Are you over 75? Here’s what you need to know about vitamin D
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Vitamin D is essential for bone health, immune function and overall wellbeing. And it becomes even more crucial as we age.
New guidelines from the international Endocrine Society recommend people aged 75 and over should consider taking vitamin D supplements.
But why is vitamin D so important for older adults? And how much should they take?
Young people get most vitamin D from the sun
In Australia, it is possible for most people under 75 to get enough vitamin D from the sun throughout the year. For those who live in the top half of Australia – and for all of us during summer – we only need to have skin exposed to the sun for a few minutes on most days.
The body can only produce a certain amount of vitamin D at a time. So staying in the sun any longer than needed is not going to help increase your vitamin D levels, while it will increase your risk of skin cancer.
But it’s difficult for people aged over 75 to get enough vitamin D from a few minutes of sunshine, so the Endocrine Society recommends people get 800 IU (international units) of vitamin D a day from food or supplements.
Why you need more as you age
This is higher than the recommendation for younger adults, reflecting the increased needs and reduced ability of older bodies to produce and absorb vitamin D.
Overall, older adults also tend to have less exposure to sunlight, which is the primary source of natural vitamin D production. Older adults may spend more time indoors and wear more clothing when outdoors.
As we age, our skin also becomes less efficient at synthesising vitamin D from sunlight.
The kidneys and the liver, which help convert vitamin D into its active form, also lose some of their efficiency with age. This makes it harder for the body to maintain adequate levels of the vitamin.
All of this combined means older adults need more vitamin D.
Deficiency is common in older adults
Despite their higher needs for vitamin D, people over 75 may not get enough of it.
Studies have shown one in five older adults in Australia have vitamin D deficiency.
In higher-latitude parts of the world, such as the United Kingdom, almost half don’t reach sufficient levels.
This increased risk of deficiency is partly due to lifestyle factors, such as spending less time outdoors and insufficient dietary intakes of vitamin D.
It’s difficult to get enough vitamin D from food alone. Oily fish, eggs and some mushrooms are good sources of vitamin D, but few other foods contain much of the vitamin. While foods can be fortified with the vitamin D (margarine, some milk and cereals), these may not be readily available or be consumed in sufficient amounts to make a difference.
In some countries such as the United States, most of the dietary vitamin D comes from fortified products. However, in Australia, dietary intakes of vitamin D are typically very low because only a few foods are fortified with it.
Why vitamin D is so important as we age
Vitamin D helps the body absorb calcium, which is essential for maintaining bone density and strength. As we age, our bones become more fragile, increasing the risk of fractures and conditions like osteoporosis.
Keeping bones healthy is crucial. Studies have shown older people hospitalised with hip fractures are 3.5 times more likely to die in the next 12 months compared to people who aren’t injured.
Vitamin D may also help lower the risk of respiratory infections, which can be more serious in this age group.
There is also emerging evidence for other potential benefits, including better brain health. However, this requires more research.
According to the society’s systematic review, which summarises evidence from randomised controlled trials of vitamin D supplementation in humans, there is moderate evidence to suggest vitamin D supplementation can lower the risk of premature death.
The society estimates supplements can prevent six deaths per 1,000 people. When considering the uncertainty in the available evidence, the actual number could range from as many as 11 fewer deaths to no benefit at all.
Should we get our vitamin D levels tested?
The Endocrine Society’s guidelines suggest routine blood tests to measure vitamin D levels are not necessary for most healthy people over 75.
There is no clear evidence that regular testing provides significant benefits, unless the person has a specific medical condition that affects vitamin D metabolism, such as kidney disease or certain bone disorders.
Routine testing can also be expensive and inconvenient.
In most cases, the recommended approach to over-75s is to consider a daily supplement, without the need for testing.
You can also try to boost your vitamin D by adding fortified foods to your diet, which might lower the dose you need from supplementation.
Even if you’re getting a few minutes of sunlight a day, a daily vitamin D is still recommended.
