we can slow down and possibly halt the loss of additional bone mass with proper exercise, diet and supplementation at any age.  *

Lets start with exercise!
As mentioned earlier, it is key to introduce weight bearing, impact and muscle contracting activities to the body early on and try to maintain a sensible exercise and strength training program throughout your life. The pull and tug of the muscles on your bones is what helps to stimulate the bone building cells to go to work.  By weight bearing activities I mean those that force your muscles to support and control your skeletal system against the pull of gravity such as walking, jogging, stair climbing. Stronger muscles also act as a cushioning for falls later in life and can help prevent falls by making it easier to control your body when moving, lifting or doing activities that challenge balance.  

Nutrition
Nutritionally you will need to maintain a balanced diet including enough calories and nutrients to supply bone and muscle tissue for proper growth and repair.  We also know that it is important to have plenty of fruits, vegetables, whole grain and milk products to insure the proper amount of important nutrients for bone health such as calcium, phosphorus and vitamin C.  

Nutritional Supplements
Supplementation of calcium and vitamin D or medications such as antiresorptive or bone anabolic agents may be necessary even with the best of diets and lifestyle practices. Calcium has been a suggested supplement for bone health for many years and more recently vitamin D has become an important recommendation to aid in the absorption of calcium in your body as well as for the overall health and strength of your bones.

For bone healthy supplements check out the Wellesse liquid calcium and vitamin D product line.    When all is said and done our choices and habits can make a huge difference to our bone health and it is never too early or late too get started.
 

You may be surprised how much milk or cheese it actually takes to get 1000 mg of the calcium you need each day from diet alone.  It takes 3 ½ cups of milk or 3 yogurts to reach 1000 mg.  Here are some great ideas and tips for strong bones and teeth and to help prevent osteoporosis.

Ways to get more Calcium for bone health: (from eatsmart.org (Washington State Dairy Council)

These ideas will help you think about and plan ways to get enough calcium. Choose one or two changes that you can easily make for optimal bone health.


- Concerned about fat? Remember that lower-fat dairy products have all the calcium of regular dairy products.
- Select milk as a beverage when eating out.
- Stir-fry broccoli, kale or bok choy and sprinkle with toasted almonds.
- Use yogurt or tahini as a dip, garnish, spread or dressing.
- Stock up on canned salmon for use in sandwiches, salads and casseroles.
- Make soups with milk instead of water.
- Try tofu burgers or lasagna.
- Make your coffee choice a caffe latte.
- Add cheese or chickpeas to salads and sandwiches.
- Select milk desserts such as custards, puddings, yogurt and ice cream.
- Add skim milk powder to mashed potatoes, cooked cereals, casseroles, hamburger patties, omelettes, etc.
- Try some whole or refried beans in a wrap.
- Sprinkle parmesan cheese on cooked broccoli.
- Try flavored milk if you don’t like plain.
- Snack on almonds once in a while.
- Try calcium-enriched milk or yogurt. Each portion has an extra 100 mg of calcium.
- Take a liquid calcium supplement with vitamin D such as Wellesse Calcium & Vitamin D Liquid.  Liquid supplements absorb better than pills and are easier to swallow.

Other tips to take for strong bones:
- Stop smoking
- Take a brisk walk every day. Walking is a good weight bearing exercise.
- Do muscle strengthening exercises.
- Eat five or more fruits and vegetables every day.  Good nutrition for healthy bones
- Keep alcohol consumption to a minimum.
- Cut back on salty foods, caffeine and soda.
- Do balance training exercises to help prevent falls.  Exercise for healthy bones
- Get a bone density test.


What You Need to Know about Osteoarthritis

As a continuation on my series of blog posts on healthy digestion, I'd like to talk about Prebiotics and how they affect digestion.

Overview
If you’ve ever seen inulin, oligofructose or fructooligosaccharides on product packages, you are probably wondering what on earth these food ingredients are and why they are were added to your food or supplements. Inulin, oligofructose and fructooligosaccharides are all prebiotics – food ingredients that are not digested by the human body but boost the growth and/or activity of the friendly bacteria in our gut, especially bifidobacteria and lactobacilli. Most prebiotics are a type of soluble fiber.

