Vitamin D recommendations revised - When food sources are not enough

If you haven't heard about the prevalence of Vitamin D deficiency yet, I consider this a must read.

Our knowledge of the role of Vitamin D has been rapidly advancing. For most of us, food sources may be insufficient to correct the problem alone. Why? Because I don't know many who enjoy cod liver oil or beef liver, or many who drink enough milk with Vitamin D added in sufficient quantities to meet our daily recommended intake of Vitamin D despite the award winning "Got Milk" advertising. We may be staying away from other good sources such as salmon, tuna, sardines due to concerns about too much mercury from fish. Vitamin D is also found in egg yolks which are great for you but old science suggested that eggs yolks contain cholesterol so we should stay away. (By the way, newer science says that dietary cholesterol does not impact the cholesterol level in your blood but did you know that? Eggs are the food that supports life, I think they're pretty important to eat.)  Fortified foods -- such as some yogurts, cereals, and orange juices -- may also provide Vitamin D but you have to seek the brands out since not all brands of these foods are fortified. Do you consume enough Vitamin D each day?
Finally, we need approximately 15 minutes of sunshine exposure daily too for our skin to produce the Vitamin D we need. This can be a challenge for those trying to stay out of the sun to avoid it's negative impact on our skin, especially for those that work too many hours indoors.

What should you do? It's certainly time to check your diet but more importantly ask your doctor to check your Vitamin D level the next time you have a blood work up. Some figures report that as many as 80% of the U.S. is now Vitamin D deficient. Even if that is too high, and it's one out of two of us, odds are that you or someone you love is deficient.

Now, why should you be concerned? For many reasons tied to your immune system, but perhaps the one I find most convincing is that Vitamin D is involved in the mechanism which checks to see that we replicate our cells properly. Cancer cells are examples of cells that have not replicated normally. If our cell checking mechanism isn't functioning correctly, we are potentially at greater risk. I would like my immune system to be in tip top shape so I'm not taking any chances. Research on the role of Vitamin D continues but early indications are strong enough that guidelines for Vitamin D have been increased.

Several years ago, I was getting sick often - so often that I went on a personal quest to sort out the issue and with my background fortunate enough to get to the root of the issue quickly. Yes, I was one of the many whose Vitamin D level was exceptionally low; a little surprising to me because I ate tuna and whole eggs and live in Southern California. After requesting a blood test, my doctors acknowledged my low level and recommended taking daily supplements in such small amounts that it would have been impossible for my levels to ever normalize.  My own research with Vitamin D experts internationally put me back on the right course and feeling much better.

Remember to have your levels rechecked if taking higher than the new recommended doses to get your level back to normal and work with your doctor. Toxic Vitamin D levels can result from excess intake. The only way to know before it's too late is to have a blood test. In fact, always talk to your doctor when taking Vitamins (especially A, D, E and K), minerals and other supplements at levels beyond daily recommended levels. Too much of a good thing isn't always better.

How much Vitamin D is recommended? The Institute of Medicine (IOM) set the following new recommendations for vitamin D:

• Ages 1-70: 600 international units (IUs) per day. Older than 71:800 IUs. The IOM previously said 200 IUs was adequate for people aged 50 and younger, 400 IU for people aged 51-70, and 600 IUs for people older than 70.
• The tolerable upper limit (UL) is 4000 IUs for ages 9 and above (up from 2000 IU in the IOM's previous guidance).
• The IOM's calcium recommendations, based on age, range from 700 to 1300 milligrams (mg) daily with a tolerable upper limit range of 1000-3000 mg.

Nutrients interact with one another so it is key to keep them in balance. If your Vitamin D level is low, you may see a higher level of calcium on your blood test - still normal but higher. This is because Vitamin D helps your bones to absorb calcium. If your blood calcium level is in the higher end of the normal range, it may not be reaching your bones. More on the relationship and new calcium recommendations in my next posting..

http://www.webmd.com/osteoporosis/features/new-vitamin-d-and-calcium-recommendations-experts-weigh-in?ecd=wnl_wmh_120610

More on the best way enjoy sweetness in your diet

People often ask which sweetner is best to consume when the answer is that all are fine in moderation - too much of anything is bad. I think we know when we are consuming too much because we are often looking for permission or the maximum amount that won't hurt us rather than focusing on how to keep the sugar we consume to a minimum. 

Most sweetners are not markedly different in terms of their impact to your body. They are all rapidly converted to blood glucose. This process begins from the moment you put the food in your mouth. Think about how quickly you feel energy from eating a candy bar or sweetened beverage. The timeframe is roughly the same if you eat table sugar or agave - both are rapidly converted to blood glucose.

The real issue is that we consume too much. A general guideline is for your total sugar intake to be less than 10% of your daily calorie intake - 24 grams or no more than 6 teaspoons. Another way to think about your consumption is to keep sugars to 100 calories for women and 150 calories for men.

When you reduce your sugar intake very gradually, it's not as difficult as you would think because your taste buds will slowly become more sensitive to sweetness.  Fruits and veggies will begin to satisfy your sweet tooth most of the time.