Elina Hypponen, Professor of Nutritional and Genetic Epidemiology, University of South Australia and Joshua Sutherland, PhD Candidate – Nutrition and Genetic Epidemiology, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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7 Healthy Gut Habits For Women Over 40 – by Lara West
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With regard to the titular 7 healthy gut habits for women over 40, a chapter is devoted to each one of those habits, and she goes into quite some detail in each category, more than you might expect.
As for the 7 things, we’ll not keep them a mystery; they are:
- Intermittent fasting
- Prebiotics & probiotics
- Mindful eating
- Understanding ingredients
- Movement
- Sleep
- Stress management
Of course, all of these things are good regardless of one’s age or gender, but West is writing with women over 40 in mind, and as such, she will focus on things that are especially relevant to those of us who are indeed women over 40.
You may be wondering: what if I’m a long way over 40, and menopause is a distant memory? In that case, 90% of this will still be relevant to you; the only parts that won’t be, are those that pertain specifically to the menopausal transitional phase itself, rather than the post-menopause state.
You may also be wondering: what if I’m a man, and menopause is just not in the cards for me? In that case, maybe about 70% of this will still be relevant to you, because of the broad applicability of most of the advice. That said, if it’s just for yourself, you’d probably do better with a book of which 100% is relevant to you, rather than this one.
The style is conversational pop-science, with personal anecdotes mixed in with references to science. It’s definitely on the light/easy-reading end of books that we’ve reviewed on the topic.
Bottom line: if you’re a woman over 40 who would like to improve your gut health, this book was written for you.
Click here to check out 7 Healthy Gut Habits For Women Over 40, and rediscover vitality!
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Chromium Picolinate For Blood Sugar Control & Weight Loss
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First, a quick disambiguation:
- chromium found in food, trivalent chromium of various kinds, is safe (in the quantities usually consumed) and is sometimes considered an essential mineral, sometimes considered unnecessary but beneficial. It’s hard to know for sure, since it’s in a lot of foods (naturally, like many trace elements)
- chromium found in pollution, hexavalent chromium (so: twice as many cationic bonds, if this writer’s chemistry serves her correctly) is poisonous.
We’re going to be writing about the food kind, which is also possible to take as a supplement.
In this case, supplementing vs getting from food is quite a big difference, by the way, since (unlike for a lot of things, which are often the other way around) the bioavailability of chromium from food is very low (around 2.5%), whereas chromium picolinate, one of the most commonly-used supplement forms, boasts higher bioavailability.
Does it work for blood sugars?
Yes, it does! At least, it does in the case of people with type 2 diabetes. Rather than bombard you with many individual studies, here’s a systematic review and meta-analysis of 22 criteria-meeting randomized clinical trials that found:
❝The available evidence suggests favourable effects of chromium supplementation on glycaemic control in patients with diabetes.
Chromium monosupplement may additionally improve triglycerides and HDL-C levels.❞
Type 1 diabetes does not have anything like the same weight of evidence, and indeed,
we couldn’t find a single human study. It was beneficial for mice with artificially-induced T1D, thoughwait no, we have an update! We found literally a single human study:Chromium picolinate supplementation for diabetes mellitus
Literally, as in: it’s a case study of one person, and the results were a modest reduction in Hb A1c levels after 3 months of 600μg daily; the researchers concluded that ❝chromium picolinate continues to fall squarely within the scope of “alternative medicine,” with both unproven benefits and unknown risks❞.
As for people without diabetes, it may reduce the risk of diabetes:
Risk of Type 2 Diabetes Is Lower in US Adults Taking Chromium-Containing Supplements
However! This was an observational study, and correlation ≠ causation.
Furthermore, they said:
❝Over one-half the adult US population consumes nutritional supplements, and over one-quarter consumes supplemental chromium. The odds of having T2D were lower in those who, in the previous 30 d, had consumed supplements containing chromium❞
That “over one-quarter consumes supplemental chromium” brought our attention to the fact that this is not talking about specifically chromium “monosupplements” (definitely not quarter of the adult population take those), but rather, “multivitamin and mineral” supplements that also contain a tiny amount (often under 50μg) of chromium.
