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Are you over 75? Here’s what you need to know about vitamin D

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Vitamin D is essential for bone health, immune function and overall wellbeing. And it becomes even <a href="https://pubmed.ncbi.nlm.nih.gov/38337682/">more crucial</a> as we age.</p> <p>New guidelines from the international Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommend</a> people aged 75 and over should consider taking vitamin D supplements.</p> <p>But why is vitamin D so important for older adults? And how much should they take?</p> <h2>Young people get most vitamin D from the sun</h2> <p>In Australia, it is possible for most people under 75 to get enough vitamin D from the sun <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">throughout the year</a>. For those who live in the top half of Australia – and for all of us during summer – we <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">only need</a> to have skin exposed to the sun for a few minutes on most days.</p> <p>The body can only produce a certain amount of vitamin D at a time. So staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.</p> <p>But it’s difficult for people aged over 75 to get enough vitamin D from a few minutes of sunshine, so the Endocrine Society <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommends</a> people get 800 IU (international units) of vitamin D a day from food or supplements.</p> <h2>Why you need more as you age</h2> <p>This is higher than the recommendation for younger adults, reflecting the increased needs and reduced ability of older bodies to produce and absorb vitamin D.</p> <p>Overall, older adults also tend to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3356951/">less exposure</a> to sunlight, which is the primary source of natural vitamin D production. Older adults may spend more time indoors and wear more clothing when outdoors.</p> <p>As we age, our skin also becomes <a href="https://pubmed.ncbi.nlm.nih.gov/18290718/">less efficient</a> at synthesising vitamin D from sunlight.</p> <p>The kidneys and the liver, which help convert vitamin D into its active form, also lose some of their efficiency with age. This makes it <a href="https://www.sciencedirect.com/science/article/abs/pii/S0889852913000145">harder for the body to maintain</a> adequate levels of the vitamin.</p> <p>All of this combined means older adults need more vitamin D.</p> <h2>Deficiency is common in older adults</h2> <p>Despite their higher needs for vitamin D, people over 75 may not get enough of it.</p> <p>Studies <a href="https://www.abs.gov.au/articles/vitamin-d">have shown</a> one in five older adults in Australia have vitamin D deficiency.</p> <p>In higher-latitude parts of the world, such as the United Kingdom, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6627050/">almost half</a> don’t reach sufficient levels.</p> <p>This increased risk of deficiency is partly due to <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">lifestyle factors</a>, such as spending less time outdoors and insufficient dietary intakes of vitamin D.</p> <p>It’s difficult to get enough vitamin D from food alone. <a href="https://dietitiansaustralia.org.au/health-advice/vitamin-d">Oily fish, eggs and some mushrooms</a> are good sources of vitamin D, but few other foods contain much of the vitamin. While foods can be fortified with the vitamin D (margarine, some milk and cereals), these may not be readily available or be consumed in sufficient amounts to make a difference.</p> <p>In some countries such as the <a href="https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/">United States</a>, most of the dietary vitamin D comes from fortified products. However, in <a href="https://pubmed.ncbi.nlm.nih.gov/35253289">Australia</a>, dietary intakes of vitamin D are typically very low because only a few foods are fortified with it.</p> <h2>Why vitamin D is so important as we age</h2> <p>Vitamin D <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367643/">helps the body absorb calcium</a>, which is essential for maintaining bone density and strength. As we age, our bones become more fragile, increasing the risk of fractures and conditions like osteoporosis.</p> <p>Keeping bones healthy is crucial. Studies <a href="https://pubmed.ncbi.nlm.nih.gov/28726112/">have shown</a> older people hospitalised with hip fractures are 3.5 times more likely to die in the next 12 months compared to people who aren’t injured.</p> <p>Vitamin D may also help <a href="https://pubmed.ncbi.nlm.nih.gov/28202713/">lower the risk</a> of respiratory infections, which can be more serious in this age group.</p> <p>There is also emerging evidence for other potential benefits, including <a href="https://pubmed.ncbi.nlm.nih.gov/29233204/">better brain health</a>. However, this requires more research.</p> <p>According to the society’s systematic review, which summarises evidence from randomised controlled trials of vitamin D supplementation in humans, there is <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">moderate evidence</a> to suggest vitamin D supplementation can lower the risk of premature death.</p> <p>The society estimates supplements can prevent six deaths per 1,000 people. When considering the uncertainty in the available evidence, the actual number could range from as many as 11 fewer deaths to no benefit at all.</p> <h2>Should we get our vitamin D levels tested?</h2> <p>The Endocrine Society’s guidelines <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">suggest</a> routine blood tests to measure vitamin D levels are not necessary for most healthy people over 75.</p> <p>There is no clear evidence that regular testing provides significant benefits, unless the person has a specific medical condition that affects vitamin D metabolism, such as kidney disease or certain bone disorders.</p> <p>Routine <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498906">testing</a> can also be expensive and inconvenient.</p> <p>In most cases, the <a href="https://pubmed.ncbi.nlm.nih.gov/38828931/">recommended approach</a> to over-75s is to consider a daily supplement, without the need for testing.</p> <p>You can also try to boost your vitamin D by adding fortified foods to your diet, which might lower the dose you need from supplementation.</p> <p>Even if you’re getting a few minutes of sunlight a day, a daily vitamin D is still recommended.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231820/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a> and <a href="https://theconversation.com/profiles/joshua-sutherland-1646406">Joshua Sutherland</a>, PhD Candidate - Nutrition and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/are-you-over-75-heres-what-you-need-to-know-about-vitamin-d-231820">original article</a>.</em></p> </div>

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Vitamins and supplements: what you need to know before taking them

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/neelaveni-padayachee-1018709">Neelaveni Padayachee</a>, <a href="https://theconversation.com/institutions/university-of-the-witwatersrand-894">University of the Witwatersrand</a> and <a href="https://theconversation.com/profiles/varsha-bangalee-1253468">Varsha Bangalee</a>, <a href="https://theconversation.com/institutions/university-of-kwazulu-natal-1941">University of KwaZulu-Natal</a></em></p> <p>If you were to open your medicine cabinet right now, there’s a fair chance that you’d find at least one bottle of vitamins alongside the painkillers, plasters and cough syrup.</p> <p>After all, people are definitely buying vitamins: in 2020, the global market for complementary and alternative medicines, which includes multivitamin supplements, had an estimated value of <a href="https://www.grandviewresearch.com/industry-analysis/complementary-alternative-medicine-market">US$82.27 billion</a>. The use of natural health products such as minerals and amino acids has <a href="https://journals.lww.com/nutritiontodayonline/Abstract/2007/03000/Why_People_Use_Vitamin_and_Mineral_Supplements.4.aspx">increased</a> – and continues to rise, partly driven by consumers’ buying habits during the COVID-19 pandemic.</p> <p>People <a href="https://www.businesslive.co.za/bd/companies/healthcare/2021-02-08-native-sales-of-sas-vitamins-and-nutritional-supplements-boom/">sought out</a> vitamins C and D, as well as zinc supplements, as potential preventive measures against the virus – even though the <a href="https://www.health.harvard.edu/blog/do-vitamin-d-zinc-and-other-supplements-help-prevent-covid-19-or-hasten-healing-2021040522310">evidence</a> for their efficacy was, and <a href="https://pubmed.ncbi.nlm.nih.gov/35888660/#:%7E:text=Concluding%2C%20available%20data%20on%20the,trials%20(RCTs)%20are%20inconsistent">remains</a>, inconclusive.</p> <p>Multivitamins and mineral supplements are easily accessible to consumers. They are often marketed for their health claims and benefits – sometimes unsubstantiated. But their potential adverse effects are not always stated on the packaging.</p> <p>Collectively, vitamins and minerals are known as micronutrients. They are essential elements needed for our bodies to function properly. Our bodies can only produce micronutrients in small amounts or not at all. We get the bulk of these nutrients <a href="https://www.iprjb.org/journals/index.php/IJF/article/view/1024">from our diets</a>.</p> <p>People usually buy micronutrients to protect against disease or as dietary “insurance”, in case they are not getting sufficient quantities from their diets.</p> <p>There’s a common perception that these supplements are harmless. But they can be dangerous at incorrect dosages. They provide a false sense of hope, pose a risk of drug interactions – and can delay more effective treatment.</p> <h2>Benefits</h2> <p>Vitamins are beneficial if taken for the correct reasons and as prescribed by your doctor. For example, folic acid supplementation in pregnant women has been shown to prevent neural tube defects. And individuals who reduce their intake of red meat without increasing legume consumption require a vitamin B6 supplement.</p> <p>But a worrying trend is increasing among consumers: intravenous vitamin therapy, which is often punted by celebrities and social media marketing. Intravenous vitamins, nutrients and fluids are administered at pharmacies as well as beauty spas, and more recently “<a href="https://www.health.harvard.edu/blog/drip-bar-should-you-get-an-iv-on-demand-2018092814899">IV bars</a>”. Users believe these treatments can quell a cold, slow the effects of ageing, brighten skin, fix a hangover or just make them feel well.</p> <p>Intravenous vitamin therapy was previously only used in medical settings to help patients who could not swallow, needed fluid replacements or had an electrolyte imbalance.</p> <p>However, the evidence to support other benefits of intravenous vitamin therapy is limited. No matter how you choose to get additional vitamins, there are risks.</p> <h2>Warning bells</h2> <p>Most consumers use multivitamins. But others take large doses of single nutrients, especially vitamin C, iron and calcium.</p> <p>As lecturers in pharmacy practice, we think it’s important to highlight the potential adverse effects of commonly used vitamins and minerals:</p> <ul> <li> <p><a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-a/">Vitamin A/retinol</a> is beneficial in maintaining good eye health. But it can cause toxicity if more than 300,000IU (units) is ingested. Chronic toxicity (hypervitaminosis) has been <a href="https://www.ncbi.nlm.nih.gov/books/NBK532916/">associated</a> with doses higher than 10,000IU a day. Symptoms include liver impairment, loss of vision and intracranial hypertension. It can cause birth defects in pregnant women.</p> </li> <li> <p><a href="https://www.hsph.harvard.edu/nutritionsource/niacin-vitamin-b3/">Vitamin B3</a> is beneficial for nervous and digestive system health. At moderate to high doses it can cause peripheral vasodilation (widening or dilating of the blood vessels at the extremities, such as the legs and arms), resulting in skin flushing, burning sensation, pruritis (itchiness of the skin) and hypotension (low blood pressure).</p> </li> <li> <p><a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-b6/">Vitamin B6</a> is essential for brain development and in ensuring that the immune system remains healthy. But it can result in damage to the peripheral nerves, such as those in the hands and feet (causing a sensation of numbness and often referred to as pins and needles) at doses over 200mg/daily.</p> </li> <li> <p><a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-c/">Vitamin C</a> is an antioxidant and assists in the repair of body tissue. Taken in high doses it can cause kidney stones and interactions with drugs, such as the oncology drugs doxorubicin, methotrexate, cisplatin and vincristine.</p> </li> <li> <p><a href="https://www.hsph.harvard.edu/nutritionsource/vitamin-d/">Vitamin D</a> is essential for bone and teeth development. At high doses it can cause hypercalcaemia (calcium level in the blood is above normal) that results in thirst, excessive urination, seizures, coma and death.</p> </li> <li> <p><a href="https://www.hsph.harvard.edu/nutritionsource/calcium/#:%7E:text=Calcium%20is%20a%20mineral%20most,heart%20rhythms%20and%20nerve%20functions">Calcium</a> is essential for bone health, but can cause constipation and gastric reflux. High doses can cause hypercalciuria (increased calcium in the urine), kidney stones and secondary hypoparathyroidism (underactive parathyroid gland). It can have drug interactions with zinc, magnesium and iron.</p> </li> <li> <p><a href="https://www.hsph.harvard.edu/nutritionsource/magnesium/">Magnesium</a> is important for muscle and nerve functioning. At high doses it can cause diarrhoea, nausea and abdominal cramping, and can interact with tetracyclines (antibiotics).</p> </li> <li> <p>Zinc <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7781367/">can impair</a> taste and smell, and doses over 80mg daily have been <a href="https://link.springer.com/article/10.1007/s10654-022-00922-0#:%7E:text=Zinc%20supplementation%20of%20more%20than,zinc%20supplements%20among%20adult%20men.">shown</a> to have adverse prostate effects.</p> </li> <li> <p><a href="https://www.hsph.harvard.edu/nutritionsource/selenium/">Selenium</a> can cause hair and nail loss or brittleness, lesions of the skin and nervous system, skin rashes, fatigue and mood irritability at high doses.</p> </li> <li> <p><a href="https://www.sciencedirect.com/science/article/pii/S0098299720300364#:%7E:text=Expert%20guidelines%20for%20oral%20iron%20supplementation&amp;text=Traditionally%2C%20the%20recommended%20daily%20dose,iron%20(Brittenham%2C%202018).">Iron</a> at 100-200mg/day can cause constipation, black faeces, black discoloration of teeth and abdominal pain.</p> </li> </ul> <h2>Recommendations</h2> <p>People need to make <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8377299/">informed decisions</a> based on evidence before consuming health products.</p> <p>Regular exercise and a well-balanced diet are more likely to do us good, as well as being lighter on the pocket.</p> <p>Seeking advice from a healthcare professional before consuming supplements can reduce the risk of adverse effects.</p> <p>Be aware of the potential adverse effects of vitamins and seek a healthcare professional’s guidance if you have symptoms.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/198345/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/neelaveni-padayachee-1018709">Neelaveni Padayachee</a>, Senior Lecturer, Department of Pharmacy and Pharmacology, <a href="https://theconversation.com/institutions/university-of-the-witwatersrand-894">University of the Witwatersrand</a> and <a href="https://theconversation.com/profiles/varsha-bangalee-1253468">Varsha Bangalee</a>, Associate Professor, Pharmaceutical Sciences, <a href="https://theconversation.com/institutions/university-of-kwazulu-natal-1941">University of KwaZulu-Natal</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/vitamins-and-supplements-what-you-need-to-know-before-taking-them-198345">original article</a>.</em></p> </div>

