Archive for General Health

The Importance of Healthy Gut Microbiota

 

Many of you may have seen the recent two part series on Catalyst regarding the importance of healthy gut bacteria, also known as gut microbiota or gut microbiome. They were fantastic episodes and relayed a very important health message that was easy to grasp and understand. If you missed these, I encourage you to watch them on iview. It will be worth your time.

This is a topic that I have lectured on extensively during both my trips to the US this year, and one that I am very excited about. Whilst watching Catalyst I was reassured to know that I had captured all the latest research and information for my lectures. At times it felt like they were reading from my lecture notes!

 

Historical Perspective

It would be quite understandable, after watching Catalyst, to be left with the impression that all of this information is new. In actual fact that is not the case. Hipprocrates, who is regarded as the Father of Western Medicine, spoke about the dangers of an unhealthy gut, “Death sits in the bowel” and “A bad digestive system is the root of all health evils”. Hippocrates lived between 460 and 377 years BC. So, you can see humans have known about the influence of the gut on health and disease for a very long time.

What is new is the science that helps us gain an understanding of how and why the gut is so influential on our health. Most importantly modern science is telling what causes altered gut microbiota (dysbiosis) and what we can do about it.

Physicians in the late 19th and early 20th centuries believed that the health of the gut influenced many aspects of health, including mental/emotional health. Modern science now shows us that anxiety and depression can be induced in both animals and humans simply by causing dysbiosis. By the 1930’s, theories about the importance of the gut in health and disease began of lose favour and the medical profession moved on to newer explanations of disease causes, one of which was Freudian psychology.

So, basically we have come full circle. Our forefathers dating back to Hippocrates (and perhaps beyond) understood that a healthy gut is the basis of good health throughout the body.

 

Functions of Gut Microbiota

After spending many hours reading research on this topic I have been left with the belief that there is not a tissue, organ or cell in the human body that is not influenced by the gut microbiota.

The functions performed by the gut microbiota are vast and I suspect, not yet fully understood.  One of the most fascinating and important factors to know is:

“The gut microbiome performs activities that are not encoded in the human genome

In other words the gut microbiome performs functions essential to life, that we are not capable of performing for ourselves. We are absolutely dependent on our gut microbes not only for our health but for our very lives. The term ‘super-organism’ has been used to describe the combination of humans and the microbes that inhabit them. The two are inseparable. It is a truly symbiotic relationship.

 

Major Influences on Gut Microbiota Population

  • Antibiotics. It is common knowledge that antibiotics can cause detrimental changes in gut microbes but there may be a few things that you do not know. We don’t necessarily have to take antibiotics ourselves in order to be exposed to them. Exposure can occur through the food we eat. For example, antibiotics are fed to food animals raised intensively eg in feed lots. Vegetables may also be a source of long-term exposure to low dose antibiotics. Scientists in America have found antibiotics in vegetables grown in manure from animals that had been fed antibiotics.
  • Diet. Diet is considered to be the control switch for the intestinal microbiota, its health and diversity. A diet high in fibre rich foods such as vegetables, fruits, whole grains, nuts and seeds, and low in refined, fatty, sugary foods will nurture a healthy gut.
  • Infant nutrition. Breast fed infants have healthier gut microbiota than those who are formula fed. Human breast milk contains mediators which modify the pattern of intestinal microbiota.
  • How you are born. Babies born vaginally have a healthier array of gut microbes than those born via caesarian section. During vaginal birth, babies are exposed to their mother’s vaginal and intestinal microbes. It is important for the mother to have a healthy gut microbiota during pregnancy, at birth and during breastfeeding. In one study, when women took probiotics for the last few weeks of pregnancy and for the first 3 months of breast feeding, there were fewer incidences of allergic diseases in the children as they aged.
  • Stress. There is a bi-directional line of communication between the gut and the brain (gut-brain axis). Research has shown that stress alone can cause dysbiosis, which in turn can have a negative impact on emotional health. Basically a vicious cycle is set up.
  • Poor upper digestive function. Inadequate hydrochloric acid in the stomach not only reduces our ability to digest food and obtain nutrients, research has shown us that it is also a major cause of lower gut dysbiosis.
  • Intestinal infection and infestation. This can be due to parasites, fungal, bacterial or viral infections. Candida is a common gut infection I see in my clinic. This can escape from the gut and become systemic, causing a wide array of symptoms. This organism is also responsible for vaginal thrush in women and can also infect men.
  • Too little or too much exercise. Exercise is important but it needs to be the right about for you as an individual.