In other words, this ruins the data and honestly the benefit could have been from anything in the “multivitamin and mineral” supplement, or indeed, could just be “the kind of person who takes supplements is the kind of person who lives a lifestyle that is less conducive to becoming diabetic”.
Does it work for weight loss?
We’re running out of space here, so we’ll be brief:
No.
There are many papers that have concluded this, but here are two:
Chromium picolinate supplementation for overweight or obese adults
and
Is it safe?
Science’s current best answer is “we don’t know; it hasn’t been tested enough; we haven’t even established the tolerable upper limit, which is usually step 1 of establishing safety”.
Nor is there an estimated average requirement (if indeed there even is a requirement, which question is also not as yet answered conclusively by science), and science falls back to “here’s an average of what people consume in their diet, so that’s probably safe, we guess”.
(that average was reckoned as 25μg/day for young women and 25μg/day for young men, by the way; older ages not as yet reckoned)
You can read about this sorry state of affairs here.
Want to try some?
Notwithstanding the above lack of data for safety, it does have benefits for blood sugars, so if that’s a gamble you’re willing to make, then here’s an example product on Amazon.
Note: the dosage per capsule there (800μg) is half of the low end of the dose that was implicated in the serious kidney condition caused in this case study (1200–2400μg), so if you are going to try it, we strongly recommend not taking more than one per day.
Take care!
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The Green Roasting Tin – by Rukmini Iyer
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You may be wondering: “do I really need a book to tell me to put some vegetables in a roasting tin and roast them?” and maybe not, but the book offers a lot more than that.
Indeed, the author notes “this book was slightly in danger of becoming the gratin and tart book, because I love both”, but don’t worry, most of the recipes are—as you might expect—very healthy.
As for formatting: the 75 recipes are divided first into vegan or vegetarian, and then into quick/medium/slow, in terms of how long they take.
However, even the “slow” recipes don’t actually take more effort, just, more time in the oven.
One of the greatest strengths of this book is that not only does it offer a wide selection of wholesome mains, but also, if you’re putting on a big spread, these can easily double up as high-class low-effort sides.
Bottom line: if you’d like to eat more vegetables in 2024 but want to make it delicious and with little effort, put this book on your Christmas list!
Click here to check out The Green Roasting Tin, and level-up yours!
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When Bad Joints Stop You From Exercising (5 Things To Change)
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The first trick to exercising with bad joints is to have better joints.
Now, this doesn’t necessarily mean you can take a supplement and magically your joint problems will be cured, but there are adjustable lifestyle factors that can and will make things relatively better or worse.
We say “and will”, because you don’t get a choice in that part. Everything we do, every little choice in our day, makes our health a little better or a little worse in some aspect(s). But we do get a choice between “relatively better” and “relatively worse”.
With that in mind, do check out:
- Avoiding/Managing Osteoarthritis
- Avoiding/Managing Rheumatoid Arthritis
- How To Really Look After Your Joints
Ok, you have bad joints though; what next?
Let’s assume you’re doing your best with the above, and/or have simply decided not to, which is your call. You know your circumstances best. Either way, your joints are still not in sufficiently good condition to be able to exercise the way you’d like.
First, the obvious: enjoy low-impact exercises
For example:
- Swimming
- Yoga (much more appropriate here than the commonly-paired “and tai chi”)*
- Isometric exercises (i.e. exercise without movement, e.g. squeezing things, or stationary stability exercises)
*This is not to say that tai chi is bad. But if your problem is specifically your knees, there are many movements in most forms of tai chi that require putting the majority of one’s weight on one bent leg, which means the knee of that leg is going to suffer. If your knees are fine, then this won’t be an issue and it will simply continue strengthening your knees without discomfort. But they have to be fine first.
See also: Exercising With Osteoporosis
Second: support your joints through a full range of motion
If you have bad joints, you probably know that there’s an unfortunate paradox whereby you get to choose between:
- Exercise, and inflame your joints
- Rest, and your joints seize up
This is the way to get around that damaging dilemma.