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Vitamin D supplements can keep bones strong – but they may also have other benefits to your health

<p><em><a href="https://theconversation.com/profiles/martin-hewison-1494746">Martin Hewison</a>, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a></em></p> <p>Most of us don’t worry about getting vitamin D when the weather’s warm and the sun is shining. But as winter approaches, accompanied by overcast days and long nights, you may be wondering if it could be useful to take a vitamin D supplement – and what benefit it might have.</p> <p>During the summer, the best way to get vitamin D is by getting a bit of sunshine. Ultraviolet rays (specifically UVB, which have a shorter wavelength) interact with a form of cholesterol called <a href="https://www.ncbi.nlm.nih.gov/books/NBK278935/">7-dehydrocholesterol</a> in the skin, which is then converted into vitamin D.</p> <p>Because vitamin D production is dependent on UVB, this means our ability to make it <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/#:%7E:text=From%20about%20late%20March%2Fearly,enough%20vitamin%20D%20from%20sunlight.">declines in the winter months</a>. Vitamin D production also <a href="https://pubmed.ncbi.nlm.nih.gov/24494042/">depends on where you live</a>, with people living nearer to the equator making more vitamin D than those living nearer the poles.</p> <p>Vitamin D deficiency is a <a href="https://assets.publishing.service.gov.uk/media/5a804e36ed915d74e622dafa/SACN_Vitamin_D_and_Health_report.pdf">problem in the UK</a> during the winter months. This is due to its northerly position and cloudy weather, and lack of time spent outdoors.</p> <p>One study of over 440,000 people in the UK found that <a href="https://pubmed.ncbi.nlm.nih.gov/33309415/">18% were vitamin D deficient</a> during the winter months. Vitamin D deficiency was even higher in certain ethnic groups – with the data showing 57% of Asian participants and 38% of black participants were vitamin D deficient. This is because the melanin content of skin determines a person’s ability to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5946242/#:%7E:text=Skin%20pigmentation%2C%20i.e.%2C%20melanin%2C,%5B7%5D%20and%20more%20generally.">make UVB into vitamin D</a>.</p> <p>Given the prevalence of vitamin D deficiency in the UK, and the importance it has for our health, in 2016 the UK’s Science Advisory Council on Nutrition outlined recommendations for the <a href="https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-report#:%7E:text=In%20a%20change%20to%20previous,aged%204%20years%20and%20older">amount of vitamin D</a> people should aim to get in the winter.</p> <p>They recommend people aim to get ten micrograms (or 400 IU – international units) of vitamin D per day. This would help people avoid severe deficiency. This can be achieved either by taking a supplement, or eating <a href="https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/ask-the-expert/foods-high-in-vitamin-d">certain foods</a> that are rich in vitamin D – including fatty fish such as herring, mackerel and wild salmon. A 100 gram serving of fresh herring, for example, would have approximately five micrograms of vitamin D.</p> <p>The clearest benefit of taking a vitamin D supplement is for <a href="https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/">bone health</a>. In fact, vitamin D was <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3899558/">first discovered</a> 100 years ago because of its ability to prevent the disease rickets, which causes weak bones that bend.</p> <p>Although rickets <a href="https://www.nhs.uk/conditions/rickets-and-osteomalacia/#:%7E:text=The%20number%20of%20rickets%20cases,from%20sunlight%2C%20can%20develop%20rickets.">isn’t very common</a> in the UK today, it can still occur in children if they lack vitamin D. In adults, vitamin D deficiency can cause bone pain, tenderness and muscles weakness, as well as increased risk of osteomalacia – often called “soft bone disease” – which leads to weakening or softening bones.</p> <p>The reason a lack of vitamin D can have such an effect on bone health is due to the vitamin’s relationship with <a href="https://pubmed.ncbi.nlm.nih.gov/18844850/">calcium and phosphate</a>. Both of these minerals help keep our bones strong – but they require vitamin D in order to be able to reinforce and strengthen bones.</p> <h2>Other health benefits</h2> <p>In addition to its effects on the skeleton, a growing body of research is beginning to indicate that vitamin D supplements may have additional benefits to our health.</p> <p>For example, <a href="https://ar.iiarjournals.org/content/42/10/5009.long">research shows</a> there’s a link between vitamin D deficiency and increased risk of catching certain viral illnesses, including the <a href="https://pubmed.ncbi.nlm.nih.gov/19237723/">common cold</a>, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7231123/">flu</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385774/">COVID</a>.</p> <p>Similarly, several studies – <a href="https://pubmed.ncbi.nlm.nih.gov/32904944/">including my own</a> – have demonstrated in cell models that vitamin D promotes immunity against microbes, such as the bacteria which causes tuberculosis. This means vitamin D may potentially prevent some types of infections.</p> <p>Vitamin D may also dampen inflammatory immune responses, which could potentially protect against autoimmune diseases, such as <a href="https://pubmed.ncbi.nlm.nih.gov/29243029/">multiple sclerosis</a> and <a href="https://www.frontiersin.org/articles/10.3389/fmed.2020.596007/full">rheumatoid arthritis</a>.</p> <p>One 2022 trial, which looked at over 25,000 people over the age of 50, found taking a 2,000 IU (50 micrograms) vitamin D supplement each day was associated with an <a href="https://www.bmj.com/content/376/bmj-2021-066452">18% lower risk</a> of autoimmune disease – notably rheumatoid arthritis.</p> <p>Vitamin D supplements may also be linked with lower risk of cardiovascular disease. A <a href="https://www.bmj.com/content/381/bmj-2023-075230">major Australian study</a>, which looked at over 21,000 people aged 60-84, found that participants who took a 2,000 IU vitamin D supplement a day for five years had a lower risk of suffering a major cardiovascular event (such as stroke or heart attack) compared to those who didn’t take a supplement.</p> <p>It’s currently not known why vitamin D may have these benefits on these other areas of our health. It’s also worth noting that in many of these trials, very few of the participants were actually vitamin D deficient. While we might speculate the observed health benefits may be even greater in people with vitamin D deficiency, it will be important for future research to study these factors.</p> <p>While it’s too early to say whether vitamin D supplements have broad health benefits, it’s clear it’s beneficial for bone health. It may be worthwhile to take a supplement in the winter months, especially if you’re over 65, have darker skin or spent a lot of time indoors as these factors can put you at <a href="https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/vitamin-d-deficiency/faq-20058397#:%7E:text=However%2C%20some%20groups%20%E2%80%94%20particularly%20people,sun%20exposure%20or%20other%20factors.">increased risk of vitamin D deficiency</a>.</p> <p>The research also shows us that we should be rethinking vitamin D supplementation advice. While in the UK it’s recommended people get 400 IU of vitamin D a day, many trials have shown 2,000 IU a day is associated with health benefits.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/219521/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/martin-hewison-1494746"><em>Martin Hewison</em></a><em>, Professor of Molecular Endocrinology, <a href="https://theconversation.com/institutions/university-of-birmingham-1138">University of Birmingham</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/vitamin-d-supplements-can-keep-bones-strong-but-they-may-also-have-other-benefits-to-your-health-219521">original article</a>.</em></p>

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6 signs you’re low in iron

<p>Feeling constantly tired, looking pale and having heart palpitations? Well you could be one of the two billion people thought to suffer from some degree of iron deficiency.</p> <p>Low iron is the most common and widespread nutritional disorder in the world, and is the only nutrient deficiency that is significantly prevalent in the western world, according to the World Health Organization.  </p> <p>Here's how to know, and what to do if you tick all the low iron boxes</p> <p><strong>1. You suffer from fatigue (aka feel tired ALL of the time)</strong></p> <p>The body uses iron to make haemoglobin, the substance in red blood cells that transports oxygen around the body. When you don't have enough healthy red blood cells, you start to feel pretty exhausted. </p> <p><strong>2. You seem to get out of breath easily – even if you’re fit</strong></p> <p>When the body is not efficiently transporting oxygen to the lungs, you can feel breathlessness after minimal exertion. Low iron levels can also cause your endurance to suffer too.</p> <p><strong>3. You look pale and washed out</strong></p> <p>In addition to looking pale, if the inside of your lips, your gums, and the inside of your bottom eyelids are less red than usual, low iron may be the reason behind this. </p> <p><strong>4. You get sick often</strong></p> <p>Ever felt like you’re fighting an endless cold? Research has shown iron deficiency can affect the immune system, making you more likely to pick up infections and viruses.</p> <p><strong>5. You experience heart palpitations</strong></p> <p>Your heart may feel like it's pounding, fluttering or beating irregularly, often for just a few seconds or minutes. </p> <p><strong>6. You get unusual cravings for non-food substances such as dirt, ice, paint, or clay</strong></p> <p>Yes, this does sound very strange, but it's a real symptom that can occur when your body is low in iron – it's called pica. </p> <p><em>Image credits: Getty Images</em></p>

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Should I be getting my vitamin D levels checked?

