Displaying items by tag: healthy eating

Addressing Vitamin D Deficiency in Later Life?

Could sun dried mushrooms and tank-top shirts be keys to reducing vitamin D deficiencies in later life thus reducing fall risks? Well, yes and let’s discuss why. Vitamin D is often called the sunshine vitamin as it is made from cholesterol in skin and as the sun’s ultraviolet B (UVB) penetrate skin cells it causes production of vitamin D3. ¹The dilemma for seniors is that older skin cannot synthesize vitamin D as efficiently while outside activities are often greatly reduced: and, while there are few foods that actually contain vitamin D, older seniors need more vitamin D, approximately 800 IU (international units) daily, as opposed to 600 IU daily for their younger counterparts. ²(According to the Institutes of Medicine, a serum 25 (OH) D level of 25 ng/ml is adequate for most populations while deficiency is defined as less than 20 ng/ml, with insufficiency being less than 30 ng/ml. Through a process called hydroxylation, the liver and kidneys turn stored vitamin D into an active form the body uses.) 

Vitamin D Deficiency is Linked to Poorer Health 

Because older adults are vulnerable to muscle weakness and falls, maintaining sufficient levels of vitamin D is important: there is evidence that sufficient vitamin D levels can strengthen bone and muscles in older adults which leads to reductions in falls³ – the primary benefit of vitamin D is to maintain serum calcium and phosphorus levels within normal ranges to support metabolic function, neuromuscular transmission, and bone mineralization.⁴ In fact, vitamin D deficiencies are linked to a multitude of health risks. For seniors in later life, vitamin D deficiency has been linked in studies to such conditions as cognitive decline, depression, osteoporosis, diabetes, cardiovascular disease, and cancer, although there is debate about the strength of the link. ⁵Vitamin deficient older adults living in areas prone to inadequate exposure to sunlight have increased risk of experiencing cognitive decline. ⁶Vitamin D deficient older adults may experience a loss of bone density which causes fractures and falls.⁷ Vitamin D deficient older adults may experience increases of risk factors for cardiovascular disease. ⁸Vitamin D deficient older adults may experience increases of risk factors for depression and other psychiatric conditions.⁹

Nutritional fads come and go. But one fad which seems to have elevated to a gold-standard of credibility has been the so-called "Mediterranean Diet". The Mediterranean diet recommends eating lots of plant-based foods mainly fruits, vegetables, and legumes and foods infused with monounsaturated fat such as olive oil. This popular diet acquired high acclaim in the US as a nutritional best-practice in preventing heart disease after a five-year study by a group of Spanish nutrition scientists caused the New England Journal of Medicine, NEJM, to publish its conclusions suggesting that the Mediterranean diet can decrease risk of heart attack and strokes. The study concluded: prolonged exposure to the Mediterranean diet produced a substantial reduction in risk of major heart disease among high-risk people.

Recently, a statistical sleuth named John Carlisle exposed many flaws in the study namely its claim to have assigned people randomly to the study and other anomalies. Carlisle’s analysis refuted the study’s findings thus discrediting it, causing the NEJM in the summer of 2018, to retract the original publication. This turn of events has re-ignited the debate on what is optimal diet for seniors in later life and whether nutrition can have a positive impact on the health and wellness of very old adults? Ironically, much the Mediterranean diet compares agreeably to nutritional best-practice recommendations of public health organizations and other accredited bodies but without all the feigned notoriety. Yet, to deliver nutritional best-practices in later stages of life requires that special accommodation be made to address health-status changes.