Are you getting enough Vitamin D?

Some days it feels like we never see the sun. With an average of nine hours of daylight during the winter months (compared to about 15 hours during the summer), most Canadians are not getting the sun exposure required for sufficient levels of Vitamin D between October to March.

Also, known as the “sunshine vitamin”, Vitamin D has many benefits: reduce heart risks, help to fight viral infections, absorb calcium for healthy bones and teeth, maintain healthy blood pressure, control insulin production and help to prevent certain cancers, especially colorectal and breast cancer.

“Low blood levels of Vitamin D are common in Canada,” says Sara Mahdavi, Nephrology Dietician at The Scarborough Hospital. “In many scientific studies, low levels of Vitamin D have been linked to several diseases such as diabetes, multiple sclerosis, and cancer of breast, prostate and colon.”

The best way to get Vitamin D is through diet and/or short periods of spring and summer sun exposure on hands and arms (15-30 minutes depending on your age, skin pigmentation and body mass) before putting on sunscreen. However, during the autumn and winter months, we have no choice but to use foods high in Vitamin D content.

“There are a number of ways you can easily add Vitamin D to your diet,” explains Sara. “These include fatty fish such as salmon and sardines, eggs, or fortified products such as cow’s milk and soy beverages. For vegetarians, mushrooms and fortified soy milk are the only non-animal sources of Vitamin D. Always look for food labels showing greater than 20 per cent daily value.”

Vitamin D supplements are also readily available over-the-counter at pharmacies and health food stores in pills, chewable tablets and drops. A registered dietician or your family physician can help you determine if you are getting enough Vitamin D. 

Sara recommends the following tips for getting more Vitamin D:

• Use low fat milk or fortified soy beverages instead of water in things like smoothies , scrambled eggs and hot chocolate
• Add salmon to your diet in foods such as wraps and sandwiches at least two times per week
• Spend more time outside
• Add a 400 IU Vitamin D daily if you are a healthy adult, 50 years of age or older

Four ways to lower your cholesterol without medication

You’ve just been told your cholesterol levels are too high. This can be overwhelming and maybe a little scary. But the good news is that if caught early, you can reduce your cholesterol levels naturally and avoid medication.

High blood cholesterol is a major risk factor for heart disease and stroke. So, it’s important to understand what it is and how you can control it.

“High cholesterol levels occur when your low-density lipoprotein (LDL), or ‘bad’ cholesterol, is high, and your high-density lipoprotein (HDL), or ‘good’ cholesterol, is low,” says Layla Al-Rehany, a clinical dietician at The Scarborough Hospital. “Healthy lifestyle and nutrition are crucial to help managing cholesterol levels.”

Here are four healthy lifestyle and nutrition strategies to reduce your cholesterol levels:

Lose weight – being overweight can result in higher LDL and lower HDL. You can improve your cholesterol levels and lower your risk of heart disease by losing about five to 10 per cent of your body weight. So, if you weigh 150 lbs, you would have to lose 7.5 to 15 lbs to reduce your risk.

Increase physical activity – to stay healthy, everyone should exercise about 30 minutes a day five times a week. This can help lower LDL and raise HDL. If you’re not currently active, try starting with a low impact activity such as brisk walking, swimming or a leisurely bike ride.

Change your diet – select foods that are lower in saturated fats, trans fat and cholesterol. Make sure to include lots of fruits, vegetables, whole grains and lean sources of protein in your diet which are good sources of fibre and unsaturated fats. Here are some healthy food options:

• Oatmeal, oat bran and high-fibre foods such as kidney beans, apples, pears, barley and prunes contain soluble fibre which reduces your LDL.
• Fish and omega-3 fatty acids can reduce blood pressure and lower your risk of developing blood clots. Try to eat two servings per week of baked or grilled fatty fish such as salmon or mackerel. You can also take a fish oil supplement.
• Skinless lean cuts of meat and poultry.
• Skim or 1 per cent milk, yogurt with 1 per cent milk fat or less, cheese with 15 -20 per cent milk fat or less.
• Unsaturated oils such as canola, olive, peanut, safflower, soybean, sunflower or corn – about two tablespoons each day. Use them in marinades, stir fry and salad dressings. When it comes to oils, do not choose “light” versions as they are just more processed and you will get less benefit.
• Non-hydrogenated soft margarine made from unsaturated oils.
• Walnuts, almonds, hazelnuts, peanuts, pecans, some pine nuts and pistachio nuts can help reduce cholesterol. But they are high in calories, so stick to about a handful per day, and avoid nuts covered in salt or sugar.

