Tidbits: Getting the most Bang for your Vitamin D Buck

Vitamin D is known as the “sunshine vitamin”, because skin exposed to the sun can produce vitamin D for you.  If you live nearer to the equator, it is more likely that you have OK blood vitamin D levels, because the sun is at the right angle most of the year to produce vitamin D via skin exposure.

But in the U.S., if you live above the 42^nd parallel (roughly a line from Boston to Chicago to Portland, Oregon), the sun is at the correct angle only from mid-March thru mid-October. This means that for over half of the year, people above this line cannot produce their own vitamin D, even if you were outside in the sun all day. (More quick facts about Vitamin D here.)

It was not common to be tested for Vitamin D levels until fairly recently. And if you were found to have a low vitamin D blood level, your provider often recommended supplementation with vitamin D, such as 1000 to 2000 units of vitamin D daily, or if the levels were very low, a prescription for 50,000 units vitamin D weekly.

(By the way, it is not very wise to take extra vitamin D “just because”, as it can build up in the body to toxic levels. To be safe, it’s best to ask for a blood test to see if you even need extra vitamin D.)

Researchers at the Cleveland Clinic Foundation Bone Clinic noticed that some of their patients did not achieve optimal vitamin D levels despite taking large doses of vitamin D for months.  They noted that many patients took the supplement either on an empty stomach or with a light morning meal.

Because vitamin D is fat soluble, meaning that it is better absorbed into the body with a fat-containing meal, they asked the study participants to take the vitamin D with the biggest meal of the day, thinking it may help improve absorption.

Sure enough, after two to three months, average blood levels of vitamin D in the participants jumped 50 percent, from about 30.5 nanograms per milliliter, to 47.2 ng/ml.

So the lesson to be learned: If  you need to take vitamin D to correct a deficiency, you are likely to get the most benefit from vitamin D if you take it with your biggest meal of the day (and be sure the meal contains some fat).

What's For Dinner: Vegetable, Beef and Barley Soup

It's getting cooler in the midwest, so time to get out the soup pans. My Vegetable, Beef and Barley soup is tried and true, and easy to whip up in a flash if you keep the ingredients on hand.

Vegetable, beef and barley soup

3/4 cup quick barley

4 cups water

1/2  tablespoon beef base (or 2-3 beef bouillon cubes)

24 to 32 ounces low-sodium V-8 or tomato juice (or add 3-4 cups more water if  you are out of tomato juice)

1 pound lean ground beef (or ground turkey)

3/4 to 1 cup chopped onions

1-2 clove garlic, minced  (or 1/4 teaspoon garlic powder)

1 pound package frozen mixed vegetables (corn, peas, carrots)

14 ounces canned diced tomatoes           

1 tablespoon chili powder (2 tablespoons if using ground turkey)

1/2 cup chopped celery tops and leaves (optional, but a good addition)

In large soup pan (Dutch oven size) bring  4 cups water to boil and add barley. Simmer for 10-15 minutes. Meanwhile in large nonstick fry pan, brown ground beef, then drain well on paper towels. Sauté the chopped onions and garlic over medium heat in the ground beef pan, just until they start to turn translucent (don’t brown them).

Add the tomato juice, ground beef, sautéed onions and garlic, mixed vegetables, chili powder and celery tops to barley in Dutch oven.  Simmer for 30 minutes (or at this point, you can add the ingredients,  then put in the refrigerator for tomorrow – the frozen vegetables help cool the soup and the soup tastes better the second day, just like a lot of things).  When reheating, add more water as needed to get the consistency you like (barley keeps soaking up liquid and makes the soup thick).

Serves 6 hungry people. Serve with grainy rolls and salad. 

Nutrition information per serving: 338 calories, 24 grams protein, 8 grams fat, 41 grams carbohydrate, 10 grams fiber, 60 milligrams cholesterol, 527 milligrams sodium.

Cook’s notes:    I usually double this recipe, but use a large stock pot.

This soup can feed a crowd, and it’s also perfect to give half away to a friend, or to someone recovering from surgery, or half can be frozen for a later meal. Also, if desired, add a can of drained black beans or another bean to the soup for more protein.

Q & A: Using Green Coffee Beans to Lose Weight?

Green, unroasted coffee beans.

Q.            My mother told me that she saw a TV medical show that was talking about using a special green coffee bean extract to lose weight. Is that anything you’ve heard of? I’m rather skeptical of the idea, but is there any merit in trying it? M.L. Wyoming, Michigan

A.            There is scant information available for people to use to decide yes or no on this type of product. The one study that was done had very few participants (less than 20); the study truly should be repeated with a larger group to see if there is validity to the weight loss claims (it’s bad science to make recommendations or change your life habits based on one study).

            So in the meantime, what can you do? If you do decide to try this up-and-coming fad (yes, it’s looking like a fad to me), be aware that you will be conducting an experiment on yourself. Is it worth the 30 or so dollars a month to see if it will work?

            If you’d like to read a more detailed analysis of why this new diet plan may not be the best, check out the article at the Science-Based Medicine blog.

Q & A: Improving Iron Absorption with Vitamin C

My cast iron Griswold #8; one of many ways to get some iron in your diet.

 Q:         I have been trying to increase the level of iron in my blood for the past year. I am on a larger dose of iron, yet no improvement. I had heard taking the iron with orange juice can help the iron be used by the body, and so I tried adding orange juice. But the acidity from the juice really bothers me, so then I end up not taking my iron at all.

