Just take your vitamin D so we can stop talking about it already

cool hand luke egg scene

"No man can eat fifty eggs"

I know, I know. We’re all sick of vitamin D.  Headline after headline tells us that we don’t get enough, we need to make sure our levels are adequate, that our kids get enough….yada, yada, yaaaawn.

Americans tend to overdue things.  As a nation, we eat too much, we watch too much television, we take too many meds and in general, rely too heavily on ‘supplements’ to catch up with our dietary shortcomings.  And for the most part, the benefits are too few anyhow.  Deep down, we know what to do and study after study confirms what is essentially common sense: eat good food, exercise and don’t smoke.  And that works really well, providing everything the body needs in the right doses and combinations.  What did you say? You knew there was a catch? Yes, you’re very smart.

Take your seats, class.  We’re going to have a quick review of the benefits of Vitamin D:

  • important for bone strength (helps calcium get into and stay in our bones)
  • reduces the risk of seemingly unrelated disease processes like cardiovascular disease, diabetes and cognitive impairment
  • may reduce risk of childhood asthma

Wow. That sounds like some really important stuff.  I rather like my bones unbroken, my heart beating properly, my pancreas unsweetened, my kids non-asthmatic and my cog to be unimpaired (unless purposely impaired with a nice single malt scotch).

How do we know if we need vitamin D and how can we get it? Sorry to pop your gym going, vegan diet eating non-smoking balloon but if you live north of say, Los Angeles or Atlanta, chances are you need it from April to September and really need it from October to March.  Those living in sunnier climates can get enough from sun exposure (about 15-30 minutes a day depending on the pigmentation level of skin).  The rest of us need to get it from our diet or through supplements.  As a general rule, we need 1000-2000 IUs per day.  Some experts recommend less and to just prevent vitamin D deficiency you can take less.  Some recommend taking larger doses but it can build up in the body so for most people, staying in the 1000-2000 IUs per day range will probably give you all the benefits.

Okay, let’s go with the dietary route then.  Usually that’s a better idea than taking supplements, right? What do you have to eat?   According to my  reliable information sources the list of Vitamin D rich foods looks like this: egg yolks, cod liver oil, salmon and other oily fish.  Uh oh.

Remember when eggs were healthy, and then they weren’t and now they are sometimes in small amounts for some people?  For a moment let’s forget about the 212 mg of cholesterol in a large egg and forget about the 5 g of total fat, and completely ignore the link between animal protein and cancer and let’s just look at vitamin D, okay?  One large egg provides (the yolk is where the vitamin D is so egg whites don’t count)…..18-20 IUs.  How can that possibly be a good source of vitamin D?  You would have to eat more than 50 eggs (everyday!) to even come close to 1000 IUs! Didn’t we learn anything from Cool Hand Luke? Ain’t nobody ever eat 50 eggs!  Yet, there they are — on the “top ten foods for vitamin D” lists.  As Miles Monroe might have told us, that’s a big omelette.

Salmon, then, we can eat some salmon.  A three and a half ounce serving of (farmed) salmon has about 245-320 IUs of vitamin D.   Should you decide to splurge and buy wild salmon the same size serving can give you up to 988 IUs.   Although, I don’t think there is any responsible nutritional source that suggests eating any kind of fish everyday or even every other day.   The FDA states that nearly all seafood and shellfish have traces of mercury and/or methylmercury.  Many have more than a trace and can contain unsafe levels of contaminants and are often high in mercury and other environmental toxins that have no place in a healthy diet. Fish also contain no fiber and are high in animal protein, and often, in saturated fat and cholesterol. Hmmm….sounds like a fishy plan to me.

Other sources of vitamin D: fortified foods.  In other words, foods that have nutrients added back in when they are done processing it.  One cup of fortified milk or orange juice has about 100 IUs.  Again, no one should be drinking 10 cups of either of these a day.

No matter how you do this math, you cannot eat your way out of a vitamin D deficiency.  Unless you live in the right climate year round and spend part of everyday walking in the sun with no sunscreen, make a vitamin D supplement part of your daily habit — at least during the darker parts of the year.