 

Conditions Linked to Dysbiosis

  • Autoimmune diseases. Research is indicating that dysbiosis may play a role in the development of all autoimmune diseases. It is important to remember that autoimmune diseases are complex and there is never a single cause but for many people dysbiosis may be an important factor, not only in causing the disease but also in sustaining it.
  • Gut disorders. Dysbiosis is probably a major factor in many gastrointestinal disorders including:
    •  Irritable bowel syndrome
    • Inflammatory bowel diseases
    • Excessive flatulence
    • Certain types of food sensitivities
    • Chronic diarrhoea and constipation
    • Diverticular disease
    • Gastrointestinal infections and intestinal overgrowth eg Candida
    • SIBO (small intestinal bacterial overgrowth)
  • Other disorders include:
    •  Allergies
    • Poor immunity
    • Chronic skin disorders
    • Lack of well-being, low energy and poor digestion
    • Emotional and psychiatric problems eg anxiety, depression
    • Obesity, metabolic syndrome, type 2 diabetes

 

How to Improve Gut Microbiota

  • The number one way to ensure that you have healthy gut microbiota is to have a healthy diet  – high in fibre rich foods such as vegetables, fruits, whole grains, nuts and seeds, and low in refined, fatty, sugary foods.
  • Engage regularly in a healthy level of exercise.
  • Minimise toxins as much as possible in your food, water, home and work environments.
  • Try to avoid exposure to antibiotics in your food – eat free range chickens and eggs; organic or grass fed meat.
  • Avoid taking antibiotics unless absolutely necessary.
  • Have a positive attitude to life. When necessary use methods/practices to minimise your stress levels. Any healthy practice that works for you is good. Take appropriate herbal medicines to improve your body’s capacity to respond to stress.

 

Natural Medicines

There are many herbal and nutritional medicines that can help to improve the health of your entire digestive system. When treating dysbiosis in the colon it is important to consider the health of the whole digestive system. The specific medicines used will depend on the gut health and general health of the individual involved. For example, if the dysbiosis in the colon is caused by low hydrochloric acid production in the stomach, there is no point focusing all treatment on only the colon. This will create only temporary improvement in the microbiota population. We must, at the same time as treating the colon, use remedies that will improve hydrochloric acid production in the upper gut. This will give us a more holistic and longer lasting solution.

I hope this brief article gives you a better understanding and an appreciation of how important the health of our digest tract is to our overall health, and what you can do to improve the health of your gut microbiota.

This is basic naturopathic philosophy which is now, thanks to modern research, also part of main stream modern medicine.

 

 

 

 

 

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Adrenal Fatigue

Adrenal Fatigue
Adrenal fatigue or deficiency is a major cause of fatigue and is also associated with hormonal imbalances. The most common cause of adrenal fatigue is STRESS. Add to this the fact adrenal fatigue in itself is stressful and you can see it is a problem that needs to be remedied quickly.

Every type of stress makes demands on the adrenal glands. Stress is not restricted to emotional stress i.e. situations when we know we are stressed. Stress can also exist in the body without us being aware of it. For example, situations that stress the body without necessarily causing emotional stress include nutritional deficiencies; exposure to environmental toxins via our food, water and air; inefficient detoxification pathways in the body; and reduced production of natural antioxidants in the body. This is just a few of the ‘unnoticed’ stresses that can occur.

A certain amount of stress is normal and in fact necessary for our continued survival, however when the stress burden becomes too great the adrenal glands begin to suffer.

What is adrenal fatigue?
The adrenal glands are small walnut sized glands that sit on top of the kidneys. Despite their small size they have huge responsibilities. They play an important role in healthy glucose metabolism, energy maintenance, the ability to relax, body weight and the production of hormones.

Adrenal fatigue describes a situation where the adrenal glands are not working to their full potential and therefore not producing a sufficient amount of hormones needed for good health, in particular cortisol and DHEA.

