HCG AND THE "SARASOTA DIET" Day 11, Lets go shopping !! ROBERT G CARLSON, MD,FACS
I have been keeping a diary but have been backlogged in writing. I have put together a grouping of articles I will tie together with catching up on my scheduled recordings.
Day#11: 219.2
My energy still is good and I have incorporated my creation of B-vitamins ,carnitine , and chromium into my ANDLOS CLINIC :FAT BURNING ACCELERATOR shots( I will tell you more about these soon) which I use three times a week in conjunction with my nightly HCG shots. I have been in somewhat of a stall and I believe it is because I need to exercise more. I love it when I am losing a pound a day, but my goal is to lose 16 pounds in 28 days. My good friend in Palm Beach has exceeded that in two weeks, but he is a "little" heavier than I. Some questions I am asked daily in my clinic are: So how do I start this 'Sarasota Diet' ?" So I decided to give you a series of brief descriptions on preparing for your first sojourn to the grocery store with Low Carbohydrate approach on your mind. I will reiterate on how to do the shots again, but that is the easy part....Well in fact this whole dietary lifestyle is easy. No caloric restrictions, eat what you can, but just stay away from carbs! If you repeat slowly and often as you walk through the grocery store: "Carbs are poison. These toxins are making me fat and trying to kill me." Repeating that a few times a day will fortify your decision to avoid your previous daily onslaught of massive amounts of dangerous toxic carbohydrates. So lets go shopping....
The new "Sarasota Diet" Low Carbohydrate Lifestyle shopping experience-
Shopping in preparation for starting your low carb Sarasota diet will be a different experience. One thing you will have to do is read labels to check for how many carbohydrates are hidden in your favorite foods. The shock may be overwhelming especially when you realize that you will be allowed a maximum of 20 grams of carbohydrates a day. A cup of rice is over 40 grams. Mountain Dew is 45 grams of carbs. The foods that you would commonly throw into your shopping cart like bread, pasta, and potatoes are no longer welcome in your shopping cart. Just like diving…plan your dive, dive your plan. Your adventure in the grocery store should start with an idea of what you plan to eat for the first week. Also key to anticipating this shopping trip is the gathering of all those high carb snacks throughout your house and hidden in your desk and locking them away if not throwing them all out.
Once in the grocery store, you should shop on the periphery, like the deli, vegetables, eggs, meat, and avoid the packaged high fructose sugar items in the center aisles. Make sure you purchase many low carb options like cheese sticks, deli meats and celery to help satisfy those mid-day cravings. I find however that before you even take a bite of a mid-day snack, you should drink an entire 8 oz glass or bottled water. Then start eating your snack.
Once you arrive at the grocery begin stocking up on cheeses, meats, other high protein options and produce. This way you will purchase the primary foods you should eat for the week and not be tempted by the packaged items in the middle aisles. More to follow…..
Posted by Dr Robert Carlson of Sarasota at 8:25 PM
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Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts
Sunday, April 17, 2011
Sunday, February 27, 2011
Vitamin D Helps Weight Loss Robert G Carlson, MD, FACS
Vitamin D Helps Weight Loss
Being overweight with excess body fat and abdominal obesity represent an overwhelming threat to the health of millions of men, women and children. Obesity is out of control, and today the number of obese people exceeds 35 % and it is growing rapidly. It is a true epidemic. Closely tied with this epidemic is the high percentage of the population of the United States that is grossly deficient in vitamin D. We have been told that the sun is bad for us, and processed foods have minimal Vitamin D in them and even Vitamin D fortified milk and orange juice are a joke, with the wrong type of Vitamin D, and amounts so small that they are essentially worthless unless you drank five gallons of milk and juice a day.
Fortunately, there is hope. Vitamin D has been shown to be critical in the creation of stored fat. You can help your body burn abdominal fat and lose weight naturally by incorporating adequate amounts of vitamin D in your diet, primarily through extremely inexpensive supplementation. A Journal of Clinical Endocrinology and Metabolism study showed that the lack of Vitamin D is important in the accumulation of excess body fat. In the absence of sufficient vitamin D the body increases the number and size of newly formed fat cells that will promote and accelerate abdominal obesity. Providing sufficient levels of vitamin D, will signal fat cells to shrink. This makes weight loss much easier when calories are restricted.
Being overweight with excess body fat and abdominal obesity represent an overwhelming threat to the health of millions of men, women and children. Obesity is out of control, and today the number of obese people exceeds 35 % and it is growing rapidly. It is a true epidemic. Closely tied with this epidemic is the high percentage of the population of the United States that is grossly deficient in vitamin D. We have been told that the sun is bad for us, and processed foods have minimal Vitamin D in them and even Vitamin D fortified milk and orange juice are a joke, with the wrong type of Vitamin D, and amounts so small that they are essentially worthless unless you drank five gallons of milk and juice a day.
Fortunately, there is hope. Vitamin D has been shown to be critical in the creation of stored fat. You can help your body burn abdominal fat and lose weight naturally by incorporating adequate amounts of vitamin D in your diet, primarily through extremely inexpensive supplementation. A Journal of Clinical Endocrinology and Metabolism study showed that the lack of Vitamin D is important in the accumulation of excess body fat. In the absence of sufficient vitamin D the body increases the number and size of newly formed fat cells that will promote and accelerate abdominal obesity. Providing sufficient levels of vitamin D, will signal fat cells to shrink. This makes weight loss much easier when calories are restricted.