<p><em><a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Australia has seen a <a href="https://insightplus.mja.com.au/2023/29/gps-urged-not-to-routinely-test-children-for-vitamin-d/">surge in vitamin D testing</a> of children, with similar trends reported for adults around the <a href="https://pubmed.ncbi.nlm.nih.gov/29659534/">world</a>. GPs are now <a href="https://insightplus.mja.com.au/2023/29/gps-urged-not-to-routinely-test-children-for-vitamin-d/">being urged</a> not to test for vitamin D unnecessarily.</p> <p>So when is low vitamin D a potential concern? And when might you need to get your levels tested?</p> <h2>How much vitamin D do we need?</h2> <p>Vitamin D is not only a nutrient – when metabolised in the body it acts as a <a href="https://pubmed.ncbi.nlm.nih.gov/29080638/">hormone</a>. We have receptors for this hormone all around our body and it helps regulate the metabolism of calcium and phosphorus.</p> <p>Vitamin D also has many other roles, including helping our immune defences and contributing to <a href="https://pubmed.ncbi.nlm.nih.gov/11295155/">DNA repair</a> and cell differentiation.</p> <p>We can thank the sun for most of our vitamin D. A chemical in our skin called 7-dehydrocholesterol is converted to vitamin D after contact with UVB radiation from the sun.</p> <p>While we get some vitamin D also <a href="https://pubmed.ncbi.nlm.nih.gov/35253289/">through our diet</a>, this makes a relatively small contribution. It’s difficult to get much more than one-third of our daily vitamin D requirement from diet without supplementation.</p> <p>Nutritional vitamin D status is <a href="https://en.wikipedia.org/wiki/Calcifediol">typically measured</a> via a blood test. This checks the calcidiol (calcifediol, 25-hydroxyvitamin D) concentrations, which reflect the average intakes from the sun and diet over the past three to four weeks.</p> <p>The <a href="https://pubmed.ncbi.nlm.nih.gov/22708765/">current recommendation</a> is that we should all aim to have at least 50nmol/L (20ng/mL) at the end of winter.</p> <p>However, one problem with vitamin D tests is that there is <a href="https://pubmed.ncbi.nlm.nih.gov/37182753/">variation</a> in measured concentrations between the laboratories and between the assays, and whether you’re deemed to have a deficiency can depend on the testing method used.</p> <p>Doctors do not always agree with what is deficiency. While very low concentrations are likely to prompt doctors to recommend a supplement (and, potentially, follow-up testing), some may consider even relatively high concentrations as inadequate.</p> <p>This is all understandable as research in this space is still evolving, and we know low concentrations do not always cause any symptoms.</p> <h2>Why avoid vitamin D deficiency?</h2> <p>Prolonged, severe vitamin D deficiency will lead to softening of bone tissue and cause diseases such as rickets (children) and osteomalacia (adults).</p> <p>However, avoiding low concentrations is likely to be good for <a href="https://pubmed.ncbi.nlm.nih.gov/37483080/">many aspects of health</a>, with consistent evidence suggesting benefits for <a href="https://www.bmj.com/content/356/bmj.i6583">infectious diseases</a> and autoimmune conditions such as multiple sclerosis.</p> <p>Randomised trials have also provided evidence for lower <a href="https://pubmed.ncbi.nlm.nih.gov/35676320/">cancer</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/24414552/">all cause mortality</a> by daily supplementation, although any benefit is likely to be restricted to those who otherwise have insufficient intakes.</p> <h2>Who is at risk of deficiency?</h2> <p>Most of us do not need tests to have a relatively good idea whether we might be at risk of a clinically important deficiency.</p> <p>If it’s not late winter, we spend regularly at least some time outside with skin exposed to the sun, and we do not belong to a specific high-risk group, it is unlikely that our <a href="https://pubmed.ncbi.nlm.nih.gov/22168576/">levels would be very low</a>.</p> <p>The two main reasons for vitamin D deficiency typically relate to:</p> <p><strong>1. not getting (enough) vitamin D through sun exposure.</strong> Deficiency risk <a href="https://www.healthdirect.gov.au/vitamin-d-deficiency">can be high</a> for anyone who is housebound, such as older or disabled people in residential care. The risk of deficiency increases if we always cover our skin carefully by <a href="https://pubmed.ncbi.nlm.nih.gov/19211395/">modest cultural dress,</a> and also <a href="https://pubmed.ncbi.nlm.nih.gov/6119494/">dark skin pigmentation</a> is known to reduce vitamin D synthesis.</p> <p><strong>2. having a chronic disease that alters your requirement.</strong> Medications such as anticonvulsants used to treat epilepsy, and conditions such as <a href="https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency">liver and kidney diseases</a> can interfere with vitamin D metabolism. Some <a href="https://my.clevelandclinic.org/health/diseases/15050-vitamin-d-vitamin-d-deficiency">digestive diseases</a> can reduce vitamin D absorption from your diet, while <a href="https://pubmed.ncbi.nlm.nih.gov/30020507">obesity</a> will increase your vitamin D requirement and make it more difficult to raise your blood levels.</p> <h2>Am I getting enough sun exposure?</h2> <p>In Australia, it is possible to get enough vitamin D from the sun <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">throughout the year</a>. This isn’t so for many people living in the northern hemisphere.</p> <p>For those who live in the top half of Australia – and for all of us during summer – we <a href="https://healthybonesaustralia.org.au/your-bone-health/vitamin-d-bone-health">only need</a> to have skin exposed to the sun a few minutes on most days.</p> <p>The body can only produce a certain amount of vitamin D at the time, so staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.</p> <p>During winter, catching enough sun can be difficult, especially if you spend your days confined indoors. Typically, the required exposure increases to two to three hours per week in winter. This is because sunlight exposure can only help produce vitamin D if the UVB rays reach us at the correct angle. So in winter we should regularly spend time outside in the middle of the day to get our dose of vitamin D.</p> <p>If you are concerned, you have very dark skin, or are otherwise in a high-risk group, you may want to talk to your GP.</p> <p>In any case, taking a modest daily dose of vitamin D (1,000-2,000 IU) during the darker winter months is unlikely to cause harm and it <a href="https://pubmed.ncbi.nlm.nih.gov/37483080/">may be beneficial</a>.</p> <h2>Why does excess vitamin D testing matter?</h2> <p>When not indicated, testing can cause unnecessary worry and promote a cascade of <a href="https://pubmed.ncbi.nlm.nih.gov/32675268/">laboratory, prescription and imaging services</a> that are of low value.</p> <p>Excessive testing is also a waste of health-care resources, with one <a href="https://onlinelibrary.wiley.com/doi/full/10.5694/mja2.50619">single test</a> costing about the same as a years’ worth of vitamin D supplementation.</p> <p>Very often, we can make relatively small changes to our lifestyles to reduce the risks of vitamin D deficiency. <!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/211268/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-i-be-getting-my-vitamin-d-levels-checked-211268">original article</a>.</em></p>

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5 vitamin deficiencies your body is trying to tell you

<p>It’s so common to have marks, bumps or blemishes on our body and just ignore them until they go away. But what if they don’t? What if your eyes, skin or hair is trying to tell you that you are lacking in a specific vitamin or mineral, which could be affecting your health and wellbeing? Speak to your doctor if you have any of these symptoms, and they can help you diagnose and treat any deficiencies.</p> <p><strong>1. Calcium deficiency</strong></p> <p>Do you have weak or brittle nails, numbness in your extremities, or regular muscle cramps? Calcium deficiency could be a problem for you. It’s not just in dairy (though that is a great source) but also in seaweed, leafy greens, legumes and nuts. You can also find calcium-fortified products such as specific cereals, orange juice and soy milk.</p> <p><strong>2. Vitamin C deficiency</strong></p> <p>Do you bruise more easily than you used to? Do you have cuts and wounds that seem to take a long time to heal? This could be a sign that you are low in vitamin C. And it’s not just from a lack of oranges. The best places to find this vitamin include strawberries, kiwi, broccoli and red capsicums.</p> <p><strong>3. Iron deficiency</strong></p> <p>If you look unusually pale, have cold hands and feet, or a swollen tongue, you could be lacking in iron. As well as iron supplements, you can bulk up your iron intake with iron-rich foods such as red meat, fish and legumes.</p> <p><strong>4. Omega 3 deficiency</strong></p> <p>Do you have bumps on the skin on your upper arms, dandruff, dry hair or dry eyes? You could be low in omega 3. Generally found in fish, seeds and nuts, leafy greens and eggs – it can also be ingested as a supplement from the chemist.</p> <p><strong>5. B12 deficiency</strong></p> <p>B12 is readily available in meat, so this is a common deficiency in vegetarians and vegans. B12 is also less able to be absorbed from food as we get older. Signs of deficiency include skin irritation and dermatitis, lethargy and unusual weakness, pins and needles, and a smooth red tongue is also common (the little bumps disappear). You can get B12 in tablets or as an injection, but ideally you can get it from your food. Go for meat, leafy greens, mushrooms and nuts.</p> <p>Do you have any of these symptoms? Will this article encourage you to speak to your doctor to get checked out?</p> <p><em>Image: Getty</em></p>

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Nationwide recall issued for popular vitamin

<p>Almost a dozen batches of a popular vitamin have been recalled over a labelling error.</p> <p>Product Safety Australia have issued the nationwide recall of certain batches of “JSHealth Vitamins Pty Ltd Detox + Debloat” this week after the error was identified.</p> <p>While the tablets contain an extract from Foeniculum vulgare (fennel seeds), the bottles say “do not have required pregnancy and children warning statements on the label”, it said.</p> <p>“This medicine should not be taken by women who are pregnant, likely to become pregnant or are breast-feeding or children under 12 years of age.”</p> <p>The impacted batch numbers are:</p> <ul> <li>B23434</li> <li>B23441</li> <li>B23462</li> <li>B23463</li> <li>B23485</li> <li>B211091</li> <li>B211111</li> <li>B211161</li> <li>B211231</li> <li>B211341</li> </ul> <p>The products were sold nationally and online at pharmacies and through the JSHealth Vitamins website between November 2020 and October 2022 and have an expiry date range of November 2022 to March 2024.</p> <p>If you are an impacted customer, you're advised to return the affected bottles to your place of purchase for a full refund.</p> <p>For more information, visit the Therapeutic Goods Administration (TGA) website <a href="https://apps.tga.gov.au/Prod/sara/arn-detail.aspx?k=RC-2022-RN-01392-1" target="_blank" rel="noopener">here</a> and here or contact JSHealth Vitamins customer service on 0405 802 877 between 9:30 am – 4:30pm, Monday to Friday.</p> <p><em>Image: https://jshealthvitamins.com/</em></p>

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Natural ways to boost your vitamin D

<p>Known as the sunshine vitamin, maintaining the right level of vitamin D is essential to keep you healthy. Luckily there are a number of ways you can naturally boost your intake.</p> <p>Research now shows that apart from bone health, vitamin D is also linked to many other functions in the body, too. We’ve done the legwork for you. The sunshine vitamin can also be beneficial for cardiovascular health, rheumatoid arthritis, cancer, glucose intolerance, multiple sclerosis, type 1 and type 2 diabetes, depression and to protect against colds. Here are four ways you can ensure adequate intake – and naturally, too! But like most things in life, a combination of diet, supplements and environment is the key.</p> <p><strong>Sunlight</strong><br />The best source of vitamin D is UV-B radiation from the sun. Approximately five to 30 minutes of sun exposure while you’re not wearing sun screen (between 10am and 3pm), at least twice a week, will do the job. It is worth keeping in mind that UV radiation levels vary depending on things like, location, time of year and time of day, so make sure you wear sun protection when the UV Index is three or above. In some states, UV radiation is higher and sun protection is needed all year round at certain times of the day. The Cancer Council Australia say that for most people, adequate vitamin D levels are reached through regular daily activity and incidental exposure to the sun. To check UV levels and the times sun protection is required, look on the Bureau of Meteorology website at www.bom.gov.au – search for UV alert.</p> <p><strong>Diet</strong><br />There are many food options that you can incorporate into your diet to ensure you have healthy levels of the sunshine vitamin. Think fatty fish (sardines, herring, mackerel, tuna and salmon), canned tuna, milk that has been fortified with vitamin D, egg yolks and cereals that have been fortified with vitamin D.</p> <p><strong>Supplements</strong><br />From tablets and capsules to liquids, supplements are a convenient way to ensure you are getting enough vitamin D. The even better news is, there are some natural supplement options out there. Be careful, though, as too much can be toxic. Depending on your situation, daily dosages vary. The safest way to be sure on what’s best for you is to consult your doctor.</p> <p><strong>Cod liver oil</strong><br />If you’re not a fan of fatty fish, then you’ll be pleased to know that cod liver oil – which comes from the liver of the cod fish – is very rich in vitamins A and D. Women 60-plus should have around 700mcg per day and men 60-plus, 900mcg per day.</p> <p><em>Image: Shutterstock</em></p>