Moving your joints through a full range of motion regularly is critical for their maintenance, so do that in a way that isn’t straining them:
If it’s your shoulders, for example, you can do (slow, gentle!) backstroke or front-crawl or butterfly motions while standing in the comfort of your living room.
If it’s your knees, then supported squats can do you a world of good. That means, squat in front of a table or other stable object, with your fingertips (or as much of your hands as you need) on it, to take a portion of your weight (it can be a large portion; that’s fine too!) while you go through the full range of motion of the squat. Repeat.
And so forth for other joints.
See also: The Most Underrated Hip Mobility Exercise (Not Stretching)
Third: work up slowly, and stop early
You can do exercises that involve impact, and if you live a fairly normal life, you’ll probably have to (walking is an impact exercise). You can also enjoy cycling (low-impact, but not so low-impact as we discussed in the last section) and work up to running if you want to.
However…
While building up your joints’ mobility and strength, it is generally a good idea to stop before you think you need to.
This means that it’s important to do those exercises in a way that you can stop early. For example, an exercise bike or a treadmill can be a lot of use here, so that you don’t find you need to stop for the day while miles from your house.
If you get such a device, it doesn’t even have to be fancy and/or expensive. This writer got herself an inexpensive exercise bike like this one, and it’s perfectly adequate.
Fourth: prioritize recovery, even if it doesn’t feel like you need it
Everyone should do this anyway, but if your joints are bad, it goes double:
Overdone It? How To Speed Up Recovery After Exercise (According To Actual Science)
Fifth: get professional help
Physiotherapists are great for this. Find one, and take their advice for your specific body and your specific circumstances and goals.
Take care!
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Relationships: When To Stick It Out & When To Call It Quits
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Like A Ship Loves An Anchor?
Today’s article may seem a little bit of a downer to start with, but don’t worry, it picks up again too. Simply put, we’ve written before about many of the good parts of relationships, e.g:
Only One Kind Of Relationship Promotes Longevity This Much!
…but what if that’s not what we have?
Note: if you have a very happy, secure, fulfilling, joyous relationship, then, great! Or if you’re single and happy, then, also great! Hopefully you will still find today’s feature of use if you find yourself advising a friend or family member one day. So without further ado, let’s get to it…
You may be familiar with the “sunk cost fallacy”; if not: it’s what happens when a person or group has already invested into a given thing, such that even though the thing is not going at all the way they hoped, they now want to continue trying to make that thing work, lest their previous investment be lost. But the truth is: if it’s not going to work, then the initial investment is already lost, and pouring out extra won’t help—it’ll just lose more.
That “investment” in a given thing could be money, time, energy, or (often the case) a combination of the above.
In the field of romance, the “sunk cost fallacy” keeps a lot of bad relationships going for longer than perhaps they should, and looking back (perhaps after a short adjustment period), the newly-single person says “why did I let that go on?” and vows to not make the same mistake again.
But that prompts the question: how can we know when it’s right to “keep working on it, because relationships do involve work”, as perfectly reasonable relationship advice often goes, and when it’s right to call it quits?
Should I stay or should I go?
Some questions for you (or perhaps a friend you might find yourself advising) to consider:
- What qualities do you consider the most important for a partner to have—and does your partner have them?
- If you described the worst of your relationship to a close friend, would that friend feel bad for you?
- Do you miss your partner when they’re away, or are you glad of the break? When they return, are they still glad to see you?
- If you weren’t already in this relationship, would you seek to enter it now? (This takes away sunk cost and allows a more neutral assessment)
- Do you feel completely safe with your partner (emotionally as well as physically), or must you tread carefully to avoid conflict?
- If your partner decided tomorrow that they didn’t want to be with you anymore and left, would that be just a heartbreak, or an exciting beginning of a new chapter in your life?
- What things would you generally consider dealbreakers in a relationship—and has your partner done any of them?