What about artificial sweetners? If you just replace the sugar sweetness with sugar substitutes, would   your consumption would be excessive? Probably, especially if your all of the beverages you consume are artificially sweetened. The key is to think about how to increase your sensitivity to sweetness rather than numbing your taste buds with excessive sweetness. It's a different mindset, aiming to heighten your sensitivity to sweetness.

Challenge for the week: Check the nutrition label for the line that says sugars under carbohydrates. Try to purchase most grocery items with no more than 2-3 grams of sugar per serving. Also try to reduce the level of sugar you consume gradually until the sweetness in the veggies you eat is more pronounced.
For more on this topic, including a list of sweetners that will be counted on your nutrion facts label as sugar, see the following link http://www.hsph.harvard.edu/nutritionsource/healthy-drinks/added-sugar-on-food-labels/index.html

Where do you get your nutrition advice?

Most physicians are not fully educated in nutrition from medical school and may not be the best professional to speak to regarding advice on your diet. That is why there are nutritionists and dieticians who not only focus in this area but are also required to keep up with the current scientific knowledge in this area. Doctors rely on them and you should too when you are determining whether you are getting the nutrients you need.

Read labels and don't assume that the nutrients you might expect are there. Just check the package and you will know for sure. Unless the food is enriched (to add back the nutrients that are removed in processing) or fortified (adding nutrients above and beyond that in the food prior to processing) you may be shortchanged.

Gluten free or not

It's a choice you definitely should consider if you are symptomatic. If gluten is an irritant for you, you will feel better quickly, if you don't notice a difference, by all means enjoy the many foods containing this protein.

Often only those diagnosed with Celiac disease are told to be on a gluten free diet but many of us react to gluten, or are either not diagnosed with the disease or the disease is not sufficiently progressed for this diagnosis. If you are one of those that are suffering, listen to your body even if the test for Celiac disease is not positive.

Should you decide to try a gluten free diet, consider supplementing your diet with the nutritients you may be eliminating such and B vitamins and fiber. Beloved broccoli and many green vegetables are a better source of these nutrients than most gluten based products.

If you are currently relying on bread and other gluten based products for your B vitamins and fiber, you need to check nutritional labels to see if you are really getting enough of what you need in terms of nutrients.  Whenever you are eliminating types of foods from your diet, always consider what nutrients you are eliminating and how you might need to supplement you diet accordingly.

Is the food you eat a good enough friend?

I've been thinking about  people eating food that isn't really a good "friend" to them. If we pick our foods like we pick our friends, would we make better choices?

Usually, we pick friends that we think are going to be nice to us, inspire us and help us along in life. We even choose some "spicy" friends and ones that are adventurous in ways we are not. Sometimes, we choose a few partners in crime but we try not to surround ourselves with too many of these because we know that we will become like our friends over time.

When we eat food that is physically nourishing and good for us we feel better. When we eat foods that weigh us down or are too indulgent, we are just that - weighed down paying the price of excess and extremes. We feel good in the moment and then crash down.

We make hundeds of food choices daily. As we select what we eat, we might think about if that food is the kind of friend we want and need.

Getting "enough" from fruits and vegetable

Aiming for 5 fruit and vegetable servings is great but what we consume matters.

Let's take an orange for example. It's a delicious fruit and provides vitamin C and fiber, aids in fat digestion and is a great antioxidant. It's only 50-60 calories for a medium orange and takes you at least 3/4 of the way towards meeting your Vitamin C need for the day and has more fiber than most prepackaged bread servings. It's contains about 4 ounces of water so it's very thirst quenching and only 1 tablespoon of sugar.

Now let's say you don't want to peel the orange and you opt for juice. It's faster and works well with your meal. Did you know that 8 ounces of juice is a one serving? Most Americans will drink from a 12 or 16 oz. glass not a little 8 oz. one. If you want 12 or 16 oz., just add water or also have a glass of water flavored as suggested in my earlier post. Drinking from little prepackaged pre-measured containers will show you how much one real serving is. Play along for a moment. Let's say, you don't like veggies much and just went for OJ for your 5 fruits and vegetable servings. Is this a good idea? If you drank 5 glasses of Minute Maid orange juice, you would get the vitamin C, D potassium and calcium you need for the day. That is really terrific and important. But you'd also get nearly half of your daily carbohydrate most of which is in the form of sugar (about 2 tablespoons or one grams worth) and a third of your calorie requirement for the day based on a 2000 calorie diet. I can tell you that most women will gain weight on a 2000 calorie diet. A 1300 - 1500 calorie diet would be more appropriate so now you are drinking almost half of your daily calorie requirements to get the nutrition you wanted from fruits and vegetables.