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The benefits of vitamin D – from head to toe

<p><strong>The benefits of vitamin D</strong></p> <p>Is it the magic vitamin? Well, it might be close. Research in recent years has shown that vitamin D may be one of the most powerful supplements to boost your total wellness and even help promote longevity. For years, vitamin D was touted as an ace for stronger bones, shinier hair and as a potential mood-booster. But you might not be aware of the many benefits vitamin D can provide for your whole system.</p> <p><strong>Brain</strong></p> <p>When taken with fish oil, vitamin D is a powerful mood booster, according to a study published in the <em>FASEB </em>journal. The aptly named ‘sunshine vitamin’ improves mood and lowers depression by aiding the conversion of the essential amino acid tryptophan into serotonin – a brain chemical that regulates mood. But that’s not all! Vitamin D improves memory and cognitive functions in older women, according to a separate study published in <em>Journals of Gerontology A</em>. Meanwhile, previous research has found it may also have some protective effects against Alzheimer’s disease.</p> <p><strong>Eyes</strong></p> <p>Laugh lines aside, your eyes themselves undergo signs of ageing that can impair your vision. According to a study published in <em>Neurobiology of Ageing</em>, a daily dose of vitamin D reduced some of the effects of ageing on eyes, reduced inflammation and improved vision in mice. A second study found that it may also help prevent macular degeneration, a common eye disease that can lead to blindness if it goes untreated.</p> <p><strong>Ears</strong></p> <p>What causes vertigo, that disorienting sensation of dizziness and spinning? Vertigo may feel like your head is spinning, but the problem often stems from the structures in your inner ear that are responsible for balance. However, taking vitamin D and calcium twice a day may reduce vertigo and lower your chances of getting vertigo again, according to a study published in <em>Neurology</em>.</p> <p><strong>Teeth</strong></p> <p>Want stronger, whiter teeth and fewer cavities? Taking a daily vitamin D supplement may help, according to a meta-analysis published in <em>Nutrients</em>. Researchers analysed dozens of controlled studies with thousands of participants in several countries to find that that vitamin D was associated with a 50 per cent reduction in the incidence of tooth decay.</p> <p><strong>Gums</strong></p> <p>The same vitamin D supplement that strengthens your teeth can also help protect your gums from bacterial infections that lead to problems like gingivitis and periodontitis, according to the <em>Nutrients </em>study. Periodontitis, a potentially serious infection of the gum tissue, is a major cause of tooth loss and can also contribute to heart disease.</p> <p><strong>Heart</strong></p> <p>One of vitamin D’s most powerful roles is in the cardiovascular system, where there are 200 genes regulated by vitamin D. How does it work? Vitamin D may help stop cholesterol from clogging arteries, regulate blood pressure and improve the function of cells in the heart. Even better, it may also be able to help heal existing heart damage, according to research published in the <em>International Journal of Nanomedicine</em>.</p> <p><strong>Lungs</strong></p> <p>Asthma, chronic obstructive pulmonary disease (COPD), emphysema and chronic bronchitis affect many people. While it’s not a cure, vitamin D can reduce the number of lung disease flareups by 40 per cent, a study published in <em>The Lancet</em> concluded. The same may be true for asthma, according to a separate study published in <em>Cochrane Review</em>. Researchers found that people who took a daily dose of vitamin D in addition to their asthma medication reduced the number of severe asthma attacks they experienced.</p> <p><strong>Gut</strong></p> <p>People with metabolic syndrome – increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol or triglyceride levels – are at a high risk of heart disease, stroke and type 2 diabetes. Exercise and a healthy diet are important practices to avoid or heal the syndrome, but research has suggested vitamin D may also help. In a study published in <em>Frontiers in Physiology</em>, vitamin D improved signs of metabolic syndrome by boosting healthy gut bacteria in mice.</p> <p><strong>Liver</strong></p> <p>Higher vitamin D levels are linked with lower levels of cancer in general, and less liver cancer specifically, according to a <em>BMJ </em>study. Researchers took samples from over 33,000 adult participants and found that higher levels of the nutrient were associated with a 20 per cent reduction in cancer and a 30-50 per cent reduction in liver cancer.</p> <p><strong>Reproductive system</strong></p> <p>Both men and women show reproductive and fertility benefits from vitamin D. Female participants who had a healthy vitamin D level early in pregnancy were more likely to have a baby with a healthy weight and head size in a study published in the <em>Journal of Clinical Endocrinology &amp; Metabolism</em>. Similarly, men with higher vitamin D levels had a better fertility potential, particularly through better sperm motility, say researchers in a separate study, published in<em> World Journal of Men’s Health</em>.</p> <p><strong>Bones</strong></p> <p>Think calcium is the best nutrient for bones? Think again. The positive effects of vitamin D on bone health are some of the most documented benefits of the nutrient. Vitamin D is essential for building and maintaining strong bones, while inadequate vitamin D can lead to osteoporosis, a brittle bone disease, according to the Mayo Clinic.</p> <p><strong>Knees</strong></p> <p>Your knees are one of the most-used joints in your body and often one of the first places to experience joint pain as you get older. Research has suggested the most common causes of joint pain are osteoarthritis from joint overuse or injury, and rheumatoid arthritis – an autoimmune disease that attacks joints. Vitamin D can help protect against both types of arthritis. People who maintained healthy vitamin D levels were less likely to get rheumatoid arthritis, according to a study published in <em>Journal of Autoimmunity</em>. Similarly, people with low vitamin D levels reported more symptoms of osteoarthritis, like knee pain and difficulty walking, according to research by the American College of Rheumatology.</p> <p><strong>Feet</strong></p> <p>Stress fractures – microfractures that often occur in small bones due to overuse – are fairly common injuries, particularly in people who participate in high impact activities, like running, or people who are significantly overweight. According to a study published in <em>The Journal of Foot and Ankle Surgery</em>, vitamin D may reduce stress fractures by helping improve bone density.</p> <p><em><span id="docs-internal-guid-41d08e27-7fff-fd5c-6a8f-fc6514936626">Written by Charlotte Hilton Andersen. This article first appeared in <a href="https://www.readersdigest.com.au/healthsmart/the-benefits-of-vitamin-d-from-head-to-toe" target="_blank" rel="noopener">Reader’s Digest</a>. For more of what you love from the world’s best-loved magazine, <a href="http://readersdigest.innovations.com.au/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA87V" target="_blank" rel="noopener">here’s our best subscription offer.</a></span></em></p> <p><em>Image: Getty Images</em></p>

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Vitamin C deficiency linked to cognitive impairment

<p dir="ltr">A new study has found a link between poor brain function and how much Vitamin C older people have, and that a deficiency could have some serious effects on the brain.</p> <p dir="ltr">Cognitive impairment is common among older, hospitalised patients, and can result in poor memory and concentration, as well as finding decision-making difficult.</p> <p dir="ltr">The team from Flinders University in Adelaide tested the cognitive function and vitamin C level of 160 people over the age of 75 who were admitted to the university’s medical centre.</p> <p dir="ltr">From this, 91 patients were found to have cognitive impairment, and 42 of this group were found to have such low levels of vitamin C - below 11 micromoles per litre - they were at risk of developing scurvy.</p> <p dir="ltr">“Our findings showed that cognitive function scores were significantly lower among patients who were vitamin C deficient, with further analysis suggesting vitamin C deficiency was almost three times more likely to be associated with cognitive impairment after adjustment for other factors,” Associate Professor Yogesh Sharma, the study’s lead author, <a href="https://www.scimex.org/newsfeed/low-vitamin-c-linked-to-cognitive-impairment-in-older-australians" target="_blank" rel="noopener">said</a>.</p> <p dir="ltr">The researchers stressed that the two were associated, not that vitamin C deficiency causes cognitive impairment.</p> <p dir="ltr">They also noted that many of the symptoms of low vitamin C levels - including skin issues, bruising and bleeding - are common in this age group because of a number of conditions.</p> <p dir="ltr">“It may, therefore, be difficult to diagnose vitamin C deficiency solely on looking for these particular symptoms in older hospitalised patients,” Associate Professor Sharma said.</p> <p dir="ltr">“Given we know vitamin C deficiency is common among older hospitalised patients, medical professionals need to remain vigilant for this condition and confirm a patient’s vitamin C status in suspected cases.”</p> <p dir="ltr">With this link, the researchers said they will need to conduct more studies to confirm the link and determine whether replacing a patient’s vitamin C levels could help prevent or reverse cognitive impairment.</p> <p dir="ltr">The study was published in the journal <em><a href="https://doi.org/10.3390/antiox11030463" target="_blank" rel="noopener">Antibiotics</a></em>.</p> <p><span id="docs-internal-guid-2ab5757b-7fff-e419-e985-eb63d06eb2d3"></span></p> <p dir="ltr"><em>Image: Getty Images</em></p>

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COVID concerns drive supplement and vitamin use