Brett L. Kinsler and Michalene Elliott are Rochester Chiropractors who take vitamin D supplements but will happily be guest speakers in tropical locations so they don’t have to.  Their website is www.rochesterchiro.com


Not All Apples Keep the Doctor Away

Those of us in healthcare often can’t help but follow distressing trends. One of these trends indicates that as the nutritional science recommendations for fruits and vegetables increases, Americans inexplicably seem to consume less of these important foods.  It’s like we are a bunch of rebellious teens trying to do the opposite of what our parents tell us. But how bad is it? According to the CDC’s Behavioral Risk Factor Surveillance System (big brother, anyone?), of adults surveyed only 32.5% ate 2 or more fruits a day in 2009 and only 26.3 % ate 3 or more vegetables a day.  Despite millions of dollars spent in marketing, fruit consumption in the US fell by almost 2% from 2000 to 2009 while vegetable consumption remained unchanged.  It should be noted that Idaho was the only state that showed a slight increase in both fruit and vegetable consumption while 10 states (who shall remain nameless) showed a decrease.  So chances are unless you live in Idaho, you are eating no better than you did in 2000 — which was probably not so good to begin with.

Sure, it can be hard to eat all those fruits and vegetables. Every day.  But there is some good news:  Last year, the relative healthiness of apples was studied in the form of phenolic profiles and antioxidant properties of apple skin extracts. Plant phenols include such beneficial compounds as cinnamic acids, benzoic acids, flavonoids, proanthocyanidins, stilbenes, coumarins, lignans and lignins. These are strong antioxidants and might prevent oxidative damage to DNA, lipids and proteins and therefore reduce the likelihood of developing things like cancer and cardiovascular disease.  So if you eat the right apples, you don’t have to eat as many to get the antioxidant benefits.  In the United States, apples alone account for 22% of our phenolic intake, we would do well to be choosy about those apples.

Which apple should we be eating?  Crabapples ranked highest with approximately 2.5 times the benefit as the lowest ranking apples, the golden nugget and the macintosh.  Also very near the bottom were the gala and the empire.  Firmly in the midrange were the granny smith, honeycrisp, and red delicious.  The top ranking palatable apple was the ……Idared.  Idareds showed twice the benefit as the ‘losers’.  A recent trip to a popular local grocery store revealed not one single solitary Idared in sight.  However, there were plenty of conveniently pre-bagged ‘mini-macs’.  Resist the temptation. Bag yourself a few honeycrisps or granny smiths and you will get nearly fifty percent more benefit for the same amount of apple.  If you are lucky enough to find an Idared, even better. Remember, the study measured the relative amounts in apple skin so making applesauce or juice doesn’t count!  How do ya like them apples?


Dr. Michalene Elliott & Dr. Brett Kinsler are apple-loving Rochester NY chiropractors.

Don’t Confuse Me With the Facts

Food labeling cartoonAs chiropractors, we often get asked about diet and lifestyle in addition to the usual neck and back pain complaints.  In the current word-of-mouse era we live in, patients have access to an unprecedented amount of information only a click away.  Most have done their own research before they bring the subject up in our office.  Sometimes this is helpful.  Other times, it has only served to confuse them.  Some patients choose to follow each and every bit of nutritional news which only serves to drive them crazy.  Today, eggs are bad but coffee is good for you.   Yesterday it sounded like coffee was the Devil’s drink but eggs were the perfect nutritional powerhouse.

So what are they looking for from us?  Google “diabetes”  or “heart disease” and you will get well over ten million hits.  Most likely, after the cereal, shake and snack bar Googlemercials, the next few links will be to popular sources like WebMD.  These have their place but they are supported largely by pharmaceutical ad revenue.  Even if patients found their way to Medline (a source for medical journals) the average person is not used to reading technical and often seemingly contradictory research studies.

What patients are looking for is a way to look out at the endless sea of information and fish out from it the most relevant facts to their own situation.  This should be the role of their health care provider — to assist in this process.  Yet, in many cases, the information from the health care provider does not help in a positive way.

 The cycle goes something like this:

  • patient gets diagnosis (or is told to “lose a few”)
  • patient finds the latest “diet” and follows it
  • patient loses a couple pounds then hits a plateau
  • patient gets frustrated and goes back to old habits
  • this becomes another “diet” that they tried that didn’t work. 

Any diet can work, especially in the short term.  The problem is most are unhealthy and are being used as a temporary fix.  Even diets like the South Beach Diet, which is very effective at weight loss in the beginning, is not an effective long term plan for health when taking into account factors like cancer and heart disease due to too much reliance upon animal protein and complicated “what you can eat when” charts.