Wednesday, December 1, 2010
Navigating The Truth About Vitamin D...keep taking at least 5000 units a day
Navigating The Truth About Vitamin D
Robert G Carlson, MD, FACS
As a Cardiac surgeon with extensive training in Oncologic (cancer) surgery, I find comfort and trust in the articles from the heart and cancer journals as a foundation for guiding my practice in medicine. The Methodist DeBakey Cardiovascular had an incredible overview of the cardiac benefits of Vitamin D with the reduction in inflammation, the primary cause of heart disease, reduction in blood pressure, reduction in heart wall thickening and peripheral vascular disease, as well as reduction in Diabetes for about $20 a year. I trust the DeBakey heart center. And of course numerous Epidemiologic studies, Meta –analyses, and Double Blinded Randomized Prospective trials that have clearly demonstrated a dramatic reduction in cancer. In addition, Dr. Cannell devotes hours to researching the benefits of Vitamin D and offers his non-profit organization’s web site to review his plethora of studies and insights. Dr Michael F. Holick, PhD, MD, Professor of Medicine, and Dr. Cedric F. Garland, a Professor from the UCSD Department of Family and Preventive Medicine, openly share their excitement and knowledge in identifying something so inexpensive, and beneficial to health, that would essentially break the American Cancer Society into shreds and reduce the need for unnecessary chemotherapies by over 50 %, and reduce a majority of the disease of aging. Now a quasi-governmental group of profit-only, hired guns, called the Institute of Medicine’s Food and Nutrition Board, with only a few physicians hidden deep in their Ivory towers, and the rest nutritionists, want me to disregard all of my cardiac and oncology literature…well I’m not changing the way I take care of my heart patients because some nutritionist didn’t like the articles he read about the medical benefits, and told me to forget about the over 500 articles written about the amazing benefits of Vitamin D, and actually reduce the acceptable low levels of vitamin D in your blood stream because…well I have no idea. Especially when levels in the mid to upper range have repeatedly demonstrated dramatic improvements in health. Well I’m sorry guys. If I depended on a nutritionist to interpret medical journals identifying the cardiac and cancer reducing benefits of Vitamin D, then I should just bury my head in the sand and wait for a 20 year randomized double blinded placebo control trial that will tell me when I am 75 years old that I could have dramatically reduced my risk of heart disease, cancer, diabetes, rheumatoid arthritis and Multiple Sclerosis. If only I would have taken more vitamin D, but they frightened me away from doing the right thing. By the way, the article that suggests that maybe, kinda, sorta, that Vitamin D could increase pancreatic cancer is impossible to locate on pub med and other reliable sources and the only way I could possible see where the article is located is if I pay them sixty dollars to see there documentation. Also why would this “committee” of wise men disregard the intellectual writings and research of over 14 of the nation’s experts in Vitamin D metabolism? It’s because this report, which you and I paid for to be done through our hard earned money and paid taxes, and can’t read it unless you pay even more money, is a needless waste of paper and should be disregarded. Nobody is making any money selling vitamin D supplements at 20 dollars a year, but what about all the poor cancer patients that are receiving deadly, expensive chemotherapies and the pharmaceutical companies and oncology practices that are making massive amounts of money managing cancer patients, a condition, cancer, that was reduced by 77% by Vitamin D supplementation in a well designed study. You do the math…you follow the money...
Robert G Carlson, MD, FACS
As a Cardiac surgeon with extensive training in Oncologic (cancer) surgery, I find comfort and trust in the articles from the heart and cancer journals as a foundation for guiding my practice in medicine. The Methodist DeBakey Cardiovascular had an incredible overview of the cardiac benefits of Vitamin D with the reduction in inflammation, the primary cause of heart disease, reduction in blood pressure, reduction in heart wall thickening and peripheral vascular disease, as well as reduction in Diabetes for about $20 a year. I trust the DeBakey heart center. And of course numerous Epidemiologic studies, Meta –analyses, and Double Blinded Randomized Prospective trials that have clearly demonstrated a dramatic reduction in cancer. In addition, Dr. Cannell devotes hours to researching the benefits of Vitamin D and offers his non-profit organization’s web site to review his plethora of studies and insights. Dr Michael F. Holick, PhD, MD, Professor of Medicine, and Dr. Cedric F. Garland, a Professor from the UCSD Department of Family and Preventive Medicine, openly share their excitement and knowledge in identifying something so inexpensive, and beneficial to health, that would essentially break the American Cancer Society into shreds and reduce the need for unnecessary chemotherapies by over 50 %, and reduce a majority of the disease of aging. Now a quasi-governmental group of profit-only, hired guns, called the Institute of Medicine’s Food and Nutrition Board, with only a few physicians hidden deep in their Ivory towers, and the rest nutritionists, want me to disregard all of my cardiac and oncology literature…well I’m not changing the way I take care of my heart patients because some nutritionist didn’t like the articles he read about the medical benefits, and told me to forget about the over 500 articles written about the amazing benefits of Vitamin D, and actually reduce the acceptable low levels of vitamin D in your blood stream because…well I have no idea. Especially when levels in the mid to upper range have repeatedly demonstrated dramatic improvements in health. Well I’m sorry guys. If I depended on a nutritionist to interpret medical journals identifying the cardiac and cancer reducing benefits of Vitamin D, then I should just bury my head in the sand and wait for a 20 year randomized double blinded placebo control trial that will tell me when I am 75 years old that I could have dramatically reduced my risk of heart disease, cancer, diabetes, rheumatoid arthritis and Multiple Sclerosis. If only I would have taken more vitamin D, but they frightened me away from doing the right thing. By the way, the article that suggests that maybe, kinda, sorta, that Vitamin D could increase pancreatic cancer is impossible to locate on pub med and other reliable sources and the only way I could possible see where the article is located is if I pay them sixty dollars to see there documentation. Also why would this “committee” of wise men disregard the intellectual writings and research of over 14 of the nation’s experts in Vitamin D metabolism? It’s because this report, which you and I paid for to be done through our hard earned money and paid taxes, and can’t read it unless you pay even more money, is a needless waste of paper and should be disregarded. Nobody is making any money selling vitamin D supplements at 20 dollars a year, but what about all the poor cancer patients that are receiving deadly, expensive chemotherapies and the pharmaceutical companies and oncology practices that are making massive amounts of money managing cancer patients, a condition, cancer, that was reduced by 77% by Vitamin D supplementation in a well designed study. You do the math…you follow the money...
Saturday, November 13, 2010
Can I get enough Vitamin D from being in the sun?
CAN I GET ENOUGH VITAMIN D FROM BEING IN THE SUN?
Robert G Carlson, MD, FACS
Spending 15 minutes in the sun each day will allow your body to produce plenty of Vitamin D – that may be true if you are sitting on a beach in Florida at noon wearing nothing but a bikini, but for the vast majority of us that’s just not happening. For a Caucasian wearing no sunscreen, sitting in the summer sun in the mid-afternoon with 40 percent of their body exposed for 20 minutes will produce about 10,000 units of vitamin D. Unfortunately, once sunscreen is applied the Vitamin D production drops to nothing. If you have darker skin, the time required in the sun increases to 45 minutes a day. If you live above 35 degrees latitude, the body is unable to produce adequate amounts of Vitamin D from the winter sun. In fact the only adequate amount of sunshine in Boston occurs, between May and Sept, otherwise there’s just not enough sunlight for Vitamin D metabolism. So, the person working in Chicago during the middle of the winter will get absolutely no Vitamin D from sunlight, and vitamin D fights the common cold better than Vitamin C. So that’s why cold and flu season occurs during the winter season.