<div> <p><em>Image: Getty </em></p> <p><span>Sales of complementary medicines have been driven up by COVID fears, but immune boosting claims for them are doing more harm than good. </span></p> <div class="copy"> <p>In an <a rel="noopener" href="https://www.nps.org.au/australian-prescriber/articles/the-safety-of-commonly-used-vitamins-and-minerals" target="_blank">article</a> published today in <em>Australian Prescriber, </em>University of Queensland Adjunct Associate Professor of Pharmacology Geraldine Moses has warned of major potential harms associated with the use of dietary supplements.</p> <p>“One reason for the persistent popularity of vitamins and minerals is the perception that they are harmless,” says Moses. But that perception masks a troublesome reality.</p> <p>“When it comes to complementary medicines, most consumers are only given information about the possible benefits of these products, and little if anything about risk – and there’s always potential risk.”</p> <p>The advice comes as supplement use is soaring. In July, a US survey claimed that nearly 30% of Americans are now taking more supplements than they were before the COVID-19 pandemic. Commissioned by the US health non-profit <a rel="noopener" href="https://www.samueli.org/" target="_blank">Samueli Foundation</a>, the <a rel="noopener" href="https://theharrispoll.com/" target="_blank">Harris Poll</a> concluded that 76% of US citizens were taking supplements.</p> <p>The article in <em>Australian Prescriber</em> discusses six potential harms of using dietary supplements:</p> <ul> <li>They can have <strong>adverse effects</strong>, particularly at high doses.</li> <li>They can <strong>interact with other medicines</strong>.</li> <li>They <strong>cost money</strong>, which may be better spent on other things.</li> <li>Time spent taking dietary supplements may delay <strong>more effective treatments</strong>.</li> <li>They may <strong>bring false hope</strong> and disappointment.</li> <li>By taking dietary supplements, people <strong>add to the number of medicines they are taking</strong>, increasing the risk of medication error, interactions and adverse effects.</li> </ul> <p>The US survey was small and not based on a probability sample, so more research is required to build an accurate picture. But the trend it highlights is supported by evidence globally of an upturn in supplement use.</p> <p>Accurate figures for Australia are hard to obtain, but market researchers <a rel="noopener" href="https://www.ibisworld.com/au/industry/online-vitamin-supplement-sales/4091/" target="_blank">report</a> that sales of vitamins and supplements soared during the pandemic. </p> <p>The trend suggests that pandemic-related fear may be driving the use of these products, which some experts say are not regulated or evidenced as rigorously as <a rel="noopener" href="https://www.tga.gov.au/registered-medicines" target="_blank">registered medicines</a>. And while the pandemic may have bolstered supplement sales, the scale of their use has always been profound: in 2018, around <a rel="noopener" href="http://www.roymorgan.com/findings/7956-australian-vitamin-market-december-2018-201904260734" target="_blank">a third of Australians</a> – 8.3 million people – reported buying supplements, according to Roy Morgan.</p> <h4><strong>Supplementary harms?</strong></h4> <p>Supplements can be benign and are critical for people with particular conditions or deficiencies, but there are notable cases in which they’ve been shown to cause long-term damage.</p> <p>Just last week, doctors at a Sydney liver transplant centre <a rel="noopener" href="https://insightplus.mja.com.au/2021/27/drug-related-liver-injury-call-for-better-regulation-of-supplements/" target="_blank">went public with concerns</a> that drug-induced liver injuries linked to dietary and herbal supplements were on the rise. </p> <p>Their <a rel="noopener" href="https://www.mja.com.au/journal/2021/215/6/drug-induced-liver-injury-australia-2009-2020-increasing-proportion-non" target="_blank">study</a>, which spanned 2009 to 2020, found that the proportion of drug-induced liver injuries that were caused by supplements (as opposed to things such as paracetamol and other medications) rose from 15% in 2009–11 to 47% in 2018–20. </p> <p>“We observed a link to bodybuilding and weight-loss supplements as has been seen in reports internationally, but also a link to traditional Chinese medicines,” says co-author Simone Strasser, president of the Gastroenterological Society. “Both groups of supplements are rising in popularity in Australia.”</p> <p>Strasser says that in many cases supplement-related drug-induced liver injuries (DILIs) were potentially severe: while 90-day transplant-free survival was 74% for liver injuries caused by paracetamol, it was 59% for those caused by supplements. </p> <p>“There’s an old saying that the difference between a drug and a poison is the dose,” says Moses. “What many people don’t realise is that high doses of some supplements can be dangerous.”</p> <p>Moses says that because consumers aren’t aware of the potential toxicity of supplements, they may be skirting perilously close to the line without even knowing.</p> <p>“Vitamin B6 is the classic one,” Moses says. “In Australia, the toxic dose is considered to be 200mg a day or more, and lots of people that I see now in hospital will be on four products with 50mg in each one, so they’re at the toxic dose, but they’re completely unaware of that.”</p> <p>The authors of the liver-damage study have expressed concern that so many supplements are escaping regulatory oversight by the Therapeutic Goods Administration (TGA), not least, Strasser says, because “not infrequently these compounds were purchased online, bypassing the Australian regulatory system”.</p> <p>Strasser adds that because reporting adverse events associated with supplements to the TGA is voluntary, many severe adverse reactions go unreported.</p> <h4><strong>Health anxiety drives demand</strong></h4> <p>As the pandemic progresses, reports of health anxiety <a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7239023/" target="_blank">naturally rise</a>. A July 2020 <a rel="noopener" href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236562" target="_blank">study</a> among 5,070 adult Australians of varying ages and from various locations found that 25% were very or extremely worried about contracting COVID-19, and around half (52%) were worried about family and friends contracting the disease.</p> <p>“When people are fearful, especially now with COVID, they will reach out and do whatever they can to assuage their anxiety, including taking natural health products,” Moses says. </p> <div class="newsletter-box"> <p class="h2"><strong>But do supplements work as promised?</strong></p> </div> <p>Ken Harvey, a professor at Bond University’s school of Health Sciences and Medicine and an outspoken critic of pharmaceutical marketing, says that supplements can be helpful in specific cases. For example, pregnant women are encouraged to take folic acid to reduce the risk of foetal defects, and older people may need certain nutritional supplements to make up for deficiencies caused by poor diet, lack of activity and a lack of sunlight. </p> <p>But Harvey says most Australians can get enough of what they need from a reasonably healthy diet, so any vitamin they take will simply be filtered out by the kidneys and excreted in urine, because the body already has enough. </p> <p>Meanwhile, social media and wellness ‘influencers’ are patently contributing to the problem. A 2020 <a rel="noopener" href="https://aacijournal.biomedcentral.com/articles/10.1186/s13223-020-00474-6" target="_blank">study</a> in <em>BMC Allergy, Ashthma and Clinical Immunology </em>found that use of the popular Instagram hashtag #immunebooster increased by over 46% between 15 April and 15 May 2020.</p> <h4><strong>The myth of “immune-boosting” products</strong></h4> <p>One of the most touted phrases by both wellness influencers and supplement brands is ‘immune-boosting’, a term that had become synonymous with “wellness” even before the global pandemic. But how accurate is the term ‘immune-boosting’?</p> <p>Well, not very. According to Harvey, the immune-boosting myth is based on the fact that a lack of vitamins and minerals is known to<em> </em>weaken immunity, for example among malnourished populations. But Harvey says that in Australia, “there is no good evidence of widespread vitamin deficiencies in the population”.</p> <p>In fact, the idea of immune-boosting is based on a misconception about how the immune system works. The immune system is <a rel="noopener" href="https://www.cedars-sinai.org/blog/boosting-your-immune-system.html" target="_blank">better off balanced</a> than boosted – if it could be boosted by supplements (<a rel="noopener" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6673706/#B7" target="_blank">which it can’t</a>), users would experience symptoms of an immune response, such as fever and a runny nose, and in extreme cases would end up very sick.</p> <p>“To ‘boost’ your immune system against specific diseases, you’ve got to either catch one, or you’ve got to be vaccinated,” Harvey says, adding that consumers often buy supplements under the mistaken belief – promoted by some brands – that they will offer immunological benefits.</p> <p>Even more alarming, there is <a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/28911953/" target="_blank">evidence</a> that some people may use ‘immune-boosting’ natural remedies as an alternative to vaccinations against viral conditions such as the flu, meaning the immune-boosting myth could hamper the fight against disease.</p> <p>Harvey says the TGA has regulated against advertising that promotes immune-boosting products by reference to the pandemic – but there’s a major loophole, because products can still be marketed as ‘immune-boosting’, provided they don’t mention COVID-19. </p> <h4><strong>So, how <em>are</em> supplements regulated?</strong></h4> <p>Under the TGA’s classification process, there are two major categories of medicines. Registered medicines include all prescription medications and most over-the-counter (OTC) medicines. Prescription medications are considered higher risk, and OTC medicines a lower but still palpable risk, so all registered medicines are assessed by the TGA for quality, safety <em>and </em>efficacy.</p> <p>Efficacy, in pharmacological terms, refers to the ability of a drug to provide the benefits to which it claims, including establishing the dosage required to provide that benefit. <a rel="noopener" href="https://www.nps.org.au/australian-prescriber/articles/efficacy-effectiveness-efficiency" target="_blank">Efficacy is established during clinical trials</a>.</p> <p>Complementary medicines such as supplements fall into the category of <a rel="noopener" href="https://www.tga.gov.au/listed-medicines" target="_blank">listed medicines</a>, which generally contain well-known, low-risk ingredients with long histories of use, such as vitamin and mineral products and sunscreens. These medicines are those that the TGA considers to be generally benign or low risk, so, “listed medicines do not undergo a full pre-market assessment of safety, quality and efficacy,” according to the TGA.</p> <p>The TGA <em>does</em> do yearly post-marketing surveillance on around 150 of the thousands of listed medicines on the Australian market, the results of which can be found in its <a rel="noopener" href="https://www.tga.gov.au/annual-performance-statistics-reports" target="_blank">annual performance statistics reports</a>. </p> <p>A review of the performance statistics over the five years from 2015 to 2020 reveals that around 75% to 80% of the listed medicines tested are found to breach compliance in some way, which would appear to point to what Harvey refers to as a “light-touch regulatory process” for listed medicines.</p> <h4><strong>Where to now?</strong></h4> <p>Approached for comment, the TGA informed <em>Cosmos </em>that enhancements to the listed medicines post-market compliance scheme are coming. </p> <p>But the supplement sector has always been resilient, offering an alluring alternative to Western medicine, whether because the supplements are perceived as low risk, or because of an inherent distrust of public-health messaging.</p> <p>“They [the TGA] have a pretty tough job to do, trying to cover every possible pharmaceutical product throughout Australia,” Moses says. “But I certainly think that with complementary medicines we could do a better job if we required manufacturers to provide consumers with information about potential risks.”</p> <p>Strasser says that a lack of public education is hampering both the TGA and the medical profession’s ability to clamp down on unsafe supplement use.</p> <p>“There is still a perception that supplements are natural and therefore healthy,” she says. “Time after time, patients who experience severe DILI are incredibly surprised that something they purchase over the counter or online with the aim of improving their health could have harmed them.”</p> <!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=160279&amp;title=COVID+concerns+drive+supplement+use" alt="" width="1" height="1" /> <!-- End of tracking content syndication --></div> <div id="contributors"> <p><a href="https://cosmosmagazine.com/health/dangers-dietary-supplements/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/amalyah-hart">Amalyah Hart</a>. </p> </div> </div>

Food & Wine

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Does vitamin D protect against coronavirus?

