Screening Children For Cardiovascular Risk

I’m a family doctor. I take care of children. When I think of patients with high blood pressure, cholesterol and diabetes, I think of my ADULT patients, not my kids.

But there’s a good reason for screening children for cardiovascular risk. A new study published in Pediatrics showed up to 40% of children may have high blood pressure, high cholesterol, and even diabetes.

We’ve known for a long time that kids are having more and more problems with overweight and obesity. Poor food choices (and limited availability of fresh whole plant foods, in many cases), decreasing levels of physical activity and increasing time spent in front of computers both in school and at home have contributed to this trend.

Researchers went to Norwood, Ohio (very close to where I grew up, actually) and studied kids in middle school. With parental permission they checked height, weight, blood pressure, cholesterol and blood sugar. 42% of the children were overweight or obese, and 34% had blood sugar or cholesterol out of the normal range.

The American Academy of Pediatrics recommends screening children for blood pressure, blood sugar and cholesterol at age 9-11, and again at age 17-21. It is more urgent if children are overweight or obese, or if they have a family history of high cholesterol.

If you have children, make sure to model good habits for them. Don’t tell them to eat their veggies while you are eating pizza and wings. Don’t tell them to exercise while you sit on the couch. Make fitness a family affair by choosing activities all family members can enjoy. Some examples are hiking, cycling, swimming, martial arts, dance, sports, etc.

As your children are growing, ask their doctor whether they need to be screened for heart risk factors. Especially ask about screening if their doctor expresses concern about their weight. Also ask if there is a family history of high cholesterol or early heart attacks. “Early” means before age 55 in men and age 65 in women).

There is an epidemic of overweight and obesity happening in the US and around the world. We must be alert and start screening children for cardiovascular risk factors earlier than we might think.

QUESTION: Do you have kids? Have they had their cholesterol and blood sugar checked?

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Multivitamin Benefits: Are They Good For You?

What do YOU think?

Anyone who knows me knows what my opinion is, but it’s been awhile since I sat down to review what the scientific research says about multivitamin benefits.

Many people believe that if they just eat healthy they will get all the nutrition they need.  Worse, health professionals like doctors and dietitians perpetuate this myth.  The research is very clear that people do NOT get all the nutrition they need from the food they eat.  Whether or not they SHOULD, they DON’T.

So if people are going around deficient in one or more nutrient every day, does supplementation help?  Can you get the nutrition you need from pills?

vitaminbottlesIn a word, no.  You can’t get all the nutrition you need from pills.  You need to eat healthy.  This is basically because we need to know that you need a nutrient before we can put it into a pill.  And whole-foods supplements (where they basically juice a food and dehydrate it and package what’s left into a pill) aren’t adequate because you’d have to take huge numbers of pills daily in order to get the content of a single piece of fruit or a vegetable.  You still need to eat healthy balanced meals and sensible portions of food.

So what’s a person to do?  The short answer is to eat healthy AND take a high-quality supplement.  I did a literature review and here are five studies from the 1980s to today.

1.  In 1985, a study was published examining blood nutrient levels in female college students living on-campus and eating a diet specifically designed for them by the college dietician.  These young women’s blood nutrient levels were significantly improved by taking a multivitamin.

2.  A study of healthy adults over age 60 showed that those who took a multivitamin-mineral supplement spent one-third as many days sick with infection-related illness as those who did not take the supplement.  (My friend Amanda knows this is true.  Her kids don’t share nearly as many colds with her since she started taking Shaklee supplements!)

3.  Calcium and vitamin D supplementation have been shown to decrease the rate of bone loss in postmenopausal women (many studies demonstrate this).

4.  Use of an herbal supplement (marketed by the Shaklee Corporation under the trade name NutriFeron) was associated with  significantly decreased menopausal symptoms, systolic and diastolic blood pressure, and plasma triglycerides and LDL-cholesterol.  Researchers also found lower plasma hepatitis C viral levels in patients with chronic active hepatitis C and improved symptoms as well in study participants who used NutriFeron.