Initially in the stress response levels of cortisone and DHEA increase but with continued stress the adrenal glands cannot keep up the demand and the levels of these hormones decrease. This means a decrease in energy, reduced brain power, increased inflammation in the body and unwanted changes in the immune system.
Symptoms of adrenal fatigue

The symptoms of adrenal fatigue are many and varied, and may be different from one person to another. It is important to note that most of the symptoms that are associated with adrenal fatigue can also exist in other conditions, for example thyroid disease, menopause.

Symptoms include:
• Fatigue
• Disturbed sleep
• Depression, anxiety, inability to cope, moodiness
• Reduced or no interest in sex
• Immune system dysfunction
• Increased infections
• Autoimmune disorders
• Thyroid disturbances
• Blood sugar and insulin disturbances
• Muscle weakness
• Inflammation

You can see from this list of symptoms what a big impact there is when the adrenals are not operating efficiently.
Healing the adrenals
Herbal medicines

There are many herbal medicines that help to restore adrenal function and protect the adrenals from further damage from stress. Two of these herbs are considered to be adrenal tonics, Rehmannia and Licorice. Both of these herbs are used widely by Naturopaths to improve adrenal function, whether it is overactive or underactive as in the case of adrenal fatigue. It is interesting that both of these herbs also have very effective anti-inflammatory activity. Licorice can be contraindicated in some situations eg hypertension and oedema so it should be prescribed carefully at the correct dose for the individual.

Herbs that protect the adrenals from the effects of continued stress are called ‘adaptogens’. This name arises from the fact that they actually help the body adapt to stress. For many years there has been a large amount of research into these herbs and we are gaining a much greater understanding of them as a result. There are a number of mechanisms by which these herbs actually improve the stress response.

One of the major factors involved is the increased production of a particular type of protein in the cell called ‘heat shock’ proteins otherwise known as ‘molecular chaperones’ because the protect proteins inside the cells during times of stress. They also stimulate the immunity and protect from infection and disorders associated with immune system.

The major adaptogenic herbs include Korean ginseng, Siberian Ginseng, Withania, Rhodiola, Schisandra, Codonopsis and Astragalus. The correct adaptogen/s has to be chosen carefully for each individual person to suit their symptoms and their situation. They certainly would not all be taken together.

The adaptogenic herbs not only support the stress response they also improve immunity, enhance sense of wellbeing and improve physical and mental performance. They are truly remarkable herbs and are indeed the remedies the 21st centuary.

Nutritional medicines
An overall good nutritional status is important for healthy adrenal function but there are some nutrients that are specific for the adrenals.
• Tyrosine – an amino acid that helps the body adapt to and cope with the effects of physical and psychological stress
• B Complex vitamins are important, particularly vitamin B5
• Vitamin C – the adrenal glands store large amounts of vitamin C and this is used up quickly during times of stress

Other important nutrients include magnesium for healthy nervous system function and healthy glucose metabolism. Zinc is also very important as a co-factor for many enzyme reactions throughout the body and it is often deficient.

Diet and the adrenals
It is important to think about what we eat and when we eat. One of the major effects of stress is poor food choices. We often choose fast, convenient food that fills us quickly so that we can move onto the next task etc. In most cases these foods will be full of refined carbohydrates, saturated fats and sugars. This leads to increased weight, blood sugar and insulin problems, low energy and further adrenal depletion. Low energy leads to cravings for more refined carbohydrates and sugars leading to even lower energy and adrenal function. It becomes a vicious cycle!

Caffeine is another item that is often consumed in large quantities when people are tired. There is no doubt it will initially pick up energy but that energy does not last and is usually followed by a crash. The main source of caffeine is traditionally coffee but in recent years we have seen the introduction of high caffeine containing energy drinks. The majority of these contain large amounts of sugar along with the caffeine. Other sources include tea and chocolate and the herb Guarana. Caffeine has profound detrimental effects on the adrenals and should be avoided during times of high stress and adrenal overload.

Wise dietary choices
In general eat meals and snacks made of fresh whole foods such as whole grains and lots of fresh vegetables and some fresh fruit. Good quality protein is also important and helps to maintain energy levels and blood sugar levels when consumed with each meal throughout the day. Protein can be obtained from animal sources such as lean meats, free range chicken and eggs, fish and sea foods, dairy products; or from vegetable sources such as soy bean products which contain whole proteins. Dried legumes such as lentils, chick peas, kidney beans etc do not contain whole protein and should be combined with a grain on the same day. This provides all the essential amino acids necessary for the body to make proteins.

