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?

OPPO Find X5 Pro/Unsplash

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.

Older woman sits with a friend
People over 75 often have less exposure to sunlight. Aila Images/Shutterstock

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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  • Psychology Sunday: Family Estrangment & How To Fix It

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    Estrangement, And How To Heal It

    We’ve written before about how deleterious to the health loneliness and isolation can be, and what things can be done about it. Today, we’re tackling a related but different topic.

    We recently had a request to write about…

    ❝Reconciliation of relationships in particular estrangement mother adult daughter❞

    And, this is not only an interesting topic, but a very specific one that affects more people than is commonly realized!

    In fact, a recent 800-person study found that more than 43% of people experienced family estrangement of one sort or another, and a more specific study of more than 2,000 mother-child pairs found that more than 11% of mothers were estranged from at least one adult child.

    So, if you think of the ten or so houses nearest to you, probably at least one of them contains a parent estranged from at least one adult child. Maybe it’s yours. Either way, we hope this article will give you some pause for thought.

    Which way around?

    It makes a difference to the usefulness of this article whether any given reader experiencing estrangement is the parent or the adult child. We’re going to assume the reader is the parent. It also makes a difference who did the estranging. That’s usually the adult child.

    So, we’re broadly going to write with that expectation.

    Why does it happen?

    When our kids are small, we as parents hold all the cards. It may not always feel that way, but we do. We control our kids’ environment, we influence their learning, we buy the food they eat and the clothes they wear. If they want to go somewhere, we probably have to take them. We can even set and enforce rules on a whim.

    As they grow, so too does their independence, and it can be difficult for us as parents to relinquish control, but we’re going to have to at some point. Assuming we are good parents, we just hope we’ve prepared them well enough for the world.

    Once they’ve flown the nest and are living their own adult lives, there’s an element of inversion. They used to be dependent on us; now, not only do they not need us (this is a feature not a bug! If we have been good parents, they will be strong without us, and in all likelihood one day, they’re going to have to be), but also…

    We’re more likely to need them, now. Not just in the “oh if we have kids they can look after us when we’re old” sense, but in that their social lives are growing as ours are often shrinking, their family growing, while ours, well, it’s the same family but they’re the gatekeepers to that now.

    If we have a good relationship, this goes fine. However, it might only take one big argument, one big transgression, or one “final straw”, when the adult child decides the parent is more trouble than they’re worth.

    And, obviously, that’s going to hurt. But it’s pretty much how it pans out, according to studies:

    Here be science: Tensions in the Parent and Adult Child Relationship: Links to Solidarity and Ambivalence

    How to fix it, step one

    First, figure out what went wrong.

    Resist any urge to protect your own feelings with a defensive knee-jerk “I don’t know; I was a good, loving parent”. That’s a very natural and reasonable urge and you’re quite possibly correct, but it won’t help you here.

    Something pushed them away. And, it will almost certainly have been a push factor from you, not a pull factor from whoever is in their life now. It’s easy to put the blame externally, but that won’t fix anything.

    And, be honest with yourself; this isn’t a job interview where we have to present a strength dressed up as a “greatest weakness” for show.

    You can start there, though! If you think “I was too loving”, then ok, how did you show that love? Could it have felt stifling to them? Controlling? Were you critical of their decisions?

    It doesn’t matter who was right or wrong, or even whether or not their response was reasonable. It matters that you know what pushed them away.

    How to fix it, step two

    Take responsibility, and apologize. We’re going to assume that your estrangement is such that you can, at least, still get a letter to them, for example. Resist the urge to argue your case.

    Here’s a very good format for an apology; please consider using this template:

    The 10-step (!) apology that’s so good, you’ll want to make a note of it

    You may have to do some soul-searching to find how you will avoid making the same mistake in the future, that you did in the past.

    If you feel it’s something you “can’t change”, then you must decide what is more important to you. Only you can make that choice, but you cannot expect them to meet you halfway. They already made their choice. In the category of negotiation, they hold all the cards now.

    How to fix it, step three

    Now, just wait.

    Maybe they will reply, forgiving you. If they do, celebrate!

    Just be aware that once you reconnect is not the time to now get around to arguing your case from before. It will never be the time to get around to arguing your case from before. Let it go.

    Nor should you try to exact any sort of apology from them for estranging you, or they will at best feel resentful, wonder if they made a mistake in reconnecting, and withdraw.

    Instead, just enjoy what you have. Many people don’t get that.

    If they reply with anger, maybe it will be a chance to reopen a dialogue. If so, family therapy could be an approach useful for all concerned, if they are willing. Chances are, you all have things that you’d all benefit from talking about in a calm, professional, moderated, neutral environment.

    You might also benefit from a book we reviewed previously, “Parent Effectiveness Training”. This may seem like “shutting the stable door after the horse has bolted”, but in fact it’s a very good guide to relationship dynamics in general, and extensively covers relations between parents and adult children.