Are there any other options instead of the orange juice? H.M. Grand Rapids

A.        Yes, there are a number of options that can help boost iron absorption.  You can take  your pill with water, and include any vitamin-C containing food along with. It’s the vitamin C that has been proven to help enhance absorption of iron. Here is a list of commonly-eaten vitamin C foods.

            What you don’t want to do is take your iron tablet with milk, or at the same time you take your calcium. Why? Because calcium blocks some of the absorption of iron. I had a patient once who was faithfully taking her iron for over a year, but had no change in her blood level of iron (hemoglobin). Upon questioning, I learned she was taking her iron with a big glass of milk; her iron pills didn’t even have a chance to get into her system.

            Some of you may be wondering why take an iron pill when there are foods that contain iron (more about iron-containing foods here).  It’s true that if your iron levels are OK or slightly low, you can choose iron-containing foods and keep your iron levels good. But some people have had a low blood iron level for so long that all of their body’s stores of iron have become depleted. At that point, a larger-dose  iron tablet is required, and even with that, it can take months to build the stores of iron so that the blood iron levels finally reflect that there is enough iron in the body.

Tidbit: Great Reasons to shop the Farmers Market

Photo courtesy of Alice Henneman, University of Nebraska-Lincoln

I missed National Farmers market week (it's earlier in August) but I’m here to declare August Farmers Market Month.

We have a small “Healthy Street” farmers market every Thursday in the summer, directly in front of the hospital where I work in Grand Rapids. It’s fun to browse on my lunch break and find yummy things to bring home for the next few night’s dinners.

My favorite farmers market thing this year was fresh strawberry shortcake served with fresh biscuits, fresh strawberries, and real whipping cream from the Dunneback Girls (local farmers on 6-Mile Road). That day I called it my lunch! (Sorry, I ate it so fast I didn’t get a photo).

There are many great reasons to shop at a local farmers market. (Here is a link to tell you 9 reasons, from University of Nebraska-Lincoln Extension.)  For me, the biggest reason to shop farmers markets is that you are helping support your local farmers.

Did you know that of every dollar spent in the conventional food market, 91 cents goes to suppliers, processors, middlemen and marketers, while 9 cents goes to the farmer? But farmers who sell direct to consumers through the farmers market or through Community Supported Agriculture (CSA) keep 80 to 90 cents of each dollar. That’s huge, because there's no middleman!

I’ll be picking up more squash, tomatoes, green beans and bread tomorrow, and maybe some peaches if there are any left. Yum!

What's for Dinner: Italian Summer Squash and Tomatoes

If you have a garden with abundant summer squash, or a friend/neighbor/relative who likes to gift you with their bounty, here's a simple and healthy side dish idea for you.  This recipe is very forgiving; I like to use both the zucchini and the yellow crookneck squash because it's more colorful.

Summer squash, onions and garlic getting nicely browned.

Recipe: Italian Summer Squash and Tomatoes
2 small zucchini squash ( 6-8 inch), sliced lengthwise in quarters then chopped
1 small crookneck squash, sliced lengthwise in quarters, then chopped
1/2 sweet onion, chopped
2 to 4 cloves garlic, chopped
1 tablespoon olive oil
1 15-ounce can diced tomatoes
1/2 to 1 teaspoon Italian seasoning
salt and pepper to taste

In large non-stick pan, sauté the summer squashes in olive oil over medium-high heat for about 5 minutes. Add the onions and garlic and continue the sautéing. When everything is getting slightly browned, add the diced tomatoes and Italian seasoning. Heat through for about 2 minutes, then serve.

Finished dish.

Serves about 6 people as a side (for us it's 4 servings because we really like vegetables).  We had this with a small steak and leftover broccoli salad.

Nutritional information per serving:  66 calories, 2 grams protein, 2 grams fat, 9 grams carbohydrate, 2 grams fiber, 0 milligrams cholesterol, 104 milligrams sodium.

Tidbit: Are you Treating your Walnuts right?

            I learned some great info at the AADE conference from a vendor booth! Who better to give great advice about walnuts than the California Walnut Board? They want you to be happy with your walnuts and to treat your walnuts right.

As you know, any fresh food needs TLC, and walnuts are no exception.  Walnuts are heart healthy, contain omega-3 fats and are a decent snack for someone with diabetes because they do not affect blood sugar.

Walnuts contain primarily polyunsaturated fat, which makes them more susceptible to the ill effects of oxygen and heat exposure.

            I have always stored walnuts and other baking nuts in the freezer because I use them often enough for various dishes, but I don’t go through a pound bag very quickly. I detest rancid or “off” flavored nuts, and really do not like having to throw them away if they have turned rancid (but there’s no fixing the flavor once it’s gone).

            Here are tips from the California Walnut Board to keep your walnuts the most flavorful and fresh:

• If storing for 6 months or less, keep them in the refrigerator.
• If storing longer than 6 months, keep them in the freezer (0 degrees F).
• Store in air-tight packaging.
• Store away from foods with strong odors, such as cabbage and onions.
• And, don’t chop nuts until you are ready to use them for the best flavor.

           It’s true that walnuts, like other nuts, have quite a bit of fat and calories, but they are a good snack if you can keep your portions in line. About 4 walnuts halves contain 45 calories, so an afternoon snack of 8 to 12 walnut halves can keep  your appetite at bay and maybe keep you from scrounging around for a not-as-healthful candy bar or bag of chips. 

For walnut recipes and more walnut info, check out the California Walnut Board’s site.