This Issue

Vitamin D A dose of sunshine goes a long way

The man to see on vitamin D

Calcium and vitamin D: The dynamic duo

Where’s the calcium?

So many choices

Who’s at risk?

• African Americans – melanin reduces the skin’s ability to make vitamin D

• Those with limited exposure to sunlight

• Breastfed infants – mother’s milk does not contain enough vitamin D

• Elderly – less able to convert vitamin D to its active form

• Vegetarians that follow a strict plant-based diet

• People with certain intestinal problems, such as celiac disease

• Obese people – excess fat impedes the circulation of vitamin D

Q & A

A closer look

Who’s at risk?

Want to know the score?


The 25-hydroxy vitamin D test measures the level of vitamin D in the body.

Vitamin D Status

Deficient

Insufficient

Sufficient

Value

Less than 20 nanograms/milliliter (ng/mL)

20 to 29 ng/mL

30 ng/mL or more


The Vitamin D Council recommends a minimum reading of 50 ng/mL


For more information, click here


Links to low levels

Weak bones cause the spine to collapse
National Institute of Arthritis & Musculoskeletal & Skin Diseases

Several studies suggest that normal levels of vitamin D are required to reduce the risk for many chronic illnesses, such as:

• Rickets

• Osteomalacia (adult rickets)

• Osteoporosis

• Fractures and falls

• Osteoarthritis

• Bone and muscle pain

• Muscle weakness

• Heart disease

• Heart failure

• Stroke

• Hypertension

• Depression

• Schizophrenia

• Multiple sclerosis

• Asthma

• Flu

• Obesity

• Inflammatory diseases

• Breast cancer

• Colon cancer

• Prostate cancer

• Autoimmune diseases

• Diabetes 1 and 2

• Fibromyalgia

• Chronic fatigue syndrome

• Metabolic syndrome


Links to low levels



So many choices


Calcium can also be obtained through supplements, but the trick is to determine which one. There are many choices — carbonate, citrate, lactate, gluconate. Here are some helpful tips.

• Calcium carbonate contains the most calcium per pill (40 percent), but should be taken after meals.

• Calcium citrate contains less calcium per pill (20 percent), but does not need to be taken with food.

• Determine the amount of “elemental calcium” — the amount available for the body to absorb and what’s counted in the recommended daily dose of calcium. If not specified, check the Nutrition Facts label. The amount of elemental calcium will be listed in milligrams (mg) according to “serving size” — generally one or two tablets.

• Gluconate and lactate contain low content of elemental calcium, and would require several tablets to meet the calcium requirement.

• Avoid dolomite, oyster shell and bone meal calcium. They might contain metals and lead.

• Look for USP (United States Pharmacopeia) symbol on the package, which designates standards for quality and purity.

• If the symbol is not listed, you can test the quality of pill by dissolving it in clear vinegar. Stir occasionally. If the pill dissolves within 30 minutes, it will also dissolve in your stomach.

For more information, click here

Looking for vitamin D?

How to get
your D

Want to know the score?

Where’s the calcium?



Calcium is found in dairy products including yogurt, cheeses and milk; to reduce fat intake try skim milk or low fat products.
Dark, leafy green vegetables such as spinach, kale, collard greens, and broccoli are all good sources of calcium. These foods are great in salads, stir-fries or even on their own.


Seafood like sardines, pink salmon, ocean perch, blue crab, clams and rainbow trout can be a tasty way to up your intake.

Select foods, including cereal and orange juice, are often fortified with calcium and can be good sources.

 

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A closer look



Vitamin D deficiency and insufficiency are common in young people. So much so that rickets, or bone weakness, has made a comeback. Rickets is seen more frequently in black children often due to less time playing outdoors and low consumption of dairy products particularly in those who are lactose intolerant. Teens who favor soft drinks and iced teas over fortified milk and cereal are also hard hit. The American Academy of Pediatrics recently revised its guidelines and now recommends a minimum daily intake of 400 IU of vitamin D beginning soon after birth and continuing through adolescence.