Prebiotics are added to foods to enhance the nutrition profile of the food and improve certain characteristics of the food. Inulin can replace some of the sugar in food while adding sweetness, replace fat, improve mouth feel and texture of certain foods.

Inulin for Good Health
Inulin is a versatile non-digestible prebiotic fiber. In other words, it is an ingredient added to food or dietary supplements to boost your health. The form of inulin (inulin-type fructans) used in food and supplements is not digested or absorbed to any extent. Inulin-type fructans are metabolized by bacteria in the colon, increasing the growth of the healthy bacteria – bifidobacteria.

Unlike other types of carbohydrate, inulin does not raise triglycerides and has a minimal effect on blood sugar. And, a thorough look through the research by a team of scientists at the University of Parma in Italy found that inulin-type fructans can reduce serum triglycerides. Inulin can cause gas and bloating in people who are not accustomed to eating a high fiber diet or inulin. These effects should go away after becoming accustomed to inulin (most Americans eat far below the dietary recommendations for fiber – 14 grams for every 1,000 calories consumed).

Prebiotics and Nutrient Absorption
Some prebiotics may improve the absorption of some minerals by changing the environment in the colon and transferring water into the large bowel thereby increasing the volume of fluid minerals can dissolve in. In human studies, inulin and oligofructose have been found to increase the absorption of calcium.  Rat studies have found these prebiotic fibers increase the absorption of calcium, magnesium and zinc.

Why is this important? Results from the largest national nutrition examination survey (NHANES 2005-2006) show that as we age, we are less likely to take in enough calcium.  Just 58% of men aged 31-50 years of age are meeting their calcium needs. And, a mere 26% of men aged 51-70 and 14% of men over 71 years of age are taking in adequate amounts of calcium.  These numbers are even more dismal for women!  Thirty-three percent of women ages 31-50, 8% of women 51-70 and 7% of women over the age of 71 are taking in enough dietary calcium needed for bone health.

A liquid calcium supplement with 1000 mg of Calcium and 1000 IU of Vitamin D3 is a great way to get the calcium needed each day to help prevent and in managing osteoporosis.
 

This is a repeat of a previous post, but with the increasing importance of vitamin D, I thought it would be appropriate to post again.

When it comes to nutrition, the media often finds an ingredient, supplement or product that steals the spotlight for a period of time.  Sometimes the ingredient is lambased to the point where it becomes an outcast at warp speed, this happened with partially hydrogenated oils (man made trans fats).  Other times, the news is good.   And this is what has happened with vitamin D.  This vitamin has gone from the kid at the back of the class to center stage in a short period of time. 

Vitamin D
When it comes to bone health, many of us automatically think of calcium and milk/dairy.  However, calcium alone can't do its job without adequate vitamin D.  Think of vitamin D as the gatekeeper to bone tissue, it aids in the absorption of calcium.  Vitamin D may also decrease our risk for certain types of cancer.  Most notably, colon, prostate and breast cancer.  And, a deficiency in vitamin D can lead to osteopenia, osteoporosis, chronic pain, muscle weakness, fractures and autoimmune diseases.
 
Vitamin D is manufactured in the skin upon exposure to sunlight.  Past recommendations have indicated that just a little exposure - say 15 minutes a day, will give us all the sunlight we need to make vitamin D.  However, recent studies have shown that many of us fall short.  Even people living in climates sunny throughout the year like southern Arizona.  How can this be the case?  Individuals with darker skin and older individuals just don't produce vitamin D as well as fair-skinned, younger people do.  And, people who live in less than sunny climates simply aren't exposed to the sun's rays often enough.  Lastly, many people have had skin cancer (basal and squamous cell carcinoma is on the rise) and are avid sun block users and therefore don't manufacture adequate vitamin D.
 