Stress management
Recognising the cause of stress and eliminating it as much as possible is a great start to adrenal health. We certainly cannot always escape from the things that stress us, so we can find ways to manage the stress whilst, at the same time using the adrenal tonic and adaptogenic herbs to improve our stress response.

Stress management techniques need to be discovered individually. One activity will not suit everyone. For example, some people find that vigorous exercise is a great stress management tool whilst for others it would be too strenuous and further deplete the adrenals. Although moderate exercise is always a good thing, too much will damage the adrenals, reduce energy, deplete immunity and lead to further problems.

Any activity that you love doing that helps you chill out is a good stress management tool and should be used on a daily basis.

If you are to have healthy adrenal functioning there are many factors to be considered and a multi-pronged approach, taking into account all the points discussed above, is usually needed. If you can follow these simple guidelines, and seek professional advice for herbal and nutritional prescriptions, you adrenals will be healthier as a result.

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Peace of Mind and Your Breathing

How many times when things get out of control in your life has someone told you to take a deep breath? Well, it is good advice. When we are under stress, feeling anxious or angry, we tend to have short and shallow breathing, which only increases the muscle tension and limits our oxygen intake. This is one reason why in stressful situations, we tend to make poor decisions or have accidents as our breathing prevents our brain from getting enough oxygen to function at its best.

One of the breathing techniques that can help you relax, release anger and tension is also called diaphragmatic or abdominal breathing. It involves breathing from the abdomen, by fully filling your lungs with air on inhale and then fully emptying it out on exhale.

You can practice it by following these steps:

  • Lie on your back with your knees bent to remove strain from your lower back.
  • If you are doing it the first time, place your hand on the center of your abdomen below your chest. Inhale slowly through your nose. While inhaling, your chest should rise lightly and your abdomen should expand and rise, making the hand on your abdomen slightly higher than your chest. This means you have drawn enough air into your lungs.
  • Exhale slowly through your mouth by entirely emptying your lungs and let your abdomen fall.
  • Repeat this breathing pattern a few times and focus on your breath and technique.

If you have trouble falling asleep, practice this technique before your bed time.

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Brown Rice Reduces the Risk of Type 2 Di

Brown Rice Reduces the Risk of Type 2 Diabetes

Brown rice reduces the risk of developing type 2 diabetes whilst white rice increases the risk.
A number of studies looking at the effect of rice on type 2 diabetes risk have found the following:
• White rice – people who had at least 5 servings per week had a higher risk of developing type 2 diabetes than those who had less than 1 serve per month
• Brown rice – people who had at least 2 servings per week had a lower risk for developing type 2 diabetes than those who consumed less than 1 serve per month
You can see from this data that 2 servings of brown rice per week can help to prevent type 2 diabetes. Whereas on the other hand the more white rice that is consumed the greater the risk of developing type 2 diabetes.
This information is particularly beneficial for those people who already have type 2 diabetes or who are at risk of developing it.

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How to Prevent Migraines • Avoid trigger

How to Prevent Migraines
• Avoid triggering factors as much as possible
• Avoid becoming over-tired
• Avoid the build up of stress. If you know you are coming up to a stressful time seek treatment that will greatly reduce the effects of the stress. If you are a regular client at Herbal Nature give us a call and we can organise for you to pick up the appropriate medicines.
Or if you haven’t been to our clinic or if we haven’t seen you for some time you may need to make an appointment. It will be well worth it!
• Make time to relax regularly. If you feel your back, neck and shoulder muscles tensing up have a massage or acupuncture treatment to relieve the tension, thus reducing the likelihood of a migraine developing.
• Adopt stress management techniques that you enjoy. For example, regular massage and/or acupuncture treatments, yoga, Reiki treatments, make time for yourself on a regular basis.
• Use preventative treatments such as Feverfew and Willow Bark as used in the recent clinical trial.
• Acupuncture is very beneficial for the prevention of migraines.

There is much that can be done
Migraine is a complex condition and the mechanisms involved are not fully understood however there is much that can be done to prevent the occurrence of migraines or at the very lease reduce their frequency and severity.

