lactose intolerance

Lactose Intolerance 

We commonly hear from people of all age groups, particularly children and elderly to be complaining of abdominal discomfort after consuming milk. Some individuals are able to tolerate a small quantity while others are unable to tolerate even a small amount. This could be due to lactose intolerance.

Lactose intolerance relates to insufficiency of the disaccharidase enzyme ‘lactase’ which is found in the greatest quantity in the outer membrane of the mucosal cell of the jejunum. The degree of lactase deficiency may vary in individuals. Lack of lactase does not break down the disaccharide sugar – lactose present in milk, to glucose and galactose, it passes unchanged into the large intestines where it gets converted to lactic acid by the bacteria, which subsequently cause diarrhea and other symptoms of discomfort, distension and abdominal pain. The problem is gene related and often seen in infants and young children commonly, but may also present in adults.

Common Symptoms of Lactose Intolerance include:

Anorexia and nausea, Intestinal distention, Abdominal cramps, Gas and flatulence, severe diarrhea, Under – nutrition and loss of weight.

Diagnostic tests are available to provide information about the level and activity of the lactase enzyme. Depending on the level of activity, the dietary treatment could be planned .

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Obesity: Why its a serious global concern

In a fast-moving world of today, the list of our health concerns keep growing by the day. Gone are the days when there was sufficient time in a day to dedicate towards eating right and living healthy. Our priorities now have changed and personal health has taken a backseat in that list.

It is therefore a serious issue that the major health concerns of today sprout not from monumental mistakes but from very tiny missteps that we take every day in an increasingly unhealthy lifestyle we lead today.

And one of the most significant of those concerns is obesity.

Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. The WHO defines it as:

  • A BMI greater than or equal to 25 is overweight
  • A BMI greater than or equal to 30 is obesity.

Body mass index (BMI) is a simple index of weight-for-height that is commonly used to classify overweight and obesity in adults. It is defined as a person’s weight in kilograms divided by the square of his height in meters (kg/m2).

Here are some statistics as revealed by WHO that sheds some light on the appalling nature of this condition:

  • Worldwide obesity has more than doubled since 1980.
  • In 2014, more than 1.9 billion adults, 18 years and older, were overweight. Of these, over 600 million were obese.
  • 39% of adults aged 18 years and over were overweight in 2014, and 13% were obese. Overall, about 13% of the world’s adult population (11% of men and 15% of women) were obese in 2014.
  • 42 million children under the age of 5 were overweight or obese in 2013.
Photo credit: Robin Stickel from Pexels

So what causes obesity?

Like mentioned earlier, the most threatening part of the problem is that it has its source embedded right into the most basic of activities that we do or fail to do in our daily lives. Technically, it can be said that the fundamental cause of obesity and overweight is an energy imbalance between calories consumed and calories expended. Globally the general trend in the present lifestyle has been:

  • An increased intake of energy-dense foods that are high in fat; and
  • An increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanization.

Why obesity is different from ‘being fat’

While being of a slightly overweight body type isn’t a matter of concern, being obese goes way beyond just looking fat. It brings with it serious threats to health. Risk factors associated are cardiovascular diseases (mainly heart disease and stroke), diabetes, musculoskeletal disorders,some cancers(breast and colon).

Childhood obesity is associated with a higher chance of obesity, premature death and disability in adulthood. But in addition to increased future risks, obese children experience breathing difficulties, increased risk of fractures, hypertension, early markers of cardiovascular disease, insulin resistance and psychological effects.

Cures and preventive measures

However, all is not lost and overweight and obesity are curable with diet and lifestyle changes. Here are some of the ways in which you can cure yourself out of overweight and obesity issues:

  • Limit energy intake from total fats and sugars;
  • Increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts;
  • Engage in regular physical activity (60 minutes a day for children and 150 minutes per week for adults).

Nevertheless, when obesity goes beyond the control of home remedies or serious health issues crop up as a result, it is always important to take expert help instead of experimenting with one’s health. Food n Wellness advises clients on how overweight and obesity can be controlled.