Calcium
Now, on to calcium. Aside from its role in bone health, calcium also aids in:  muscle contraction, blood vessel contraction and expansion, hormone secretion, heartbeat regulation, conducting nerve impulses and blot clotting.  And, all of these functions are considered more vital than keeping our bones strong.  So, when we fall short on our calcium intake our body leaches it from our bones. If this process occurs frequently, over time we end up with weak, porous bones, osteopenia and osteoporosis.
 
How to Get It
It's clear we need to take in adequate levels of calcium and vitamin D daily.  Calcium is more easily obtained from foods, especially dairy foods.  Greens like spinach are often noted for their calcium but, this calcium is bound to the oxalic acid present in these greens and therefore, not readily absorbed.  The same thing goes for calcium that is fortified into grain products - it is bound to phytic acid and not easily absorbed in the body.  Vitamin D is a bit harder to find in foods.  Salmon, mackerel, canned tuna, canned sardines, and milk are your best options.  If you don't drink 4 glasses of milk a day or a combination of other dairy and the fish mentioned above, try a liquid calcium and vitamin D supplement.

 

True or False?

This is our latest question in the Liquid Sunshine Vitamin D Instant Win and Sweepstakes at http://vitamind.wellesse.com/

True!  Although women have a higher risk and prevalence of osteoporosis, men are also susceptible. According to the National Osteoporosis Foundation, 20 percent of those with osteoporosis are men.

One in every eight men over the age of 50 will suffer a hip fracture because of osteoporosis, according to statistics from Oregon Health Services University. Trouble is, men often are not screened for the disorder until they have their first broken bone.

It is just as important for men and women to get enough calcium and vitamin D for strong bones now and later in life.  Take a liquid calcium and vitamin D supplement with at least 1000 IU of vitamin D.  Get a bone density test and your blood levels checked for vitamin D deficiency. 

You could win a year's supply of Vitamin D in the Liquid Sunshine Sweepstakes.  There are only 8 more days left, so don't wait!  Play now!

8 Facts About Osteoporosis - it's not just an "old lady" disease.

1. It's a silent disease.  It's easy to tell when an older person is bent over from osteoporosis, but in the early stages it is typically asymptomatic.  That's why it's so important to get a bone density test, especially for women over age 65 and men over 70 and for any younger who are at risk.
    
2. Prevention starts early.  Don't wait until your 50 to start taking calcium and vitamin D supplements and to do weight-bearing exercises. 
    
3. Get Vitamin D.  Sunshine can help protect you, but only if you get outside during the summer when the UV index is 3 or higher.  Living in a sunny climate does not automatically mean you are getting enough vitamin D.  Also, as we age, it is more difficult for the body to generate vitamin D.  Taking nutritional supplements such as a liquid vitamin D is one way to ensure adequate amounts every day, all year round for bone health.
    
4. Calcium doesn't have to mean dairy.  If you are lactose intolerant, getting calcium from dairy is not an option.  There are other good food sources of calcium such as fortified orange juice, soy milk and cereal and dark leafy greens.  Take a liquid calcium supplement with 1000 mg of calcium, but don't forget the vitamin D.  It plays a major role in calcium absorption and bone health.
    
5. Exercise the right way.  Weight-bearing exercise is important to help build strong bones.  Walking, running, tennis or dancing will do it - bicycling and swimming won't. 
    
6. A few extra pounds are OK.  Thin people are at higher risk of osteoporosis than those who are carrying a few extra pounds.  This doesn't mean overweight - it just means a healthy weight for your gender and height - you should be at the "normal" range.
    
7. African Americans have lower risk.  They are far less likely to get osteoporosis than Caucasians because they have stronger bones and tend to have greater bone density.  African Americans are not off the hook though, they still need to take preventative measures for bone health.
    
8. More in the future.  Even more women may develop osteoporosis due to increased anti-hormone replacement therapy a few years ago.  Going off of hormone therapy may cause more rapid estrogen loss which could result in an increased risk of osteoporosis.