Now what about when you are out and go to a place like a Jamba Juice franchise for fresh squeezed orange juice http://www.jambajuice.com/component/nutfacts ? It's one of the lowest calorie juice items on their menu. You can't purchase one 8 ounce serving from their menu but if you had a twelve ounce serving (just a little more) you would get much of the fiber you need for the day (not in the store bought juice unless you buy it with pulp) and 300% of the vitamin C. But you'd miss the Vitamin D since it is added to store bought orange juice but not necessarily added otherwise. Did you know that 80% of Americans are Vitamin D deficient? We have to fix that if we want to have strong bones and lower the chance of getting many illnesses.

I hope you now realize that even when considering a serving of a single type of fruit - an orange or orange juice and where you buy it can impact your nutritional intake drastically. 

Simple Takeaway 1: Stick to serving sizes. The easiest way to do this is to buy the right size glass or container. Clear plates and glasses are preferred so you can see what you are consuming and many studies show you will eat less. If you don't know how much a serving size is, just look on any container in the supermarket for items you eat commonly. Or go to http://www.livestrong.com/ or http://www.nutritiondata.gov/.

Simple Takeaway 2: An easy rule of thumb is to know that 10% of the daily value on a package for carbohydrates translates to about 2 tablespoons of sugar. 100% of the Daily Value for a 2000 calorie diet is then 20 tablespoons. Take a look at 20 tablespoons of sugar in a glass. Look at it again so you have a picture in your mind.  If you are adding sugar to your coffee or tea, are drinking lots of sugared soda or juice, etc. you won't be able to eat real food with nutrients for you calories. More often than not sugars or carbohydrates that break down in your body to sugar account for much of the carbohydrates in food and you need to watch out so you don't go overboard. Too much sugar is excess energy that the body will store as fat and will cause premature aging if you are past your growing years. Sugar helps all things grow so if you are not growing taller you are growing wider or growing what shouldn't be growing inside you.  Sugar and other carbohydrates are less expensive ingredients to use, tend to increase taste appeal so it will find it's way into many products that you buy. If you don't like that then buy product that you do like, it's election time and remember to vote if you want to find the foods that you like and are good for you.

Simple Takeaway 3: If you slowly decrease the amount of sugar and carbs that you eat, you will easily get used to lower levels and foods you previously thought were not sweet will taste sweeter.  It works. You just have to make a committment to look at what you are eating and take baby steps.

Simple Takeaway 4: Eating less sugar if you are eating too much is being good to yourself. Because we like sugar as children, we have an emotional attachment to it as a reward.  If you eat too much sugar or too much of anything that puts on the pounds you are not being good to yourself, if you are overweight. You want to be good to yourself and do what is in your best interest, don't you? Our emotions are powerful and we need to respect them in ways that benefit rather than harm us. Words to remember.

Simple Takeaway 5: Variety is the spice of life! Always vary your fruits and vegetables as well as the rest of your diet.  Seasonal variation help us do this naturally and cost effectively. There is no perfect set of foods because you need to eat different foods to get all of the nutrition you need. It's all about eating lots of different foods in the right quantities.

Making breakfast healthier

Are your breakfasts high in grains but don't provide the protein and fiber you want for a good start to your day and a well running metabolism? A small amount of "good" fat will also help absorbtion of the Vitamins A, D, E and K - essential fatty acids, vitamins and  fat soluble nutritients you consume from food or a mutivitamin.

Typical cereal and muffin style breakfasts rarely offer much other than carbohydrates for energy so consider the following convenient and healthy options to help sustain you through the morning.

Convenience:

Add a slice or two of sliced chicken or meat, you might have for lunches or leftover from yesterday's dinner. Heat and it's ready.

Do you eat oatmeal? Great on fiber and better with an add-in of a spoonful of flavored beans for a savory flavor. There are lots of varieties in the store - I love Trader Joe's Cuban style black beans adding protein, fat and fiber to my breakfast for under 50 calories. Use any spices you like. For other less savory oatmeal flavors mix-in cinnamon. It's great to lower inflammation and consistently one of the top selling flavors of cereal hot or cold. If you must use a sweetener, limit it to a teaspoon or two of raw sugar or honey. Consider fresh fruit to add fiber and vitamin C. An occasional 8 oz. glass  of juice (1 serving) with pulp preferrably for fiber and added water for more hydration can complete your meal.

Boil a few eggs at a time for hard boiled eggs in 5-10 minutes. You'll want to eat about 2-3 a week for protein and nutrients. Eggs have the most "complete" protein. If they are good enough to develop life, they are good for you! If you do want to make an egg dish, buy whites only in a container and and add them to extend your whole egg. You can take a hot cup, pour in the eggs and or whites, a slice of ham or even crumble of cheese, microwave for 2 minutes and you have a breakfast to go. You can add some egg whites to your oatmeal in the microwave too. I like to add a spoonful of low fat cottage cheese (chosing one with no additives) for a great boost to my breakfast.

Save your money:

Light juices just have water added so save money by adding your own. Buy pure juices and over time add more and more water to your juice. You'll get used to the light flavor and lower the amount of sugar you consume. Drinking no more than 8 oz. of pure juice per serving will give you what you need nutritionally.