So can I get enough Vitamin D by eating a balanced diet? That won’t work, because Vitamin D is present, in small amounts, in only a handful of foods – oily fish, and eggs. Vitamin D fortified foods such as Vitamin D fortified Milk and Orange Juice are a joke containing a measly 50 units of Vitamin D2(the wrong kind of Vitamin D), not Vitamin D3. You will need about 5000 units a day to help your body fight the battle against the cold viruses, and by the way, that dose also reduces breast and colon cancer, diabetes, and heart disease. I don’t recommend Cod Liver Oil since its nasty tasting, and is full of Vitamin A, which blocks all the amazing benefit of Vitamin D. Now Vitamin D in gel cap form, sprays or liquids will provide all the necessary Vitamin D you will need, and will cost you only a few pennies a day.
For more information check-out www.andlos.com
Robert G Carlson, MD, FACS
Spending 15 minutes in the sun each day will allow your body to produce plenty of Vitamin D – that may be true if you are sitting on a beach in Florida at noon wearing nothing but a bikini, but for the vast majority of us that’s just not happening. For a Caucasian wearing no sunscreen, sitting in the summer sun in the mid-afternoon with 40 percent of their body exposed for 20 minutes will produce about 10,000 units of vitamin D. Unfortunately, once sunscreen is applied the Vitamin D production drops to nothing. If you have darker skin, the time required in the sun increases to 45 minutes a day. If you live above 35 degrees latitude, the body is unable to produce adequate amounts of Vitamin D from the winter sun. In fact the only adequate amount of sunshine in Boston occurs, between May and Sept, otherwise there’s just not enough sunlight for Vitamin D metabolism. So, the person working in Chicago during the middle of the winter will get absolutely no Vitamin D from sunlight, and vitamin D fights the common cold better than Vitamin C. So that’s why cold and flu season occurs during the winter season.
So can I get enough Vitamin D by eating a balanced diet? That won’t work, because Vitamin D is present, in small amounts, in only a handful of foods – oily fish, and eggs. Vitamin D fortified foods such as Vitamin D fortified Milk and Orange Juice are a joke containing a measly 50 units of Vitamin D2(the wrong kind of Vitamin D), not Vitamin D3. You will need about 5000 units a day to help your body fight the battle against the cold viruses, and by the way, that dose also reduces breast and colon cancer, diabetes, and heart disease. I don’t recommend Cod Liver Oil since its nasty tasting, and is full of Vitamin A, which blocks all the amazing benefit of Vitamin D. Now Vitamin D in gel cap form, sprays or liquids will provide all the necessary Vitamin D you will need, and will cost you only a few pennies a day.
For more information check-out www.andlos.com
Sunday, September 19, 2010
I Love Vitamin D, but watch out for Vitamin A in your multivitamin
I Love Vitamin D, but watch out for Vitamin A in your multivitamins
Robert G Carlson, MD, FACS
No other nutrient, hormone or even drug has gained so much scientifically supported credibility than Vitamin D, demonstrating reductions in cancer, heart disease, blood pressure, chronic inflammation, diabetes, viral infections and the autoimmune diseases( arthritis, Lupus, Hashimoto’s thyroiditis). Even though Vitamin D has been shown to be so incredibly beneficial , it is often in very low doses in standard multivitamins, and often side by side with high doses of Vitamin A. Unfortunately some forms of Vitamin A actually BLOCK the benefit of Vitamin D. So grab your multivitamin bottle and look at how much vitamin D and Vitamin A is in it. Most multivitamins have woeful amounts of vitamin D , often ranging from 200 units to 1000, but we should be taking at least 5000 units a day and now more studies show absolutely no toxicity at 10,000 units(should consider this dose in the fall/winter months) and incredible benefits. So what about Vitamin A? The preformed Vitamin A (retinols) are often excessive in multivitamins and having Vitamin A in the beta-carotene form is the form you want. “Preformed” vitamin A comes only from animal products, fortified foods, and supplements. It is most commonly measured in International Units (IU). The Recommended Dietary Allowance (RDA) for vitamin A is 2,310 IU daily for women, 3,000 IU for men, although some food products identify the recommended dose as 5000 IU. Watch out because preformed Vitamin A is not your friend. Studies have proven that too much preformed Vitamin A results in a two fold increase in hip fractures, and a 16 % increase in total mortality, undoubtedly because it blocks all the amazing benefits of Vitamin D. Keep that form of Vitamin A no higher than 1000 IU. Now if the Vitamin A is in the beta-carotene form, there are fewer issues because it is found in plant foods, especially dark green and highly colored vegetables and fruits. It is converted to vitamin A only as our body needs it. Therefore one can’t get dangerous levels of vitamin A by consuming too much beta carotene. By the way that foul tasting modern day Cod Liver oil has up to 10,000 units of preformed Vitamin A….so don’t drink that stuff!
Robert G Carlson, MD, FACS
No other nutrient, hormone or even drug has gained so much scientifically supported credibility than Vitamin D, demonstrating reductions in cancer, heart disease, blood pressure, chronic inflammation, diabetes, viral infections and the autoimmune diseases( arthritis, Lupus, Hashimoto’s thyroiditis). Even though Vitamin D has been shown to be so incredibly beneficial , it is often in very low doses in standard multivitamins, and often side by side with high doses of Vitamin A. Unfortunately some forms of Vitamin A actually BLOCK the benefit of Vitamin D. So grab your multivitamin bottle and look at how much vitamin D and Vitamin A is in it. Most multivitamins have woeful amounts of vitamin D , often ranging from 200 units to 1000, but we should be taking at least 5000 units a day and now more studies show absolutely no toxicity at 10,000 units(should consider this dose in the fall/winter months) and incredible benefits. So what about Vitamin A? The preformed Vitamin A (retinols) are often excessive in multivitamins and having Vitamin A in the beta-carotene form is the form you want. “Preformed” vitamin A comes only from animal products, fortified foods, and supplements. It is most commonly measured in International Units (IU). The Recommended Dietary Allowance (RDA) for vitamin A is 2,310 IU daily for women, 3,000 IU for men, although some food products identify the recommended dose as 5000 IU. Watch out because preformed Vitamin A is not your friend. Studies have proven that too much preformed Vitamin A results in a two fold increase in hip fractures, and a 16 % increase in total mortality, undoubtedly because it blocks all the amazing benefits of Vitamin D. Keep that form of Vitamin A no higher than 1000 IU. Now if the Vitamin A is in the beta-carotene form, there are fewer issues because it is found in plant foods, especially dark green and highly colored vegetables and fruits. It is converted to vitamin A only as our body needs it. Therefore one can’t get dangerous levels of vitamin A by consuming too much beta carotene. By the way that foul tasting modern day Cod Liver oil has up to 10,000 units of preformed Vitamin A….so don’t drink that stuff!
Saturday, September 11, 2010
Weight Savior and Irvingia-Getting Rid of Fat...and Inflammation-Part 2
More about how Weight Savior enriched with Irvingia works its magic, reducing your abdominal fat, cholesterol, and diabetes.
Fat cells function is to store calories and release them for energy use when needed. Fat cells are engorged with triglycerides, which is the main storage form of fat. Problems occur when these fat cells become bloated with triglycerides, and become enlarged. They also tend to accumulate excess fat, because of increase intake, lack of exercise, hormonal imbalances and inflammation, and there lies the problem. Fat cells also release another hormone called Adiponectin, which controls diabetes, decreasing sugar levels in your blood stream, as well as reducing inflammation, and heart disease. Irvingia, and weight Savior make Adiponectin’s work better and be more effective. 10 weeks of using Irvingia alone increased the amount of Adiponectin by 160%. And that’s a good thing in the battle against belly fat, as well as controlling diabetes and inflammation.
The third major benefit of having Irvingia in Weight Savior is the inhibition of the enzyme glycerol-3-phospate. What has that enzyme done for me lately? Well produced in fat cells, it causes excess sugar to be converted to triglycerides so as to make the fat cells bigger and plumper. Now that doesn’t sound too good to me. Blocking it reduces fatty acid formation and reduces the amount of sugar converted into fat. Now that’s good.
http://www.youtube.com/watch?v=IPAXuaxIXOs
Fat cells function is to store calories and release them for energy use when needed. Fat cells are engorged with triglycerides, which is the main storage form of fat. Problems occur when these fat cells become bloated with triglycerides, and become enlarged. They also tend to accumulate excess fat, because of increase intake, lack of exercise, hormonal imbalances and inflammation, and there lies the problem. Fat cells also release another hormone called Adiponectin, which controls diabetes, decreasing sugar levels in your blood stream, as well as reducing inflammation, and heart disease. Irvingia, and weight Savior make Adiponectin’s work better and be more effective. 10 weeks of using Irvingia alone increased the amount of Adiponectin by 160%. And that’s a good thing in the battle against belly fat, as well as controlling diabetes and inflammation.
The third major benefit of having Irvingia in Weight Savior is the inhibition of the enzyme glycerol-3-phospate. What has that enzyme done for me lately? Well produced in fat cells, it causes excess sugar to be converted to triglycerides so as to make the fat cells bigger and plumper. Now that doesn’t sound too good to me. Blocking it reduces fatty acid formation and reduces the amount of sugar converted into fat. Now that’s good.
http://www.youtube.com/watch?v=IPAXuaxIXOs
Weight Savior and Irvingia-Getting Rid of Fat...and inflammation
Weight Savior is just one, but six separate ingredients blended together to maximize weight loss. One of these amazing ingredients is Irvingia. This natural compound actually circumvents the molecular factors critical in causing obesity. This breakthrough compound, Irvingia, may actually be the key to reversing today’s epidemic of obesity. One of the main reasons we develop increasing abdominal fat is something called Leptin-resistance. So what is Leptin? It is released from our fat cells for two primary reasons. The first, is to tell the brain that you have eaten enough and it quiets your appetite. Secondly, Leptin then causes triglycerides that are stored in the fat cells (increase waist line) to be broken down so that the body can use them as an energy source. So decrease in fat cells, and increase in energy. That sounds pretty good to me. Unfortunately in people with increased abdominal fat they produce more inflammation ( increased CRP levels) and that blocks the benefits of Leptin. Obese people have much higher CRP levels, markers of inflammation, and even higher Leptin levels but CRP binds to Leptin stopping it from entering the brain and from breaking down fat.
Okay, so how does Irvingia, and Weight Savior reduce fat? It dramatically reduces CRP and thus freeing up Leptin to work its magic. We also know that Heart disease is associated with elevated inflammation and CRP. Newest studies show taking very high doses of Crestor, albeit associated with massive side-effects, reduces CRP by 17 % in a year. But Irvingia, a main component of Weight Savior reduces CRP by 52% in only 10 weeks. Now that is impressive, and the only side-effects were weight loss and a 16% reduction in your waist line in 10 weeks.
More to come about how Irvingia, and Weight Savior work their magic, reducing your abdominal fat, cholesterol, and diabetes.
Okay, so how does Irvingia, and Weight Savior reduce fat? It dramatically reduces CRP and thus freeing up Leptin to work its magic. We also know that Heart disease is associated with elevated inflammation and CRP. Newest studies show taking very high doses of Crestor, albeit associated with massive side-effects, reduces CRP by 17 % in a year. But Irvingia, a main component of Weight Savior reduces CRP by 52% in only 10 weeks. Now that is impressive, and the only side-effects were weight loss and a 16% reduction in your waist line in 10 weeks.
More to come about how Irvingia, and Weight Savior work their magic, reducing your abdominal fat, cholesterol, and diabetes.
Wednesday, September 8, 2010
Get Rid Of My Tummy Fat...with Weight Savior
I hope you enjoy this new video on a new supplement for weight loss that specifically attacks the fat around our tummy and inside of our belly (visceral fat).
http://www.youtube.com/watch?v=IPAXuaxIXOs
Dr. C
http://www.youtube.com/watch?v=IPAXuaxIXOs
Dr. C
Sunday, September 5, 2010
Lose Weight And Not Be Hungry With Low Carbohydrate Approach
Low Carbohydrate approach to successful weight loss
Robert G Carlson, MD, FACS
Patients often ask me for a dietary recommendation. I believe that a change of habits is better than a “new diet”, and my preference is a low carbohydrate approach. The low fat diet is just forcing large amounts of sugar into your system, making you fatter and increasing you risk of developing diabetes. Let me give you an example of a daily low carbohydrate approach:
Goal is to keep your total carbohydrate intake to 20 grams of carbohydrates a day for two weeks and then increase to 30 grams. You can’t eat bread, pasta, rice, ice cream or candy. For instance one can of mountain dew has 46 grams of carbohydrates or over two days worth of carbohydrates. A two ounce serving of pasta, has 42 grams of carbohydrates! Alright here we go:
Breakfast- Coffee/Tea with/without cream, no sugar but can have splenda or estevia or even better Erythritol.
Two egg omelet with bacon and cheese using only water to mix eggs. (no carbohydrates or maybe 1 total for breakfast. Avoid low fat cheese, because that means high sugar cheese No bread
Snacks: Macadamia nuts, almonds (8 nuts is about 2 grams carbohydrates), avoid cashews
Lunch- Roll-ups Go to your favorite deli and get the thicker slice cheese and meats. Roll the cheese and meat together and use mayonnaise or mustard... I even take lunch meat and put cream cheese into the roll-up…no carbs! You can eat these all day long and there are essentially no carbohydrates in a roll-up.
Dinner- Go to Publix and get a lemon pepper chicken, or to sonny’s BBQ ( or your local favorite) and eat the chicken, beef etc, but avoid too much red sauce as they sneak sugar into that. And of course NO sweetened tea. I also eat steak, seafood, turkey as well. No ketchup.
Also at dinner I recommend a salad, and this has some carbohydrates in it. I like spinach, with cucumbers, olives, and some tomatoes. The tomatoes have some carbs in them. Putting blue cheese dressing/most Ranch dressings, balsamic vingarette on your salad and cover it with sharp cheddar cheese. There is very few carbs in this meal, with the exception of the tomatoes. Onions are ok as well, but I just don’t eat them very often. Avoid Garbanzo beans as well
At bedtime you should try another roll-up or eat some more nuts as it is important to have some protein at bedtime.
An evening snack when craving sweets is my favorite. I take two or even three containers of sugar free jello, my favorite is the cherry, and cover it generously with whip cream, you can even use the heavy whipping cream. There are absolutely no carbohydrates in this and you can even go back for seconds or sneak a shot of whipping cream from your own personal can. In the past I have eaten popcorn, but I would definitely avoid it as it is a source of carbohydrates. Fruits I like are strawberries, blackberries, and blueberries, but you need to avoid bananas and oranges (very high glycemic index).
I hope this gives you some direction. When you go shopping look at the labels for how much carbohydrate is present per serving.
Robert G Carlson, MD, FACS
Patients often ask me for a dietary recommendation. I believe that a change of habits is better than a “new diet”, and my preference is a low carbohydrate approach. The low fat diet is just forcing large amounts of sugar into your system, making you fatter and increasing you risk of developing diabetes. Let me give you an example of a daily low carbohydrate approach:
Goal is to keep your total carbohydrate intake to 20 grams of carbohydrates a day for two weeks and then increase to 30 grams. You can’t eat bread, pasta, rice, ice cream or candy. For instance one can of mountain dew has 46 grams of carbohydrates or over two days worth of carbohydrates. A two ounce serving of pasta, has 42 grams of carbohydrates! Alright here we go:
Breakfast- Coffee/Tea with/without cream, no sugar but can have splenda or estevia or even better Erythritol.
Two egg omelet with bacon and cheese using only water to mix eggs. (no carbohydrates or maybe 1 total for breakfast. Avoid low fat cheese, because that means high sugar cheese No bread
Snacks: Macadamia nuts, almonds (8 nuts is about 2 grams carbohydrates), avoid cashews
Lunch- Roll-ups Go to your favorite deli and get the thicker slice cheese and meats. Roll the cheese and meat together and use mayonnaise or mustard... I even take lunch meat and put cream cheese into the roll-up…no carbs! You can eat these all day long and there are essentially no carbohydrates in a roll-up.
Dinner- Go to Publix and get a lemon pepper chicken, or to sonny’s BBQ ( or your local favorite) and eat the chicken, beef etc, but avoid too much red sauce as they sneak sugar into that. And of course NO sweetened tea. I also eat steak, seafood, turkey as well. No ketchup.
Also at dinner I recommend a salad, and this has some carbohydrates in it. I like spinach, with cucumbers, olives, and some tomatoes. The tomatoes have some carbs in them. Putting blue cheese dressing/most Ranch dressings, balsamic vingarette on your salad and cover it with sharp cheddar cheese. There is very few carbs in this meal, with the exception of the tomatoes. Onions are ok as well, but I just don’t eat them very often. Avoid Garbanzo beans as well
At bedtime you should try another roll-up or eat some more nuts as it is important to have some protein at bedtime.
An evening snack when craving sweets is my favorite. I take two or even three containers of sugar free jello, my favorite is the cherry, and cover it generously with whip cream, you can even use the heavy whipping cream. There are absolutely no carbohydrates in this and you can even go back for seconds or sneak a shot of whipping cream from your own personal can. In the past I have eaten popcorn, but I would definitely avoid it as it is a source of carbohydrates. Fruits I like are strawberries, blackberries, and blueberries, but you need to avoid bananas and oranges (very high glycemic index).
I hope this gives you some direction. When you go shopping look at the labels for how much carbohydrate is present per serving.
Saturday, August 28, 2010
THE AMAZING VITAMIN D...JUST THE FACTS
Please check out all the amazing benefits of Vitamin D in this linked video. Even in Florida we don't get enough because we wear sunscreen all the time, that blocks all of the Vitamin D production. In the winter we did a study on women 30-65 years of age and 92 % of the women were below the lowest normal range of vitamin D, essentially Vitamin D deficient. When Vitamin D protects from Cancer, Heart Disease, Diabetes,Autoimmune diseases like Rheumatoid arthritis,the common cold as well as upper respiratory infections so prevalent in the winter months, we would be better off if we kept our Vitamin D levels. Doesn't that make sense? And it is so inexpensive...not cheap!
check this you tube video out....
http://www.youtube.com/watch?v=wQbVTEesb3I
check this you tube video out....
http://www.youtube.com/watch?v=wQbVTEesb3I
Monday, June 21, 2010
Vitamin D myths and management-Robert Carlson,MD
THE MANY VITAMIN D MYTHS
Patient EB is a 50-year-old female with a family history of colon cancer and breast cancer as well as a history of arthritis with probable autoimmune etiology. She takes a daily multivitamin which includes 10,000 units of Vitamin A as well as a separate 1000 IU of Vitamin D3 and her 25-(OH) Vitamin D3 level is 36 ng/mL (reference range 33-100 ng/mL). Should EB increase her dose of Vitamin D3? Should she continue her multi-vitamin?
There are so many myths surrounding Vitamin D. First and foremost, is the myth that Vitamin D is
a Vitamin. Vitamin D is not a Vitamin, it is actually a steroid hormone. Vitamin D is produced in one part of the body (the skin), and then travels to a remote site, where it exerts an endocrine effect. Thus, it fulfills the definition of a hormone. Another Vitamin D myth is that its only function is calcium regulation. That idea has been well and truly debunked in recent years. Then there is the idea that 1000 IUs a day is more than enough, which is simply not true. Also many believe that taking over 2000 units a day might cause toxicities. I hear this from numerous health professionals and even from pharmacists who should know better. The literature is very clear…..evidence from clinical trials shows that a prolonged intake of 10,000 units of Vitamin D per day poses no risk of adverse effects for adults 1 ……therefore one can take 10,000 units a day and have no risk for toxicity.