<p>Recent headlines have suggested vitamin D deficiency could increase the <a href="https://www.news.com.au/world/coronavirus/health/experts-claim-those-with-low-vitamin-d-levels/news-story/8207fd86200fd4902b25d47990464f6a">risk of dying</a> from COVID-19, and in turn, that we should consider taking <a href="https://www.bbc.com/news/health-52371688">vitamin D supplements</a> to protect ourselves.</p> <p>Is this all just hype, or could vitamin D really help in the fight against COVID-19?</p> <p><strong>Vitamin D and the immune system</strong></p> <p>At least in theory, there may be something to these claims.</p> <p>Nearly all immune cells have <a href="https://www.ncbi.nlm.nih.gov/pubmed/22503810">vitamin D receptors</a>, showing vitamin D interacts with the immune system.</p> <p>The active vitamin D hormone, calcitriol, helps regulate both the <a href="https://www.ncbi.nlm.nih.gov/books/NBK279396/">innate and adaptive immune systems</a>, our first and second lines of defence against pathogens.</p> <p>And vitamin D deficiency is associated with <a href="https://www.mdpi.com/2072-6643/12/5/1248/htm">immune dysregulation</a>, a breakdown or change in the control of immune system processes.</p> <p> </p> <p>Many of the ways calcitriol affects the immune system are directly relevant to our ability to defend against viruses.</p> <p>For example, calcitriol triggers the production of cathelicidin and other defensins – natural antivirals capable of <a href="https://www.ncbi.nlm.nih.gov/pubmed/30614127">preventing the virus</a> from replicating and entering a cell.</p> <p>Calcitriol can also increase the number of a particular type of immune cell (CD8+ T cells), which play a critical role in <a href="https://www.ncbi.nlm.nih.gov/pubmed/30614127">clearing acute viral infections</a> (such as influenza) in the lungs.</p> <p>Calcitriol also suppresses pro-inflammatory cytokines, molecules secreted from immune cells which, as their name suggests, promote inflammation. Some scientists have suggested vitamin D might help to alleviate the “<a href="https://www.ncbi.nlm.nih.gov/pubmed/32353742">cytokine storm</a>” described in the most severe COVID-19 cases.</p> <p>Evidence from randomised controlled trials suggests regular vitamin D supplementation may help protect against acute respiratory infections.</p> <p>A recent <a href="https://www.ncbi.nlm.nih.gov/pubmed/30675873">meta-analysis</a> brought together results from 25 trials with more than 10,000 participants who were randomised to receive vitamin D or a placebo.</p> <p>It found vitamin D supplementation reduced the risk of acute respiratory infections, but only when it was given daily or weekly, rather than in a large single dose.</p> <p>The benefits of regular supplementation were greatest among participants who were severely vitamin D deficient to begin with, for whom the risk of respiratory infection went down by 70%. In others the risk decreased by 25%.</p> <p>Large one-off (or “bolus”) doses are often used as a quick way to achieve vitamin D repletion. But in the context of respiratory infections, there were no benefits if participants received high single doses.</p> <p>In fact, <a href="https://pubmed.ncbi.nlm.nih.gov/26747333/">monthly</a> or <a href="https://www.ncbi.nlm.nih.gov/pubmed/20460620">annual</a> vitamin D supplementation has sometimes had unexpected side effects, such as increased risk of falls and fractures, where vitamin D was administered to <em>protect</em> against these outcomes.</p> <p>It’s possible intermittent administration of large doses may <a href="https://www.ncbi.nlm.nih.gov/pubmed/19667164">interfere</a> with the synthesis and breakdown of the enzymes regulating vitamin D activity within the body.</p> <p><strong>Vitamin D and COVID-19</strong></p> <p>We still have relatively little direct evidence about the role of vitamin D in COVID-19. And while early research is interesting, much of it may be circumstantial.</p> <p>For example, <a href="https://www.medrxiv.org/content/10.1101/2020.04.24.20075838v1">one small study</a> from the United States and <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484">another study</a> from Asia found a strong correlation between low vitamin D status and severe infection with COVID-19.</p> <p>But neither study considered any confounders.</p> <p>In addition to the elderly, COVID-19 generally has the greatest consequences for people with <a href="https://www.medrxiv.org/content/10.1101/2020.05.06.20092999v1">pre-existing conditions</a>.</p> <p>Importantly, people with existing medical conditions are also often vitamin D deficient. Studies assessing <a href="https://www.ncbi.nlm.nih.gov/pubmed/30682545">ICU patients</a> have reported high rates of deficiency even before COVID-19.</p> <p>So we would expect to see relatively high rates of vitamin D deficiency in seriously ill COVID-19 patients – whether vitamin D has a role or not.</p> <p>Some researchers have noted high rates of COVID-19 infections in <a href="https://www.bmj.com/content/369/bmj.m1548/rr-6">ethnic minority groups</a> in the UK and US to suggest a role for vitamin D, as ethnic minority groups tend to have lower levels of vitamin D.</p> <p>However, analyses from the <a href="https://www.ncbi.nlm.nih.gov/pubmed/32413819">UK Biobank</a> did not support a link between vitamin D concentrations and risk of COVID-19 infection, nor that vitamin D concentration might explain ethnic differences in getting a COVID-19 infection.</p> <p>Although this research adjusted for confounders, vitamin D levels were measured ten years earlier, which is a drawback.</p> <p>Researchers have also suggested vitamin D <a href="https://www.researchsquare.com/article/rs-21211/v1">plays a role</a> by looking at the average vitamin D levels of different countries alongside their COVID-19 infections. But in the hierarchy of <a href="https://www.healthknowledge.org.uk/public-health-textbook/research-methods/1a-epidemiology/descriptive-studies-ecological-studies">scientific evidence</a> these types of studies are weak.</p> <p><strong>Should we be trying to get more vitamin D?</strong></p> <p>There are several registered <a href="https://clinicaltrials.gov/ct2/results?cond=Covid-19&amp;term=vitamin+D&amp;cntry=&amp;state=&amp;city=&amp;dist=">trials</a> on vitamin D and COVID-19 in their early stages. So hopefully in time we’ll get some more clarity about the potential effects of vitamin D on COVID-19 infection, particularly from studies using stronger designs.</p> <p>In the meantime, even if we don’t know whether vitamin D can help mitigate the risk of or outcomes from COVID-19, we do know being vitamin D deficient won’t help.</p> <p> </p> <p>It’s difficult to get enough vitamin D from food alone. A generous portion of oily fish can cover much of our need, but it’s neither healthy nor palatable to eat this every day.</p> <p>In Australia we get most of our vitamin D from the sun, but about 70% of us have <a href="https://pubmed.ncbi.nlm.nih.gov/30674358/?from_term=vitamin+D+status+australia+winter&amp;from_sort=date&amp;from_pos=5">insufficient levels</a> during winter. The <a href="https://www.osteoporosis.org.au/vitamin-d">amount of exposure</a> we need to get enough vitamin D is generally low, only a few minutes during summer, while during the winter it might take a couple of hours of exposure in the middle of the day.</p> <p>If you don’t think you’re getting enough vitamin D, speak to your GP. They may recommend incorporating <a href="https://www.healthline.com/nutrition/how-much-vitamin-d-to-take">daily supplements</a> into your routine this winter.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/138001/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/elina-hypponen-108811">Elina Hypponen</a>, Professor of Nutritional and Genetic Epidemiology, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-vitamin-d-protect-against-coronavirus-138001">original article</a>.</em></p>

Body

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The truth about vitamin D

<p>It’s one of life’s little ironies that we live in a country with abundant sunshine yet every year the rates of vitamin D deficiency in the Australian population continue to soar.</p> <p>Health experts know the importance of maintaining adequate levels of vitamin D and there is increasing evidence that this is also a contributor to our overall health. While studies are still embryonic, there are signs that low levels of vitamin D is linked to serious illnesses such as heart disease, diabetes and some cancers.</p> <p>Vitamin D helps our body absorb calcium, and that’s a major factor for maintaining our bone health and muscle mass.</p> <p>As we get older, being vitamin D deficient is known to be a mitigating factor in increased falls and bone fractures, says <a href="https://www.osteoporosis.org.au/">Osteoporosis Australia</a>, with more than six million Australians known to have low bone density. Osteoporosis Australia is currently inviting people to visit their website to try the <a href="http://osteoporosisdtc.azurewebsites.net/home">'Know Your Bones' bone health assessment tool</a>.</p> <p>Experts say the best way to “top up” on vitamin D is to spend some time outdoors in the sunshine; especially recommended in winter.</p> <p>Australian Bureau of Statistics figures in 2011 found that by the end of winter, nearly 50 per cent of all Australians in Victoria, Tasmania and the ACT had a vitamin D deficiency, with NSW not far behind with around 40 per cent.</p> <p>It was only the sunnier states of Queensland, Western Australia and the Northern Territory that had far lower percentages – generally less than 20 per cent.</p> <p>While those percentages may fluctuate from year to year, experts agree that many of us need to rethink our relationship with the sun in the colder months. </p> <p>Professor Rebecca Mason, the head of physiology and deputy director of the Bosch Institute at Sydney Medical School at the University of Sydney, who has studied vitamin D for decades, says that exposing parts of our body – arms and legs, for example – to sunlight is by far the preferred way to get vitamin D.</p> <p>“Energy absorption from sunlight is absolutely critical to make vitamin D in skin and the high energy is only available from the UVB part of sunlight,” says Professor Mason. This means we need to try to get in the sun between 11am and 1pm on a daily basis in winter, she adds.</p> <p>However, there is a resistance to getting out there among many Australians, who are often worried about sun exposure and skin cancer as well as preferring to stay indoors.</p> <p>“One of the biggest problems with some older Australians is that they just don’t get outside enough,” says Professor Mason. “Mobility can be an issue, not being well enough and generally not wanting to go out.”</p> <p>There is a lot of confusing information on the internet about how much sun on your skin you need to maintain healthy vitamin D levels. It depends, in fact, on where you live. In Cairns, for example, you will probably only need about 10 minutes per day, whereas in Melbourne or Hobart, you will need at least 40 minutes. Unless you’re playing sport or doing something physical to keep you warm, this can be extremely difficult when it’s freezing cold outside.</p> <p>So are there any worthwhile alternatives? Not really, says Professor Mason, though some, like vitamin D supplements, may be “perfectly reasonable” if you have concerns about skin cancer or other medical, practical or cultural reasons why going out in the sunshine is not an option.</p> <p>“The main problem with supplements,” says Professor Mason, “is that we are becoming increasingly aware that being out in the sun has health benefits that are not necessarily just due to vitamin D.”</p> <p>While there are some foods that do contain vitamin D – such as fish with the skin left on, eggs, meat, some cereals, and margarine – these will only provide about 10 per cent of your daily requirement at best.</p> <p>The only way to find out if you are vitamin D deficient is to have a blood test. The best time to go is at the end of winter or early spring.</p> <p>There are no major physical symptoms if your vitamin D levels have dropped - unless you have very low levels. Then, you may notice general aches and pains, bone tenderness, and a much higher risk of bone fractures if you have a fall.</p> <p><em>Republished with permission of <a href="https://www.wyza.com.au/articles/health/the-truth-about-vitamin-d.aspx">Wyza.com.au.</a></em></p>

Retirement Life

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Everything you need to know about vitamin drips

