Month: May 2014

Asthma 哮喘

Asthma is an inflammatory condition of the lungs where the walls of the airways are inflamed and swollen. This makes the muscles surrounding the airways very sensitive, so they tighten and constrict at the slightest stimulus. In addition, membranes in the airway linings secrete excess mucus. The result is narrowed airways and obstructed airflow that typically result in wheezing and shortness of breath.

Studies on asthma and allergies conducted by doctors in Singapore revealed that the prevalence of asthma and allergic rhinitis and eczema, have remained consistently high.
The prevalence of asthma and allergies in Hong Kong is comparable to that of many of its neighboring territories. A positive family history of asthma and allergy is frequently present.

Doctors usually treat asthma by recommending the use of corticosteroid pharmaceutical drugs and/or puffers. This suppresses the immune system reaction and opens up the narrowed airways again, allowing air to pour in. Regular usage may disrupt the natural function of the immune system.

Possible signs and symptoms

Commonly experienced symptoms of asthma include shortness of breath, chest tightness, wheezing and coughing.

Possible causes

Caused by allergic and non-allergic factors involving air pollutants such as dust, pollen, grass, ragweed, mold spores, dust mites, animal dander and cockroach excrement. Stress is also a contributing factor.

Applied nutrition

Supplement Benefit Suggested Dosage
 Protein Replace intake of animal protein with plant protein. A high quality protein supplement that supplies balanced amounts of the nine essential amino acids. 1 scoop,
2x daily
Multivitamin + minerals + phytonutrients Improves overall health and assures proper nutrition. Reduces inflammation. As instructed on packaging
Multi-carotene Needed for tissue repair and improves immunity. 1 tab daily
B Complex Stimulates the immune system. B5 reduces stress-related responses; B6 is helpful in the treatment of allergies-based asthma; B12 reduces lung inflammation during an attack. 2 tabs,
3x daily
Vitamin C + bioflavonoids Powerful free radical destroyer and anti-inflammatory agent. 5 tabs,
3x daily
Parselenium E A powerful antioxidant that protects the airways from damage by free radicals. 1 tab,
2x daily
Garlic Needed to protect lung tissue and suppress infection. Also increases airflow and fights inflammation 2 tabs,
3x daily

Invest in a high quality air purification appliance where the patient sleeps and spends most of his/her time.
Do aerobic exercise in a clean-air environment.

Monitor patient progress until next appointment 1 month later.

Arthritis 风湿病

Arthritis is the inflammation of one or more joints. It causes painful joints, swelling and stiffness, which can be due to a variety of causes. There are also many different forms of arthritis – two of the most common being Osteoarthritis and Rheumatoid arthritis. Arthritis generally manifests itself in pain, swelling and inflammation at the affected joint.

Osteoarthritis is associated with ageing and can affect any joint. The cartilage of the affected joint is gradually worn down, eventually causing bone to rub against bone. Bony spurs develop on the unprotected bones causing pain and inflammation. There are other causes such as congenital effects, trauma and metabolic disorders. Joints appear larger, are stiff, painful and usually feel worse the more they are used throughout the day.

Rheumatoid arthritis is a systemic autoimmune disease which initially attacks the synovium, a connective tissue membrane that lines the cavity between joints and secretes a lubricating fluid.

Applied nutrition

Supplement Benefit Suggested Dosage
Protein A  high-quality protein supplement specially formulated wholly from plants. It supplies balanced amounts of the nine essential amino acids. 1-2 scoops,
3x daily
Omega 3 These fatty acids are necessary for health and cannot be generated by the body (essential fatty acids). These increase production and activity of anti-inflammatory prostaglandins. They may assist in relieving symptoms associated with arthritis 1 tab,
2x daily
Calcium + magnesium Needed to prevent bone loss. Calcium is a natural tranquilizer. Together with magnesium, it relives anxiety, tension, nervousness and muscular spasms. 3 tabs,
3x daily
B Complex  Needed for proper digestion, formation of cells, production of myelin and the protective coating around the nerves. Prevents nerve damage 3 tabs,
3x daily
Parselenium E A powerful antioxidant that protects the joints from damage by free radicals. Increases joint mobility. Low levels of vitamin E is found in people with arthritis and Lupus. 1 tab,
1x daily
Vitamin C + bioflavonoids Powerful free radical destroyer and anti-inflammatory agent.  Bioflavonoids enhance the activity of vitamin C. 3 tabs,
3x daily
Glucosamine HCI Very important to the formation of bones, tendons, ligaments, cartilage and synovial joint fluid. 3 tabs,
3x daily

Anaemia 贫血

Anaemia is a condition in which there aren’t enough healthy red blood cells (haemoglobin) to carry adequate oxygen to body tissues causing fatigue. To produce haemoglobin and red blood cells, your body needs ample iron and complimentary vitamins from the foods you eat.

