Sunday, January 18, 2015

Monday, January 5, 2015

Be sure to Get in Enough Vitamin D this Winter


My guess is that a Vitamin D supplement is probably the #1 prescribed supplement by physicians over the past few years. It seems like most of my clients were told they are deficient in Vitamin D and have been told to take a supplement. Typically, I tell my clients that I do not think most supplements people take are necessary, and can actually be doing damage. What is especially concerning is many people are taking supplements, for example, because Dr. Oz recommended it (which a new study shows 50% of what he recommends is not valid) and they aren’t even sure what the supplement does. If you are eating an adequate amount of calories and consuming a well balanced diet – especially one that is very high in non-starchy vegetables – you should be getting close to most of the vitamins and minerals your body requires. It’s when you start cutting out specific food groups like grains and dairy when it is troublesome to get in all the nutrients you need.  However, Vitamin D is a very challenging nutrient to get in through diet alone for almost everybody and I do back up the advice that people showing suboptimal levels should take a supplement. 

 For most people, the IOM recommendation for Vitamin D is 600 IU per day and adults over the age of 70 are recommended to get in 800 IUs per day because synthesis decreases with age. Vitamin D is critical for bone development and a deficiency is known to cause rickets, osteomalacia and osteoporosis. The best sources of dietary Vitamin D are cod liver oil (my favorite!), swordfish, salmon, tuna, and fortified foods such as milk, yogurt, and cereals. Three ounces of salmon or swordfish will get you the recommended amount of Vitamin D for younger people… but it is rare that people are eating that amount on a regular basis. From doing diet analyses on a regular basis, I can tell you that the average person has a lot of trouble getting Vitamin D in through dietary sources.
           
Alas, there is good news since Vitamin D is so hard to get in through diet: the best source is through synthesis in the skin from the sun’s UV rays.  It seems there is definitely a relationship between Vitamin D deficiency and a higher risk of most major diseases and conditions prevalent in the US (diabetes, certain cancers, depression, weight gain, etc.). In grad school I wrote a comprehensive research paper on Vitamin D as an anti-cancer agent and found there is ample evidence showing a link between Vitamin D status and breast, colon, prostate, and pancreatic cancers.  However, they have not found if Vitamin D deficiency increases the risk, or if higher levels of Vitamin D in the blood is protective against these cancers.

If you spend much time outside during the summer, you probably do get in enough Vitamin D, since a fair-skinned person can get a whole day worth of Vitamin D synthesized from amount fifteen minutes in sunlight. However, darker skinned individuals and the obese need more exposure.  During the winter, it is much harder due to make enough because the intensity of the sun’s rays are lacking due to the angle of the sun, but being outside in sunlight is incredibly important. You still will synthesize some Vitamin D by being outside during the winter, and certainly it is important to get outside to combat depression associated with the doldrums of winter. That being said, there is also some link between depression and Vitamin D deficiency, go figure!

If you have had blood work done recently and found that you have suboptimal Vitamin D levels, I recommend you ask your doctor if a supplement is warranted. To figure out how much you should be taking, ask your doctor, or visit the Mayo Clinic’s dosing guidelines page here. In May 2013, Consumer Reports rated the best Vitamin D supplements, and the best bang for your buck seems to be Trader Joe’s Vitamin D softgels, and Costco’s Kirkland Signature (for Calcium + Vitamin D supplement) seem to be the best value. One note is that more is not better when it comes to Vitamin D, especially because it is fat soluble and your body cannot excrete excess. According to WebMD, taking 4,000 mg or more for a prolonged period of time is deemed possibly unsafe and too much Vitamin D can cause kidney problems.

The research regarding the “Sunshine Vitamin” and its link to disease prevention is very exciting and there is a lot more to come. The majority of the research shows that a deficiency of this Vitamin can definitely harm your health. So, my recommendation is get your blood work done, see how you are doing, and possibly consider taking a supplement if need be. However, I always recommend getting outside for a walk as much as possible- even if it’s cold! You won’t get the optimal amount of UV exposure for Vitamin D synthesis if you are living in the north during the winter, but it’s definitely beneficial. Visit my blog on how walking and regularly exposing your body to cold is actually advantageous for losing weight!


References:
http://www.bmj.com/content/349/bmj.g7346

http://www.foxnews.com/health/2014/12/19/half-dr-oz-health-advice-is-bad-study-finds/

http://iom.edu/Reports/2010/Dietary-Reference-Intakes-for-Calcium-and-Vitamin-D/DRI-Values.aspx

http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

https://www.vitamindcouncil.org/health-conditions/depression/

http://www.consumerreports.org/cro/magazine/2013/05/most-vitamin-d-pills-measure-up-our-tests-find/index.htm

http://www.webmd.com/vitamins-supplements/ingredientmono-929-vitamin%20d.aspx?activeingredientid=929&activeingredientname=vitamin%20d

Picture Source: http://tcwchiro.com/wp-content/uploads/2014/09/VitaminD-Sun.jpg



             

Monday, December 1, 2014

Don't Lose Focus During the Holidays: Continue to Eat Healthy and Exercise, NO EXCUSES!