"Serum levels of vitamin D in more than 600 Costa Rican children were inversely linked to several indicators of allergy and asthma severity, including hospitalizations for asthma, use of inhaled steroids and total IgE levels, according to a study that will appear in the first issue for May of the American Journal of Respiratory and Critical Care Medicine.

While previous in vitro studies have suggested that vitamin D may affect how airway cells respond to treatment with inhaled steroids, this is the first in vivo study of vitamin D and disease severity in children with asthma.

Juan Celedón, M.D., Dr. P.H. and Augusto Litonjua, M.D., M.P.H. of Harvard Medical School and colleagues recruited 616 children with asthma living in the Central Valley of Costa Rica, a country known to have a high prevalence of asthma. Each child was assessed for allergic markers, including both allergen-specific and general sensitivity tests, and assessed for lung function and circulating vitamin D levels. Children whose forced expiratory volume in one second (FEV1) exceeded 65 percent of the predicted value were also tested for airway reactivity.

They found that children with lower vitamin D levels were significantly more likely to have been hospitalized for asthma in the previous year, tended to have airways with increased hyper reactivity and were likely to have used more inhaled corticosteroids, all signifying higher asthma severity. These children were also significantly more likely to have several markers of allergy, including dust-mite sensitivity.

"To our knowledge this is the first study to demonstrate an inverse association between circulating levels of vitamin D and markers of asthma severity and allergy," wrote Drs. Celedón and Litonjua "While it is difficult to establish causation in a cross-sectional study such as this, the results were robust even after controlling for markers of baseline asthma severity."

"This study suggests that there may be added health benefits to vitamin D supplementation" said Dr. Celedón. Current recommendations for optimal vitamin D levels geared toward preserving bone health, such as preventing rickets in children and osteoporosis in adults.

"This study also provides epidemiological support for a growing body of in vitro evidence that vitamin D insufficiency may worsen asthma severity, and we suspect that giving vitamin D supplements to asthma patients who are deficient may help with their asthma control" wrote Drs. Celedón and Litonjua, noting that a clinical trial should be the next step in this research. "Whether vitamin D supplementation can prevent the development of asthma in very young children is a separate question, which will be answered by clinical trials that are getting under way," he said.

A complication is that vitamin D, unlike most other nutrients, is primarily synthesized in the body rather than consumed. Because about 90 percent of circulating vitamin D is produced by the body in response to sun exposure, deficiency is often related to behavioral issues rather than an inadequate dietary intake. Increased time spent indoors, increased use of sunscreen and sun-protective clothing all lead to decreased levels of vitamin D. Dietary sources of vitamin D, primarily fortified foods and fatty fish or fish oils, and vitamin D in current multivitamin preparations are unlikely to make up the deficiency.

"Ultimately, it is only by investigating the effects of vitamin D in doses at, and above, those currently recommended that decisions can be made on the optimal intake of vitamin D and the possible prevention and treatment of asthma," wrote Graham Devereux, M.D., of the Department of Environmental and Occupational Medicine at the University of Aberdeen in the accompanying editorial in the same issue of the journal."

Source:  EurekAlert Press Release  American Thoracic Society


Finding vitamins safe for children and that they will take is not easy.  Try our new liquid vitamin D3 in a yummy berry flavor.  It's easy to swallow and tastes like grape punch.  With all the evidence showing how important vitamin D is for children and adults, giving them and yourself a  daily dose of D is essential for good health.

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. 
 

What can you do?
Perhaps despite your best efforts, you've been diagnosed with Osteoporosis, a disease in which bones become fragile and are more like to break.  Millions of Americans are at risk for Osteoporosis.  Women are four times more likely than men to have the disease, but men are also at risk. 

Get plenty of calcium and vitamin D
Although there is no cure for osteoporosis, there are steps you can take to slow and even stop the further progression of the disease.  Aside from taking osteoporosis drugs, your physician probably prescribed calcium and vitamin D supplements and maybe even magnesium and vitamin K2.  What else can you do to ensure you are taking care of yourself?

