The most important thing is to monitor your diet. You need to eat foods that are low in glycemic load which takes into consideration the glycemic index of a food and the quantity of it that you eat so that it measures the sugar load you consume at any given food intake point. When you learn to eat a low glycemic load diet, your body will be healthier because there won’t be a rapid rise in blood sugar such that your body is unable to process it.

If you are concerned about diabetes, you should learn more about these key words such as glycemic load and glycemic index. You can also ask your physician for a fasting blood glucose level and a hemoglobin A1C level to see how efficient your body is at processing sugar at this point. If it is already impaired, it is extremely important to start implementing dietary changes as soon as possible.

Diabetes is a disease where if you catch it early and you take the steps to improve your health, it will definitely make an impact on the outcome. So, make sure you start learning about eating low glycemic index foods and keep in mind to keep all foods in moderation and smaller portions.

While making dietary changes is a very potent way of impacting your diabetes risk factor, exercise is also extremely important in your battle against diabetes. Start by increasing your daily activity level and incorporating even small amount of exercise daily and build up to at least about 30 minutes of exercise on a daily basis with variations of activity types throughout the days of the week. If you are a beginner, you should enlist a personal trainer or ask your work out fiend of a friend for help! This is so that you start exercising safely. You should also gain the approval of your doctor before you start this regimen to make sure you are safe to start.

Finally, there are a few things you can take to help with your sugar metabolism and I would start with the safest options. When you start to incorporate bitter vegetables into your diet and vinegars into your dressings and cooking, you’ll naturally help your body’s insulin sensitivity. Insulin is the main hormone that helps to take sugar from your blood stream and allows it to be processed into your metabolic demands of your body. The supplements you can take to help with this as well are cinnamon, alpha lipoic acid, nopal cactus, resveratrol, and bitter melon, just to name a few.

So, make sure that you attack your sugar concerns from all directions with your food, activities, and your supplements…this way you’ll make sure you are victorious in your battle against diabetes!

I would like to take this opportunity to clarify some issues with these studies. When you are reading summarized reports about various studies, you should know that in order to truly understand what these studies show, you have to go look at the primary study article and not a summary article. Frequently, the poor results apply only to a specific population of people or that they did the study in a way that does not apply to clinical practice. Allow me to explain…

For example, the studies that look at vitamin D at high dosages leading to more fractures were done with dosages that are not used in clinical practice so would not apply to the general public. Even in prior studies with dosages closer to that used in clinical practice, those studies showed benefit, not harm, in regards to fractures.

Another example is a study done on calcium and vitamin D causing more heart attacks in women. This study looked at a subgroup of a larger study and drew that conclusion but various other subgroup studies done on that larger study did not show the same result. The hypothesis is that the calcium and vitamin D, when taking abruptly higher dosages in a woman who has never taken calcium or D supplementation, might be concerning but is still not definitive. The recommendation is to take calcium and D if osteoporosis is a concern and to adjust dosing slowly upwards toward the health goal dosage.

So, as you can see, the studies are complex and if you are concerned, you should print out the primary article and bring it to your doctor so that he or she can explain it to you. In regards to those who are very much a believer of supplements, there are a few that you should make sure you have in your supplement cabinet.

1. Turmeric or Curcumin with black pepper to improve systemic absorption
2. Fish oil and Omega-3
3. Resveratrol
4. Free form amino acids
5. Vitamin D3

Turmeric is seen to have some anti-cancer properties as well as being anti-inflammatory. There are numerous other health benefits but for the purposes of this article, I will stick to these two and you can read more about it and ask your physician about it.

Fish oil or omega-3 and resveratrol also has many health benefits but it can be helpful as an adjunctive therapy for anti-inflammation, sugar metabolism, and high cholesterol or triglycerides, just to name a few benefits. You should of course clear all supplements by your physician before taking them and make sure that there are not any contraindications for you to use them.

Finally, vitamin D3 and free form amino acids are helpful for many body functions. Vitamin D is a hormone in the body and is important for bone health, mood, and even has effects on cancer if that is a concern in your family history. Free form amino acids are more easily absorbed and usable than long-chain amino acids and they are used in many organ functions. So these two supplements are meant as gap fillers since many people are not getting enough in their diet.

While there are many other supplements that should also belong in your supplement cabinet, the most important thing to keep in mind is to clear your supplements by your doctor first before using them and to always update all your physicians of your supplement list so that they can help you avoid complications and drug-supplement interactions.

Thank you all for following my blog. I have had a lot more articles and interviews posted recently on my website…check them out at www.makinghealthyez.com !

