Your bone strength and size peaks by age 30. After that, bones tend to become less dense, making them more fragile and subject to breaks. Bone strength in later life depends upon your peak bone mass in youth. An active lifestyle in youth can increase maximum bone density.

Even if you’re older, exercise is still a great way to protect your bones. The physical stress placed on bones during exercise stimulates the growth of new bone tissue. The type of exercise you do matters. To bolster your bones, you need to get regular weight-bearing exercise. This includes weight lifting and resistance training, as well as any type of activity that forces you to work against gravity by standing or carrying your body’s weight, including running, walking, dancing, and stair climbing. Activities such as swimming or biking aren’t weight-bearing and thus don’t build bone. Generally, higher-impact activities (such as running) or resistance exercises (such as strength training) have a more pronounced effect on bone than lower-impact exercises, such as walking.

Only the bones that bear the load of the exercise will benefit. For example, running protects bones in the hips and legs, but not the arms. A well-rounded strength training plan can benefit practically all of your bones.

Because exercise improves your overall strength, coordination, and balance, it also makes you less likely to fall, which means less opportunity to break a bone.

To read more about the many benefits of exercise and learn how to start an exercise program that works for you, contact Ronald on 07929 256856.

The next time you have a check-up, don’t be surprised if your doctor hands you a prescription to walk. Yes, this simple activity that you’ve been doing since you were about a year old is now being touted as “the closest thing we have to a wonder drug,” in the words of Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention.

Of course, you probably know that any physical activity, including walking, is a boon to your overall health. But walking in particular comes with a host of benefits. Here’s a list of five that may surprise you.

1. It counteracts the effects of weight-promoting genes. Harvard researchers looked at 32 obesity-promoting genes in over 12,000 people to determine how much these genes actually contribute to body weight. They then discovered that, among the study participants who walked briskly for about an hour a day, the effects of those genes were cut in half.

2. It helps tame a sweet tooth. A pair of studies from the University of Exeter found that a 15-minute walk can curb cravings for chocolate and even reduce the amount of chocolate you eat in stressful situations. And the latest research confirms that walking can reduce cravings and intake of a variety of sugary snacks.

3. It reduces the risk of developing breast cancer. Researchers already know that any kind of physical activity blunts the risk of breast cancer. But an American Cancer Society study that zeroed in on walking found that women who walked seven or more hours a week had a 14% lower risk of breast cancer than those who walked three hours or fewer per week. And walking provided this protection even for the women with breast cancer risk factors, such as being overweight or using supplemental hormones.

4. It eases joint pain. Several studies have found that walking reduces arthritis-related pain, and that walking five to six miles a week can even prevent arthritis from forming in the first place. Walking protects the joints — especially the knees and hips, which are most susceptible to osteoarthritis — by lubricating them and strengthening the muscles that support them.

5. It boosts immune function. Walking can help protect you during cold and flu season. A study of over 1,000 men and women found that those who walked at least 20 minutes a day, at least 5 days a week, had 43% fewer sick days than those who exercised once a week or less. And if they did get sick, it was for a shorter duration, and their symptoms were milder.

From fast food restaurants and delis exploding with high-calorie sandwiches to salad bars stocked with high fat and high sugar salad add-ons — lunchtime can be a minefield of temptation for those trying to eat a healthy and balanced diet.

But a healthful and enjoyable lunch can be done. These simple tips can help.

Your meal should include lean protein, whole-grain carbohydrates, and produce. Roughly half of your plate should be vegetables or fruit; one-quarter should be lean protein such as fish, chicken, turkey, tofu, beans, or low-fat cottage cheese; and one-quarter should be whole grains, such as one slice of whole-grain bread, or half a cup of brown rice, whole-wheat pasta, or quinoa. You might include a small amount of healthy fat, such as a tablespoon of oil-and-vinegar dressing on your salad.

Salad can be a good way to go, but you need to be careful. Regular salad dressings, cheeses, and mayonnaise-based salads (such as tuna, chicken, and egg salads) can contain unhealthy fats, hidden sugar, and salt. Not to mention lots of calories. Here’s the trick to a healthy and satisfying lunch salad.