The last one can be surprising, by the way. We often see or hear of other people’s adverse relationship situations and think “I would never allow…” yet when we are in a relationship and in love, there’s a good chance that we might indeed allow—or rather, excuse, overlook, and forgive.
And, patience and forgiveness certainly aren’t inherently bad traits to have—it’s just good to deploy them consciously, and not merely be a doormat.
Either way, reflect (or advise your friend/family member to reflect, as applicable) on the “score” from the above questions.
- If the score is good, then maybe it really is just a rough patch, and the tools we link at the top and bottom of this article might help.
- If the score is bad, the relationship is bad, and no amount of historic love or miles clocked up together will change that. Sometimes it’s not even anyone’s fault; sometimes a relationship just ran its course, and now it’s time to accept that and turn to a new chapter.
“At my age…”
As we get older, it’s easy for that sunk cost fallacy to loom large. Inertia is heavy, the mutual entanglement of lives is far-reaching, and we might not feel we have the same energy for dating that we did when we were younger.
And there may sometimes be a statistical argument for “sticking it out” at least for a while, depending on where we are in the relationship, per this study (with 165,039 participants aged 20–76), which found:
❝Results on mean levels indicated that relationship satisfaction decreased from age 20 to 40, reached a low point at age 40, then increased until age 65, and plateaued in late adulthood.
As regards the metric of relationship duration, relationship satisfaction decreased during the first 10 years of the relationship, reached a low point at 10 years, increased until 20 years, and then decreased again.❞
Source: Development of Relationship Satisfaction Across the Life Span: A Systematic Review and Meta-Analysis
And yet, when it comes to prospects for a new relationship…
- If our remaining life is growing shorter, then it’s definitely too short to spend in an unhappy relationship
- Maybe we really won’t find romance again… And maybe that’s ok, if w’re comfortable making our peace with that and finding joy in the rest of life (this widowed writer (hi, it’s me) plans to remain single now by preference, and her life is very full of purpose and beauty and joy and yes, even love—for family, friends, etc, plus the memory of my wonderful late beloved)
- Nevertheless, the simple fact is: many people do find what they go on to describe as their best relationship yet, late in life ← this study is with a small sample size, but in this case, even anecdotal evidence seems sufficient to make the claim reasonable; probably you personally know someone who has done so. If they can, so can you, if you so wish.
- Adding on to that last point… Later life relationships can also offer numerous significant advantages unique to such (albeit some different challenges too—but with the right person, those challenges are just a fun thing to tackle together). See for example:
An exploratory investigation into dating among later‐life women
And about those later-life relationships that do work? They look like this:
this one looks like the title says it all, but it really doesn’t, and it’s very much worth at least reading the abstract, if not the entire paper—because it talks a lot about the characteristics that make for happy or unhappy relationships, and the effect that those things have on people. It really is very good, and quite an easy read.
See again: Healthy Relationship, Healthy Life
Take care!
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New study suggests weight loss drugs like Ozempic could help with knee pain. Here’s why there may be a link
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The drug semaglutide, commonly known by the brand names Ozempic or Wegovy, was originally developed to help people with type 2 diabetes manage their blood sugar levels.
However, researchers have discovered it may help with other health issues, too. Clinical trials show semaglutide can be effective for weight loss, and hundreds of thousands of people around the world are using it for this purpose.
Evidence has also shown the drug can help manage heart failure and chronic kidney disease in people with obesity and type 2 diabetes.
Now, a study published in the New England Journal of Medicine has suggested semaglutide can improve knee pain in people with obesity and osteoarthritis. So what did this study find, and how could semaglutide and osteoarthritis pain be linked?
Pormezz/Shutterstock Osteoarthritis and obesity
Osteoarthritis is a common joint disease, affecting 2.1 million Australians. Most people with osteoarthritis have pain and find it difficult to perform common daily activities such as walking. The knee is the joint most commonly affected by osteoarthritis.
Being overweight or obese is a major risk factor for osteoarthritis in the knee. The link between the two conditions is complex. It involves a combination of increased load on the knee, metabolic factors such as high cholesterol and high blood sugar, and inflammation.