Keep tuning in for more articles every month on new health topics that you’ll definitely want to learn more about!

Just remember…living healthy doesn’t have to be hard, so let’s take those steps towards making living healthy EZ!

Dr. Julie

She was concerned that taking her usual low dosage of 400-800mg of calcium supplement per day would put her at higher risk of heart attacks. This incident spurred me to want to write this article to clarify this issue for all women who were concerned about their bones, but are now even more concerned about their heart as well as their bones.

The article published in BMJ in 2011, was one in which the authors re-evaluated the data from the Women’s Health Initiative (WHI) study on calcium supplementation where 36, 282 women were looked at in a seven year randomized placebo-controlled study as to how calcium and vitamin D supplementation affected them.

In the initial study meta-analysis, there was no increased risk of heart disease seen in the study for women on calcium and vitamin D. But in the re-evaluation of a sub-group of the study (about 16,718 women) which then was published as the 2011 article in BMJ, the women who were not taking any personal stash of calcium were lower in risk of heart attacks then those women who were taking the treatment dosages of calcium and vitamin D.

The authors in the 2011 study felt that the original interpretation did not account for the fact that some of the women in the placebo group were taking low dosages of calcium from their own regimen aside from the study and so the placebo group was not a true placebo group in the initial evaluation; which they felt was then not a true representation of what calcium and vitamin D would do to a women’s body in respect to heart disease risks.

This reasoning seems initially plausible…however, when you look at other subgroups in the WHI study, you do not see the same concerning finding of the heart attack risk. What is interesting about this study is that, depending on which subgroups you look at, you might get different findings in respect to impact of calcium and vitamin D on heart disease in women. So in another subgroup where if you just look at coronary artery calcium levels, there were no increased heart disease risk in these women who were taking calcium and vitamin D compared to the placebo group.

Basically, when you put aside all the nitty-gritty details and science jargon of all the published articles that came out of the Women’s Health Initiative study on calcium and vitamin D, what you should take away from these studies are that you should take what your body needs and don’t take more than what it needs.

What this means is that if your calcium level is low and your vitamin D level is low and you are at higher risk for osteoporosis than heart disease, you should focus on getting adequate levels of calcium and D in foods and supplements. I am a huge proponent of getting your nutrients from food first and foremost…then using supplements as a gap-filler if you are not absorbing what you need via your foods. So, aim for foods rich in vitamin D and calcium if you need these fundamental building blocks of your body. Then, if your levels are still low or that you have osteopenia or osteoporosis, you should have some additional supplementation of these two nutrients.

When it comes to supplementation, I always advise my patients to always be the bear that gets it just right. Too much or too little is not good…so aim for getting what you need in a balanced diet rich in vegetables and nutrient-rich foods like nuts, legumes, and fruits and less from processed foods. Then, if you are still lacking in nutrient levels, or your health concerns demand more of various fundamental building blocks of various nutrients, then ask your physician about appropriate dosing of these nutrients via supplementation. Just remember, more isn’t always better.

For all the women who have a strong family history of heart disease, there is one last point I want to touch on from this study to bring you peace of mind. There is suggestion that it is the abrupt rise in calcium and vitamin D in the women who were treated with these supplements that may have some impact on heart disease.

So, if you are someone who eats foods low in calcium and vitamin D and then suddenly take high dosages of vitamin D and calcium, it might not be the best idea. Instead, make sure you are getting foods rich in these nutrients, in which case you may not need supplementation of vitamin D and calcium.

However, if you see that you still need more of these two ingredients in your body, then consider adding low dosages of the supplements slowly and incrementally to reach the level you need; instead of going from no exposure of these nutrients in your body to suddenly high dosages.

So, the main take-away points are to make sure you are getting enough of these nutrients in your diet and if you have osteoporosis or osteopenia, ask your physician about slowly titrating you up on these nutrients for healthy bones.

If you have heart disease concerns but you also need vitamin D and calcium, try to get them in your diet first then gap-fill with low levels of vitamin D and calcium and slowly titrate up on dosages of these supplements with your physician’s guidance until you reach the levels you need for these two important nutrients of the body.

Just remember that calcium and vitamin D are not menacing compounds that our body rejects…we actually need them for our organs and body to functioning correctly. So the key is not to avoid them…because we need them…but rather to get them in healthy amounts in foods and supplements at dosages and levels that are appropriate for your own individual health needs.