Step 1: Build a vegetable base. Load your plate with leafy greens and raw or grilled vegetables.

Step 2: Add some protein — a few scoops of garbanzo or kidney beans. Beans are an excellent source of fiber — and they’re filling! Other good selections include grilled chicken, low-fat cottage cheese, or chopped eggs. Go light on the cheese. A sprinkle of a strongly flavored cheese like feta or Parmesan can deliver flavor with fewer calories.

Step 3: Add a small amount of healthy fat. Sprinkle on the nuts and seeds. They are high in heart-healthy unsaturated fat and healthy protein, give you a feeling of fullness, and help food stay in your stomach longer. You might also opt for a dash of oil and vinegar.

Step 4: Whole grains and fruit make a nice addition to a creative salad. Look for whole grains like barley or bulgur wheat to sprinkle on top. Or add a few slices of fruit.

If you want to learn about other effective strategies for healthy eating contact Ronald on 07929 256856

This quick and simple salad is a delicious solution to the age-old question, “What’s for dinner?” It’s filled with wholesome ingredients, protein and fiber to enhance your hard earned fitness results.

Servings: 6 
Here’s what you need:

For the Salad

• 2 cooked chicken breasts, chopped
• 1.2 cup cherry tomatoes, quartered
• 1 Tablespoon red onion, minced
• 1/2 cup cucumber, chopped
• 4 cups romaine lettuce, chopped
• 4 strips, cooked nitrate-free bacon, chopped
• 1 avocado, chopped

For the Dressing

• 1/8 cup olive oil
• 2 Tablespoons lemon juice
• 1 packet stevia
• 1 teaspoon crushed garlic
• 1 teaspoon Dijon mustard

Instructions

1. Combine all of the salad ingredients in a large salad bowl. Mix to combine.
2. Combine all of the dressing ingredients in a small bowl. Drizzle over the salad and serve.

Nutritional Analysis: One serving equals: 218 calories, 12g fat, 189mg sodium, 5g carbohydrate, 4g fiber, and 22g protein

Our bodies can obtain vitamin D from diet and make it from sun exposure. Even with these two routes for obtaining vitamin D, however, inadequate vitamin D is common, and deficiencies can be found on all continents, in all ethnic groups, and across all ages—a major concern, given the many ways that vitamin D helps protect our health. (1) There are a number of factors that increase the risk of having inadequate vitamin D, among them, lifestyle, sunscreen use, geographic location, skin tone, age, and body weight.

• Lifestyle: People who spend less time outdoors, or who cover up with clothing when they are outdoors, get less exposure to the sun, so they make less vitamin D. (1)
• Sunscreen Use: Correctly-applied sunscreen blocks the harmful ultraviolet B rays that cause skin cancer, but it also blocks most of the skin’s production of vitamin D. So people who use sunscreen daily are more likely to be low in vitamin D. (1) But don’t ditch the sunscreen: The American Academy of Dermatologists says that sunlight exposure to unprotected skin increases the risk of skin cancer, and that there’s no safe level of sunlight exposure that allows you to make vitamin D without increasing skin cancer risk. Their advice? Use sunscreen or other sun protection daily, skip the tanning booths, and get your vitamin D from diet or supplements. (2) Some Vitamin D experts take issue with the American Academy of Dermatologists’ hard line on sun exposure, and they recommend a more moderate option: Put sunscreen on your face, and allow your arms and legs to get a small amount of unprotected sun exposure—say, 15 minutes max—before applying sunscreen or covering up. It’s still a matter of scientific debate.
• Geographic Location and Season: In the summer, if you sat out in a bathing suit on a sunny afternoon for long enough to turn your skin slightly pink, you could make plenty of vitamin D. Yet during the late autumn and winter, people who live at higher latitudes produce little or no vitamin D from the sun, because the sun is at too low an angle in the sky. In the northern hemisphere, people who live in Boston (U.S.), Edmonton (Canada), and Bergen (Norway) can’t make enough vitamin D from the sun for 4, 5, and 6 months out of the year. (3) In the southern hemisphere, residents of Buenos Aires (Argentina) and Cape Town (South Africa) can make far less vitamin D from the sun during their winter months (June through August) than they can during their spring and summer. (3) The body stores vitamin D from summer sun exposure, but it must last for many months. By late winter, many people in these higher-latitude locales are deficient. (1)
• Skin Tone: People who have a darker skin tone have more melanin in their skin, and this pigment is a “natural sunscreen” that slows down skin production of vitamin D. (3)  This the main reason why African Americans are more likely to be low in vitamin D. (4)
• Age: The ability to make vitamin D in the skin drops as we age, and is one of the reasons why older individuals are more likely to have low vitamin D levels. (1)
• Body Weight: People with excess body fat have lower vitamin D levels, so those who are overweight or obese have a higher risk of having inadequate vitamin D.  (1, 5, 6)