Many forms of anaemia exist, each with its own cause. Anaemia can be temporary or long-term, and it can range from mild to severe. Anaemia can be a sign of serious illness. Some types of anaemia can be prevented by having a healthy, varied diet, through serious cases have to be referred to medical professionals.

Possible signs and symptoms

Weakness, pale skin, rapid heartbeat, low blood pressure, shortness of breath, chest pain, dizziness, cognitive problems, numbness or coldness in the periphery, headaches.

Possible causes

Broadly, causes of anaemia may be classified as impaired red blood cell (RBC) production, increased RBC destruction (hemolytic anaemias), blood loss and fluid overload (hypervolemia). Several of these may interplay to cause anemia eventually. Indeed, the most common cause of anaemia is blood loss, but this usually does not cause any lasting symptoms unless a relatively impaired RBC production condition develops, in turn most commonly by iron deficiency.

Applied nutrition

Supplement Benefit Suggested Dosage
Protein A high-quality protein supplement specially formulated wholly from plants. It supplies balanced amounts of the nine essential amino acids. 1 scoop,
3x daily
Multivitamin + minerals + phytonutrients Supplies a balance of nutrients important in red blood cell production As indicated on packaging
B Complex Essential in red blood cell production and to break down and prepare protein for cellular use 4 tabs,
3x daily
Iron + folic acid Needed for red blood cell formation. Plant-derived iron does not interfere with vitamin E absorption. 1 tab,
3x daily
Vitamin C + bioflavonoids Important for iron absorption 2 tabs,
3x daily

Alzheimer’s disease (AD) 老人痴呆症

Alzheimer’s disease, a form of dementia, is a progressive form, incurable disease of the brain caused by the degeneration and eventual death of nerve cells in the brain. It affects memory, thinking and behaviour.

Memory impairment in one of the following areas will also be present: language, decision-making ability, judgement, attention, personality and other areas of mental function.
Possible signs and symptoms

During early stages, the symptoms of AD may be subtle and resemble signs that people mistakenly attribute to “natural ageing”. These include:

  • Repeating statements
  • Misplacing items
  • Getting lost on familiar routes
  • Personality changes
  • Losing interest in hobbies
  • Difficulty performing tasks
  • Having trouble finding names for familiar objects.

Possible causes

In addition to age and family history, risk factors for AD include: longstanding high blood pressure; history of head trauma; being female; and high levels of homocysteine – a bodily chemical that contributes to chronic illnesses such as heart disease, depression and possible AD.

To reduce AD risk, all persons should be encouraged to engage in activity which stimulates mental activity in all stages of their lives.

Applied nutrition

Supplement Benefit Suggested Dosage
Protein Basic building block and necessary party of living cells in the body. Produces collagen and promotes skin repair, smoothing and softness. 1 scoop, 2x daily
Co-enzyme Q10 Increase oxygenation of cells and increase generation of cellular energy 2 tabs, 2x daily
Iron + folic acid Aids controlling homocysteine levels 1 tab, 2x daily
Calcium + magnesium Sustains nerve integrity, calms the nerves. 2 tabs, 3x daily
Lecithin + vitamin E Needed to improve memory. Deficiencies of antioxidants expose the brain to oxidative damage. Helps to transport oxygen to the brain cells and protects them from free radical damage. 2 tabs, 2x daily
Multivitamin + minerals + phytonutrients Provides general nutritional supplementation. As indicated on packaging
B Complex Important for proper brain function and digestion. Deficiency can cause depression and mental difficulties in people with AD 2 tabs, 2x daily
Omega 3 These are the brain’s cellular building blocks 1 tab, 2x daily
Ginkgo biloba + ginseng Assists brain function and concentration. Builds memory. 2 tabs, 2x daily

Take honeybee products (honey, propolis) and increased intake of fruits and vegetables.