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Triggers for Migraine Stress – One of th

Triggers for Migraine
Stress – One of the triggers for migraine in many people is stress, although the migraine may not occur until after the stressful event. Stress can initiate a migraine (or other types of headaches) because of the tightening of muscles around the neck and shoulders. Finding ways of management stress can be very beneficial. There are many herbal medicines that help the body to cope with stress much better and some are given specifically to prevent headaches and migraines associated with stress. Our clinical experience show that these work very well as part of the management and treatment of migraines.

Menstrual Cycle – Many women will experience migraines at specific times during their menstrual cycle. Most commonly the migraines will occur in the premenstrual phase however they can also occur at other times during the cycle. When headaches are associated with the menstrual cycle part of the treatment must include herbs can correct hormonal irregularities and/or the woman’s sensitivity to changing hormonal levels that occur naturally throughout the cycle.

Diet – Diet can definitely be a trigger for migraine in many sufferers. The offending foods vary greatly between individuals however the most common foods associated with the onset of a migraine include cheese, chocolate, citrus fruits and alcohol, especially red wine.

Sluggish liver function – The liver is responsible for many functions in the body however one of its major functions is the elimination of toxins. If there is reduced ability for the liver to perform this important task, toxins can build up and cause or contribute to the onset of migraine headaches.
Decreased liver function can also lead to food intolerances and sluggish bowel function, which further contributes to migraines.

Other triggers include too little or too much sleep, tiredness/fatigue, bright lights, noise, excessive heat or exposure to chemicals.

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Feverfew and Willow Bark for Migraines –

Feverfew and Willow Bark for Migraines – New Clinical Trial

There has been several clinical trials that show the effectiveness of long-term use of Feverfew for management of migraines. These trials demonstrate that it can take several months to have a significant reduction in the frequency of migraines. The length of time taken to achieve results may be dose related.

In a recent clinical trial researchers used much higher doses of Feverfew and combined it with Willow Bark. The trial went for 12 weeks in total and achieved the following results:

• a 57% reduction in the frequency of migraines within a 6-week period and a 61.7% reduction after 12 weeks of the herbal therapy
• a 38.7% reduction in migraine severity after 6 weeks and a 62.6% reduction after 12 weeks of treatment
• a 27.2% reduction in migraine duration at 6 weeks and a 76.2% reduction after 12 weeks

These results are very interesting and suggest that the combination of the correct dose of Feverfew and Willow Bark is well worth trying for the treatment/management of recurrent migraines.

If you have tried Feverfew previously and found it ineffective this new treatment regime may give better results.

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An Apple A Day…… We have all heard the s

An Apple A Day……
We have all heard the saying, “An apple a day keeps the doctor away”. Well, according to research carried out in Poland this old saying appears to be true, at least in the case of bowel cancer.
Researchers found that eating as little as 1 apple per day seemed to reduce the risk of developing colorectal cancer. The risk reduction correlated with the number of apples per day.
It is thought that the protective effect is probably caused by antioxidants in apples. These antioxidants inhibit cancer onset and the growth of cancer cells.
Fresh fruit and vegetables generally provide lots of antioxidants and should be eaten in significant quantities everyday. In light of this research it might be worth adding an apple a day to your diet.
To read the abstract go to this PubMed link:
http://www.ncbi.nlm.nih.gov/pubmed?term=42%5Bpage%5D+AND+Jedrychowski+W%5Bauthor%5D&cmd=detailssearch

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Avoid Winter Infections

Avoid Winter Infection

It is inevitable that an unexpected strain of influenza will occasionally hit our shores. A few years ago it was SARS. This year it is swine flu which is caused by type A influenza (H1N1). Swine influenza is usually confined to pigs and until recently human infection with the virus was rare (limited to 3 people). However, in March 2009 human cases of swine flu began emerging in Mexico and in some areas of the United States, mainly affecting healthy young adults. More than 100 people have died from the virus in Mexico. The infection is not limited to the Northern Hemisphere. In New Zealand 10 students returning from Mexico have tested positive to swine flu and suspected cases in Australia are being monitored.

Prevention
Queensland Health has stated on their website that the seasonal influenza vaccine is unlikely to offer useful protection against swine flu. So what can you do?