5.  Long-term users of a number of supplements produced by the Shaklee Corporation were shown to have lower blood pressure, better cholesterol profiles, lower levels of certain inflammatory markers, lower risk of diabetes and were more likely to rate their health as “good” or “excellent.”  Here is the study link.

There are many more studies I can cite, but I think you’ll agree that the evidence is clear that taking a carefully designed program of supplements including a high-quality multivitamin is an important ingredient in a healthy lifestyle.

I should add that all the research I discussed above was supported and published by Shaklee.  There are over 100 research studies published in peer-reviewed journals supported by Shaklee, which you can check out at the Shaklee Health Resource.  How many studies has your supplement company published?

If you’d like more information about what supplements would be appropriate for you, please fill out a HealthPrint assessment or email me at drjen@jenniferwurstmd.com.

Question:  Do you take a multivitamin?  Do you think it makes you healthier?

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Suicide Games And Social Media

If you have children, have you heard of the Momo challenge? This was a supposed series of social media posts targeting children and teens. The challenge asks children to perform an escalating series of dangerous actions ending by telling the child to hurt or kill themselves.

This is just the latest in a series of supposed “suicide games” making the rounds on social media. The Momo challenge itself turned out to be a hoax, but there definitely have been instances of kids and teens being challenged to do dangerous things (like eating Tide Pods) during social media suicide games.

We as adults see social media as a way to share information, keep up with what’s going on with our friends and families, raise awareness, argue about politics and engage in other activities. Sometimes these activities are very beneficial. Think of the ALS ice water challenge that raised awareness and funds for ALS research several years ago.

Our kids, however, are very vulnerable online. Even more than in person, children are susceptible to grooming by predators, bullying and other dangerous influences via social media.

It’s been said many times before but bears repeating. Our children need us to be vigilant in protecting them. They have a hard time knowing whether someone is trustworthy in the best of times. When you take away the body language clues, social media interactions are even harder for them to judge.

Kids are impulsive. Many times they don’t stop to think through the consequences of their actions. Couple that with kids’ natural risk-taking behavior and the anonymous nature of online interaction, and you make it very easy to coax a child or teen into doing something very dangerous.

If you allow your child or teen to have a smartphone or online access, make sure you supervise them. Privacy online should NOT exist when it comes to children. You are not their friend – you are there to protect them, whether they like it or not. You should have all their passwords and the right to inspect their accounts at any time, with no warning, or they are not online.

Many of our children do have access online while at school. Make sure to check with your child’s school to understand their security procedures. Children shouldn’t be able to access forbidden content while at school.

So-called suicide games are only one of the dangers our kids face online. If your child’s behavior changes or they act secretive, be suspicious and investigate their online accounts. Our kids need us to protect us online the way we protect them offline. You insist your child buckle up in the car and wear a helmet when riding their bike, right? You should be as vigilant to make sure they are safe when they are online.

QUESTION: What steps do you take to monitor your child’s online activity?

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How To Get Quality Sleep

One of the most common problems we see in primary care is complaints about not getting quality sleep. People can’t fall asleep. Once they’re asleep they keep waking up. They wake up unrested. They’re tired and sleepy during the day.

Sleep disturbances have huge impact on our quality of life. Fatigue and sleepiness decrease our enjoyment of our hobbies and activities with family. In extreme cases, severe fatigue can be fatal in the case of people who fall asleep behind the wheel.

The good news is that sleep problems are very responsive to treatment even without medications. Changes in behavior related to sleep make a huge difference in quality of sleep. Continuing bad sleep habits (called poor sleep hygiene) make it very difficult for even sleeping pills to produce good results.

The absolute first thing to do is to have a consistent wake-up time every morning, 7 days per week. This sets your “biological clock” and helps improve sleep onset. And don’t nap. If you absolutely must nap every once in a while, set an alarm so you only sleep 20-30 minutes, and nap early in the day.

Can’t Fall Asleep

This actually is one of the easier problems to correct. Why can’t you fall asleep? Usually it’s because you’re worrying about something, or because you have trained yourself to be awake in bed.