We have marked the beginning of the “holiday” season with our Thanksgiving feast and now are moving onward into the crux of holiday party season. Most studies estimate that the average weight gain between Thanksgiving and New Year’s Day is about one pound. While that does not seem like a lot, it is, considering that most Americans don’t ever lose that pound and the weight is gained in just a little over one month. In order to help prevent the weight gain and just to stay healthy during this time, I preach five main things:

1.Practice mindful eating
By eating mindfully, you should be aware of EVERYTHING you are putting in your mouth. I tell all my clients to THINK before you eat anything, no matter what it is! Each truffle of chocolate will be about 80 calories, each cookie is approximately 100 calories, and each ounce of cheese is over 100 calories. So, at a party if you eat a cube of cheese, one chocolate chip cookie, and a piece of chocolate, you are already in almost 300 calories without even having any other hors d'oeuvres, your meal, or any alcohol.

2. Stay physically active EVERY day
You should be doing some cardiovascular activity every single day of your life. You should never have off days, especially during a time when you may be indulging more so than other times of year. Some people use lack of time due to work as an excuse not to exercise, so certainly don’t use your vacation days as an excuse either- otherwise you will never exercise! Vacation days allow you plenty of time (24 hours) to travel, visit family, relax, and EXERCISE! No matter where you may be going, do some research and figure out ways you can get in exercise. Even if it is just a brisk walk around your aunt’s neighborhood, that counts. Try to get in more intense exercise if possible- jog, jump rope, do jumping jacks and burpees, pack a workout DVD or go on You Tube, do something!!! Using your muscles is incredibly important, especially after you eat, to reduce the rise in blood sugar which will help prevent cell damage and fat storage.

3. Continue to eat 90% healthy
My rule with clients is that you should eat healthy/clean 90% of the time, and allow yourself some “wiggle room” 10% of the time- meaning that you should be allowed to have a piece of chocolate, drink a glass of wine, or try a small piece of your mom’s lasagna if that’s what really makes you happy. This rule should not go out the door during the holidays. Sure, there are foods that are special to you during the holidays and bring back good feelings, but the more you eat of them doesn’t correlate with the better you’ll feel (it’s often the reverse). So yes, you can eat them… in small quantities! There is no reason why 1 normal slice of pie will make you any happier than two bites- many studies show the first bite is when your brain lights up and is most excited about the flavor. This is called sensory specific satiety, which basically means that food gives you decreased pleasure as you continue to eat the same thing. So again, practice mindful eating and notice when you are eating just to eat and not actually enjoying it!

4.  Don’t plan on dieting in the New Year
Allowing yourself to go crazy and eat whatever even just one day a week sets you up for failure since it can really pack on the calories. Furthermore, many people report to me that it then causes them to crave bad foods like sugar and fatty dishes for a few days after. If you spend a whole month eating poorly, you can gain weight, but more importantly, you are harming your body- some studies show just one meal can markedly increase blood lipid levels, and a high carb intake can raise triglycerides. Again, high blood sugar damages cells, so during this time you will be experience more cell damage and accelerated aging. Putting things off in the future for what you can do now is never a good idea. You will feel healthy and energetic if you eat healthy, so why not do something that makes you feel good instead feeling like a slug? Refer to my blog from last year on how to prevent weight gain during the holidays.

5.  Limit alcohol intake
Most parties are centered on alcohol, but for some reason, holiday parties and dinners tend to highlight some of the most calorie dense varieties. For example, hot cider is usually a mix of apple cider (1 cup= 120 calories) with at least a shot of whiskey or rum (minimum 100 calories) and many have added brandy, sugar, and/or honey which contributes even more calories. Egg nog is pretty terrible for you with about 350 calories per cup, over half your daily value of saturated fat, and over 20 grams of sugar… WITHOUT the alcohol! Add a shot, and your tacking on another 100 calories. Even if wine is your preferred beverage choice, it is still more calorie dense than drinking a can of coke (12 fl oz wine ~ 300 calories, 12 fl oz Coca Cola ~ 140 calories). I am not advocating you drink soda instead, but just be aware that wine is not your weight loss friend. For more about alcohol, read my previous blogs on wine  and alcohol.

So this holiday season, treat each day as a normal day where you should eat healthy and exercise. Sure, have a special treat or a drink here and there, but don't throw out the whole month of December as an excuse to pack on the pounds. It's a lot easier to eat a cookie than burn it off- so each extra cookie, drink, cheese cube, etc. will just make your life come January harder. Think before you eat and try to stay on track- no need to throw all your hard work out the window because it's holiday season. Many of my clients do not gain weight during this time, and some actually lose- so it is possible!

References: