nergy drinks: boon or bane?
Your Health
DR GITA MATHAI
New age gadgets are supposed to make life simpler. A majority of us, however — and this includes children, teenagers, adults and the elderly — always seems to complain about a lack of energy, tiredness and an overwhelming feeling of lethargy. Apparently, these symptoms exist in epidemic proportions. Perhaps the gadgets only aggravate the problem.
A variety of nutritional drinks, like Complan, Boost and Horlicks, are advertised on television. Most provide between 170 and 250cal (equal to two and a half chapatis) when prepared as per the instructions. Milk adds another 60 cal per 100 ml. Such drinks do boost one’s energy level, but it’s temporary. The perceived increase in energy fades rapidly. When the same amount of calories is provided by cooked stuff like chapatis or dosas, the food has to be digested and slowly absorbed by the body. The energy provided is released gradually in a sustained manner.
A “health” drink first thing in the morning produces a rapid rise in energy. The stomach feels bloated and full. This results in a failure to eat a good breakfast (which will carry the child through the day), and eventual hunger and tiredness. If you must give your child such a drink, do so after breakfast.
Ads of energy drinks aimed at teens and adults too abound. They are touted to lift sagging spirits, perk you up, enable you to party all night and work 20 hours a day without fatigue. There are more than a dozen on the market — Red Bull, Cloud 9, XXX, Gatorade, Lucozade and so on. Some are locally made while others are imported. A few “sports drinks” claim to replenish the calories and electrolytes lost after gruelling sporting events.
Before buying such drinks, read the labels on them carefully. India is not as strict as some EU nations vis-a-vis regulating the sale of recreational drinks to under age persons. Most drinks contain only sugar, electrolytes, ginseng, taurine (a naturally occurring amino acid found in the intestine) and glucuronolactone (a component of connective tissue). Studies have not shown these to be either beneficial or harmful.
The energy boost is usually provided by the caffeine in these (80 to 150mg, same as in a cup of coffee). Caffeine as a drink reaches all tissues in five minutes. A peak level is reached in 30 minutes. It does not accumulate in the body but is metabolised and excreted within a few hours. Side effects appear with as little as 75mg. There is an increase in temperature, activity, breathing and urination. The brain gets stimulated, sleep and fatigue are postponed, and performance at intellectual tasks is improved.
Unfortunately, children and teens who consume energy drinks don’t stop with one. The average is two to three drinks a day. These larger doses of caffeine can produce headache, jitteriness, rapid heartbeat and even convulsions and delirium. A dose of 3,200mg is fatal.
With habituation, bigger amounts are needed for the same effect. Ephedrine, dextrorphan, codeine and alcohol are added to these to give a sense of euphoria. These are dangerous and can lead to drug addiction and abuse.
Fizzy cola drinks contain sugar, water, carbon dioxide, flavouring agents and 30 to 50mg of caffeine. Many consume large quantities of colas, increasing their caffeine intake. As little as 30mg of caffeine (a cup of tea) impacts a child’s brain. It causes hyperactivity, an inability to think clearly, lack of energy and irrational anger.
Caffeine is a habit with many adults; they require a cup of coffee or tea to kick-start the day. Up to a maximum of six cups (650mg of caffeine) is usually tolerated without side effects. Some people are more caffeine sensitive than others.
A balanced diet with sufficient calories, antioxidants, vitamins and minerals will provide the energy you need. To increase endurance and develop the ability to work or play through fatigue, you have to build stamina. This can be done naturally with regular aerobic activity. Children need to play in fresh air for at least an hour a day. Teens burdened with vast syllabi and exams must jog 40 minutes or run half an hour regularly.
The Chinese tackle sleepiness and fatigue with self applied acupressure. The claims have recently been verified by studies at the Michigan School of Public Health in the US. A steady downward pressure is applied with a finger, thumb or palm to specific points on the base of the thumb, front of the leg, top of the head, and on both sides of the neck for one to two minutes. This alleviates fatigue and reduces sleepiness.
If fatigue can be tackled naturally without energy boosters, why spend money on them?
Wednesday, January 26, 2011
Sunday, January 16, 2011
overindulgence
ess is more
YOUR HEALTH
DR GITA MATHAI
Overeating and overindulgence in anything is detrimental. No wonder it is classified as one of the deadly sins. It is easy to go overboard, with so many festivals one after the other — Ganesh Chaturthi, Dusshera, Diwali, Ramzan, Bakrid, Christmas and New Year. It has been like a continuous eating and drinking festival for the last four months.
Gaining weight is easy. All you need to do is eat 3,500 calories more than required, and bingo — you are heavier by more than 2 kg. The average calorific requirement for a 5’8’’, 70-kg man is 2,000 calories. This assumes that he has a sedentary job and does not actively exercise. He probably manages to maintain his weight without much effort, till the festive season rolls out.
Calories add on if the activity remains constant and the person decides to eat just “a little extra”, like an omelette (150 calories), a vadai (100 calories), a samosa (200 calories), some halwa (100gm — 322 calories), a paratha (300 calories) or peanuts or cashew nuts (100gm — 600 calories).
The weight creeps up gradually. Also, food transiently elevates the mood. Eventually the person finds he has gained 5-10kg without realising why or how.
This New Year, try to step up your level of physical activity. All it requires is an hour of brisk walking, jogging, swimming or half an hour of continuous stair climbing. This consumes around 300-350 calories, and, all other factors remaining constant, takes care of the “little extra” eating during festival time.
Alcohol is the other bane of celebrations. Although India is traditionally regarded as a temperate and controlled society, alcohol consumption is on the rise. Around 21 per cent of adult males and 5 per cent of women consume alcohol. The consumption is higher in the northeastern part of the country and lowest in the traditionally dry state of Gujarat.
The government and distilleries profit from the manufacture and sale of alcohol. Surrogate advertising promotes it as “the king of good times”. Mild and flavoured beverages are now being promoted to attract women and young first time consumers.
People drink socially to relax, forget their worries and cope with difficulties. At first, it is only with friends, on weekends or during celebrations. This sounds innocuous enough, but 20 per cent develops alcohol dependence of which 20 per cent go on to become problem drinkers.
Alcohol consumption gets out of hand when there is a strong uncontrollable urge to drink earlier and earlier in the day, accompanied by an inability to stop. The numbed conditioned brain does not emit warning signals saying “enough”. Stronger and larger drinks are required to achieve the same “kick”. Failure to consume alcohol results in sleeplessness, anxiety, nervousness, hallucinations, tremors and eventually convulsions. The patient ignores the side effects and thrives on the initial euphoria produced by the alcohol. The brain, heart, liver, pancreas and stomach are all eventually damaged.
Alcohol must be stopped abruptly. It cannot be reduced one drink at a time. Gradual reduction results in relapse and failure.
Help and support are available in specialised psychiatric detoxification centres. Also, there are Alcoholics Anonymous (AA) cells in major cities in India.
No one realises that drug overuse is actually rampant in India. There are one million (0.1 per cent of the population) heroin addicts officially registered but the number may actually be 5 million (0.5 per cent). The exact usage of “soft” drugs like marijuana (bhang) is not known as it is used traditionally by labourers.
Today the lines between different addictions are blurred. Hard and soft drug usage has permeated all strata of society. It often starts as casual recreational use just once or twice. Drugs are very addictive and the habit soon escalates. Oral or inhaled use eventually leads to intravenous use. Academic and professional performance drops. It can lead to infectious diseases like hepatitis B, C and AIDS and death from accidental overdose. It is a myth to think that you control your drug usage.
A large and unknown percentage of the population uses “medicines” to relieve sleeplessness, pain and to “feel good”. Cough mixtures available over the counter containing diphenhydramine (like Benedryl) or codeine are drunk in large quantities. Painkillers like dextropropoxyphene (Proxyvon) are either swallowed or injected. Sometimes these medications are mixed with caffeine-containing cola drinks. Others take sleeping tablets, like alpraxolam or diazepam (valium) regularly. Dependence and habituation set in, requiring higher doses to sleep. These medicines cause sleep disturbances, an inability to think clearly, poor decision making, tiredness and depression. An inability to obtain the medication may result in agitation.
Control in every aspect — food, medication and partying — is necessary for a long, healthy and disease free life. Endorphins that elevate the mood are released with exercise. To achieve a “high”, good mental acuity and concentration, exercise by running, jogging or swimming for an hour a day. Why resort to drugs and alcohol?
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
YOUR HEALTH
DR GITA MATHAI
Overeating and overindulgence in anything is detrimental. No wonder it is classified as one of the deadly sins. It is easy to go overboard, with so many festivals one after the other — Ganesh Chaturthi, Dusshera, Diwali, Ramzan, Bakrid, Christmas and New Year. It has been like a continuous eating and drinking festival for the last four months.
Gaining weight is easy. All you need to do is eat 3,500 calories more than required, and bingo — you are heavier by more than 2 kg. The average calorific requirement for a 5’8’’, 70-kg man is 2,000 calories. This assumes that he has a sedentary job and does not actively exercise. He probably manages to maintain his weight without much effort, till the festive season rolls out.
Calories add on if the activity remains constant and the person decides to eat just “a little extra”, like an omelette (150 calories), a vadai (100 calories), a samosa (200 calories), some halwa (100gm — 322 calories), a paratha (300 calories) or peanuts or cashew nuts (100gm — 600 calories).
The weight creeps up gradually. Also, food transiently elevates the mood. Eventually the person finds he has gained 5-10kg without realising why or how.
This New Year, try to step up your level of physical activity. All it requires is an hour of brisk walking, jogging, swimming or half an hour of continuous stair climbing. This consumes around 300-350 calories, and, all other factors remaining constant, takes care of the “little extra” eating during festival time.
Alcohol is the other bane of celebrations. Although India is traditionally regarded as a temperate and controlled society, alcohol consumption is on the rise. Around 21 per cent of adult males and 5 per cent of women consume alcohol. The consumption is higher in the northeastern part of the country and lowest in the traditionally dry state of Gujarat.
The government and distilleries profit from the manufacture and sale of alcohol. Surrogate advertising promotes it as “the king of good times”. Mild and flavoured beverages are now being promoted to attract women and young first time consumers.
People drink socially to relax, forget their worries and cope with difficulties. At first, it is only with friends, on weekends or during celebrations. This sounds innocuous enough, but 20 per cent develops alcohol dependence of which 20 per cent go on to become problem drinkers.
Alcohol consumption gets out of hand when there is a strong uncontrollable urge to drink earlier and earlier in the day, accompanied by an inability to stop. The numbed conditioned brain does not emit warning signals saying “enough”. Stronger and larger drinks are required to achieve the same “kick”. Failure to consume alcohol results in sleeplessness, anxiety, nervousness, hallucinations, tremors and eventually convulsions. The patient ignores the side effects and thrives on the initial euphoria produced by the alcohol. The brain, heart, liver, pancreas and stomach are all eventually damaged.
Alcohol must be stopped abruptly. It cannot be reduced one drink at a time. Gradual reduction results in relapse and failure.
Help and support are available in specialised psychiatric detoxification centres. Also, there are Alcoholics Anonymous (AA) cells in major cities in India.
No one realises that drug overuse is actually rampant in India. There are one million (0.1 per cent of the population) heroin addicts officially registered but the number may actually be 5 million (0.5 per cent). The exact usage of “soft” drugs like marijuana (bhang) is not known as it is used traditionally by labourers.
Today the lines between different addictions are blurred. Hard and soft drug usage has permeated all strata of society. It often starts as casual recreational use just once or twice. Drugs are very addictive and the habit soon escalates. Oral or inhaled use eventually leads to intravenous use. Academic and professional performance drops. It can lead to infectious diseases like hepatitis B, C and AIDS and death from accidental overdose. It is a myth to think that you control your drug usage.
A large and unknown percentage of the population uses “medicines” to relieve sleeplessness, pain and to “feel good”. Cough mixtures available over the counter containing diphenhydramine (like Benedryl) or codeine are drunk in large quantities. Painkillers like dextropropoxyphene (Proxyvon) are either swallowed or injected. Sometimes these medications are mixed with caffeine-containing cola drinks. Others take sleeping tablets, like alpraxolam or diazepam (valium) regularly. Dependence and habituation set in, requiring higher doses to sleep. These medicines cause sleep disturbances, an inability to think clearly, poor decision making, tiredness and depression. An inability to obtain the medication may result in agitation.
Control in every aspect — food, medication and partying — is necessary for a long, healthy and disease free life. Endorphins that elevate the mood are released with exercise. To achieve a “high”, good mental acuity and concentration, exercise by running, jogging or swimming for an hour a day. Why resort to drugs and alcohol?
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Thursday, January 6, 2011
sunshine effect
The sunshine effect
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
The sun shines almost all the year round in India. Doctors were thus surprised when studies showed that 30 per cent of urban males, 50 per cent of rural and almost 90 per cent of urban women were vitamin D deficient. This vitamin is produced naturally by the action of sunlight on skin. Only 10 minutes of exposure, particularly to ultraviolet rays that appear at sunrise, is sufficient for the daily requirement.
Vitamin D can also be obtained from cereals, almonds, spinach, soya products, eggs, meat and fish. About 5 micrograms (200 International Units) are needed daily for all individuals (men and women, including those pregnant or lactating) under the age of 50 years. Those between 50 and 70 years need 10 micrograms (400IU), while those above 70 require 15 micrograms (600IU). Excessive intake — more than 2000IU or 50 micrograms — may result in side effects and toxicity.
Vitamin D is essential for proper calcium metabolism and bone mineralisation. Deficiency occurs because of changing lifestyles. In children, inadequate intake results in rickets characterised by soft, defective bones. The rib cage may become permanently misshapen, leading to breathing difficulties, and the long bones of the legs may be bowed. Similar softening of the bones in adults is called osteomalacia. In older people, the bone structure may become damaged, resulting in osteoporosis.
Vitamin D also affects enzymes and cell division. Its deficiency may cause excessive fatigue, muscle cramps, depression, insomnia and low immunity levels. Adequate levels have a protective effect against high blood pressure, auto immune diseases and the development of certain types of cancer.
Adequate amounts of calcium are needed for the vitamin to function efficiently. Children up to one year need 200mg daily, those between one and three need 500mg, four to 10-year-olds need 800mg, 10 to 18-year-olds need 1,300mg and adults 1,000mg. Adolescents require big amounts because that’s when a “calcium bank” is being built.
Women require more calcium than men, because of the loss during pregnancy and lactation. The female hormone estrogen makes calcium metabolism efficient. However, their bones may deteriorate rapidly after menopause. The vertebrae are primarily affected, resulting in a “dowager’s hump”, and the slightest fall can result in fractures, particularly of the hip and wrist.
Men, too, may develop osteoporosis and need sunlight exposure and calcium supplementation.
Some of the predisposing factors for weak bones cannot be changed. The risk increases if you are a woman, of Asian descent, have a family history of osteoporosis and as age advances. In both the sexes, a small frame with a body mass index or BMI (weight in kilogram divided by height in metre squared) of 19 or less adds to the risk as such persons have very little bone reserve. Thyroid diseases, diabetes and malfunctions of the adrenal glands contribute to weak bones. Digestive disorders with malabsorption adversely affect calcium and vitamin D uptake as both are absorbed from the intestines.
A low calcium intake can be tackled by consuming more dairy products or taking calcium and vitamin D supplements. Weight-bearing exercises like walking, running, jumping, dancing and weightlifting are helpful for developing healthy bones.
Tobacco contains nicotine, which contributes to weak bones. Alcohol interferes with calcium and vitamin D absorption and increases the risk of osteoporosis if more than two pegs (60ml) a day are drunk .
Osteoporosis is treated with calcium supplementation. To help the mineral enter the bones, selective estrogen receptor modulators like raloxifene and other drugs like calcitonin, bisphosphonates and parathyroid hormone may be used. In women, hormone replacement therapy after menopause was initially popular, as it appeared to reverse many of the adverse health effects of menopause. However, it has side effects, and is now used only in selected women under medical supervision.
Natural supplements from evening primrose oil, ginseng, natural soy products and tropical wild yam are popular. The advantages are anecdotal and scientifically unproven.
Osteoporosis, osteomalacia and rickets are totally preventable.
• Maintain an ideal body weight (BMI 23)
• Exercise seven days a week, one hour a day
• Expose the body to the early morning sun for 10 minutes
• Take calcium supplements.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
--------------------------------------------------------------------------------
DR GITA MATHAI
The sun shines almost all the year round in India. Doctors were thus surprised when studies showed that 30 per cent of urban males, 50 per cent of rural and almost 90 per cent of urban women were vitamin D deficient. This vitamin is produced naturally by the action of sunlight on skin. Only 10 minutes of exposure, particularly to ultraviolet rays that appear at sunrise, is sufficient for the daily requirement.
Vitamin D can also be obtained from cereals, almonds, spinach, soya products, eggs, meat and fish. About 5 micrograms (200 International Units) are needed daily for all individuals (men and women, including those pregnant or lactating) under the age of 50 years. Those between 50 and 70 years need 10 micrograms (400IU), while those above 70 require 15 micrograms (600IU). Excessive intake — more than 2000IU or 50 micrograms — may result in side effects and toxicity.
Vitamin D is essential for proper calcium metabolism and bone mineralisation. Deficiency occurs because of changing lifestyles. In children, inadequate intake results in rickets characterised by soft, defective bones. The rib cage may become permanently misshapen, leading to breathing difficulties, and the long bones of the legs may be bowed. Similar softening of the bones in adults is called osteomalacia. In older people, the bone structure may become damaged, resulting in osteoporosis.
Vitamin D also affects enzymes and cell division. Its deficiency may cause excessive fatigue, muscle cramps, depression, insomnia and low immunity levels. Adequate levels have a protective effect against high blood pressure, auto immune diseases and the development of certain types of cancer.
Adequate amounts of calcium are needed for the vitamin to function efficiently. Children up to one year need 200mg daily, those between one and three need 500mg, four to 10-year-olds need 800mg, 10 to 18-year-olds need 1,300mg and adults 1,000mg. Adolescents require big amounts because that’s when a “calcium bank” is being built.
Women require more calcium than men, because of the loss during pregnancy and lactation. The female hormone estrogen makes calcium metabolism efficient. However, their bones may deteriorate rapidly after menopause. The vertebrae are primarily affected, resulting in a “dowager’s hump”, and the slightest fall can result in fractures, particularly of the hip and wrist.
Men, too, may develop osteoporosis and need sunlight exposure and calcium supplementation.
Some of the predisposing factors for weak bones cannot be changed. The risk increases if you are a woman, of Asian descent, have a family history of osteoporosis and as age advances. In both the sexes, a small frame with a body mass index or BMI (weight in kilogram divided by height in metre squared) of 19 or less adds to the risk as such persons have very little bone reserve. Thyroid diseases, diabetes and malfunctions of the adrenal glands contribute to weak bones. Digestive disorders with malabsorption adversely affect calcium and vitamin D uptake as both are absorbed from the intestines.
A low calcium intake can be tackled by consuming more dairy products or taking calcium and vitamin D supplements. Weight-bearing exercises like walking, running, jumping, dancing and weightlifting are helpful for developing healthy bones.
Tobacco contains nicotine, which contributes to weak bones. Alcohol interferes with calcium and vitamin D absorption and increases the risk of osteoporosis if more than two pegs (60ml) a day are drunk .
Osteoporosis is treated with calcium supplementation. To help the mineral enter the bones, selective estrogen receptor modulators like raloxifene and other drugs like calcitonin, bisphosphonates and parathyroid hormone may be used. In women, hormone replacement therapy after menopause was initially popular, as it appeared to reverse many of the adverse health effects of menopause. However, it has side effects, and is now used only in selected women under medical supervision.
Natural supplements from evening primrose oil, ginseng, natural soy products and tropical wild yam are popular. The advantages are anecdotal and scientifically unproven.
Osteoporosis, osteomalacia and rickets are totally preventable.
• Maintain an ideal body weight (BMI 23)
• Exercise seven days a week, one hour a day
• Expose the body to the early morning sun for 10 minutes
• Take calcium supplements.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Monday, January 3, 2011
sunshine effect
The sunshine effect
Your Health
DR GITA MATHAI
The sun shines almost all the year round in India. Doctors were thus surprised when studies showed that 30 per cent of urban males, 50 per cent of rural and almost 90 per cent of urban women were vitamin D deficient. This vitamin is produced naturally by the action of sunlight on skin. Only 10 minutes of exposure, particularly to ultraviolet rays that appear at sunrise, is sufficient for the daily requirement.
Vitamin D can also be obtained from cereals, almonds, spinach, soya products, eggs, meat and fish. About 5 micrograms (200 International Units) are needed daily for all individuals (men and women, including those pregnant or lactating) under the age of 50 years. Those between 50 and 70 years need 10 micrograms (400IU), while those above 70 require 15 micrograms (600IU). Excessive intake — more than 2000IU or 50 micrograms — may result in side effects and toxicity.
Vitamin D is essential for proper calcium metabolism and bone mineralisation. Deficiency occurs because of changing lifestyles. In children, inadequate intake results in rickets characterised by soft, defective bones. The rib cage may become permanently misshapen, leading to breathing difficulties, and the long bones of the legs may be bowed. Similar softening of the bones in adults is called osteomalacia. In older people, the bone structure may become damaged, resulting in osteoporosis.
Vitamin D also affects enzymes and cell division. Its deficiency may cause excessive fatigue, muscle cramps, depression, insomnia and low immunity levels. Adequate levels have a protective effect against high blood pressure, auto immune diseases and the development of certain types of cancer.
Adequate amounts of calcium are needed for the vitamin to function efficiently. Children up to one year need 200mg daily, those between one and three need 500mg, four to 10-year-olds need 800mg, 10 to 18-year-olds need 1,300mg and adults 1,000mg. Adolescents require big amounts because that’s when a “calcium bank” is being built.
Women require more calcium than men, because of the loss during pregnancy and lactation. The female hormone estrogen makes calcium metabolism efficient. However, their bones may deteriorate rapidly after menopause. The vertebrae are primarily affected, resulting in a “dowager’s hump”, and the slightest fall can result in fractures, particularly of the hip and wrist.
Men, too, may develop osteoporosis and need sunlight exposure and calcium supplementation.
Some of the predisposing factors for weak bones cannot be changed. The risk increases if you are a woman, of Asian descent, have a family history of osteoporosis and as age advances. In both the sexes, a small frame with a body mass index or BMI (weight in kilogram divided by height in metre squared) of 19 or less adds to the risk as such persons have very little bone reserve. Thyroid diseases, diabetes and malfunctions of the adrenal glands contribute to weak bones. Digestive disorders with malabsorption adversely affect calcium and vitamin D uptake as both are absorbed from the intestines.
A low calcium intake can be tackled by consuming more dairy products or taking calcium and vitamin D supplements. Weight-bearing exercises like walking, running, jumping, dancing and weightlifting are helpful for developing healthy bones.
Tobacco contains nicotine, which contributes to weak bones. Alcohol interferes with calcium and vitamin D absorption and increases the risk of osteoporosis if more than two pegs (60ml) a day are drunk .
Osteoporosis is treated with calcium supplementation. To help the mineral enter the bones, selective estrogen receptor modulators like raloxifene and other drugs like calcitonin, bisphosphonates and parathyroid hormone may be used. In women, hormone replacement therapy after menopause was initially popular, as it appeared to reverse many of the adverse health effects of menopause. However, it has side effects, and is now used only in selected women under medical supervision.
Natural supplements from evening primrose oil, ginseng, natural soy products and tropical wild yam are popular. The advantages are anecdotal and scientifically unproven.