The very best protection against infection is a healthy immune system. If your immune system is healthy it has a very good chance of fighting any type of infection so that illness does not occur or, if symptoms do occur the severity will be reduced. As always prevention is easier than cure and it is necessary that we go into winter as healthy as possible. This means having a healthy diet, regular exercise and plenty of rest and relaxation. These lifestyle factors are fundamental to optimal immune function. Adequate levels of vitamin C, zinc and many of the B Complex vitamins are necessary for healthy immunity.

Immune Enhancing Herbs
Apart from these fundamental necessities, there are many herbal medicines that can help to improve the immune system, thus avoiding or minimising infection. Perhaps the best known of these is Echinacea, which is one of the most commonly prescribed herbs by health professionals around the world. However, not all Echinacea products are the same. Patients will often say, “I have already tried Echinacea and it didn’t work”. What has to be asked in such situations is “which Echinacea product was used and how much was taken?” It often turns out that the patient was unknowingly taking a cheap low quality product or an ineffective dose.

The quality and dose issues are best illustrated by a clinical trial conducted in the USA. The product used was made from the roots of 2 Echinacea species, Echinacea purpurea and Echinacea angustifolia. These are considered to be the most active species and their roots are the most potent part. Several doses were used in the trial, but it was found that only when the dose exceeded 2000 mg per day did regular use of Echinacea significantly prevent colds.

Apart from Echinacea there are many other herbs that are very beneficial for the prevention and treatment of winter infections. When treating winter infections, each individual’s requirements differ and in some cases a combination of herbs may be more beneficial for the prevention and treatment of winter infections.

Once a viral infection has taken hold it is often necessary to use a combination of immune enhancing herbs to bring about a quick recovery. Herbs such as Andrographis, Cat’s Claw and Sacred Basil can be very beneficial for the treatment of acute infections. As already discussed for Echinacea, quality of the herbs has to be high and the dosage needs to be correct for the individual and the type of infection.

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Vitamin D Deficiency is Common

Vitamin D Deficiency is Common

 

In Brief

  • Vitamin D deficiency is common in Australia
  • In many cases Australians do not receive adequate vitamin D from casual sun exposure
  • Vitamin D is essential for healthy, strong bones and is protective against cancer
  • Postmenopausal are at greatest risk of osteoporosis and vitamin D deficiency significantly increases the risk
  • Many women I see in my clinic have low levels of vitamin D
  • All adults should be checked routinely for vitamin D deficiency, particularly those in the high risk groups discussed below
  • Vitamin D supplementation may be necessary

 

 

What is vitamin D?

Vitamin D is a fat soluble vitamin, also called calciferol and sunlight vitamin. Although small amounts of Vitamin D can be obtained from some foods (see below), the majority of our vitamin D is produced by the body when UV radiation in sunlight hits our skin and reacts with a cholesterol-like substance in the skin. It is the only vitamin that is manufactured in body and is also considered a hormone. After being produced in the skin vitamin D enters the circulation and travels to liver and kidneys where it is synthesised into its active form.

 

Prevalence of vitamin D deficiency in Australia

The prevalence of vitamin D deficiency in Australia varies, however according to an article in the Medical Journal of Australia it is much higher than previously thought. Studies have shown that vitamin D deficiency is common in the elderly with up to 76% having a marginal deficiency. Other studies have shown that up to 43% of younger adults have inadequate vitamin D levels. The highest rates of severe deficiency occur in dark-skinned, veiled, and pregnant women with a deficiency incidence of up to 80%.

 

The importance of vitamin D

Adequate levels of vitamin D are essential for healthy, strong bones. Therefore its importance increases in menopausal and postmenopausal women, who are already at risk of developing osteoporosis due to decreased oestrogen levels.

 

Vitamin D is necessary for calcium absorption and for regulating calcium and phosphate concentrations in the blood, which ensure normal mineralisation of bone. Without sufficient vitamin D bones can become weak and the incidence of fracture may increase.

 

Ensuring healthy bones is not the only job of vitamin D. It also plays important roles in the health and functioning of the immune system, neuromuscular function and in the reduction of inflammation. In addition, vitamin D plays a role in the prevention and treatment of type 1 and type 2 diabetes, hypertension, glucose intolerance, autoimmune thyroid disease and multiple sclerosis.

 

Vitamin D deficiency and increased cancer risk

Vitamin D has potent anticancer properties and vitamin D deficiency may be associated with an increased incidence of a number of cancers, particularly those of the gastrointestinal tract.  According to a study published in 2008, low vitamin D status may increase breast cancer risk in post-menopausal women. 4 Vitamin D may also play a role in the outcome for cancer patients.