Acne 暗疮

The cause of acne is unknown. Acne is most common in teenagers but it can happen at any age. 3 out of 4 teenagers have acne to some extent, probably caused by hormonal changes that stimulate oil production. However, people in their 30s or 40s may also have acne.

Acne is most likely caused by overactive glands. The excess oil allows bacteria to become trapped inside the pores, causing inflammation (redness).

Factors that contribute to this condition include heredity, oily skin and other factors such as allergies, diet and stress. A healthy, well balanced diet, clean skin, plenty of filtered water, adequate rest, exercise and fresh air are beneficial to the treatment of acne.

Applied Nutrition

Supplement Benefit Suggested dosage
Protein  Basic building block and necessary party of living cells in the body. Produces collagen and promotes skin repair, smoothening and softness. 1 scoop, 2x daily
Multi Carotene Converted to vitamin A, strengthens epithelial skin. Strong antioxidant. 1 tab, 2x daily
B Complex Important for healthy skin tone. Deficiencies of vitamin B6 have been associated with acne. B3 improves blood flow to the surface of the skin. 2 tabs, 2x daily
Bio C Plus Promotes immune function and reduces inflammation. Needed for skin collagen repair. 3 tabs, 3x daily
Lecithin E Lecithin increases skin hydration. Vitamin E provides antioxidant effects and enhances healing and tissue repair. 4 tabs, 2x daily
Garlic + Licorice Natural antibiotic, destroys bacteria and enhances immune function. 2 tabs. 2x daily

Magnesium 鎂

Overview

Every organ in the body, especially the heart, muscles, and kidneys, needs the mineral magnesium. It also contributes to the makeup of teeth and bones. Most important, it activates enzymes, contributes to energy production, and helps regulate calcium levels, as well as copper, zinc, potassium, vitamin D, and other important nutrients in the body.

You can get magnesium from many foods. However, most people do not get as much magnesium as they should from their diet. Foods rich in magnesium include whole grains, nuts, and green vegetables. Green leafy vegetables are particularly good sources of magnesium.

Although you may not get enough magnesium from your diet, it’s rare to be severely deficient in magnesium. Certain medical conditions, however, can upset the body’s magnesium balance. For example, an intestinal virus that causes vomiting or diarrhea can cause temporary severe magnesium deficiencies. Some gastrointestinal diseases (such as irritable bowel syndrome or IBS and ulcerative colitis), diabetes, pancreatitis, hyperthyroidism (high thyroid hormone levels), kidney disease, and taking diuretics can lead to deficiencies. Too much coffee, soda, salt, or alcohol, as well as heavy menstrual periods, excessive sweating, and prolonged stress can also lower magnesium levels.

Symptoms of magnesium deficiency may include agitation and anxiety, restless leg syndrome (RLS), sleep disorders, irritability, nausea and vomiting, abnormal heart rhythms, low blood pressure, confusion, muscle spasm and weakness, hyperventilation, insomnia, poor nail growth, and even seizures.

Uses

Getting enough magnesium may enhance the effectiveness of conventional treatment for the following conditions:

Asthma
Several studies show that intravenous (IV) magnesium and magnesium inhaled through a nebulizer can help treat acute attacks of asthma in children 6 – 18 years of age, as well as adults. Low levels of magnesium may increase risk of developing asthma. A population based clinical study of more than 2,500 children 11 – 19 years of age found that low dietary magnesium intake may be associated with risk of asthma. The same was found in a group of more than 2,600 adults 18 – 70 years of age.

Depression
Inadequate magnesium appears to reduce serotonin levels, and antidepressants have been shown to raise brain magnesium. A 2008 study found that magnesium was as effective as the tricyclic antidepressants in treating depression among people with diabetes.

Diabetes
People who have type 2 diabetes often have low levels of magnesium in the blood. A large clinical study of over 2,000 people found that getting more magnesium in the diet may help protect against developing type 2 diabetes. Some studies suggest that taking magnesium supplements may help blood sugar control and insulin sensitivity in people with diabetes or prediabetes.

Noise related hearing loss
One study suggests that taking magnesium may prevent temporary or permanent hearing loss due to very loud noise.