Stop smoking – smoking lowers your HDL and raises your LDL. You can reverse these effects if you stop smoking today.

With some hard work and dedication, you can implement all of these strategies into your lifestyle and see significant changes in your blood cholesterol levels.

When does a diet become an Eating Disorder?

Many of us have experimented with crash diets, trendy exercise routines, calorie counting and a love-hate relationship with the bathroom scale because we may be dissatisfied with our bodies. But when does common concern become an obsession, and ultimately lead to an eating disorder? 

“An eating disorder begins to develop when an individual demonstrates goal-directed behaviour to lose weight, even when they are already clinically underweight,” says Joanna Blanchard, Mental Health Therapist at The Scarborough Hospital. “Pressure can come from media images that have likely been manipulated, and individuals aim for the physically impossible.”

However, many people are exposed to the same media, but do not develop an eating disorder. While societal and familial pressures or existing mental health issues such as depression can play a role in developing this mental illness, the direct cause remains unknown.

Some signs that an individual may be struggling with an eating disorder include:
• Restricted calorie intake
• Excessive exercise
• Excessive use of laxatives and/or diuretics
• Rapid weight loss

Often considered a ‘women’s disease,’ research shows that over the past few years, eating disorders such as Anorexia Nervosa and Bulimia Nervosa are affecting an increasing number of men.

“Traditionally men aspired for a muscular figure, but the modern male model is slim, which can put pressure on men to lose weight,” says Stephanie Luke, Child and Youth Worker at TSH.

Stephanie adds that athletes, who gain a competitive edge from weight control, are a high risk group. For example, wrestlers are seven to 10 times more likely to develop an eating disorder from a constant pressure to maintain a specific weight range.

Despite the goal, an eating disorder is the most lethal mental health disorder. It damages normal body functions, which can lead to several physical conditions including malnutrition, dehydration, esophageal damage and heart failure.

To learn more about eating disorders and other health and nutrition topics, please join us for the It’s Time to Talk Speakers’ Series, “Food for Thought: You Are What You Eat,” on March 1. Click here for more details.

The importance of prevention and screening for cervical cancer

Worldwide, cervical cancer is the second most common type of gynaecological cancer. In North America, it is the eighth most common cancer. The incidence of cervical cancer has decreased in the developed world because of regular Pap screening. Pap tests detect abnormal cells before they become cancer and further treatments can prevent them from ever becoming cancer. 

“Sadly, not all women go for regular testing and so we continue to see this lethal disease,” said Dr. Georgina Wilcock, an Obstetrician/Gynecologist at The Scarborough Hospital. “Each year in Canada, it’s estimated there are 1,300 new cases of cervical cancer diagnosed and 390 women will die of the disease. “

For these reasons, Dr. Wilcock reminds women about the importance of regular Pap test screening, which has been shown to decrease the incidence of cervical cancer by 50 per cent.

The Pap test is a quick, simple and usually painless procedure where a doctor scrapes and removes cells from the surface of the cervix with a small brush or spatula.  The cells are then examined in a laboratory. In the event that a Pap test shows  changes or abnormalities in the cervical cells, follow-up tests or procedures may be done.

Currently in Canada, it is recommended that women between the ages of 18 and 69 (or women under 18 who are sexually active) undergo cervical screening.

“Although the cause of cancer in general remains somewhat of a mystery, the cause of cervical cancer is not. The culprit is almost always the human papilloma virus (HPV) infection, one of the most common sexually transmitted infections (STIs),” points out Dr. Wilcock.

While some types of HPV cause genital warts, other strains of the virus can infect the cervix and then cause abnormal changes within the cells that may slowly progress to cancer.

There are several other important steps women can take to minimize their risk of developing cervical cancer:

• Get the HPV vaccine – The world’s first vaccination against HPV was approved in Canada and the U.S. in 2006. The vaccination provides protection from four different types of HPV – two of which cause 70 per cent of cervical cancer. In Ontario, this vaccine is given free to girls in grade eight. It is given at this young age because it has been shown that this is the best age for young women to develop a strong immunity to the virus.
• Practice safe sex – The HPV virus is most commonly transmitted via sexual contact and intercourse. Refraining from genital contact with an infected person or using a condom will reduce the risk of HPV infection.  However, condoms are not 100 per cent effective as they only protect the covered area.
• Stop smoking – Both tobacco smoking and exposure to second hand smoke have been associated with the development of cervical cancer. Quitting smoking can reduce the chance of developing the disease.

And, of course, ensure that you are receiving regular Pap testing.