For example, elevated blood sugar levels increase the production of inflammatory molecules in the body, which can damage the cartilage in the knee, and lead to the development of osteoarthritis.
Weight loss is strongly recommended to reduce the pain of knee osteoarthritis in people who are overweight or obese. International and Australian guidelines suggest losing as little as 5% of body weight can help.
But losing weight with just diet and exercise can be difficult for many people. One study from the United Kingdom found the annual probability of people with obesity losing 5% or more of their body weight was less than one in ten.
Semaglutide has recently entered the market as a potential alternative route to weight loss. It comes from a class of drugs known as GLP-1 receptor agonists and works by increasing a person’s sense of fullness.
Semaglutide for osteoarthritis?
The rationale for the recent study was that while we know weight loss alleviates symptoms of knee osteoarthritis, the effect of GLP-1 receptor agonists was yet to be explored. So the researchers set out to understand what effect semaglutide might have on knee osteoarthritis pain, alongside body weight.
They randomly allocated 407 people with obesity and moderate osteoarthritis into one of two groups. One group received semaglutide once a week, while the other group received a placebo. Both groups were treated for 68 weeks and received counselling on diet and physical activity. At the end of the treatment phase, researchers measured changes in knee pain, function, and body weight.
As expected, those taking semaglutide lost more weight than those in the placebo group. People on semaglutide lost around 13% of their body weight on average, while those taking the placebo lost around 3% on average. More than 70% of people in the semaglutide group lost at least 10% of their body weight compared to just over 9% of people in the placebo group.
Osteoarthritis of the knee is the most common type of osteoarthritis. SKT Studio/Shutterstock The study found semaglutide reduced knee pain significantly more than the placebo. Participants who took semaglutide reported an additional 14-point reduction in pain on a 0–100 scale compared to the placebo group.
This is much greater than the pain reduction in another recent study among people with obesity and knee osteoarthritis. This study investigated the effects of a diet and exercise program compared to an attention control (where participants are provided with information about nutrition and physical activity). The results here saw only a 3-point difference between the intervention group and the control group on the same scale.
The amount of pain relief reported in the semaglutide trial is also larger than that reported with commonly used pain medicines such as anti-inflammatories, opioids and antidepressants.
Semaglutide also improved knee function compared to the placebo. For example, people who took semaglutide could walk about 42 meters further than those on the placebo in a six-minute walking test.
How could semaglutide reduce knee pain?
It’s not fully clear how semaglutide helps with knee pain from osteoarthritis. One explanation may be that when a person loses weight, there’s less stress on the joints, which reduces pain.
But recent studies have also suggested semaglutide and other GLP-1 receptor agonists might have anti-inflammatory properties, and could even protect against cartilage wear and tear.
While the results of this new study are promising, it’s too soon to regard semaglutide as a “miracle drug” for knee osteoarthritis. And as this study was funded by the drug company that makes semaglutide, it will be important to have independent studies in the future, to confirm the findings, or not.
The study also had strict criteria, excluding some groups, such as those taking opioids for knee pain. One in seven Australians seeing a GP for their knee osteoarthritis are prescribed opioids. Most participants in the trial were white (61%) and women (82%). This means the study may not fully represent the average person with knee osteoarthritis and obesity.
It’s also important to consider semaglutide can have a range of side effects, including gastrointestinal symptoms and fatigue.
There are some concerns that semaglutide could reduce muscle mass and bone density, though we’re still learning more about this.
Further, it can be difficult to access.
I have knee osteoarthritis, what should I do?
Osteoarthritis is a disease caused by multiple factors, and it’s important to take a multifaceted approach to managing it. Weight loss is an important component for those who are overweight or obese, but so are other aspects of self-management. This might include physical activity, pacing strategies, and other positive lifestyle changes such as improving sleep, healthy eating, and so on.
Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney and Christina Abdel Shaheed, Associate Professor, School of Public Health, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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