The bottom line: Low vitamin D can be found in all ethnic and age groups, around the world, for a host of reasons. Even if you are taking a standard multiple vitamin, the amount of vitamin D in most vitamins (400 IU) is not enough to prevent low blood levels. If you suspect that you are at risk of vitamin D deficiency, you can ask your physician to order a blood test for vitamin D.

Legumes play an important role in traditional diets in many parts of the world. They are low in fat, are good sources of protein and fiber, and contain a variety of micronutrients and phytoestrogens (plant estrogens). Phytoestrogens have received a lot of attention for their ability to fight not only cancer, but also heart disease and osteoporosis. They help balance hormones in the body and thus are thought to be particularly valuable for the hormone-dependent cancers: breast cancer and prostate cancer. It is well known that male hormones play a role in prostate cancer development.

Despite their advantages, legumes play a minor role in most Western diets. The typical Western based diet (lower in vegetables and legumes and higher in animal-based foods) can cause an increase in both male and female hormones (androgens and estrogens), while a plant-based diet tends to lower these hormones. This is the basis for the role of diet in the development of hormone-dependent cancers.

Soy foods, such as tofu, soy milk, soy beans, and vegetarian burgers, seem to be particularly rich in cancer-fighting properties. This is at least partially due to a form of phytoestrogen, called isoflavones, that is found primarily in soy. It appears to help prevent prostate cancer by binding to male hormone receptors in the prostate, thus reducing the stimulating effect of male hormones on prostate cell growth.

Epidemiological studies have shown that high levels of isoflavones are often associated with low rates of breast, colon, and prostate cancer. This has been used to explain why countries such as Japan and China that typically consume large amounts of soy have lower risks of these diseases.

The difficulty with consuming soy for reducing risk of prostate cancer is the lack of clinical trial evidence to support its use. As with any dietary component, it is difficult to isolate the effect of a particular food type to prove its effectiveness. One prospective study, including over 12,000 men, did evaluate consumption of soy milk. It found that those who drank soy milk regularly had a reduced risk of prostate cancer. The relationship held up after other factors were controlled for. Other studies need to be done to further establish the benefits of soy. In the meantime, getting more soy foods into your diet can be healthy for many reasons, and lowering your risk of prostate cancer may be one of these.

Vitamin D Deficiency: A Global Concern

If you live north of the line connecting San Francisco to Philadelphia and Athens to Beijing, odds are that you don’t get enough vitamin D. The same holds true if you don’t get outside for at least a 15-minute daily walk in the sun. African-Americans and others with dark skin, as well as older individuals, tend to have much lower levels of vitamin D, as do people who are overweight or obese.

Worldwide, an estimated 1 billion people have inadequate levels of vitamin D in their blood, and deficiencies can be found in all ethnicities and age groups. (1-3)  Indeed, in industrialized countries, doctors are even seeing the resurgence of rickets, the bone-weakening disease that had been largely eradicated through vitamin D fortification. (4-6)

Why are these widespread vitamin D deficiencies of such great concern? Because research conducted over the past decade suggests that vitamin D plays a much broader disease-fighting role than once thought.