    If they don’t reply, then, you did your part. Take solace in knowing that much.

    Some final thoughts:

    At the end of the day, as parents, our kids living well is (hopefully) testament to that we prepared them well for life, and sometimes, being a parent is a thankless task.

    But, we (hopefully) didn’t become parents for the plaudits, after all.

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  • Sprout Your Seeds, Grains, Beans, Etc

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    Good Things Come In Small Packages

    “Sprouting” grains and seeds—that is, allowing them to germinate and begin to grow—enhances their nutritional qualities, boosting their available vitamins, minerals, amino acids, and even antioxidants.

    You may be thinking: surely whatever nutrients are in there, are in there already; how can it be increased?

    Well, the grand sweeping miracle of life itself is beyond the scope of what we have room to cover today, but in few words: there are processes that allow plants to transform stuff into other stuff, and that is part of what is happening.

    Additionally, in the cases of some nutrients, they were there already, but the sprouting process allows them to become more available to us. Think about the later example of how it’s easier to eat and digest a ripe fruit than an unripe one, and now scale that back to a seed and a sprouted seed.

    A third way that sprouting benefits us is by reducing“antinutrients”, such as phytic acid.

    Let’s drop a few examples of the “what”, before we press on to the “how”:

    Sounds great! How do we do it?

    First, take the seeds, grains, nuts, beans, etc that you’re going to sprout. Fine examples to try for a first sprouting session include:

    • Grains: buckwheat, brown rice, quinoa
    • Legumes: soy beans, black beans, kidney beans
    • Greens: broccoli, mustard greens, radish
    • Nuts/seeds: almonds, pumpkin seeds, chia seeds

    Note: whatever you use should be as unprocessed as possible to start with:

    • On the one hand, you’d be surprised how often “life finds a way” when it comes to sprouting ridiculous choices
    • On the other hand, it’s usually easier if you’re not trying to sprout blanched almonds, split lentils, rolled oats, or toasted hulled buckwheat.

    Second, you will need clean water, a jar with a lid, muslin cloth or similar, and a rubber band.

    Next, take an amount of the plants you’ll be sprouting. Let’s say beans of some kind. Try it with ¼ cup to start with; you can do bigger batches once you’re more confident of your setup and the process.

    Rinse and soak them for at least 24 hours. Take care to add more water than it looks like you’ll need, because those beans are thirsty, and sprouting is thirsty work.

    Drain, rinse, and put them in a clean glass jar, covering with just the muslin cloth in place of the lid, held in place by the rubber band. No extra water in it this time, and you’re going to be storing the jar upside down (with ventilation underneath, so for example on some sort of wire rack is ideal) in a dark moderately warm place (e.g. 80℉ / 25℃ is often ideal, but it doesn’t have to be exact, you have wiggle-room, and some things will enjoy a few degrees cooler or warmer than that)

    Each day, rinse and replace until you see that they are sprouting. When they’re sprouting, they’re ready to eat!

    Unless you want to grow a whole plant, in which case, go for it (we recommend looking for a gardening guide in that case).

    But watch out!

    That 80℉ / 25℃ temperature at which our sprouting seeds, beans, grains etc thrive? There are other things that thrive at that temperature too! Things like:

    • E. coli
    • Salmonella
    • Listeria

    …amongst others.

    So, some things to keep you safe:

    1. If it looks or smells bad, throw it out
    2. If in doubt, throw it out
    3. Even if it looks perfect, blanch it (by boiling it in water for 30 seconds, before rinsing it in cold water to take it back to a colder temperature) before eating it or refrigerating it for later.
    4. When you come back to get it from the fridge, see once again points 1 and 2 above.
    5. Ideally you should enjoy sprouted things within 5 days.

    Want to know more about sprouting?

    You’ll love this book that we reviewed recently:

    The Sprout Book – by Doug Evans

    Enjoy!

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  • Statins: Study Insights

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    It’s Q&A Day at 10almonds!

    Q: Can you let us know about more studies that have been done on statins? Are they really worth taking?

    That is a great question! We imagine it might have been our recent book recommendation that prompted it? It’s quite a broad question though, so we’ll do that as a main feature in the near future!

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  • Sugar, Hazelnuts, Books & Brains

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    It’s Q&A Day!

    Each Thursday, we respond to subscriber questions and requests! If it’s something small, we’ll answer it directly; if it’s something bigger, we’ll do a main feature in a follow-up day instead!

    So, no question/request to big or small; they’ll just get sorted accordingly

    Remember, you can always hit reply to any of our emails, or use the handy feedback widget at the bottom. We always look forward to hearing from you!