Osteoporosis, osteomalacia and rickets are totally preventable.
• Maintain an ideal body weight (BMI 23)
• Exercise seven days a week, one hour a day
• Expose the body to the early morning sun for 10 minutes
• Take calcium supplements.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
The sun shines almost all the year round in India. Doctors were thus surprised when studies showed that 30 per cent of urban males, 50 per cent of rural and almost 90 per cent of urban women were vitamin D deficient. This vitamin is produced naturally by the action of sunlight on skin. Only 10 minutes of exposure, particularly to ultraviolet rays that appear at sunrise, is sufficient for the daily requirement.
Vitamin D can also be obtained from cereals, almonds, spinach, soya products, eggs, meat and fish. About 5 micrograms (200 International Units) are needed daily for all individuals (men and women, including those pregnant or lactating) under the age of 50 years. Those between 50 and 70 years need 10 micrograms (400IU), while those above 70 require 15 micrograms (600IU). Excessive intake — more than 2000IU or 50 micrograms — may result in side effects and toxicity.
Vitamin D is essential for proper calcium metabolism and bone mineralisation. Deficiency occurs because of changing lifestyles. In children, inadequate intake results in rickets characterised by soft, defective bones. The rib cage may become permanently misshapen, leading to breathing difficulties, and the long bones of the legs may be bowed. Similar softening of the bones in adults is called osteomalacia. In older people, the bone structure may become damaged, resulting in osteoporosis.
Vitamin D also affects enzymes and cell division. Its deficiency may cause excessive fatigue, muscle cramps, depression, insomnia and low immunity levels. Adequate levels have a protective effect against high blood pressure, auto immune diseases and the development of certain types of cancer.
Adequate amounts of calcium are needed for the vitamin to function efficiently. Children up to one year need 200mg daily, those between one and three need 500mg, four to 10-year-olds need 800mg, 10 to 18-year-olds need 1,300mg and adults 1,000mg. Adolescents require big amounts because that’s when a “calcium bank” is being built.
Women require more calcium than men, because of the loss during pregnancy and lactation. The female hormone estrogen makes calcium metabolism efficient. However, their bones may deteriorate rapidly after menopause. The vertebrae are primarily affected, resulting in a “dowager’s hump”, and the slightest fall can result in fractures, particularly of the hip and wrist.
Men, too, may develop osteoporosis and need sunlight exposure and calcium supplementation.
Some of the predisposing factors for weak bones cannot be changed. The risk increases if you are a woman, of Asian descent, have a family history of osteoporosis and as age advances. In both the sexes, a small frame with a body mass index or BMI (weight in kilogram divided by height in metre squared) of 19 or less adds to the risk as such persons have very little bone reserve. Thyroid diseases, diabetes and malfunctions of the adrenal glands contribute to weak bones. Digestive disorders with malabsorption adversely affect calcium and vitamin D uptake as both are absorbed from the intestines.
A low calcium intake can be tackled by consuming more dairy products or taking calcium and vitamin D supplements. Weight-bearing exercises like walking, running, jumping, dancing and weightlifting are helpful for developing healthy bones.
Tobacco contains nicotine, which contributes to weak bones. Alcohol interferes with calcium and vitamin D absorption and increases the risk of osteoporosis if more than two pegs (60ml) a day are drunk .
Osteoporosis is treated with calcium supplementation. To help the mineral enter the bones, selective estrogen receptor modulators like raloxifene and other drugs like calcitonin, bisphosphonates and parathyroid hormone may be used. In women, hormone replacement therapy after menopause was initially popular, as it appeared to reverse many of the adverse health effects of menopause. However, it has side effects, and is now used only in selected women under medical supervision.
Natural supplements from evening primrose oil, ginseng, natural soy products and tropical wild yam are popular. The advantages are anecdotal and scientifically unproven.
Osteoporosis, osteomalacia and rickets are totally preventable.
• Maintain an ideal body weight (BMI 23)
• Exercise seven days a week, one hour a day
• Expose the body to the early morning sun for 10 minutes
• Take calcium supplements.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Subscribe to:
Posts (Atom)