The first thing to do is to make a commitment that the ONLY things you’re going to do in bed are sleep and have sex. Everything else happens somewhere else. No watching TV, no reading, no eating, no nothing. Often just taking this one step is enough to help gradually improve your ability to fall asleep.

If you are a light sleeper and use the TV to block out outside noise, change to a white-noise machine. TV noise (and light) actually makes it hard to sleep because of the change in pitch and volume from show to show and with commercial breaks.

If you have trouble getting to sleep because you’re worrying about something, take a week and try scheduling time earlier in each day to make a plan for dealing with whatever is worrying you. If you lie down and then remember something, get up and take care of it right away or make yourself a note so you don’t forget to deal with it in the morning. Oh, and don’t check work emails right before bed!

Can’t Stay Asleep

Many people fall asleep just fine but wake up before they need to get up, and then have trouble going back to sleep. This is often stress related and responds to stress reduction, meditation, and exercise.

This may sound weird, but it is important to only sleep as much as you need to feel refreshed the next day. Not everyone needs 8 hours, and spending excess time in bed can increase broken sleep and make it hard to get deep, restful sleep.

One important thing to do is STOP watching the clock. This makes it even harder to go to sleep. Set your alarm for your wake-up time and turn the clock towards the wall. Turn your phone over or plug it in in a place where you can’t reach it without getting out of bed.

Also, make sure you have a comfortable bed and bedroom. Cooler temperatures usually make it easier to sleep. It should be quiet and dark. As I said earlier, a white noise machine and blackout curtains can help if you are a light sleeper.

Substance use can interfere with quality sleep too. Caffeine, alcohol and nicotine all interfere with quality sleep. Caffeine should be avoided after noon, alcohol should be avoided after dinner and nicotine should be avoided altogether 😉

What Next?

If you have tried these measures and still find yourself unable to fall asleep, unable to stay asleep, and feeling sleepy during the day, it’s time to see the doctor. Sleep trouble is potentially dangerous and treatment can significantly improve your quality of life.

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Fish Oil Is Good For Body And Mind

What if I told you there was a supplement that has proven to be good for your heart, your mind, your brain, your immune system, your joints, your digestive system AND improves women’s health?  There is!

It’s fish oil.  Yep, the lowly fish oil capsule can help ALL these parts of your body.

As you know, I’m very interested in nutrition and supplementation and their role in health.  It’s been fascinating to read research supporting the role of fish oil in general health.

I’m beginning to think EVERYONE from birth to death should take fish oil.

First let’s talk about all the physical and mental benefits of fish oil supplementation.  I’ll try to be brief!

HEART HEALTH

  • Reduces the risk of atrial fibrillation after heart attack
  • Reduces blood pressure
  • Eliminates aspirin resistance
  • Helps keep grafts open after bypass surgery
  • Decreases triglyceride levels
  • Improves heart function and decreases hospitalizations in heart failure patients
  • Inconclusive evidence about preventing both first and subsequent heart attacks

MENTAL HEALTH

  • Reduces anxiety symptoms by 20%
  • Prolongs remission and decreases depression symptoms in patients with bipolar disorder
  • Decreases depression symptoms and aggression in patients with borderline personality disorder
  • Decreases symptoms and promotes remission in major depression
  • Decreases psychotic symptoms in schizophrenia

BRAIN HEALTH

  • Improves cognition and behavior in children with developmental disorders
  • Inconsistent benefit in Alzheimer’s patients (some studies show benefit, some don’t)

IMMUNE RESPONSE / PAIN

  • Decreases pain and stiffness in rheumatoid arthritis
  • Decreases symptoms in systemic lupus
  • Decreases pain and the need for pain medication in patients with nonsurgical neck and back pain
  • Decreases need for rescue inhaler in exercise-induced asthma

DIABETES

  • Decreases risk of type I diabetes in children
  • Decreases insulin resistance in type II diabetes

WOMEN’S HEALTH

  • Significantly reduces menstrual symptoms in women
  • Reduces the frequency of menopausal hot flushes (but not their severity, unfortunately)
  • Decreases testosterone levels in women with PCOS
  • Decreases the rate of preterm birth when used in pregnancy

Wow, fish oil is good for such a long list of conditions and problems!  So how much fish oil is the right amount?  It depends on why you’re taking it, and what your diet is like.