    Q: Interesting info, however, I drink hazelnut milk LOL so would have liked a review of that. But now I want to give hemp and pea milks a try. Thanks

    Aww! Here then just for you, is a quick rundown…

    • Pros: high in protein¹, vitamin B, and vitamin E
    • Cons: high in fat², low in calcium

    ¹Compared head-to-head with almond milk for example, it has double the protein (but also double the calories)

    ²However, is also has been found to lower LDL (bad) cholesterol (and incidentally, also reduce inflammation), and in a later systematic review, it was found to not correlate to weight gain, despite its high calorie-content.

    If you don’t already, and would like to try making your own…

    Click here for step-by-step instructions to make your own hazelnut milk! (very simple)

    Q: Wondering if you can evaluate CLA and using it to assist with weight loss. Thanks

    Will do! (Watch this space)

    Q: What’s the process behind the books you recommend? You seem to have a limitless stream of recommendations

    We do our best!

    The books we recommend are books that…

    • are on Amazon—it makes things tidy, consistent, and accessible. And if you end up buying one of the books, we get a small affiliate commission*.
    • we have read—we would say “obviously”, but you might be surprised how many people write about books without having read them.
    • pertain in at least large part to health and/or productivity.
    • are written by humans—bookish people (and especially Kindle Unlimited users) may have noticed lately that there are a lot of low quality AI-written books flooding the market, sometimes with paid 5-star reviews to bolster them. It’s frustrating, but we can tell the difference and screen those out.
    • are of a certain level of quality. They don’t have to be “top 5 desert-island books”, because well, there’s one every day and the days keep coming. But they do have to genuinely deliver the value that we describe, and merit a sincere recommendation.
    • are varied—we try to not give a run of “samey” books one after another. We will sometimes review a book that covers a topic another previously-reviewed book did, but it must have something about it that makes it different. It may be a different angle or a different writing style, but it needs something to set it apart.

    *this is from Amazon and isn’t product-specific, so this is not affecting our choice of what books to review at all—just that they will be books that are available on Amazon.

    Q: Great video on dopamine. Thumbs up on the book recommendation. Would you please consider doing a piece or two on inflammation? I live with Lupus and it is a constant struggle. Thanks for the awesome work you do. Have an excellent day.

    Great suggestion! We will do that, and thank you for the kind words!

    Q: Why is your newsletter called 10almonds? Maybe I missed it in the intro email, but my curiosity wants to know the significance. Thanks!”

    It’s a reference to a viral Facebook hoax! There was a post going around that claimed:

    ❝HEADACHE REMEDY. Eat 10–12 almonds, the equivalent of two aspirins, next time you have a headache❞ ← not true!

    It made us think about how much health-related disinformation there was online… So, calling ourselves 10almonds was a bit of a tongue-in-cheek reference to that story… but also a reminder to ourselves:

    We must always publish information with good scientific evidence behind it!

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  • The 4 Bad Habits That Cause The Most Falls While Walking

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The risk of falling becomes greater (both in probability and in severity of consequences) as we get older. But, many people who do fall do so for the same reasons, some of which are avoidable. Dr. Doug Weiss has advice based on extensive second-hand experience:

    Best foot forward!

    If any of these prompt a “surely nobody does that” response, then, good for you to not have that habit, but Dr. Weiss has seen many patients who thusly erred. And if any of these do describe how you walk, then well, you’re not alone—time to fix it, though!

    • Walking with Stiff Legs: walking with a hyperextended (straight) knee instead of a slight bend (5-15°) makes it harder to adjust balance, increasing the risk of falls. This can also put extra pressure on the joints, potentially leading to osteoarthritis.
    • Crossing Legs While Turning: turning by crossing one leg over the other is a common cause of falls, particularly in the elderly. To avoid this, when turning step first with the foot that is on the side you are going to go. If you have the bad habit, this may feel strange at first, but you will soon adapt.
    • Looking Down While Walking: focusing only on the ground directly in front of you can cause you to miss obstacles ahead, leading to falls. Instead, practice “scanning”, alternating between looking down at the ground and looking up to maintain awareness of your surroundings.
    • Shuffling Instead of Tandem Walking: shuffling with feet far apart, rather than walking with one foot in front of the other, reduces balance and increases the risk of tripping. Tandem walking, where one foot is placed directly in front of the other, is the safer and more balanced way to walk. It also helps disguise your numbers.

    For more details on all of these, plus visual demonstrations, enjoy:

    Click Here If The Embedded Video Doesn’t Load Automatically!

    Want to learn more?

    You might also like to read:

    Fall Special (How To Not Fall, And How To Minimize Injury If You Do) ← this never seems like an urgent thing to learn, but trust us, it’s more fun to read it now, than from your hospital bed later

    Take care!

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  • Fasting Without Crashing?

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    Intermittent Fasting: What’s the truth?

    Before we get to facts and fictions, let’s quickly cover:

    What is Intermittent Fasting?