Being “D-ficient” may increase the risk of a host of chronic diseases, such as osteoporosis, heart disease, some cancers, and multiple sclerosis, as well as infectious diseases, such as tuberculosis and even the seasonal flu.

Currently, there’s scientific debate about how much vitamin D people need each day. The Institute of Medicine, in a long-awaited report released on November 30, 2010 recommends tripling the daily vitamin D intake for children and adults in the U.S. and Canada, to 600 IU per day. (7) The report also recognized the safety of vitamin D by increasing the upper limit from 2,000 to 4,000 IU per day, and acknowledged that even at 4,000 IU per day, there was no good evidence of harm. The new guidelines, however, are overly conservative about the recommended intake, and they do not give enough weight to some of the latest science on vitamin D and health. For bone health and chronic disease prevention, many people are likely to need more vitamin D than even these new government guidelines recommend.

Vitamin D Sources and Function

Vitamin D is both a nutrient we eat and a hormone our bodies make. Few foods are naturally rich in vitamin D, so the biggest dietary sources of vitamin D are fortified foods and vitamin supplements. Good sources include dairy products and breakfast cereals (both of which are fortified with vitamin D), and fatty fish such as salmon and tuna.

The body also manufactures vitamin D from cholesterol, through a process triggered by the action of sunlight on skin, hence its nickname, “the sunshine vitamin.”  Yet some people do not make enough vitamin D from the sun, among them, people who have a darker skin tone, who are overweight, who are older, and who cover up when they are in the sun. (1)

Correctly applied sunscreen reduces our ability to absorb vitamin D by more than 90 percent. (8) And not all sunlight is created equal: The sun’s ultraviolet B (UVB) rays—the so-called “tanning” rays, and the rays that trigger the skin to produce vitamin D—are stronger near the equator and weaker at higher latitudes. So in the fall and winter, people who live at higher latitudes (in the northern U.S. and Europe, for example) can’t make much if any vitamin D from the sun. (8)

Vitamin D helps ensure that the body absorbs and retains calcium and phosphorus, both critical for building bone. Laboratory studies show that vitamin D can reduce cancer cell growth and plays a critical role in controlling infections. Many of the body’s organs and tissues have receptors for vitamin D, and scientists are still teasing out its other possible functions.

New Vitamin D Research: Beyond Building Bones

Several promising areas of vitamin D research look far beyond vitamin D’s role in building bones. And, as you might expect, the news media release a flurry of reports every time another study links vitamin D to some new ailment. These reports can be confusing, however, because some studies are stronger than others, and any report needs to be interpreted in the light of all other evidence. More answers may come from randomized trials, such as the VITamin D and OmegA-3 TriaL (VITAL), which will enroll 20,000 healthy men and women to see if taking 2,000 IU of vitamin D or 1,000 mg of fish oil daily lowers the risk of cancer, heart disease, and stroke.

Here, we provide an overview of some of the more promising areas of vitamin D research, highlighting the complex role of vitamin D in disease prevention—and the many unanswered questions that remain.

Vitamin D and Bone and Muscle Strength

Several studies link low vitamin D levels with an increased risk of fractures in older adults, and they suggest that vitamin D supplementation may prevent such fractures—as long as it is taken in a high enough dose. (9-13)

A summary of the evidence comes from a combined analysis of 12 fracture prevention trials that included more than 40,000 elderly people, most of them women. Researchers found that high intakes of vitamin D supplements—of about 800 IU per day—reduced hip and non-spine fractures by 20 percent, while lower intakes (400 IU or less) failed to offer any fracture prevention benefit. (13)

Vitamin D may also help increase muscle strength, which in turn helps to prevent falls, a common problem that leads to substantial disability and death in older people. (14-16)  Once again, vitamin D dose matters: A combined analysis of multiple studies found that taking 700 to 1,000 IU of vitamin D per day lowered the risk of falls by 19 percent, but taking 200 to 600 IU per day did not offer any such protection. (17)

A recent vitamin D trial drew headlines for its unexpected finding that a very high dose of vitamin D increased fracture and fall risk in older women. (18) The trial’s vitamin D dose—500,000 IU taken in a once-a-year pill—was much higher than previously tested in an annual regimen. After up to 5 years of treatment, women in the vitamin D group had a 15 percent higher fall risk and a 26 percent higher fracture risk than women who received the placebo.