Nutritional science can be very technical and complex.  Even if you make it a full time endeavor, keeping up on all the latest research is nearly impossible.  What is a person to do?  First, forget about the current politics of food.  Using only common sense, imagine what a healthy, nutritional meal might look like.  Chances are you imagined a plateful of vegetables.  Maybe there was some meat or fish on the side but the bulk of the plate was filled with plant foods.  Well, let’s start there.  Make your meals (and snacks) look like that imagined ideal meal.  Dramatically reduce (or eliminate if you can) the size of the animal protein (meat, fish, dairy) you have on the plate.  Push it off to the side and fill the rest of the space with several different plant foods.  Add a heap of brown rice or a plain baked or sweet potato.  Then add sauteed spinach, roast carrots, steamed broccoli and/or peas.  See what you did there?  Without even going to night school to get your Masters in Clinical Nutrition, you just put together a perfectly healthy meal.  Just make sure the vast majority of stuff on your plate is unprocessed and plant based.  Still hungry?  Try some whole grain bread with your meal and some fruit for dessert.  Getting started really is that simple.

Dr. Michalene Elliott is a chiropractor in Rochester, NY who has gotten started.

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Servings per container: 557?


One of those people with a good sense of the absurd?  Here is something absurd that’s probably right in your kitchen.  Get out your favorite brand of cooking spray (found in almost all American homes) and check the serving size.  Chances are, it will be somewhere between 0.25 and 0.33 seconds.  That’s between 1/4 and 1/3 of a second.  The servings per container will be between 350 and 600. 

This is a perfect example of why we have such a problem with achieving health in this country.  No, not cooking spray.  Misleading information presented as fact.  Maybe somewhere, in some test kitchen, a trained professional can spray for only .25 seconds but everyone I know really wants to coat that pan with ‘non-fat’ cooking spray.  Problem is, used the way most people really do, it is not non-fat.  In fact, it is oil.  Pure fat. 

For comparison, a can of cooking spray is about 6 ounces. A stick and a half of butter is 6 ounces.  Imagine cutting that stick and a half of butter into 557 pieces.  Now, spread one on your toast.  Congratulations, you have just had ‘fat-free’ butter.

We have been led to believe that non-fat cooking spray is much healthier than oil.  So which is better?  Well, one comes in a spray can with propellants.  At least with the pure oil most people would try to be judicious. 

In fact, if you are using non stick pans, then the cooking spray is redundant.  If you are trying to cook with no fat, it would be preferable to cook  just with broth or water.  Yes, you really can sauté in just plain water.  I prefer broth or wine for flavor but water works just fine.  Plus, it’s free –no spray can needed.

Dr. Michalene Elliott is a chiropractor in Rochester who writes for RochesterChiro’s blog and has tried to spray for less than half a second but, sadly, cannot.

It’s More Watery Than Water

On a recent journey through Wal*targ the other day, while passing rows of cheap plastic crap from Asian netherworlds, I came across an aisle marker that read “Enhanced Water”.  What the heck?  Isn’t every drinkable liquid simply enhanced water?  Orange juice is water enhanced by oranges.  Coffee is water enhanced by coffee grounds.  Mud is water enhanced by dirt.  Eye of the beholder, no?

But that lead me to think about these so called energy drinks.  Red Bull, Rockstar, Monster, whatever.   People are going crazy for this enhanced sugar and caffeine water.  Researchers have actually called them a “gateway drug” due to the high caffeine content.  Gateway drug! 

Back up a smidge Chicken Little.  Whether or not these drinks enhance any performance is besides the point…but calling the amount of caffeine in these drinks a gateway drug, you’d better stick a warning sign up on all the Starbucks in town as well.  Most of these drinks are similar in caffeine content to your decaf mocha crapochino with lite whip.  Is that cup of brewed enhanced sugar and caffeine water a gateway drug too?

I’m not condoning over use of caffeine or sugar but talk about the pot calling the kettle black.  Don’t lose your heads over this one.  What’s the take home point? If you don’t want your kids to down shots of double espresso, you should probably limit their intake of other enhanced waters as well.

Have an opinion on this?  I’d love to hear it.

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