    Intermittent Fasting (IF) is an umbrella term for various kinds of time-restricted fasting, based on a schedule. Types include:

    Time-restricted IF, for example:

    • 16:8—Fast for 16 hours, eat during an 8-hour window
    • 18:6–Fast for 18 hours, eat during a 6-hour window
    • 20:4—Fast for 20 hours, eat during a 4-hour window

    24hr fasting, including:

    • Eat Stop Eat—basically, take a day off from eating once a week
    • Alternate Day Fasting—a more extreme version of the above; it is what it sounds like; eat one day, fast the next, repeat

    Non-fast fasting, e.g:

    • 5:2—Eat normally for 5 days, have a very reduced calorie intake (⅓ of normal intake) for the other 2 days
    • Fruit Fasting—have a small amount of fruit on “fast” days, but no other food
    • The Warrior Diet—as above, but include a small amount of non-starchy vegetables

    Why IF?

    While IF is perhaps most commonly undertaken as a means of fat loss or fat management (i.e., keeping fat down when it is already low), others cite different reasons, such as short term cognitive performance or long-term longevity.

    But… Does it work?

    Here we get into the myth-busting bit!

    “IF promotes weight loss”

    Mix of True and False. It can! But it also doesn’t have to. If you’re a bodybuilder who downs 4,000 calories in your 4hr eating window, you’re probably not going to lose weight! For such people, this is of course “a feature, not a bug” of IF—especially as it has been found that, in an acute study, IF did not adversely impact muscle protein synthesis.

    “IF promotes fat loss, without eating less”

    Broadly True. IF was found to be potentially equal to, but not necessarily better than, eating less.

    “IF provides metabolic benefits for general health”

    Broadly True. IF (perhaps counterintuitively) decreases the risk of insulin resistance, and also has anti-inflammatory effects, benefits a healthy gut microbiome, and promotes healthy autophagy (which as we noted in a previous edition of 10almonds, is important against both aging and cancer)

    However, results vary according to which protocol you’re observing…

    For what it’s worth, 16:8 is perhaps the most-studied protocol. Because such studies tend to have the eating window from midday to 8pm, this means that—going against popular wisdom—part of the advice here is basically “skip breakfast”.

    “Unlike caloric restriction, IF is sustainable and healthy as a long-term protocol”

    Broadly True. Of course, there’s a slight loophole here in that IF is loosely defined—technically everyone fasts while they’re sleeping, at the very least!

    However, for the most commonly-studied IF method (16:8), this is generally very sustainable and healthy and for most people.

    On the other hand, a more extreme method such as Alternate Day Fasting, may be trickier to sustain (even if it remains healthy to do so), because it’s been found that hunger does not decrease on fasting days—ie, the body does not “get used to it”.

    The American Journal of Clinical Nutrition wrote:

    ❝Alternate-day fasting was feasible in nonobese subjects, and fat oxidation increased. However, hunger on fasting days did not decrease, perhaps indicating the unlikelihood of continuing this diet for extended periods of time. Adding one small meal on a fasting day may make this approach to dietary restriction more acceptable.❞

    American Journal of Clinical Nutrition

    “IF improves mood and cognition”

    Mix of True and False (plus an honest “We Don’t Know” from researchers).

    Many studies have found benefits to both mood and cognition, but in the short-term, fasting can make people “hangry” (or: “experience irritability due to low blood sugar levels”, as the scientists put it), and in the long term, it can worsen symptoms of depression for those who already experience such—although some studies have found it can help alleviate depressive symptoms.

    Basically this is one where researchers typically append the words “more research is needed” to their summaries.

    “Anyone can do IF”

    Definitely False, unless going by the absolute broadest possible interpretation of what constitutes “Intermittent Fasting” to the point of disingenuity.

    For example, if you are Type 1 Diabetic, and your blood sugars are hypo, and you wait until tomorrow to correct that, you will stand a good chance of going into a coma instead. So please don’t.

    (On the other hand, IF may help achieve remission of type 2 diabetes)

    Lastly, IF is broadly not recommend to children and adolescents, anyone pregnant or breastfeeding, and certain underlying health conditions not mentioned above (we’re not going to try to give an exhaustive list here, but basically, if you have a chronic health condition, we recommend you check with your doctor first).

    WHICH APP?

    Choosing a fasting app

    Thinking of giving IF a try and would like a little extra help? We’ve got you covered!

    Check out: Livewire’s 7 Best Intermittent Fasting Apps of 2023

    Prefer to just trust us with a recommendation?

    We like BodyFast—it’s #2 on Lifewire’s list, but it has an array of pre-set plans to choose from (unlike Lifewire’s #1, Zero), and plenty of clear tracking, scheduling help, and motivational features.

    Both are available on both iOS and Android:

    See the BodyFast App / See the Zero App

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    Learn to Age Gracefully

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