Arrhythmia and heart failure
Magnesium is essential to heart health. Studies suggest a possible association between a modestly lower risk of CHD in men and increased magnesium intake. In one study of women, higher dietary intakes of magnesium were associated with a lower risk of sudden cardiac death. Magnesium helps maintain a normal heart rhythm and is sometimes given intravenously (IV) in the hospital to reduce the chance of atrial fibrillation and cardiac arrhythmia (irregular heartbeat). People with congestive heart failure (CHF) are often at risk for developing cardiac arrhythmia.  One well designed study found that taking magnesium orotate for a year reduced symptoms and improved survival rates compared to placebo in people with CHF. Magnesium and calcium work together at very precise ratios to ensure your heart functions properly.

Results of studies using magnesium to treat heart attack survivors, however, have been mixed. Some have reported lower death rates, as well as fewer arrhythmias and improved blood pressure when magnesium is used as part of the treatment following a heart attack.

High blood pressure
Eating low fat dairy products, along with lots of fruits and vegetables on a regular basis, is associated with lower blood pressure. All of these foods are rich in magnesium, as well as calcium and potassium. A large clinical study of more than 8,500 women found that a higher intake of dietary magnesium may decrease the risk of high blood pressure in women. A few studies also suggest that magnesium supplements may help lower blood pressure, although not all studies agree.

Migraine headache
A few studies suggest that taking magnesium supplements may help prevent migraine headaches. In addition, a few clinical studies suggest that magnesium supplements may shorten the duration of a migraine and reduce the amount of medication needed. People who have migraine headaches tend to have lower levels of magnesium compared to those with tension headaches or no headaches at all.

Some experts suggest combining magnesium with the herb feverfew along with vitamin B2 (riboflavin) may be helpful when you have a headache.

However, some studies suggest that magnesium sulfate may be less effective than prescription medications for preventing migraines in those who have 3 or more headaches per month. The only exception to this may be women who get migraine headaches around the time of their period.

Osteoporosis
Not getting enough calcium, vitamin D, magnesium, and other micronutrients play a role in the development of osteoporosis. To prevent osteoporosis, it is important to get enough calcium, magnesium, and vitamin D; to eat a well balanced diet; and to do weight bearing exercises throughout life.

Preeclampsia and eclampsia
Preeclampsia is characterized by a sharp rise in blood pressure during the third trimester of pregnancy. Women with preeclampsia may develop seizures, which is then called eclampsia. Magnesium, given in the hospital intravenously (IV), is the treatment of choice to prevent or treat seizures associated with eclampsia or to prevent complications from preeclampsia.

Premenstrual syndrome (PMS)
Scientific studies suggest that magnesium supplements may help relieve symptoms associated with PMS, particularly bloating, insomnia, leg swelling, weight gain, and breast tenderness. One study suggests that a combination of magnesium and vitamin B6 may work better than either one alone.

Dietary Sources

Rich sources of magnesium include tofu, legumes, whole grains, green leafy vegetables, wheat bran, Brazil nuts, soybean flour, almonds, cashews, blackstrap molasses, pumpkin and squash seeds, pine nuts, and black walnuts. Other good dietary sources of this mineral include peanuts, whole wheat flour, oat flour, beet greens, spinach, pistachio nuts, shredded wheat, bran cereals, oatmeal, bananas, and baked potatoes (with skin), chocolate, and cocoa powder. Many herbs, spices, and seaweeds supply magnesium, such as agar seaweed, coriander, dill weed, celery seed, sage, dried mustard, basil, cocoa powder, fennel seed, savory, cumin seed, tarragon, marjoram and poppy seed.

It is a good idea to take a B vitamin complex, or a multivitamin containing B vitamins, because the level of vitamin B6 in the body determines how much magnesium will be absorbed into the cells.

Upper Limits

The Council for Responsible Nutrition recommends an upper limit of 400 mg per day (supplemental) for healthy adults.

Sources

University of Maryland Medical Center
Council for Responsible Nutrition

Vitamin A

Overview

Vitamin A has essential actions in areas of health including:

  • helping cells reproduce normally — a process called “cellular differentiation.”
  • good vision — the first sign of a vitamin A deficiency is often poor sight at night.
  •  proper development of an embryo and foetus.
  • keeping skin and mucous membranes that line the nose, sinuses, and mouth healthy
  • playing a role in immune system function, growth, bone formation, reproduction, and wound healing.