Eat a well-rounded diet
You can also eat a well-rounded diet with several servings of fruits and vegetables everyday, whole grains, soy foods (which may help your bones) and lean sources of protein.   See Good Nutrition Builds Healthy Bones

Exercise
In addition to diet, physical activity is crucial for managing osteoporosis.  Did you know that strengthening your muscles can also make your bones stronger?  Physical activity not only makes you stronger but it can also help you maintain your mobility so you decrease your risk of falling and breaking your bones.  Strength training and functional movement exercises are excellent for people with osteoporosis (talk to your physician first of course).  

If you don’t know where to start, consult with a personal trainer who is well versed on this disease.  Aside from strengthening and doing functional movement exercises, non-impact exercise such as water aerobics can also increase your mobility and strength.  See post on Exercise for Healthy Bones


See www.nof.org for more information on managing osteoporosis.

Heart Health Month is over, but spring is a good time to start a heart healthy exercise program.

It seems to me that younger people are motivated to exercise so they look good and feel good.  Some older Americans also exercise for the same reasons but there is another set of people that are prescribed exercise.  That’s right, physicians don’t just prescribe medicine.  They also prescribe exercise, meditation and yoga for people who have cardiovascular disease.  Even those who have had heart attacks and bypass surgery start exercising soon after they recover.  And their exercise prescription progresses, as they get stronger.

According to joint guidelines between the American Heart Association and American College of Sports Medicine, all healthy adults 18-65 years of age should be getting at least 30 minutes of moderate intensity physical activity at least 5 days a week or vigorous physical activity for 20 minutes 3 days per week.  Those who are 65 years of age or older or have limitations to physical activity should still engage in physical activity as well.

It's vital to your heart health!
Exercise helps strengthen your heart and it can help prevent chronic diseases such as cardiovascular disease, osteoporosis, sarcopenia and obesity.  In addition to exercising, you can also benefit from increasing your activities of daily living.  You can do this by walking more (strap on a pedometer to keep track), working on your house, cleaning your car, raking your leaves vs. blowing them, taking the stairs instead of the elevator and walking around the airport vs. taking the people movers.

Regardless of what your favorite exercise is - spin class at the gym or walking your dog, just make sure you get out there and do something.  And take comfort in the fact that every step you take will help your heart!

Exercise is also an important step for managing arthritis for overall joint health and for bone health and osteoporosis.  The more you keep moving, the better your body will feel.  Make this spring a jump start to a healthier you!


 

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.
 

The first question of the week in the Liquid Sunshine Instant Win & Sweepstakes was:

"According to many experts, how much vitamin D do you need each day?" 

200 IU, 400 IU, or 1000 IU

The majority answered c. 1000 IU and that was correct!  I was surprised at how many answered correctly since there is so much conflicting information on this topic.

200 IU - This is the the Adequate Intake (AIs) for vitamin D established by the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies many years ago.  According to the FNB, this amount is sufficient to maintain bone health and normal calcium metabolism in healthy people.  This is now under debate.

400 IU - This is the Recommended Daily Value (RDV or RDA) for vitamin D.  In 2008, the American Academy of Pediatrics (AAP) issued recommended intakes for vitamin D that exceed those of FNB.  These recommendations are based on more recent research and clinical trials.  AAP recommended that children and adolescents who do not get enough vitamin D from milk or food should take a 400 IU vitamin D supplement daily.

1000 IU - Many health experts and health care professionals are recommending at least 1000 IU of vitamin D daily (some are even saying 2000 IU is needed), especially if you have any risk factors such as dark skin, lack of sunshine, wear sunscreen, or live in a northern climate. 

These same experts are pushing for an increase in the RDA (Recommended Daily Allowance) but this could take months or even years.  The National Osteoporosis Foundation urges adults over the age of 50 to get at least 800 to 1,000 IUs to prevent fractures.  As you age, your skin makes less and less vitamin D from the sun so it's important to take a vitamin D supplement.