Please contact our expert, Mrs. Meenu Agarwal @+65 96479240 or [email protected].

To end on a positive note, it is not humongous a task to prevent or cure obesity. A slight change in our daily activities and a disciplined commitment towards our health and wellbeing goes a very long way. And we believe that it is certainly more rewarding to be responsible in our choice of lifestyle than to fight endless battles with health issues all our life!

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Acidity / Gastric reflux (GERD)

Gastric Reflux (GERD) refers to the regurgitation of acid stomach contents into the esophagus. The most common clinical manifestation of GERD being heartburn and acid regurgitation.

Reflux occurs when the pressure inside the stomach is higher than that maintained by the muscles found where the stomach and oesophagus meet.

Causes of Acid Reflux

GERD may develop due to decreased muscle tone or abnormal relaxation of lower oesophageal sphincter or reduced stomach motility, allowing food to remain too long in the stomach.

Episodes of reflux are triggered or worsened by a variety of factors. Symptoms may be aggravated by chocolate, caffeine, alcohol and spicy foods, which stimulate acid secretion or by fatty foods, which delay stomach emptying,or even when the patient bends over or lies horizontally after having meal. In addition, pregnancy or constipation may worsen GERD by increasing intra-abdominal pressure.

Secondary causes of GERD includes reflux caused by acid hypersecretory states, connective tissue disorder(scleroderma), gastric outlet obstruction as caused by ulceration and stricture, and delayed gastric emptying due to conditions such as stasis, neuromuscular disease, pyloric dysfunction, duodenal dysmotility, or duodeno-gastro-esophageal bile reflux.


Symptoms of GERD includes in addition to heartburn, difficult or painful swallowing, a sour taste in the mouth, and frequent belching. Less typical features include chronic cough, hoarseness, sore throat and a sensation of fullness. Acid reflux due to GERD can also erode teeth.

Obesity is thought to be another potential predisposing factor to gastro-esophageal reflux. Maintenance of ideal weight for age may help in reducing the symptoms.

Dietary Modification

The foods you eat affect the amount of acid your stomach produces. They can also be directly irritating to the esophagus. Diet and nutrition are key considerations for those who suffer from acid reflux or gastro esophageal reflux disease (GERD), a severe, chronic form of acid reflux. You can prevent or relieve your symptoms from gastro esophageal reflux (GER) or gastro esophageal reflux disease (GERD) by changing your diet. You may need to avoid certain foods and drinks that make your symptoms worse. Other dietary changes that can help reduce your symptoms include

  • decreasing fatty foods
  • eating small, frequent meals instead of three large meals

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Gluten Allergy or Gluten Intolerance

A gluten allergy is caused by gliadin, a glycoprotein that, along with glutenin (another protein), helps to form the gluten protein. Gluten is found in wheat and other related grains such as barley, oats, and rye. Gliadin is also one of the major allergens associated with wheat allergies and a trigger for celiac disease, a serious autoimmune disorder of the small intestine.

“Gluten Intolerance” is the term used to refer to the entire category of gluten issues: Celiac Disease, Non-Celiac Gluten Sensitivity and Wheat Allergy.

Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine.

Celiac disease is a problem with digesting gluten.

Symptoms of a gluten allergy are often similar to those in celiac disease and may include Abdominal pain, Diarrhea, Constipation, Fatigue, Heartburn, Bloating, Anxiety and Anemia.

Additional symptoms of a gluten allergy may include:

  • trouble breathing
  • ulcers in the mouth
  • asthma
  • depression
  • osteoporosis
  • weight loss
  • rash
  • swelling of the lips
  • irritability
  • anaphylaxis (in extreme cases)

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The Eating Disorders

Eating Disorders : Social problem born out of social FADS?

When a reed-thin Kate Moss appeared on a controversial Calvin Klein jeans ad in 1992, the world was hooked. Size zero was a thing. Every woman felt overweight in their skin. But then the world of fashion saw the championing of curvy models and they eventually moved on to Gigi Hadid.

But not everyone did. Losing weight started out as a way to shed off extra kilos, stay healthy and look good, but it soon became an obsession that took to extreme levels. This obsessive behavior led to what are known as eating disorders. The common types of eating disorders, anorexia nervosa, bulimia nervosa, and binge-eating disorder are real, treatable medical illnesses, and are not to be confused with “dieting”. They can be identified by serious disturbances in eating behavior and weight regulation, that can start with eating less or more amounts of food but the tendency can soon go out of control.

Here are some scary facts about eating disorders:

  • They frequently coexist with other illnesses such as depression, substance abuse, or anxiety disorders.
  • The mortality rate for people with eating disorders is the highest of all psychiatric illnesses.
  • Although eating disorders affect both genders, rates among women and girls are 2.5 times higher than among men and boys.
  • The problem mostly manifests during the teen years or young adulthood but may also develop before or after that age range.
  • Only about 10% of people with eating disorders receive treatment, and out of them only 35% get treated from specialized facilities.

Detect eating disorders!

Since this is a behavioral disorder with respect to eating, it is easy to overlook the problem as a bad habit instead of acknowledging it as a medical ailment. The following are the different types and symptoms of eating disorders:

Anorexia nervosa

People suffering from this disorder consider themselves overweight even when they are underweight. They eat selectively and in very small portions, repeatedly weighing them. They may also binge eat and later compensate the same with dieting and exercising in extreme levels or with self-induced vomiting and misuse of laxatives, diuretics, or enemas.


  • Extremely low body weight
  • Severe control on eating habits
  • Obsession over staying thin at the cost of health
  • Constant anxiety over gaining weight
  • Irrational lack of self esteem over one’s body shape and weight
  • Lack of menstruation among girls and women

Some additional symptoms appear if the condition goes untreated considerably long:

  • Thinning of the bones (osteopenia or osteoporosis)
  • Brittle hair and nails
  • Dry and yellowish skin
  • Growth of fine hair all over the body (lanugo)
  • Mild anemia, muscle wasting, and weakness
  • Low blood pressure, or slow pulse and breathing
  • Damage to the structure and function of the heart
  • Brain damage
  • Damaged functioning of the liver
  • Multi-organ failure
  • Infertility
  • Peripheral oedema
  • Hypokalemia

Bulimia nervosa

This type of disorder is characterized by a cyclic habit of a rapid intake of large quantities of food followed by self-induced vomiting or extreme dieting and exercising or abuse of laxatives and diuretics or all of these, in a bid to prevent weight gain.

  • Symptoms
  • Binge eating, both periodically, as well as under emotional stress
  • Purging
  • Irregular menstruation
  • Frequent weight fluctuations
  • Depression and mood swings
  • Anxiety over body shape and weight
  • Guilt/shame over eating habits

Due to the punishing behavior of vomiting and use of laxatives associated with bulimia, the following complications may also develop over time:

  • Cardiac arrhythmias
  • Renal impairment from hypokalemia
  • Muscular paralysis
  • Urinary infection epileptic seizures
  • Swollen salivary glands
  • Eroded dental enamel

Binge eating disorder

As the name implies, people suffering from this disorder indulge in excessive overeating. However, here the binge eating is not compensated with vomiting or excessive dieting or exercising, as seen in the case of Bulimia, and so patients are usually overweight or obese. There is also a feeling of guilt and shame involved over this habit of overeating, which in turn leads to more binge eating.

Nutritional counseling to the rescue!

Eating disorders are now a social health problem in the sense that there are more people suffering from them than we know, and because some of the symptoms can hardly be differentiated from the general pattern of behavior. Complete recovery, however, is possible and treatment needs to be professionally undertaken to suit individual needs. The following measures are instrumental:

  • Individual, group, or family psychotherapy or all.
  • Professional medical care and monitoring
  • Nutritional counseling
  • Proper medications (for example, antidepressants)
  • Hospitalization, if required, to treat related problems caused by malnutrition

Even after the patient has been treated, continuous guidance of their eating habits needs to be maintained. Nutritional counseling is extremely effective in regulating eating habits and exercise routines and to maintain a healthy rhythm of both.