It’s possible that giving the vitamin D in one large dose, rather than in several doses spread throughout the year, led to the increased risk. (18) The study authors note that only one other study—also a high-dose, once-a-year regimen—found vitamin D to increase fracture risk; no other studies have found vitamin D to increase the risk of falls. Furthermore, there’s strong evidence that more moderate doses of vitamin D taken daily or weekly protect against fractures and falls—and are safe.

So what is the significance of this study for people who want to take vitamin D supplements? A reasonable conclusion would be to continue taking moderate doses of vitamin D regularly, since these have a strong safety record, but to avoid extremely high single doses. This recent finding does present a challenge to scientists who will work to understand why the extreme single dose appears to have adverse effects.

Vitamin D and Heart Disease

The heart is basically a large muscle, and like skeletal muscle, it has receptors for vitamin D. (19) So perhaps it’s no surprise that studies are finding vitamin D deficiency may be linked to heart disease. The Health Professional Follow-Up Study checked the vitamin D blood levels in nearly 50,000 men who were healthy, and then followed them for 10 years. (20) They found that men who were deficient in vitamin D were twice as likely to have a heart attack as men who had adequate levels of vitamin D. Other studies have found that low vitamin D levels were associated with higher risk of heart failure, sudden cardiac death, stroke, overall cardiovascular disease, and cardiovascular death. (21-24) How exactly might vitamin D help prevent heart disease? There’s evidence that vitamin D plays a role in controlling blood pressure and preventing artery damage, and this may explain these findings. (25) Still, more research is needed before we can be confident of these benefits.

Vitamin D and Cancer

Nearly 30 years ago, researchers noticed an intriguing relationship between colon cancer deaths and geographic location: People who lived at higher latitudes, such as in the northern U.S., had higher rates of death from colon cancer than people who live closer to the equator. (26) Many scientific hypotheses about vitamin D and disease stem from studies that have compared solar radiation and disease rates in different countries. These can be a good starting point for other research but don’t provide the most definitive information. The sun’s UVB rays are weaker at higher latitudes, and in turn, people’s vitamin D levels in these high latitude locales tend to be lower. This led to the hypothesis that low vitamin D levels might somehow increase colon cancer risk. (2)

Since then, dozens of studies suggest an association between low vitamin D levels and increased risks of colon and other cancers. (1,27)  The evidence is strongest for colorectal cancer, with most (but not all) observational studies finding that the lower the vitamin D levels, the higher the risk of these diseases. (28-38) Vitamin D levels may also predict cancer survival, but evidence for this is still limited. (27) Yet finding such associations does not necessarily mean that taking vitamin D supplements will lower cancer risk.

The VITAL trial will look specifically at whether vitamin D supplements lower cancer risk. It will be years, though, before it releases any results. It could also fail to detect a real benefit of vitamin D, for several reasons: If people in the placebo group decide on their own to take vitamin D supplements, that could minimize any differences between the placebo group and the supplement group; the study may not follow participants for a long enough time to show a cancer prevention benefit; or study participants may be starting supplements too late in life to lower their cancer risk. In the meantime, based on the evidence to date, 16 scientists have circulated a “call for action” on vitamin D and cancer prevention: (27) Given the high rates of vitamin D deficiency in North America, the strong evidence for reduction of osteoporosis and fractures, the potential cancer-fighting benefits of vitamin D, and the low risk of vitamin D supplementation, they recommend widespread vitamin D supplementation of 2000 IU per day. (27)

Vitamin D and Immune Function

Vitamin D’s role in regulating the immune system has led scientists to explore two parallel research paths: Does vitamin D deficiency contribute to the development of multiple sclerosis, type 1 diabetes, and other so-called “autoimmune” diseases, where the body’s immune system attacks its own organs and tissues? And could vitamin D supplements help boost our body’s defenses to fight infectious disease, such as tuberculosis and seasonal flu? This is a hot research area and more findings will be emerging.

