Archive for December, 2008

Vitamin D Deficiency: What is it and how do I prevent it?

A few weeks ago I was sitting with a client who was very concerned that her son might be at risk for vitamin D deficiency after reading a New York Times. For the first time in several years, there has been a rise in the number of people who have vitamin D deficiency disorder. Some 60% of Americans are said now to be deficient in vitamin D. Incidences have always been higher in places where it is darker and there is lower sun exposure such as England, Iceland and New Zealand but in America this is a whole new phenomenon! Now that we are entering the winter months, it is essential that we take extra steps to make sure our children and ourselves are getting adequate levels of vitamin D.

So, what is vitamin D?

Vitamin D is a vitamin that is part of the steroid hormone family that includes cortisol, estrogen, progesterone and testosterone. It is contained in egg yolks, cold water fish, shiitake mushrooms, cod liver oil and vitamin D fortified foods such as milk (now even some rice and soy milks are fortified,) orange juice and cereals. Vitamin D is created by our bodies when the sun directly hits our skin. It is very hard to get adequate levels of vitamin D solely through our diets.

What are the symptoms of vitamin D deficiency?

Vitamin D deficiency has been associated with poor bone health (like rickets,) heart disease, colon cancer, diabetes, depression, high blood pressure, arthritis, autoimmune disorders and obesity. It often remains undiagnosed because the symptoms are so hard to pinpoint the deficiency.

How can I find out if I am deficient?

It is very simple. You can take a blood test called the 25-hydroxy test. The optimal result should be above 35 ng/ml.

Why is this happening?

Several months ago I went to hear the nutritional expert and advocate for childrens’ health, Marion Nestle, talk about how we were entering an age where we were seeing record levels of children with vitamin D deficiency. So, how could this be in a time where everything from orange juice, to milk, to cereal was fortified with vitamin D? The answer may surprise you! Nestle is attributing this rise in vitamin D deficiency to sunscreen coupled with lack of time outdoors!

Not only are we spending less time outdoors due to more and more indoor “screen time” but when we do go outdoors because of the fear of skin cancer we feel compelled to immediately slather ourselves and our children with sunscreen and never allow the rays of the sun to hit our skin. Sunscreen blocks the rays of the sun and prohibits our bodies from producing vitamin D.

In the recent NYT article cited above, leading pediatricians are quoted as recommending children double the amount of vitamin D they are getting. While I do agree with their belief that we are seeing a rice in vitamin D deficiencies and need to increase it in our diets, I don’t agree with their stance that it should come from either dairy or supplements. There are many other factors to consider and many other choices.

So, how much do we need?

The ideal dosage for infants up to age 3-4 is 1,000 IU, children 4 and up 2,000 IU and teenagers and adults 4,000 IU. To put this into perspective, a 4-ounce serving of fish has approximately 300-650 IU, an egg yolk 100 IU, 3.5-ounces of shiitake mushrooms 1,600 IU, and an 8-ounce glass of milk 100 IU. As you can see, it would be hard to get adequate amounts of vitamin D through diet alone!

The previously noted NYT article quotes a 2003 American Academy of Pediatrics report recommending as little as 200 IU for those under 50, 400 IU for adults 51-70, and 600 IU for adults over 71. Many experts believe that these numbers are very low and completely out of date.

So, what do I do to prevent vitamin D deficiency?

Of course, diet is important. But, it is equally important that you get adequate amounts of time outside in the sunlight! Experts recommend that we get at least 15-20 minutes of time in the sun per day. If you are at your desk all day, get out and take a walk and bask in the sun or just take a walk around the block.

Make sure your children get a lot of time outside as well. They don’t feel the cold like we do! Even when it is cold, encourage them to go outside and play in the park, ride their bikes, play baseball or do whatever will get them outside and away from the computer or TV. And, let them go outside and beexposed to the sun for at least 20 minutes before you apply sunscreen!

If you live either in a place such as London where you are not getting as much sun as you should or if you know you are not getting outside and getting enough sunlight each day, my recommendation is to take a spoonful of good old-fashioned cod liver oil.

Eating vitamin D fortified foods is helpful as well. That does not mean that you have to have your children drink glass after glass of milk. Cereals, orange juice, and even many soy and rice milks are fortified with vitamin D so just look on the labels and make sure you and your children are getting adequate amounts.

Another viable option is to take a vitamin D supplement. I am not an advocate of taking a lot of supplements but if you live in a dark place or never get outside then it might be a good idea. Vitamin D is a fat-soluble vitamin, however, which means that it is stored and if you ingest too much it can be harmful.

Goji Berries Anyone?

Have you ever heard of goji berries? If you have not, then it is time to get to know them! Goji berries, sometimes called wolfberries, have been a staple food in Chinese culture and herbal medicine since the first century A.D. and are perhaps one of the most nutritionally dense fruits on the planet.

Goji berries are small and red and look a bit like raisons. Goji berries contain18 kinds of amino acids, more beta-carotene than carrots, more vitamin C than carrots and up to 21 trace minerals such as iron (more than soybeans or spinach), zinc, copper, calcium, germanium, selenium, and phosphorus.

Goji berries have been recommended for anemia, dizziness, inflammation, enhanced immunity, improved circulation, stronger eyesight, liver and kidney health as well as an increased sense of well-being. They are also one of the only known foods to stimulate the secretion of human growth hormone thought to inhibit the classic signs of aging.

During the holidays when we are rushing off to cocktail parties and always tempted by fattening foods, Goji berries are a perfect high-protein snack to have beforehand. Grab a handful of goji berries as a high-protein pick-me-up in the afternoon, sprinkle them on top of yogurt or throw a handful on salads to make them more colorful and add more protein to your mid-day meal. Because they are so portable, goji berries are easy to keep in your desk at the office or in your purse or briefcase for a quick, healthy snack!

You can find gogi berries in the dried fruit and nut section of your local health food shop or Whole Foods or you can purchase them online. One of my favorite’s is the brand Go Hunza’s Go Take a Hike, which is a trailmix of goji berries, mulberries, raisons, cacoa nibs, cashews and pistachios. This brand also has a bag of goji berries.