<p>Want to boost your immune system, reduce your physical signs of ageing, or cleanse your blood to get rid of toxins? Intravenous (IV) vitamin therapy, or vitamin drips, promise to help. Some claim they can even benefit serious conditions like cancer, Parkinson’s disease, the eye condition macular degeneration, the pain of fibromyalgia and depression.</p> <p><a href="https://www.refinery29.com/en-us/2018/03/192731/vitamin-iv-drip-side-effects-kendall-jenner-hospitalized">Celebrities</a> have promoted them on social media. The demand has led to <a href="https://www.theguardian.com/lifeandstyle/2019/mar/03/intravenous-vitamin-injection-goes-mainstream">alternative therapy lounges</a> popping up around the world, including in Australia. Patients can kick back in comfy leather chairs while they’re hooked up to IVs in the infusion lounge, watch Netflix and have some tea.</p> <p>But do they work? Or are you just paying for really expensive urine? Let’s look at what the science says.</p> <p><strong>What is IV vitamin therapy?</strong></p> <p>IV vitamin therapy administers vitamins and minerals directly into the bloodstream via a needle that goes directly into your vein. Fans of the therapy believe this enables you to obtain more nutrients as you avoid the digestion process.</p> <p>Providers of these injections say they customise the formula of vitamins and minerals depending on the perceived needs of the patient.</p> <p>Right now for example, many Australian lounges are offering drip “cocktails” containing immune boosting vitamins like vitamin C and zinc to help <a href="https://www.irefresh.com.au/">protect against the flu</a>. Other popular therapy sessions come under names like <a href="https://infusion.clinic/treatments">“Energy Cocktail”</a> and <a href="https://www.dripiv.com.au/services">“Glow”</a>. One vitamin IV therapy session can take 30-90 minutes and will cost between A$80 to $1,000.</p> <p><strong>Does IV vitamin therapy work?</strong></p> <p>IV therapy itself is not new and has been used in the medical profession for decades. In hospitals, it is commonly used to <a href="https://www.nice.org.uk/guidance/cg174">hydrate patients</a> and administer <a href="https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-2-18">essential nutrients</a> if there is an issue with gut absorption, or long-term difficulty eating or drinking due to surgery. Single nutrient deficiencies like vitamin B12 or iron are also often treated in hospital with infusions under medical supervision.</p> <p>But the “cocktails” IV vitamin therapy clinics create and administer are not supported by scientific evidence. There have been no clinical studies to show vitamin injections of this type offer any health benefit or are necessary for good health. In fact, there are very few studies that have looked at their effectiveness at all.</p> <p>There is <a href="http://www.altmedrev.com/archive/publications/7/5/389.pdf">one review</a> on the use of the “Myers’ cocktail” (a solution of magnesium, calcium, vitamin C and a number of B vitamins). But it just contains a collection of anecdotal evidence from singular case studies.</p> <p>Another <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894814/">trial</a> looked into the effectiveness of IV vitamin therapy in reducing symptoms of 34 people with the the chronic pain condition fibromyalgia. It found no significant differences between those who received the “Myers’ cocktail” once a week for eight weeks and those who did not. In fact, the authors noted a strong placebo effect. In other words, many people said their symptoms improved when they were only injected with a “dummy” cocktail.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pubmed/17515022">Another study</a> that examined IV vitamin use in fibromyalgia patients was missing a placebo group, involved just seven patients and showed only short-term improvement in symptoms. The only other published <a href="https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-3-6">study</a> examined IV vitamin therapy use for asthma. But that study was of even poorer quality.</p> <p><strong>What are the risks of IV vitamin therapy?</strong></p> <p>Even when it comes to vitamins and minerals, you can have too much of a good thing. For example, if you take in more of the fat soluble <a href="https://onlinelibrary-wiley-com.libraryproxy.griffith.edu.au/doi/abs/10.1002/lt.21007">vitamin A</a> than you need, your body stores it, risking <a href="https://www.ncbi.nlm.nih.gov/books/NBK234920/">damage</a> to major organs, like the liver.</p> <p>IV vitamin therapy “cocktails” also often contain significant levels of the water soluble vitamins C and B. These are processed by the kidneys and excreted into urine when the body cannot store any more. This makes for some very expensive urine.</p> <p>There is also the risk of infection with IV vitamin therapy. Any time you have an IV line inserted, it creates a direct path into your bloodstream and bypasses your skin’s defence mechanism against bacteria.</p> <p>People with certain conditions like <a href="https://www.tandfonline.com/doi/full/10.3109/0886022X.2014.882714">kidney disease or renal failure</a> shouldn’t have IV vitamin therapy because they cannot quickly remove certain minerals from the body. For these people, adding too much <a href="https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1525-139X.2001.00087.x?casa_token=Q5YupqqGg5gAAAAA:raHNHEk0AHDe45EvVsC3MnNjfxlFqoCoJL8QijrwJLQW5MLCERDly2g_krTTYjMNvreuQuzya211">potassium</a> could lead to a heart attack.</p> <p>People with heart, kidney or blood pressure conditions should also avoid IV vitamin therapy as there is risk of <a href="https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.115.002922">fluid overload</a> without consistent monitoring. The <a href="https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-016-0323-6">consequences</a>of fluid overload in these patients can include heart failure, delayed wound healing, and impaired bowel function.</p> <p><strong>What’s the bottom line?</strong></p> <p>For most of us, the quantities of vitamins and minerals needed for good health can be obtained by eating a healthy diet with a wide range of foods and food groups. Obtaining vitamins and minerals from your diet is much easier, cheaper, and safer.</p> <p>Unless you have a medically diagnosed reason for getting a vitamin infusion and it was prescribed by your doctor, you are always better off obtaining vitamins and minerals through food.</p> <p><em>Written by Emily Burch. Republished with permission of </em><a href="https://theconversation.com/do-vitamin-drips-really-work-the-evidence-says-no-so-save-your-money-and-eat-real-food-116823"><em>The Conversation</em></a><em>.</em></p>

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Everything you need to know about vitamin intake

<p>We all know that vitamins and minerals – whether we get them from fresh fruit and vegetables or supplements – are essential for our health. But how do we know if we’re not getting enough? And how can we be sure our medications aren’t affecting our vitamin absorption?</p> <p>Lucky for you, we’ve got the answers to all your questions.</p> <p><strong>1. Signs of deficiency</strong></p> <p>Vitamin deficiency can manifest itself in a number of ways that can mimic symptoms of other conditions, so if you’re experiencing any of the following symptoms, it’s worth a visit to your GP.</p> <ul> <li>Dry, flaky skin</li> <li>Small wounds that take a long time to heal</li> <li>Unexpected bruises</li> <li>Dull, brittle nails</li> <li>Spots, stripes and ridges on the nails</li> <li>Brittle hair</li> <li>Hair loss</li> <li>Insomnia</li> <li>Depression</li> <li>Poor concentration</li> <li>Lack of energy</li> </ul> <p> </p> <p><strong>2. Which vitamin does what</strong></p> <p>We all know the basics, like that calcium is essential for healthy bones and that beta carotene (which turns into vitamin A) is good for eyesight, but what do the rest do? Let’s find out.</p> <p><strong>1. Vitamin A –</strong> Supports eyesight, protects from infection by keeping the skin healthy and promotes growth and development.</p> <p><strong>2. Vitamin B1</strong> – Good for the nervous system, digestion, muscle and heart health and repairing alcohol-damaged nerve tissues.</p> <p><strong>3. Vitamin B2</strong> – Promotes growth, supports skin, nail, hair and eye health, aids in the breakdown of protein, fat and carbohydrates.</p> <p><strong>4. Vitamin B6</strong> – Helps the body produce and use protein and sugar for energy and helps form haemoglobin, which carries oxygen in the blood.</p> <p><strong>5. Vitamin B12</strong> – Works with folate to make DNA, promotes healthy blood cells and keeps nerves working properly.</p> <p><strong>6. Vitamin C</strong> – May prevent cell damage and reduce risk of certain types of cancers and heart disease, helps heal cuts and wounds, keeps gums healthy and supports immune health.</p> <p><strong>7. Vitamin D</strong> – Supports calcium absorption to keep bones strong and healthy and improves immune health.</p> <p><strong>8. Vitamin E</strong> – Helps maintain a healthy immune system and acts as an antioxidant, promoting cell health.</p> <p><strong>9. Vitamin K</strong> – Produces proteins that cause the blood to clot when bleeding and promotes blood, bone and kidney health.</p> <p><strong>10. Folate</strong> – Produces and maintains DNA and cells, makes red blood cells and prevents anaemia.</p> <p><strong>11. Calcium</strong> – Good for strengthening bones, improving nerve function, muscle health and blood clotting.</p> <p><strong>12. Iron</strong> – Produces red blood cells, supports muscle health and the immune system.</p> <p><strong>13. Magnesium</strong> – Helps convert food to energy, promotes cell repair, bone and muscle strength and temperature regulation.</p> <p><strong>14. Zinc</strong> – Helps maintain a healthy immune system and helps break down protein, fat and carbohydrates.</p> <p> </p> <p><strong>3. How common medications can affect vitamin absorption</strong></p> <p>That aspirin might be helping your headaches, but it might also be dragging down your vitamin levels. Here are six common drugs that can affect absorption.</p> <p><strong>1. Aspiri</strong>n – Causes a decrease in calcium levels and the amount of vitamins A, B and C.</p> <p><strong>2. Antibiotics</strong> – Reduce the amount of magnesium, calcium, iron and B vitamins.</p> <p><strong>3. Diuretics</strong> – Reduce the amount of potassium, magnesium zinc and B vitamins.</p> <p><strong>4. Laxatives</strong> – Reduce the absorption of vitamins A, E and D.</p> <p><strong>5. Blood thinners</strong> – Can’t be combined with vitamin K or E.</p> <p><strong>6. Cholesterol-lowering medications</strong> – Can’t be combined with vitamin A.</p> <p> </p> <p><strong>4. Which vitamins to combine for the best effect</strong></p> <p>If you’re taking supplements to boost your vitamin levels, it can be helpful to combine them with other minerals, which can increase their effectiveness and absorption.</p> <p><strong>1. Vitamin A</strong> – Best used with vitamins B, D and E, phosphorous, calcium and zinc.</p> <p><strong>2. B vitamins</strong> – Best used with vitamin C.</p> <p><strong>3. Vitamin C</strong> – Best used with calcium and magnesium.</p> <p><strong>4. Iron</strong> – Best used with vitamin C.</p> <p><strong>5. Vitamin D</strong> – Best used with calcium, phosphorous and vitamins A and C.</p> <p><strong>6. Calcium</strong> – Can’t be used with multivitamins containing iron.</p> <p> </p> <p><strong>5. Best food sources of vitamins and minerals</strong></p> <p>You don’t need supplements to get your recommended intake of vitamins. Here are eight vitamins you can get simply by adding certain foods to your diet.</p> <p><strong>1. Vitamin A</strong> – Milk, cheese, some fish and liver.</p> <p><strong>2. Vitamin B1</strong> – Liver, yeast, egg yolk, cereal, red meat, nuts and wheat germ.</p> <p><strong>3. Vitamin B2</strong> – Milk, liver, yeast, cheese, leafy greens and fish.</p> <p><strong>4. Vitamin B6</strong> – Lentils, fish, legumes, nuts, bran, meat, banana and potatoes.</p> <p><strong>5. Vitamin B12</strong> – Milk, cheese, eggs, yoghurt, meat, fish, poultry and tofu.</p> <p><strong>6. Vitamin C</strong> – Citrus fruits, leafy greens, kiwi fruit, strawberries, mangoes, capsicum, tomato, brussels sprouts and broccoli.</p> <p><strong>7. Vitamin D</strong> – Milk, soy and rice beverages, some fish, eggs, liver and fish liver oil.</p> <p><strong>8. Vitamin E</strong> – Vegetable oils, avocado, leafy greens, wheat germ, some nuts, sunflower seeds and peanut butter.</p> <p><strong>9. Vitamin K</strong> – Broccoli, soybeans and leafy greens.</p> <p><strong>10. Folate</strong> – Asparagus, cooked spinach, cos lettuce, beetroot, broccoli, corn, green peas, oranges, bread, lentils, seeds, liver and wheat germ.</p> <p><strong>11. Calcium</strong> – Milk, cheese, butter, yoghurt and leafy greens.</p> <p><strong>12. Iron</strong> – Lean red meat, oily fish, egg yolks, leafy greens, nuts, grains and wheat germ.</p> <p><strong>13. Magnesium</strong> – Leafy greens, grains and nuts.</p> <p><strong>14. Zinc</strong> – Meat, shellfish, milk, brown rice and grains.</p>

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Why these vitamins are useless and ripping you off