Other myths of interest include:
1) Most people living in the US get adequate amounts of Vitamin D – not true (see below).
2) Extreme care must be taken to avoid toxicity – not true! There have been numerous
studies on Vitamin D toxicity and no toxicity has been seen in doses lower than 30,000
IU/day (200 ng/mL). An excess of Vitamin D causes hypercalcemia, however all known
cases of Vitamin D toxicity with hypercalcemia have involved intakes of 40,000 IU or more
per day.2
3) Spending 15 minutes in the sun each day enables the body to produce ample amounts of
Vitamin D – that may be true if you are sitting on a beach in Hawaii at noon wearing
nothing but a bikini, but for the vast majority of us that is a myth. Unfortunately, once sunscreen is applied the Vitamin D production drops to nothing. If you live above 35 degrees latitude, the body is unable to produce adequate amounts of Vitamin D from the winter sun. In fact the only adequate amount of sunshine in Boston occurs, between May and Sept, otherwise there is inadequate sunlight for Vitamin D metabolism.
4) Eating a balanced diet will provide adequate amounts of Vitamin D – not true! Vitamin D is present, in small amounts, in only a handful of foods – oily fish, eggs, and fortified
foods. Vitamin D fortified Milk and Orange Juice only contain 50 Units of Vitamin D2, not Vitamin D3. Thus it is very unlikely that adequate amounts could be obtained from the diet.
• Vitamin D does not prevent cancer – it does , in fact one study showed the reduction in all cancers by 77 % over a four year period in a well designed study.(see below).
• Vitamin D does not prevent autoimmune disease – it does , reducing Systemic Lupus ,Rheumatoid Arthritis and Childhood onset diabetes(see below).
• Vitamin D does not prevent acute MI and heart disease – it does (see below).
As mentioned above, the notion that most people living in the US get adequate amounts of
Vitamin D is far from true. Research has shown that Vitamin D deficiency is present among all age groups of US citizens from children to the elderly, and especially in African-Americans.3 Studies have shown that the prevalence of low 25-(OH) D levels (<20 ng/mL) is approximately 36% in young adults aged 18-294 ,42% of African-American women aged 15-495 ,41% of outpatients aged 49-83,6 and 57% of inpatients.7
In Europe, it is believed that between 28 and 100% of healthy adults and 70-100% of hospitalized adults have low 25-(OH) D levels (<20 ng/mL).8,9,10
A study we completed examining women age 35-65 in Tampa, Florida in December, demonstrated that 92 % of the women had 25-(OH) D levels less than the low normal range of 32. Can you imagine what the Vitamin D levels are in the same group of women in Minneapolis, Minnesota in December?
Research has shown that the incidence of many diseases could be dramatically reduced by
increasing serum 25-(OH) D levels, and by looking at the list below, it is easy to see why Vitamin D has become a very hot topic in recent years:
1) Increasing serum 25-(OH) D levels to 35 ng/mL could prevent 30% of MI in men11 and
reduce the risk of fracture in elderly people by 50%.12
2) Increasing serum 25-(OH) D levels to approximately 40 ng/mL could reduce the risk of
cancer in postmenopausal women by 35%13 and reduce the risk of falls in elderly people
by 50%. 14
3) Increasing serum 25-(OH) D levels to 50 ng/mL could reduce the incidence of breast
cancer by as much as 80%,15 multiple sclerosis by as much as 60%,16 and type I
diabetes by up to 50%.17
Why is Vitamin D so beneficial? There is no clear answer at present. However, anything that has
such wide-ranging benefits has to possess the ability to modulate inflammation. Indeed, studies have shown that Vitamin D inhibits nuclear factor-κβ (NF-κβ) 18 – a protein that plays a key role in the inflammatory response and in the proliferation of cancer cells. It has also been shown to lower levels of the inflammatory marker CRP.19 Thus, it is vital that we ensure our patients are getting plenty of Vitamin D.
What about Patient EB, does she need to increase her daily dose of Vitamin D3? Yes. The
reference range for 25-(OH) D is 32-100 ng/mL Given the evidence published in the medical literature over the last few years, it is advisable to try and keep patients at the top end of the reference range – so, we should be aiming for 75-100 ng/mL The optimal dose for an average person is 5000-15,000 IU/day; however this should be lowered for people who get a lot of sun exposure. Ideally check Vitamin D leveIs and regularly check serum calcium in patients who take supplementary Vitamin D, just to ensure there is no risk of hypercalcemia.
So what about her multi-Vitamin choice? Some multi-Vitamins may be doing more harm than good. I recommend avoiding excessive amount of pre-formed Vitamin A in the retinol form, as opposed to the beta-carotene form that converts to Vitamin A in your body. The presence of excessive pre-formed actually will neutralize all the amazing benefits of Vitamin D3.20 Unfortunately, multi-vitamins often continue a lot of Vitamin A(average 4400 units) as retinol and very low levels of D3( average 400). Vitamin A and Vitamin D receptors are very close to each other and excess Vitamin A will block the beneficial effects of Vitamin D. Women who took the highest intake of pre-formed Vitamin A actually had twice as many hip fractures. 21 So keep the non- beta carotene Vitamin A supplements to less than 1000 units, and this will allow all the amazing benefits of Vitamin D3.
CONCLUDING REMARKS
There are many myths surrounding hormone replacement therapies, however from the evidence
presented above, we can see that not one of them is true. Hormone optimization provides us with an extremely powerful anti-aging tool to maximize quality of life.
REFERENCES
1. Vieth R. Vitamin D and Cancer Mini-Symposium: the risk of additional Vitamin D. Ann Epidemiol. 2009; 19(7):441-5.
2. Vieth R. Vitamin D supplementation, 25-hydroxyVitamin D concentration, and safety. Am J Clin Nutr. 1999;69:842-56.
3. Holick MF. High prevalence of Vitamin D inadequacy and implications for health. Mayo Clin Proc.
2006;81:353-373.
4. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young
adults. Am J Med. 2002;112:659-662.
5. Nesby-O'Dell S, Scanlon KS, Cogswell ME, Gillespie C, Hollis BW, Looker AC, Allen C, Doughertly C,
Gunter EW, Bowman BA. HypoVitaminosis D prevalence and determinants among African American and
336 white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994. Am
J Clin Nutr. 2002;76:187-192.
6. Malabanan A, Veronikis IE, Holick MF. Redefining Vitamin D insufficiency [letter]. Lancet. 1998;351:805-
806.
7. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM,
Prince RL, Finkelstein JS. HypoVitaminosis D in medical inpatients. N Engl J Med. 1998;338:777-783.
8 . McKenna MJ. Differences in Vitamin D status between countries in young adults and the elderly. Am J
Med. 1992;93:69-77.
9. Isaia G, Giorgino R, Rini GB, Bevilacqua M, Maugeri D, Adami S. Prevalence of hypoVitaminosis D in
elderly women in Italy: clinical consequences and risk factors. Osteoporos Int. 2003;14:577-582.
10. Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi P, Delsignore R, Pedrazzoni M,
Franceschi C. Low Vitamin D status, high bone turnover, and bone fractures in centenarians. J Clin
Endocrinol Metab. 2003;88:5109-5115.
11. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyVitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168:1174-80.
12. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture
prevention with Vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA.
2005;293:2257-2264.
13. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium
supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85:1586-1591.
14. Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP. A higher dose of Vitamin d
reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc.
2007;55:234-239.
15. Garland CF, Gorham ED, Mohr SB, Grant WB, Garland FC. Breast cancer risk according to serum s5-
hydroxyVitamin D: Meta-analysis of dose-response. Presented at: American Association for Cancer
Research Annual Meeting; April 12-16, 2008; San Diego, California.
16. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyVitamin D levels and risk of
multiple sclerosis. JAMA. 2006;296:2832-2838.
17. Hyppönen E, Läärä E, Reunanen A, Järvelin MR, Virtanen SM. Intake of Vitamin D and risk of type 1
diabetes: a birth-cohort study. Lancet. 2001;358:1500-1503.
18. Szeto FL, Sun J, Kong J, Duan Y, Liao A, Madara JL, Li YC. Involvement of the Vitamin D receptor in the
regulation of NF-kappaB activity in fibroblasts. J Steroid Biochem Mol Biol. 2007;103:563-566.
19. Boxer RS, Dauser DA, Walsh SJ, Hager WD, Kenny AM. The association between Vitamin D and
inflammation with the 6-minute walk and frailty in patients with heart failure. J Am Geriatr Soc.
2008;56:454-461.
20. Melhus H, Michaëlsson K, Kindmark A, Bergström R,. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Annals of Internal Medicine, 1998;129(10):770-8.
21. Johansson S, Melhus H. Vitamin A antagonizes calcium response to vitamin D in man. J Bone Mineral Res. 2001;16(10):1899-905.
Robert G Carlson, MD, FACS
Patient EB is a 50-year-old female with a family history of colon cancer and breast cancer as well as a history of arthritis with probable autoimmune etiology. She takes a daily multivitamin which includes 10,000 units of Vitamin A as well as a separate 1000 IU of Vitamin D3 and her 25-(OH) Vitamin D3 level is 36 ng/mL (reference range 33-100 ng/mL). Should EB increase her dose of Vitamin D3? Should she continue her multi-vitamin?
There are so many myths surrounding Vitamin D. First and foremost, is the myth that Vitamin D is
a Vitamin. Vitamin D is not a Vitamin, it is actually a steroid hormone. Vitamin D is produced in one part of the body (the skin), and then travels to a remote site, where it exerts an endocrine effect. Thus, it fulfills the definition of a hormone. Another Vitamin D myth is that its only function is calcium regulation. That idea has been well and truly debunked in recent years. Then there is the idea that 1000 IUs a day is more than enough, which is simply not true. Also many believe that taking over 2000 units a day might cause toxicities. I hear this from numerous health professionals and even from pharmacists who should know better. The literature is very clear…..evidence from clinical trials shows that a prolonged intake of 10,000 units of Vitamin D per day poses no risk of adverse effects for adults 1 ……therefore one can take 10,000 units a day and have no risk for toxicity.
Other myths of interest include:
1) Most people living in the US get adequate amounts of Vitamin D – not true (see below).
2) Extreme care must be taken to avoid toxicity – not true! There have been numerous
studies on Vitamin D toxicity and no toxicity has been seen in doses lower than 30,000
IU/day (200 ng/mL). An excess of Vitamin D causes hypercalcemia, however all known
cases of Vitamin D toxicity with hypercalcemia have involved intakes of 40,000 IU or more
per day.2
3) Spending 15 minutes in the sun each day enables the body to produce ample amounts of
Vitamin D – that may be true if you are sitting on a beach in Hawaii at noon wearing
nothing but a bikini, but for the vast majority of us that is a myth. Unfortunately, once sunscreen is applied the Vitamin D production drops to nothing. If you live above 35 degrees latitude, the body is unable to produce adequate amounts of Vitamin D from the winter sun. In fact the only adequate amount of sunshine in Boston occurs, between May and Sept, otherwise there is inadequate sunlight for Vitamin D metabolism.
4) Eating a balanced diet will provide adequate amounts of Vitamin D – not true! Vitamin D is present, in small amounts, in only a handful of foods – oily fish, eggs, and fortified
foods. Vitamin D fortified Milk and Orange Juice only contain 50 Units of Vitamin D2, not Vitamin D3. Thus it is very unlikely that adequate amounts could be obtained from the diet.
• Vitamin D does not prevent cancer – it does , in fact one study showed the reduction in all cancers by 77 % over a four year period in a well designed study.(see below).
• Vitamin D does not prevent autoimmune disease – it does , reducing Systemic Lupus ,Rheumatoid Arthritis and Childhood onset diabetes(see below).
• Vitamin D does not prevent acute MI and heart disease – it does (see below).
As mentioned above, the notion that most people living in the US get adequate amounts of
Vitamin D is far from true. Research has shown that Vitamin D deficiency is present among all age groups of US citizens from children to the elderly, and especially in African-Americans.3 Studies have shown that the prevalence of low 25-(OH) D levels (<20 ng/mL) is approximately 36% in young adults aged 18-294 ,42% of African-American women aged 15-495 ,41% of outpatients aged 49-83,6 and 57% of inpatients.7
In Europe, it is believed that between 28 and 100% of healthy adults and 70-100% of hospitalized adults have low 25-(OH) D levels (<20 ng/mL).8,9,10
A study we completed examining women age 35-65 in Tampa, Florida in December, demonstrated that 92 % of the women had 25-(OH) D levels less than the low normal range of 32. Can you imagine what the Vitamin D levels are in the same group of women in Minneapolis, Minnesota in December?
