The most known function is in calcium absorption, but it has many other roles including immune function and cardiovascular health.

Vitamin D deficiency causes some very serious conditions, such as rickets in children, and osteoporosis in adults.

Insufficiency has been associated with increased risks of:

• Various cancers
• Cardiovascular disease
• Multiple Sclerosis
• Rheumatoid arthritis
• Type 1 diabetes mellitus

The most important source of vitamin D is the sun; although we can get vitamin D from foods it isn’t enough to meet our needs and is considered a minor contributor. Foods that contain vitamin D include:

• Oily fish (e.g. salmon, mackerel, sardines)
• Irradiated mushrooms
• Egg yolks
• Cod liver oil
• Fortified foods (e.g. milk, juice, bread, cereal, margarine)

To meet our needs through sunlight various factors need to be taken into account, including: age, skin pigmentation, and where we live.

Recommendations for adequate vitamin D synthesis in Australia and New Zealand:

• 1/3 minimal erythemal dose (MED) of sun exposure to hands, face and arms most days

(MED  – amount required to produce a faint redness of the skin)

• Sun exposure during high risk times is not recommended, this is between 10am and 2pm (11am and 3pm during daylight savings)
• Take into account variations in season, latitude, time of day and skin type [1]

For people in climates that see little sunlight it is difficult to obtain the needed vitamin D, and supplementation may be necessary.

For people with chronic illness (especially bedridden patients) obtaining enough vitamin D may be difficult due to physical restrictions, getting outdoors may not be something done easily or often. If you are not getting regular exposure to vitamin D, a supplement may be needed.

Tips for getting out in the sun – for restricted people:

• Schedule outdoor time, ensuring it happens when someone else is home to help you in and out
• Do not put sunscreen on before you leave the house, try and get a bit of exposure and then apply it. You shouldn’t get burnt, just enough to feel the warmth and enjoy it for a short period. There is a risk of melanoma with sun exposure, it must be safe levels. A healthy exposure is the key.
• Expose hands, arms, and face when possible. If it is too cold save the outdoor trip for another day.
• Get someone to set up a chair in a good spot that you can easily get to, somewhere close to the house is ideal, and if possible avoid needing to use stairs to get to the seat (important for the physically restricted)
• Plan to do activities you would normally do inside outside, such as reading a book, or have your morning coffee outside.

Note for people with Lupus: Sun exposure can be a major problem for people with Lupus and could exacerbate symptoms. Lupus patients should keep sun exposure to a minimum, supplementation may be a good idea depending on severity of reactions to sunlight.

Reference:

1. Working group of the Australian and New Zealand Bone and Mineral Society, Endocrine Society of Australia and Osteoporosis Australia. Vitamin D and adult bone health in Australia and New Zealand: A position statement. MJA. 2005 Mar 21; 182 (6): 281-5.

Post from: The Recovery Room

Vitamin D

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Here are some tips to help you make long term changes to your lifestyle:

• Set realistic goals – Set both long and short term goals, but be sure they are achievable, and don’t set too many at once. Write them down, it can help to put them in places you will regularly read them, like on the back of the toilet door, or on the fridge.

• Change one thing at a time – If you try to make too many changes at once you will inevitably give up, the life change will be too dramatic and not something that can be easily stuck to. Just pick one thing, and work on that for at least 6 weeks, this makes the transition comfortable and it is more likely that the change will become habit and not something you need to be thinking about.

• Get support – Talking to other people who are attempting to make the same changes will make it more likely you are going to see things out; it makes it harder to give up when other people are encouraging you regularly.

• Don’t make it work – leading a healthy lifestyle should be something that is easy and happens naturally; be sure you are still giving yourself treats. Remember no food is evil; it can all be included in a healthy lifestyle as long as it is kept in moderation.

• Don’t put too much pressure on yourself – You can’t go from one extreme to another in a week, take your time making changes, and feel proud of your achievements. NEVER focus on what you have not achieved or failed at, it can be beneficial to write down at the end of every week what you have done well.

• Educate yourself – It can be easier to stick to healthier choices when you know the reasoning behind it, read up and learn what you can.

• Enjoy your food – Healthy doesn’t mean horrible, make tasty and healthy choices. Don’t go on a diet, lead a healthy lifestyle. 

• All activity is exercise – You don’t have to go to the gym, or go on long walks, you just need to keep active. Try and choose exercise you really enjoy, if you really hate exercise consider increasing your incidental activity. Gardening, dancing, cleaning, are all exercise. 

Post from: The Recovery Room

Healthy Lifestyle Tips

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Rich Sources of Iron

Red meat

Fish

Poultry

Eggs

Soy

Lentils

Beans

Spinach

Cereals

Ways to increase absorption

This is especially important when consuming a lot of non-haem sources of iron, i.e. non-meat sources. It’s not just vegetarian’s that need to be concerned with this, unless you’re a full carnivore your iron will come from a variety of sources; of meat, vegetable and grain origin.

Some simple ways to increase absorption:

·       Combine meat protein with vegetables and grains, the meat protein will increase the absorption of iron from the non-haem sources.

·       Consume vitamin C with iron rich meals

·       Cook using cast-iron cookware – this is strange but true.

What to avoid:

·        Meals high in phytates – these are found in grains, beans, legumes, seeds and nuts. Sprouted and fermented foods are not high in phytates. For example, tempeh, is fermented soybeans and will have better iron absorption than tofu.

·        Tannins and caffeine – Found in tea and coffee; that’s not to say you cannot enjoy a hot cuppa, just perhaps have it away from meal times.

·        Calcium rich foods and supplements – Calcium and iron compete with each other; try to avoid having calcium rich food with an iron rich meal. Some meals have both in them, it’s ok to do this, you will still absorb both, but for maximum absorption aim to have most of your meals mostly one or the other.

A study in 2001 by Heath, Skeaff, O’Brien, Williams and Gibson implemented many of these strategies in a randomized control intervention; there were 75 women in the study. This study demonstrated that a dietary program could be used to improve iron status. If you would like to read the study in full, it can be found here

Post from: The Recovery Room

Iron: A quick guide

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