In the USA we eat a LOT of omega-6 fatty acids.  They are found in nearly every oil used in cooking.  Omega-3 fatty acids are harder to get.  They are in flaxseeds, hemp seeds, purslane and walnuts as well as in fatty fish.

The best and safest sources of fish oil are small oily fish (like anchovies, sardines and herring) found low down on the food chain.  Fish high on the food chain (like tuna, mackerel and shark) tend to store up toxins from fish they’ve eaten, a phenomenon called bioaccumulation.

Recommended dosages vary based on why you’re taking it.  For general health purposes it’s reasonable to take 500-1000 mg daily.  Those with heart or vascular disease (including high cholesterol) should consider 1-3 gm daily.  Much higher doses are needed for those with autoimmune disease, neurological or psychiatric problems, or chronic pain.  A therapeutic trial of 5-10 gm daily is reasonable for these conditions.

Be careful which fish oil products you buy, some are not labeled accurately according to a review I found at ConsumerLab.com.  (I subscribe to this website because it gives me third-party testing results for all sorts of supplements.)

Want to know what fish oil my family and I take?  (Bet you can guess, if you’ve been reading this blog for awhile.)

OmegaGuard from the Shaklee Corporation is ultrapurified fish oil made from sardines.  Two capsules gives 1200 mg fish oil, free of mercury and other contaminants.

And no fish burps!  Yay!

Here’s a link to more information about OmegaGuard.  You can order it through this link.

QUESTION:  I was surprised to learn that fish oil was so effective in controlling chronic pain.  Was there one use for fish oil that surprised you?

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Asthma Education Programs In School

You know, air is one of those things you just have to have. Asthma interferes with airflow, causing air trapping in the lungs, wheezing, cough and shortness of breath. It is estimated that one in 12 children has asthma, and it is the single most common reason for missed days of school.

Asthma attacks are common. Almost 50% of children with asthma report having at least one attack in any given year. Attacks are very frightening, with sudden onset of symptoms, and are a common reason for ER visits. It is the third leading cause of hospitalization for children under 15. Thousands of Americans die every year from asthma. Black people are three times more likely to die from asthma than Caucasians.

Credit: Healthdirect.gov.au

There was a study published that explored using school-based education programs about asthma. They found that teaching children about asthma in school decreased trips to the ER and hospitalizations.

There is a big problem with asthma management in this country. Many children and parents don’t know how to use inhalers properly. Children aren’t comfortable reporting symptoms at school because they’re embarrassed to ask to go to the nurse to use their medication. And access to primary care is inconsistent, leading parents to overuse the ER.

Asthma education programs in school raise awareness among students and teachers so children with asthma are less likely to be stigmatized. The more people who are able to recognize early signs of an asthma attack, the more likely a child will get treatment quickly when it is most effective.

Asthma claims the lives of thousands of people yearly. There is unfortunately limited primary care access in many parts of the country. With higher illness burden in African American children, more ways to educate patients and parents about asthma management are needed. Asthma education programs in schools are a natural and (now) proven option to decrease ER visits and hospital stays.

QUESTION: Do you think teaching children about asthma in school will help raise awareness and improve health outcomes?

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Is Measles Making A Comeback?

Lately measles has been in the news a lot  Five years we had a big outbreak of measles here in Ohio.  Currently Europe is seeing the highest numbers of measles cases they have had in 20 years.  The Pacific Northwest,  Texas and New York (among others) are seeing cases and it’s estimated that the US may see more measles cases in 2019 than we have seen in 30 years.

It is ironic that the success of childhood vaccination is the reason we’re seeing the resurgence of this disease.

Most people have never seen measles and don’t know how to recognize it.  I have never seen measles either.  Before you go questioning my training, you should know the reason WHY I’ve never seen measles.  For a very long time, measles has been extraordinarily rare in the United States.  The reason for this is universal childhood vaccination.