Beta-carotene is synthesised in humans to form vitamin A and vitamin A activity from high intakes of carotenes seems not to produce adverse levels of vitamin A. The safety of beta-carotene itself will be discussed separately from vitamin A.

Vitamin A is fat-soluble and readily accumulates in the liver. Therefore, if taken at high dosages on a daily basis, the vitamin can easily accumulate to dangerous levels in the liver and other tissues. However, in nutritionally deprived populations who do not have a steady, sufficient intake of vitamin A, the same high dosages may be necessary as occasional supplements in order to prevent the severe health consequences of vitamin A deficiency. This makes the safety of vitamin A highly dependent on both the daily level of intake and the duration of consumption.

Uses

Acne, Psoriasis, Eczema and other Skin disorders
Vitamin A can help clear up severe acne and psoriasis and have shown promise for treating other skin disorders, premature aging from the sun and warts.

Eye Disorders
Getting enough vitamin A in your diet is essential for good vision. Research shows that people who eat more foods with vitamin A are less likely to develop age-related macular degeneration. In addition, a large population study found that people who got high levels of vitamin A though their diets had a lower risk of developing cataracts. Vitamin A supplements may help slightly slow down the damage from retinitis pigmentosa, a hereditary disease that causes poor night vision.

Measles
For children who have vitamin A deficiency, supplements can reduce the severity and complications of measles. Children who are deficient in vitamin A are more likely to develop infections, including measles. In areas of the world where vitamin A deficiency is widespread or where at least 1% of those with measles die, the World Health Organization recommends giving vitamin A supplements to children who have measles. However, vitamin A does not seem to help unless a child has vitamin A deficiency. Never give a child high-dose vitamin A supplements without expert supervision.

Inflammatory Bowel Disease (IBD)
People with IBD, both ulcerative colitis and Crohn’s disease, may have a hard time absorbing all the nutrients their bodies need. Health care providers often recommend that people with IBD take a multivitamin, including vitamin A.

Cancer
Whether vitamin A can reduce the risk of cancer is not clear. People who eat a healthy diet with enough beta-carotene and other carotenoids from fruits and vegetables seem to have a lower risk of certain cancers, such as breast, colon, oesophageal, and cervical cancer. And some laboratory studies suggest that vitamin A and carotenoids may help fight certain types of cancer in test tubes.

One preliminary study suggests that a topical form of vitamin A may reduce abnormal growth of cells on the cervix, called cervical neoplasia.

Researchers are also investigating retinoids, a synthetic form of vitamin A, for skin cancer. People with certain types of skin cancer tend to have lower levels of vitamin A and beta-carotene in the blood.

Sources

Vitamin A, in the form of retinyl palmitate, is found in beef, calf, and chicken liver; eggs; fish liver oils; and dairy products, including whole milk, whole milk yoghurt, whole milk cottage cheese, butter, and cheese.

The body can also make vitamin A from beta-carotene and other carotenoids, fat-soluble nutrients found in fruits and vegetables that give them their colour. Most dark-green leafy vegetables and deep yellow/orange vegetables and fruits — sweet potatoes, carrots, pumpkin and other winter squashes, cantaloupe, apricots, peaches, and mangoes — contain substantial amounts of beta-carotene. By eating these beta-carotene rich foods, you can increase levels of vitamin A in your body.

Upper intake limits and risks

Regular intakes of excess vitamin A can lead to liver abnormalities (25,000 IU), bone fragility (27,000 IU) and birth defects (30,000 IU).

The Council for Responsible Nutrition considers supplements of 10,000 IU (3,000 µg) per day of preformed retinol to be safe for most people. As stated earlier, the recommendations for nutritionally replete populations must be considered separately from nutritionally deprived populations. In addition, even within nutritionally replete populations, intake from food sources can vary widely. Therefore, for people who consume high levels of vitamin-A-fortified foods or liver, a lower limit of 5,000 IU (1,500 µg) per day is recommended.