Many of us were taught growing up that calcium is the building block to healthy bones — drinking milk and eating dairy products will make us healthy and strong. This adage is undisputedly true, but what we didn’t know was that vitamin D is required for calcium to do its job.

Where’s the calcium?



Calcium is found in dairy products including yogurt, cheeses and milk; to reduce fat intake try skim milk or low fat products.
Dark, leafy green vegetables such as spinach, kale, collard greens, and broccoli are all good sources of calcium. These foods are great in salads, stir-fries or even on their own.


Seafood like sardines, pink salmon, ocean perch, blue crab, clams and rainbow trout can be a tasty way to up your intake.

Select foods, including cereal and orange juice, are often fortified with calcium and can be good sources.

If calcium is the building block to healthy bones, vitamin D is considered the cement. Without an adequate supply, calcium can not be utilized by our bodies to build strong bones and perform other vital physiological functions. Calcium is absorbed through the small intestine, and this process is not possible without ample amounts of vitamin D. The two work in unison to build a healthy body.

“Vitamin D’s role in keeping our bodies functioning properly has been underappreciated,” says Dr. Jan Cook, Medical Director of Medical Innovation and Leadership for Blue Cross Blue Shield of Massachusetts. “It plays an extremely important role in the body’s absorption of calcium and is vital to a person’s development, growth, and maintenance of a healthy body.”

A Powerhouse

Scientists are learning more every day about the important link between calcium and vitamin D. Researchers have discovered that vitamin D actually regulates the amount of calcium in our bodies. Vitamin D increases the rate at which calcium is reabsorbed from the food in the gastro-intestinal tract. Without adequate levels of vitamin D, a large percentage of dietary calcium is never absorbed by the intestine and instead is lost as waste products. Sounds scientific, but it is a very important fact to know!

Calcium is the most common mineral in the body and one of the most important for proper functioning. Although 99 percent of calcium is found in bones and teeth, it’s that 1 percent that’s the powerhouse of the body. Without calcium, muscles would not contract, nerve cells would not communicate with each other, the heart would not beat effectively. Blood clots because of calcium, and hormones, such as insulin — which regulates sugar in the blood — are secreted with calcium’s help.

So important are these functions to survival that, when levels of calcium fall below the required level, the body robs the vital mineral from the bones — the storehouse of calcium. So you can see why maintaining a good level of calcium and vitamin D is critical.

Calcium for life

It is clear then that too little calcium can result in bone loss, particularly in postmenopausal women. The National Institutes of Health has determined that women may lose as much as 5 percent of their bone mass every year after menopause. Men are not exempt. According to the website www.aboutcalcium.com, men are also vulnerable to bone loss and need to consume adequate calcium through their older years as a preventive measure, and in their younger years to achieve peak bone mass.

Children often don’t get enough calcium, which is essential to build their growing bones. A lack of calcium in childhood can also have a lasting health impact. In recognition of this fact, the Massachusetts Department of Public Health has taken an active role in targeting youth for the prevention of adult bone loss. This action stems from research findings that suggest the most important period for adequate calcium and vitamin D absorption is during teenage years. Studies have shown that peak bone mass is reached around the age of 20. After adolescence, as the body ages, bones gradually deteriorate.

Your body needs more calcium as you age. The federal government’s recommended daily requirement for infants is 210 milligrams (mg), whereas adults 19 to 50 years should get a minimum of 1,000 mg per day. Over 50, you need at least 1,200 mg per day. Calcium intake above the recommended daily requirement is usually not a problem. However, over a long period of time, people ingesting large amounts of calcium (above 2,500 mg per day) can get kidney stones.

The good news is that it’s easy to get calcium. It’s found naturally in dairy products, leafy green vegetables and certain seafood, and is added to foods, such as cereals and orange juice. Supplements can help when diets are lacking.