The live measles vaccine was introduced in 1963.  Before that time, according to the CDC it is estimated that 3-4 million people in the US got measles every year.  About 48,000 people were hospitalized, over 400 people died and 1000 people were left permanently disabled from measles encephalitis (brain infection).  That’s EVERY YEAR.

In the 1990s over 500,000 children still died worldwide ever year from measles.  That’s like 3 Boeing 747 jumbo jets crashing EVERY DAY, all year long.  From 2000-2013 there were 37-220 cases of measles in the US per year.  All of these cases were related to international travel, or exposure to an infected international traveler.  Measles was common in other parts of the world, you see.  It is much less common now, but by no means gone.

Ten states in the USA are reporting measles outbreaks right now.  What is interesting is that researchers predicted this last year, by looking at the rates of non-medical exemptions for vaccination.  The areas that have the highest rates of non-medical exemptions are the hot spots for the current outbreaks.

Why?

If vaccination resulted in the near-eradication of measles in this country, it doesn’t take a genius to see that falling vaccination rates will result in a resurgence of the disease.

Well-intentioned parents who love their children are frightened by all the reports of vaccine injury in the news media and on bloggers’ websites.  So they refuse to vaccinate and therefore put their families at risk from a dangerous, highly contagious disease that has no specific treatment.

If you or a family member get measles it is critically important to recognize it as soon as possible.  So let’s review the symptoms of measles.

  1. Fever:  sudden onset of high fever, sometimes up to 105F
  2. Cough, runny nose (coryza) and conjunctivitis:  These are sometimes called the “3 C’s” of measles.  Measles is a respiratory illness so the cough and sneezing is how the virus is spread.  Anyone with a fever, cough and runny nose should stay at home until the fever is gone.  If they get red, watery eyes they should ESPECIALLY be isolated until the fever is gone.
  3. Koplik’s spots:  These are little gray-white spots (like grains of sand or salt) surrounded by a red ring on the insides of the cheeks.  Those who have these spots are VERY contagious.  You can see a picture of them here.
  4. Rash:  The rash is what most people associate with measles.  It starts at the hairline and spreads down to the feet, and disappears slowly the same way.  This picture is from the CDC website.

measles-22-lg

If you are planning to travel to a country where measles is common, make sure your immunizations are up-to-date.  Large outbreaks have been reported in England, France, Germany, India, and the Philippines, to name a few.  The outbreak here in Ohio five years ago was related to unvaccinated travelers to the Philippines who then came back and exposed people in Ohio’s unvaccinated Amish population.

These measles cases are a good illustration of why universal vaccination doesn’t work as well if it’s NOT universal.  As vaccination rates fall because parents refuse to allow their children to be immunized, outbreaks of vaccine-preventable diseases will become more and more common.

Measles is highly contagious.  Approximately 90% of non-immune people exposed to a sick patient will get sick with the disease.  This is compared to an estimated 33-45% for influenza.

There are people who CANNOT be immunized.  The immunocompromised, those who are allergic to vaccine components, and the very young are unable to be fully vaccinated.  They depend on us to limit our ability to spread these vaccine preventable illnesses to them.

QUESTION: Have you ever seen measles?

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Healthy Skin Care

Believe it or not, summer is coming. Eventually.

Today I found myself dreaming about slathering on sunscreen and heading out to ride roller coasters at my favorite amusement park. I put sunscreen on my face every morning all year around. It occurred to me how many people don’t know how to tell the difference between dangerous and healthy skin care products.

This week I wanted to round up a list of the most dangerous skin care ingredients so you can check your products and make sure your skin is safe. Your skin is your largest organ and it’s the first thing people see so you should take good care of it and keep it healthy!

Parabens

Parabens are chemicals that are used as preservatives in skin care products. They mimic estrogen and disrupt endocrine signaling. Researchers have found parabens in breast tissue and have shown that they increase breast cancer cell growth. Parabens can even block the activity of tamoxifen, a drug that inhibits the growth of estrogen-sensitive breast cancer cells.