Vitamin D

Overview

Vitamin D is a fat-soluble vitamin that plays a role in many important body functions. It is best known for working with calcium in your body to help build and maintain strong bones. Vitamin D is also involved in regulating the immune system and cells, where it may help prevent cancer.

In children, a vitamin D deficiency can cause rickets, a condition of soft, weak bones. In adults, many people may not be getting enough vitamin D, especially those who work in offices and the elderly. People with dark skin do not absorb sunlight as easily as those with light skin, so their risk of low vitamin D is even higher. One study of childbearing women in the Northern U.S. found that 54% of African-American women and 42% of white women had low levels of vitamin D.

That’s important because researchers are beginning to find that low levels of vitamin D may be linked to other diseases, including breast and colon cancer, prostate cancer, high blood pressure, depression, and obesity. The evidence doesn’t prove that too little vitamin D causes these conditions, but that people with higher levels of vitamin D are less likely to get these diseases.

Uses

Getting the proper amount of vitamin D may help prevent several serious health conditions.

Osteoporosis
Vitamin D helps your body absorb and use calcium, which you need for strong bones. Getting enough vitamin D throughout your life is important, since most bone is formed when you are young. For post-menopausal women who are at higher risk of osteoporosis, taking vitamin D along with calcium supplements can reduce the rate of bone loss, help prevent osteoporosis, and may reduce the risk of fractures.

Other Bone Disorders
Vitamin D protects against rickets and osteomalacia, softening of the bones in adults. Seniors who do not get direct sunlight for at least 45 minutes per week should make sure they get enough vitamin D through food supplements.

Prevention of Falls
People who have low levels of vitamin D are at greater risk of falling, and studies have found that taking a vitamin D supplement (700 – 1000 IU daily) may reduce that risk. In seniors, vitamin D may reduce falls by 22%.

Parathyroid Problems
The four parathyroid glands are located in the neck. They make parathyroid hormone (PTH), which helps the body store and use calcium and phosphorus. Vitamin D is often used to treat disorders of the parathyroid gland.

High Blood Pressure (Hypertension)
In population studies, people with low levels of vitamin D seem to have a high risk of developing high blood pressure than those with higher levels of vitamin D. However, there’s no proof that low levels of vitamin D cause high blood pressure in healthy people.

Evidence about vitamin D and blood pressure has been mixed. When people with kidney disease or an overactive parathyroid gland (hyperparathyroidism) develop high blood pressure, low levels of vitamin D may play a role. But another large study found that taking vitamin D and calcium supplements did not lower blood pressure significantly or reduce the risk of developing high blood pressure in postmenopausal women. If you have high blood pressure, you should follow your optimal health guide’s advice about whether vitamin D might help.

Cancer
There is some evidence that getting enough vitamin D may lower your risk of certain cancers, especially of the colon, breast, prostate, skin, and pancreas. This evidence is based mostly on studies of large groups of people

Some research suggests that postmenopausal women who take calcium and vitamin D supplements may have a lower risk of developing cancer of any kind compared to those who don’t take these supplements.

Seasonal Affective Disorder (SAD)
SAD is a type of depression that happens during the long dark winter months. It is often treated with photo (light) therapy. A few studies suggest that the mood of people with SAD improves when they take vitamin D directly.

Diabetes
Population studies find that people who have lower levels of vitamin D are more likely to develop type 2 diabetes than people who have higher levels of vitamin D. But there is no evidence that taking vitamin D can help prevent or treat type 2 diabetes.

One study found that giving infants doses of 2,000 IU per day of vitamin D during the first year of life may help protect them from developing type 1 diabetes when they are older.

Heart Disease
Population studies suggest that people with low levels of vitamin D have a greater risk of developing heart disease, including heart attack, stroke, and heart failure compared to people with higher levels of vitamin D. Low levels of vitamin D may increase the risk of calcium build-up in the arteries. Calcium build-up is part of the plaque that forms in arteries when you have atherosclerosis and can lead to a heart attack or stroke. Other population studies show that people with lower levels of vitamin D are more likely to have risk factors for heart disease, including high blood pressure, type 2 diabetes, obesity, and high cholesterol.

Obesity
Population studies have found that people who have lower levels of vitamin D are more likely to be obese compared to people with higher levels of vitamin D. One high-quality study also found that postmenopausal women who took 400 IU vitamin D plus 1,000 mg calcium daily for 3 years were less likely to gain weight than those who took placebo, although the weight difference was small. Women who were not getting enough calcium to start with (less than 1,200 mg per day) saw the most benefit.