Find out if you are at risk - take the Vitamin D Risk Assessment Quiz now!

It's important to have a blood test to find out what your blood level of vitamin D is.  Then your doctor can recommend the right amount of vitamin D for you.  It may be more at first if your blood levels are low and then less once you have achieved a healthy level. 

Don't forget to answer the new question of the week in the Liquid Sunshine Sweepstakes.  "How many glasses of milk would you need to drink to get 1000 IU of vitamin D?"

Speed Walking

Another great way to add a bit of spice to your walk program is with speed play.  Some times called interval or Fartlek training, it is the best way to rev up your walk and train towards faster race time. 

The difference between this type of training and your continuous walk training is that the intensity and speed of the exercise varies, to train both the aerobic (with oxygen) and anaerobic systems (without oxygen).  Simply put, the aerobic system is the system your body uses to perform continuous activities like walking, swimming and bike riding.  Your respiration and pulse rate increase, but you can handle it and keep going for 20 or more minutes.


The anaerobic system is used for high intensity activities like sprinting and jumping, that cause you to become winded and fatigued, forcing you to stop within a 30 to 90 seconds. 

By training both of these systems you will become more fit and able to walk at faster, harder paces.  The easiest way to implement this into your existing walk routine is to perform timed bouts of fast walking followed by slow, recovery walking.  This can be accomplished using the walking techniques described in the previous walking pace articles. 

Start with a warm up walk lasting between 10 and 15 minutes and then pick up your pace to a 30 to 60 second speed walk, followed by 1 to 3 minutes of leisurely paced, health walking.  Once you feel that you have adequately recovered you can go back to a moderate fitness paced walk.  Every time you do a 30 to 60 second speed pace, follow it up with a 1 to 2 minute recovery pace.   Start with two or three of these bouts equally disbursed within your walk, then add in another every few weeks as desired.

The ratio is the time difference between the fast, work pace and the slow, recovery pace.  Typically you begin with a 1 to 3 ratio.  That means the recovery pace is 3 times the length of the work pace.  For example:

30 seconds fast – 1.5 minutes slow (1 to 3 ratio)
or,  1 minute fast – 3 minutes slow  (1 to 3 ratio)

As you get in better condition for intervals you can reduce the ratio to 1 to 2

30 seconds fast – 1 minute slow (1 to 2 ratio)
Or, 1 minute fast – 2 minutes slow (1 to 2 ratio)

It can be a lot of fun trying different ratios. Soon you’ll be cruising down the road with greater speed and energy.  But don’t overdue it... interval training is quite intense so limit these types of training sessions to no more than a few times per week.

Many of the abilities and improvements you will be working on in this three part series go hand and hand because of the cross over between strength, power and speed... so feel free to use a variety of these suggested programs during your week, month and/or year...

Remember, walking is essential for joint health and for managing arthritis and managing osteoporosis.  Try these walking programs and you might walk in the next race!

Join a Walk it Prevention team!

What Vitamin D means to you and your family

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.

Studies show that people with low levels of vitamin D have lower bone density or bone mass.  Vitamin D is important for managing osteoporosis and joint health especially for those over 50.

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 convert 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 vitamin D supplements 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.



References:
Gartner LM, Greer FR, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics 2003:111:908-10

  Alsafwah S, Laguardia SP, Nelson MD et al.   Hypovitaminosis D in African Americans residing in Memphis, Tennessee with and without heart failure. Am J Med Sci 2008;335(4):292-7.

  Holick MF. Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes 2002;9:87-98

  Glerup H, Mikkelsen K, Poulsen L, et al. Commonly recommended daily intake of vitamin D is not sufficient if sunlight exposure is limited. J Intern Med 2000;247(2):260-268

  Lo CW, Paris PW, Clemens TL et al. Vitamin D absorption in healthy subjects and in patients with intestinal malabsorption syndromes. Am J Clin Nutr 1985;42:644-49.