Parabens in breast tissue are intact, meaning they did not go through the liver. These parabens were not in food, but instead were absorbed directly across the skin. Parabens are used in a lot of very expensive skin care products, but it is becoming better understood that these preservatives are not safe. Check your skin care product ingredient labels to make sure parabens are nowhere to be found!

Artificial Colors

If there is something in your skin care that has a color followed by a number, it doesn’t belong in or on your body. These coloring agents are derived from petroleum. In general products derived from petroleum are considered human carcinogens and artificial colors are associated with ADHD in children. The EU has banned them. They shouldn’t be in your skin care products.

“Fragrance”

What does THIS mean? No one knows, actually. The word “fragrance” on a skin care label is deliberately vague and may include a number of dangerous ingredients like phthalates, solvents and other toxic chemicals.

Fragrances are associated with skin problems like rashes and eczema and they can trigger allergies and asthma attacks in sensitive people. It’s safest to use products that don’t have added fragrance.

Phthalates

These chemicals are used to soften plastics and are also found in lotions, creams, perfumes, nail polish and hair spray. They are often part of the “fragrance” in scented products (see above). Like parabens they mimic hormones and can affect cancer risk and fertility in both men and women.

Bottom Line

There are a number of dangerous chemicals that have no place in our diet, our water supply and our health and beauty products. This is by no means an exhaustive list. Since I’m focusing today on healthy skin care today I wanted to briefly touch on some of the most prevalent.

Please go grab your skin care products and check the ingredient lists. If you find parabens, phthalates, “fragrance” or artificial coloring agents please consider switching to skin care products which don’t use these ingredients.

Want to know what skin care I use? Bet you can guess 😉 Click here to see the products I trust for myself and my family, and click here to see the list of 2500 harmful ingredients NEVER present in the products I use.

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Reduce Colds And Flu With Vitamin D

How many colds and bouts of bronchitis do you have in any given winter?  Two?  Three?  Or are you one of those people who gets over one cold just to come down with the next?

Are you envious of those who don’t ever seem to get sick?  What if I told you the difference could be in your blood?  AND that it’s something EASY to change?

Turns out taking a vitamin D supplement reduces the risk of acute respiratory infections!  I’ve written about vitamin D before.  This nutrient has a lot of health benefits that we’re just starting to understand.  It helps keep bones strong.  It has mental health benefits.  Vitamin D levels are linked to the risk for multiple sclerosis.  We really don’t understand everything about how vitamin D works.

Credit: https://www.humnutrition.com/

Researchers in the UK wanted to know if there was a link between vitamin D levels and risk of colds and flu.  Specifically, they wanted to know if vitamin D supplements helped prevent respiratory infections.

Last year their study was published in the British Medical Journal.  They analyzed 25 other papers involving over 11,000 people to see if there was evidence that vitamin D supplements protect against respiratory infection.

They found that people who took vitamin D supplements did have a lower risk of acute respiratory infection, but the effect was pretty modest.  Overall, those who took vitamin D supplements had a 40.3% risk of acute respiratory infection, while those who didn’t had a 42.2% risk.  That means you have to treat 53 people to keep one person URI-free.  (The rest either would have been URI free without the supplement, or would have still gotten respiratory infections in spite of the supplement.)

Not a big effect, right?  Well let’s look deeper, OK?  The authors looked at those who were deficient to begin with, having a blood level less than 25 nmol/L, and found that with supplementation the risk dropped from 55% to 40.5%.  Your number needed to treat dropped from 53 to 7!

The authors also wanted to know if it mattered how you took your vitamin D.  In Europe apparently it’s common to give a huge dose (>30,000 IU) every once in awhile, called bolus dosing.  In the US we usually dose daily or weekly instead.

The study found that bolus dosing was NOT effective, and if you just looked at the studies that gave the vitamin D supplements on a daily or weekly schedule the effect was quite dramatic.

Those who started with low vitamin D levels saw their risk of upper respiratory infections drop from 59.8% to 31.5%.  (NNT=3.5)  That is a huge impact!  The fact that correcting deficiency had such a big effect is good evidence that this is real and not just statistical fancy footwork or a coincidence.