Overall Mortality
Population studies suggest that people with lower levels of vitamin D have a higher risk of dying from any cause.

Dietary and other natural sources

Vitamin D has been described as a sunshine-dependent vitamin. Some dietary vitamin D2 comes from plants, but the largest contribution to dietary intake of vitamin D is the vitamin D3 in fish liver oils, eggs, milk, and liver. Milk is commonly fortified with 10 µg (400 IU) of vitamin D3 per quart. Extremely high potency (40,000 to 50,000 IU) products—sold as prescription or sometimes over the counter—often consist of vitamin D2. Most vitamin D dietary supplements contain vitamin D3. The conversion of international units to metric weights is extremely simple for both vitamin D2 and D3: 1 µg equals 40 IU; 0.025 µg equals 1 IU.

Vitamin D3 (or D2) from foods, or vitamin supplements is inert and must undergo two hydroxylation reactions in the body for activation. The first occurs in the liver and the second in the kidneys, which converts the vitamin D into calcitrol As calcitriol, vitamin D is fundamentally involved in the formation of bone, and so its deficiency can lead to rickets in children or osteoporotic changes in adults.

Although the vitamin can be synthesised in the body with sufficient exposure to sunlight or another ultraviolet (UV) light source, most people are not exposed to such UV light in consistent and sufficient quantities. No extra vitamin D is required when skin exposure to UV light is ample; but without such exposure, a person is completely dependent on ingested vitamin D.

Although adequate UV light exposure can provide sufficient vitamin D, many elderly persons have limited sunlight exposure, inadequate dietary sources, and a decreased ability to activate vitamin D, making them susceptible to vitamin D deficiency (Gloth et al. 1995; Holick 1999). Elderly people are likely to have substantially increased needs for dietary vitamin D because of their decreased mobility and exposure to sun and decreased activation in the liver and kidneys.

Thus, the nutritional need for dietary vitamin D depends on the biosynthesis in the skin, which in turn is influenced by time of exposure to sunlight, season (sun intensity and clothing), latitude, skin pigmentation, and the use of sunscreens.

Safety Considerations and limits

The formation of vitamin D in the skin is slowed once dietary vitamin D intakes are sufficient and blood levels of the activated forms are high. Therefore, excess exposure to sunlight does not lead to vitamin D toxicity (Holick 1999; Hathcock et al. 2007).

Dietary vitamin D can, however, produce toxic effects when consumed in very large quantities, especially over an extended period of time. Studies have shown that subjects with abnormally high levels of vitamin D intake can suffer from a wide range of signs and symptoms, from dehydration to permanent mineral deposits in soft tissues, including muscle, heart, kidney, and cartilage. Continued intake of toxic levels can have severe and persistent adverse consequences.

The traditional—but not data-based—conservatism of vitamin D recommendations is rapidly being corrected to evidence-based assessments. These assessments indicate that larger amounts are now considered safe for most persons. The Council for Responsible Nutrition recommends upper limits for  vitamin D supplementation of 250 µg (4,000 IU) per day.

Beta Carotene

Overview

Beta-carotene is one of many hundreds of food carotenoids. Beta-carotene is the most abundant form of provitamin A (material that can be converted into vitamin A) in fruits and vegetables. It gives yellow and orange fruits their rich colours. Beta carotene is an effective source of vitamin A in both conventional foods and vitamin supplements, and is generally safe.

Beta-carotene is an antioxidant. It protects the body from damaging molecules called free radicals. Free radicals damage cells through a process known as oxidation. Over time, this damage can lead to a number of chronic illnesses. There is good evidence that eating more antioxidants foods helps boost your immune system, protect against free radicals, and may lower your risk of heart disease and cancer.

Studies have shown that people with high intakes of beta-carotene or high blood levels of this nutrient have a reduced risk of various diseases, including cancer and heart disease (van Poppel and Goldbohm 1995).  In addition, beta-carotene and some other carotenoids may play an important role in facilitating cell-to-cell communications (Acevedo and Bertran 1995). Because many carcinogens inhibit such cellular communications (Gregus and Klaasen 1996), protection of this activity by dietary substances could be an important function in the protection against cancer.