  Arunabh S, Pollack S, Yeh J, Aloia JF. Body fat content and 25-hydroxyvitamin D levels in healthy women. J Clin Endocrinol Metab 2003;88(1):157-161

  Gal-Moscovici A, Sprague SM. Role of vitamin D deficiency in chronic kidney disease.  J Bone Miner Res 2007;22 Suppl 2:V91-4.

  Pappa HM, Bern E, Kamin D, Grand RJ.  Vitamin D status in gastrointestinal and liver disease. Curr Opin Gastroenterol 2008;24(2):176-83.

  Silverberg SJ.  Vitamin D deficiency and primary hyperparathyroidism. J Bone Miner Res 2007;22 Suppl 2:V100-4.

Have you hit the point where your mind may say ‘go’ yet your body says ‘no’, when it comes to high impact activities like running? 

Don’t let aging joints limit your competitive spirit.  Many people are finding the joys of walking in community 10K's, half marathons and even marathons.  After giving birth to five children, my own program has evolved to a brisk fitness walk... It keeps my blood pumping with less joint impact, along with the fact that it is a whole lot easier on the pelvic floor muscles. 

Walking is awesome exercise and can be a great way to complete any race event you may be interested in, even a marathon!  It's also great for overall bone and joint health and for managing arthritis. 

To pick up your pace without increasing joint impact you need to move from a healthy, leisure walk towards a faster race walk style.  It is all in the technique.  The following easy and progressive walk tips can get you moving faster, burning more calories, toning extra muscle, and crossing the finish line in record time.

There are three primary walking styles, originally introduced into the fitness education market by Reebok over 10 years ago.  First is health walking, which includes a leisurely paced stroll (16 to 30 minutes per mile), done with your focus on good posture and a relaxed arm swing.  It is perfect for increasing health and preventing the diseases that have been linked to inactivity including arthritis, obesity and osteoporosis.  The U.S. surgeon general has recommended that everyone try to accumulate at least 30 minutes of this moderately paced style of walking, most if not all days of the week.

The other two styles, fitness walking and speed walking, I will discuss in my next two posts.

Health Walking
The following technique tips will help you perform health walking with good form and mechanics.

• Head in neutral position (head centered, chin parallel to ground, eyes looking ahead).
• Shoulders down, pulled back and relaxed
• Chest lifted
• Abdominals contracted and buttocks tucked under hips
• Arms relaxed and swinging in opposition to the legs
• Comfortable stride   

It's even better if you can walk with a partner each day.  As the weather worsens during the winter, try walking in your local mall or on a treadmill.

Illustration:  Walk Reebok Training Manual: 1995.

A new study just released revealed the five top reasons why physicians recommend dietary supplements to their patients.  The Life Supplemented Healthcare Professionals (HCP) Impact Study found that a majority of physicians - 79% - recommend supplements to their patients for these health reasons:

1. Bone Health 33%
2. Overall health and wellness 32%
3. Joint Health 29%
4. Heart Health 26%
5. Maintain healthy cholesterol 22%

The physicians were not asked to specify which supplements they would recommend for each condition; however, there are certain supplements that are widely recognized for each of these health areas.

1.  Bone Health - Calcium and Vitamin D are widely recognized and recommended for maintaining bone health and managing osteoporosis

2.  Overall health and wellness - This survey found that 72 percent of physicians think its a good ideas for patients to take a multivitamin. 

3.  Joint Health - Glucosamine and chondroitin supplements have been shown in clinical trials to aid in joint discomfort and mobility often caused by osteoarthritis.

4.  Heart Health - Omega-3's, EPA and DHA, found in fatty fish such as salmon are often taken for many health reasons, including a healthy heart.  Other supplements include vitamin E and B vitamins. 

5.  Maintain healthy cholesterol - Soluble fiber is known for its cholesterol-lowering effects and plant sterols are becoming popular also.

Top supplements used by the 72 percent of physicians who say they use a dietary supplement:

1. Multivitamin
2. Vitamin C
3. B vitamins
4. Vitamin D
5. Vitamin E
6. Calcium

Read more about this study here