 

Vitamin D deficiency in children

In recent times vitamin D deficiency has re-emerged as a significant health issue in children. This can result in seizures (due to low calcium), limb pain, fractures and rickets.

 

Vitamin D deficiency in pregnant women will result in a deficiency in their infants. Therefore all women considering pregnancy should have their vitamin D levels checked before conception and during pregnancy.

 

What causes vitamin D deficiency?

The major cause of vitamin D deficiency is inadequate exposure to sunlight. This is a difficult issue because we also know that too much sun exposure can lead to skin cancer and malignant melanoma. It is quite ironic that scientists now believe that vitamin D is protective against skin cancer. Therefore we may be putting a little too much effort (and money) into protecting ourselves from the sun.

 

Although you may often read that most Australians get enough sun exposure to ensure adequate vitamin D levels, especially in the more northern parts of Australia, this is not the reality and certainly is not what I see in my clinical practice. Almost every woman I have seen who has had a blood test for vitamin D levels has either been on the low side of normal or outside the normal range, exhibiting a deficiency.

 

How much sun is enough (but not too much)?

It is difficult to find a definitive answer about the optimal amount of sun exposure which ensures adequate vitamin D levels without causing a risk of skin cancer etc. In actual fact the answer will be quite different for different regions of Australia and for different individuals.

 

Sun exposure should be limited to the early morning and late afternoon and the amount of exposure needs to suit the individual skin type. Very fair skinned people can tolerate less sun that those with olive skin or darker skin. Indeed people with fair skin actually need much less sun exposure for the production of vitamin D because the UV rays penetrate the skin much easier.

 

In 2006 the Medical Journal of Australia published information on recommended sun exposure times (at 10am or 3pm) for fair skinned individuals aged 19-50 years with 15% of their body exposed to the sun eg face, arms and hands. As you would expect exposure time varied greatly depending on locality. For example in Townsville as little as 10 minutes in summer and up to 15 minutes in winter, whilst in Hobart up to 13 minutes in summer and as much as 166 minutes in winter may be needed to ensure sufficient vitamin D levels based on current recommended daily allowances.

 

These recommended times are only estimations and are subject to many variations including seasonal differences in UVB levels from one year to another, altitude, skin type, level of cloud cover etc. It is also worth noting that many researchers have suggested that optimal vitamin D intake has been underestimated and that official recommendations are too low.  If this is the case recommended sun exposure times may be too short, however excessive unprotected sun exposure may increase risk of skin cancer.

 

The best way to ensure that you have adequate vitamin D is to have yearly or twice yearly blood tests to check your vitamin D status. Try to ensure adequate sun exposure without overdoing it. You need to be careful and take your skin type, your location, time of day and season into account. If the exposed area begins to redden slightly it is time to get out of the sun.

 

 

Those at most risk of vitamin D deficiency

Older adults

As we age the skin is less able to produce vitamin D and the kidneys are less efficient at converting it into the active form. The risk of vitamin D deficiency is increased for older people who spend most of their time indoors.

 

People with limited sun exposure

People who are homebound and women who wear veils and/or long robes are very likely to have vitamin D deficiency. Many people get very little or no sun exposure during winter, particularly on their working days. Vitamin D supplementation may be necessary during the winter months.

 

People with dark skin are also at increased risk of vitamin D deficiency because the increased pigment in the skin (melanin) reduces penetration of UV rays and the production of vitamin D.

 

Obesity

Being overweight, particularly if you have a body mass index (BMI) of greater than 30 you are at increased risk of vitamin D deficiency. This is not because vitamin D production is decreased but because the subcutaneous fat decreases the release of vitamin D into the circulation. Even when vitamin D is taken orally through food or supplementation the amount of available vitamin D in the circulation is reduced in obese people.

 

 

Dietary sources of vitamin D

Very few foods contain significant amounts of vitamin D. The richest sources are oily fish such salmon, sardines, herring and mackerel. Other foods containing some vitamin D include milk, meat, eggs, cheese and fortified foods.

 

Most experts agree that it is very difficult to obtain sufficient vitamin D from foods alone and that sun exposure and/or supplementation is essential to prevent vitamin D deficiency.

 

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