Reference:

Abrahamsen, B. BMJ 2011; 342 doi: 10.1136/bmj.d2080 (Published 19 April 2011)

Cite this as: BMJ 2011;342:d2080

Boland, M, et al. BMJ 2011; 342 doi: 10.1136/bmj.d2040 (Published 19 April 2011)

Cite this as: BMJ 2011;342:d2040

Even though I am a believer of supplements and what it can do for people as long as they are being prescribed correctly for different people, I always will have people get their nutrients through their food if possible. We are seeing more and more that what we used to think is garbage in various foods is in fact Mother Nature’s treasure.

For example, grape seeds are high in antioxidants like resveratrol and should be eaten and not thrown out; also pectin from from the white material on the flesh of oranges has anti-cancer properties and again should be eaten. Food is powerful medicine and that is likely going to gain more steam in future years as far as our understanding and focus in research and daily life.

As research delves deeper into nutrition and alternative methods of health maintenance and disease treatment, we are now fortunately much more aware of what is beneficial to our health and what is not. For example, too much of synthetic vitamins can harm us versus too little of certain natural forms of nutrients can significantly debilitate our body’s natural ability to heal and function optimally.

With the ever increasing research efforts about nutrition, we are now seeing that pectin may have anti-cancer properties, grape seeds may have high antioxidant activity, and grapes in their entirety may help us with weight loss. So, what are the main take-away points from all of the abundant, albeit sometimes confusing, research findings?

We may not like the taste of all the parts of our foods, but if it came naturally from Mother Nature and it is safely edible, you may want to think twice about cutting it off and throwing it away. When there are any doubts, you should of course ask your registered dietitian and your physician, but I am consistently recommending to my patients to eat the pectin encasing the orange and encouraging my patients to chew and eat the grape seeds along with the grape.

Instead of buying pectin and grape or resveratrol supplements, we may want to first start by getting these from plant-sources. Rarely, too high dosages of green tea supplements may lead to elevated liver function test levels, but drinking green tea in its natural form is significantly safer (even at higher intake levels). In other words, foods in its natural form tend to have less risk for adverse events. So, what should we keep in mind the next time we are grocery shopping for supplements and foods?

Give Mother Nature’s plants a try first and if you need to use nutraceuticals to supplement your nutrient intake, use it as an adjunctive therapy to an otherwise healthy balanced plant-based diet…because no amount of nutraceutical supplements can make up for a poor diet.

When you eat a well-balanced plant-based anti-inflammatory diet and use supplements as adjunctive gap-fillers to create an optimized nutrient-rich environment, not only will your physiological functioning improve but your skin and weight will similarly be optimized as well.

Sunlight helps to increase our brain’s happy chemicals and also vitamin D level in our body, which helps with our mood and other very important bodily functions. So, how can we get our body to be more efficient and less sluggish when we are seemingly fighting Mother Nature in her quest to keep us in the dark without sunlight? Besides asking our doctors to check our vitamin D levels and supplementing it if we need it, what else can we do?

For those of you who are very much affected by the lack of sun and has seasonal affective disorder, ask your doctor about therapeutic light therapy or sun lamps. For those of you who are not affected to that severity, let’s discuss some ways to help our body’s metabolism, mood, and energy level improve despite not having as much sunlight in the day.

Our body craves rhythm, so despite it still being dark in the mornings, if you can no longer work out in the morning, try to make sure you work out in the evenings right after work on a consistent basis. If you can try to still work out at your usual time in the mornings, your body will be able to sleep better at nights and your energy level during the day will be better. I generally recommend people to work out in the morning if at all possible so that you can wake up your body and its metabolism, have more energy during the day, and be able to sleep better at night. I usually notice that people eat healthier and make smarter choices in regards to food as well if they work out in the mornings.

Another thing to make sure you do more consistently during the winter time to keep your mood elevated is to set aside time for enjoyable activities. Having something to look forward to will help your mood and help you de-stress. Incorporating time with friends and family who you enjoy their company could also be extremely beneficial in de-stressing and improving your mood. You may want to combine time with your loved ones with exercise by finding physically-active activities for everyone to do together. This will help to boost your mood, energy, and metabolism, all in one.

Sometimes, it may be helpful to incorporate calming and relaxing activities like breath work, gentle yoga, pilates, or stretches into your morning and evening routine with relaxing music and scents to ease your body into wakefulness and sleep. These calming routines may help to elevate your mood and help you to de-stress and calm your body in a way where it starts to help you to appreciate the darker and quieter evenings and mornings.

As you start to appreciate these aspects of the winter months more, you may not notice the lack of chirping birds and bright sunlight in the mornings anymore…until Mother Nature decides to be lenient again and give us back our much desired sunlight!