They also found a big drop, 46.2% to 33.6%, in children aged 1-16 years who were supplemented with vitamin D.  (NNT=8)  Since kids in school are exposed to germs all the time, this reduction is very important.

How can we use this information?  If you live in northern Ohio (or anywhere north of 40 degrees north latitude) you ARE vitamin D deficient unless you are taking a supplement.  So everyone in Cleveland needs to take a supplement all year ’round.  You also should have your levels checked periodically by your doctor or health practitioner to make sure you’re taking enough of a supplement, because some people need more than others.

I prefer to have my patients take their vitamin D every day rather than once per week.  It is easier to remember to take something every day, just make it part of your morning routine.  The best dose I’ve found is 2000-3000 units daily.  What is in your multivitamin is NOT enough.

While taking a vitamin D supplement is helpful, there’s more to staying healthy and warding off colds and flu than taking vitamins.  Make sure you’re washing your hands regularly.  Drink plenty of fresh clean water, get enough sleep, and watch your stress levels.  Stress depresses the immune system so if you’re feeling overwhelmed make sure to beef up your self-care routine!

If you’re wondering how to get enough vitamin D, please check out Shaklee’s Vita D3.  It’s an inexpensive way to add insurance for heart, bone AND immune health!  If you’re not already a Shaklee family member, why not click this link to get your personalized health assessment?  There’s no cost and no commitment, just individual recommendations for diet and lifestyle changes (and smart supplementation of course) to meet your health goals.

I have so many friends and patients suffering cold after cold this winter.  Now you have one more tool in the toolbox to keep you well!

QUESTION: Do you take vitamin D every day?

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Preventing Falls And Fractures

With the Snowpocalypse on its way this weekend I’ve been thinking about the rash of injuries that result from snow and ice every winter. Wrist fractures, back injuries, and the dreaded hip fracture happen when older adults slip and fall on snow and ice. What are some ways we have of preventing falls?

It’s obvious that preventing falls is much better than treating injuries when they happen. About 20% of hip fracture patients won’t leave the nursing home afterwards. Prevention strategies can be broadly divided into two categories: environmental measures and personal factors.

Environmental Measures

What can we do to make the environment safer and prevent falls? Snow removal and preventing the formation of ice (where possible) are obvious steps to take. Less obvious are installing railings on stairs, improving lighting, and placing awnings to prevent accumulation of snow and ice on landings and access points.

Personal Factors

Let’s face it, we live in northern Ohio. Snow and ice happen for about half the year. We can’t avoid it altogether and we can’t remove it all. So improving each person’s ability to avoid falls and avoid injury if they DO fall is critically important.

If you’re faced with ice and more snow than you’re comfortable with, stay home if possible. If you must go out, keeping one hand on something stable like a railing is smart when navigating stairs or other risky places. Using a cane if you have one can help.

Exercise, particularly Tai Chi, has been shown to reduce the risk of falls in senior adults. Better body awareness, better muscle strength and tone, and better balance are some of the benefits offered by regular exercise and Tai Chi in particular.

For the more adventurous, martial arts like jiu jitsu teach the student how to fall safely and reduce the risk of injuries in a fall. I myself have avoided serious injury in a fall not long ago, due to my training.

If you’re a woman over 60, make sure you’ve had a bone density (DEXA) test. This is a simple Xray that measures the strength of your bones. Using your bone density and other risk factors like age, gender and medical history, your doctor can estimate your fracture risk. If your fracture risk is high, you should discuss with your doctor what you can do to reduce your risk.

One important thing to do to keep your bones strong is to take vitamin D and a bone health supplement daily. Here in northern Ohio adults need 2000-3000 units of vitamin D every day, all year around. A lot of doctors tell patients to take calcium but bones need calcium, magnesium and vitamin D to be healthy. I recommend Shaklee’s OsteoMatrix which provides SMALL coated caplets proven to be well absorbed to support bone health.

Avoiding falls and avoiding injury from falls is very important. First, you have to stay on your feet. If a fall does happen, being able to fall safely and having strong bones to prevent fractures is critical.

QUESTION: Are you afraid of falls? What do you do to avoid them and stay safe?

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