<p>As a nation, we’re spending more money than ever on vitamins and supplements in the pursuit of a longer, healthier life, but many of these products aren’t all that beneficial. In some cases, they may even be harmful.</p> <p>So which ones are worth your hard-earned cash? We take a look.</p> <p>While vitamin B supplements are touted as being good for keeping your brain sharp and warding off depression, dementia, heart disease, stroke and cancer, there’s little to no evidence that it’s true.</p> <p>On the other hand, there are a number of studies suggesting that <a href="https://www.ncbi.nlm.nih.gov/pubmed/10796569" target="_blank"><strong><span style="text-decoration: underline;">vitamin C</span></strong></a> and <a href="http://onlinelibrary.wiley.com/wol1/doi/10.1111/bcp.13057/abstract" target="_blank"><strong><span style="text-decoration: underline;">zinc lozenges</span></strong></a> could shorten the duration of a cold – but chances are they won’t help you avoid getting sick altogether.</p> <p>Vitamin D is a little more complicated. We’ve recently been hearing of a widespread vitamin D deficiency, but that only makes sense if scientists can agree on how much we actually need – which they haven’t.</p> <p>In fact, they’re still a little unclear on what vitamin D is actually helpful for. Some have suggested it may benefit bone health, others claim it could help sufferers of diabetes, depression and cancer, but none of these claims have been backed up by scientific evidence.</p> <p>As for vitamin E, nutritional epidemiologist Professor Katherine Tucker from the University of Massachusetts warns <a href="http://www.news.com.au/lifestyle/health/diet/which-vitamins-should-you-actually-buy/news-story/d2792082ed728a5fb653ceb7432ea3b9" target="_blank"><strong><span style="text-decoration: underline;">news.com.au</span></strong></a>, “don’t take it”. Scientists found it was not only unhelpful, but also may <a href="https://jamanetwork.com/journals/jama/fullarticle/1104493" target="_blank"><strong><span style="text-decoration: underline;">increase your risk</span></strong></a> of certain cancers.</p> <p>What about a multivitamin? Surely you can’t go wrong with that, right? Well, it won’t hurt, but it might not necessarily help, either. “There’s been some big studies that show they didn’t really have major effect," Professor Tucker explains.</p> <p>Do you take any vitamins or supplements? Do you believe they’ve helped improve your health? Share your thoughts with us in the comments below.</p>

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5 lesser known benefits of taking vitamin C

<p>Many people tell me they take a vitamin C supplement as part of their winter wellness regime, to help ward off illness during the colder months.</p> <p>Vitamin C is well known for its bolstering effect on the immune system, so I love to boost my vitamin C intake whenever I'm travelling, too.</p> <p>But this superstar nutrient has many other functions that are critical to how we look, feel and function on a daily basis.</p> <p>It's a nutrient that we must consume daily, and consuming additional amounts above what is needed to prevent a deficiency is associated with health benefits.</p> <p>Just in case you needed more reasons to love vitamin C, here are five of its lesser-known functions in the body:</p> <p><strong>1. Adrenal health</strong></p> <p>The adrenal glands love vitamin C! The adrenals produce our stress hormones (adrenalin and cortisol) as well as some of our sex hormones, so adrenal function – for which vitamin C is essential – is inextricably linked to how we feel.</p> <p>Vitamin C is used up when stress hormones are produced, so requirements may be increased during periods of stress (which unfortunately seems to be more often than not, these days). Chronic stress can also impact immune function and vitamin C is wonderfully supportive for this.</p> <p><strong>2. Efficient fat burning</strong></p> <p>Vitamin C is involved in the production of carnitine, a compound that is essential for transporting fatty acids into the mitochondria, the energy factories of each cell (think of each mitochondria as a mouse running on a wheel), so that they can be used for energy.</p> <p>Really think about this – fat is a slow burning fuel, so if you want to avoid an energy rollercoaster you want this process to be functioning optimally.</p> <p><strong>3. Maintaining the body's structure</strong></p> <p>Vitamin C is required for the production of collagen, a structural protein in bones, tendons, cartilage and skin. While many people have heard about the importance of collagen in the skin from a beauty perspective, its other roles seem to be less appreciated.</p> <p>Healthy bones and tendons are critical to our ability to move with ease and therefore for maintaining our body's functionality, and this has a huge impact on quality of life. Vitamin C is also essential for wound healing.</p> <p><strong>4. Improves iron absorption</strong></p> <p>Iron absorption from plant-based foods is enhanced in the presence of vitamin C. This is important considering that iron deficiency is the most common nutritional deficiency in the world.</p> <p>The presence of 75 milligrams of vitamin C can increase the amount of plant-based iron absorbed by around 300 per cent, or even more if the person is iron deficient. Include vitamin C rich vegetables with your meals. Brassica family vegetables such as broccoli, cauliflower, brussels sprouts and kale are good sources.</p> <p><strong>5. Reduced risk of chronic diseases</strong></p> <p>Vitamin C is a powerful antioxidant that reduces damage and inflammation in the body, helping to protect you from degenerative diseases. There is evidence that eating plenty of fruit and vegetables (which tend to be rich sources of vitamin C) as well as adequate vitamin C levels are associated with reduced risk of cardiovascular disease and some cancers. </p> <p>Great food sources of vitamin C include broccoli, capsicum, kiwifruit and citrus fruits, however it's important to know that preparation and cooking methods can influence the vitamin C content of these foods. Vitamin C is sensitive to heat and is water-soluble so it can be lost in water. Lightly steaming or stir-frying vegetables instead of boiling them will retain more vitamin C.</p> <p><em>Written by Dr Libby Weaver. Republished with permission of <a href="http://www.stuff.co.nz/" target="_blank"><strong><span style="text-decoration: underline;">Stuff.co.nz</span></strong></a>.</em></p>

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The vitamin that helps fend off Alzheimer’s

<p><em><strong>Richard Hoffman is a Lecturer in Nutritional Biochemistry at the University of Hertfordshire. He is a strong advocate of the Mediterranean diet.</strong></em></p> <p>A feeling of apathy or being a little forgetful from time to time is nothing unusual. But for some, this could be an early sign of not getting enough thiamine (also known as vitamin B1). Long term, this can have serious consequences, including an <strong><span style="text-decoration: underline;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/22218733" target="_blank">increased risk</a></span></strong> of developing Alzheimer’s disease.</p> <p>There is often a fatalistic attitude towards Alzheimer’s disease, with the belief that it’s a consequence of old age or it’s in our genes. But most old people don’t get Alzheimer’s disease, and it’s now clear that decisions made about <strong><span style="text-decoration: underline;"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60461-5/abstract" target="_blank">lifestyle</a></span></strong> and <strong><span style="text-decoration: underline;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/26294005" target="_blank">diet</a></span></strong> play a huge role in singling out those who will – and those who won’t – develop the disease.</p> <p>Ensuring your diet contains enough B vitamins is one of those crucial dietary decisions. And the central role of thiamine is <strong><span style="text-decoration: underline;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/26971083" target="_blank">now becoming apparent</a></span></strong>. The brain needs thiamine to use glucose for energy, and without adequate thiamine, <strong><span style="text-decoration: underline;"><a href="http://europepmc.org/abstract/med/21130821" target="_blank">brain cells die</a></span></strong>. The brain also needs thiamine to make acetylcholine, the main neurotransmitter that is deficient in patients with Alzheimer’s disease. Thiamine levels are frequently low in patients with Alzheimer’s disease and the early stages of cognitive decline, and there are <strong><span style="text-decoration: underline;"><a href="https://clinicaltrials.gov/ct2/show/NCT02292238" target="_blank">trials underway</a></span></strong> to see if taking thiamine derivatives can reduce the symptoms of this disease. The evidence is now pretty clear: a healthy brain needs an adequate supply of thiamine.</p> <p><strong>Getting enough thiamine</strong></p> <p>So how can you be sure you are getting enough of this essential brain vitamin? In the UK, thiamine is added to fortified cereals and bread, and other good sources include whole grain cereals, pork, trout, peas and beans. Government surveys in the UK present a generally reassuring picture, suggesting that for most people their <span style="text-decoration: underline;"><strong><a href="https://www.gov.uk/government/statistics/national-diet-and-nutrition-survey-results-from-years-1-to-4-combined-of-the-rolling-programme-for-2008-and-2009-to-2011-and-2012" target="_blank">thiamine intake is sufficient</a></strong></span>. But these surveys only report average intakes, and do not take into account groups who, for one reason or another, may be vulnerable to thiamine deficiencies.</p> <p>One of the groups vulnerable to thiamine deficiencies is <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4531469/" target="_blank">the elderly</a></strong></span>. And there are other groups, too, such as the steadily increasing numbers of people who avoid most cereal products (such as bread and pasta) because of gluten intolerance. These food products are the main source of thiamine in the average UK diet, so it’s not surprising that <strong><span style="text-decoration: underline;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/23198728" target="_blank">many gluten-intolerant people are thiamine deficient</a></span></strong>. Fortifying gluten-free alternatives with thiamine and other vitamins would be an obvious solution, but, unfortunately, this is not usually done. Followers of the Paleo diet also avoid cereal products, leaving this group <strong><span style="text-decoration: underline;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/27666153" target="_blank">vulnerable to thiamine deficiencies</a></span></strong> as well.</p> <p>Pork is an especially good dietary source of thiamine, but many people do not eat pork. Also, if you prefer your pork as sausages rather than fresh meat, then you are waving goodbye to most of the thiamine, since, in the UK, pork sausages are preserved with sulphites that destroy the thiamine. Some countries, such as the US, take a more sensible approach and have banned the use of sulphites in sausages for this very reason. Isn’t it time that the UK also removed sulphites from sausages and other foods where it is not necessary?</p> <p>Sausages are also very popular as part of ready meals. Ready meals are a rapidly increasing sector of the food market, but there is no requirement to label their vitamin content. This is especially concerning for the many, such as many older people, who <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/27170224" target="_blank">rely on ready meals</a></strong></span> for a large part of their daily vitamin intake.</p> <p>And it’s not only sausages that are of concern. Thiamine is heat sensitive, and being water soluble as well, it leaches out of vegetables and beans during cooking, and so could easily be lost during the manufacture of ready meals. Without adequate labelling, we simply don’t know the extent to which this may be occurring. As I have <strong><span style="text-decoration: underline;"><a href="https://www.cambridge.org/core/journals/journal-of-nutritional-science/article/div-classtitlemicronutrient-deficiencies-in-the-elderly-could-ready-meals-be-part-of-the-solutiondiv/8DEB91185B23FB25E76B6773B1BCF1E9" target="_blank">argued</a></span></strong>, the rapid growth of the ready meals market means there is a strong case for demanding greater information on the vitamin content of these meals.</p> <p><strong>The whole diet matters</strong></p> <p>Taking a vitamin supplement may seem an obvious way to boost thiamine intake to help maintain a healthy brain. This may be a good idea for some people, but thiamine – unlike most other vitamins – is poorly absorbed when taken as a supplement. There is a consensus among nutritionists that a better approach is a healthy diet, not least because multivitamin pills are linked to an increased <strong><span style="text-decoration: underline;"><a href="https://www.ncbi.nlm.nih.gov/pubmed/24965635" target="_blank">risk of cancer</a></span></strong> in some people. Also, it is only with a healthy diet that we can be sure of obtaining the myriad of vitamins, minerals and phytonutrients needed for a healthy brain.</p> <p>It is probably the wide range of brain-friendly nutrients – including thiamine – in the Mediterranean diet that makes it so effective at <span style="text-decoration: underline;"><strong><a href="https://www.ncbi.nlm.nih.gov/pubmed/24164735" target="_blank">reducing the risk of developing Alzheimer’s disease</a></strong></span>. In a way, it’s a shame that the Mediterranean diet wasn’t “invented” by a drug company as a means to help prevent or delay Alzheimer’s. If it was, it would probably be one of the most widely marketed and prescribed drugs in the world.</p> <p>It is not known to what extent thiamine deficiencies are contributing to the rise in Alzheimer’s disease. But despite the gloomy news about the rising tide of Alzheimer’s disease, there is certainly no need to feel powerless, as current research suggests that a healthy Mediterranean-style diet containing adequate thiamine can go a long way to help you fend off this disease.</p> <p><em>Written by Richard Hoffman. First appeared on <a href="https://theconversation.com/why-we-become-more-forgetful-with-age-and-what-you-can-do-about-it-70102" target="_blank"><strong><span style="text-decoration: underline;">The Conversation</span></strong></a>. </em></p>

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