Vitamin D and Multiple Sclerosis: Multiple sclerosis (MS) rates are much higher far north (or far south) of the equator than in sunnier climes, and researchers suspect that chronic vitamin D deficiencies may be one reason why. One prospective study to look at this question found that among white men and women, those with the highest vitamin D blood levels had a 62 percent lower risk of developing MS than those with the lowest vitamin D levels. (39) The study didn’t find this effect among black men and women, most likely because there were fewer black study participants and most of them had low vitamin D levels, making it harder to find any link between vitamin D and MS if one exists.

Vitamin D and Type 1 Diabetes: Type 1 diabetes is another disease that varies with geography—a child in Finland is about 400 times more likely to develop it than a child in Venezuela. (40) Evidence that vitamin D may play a role in preventing type 1 diabetes comes from a 30-year study that followed more than 10,000 Finnish children from birth: Children who regularly received vitamin D supplements during infancy had a nearly 90 percent lower risk of developing type 1 diabetes than those who did not receive supplements. (41)  Other European case-control studies, when analyzed together, also suggest that vitamin D may help protect against type 1 diabetes. (42) No randomized controlled trials have tested this notion, and it is not clear that they would be possible to conduct.

Vitamin D, the Flu, and the Common Cold: The flu virus wreaks the most havoc in the winter, abating in the summer months. This seasonality led a British doctor to hypothesize that a sunlight-related “seasonal stimulus” triggered influenza outbreaks. (43) More than 20 years after this initial hypothesis, several scientists published a paper suggesting that vitamin D may be the seasonal stimulus. (44) Among the evidence they cite:

• Vitamin D levels are lowest in the winter months. (44) 
• The active form of vitamin D tempers the damaging inflammatory response of some white blood cells, while it also boosts immune cells’ production of microbe-fighting proteins. (44) 
• Children who have vitamin D-deficiency rickets are more likely to get respiratory infections, while children exposed to sunlight seem to have fewer respiratory infections. (44) 
• Adults who have low vitamin D levels are more likely to report having had a recent cough, cold, or upper respiratory tract infection. (45)

A recent randomized controlled trial in Japanese school children tested whether taking daily vitamin D supplements would prevent seasonal flu. (46) The trial followed nearly 340 children for four months during the height of the winter flu season. Half of the study participants received pills that contained 1,200 IU of vitamin D; the other half received placebo pills. Researchers found that type A influenza rates in the vitamin D group were about 40 percent lower than in the placebo group; there was no significant difference in type B influenza rates. This was a small but promising study, and more research is needed before we can definitively say that vitamin D protects against the flu. But don’t skip your flu shot, even if vitamin D has some benefit.

Vitamin D and Tuberculosis: Before the advent of antibiotics, sunlight and sun lamps were part of the standard treatment for tuberculosis (TB). (47) More recent research suggests that the “sunshine vitamin” may be linked to TB risk. Several case-control studies, when analyzed together, suggest that people diagnosed with tuberculosis have lower vitamin D levels than healthy people of similar age and other characteristics. (48)   Such studies do not follow individuals over time, so they cannot tell us whether vitamin D deficiency led to the increased TB risk or whether taking vitamin D supplements would prevent TB. There are also genetic differences in the receptor that binds vitamin D, and these differences may influence TB risk. (49) Again, more research is needed. (49)

Vitamin D and Risk of Premature Death

A promising report in the Archives of Internal Medicine suggests that taking vitamin D supplements may even reduce overall mortality rates: A combined analysis of multiple studies found that taking modest levels of vitamin D supplements was associated with a statistically significant 7 percent reduction in mortality from any cause. (50) The analysis looked at the findings from 18 randomized controlled trials that enrolled a total of nearly 60,000 study participants; most of the study participants took between 400 and 800 IU of vitamin D per day for an average of five years. Keep in mind that this analysis has several limitations, chief among them the fact that the studies it included were not designed to explore mortality in general, or explore specific causes of death. More research is needed before any broad claims can be made about vitamin D and mortality. (51)