Research has shown that the incidence of many diseases could be dramatically reduced by
increasing serum 25-(OH) D levels, and by looking at the list below, it is easy to see why Vitamin D has become a very hot topic in recent years:
1) Increasing serum 25-(OH) D levels to 35 ng/mL could prevent 30% of MI in men11 and
reduce the risk of fracture in elderly people by 50%.12
2) Increasing serum 25-(OH) D levels to approximately 40 ng/mL could reduce the risk of
cancer in postmenopausal women by 35%13 and reduce the risk of falls in elderly people
by 50%. 14
3) Increasing serum 25-(OH) D levels to 50 ng/mL could reduce the incidence of breast
cancer by as much as 80%,15 multiple sclerosis by as much as 60%,16 and type I
diabetes by up to 50%.17
Why is Vitamin D so beneficial? There is no clear answer at present. However, anything that has
such wide-ranging benefits has to possess the ability to modulate inflammation. Indeed, studies have shown that Vitamin D inhibits nuclear factor-κβ (NF-κβ) 18 – a protein that plays a key role in the inflammatory response and in the proliferation of cancer cells. It has also been shown to lower levels of the inflammatory marker CRP.19 Thus, it is vital that we ensure our patients are getting plenty of Vitamin D.
What about Patient EB, does she need to increase her daily dose of Vitamin D3? Yes. The
reference range for 25-(OH) D is 32-100 ng/mL Given the evidence published in the medical literature over the last few years, it is advisable to try and keep patients at the top end of the reference range – so, we should be aiming for 75-100 ng/mL The optimal dose for an average person is 5000-15,000 IU/day; however this should be lowered for people who get a lot of sun exposure. Ideally check Vitamin D leveIs and regularly check serum calcium in patients who take supplementary Vitamin D, just to ensure there is no risk of hypercalcemia.
So what about her multi-Vitamin choice? Some multi-Vitamins may be doing more harm than good. I recommend avoiding excessive amount of pre-formed Vitamin A in the retinol form, as opposed to the beta-carotene form that converts to Vitamin A in your body. The presence of excessive pre-formed actually will neutralize all the amazing benefits of Vitamin D3.20 Unfortunately, multi-vitamins often continue a lot of Vitamin A(average 4400 units) as retinol and very low levels of D3( average 400). Vitamin A and Vitamin D receptors are very close to each other and excess Vitamin A will block the beneficial effects of Vitamin D. Women who took the highest intake of pre-formed Vitamin A actually had twice as many hip fractures. 21 So keep the non- beta carotene Vitamin A supplements to less than 1000 units, and this will allow all the amazing benefits of Vitamin D3.
CONCLUDING REMARKS
There are many myths surrounding hormone replacement therapies, however from the evidence
presented above, we can see that not one of them is true. Hormone optimization provides us with an extremely powerful anti-aging tool to maximize quality of life.
REFERENCES
1. Vieth R. Vitamin D and Cancer Mini-Symposium: the risk of additional Vitamin D. Ann Epidemiol. 2009; 19(7):441-5.
2. Vieth R. Vitamin D supplementation, 25-hydroxyVitamin D concentration, and safety. Am J Clin Nutr. 1999;69:842-56.
3. Holick MF. High prevalence of Vitamin D inadequacy and implications for health. Mayo Clin Proc.
2006;81:353-373.
4. Tangpricha V, Pearce EN, Chen TC, Holick MF. Vitamin D insufficiency among free-living healthy young
adults. Am J Med. 2002;112:659-662.
5. Nesby-O'Dell S, Scanlon KS, Cogswell ME, Gillespie C, Hollis BW, Looker AC, Allen C, Doughertly C,
Gunter EW, Bowman BA. HypoVitaminosis D prevalence and determinants among African American and
336 white women of reproductive age: third National Health and Nutrition Examination Survey, 1988-1994. Am
J Clin Nutr. 2002;76:187-192.
6. Malabanan A, Veronikis IE, Holick MF. Redefining Vitamin D insufficiency [letter]. Lancet. 1998;351:805-
806.
7. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, Vamvakas EC, Dick IM,
Prince RL, Finkelstein JS. HypoVitaminosis D in medical inpatients. N Engl J Med. 1998;338:777-783.
8 . McKenna MJ. Differences in Vitamin D status between countries in young adults and the elderly. Am J
Med. 1992;93:69-77.
9. Isaia G, Giorgino R, Rini GB, Bevilacqua M, Maugeri D, Adami S. Prevalence of hypoVitaminosis D in
elderly women in Italy: clinical consequences and risk factors. Osteoporos Int. 2003;14:577-582.
10. Passeri G, Pini G, Troiano L, Vescovini R, Sansoni P, Passeri M, Gueresi P, Delsignore R, Pedrazzoni M,
Franceschi C. Low Vitamin D status, high bone turnover, and bone fractures in centenarians. J Clin
Endocrinol Metab. 2003;88:5109-5115.
11. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyVitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168:1174-80.
12. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture
prevention with Vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA.
2005;293:2257-2264.
13. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium
supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007;85:1586-1591.
14. Broe KE, Chen TC, Weinberg J, Bischoff-Ferrari HA, Holick MF, Kiel DP. A higher dose of Vitamin d
reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc.
2007;55:234-239.
15. Garland CF, Gorham ED, Mohr SB, Grant WB, Garland FC. Breast cancer risk according to serum s5-
hydroxyVitamin D: Meta-analysis of dose-response. Presented at: American Association for Cancer
Research Annual Meeting; April 12-16, 2008; San Diego, California.
16. Munger KL, Levin LI, Hollis BW, Howard NS, Ascherio A. Serum 25-hydroxyVitamin D levels and risk of
multiple sclerosis. JAMA. 2006;296:2832-2838.
17. Hyppönen E, Läärä E, Reunanen A, Järvelin MR, Virtanen SM. Intake of Vitamin D and risk of type 1
diabetes: a birth-cohort study. Lancet. 2001;358:1500-1503.
18. Szeto FL, Sun J, Kong J, Duan Y, Liao A, Madara JL, Li YC. Involvement of the Vitamin D receptor in the
regulation of NF-kappaB activity in fibroblasts. J Steroid Biochem Mol Biol. 2007;103:563-566.
19. Boxer RS, Dauser DA, Walsh SJ, Hager WD, Kenny AM. The association between Vitamin D and
inflammation with the 6-minute walk and frailty in patients with heart failure. J Am Geriatr Soc.
2008;56:454-461.
20. Melhus H, Michaëlsson K, Kindmark A, Bergström R,. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Annals of Internal Medicine, 1998;129(10):770-8.
21. Johansson S, Melhus H. Vitamin A antagonizes calcium response to vitamin D in man. J Bone Mineral Res. 2001;16(10):1899-905.
Robert G Carlson, MD, FACS
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