Dietary Sources

The richest sources of beta-carotene are yellow, orange, and green leafy fruits and vegetables (such as carrots, spinach, lettuce, tomatoes, sweet potatoes, broccoli, cantaloupe, and winter squash). In general, the more intense the colour of the fruit or vegetable, the more beta-carotene it has.

Beta-carotene is fat-soluble, so you should take it with meals containing at least 3 g of fat to ensure absorption.

Limits and safety levels

Extensive data show that beta-carotene supplements of 50 mg every other day (the equivalent to 25 mg per day) can be taken for more than a decade without harm in a large group of mostly nonsmokers (Hennekens et al. 1996). The Council for Responsible Nutrition concludes that an intake of 25 mg per day is acceptable for non-smokers. Skin discolouration may occur with larger amounts, but this effect is harmless and self-correcting with intake reduction.

The only evidence of adverse effects of beta-carotene comes from the ATBC and CARET studies, which involved long-term heavy smokers and asbestos workers. These data suggest a LOAEL of 20 mg per day for smokers or asbestos workers, but disparities between the ATBC and CARET results and other data prevent confident identification of any LOAEL for beta-carotene. Smokers and asbestos workers should first control these health risks, then evaluate whether beta-carotene supplements are necessary.

Sources

University of Maryland Medical Center

Phosphorus

Overview

Next to calcium, phosphorus is the most abundant mineral in the body. These two important nutrients work closely together to build strong bones and teeth. About 85% of phosphorus in the body can be found in bones and teeth, but it is also present in cells and tissues throughout the body. Phosphorus helps filter out waste in the kidneys and plays an essential role in how the body stores and uses energy. It also helps reduce muscle pain after a hard workout. Phosphorus is needed for the growth, maintenance, and repair of all tissues and cells, and for the production of the genetic building blocks, DNA and RNA. Phosphorus is also needed to help balance and use other vitamins and minerals, including vitamin D, iodine, magnesium, and zinc.

Most people get plenty of phosphorus in their diets. The mineral is found in milk, grains, and protein rich foods. Some serious health conditions such as diabetes, starvation, and alcoholism can cause levels of phosphorus in the body to fall. The same is true of conditions that make it hard for people to absorb nutrients, such as Crohn’s disease and celiac disease. Some medications can cause phosphorus levels to drop, including some antacids and diuretics (water pills). Symptoms of phosphorus deficiency include loss of appetite, anxiety, bone pain, fragile bones, stiff joints, fatigue, irregular breathing, irritability, numbness, weakness, and weight change. In children, decreased growth and poor bone and tooth development may occur.

Having too much phosphorus in the body is actually more common and more worrisome than having too little. Too much phosphorus is generally caused by kidney disease or by consuming too much dietary phosphorus and not enough dietary calcium. Several studies suggest that higher intakes of phosphorus are associated with an increased risk of cardiovascular disease. As the amount of phosphorus you eat rises, so does the need for calcium. The delicate balance between calcium and phosphorus is necessary for proper bone density and prevention of osteoporosis. Many soft drinks contain phosphoric acid, which increases the requirement for calcium. If the increase calcium requirements are not satisfied, such drinks can lead to calcium-deficiency issues.

Uses

Phosphates (phosphorus) are used clinically to treat the following:

  • Hypophosphatemia, low levels of phosphorus in the body
  • Hypercalcemia, high blood calcium levels
  • Calcium based kidney stones

Phosphates are also used in enemas as laxatives. Most people get plenty of phosphorus in their diets. Sometimes athletes use phosphate supplements before competitions or heavy workouts to help reduce muscle pain and fatigue, although it’s not clear how much it helps or if it improves performance.

 

Dietary Sources

Protein rich foods, such as meat, poultry, fish, eggs, dairy products, nuts, and legumes, are good sources of phosphorus. Other sources include whole grains, hard potatoes, dried fruit, garlic cloves, and carbonated beverages.

Upper Limits

As most people get plenty of phosphorous from their diets, supplementation is not recommended. The Council for Responsible Nutrition puts the upper limit for supplemental phosphorous at 1,500 mg / day, to maintain its optimal 1:1 ratio with calcium.

Source

University of Maryland Medical Center