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Gout or Gouty Arthritis : On an alarming rise

Gouty arthritis might not be an ailment that has been talked about as much as say, Diabetes, Obesity or Cancers, but it has been something man has been living with since ages. From King Louis XIV of France to Queen Anne of England to Sir Robert Walpole, Britain’s first Prime Minister—victims of gout were as commonplace then as it is now.

What is Gout and what causes it?

Simply put, Gout is a form of arthritis and is caused by an accumulation of excess uric acid in the bloodstream. Uric acid has no useful function in the human body and is a byproduct of the breakdown of a group of chemicals called purines, a basic building block of DNA, present body tissues and also in many foods. Accumulation of uric acid on its own is not a harmful affair and elevated levels of uric acid do not necessarily ensure a gout attack. However, when the excess levels of uric acid form hard crystals that get deposited in joints, tendons, and other tissues, the patient experiences intense pain in those areas.

Signs and symptoms

The most common manifestation of gout is acute arthritis, or severe pain in joints. Usually, the metatarsal-phalangeal joint, which is at the base of the big toe, is most commonly affected by gout, accounting for almost 50% of the cases. Other areas prone to attack include the forefoot, instep, heel, ankle, and knee. The attack typically begins abruptly, often at night, and the pain is accompanied by swelling and redness in the affected area. Sometimes, the intensity of the pain can cause other ailments like fever, flu or muscle aches.

A man’s disease

Although all humans are at risk of gout, it is mostly seen in men past adolescence. It is rarely seen in women before menopause, as estrogen protects women from developing gout until after menopause when the estrogen levels fall.

You are also prone to gout if your family holds a history of an affected. Your medical history such as if you have undergone an organ transplant, or regularly take medicines such as diuretics, aspirin, cyclosporine, or levodopa, the vitamin niacin, also increase your risk of being affected.

Gout left untreated usually increases the frequency of attacks, and over time, uric acid crystals form gritty, chalky nodules called tophi, that may need to be surgically removed. Further neglect of gout could also result in serious issues such as joint deformity, kidney stones (formed by the same urate crystals), and as a result kidney disease and kidney failure.

What to do in the middle of an attack

  • Rest the affected joint in an elevated position until the bout of pain reduces.
  • Use ice compression to ease the discomfort and reduce the swelling.
  • For pain relief, nonsteroidal anti-inflammatory drugs could be taken; however, avoid drugs like aspirin that are high in purines.
  • Do not neglect gout attacks for too long. Consult a rheumatologist and get a joint fluid analysis done before the problem gets recurrent.

Watch what you eat

Gouty arthritis also affects overweight people or those who have weight-related health issues including diabetes and high blood pressure or cholesterol. Dietary causes also account for about 12% of gout. Alcoholic drinks, especially beer, and organ meats such as liver and seafood and oily sea fish like anchovies and sardines, are high in purines. Therefore it is of utmost importance to maintain a general healthy and balanced diet and an effective exercise routine to keep body weight in control throughout the year, so as to reduce the chances of painful gout attacks.

Consulting a certified nutritionist is mandatory so as to have a clear knowledge of which foods to avoid or eat in moderation that would address the requirement of maintaining a healthy weight, yet that are not high in purines.

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Hypercholesterolaemia (Elevated Cholesterol levels)

Cholesterol is a waxy, fat-like substance that occurs naturally in all parts of the body. Your body needs some cholesterol to work properly. But if you have too much in your blood, it can combine with other substances in the blood and stick to the walls of your arteries. This is called plaque. Plaque can narrow your arteries or even block them. Increased cholesterol in blood is called hypercholesterolaemia.

High levels of cholesterol in the blood can increase your risk of heart disease. Your cholesterol levels tend to rise as you get older. There are usually no signs or symptoms that you have high blood cholesterol, but it can be detected with a blood test. You are likely to have high cholesterol if members of your family have it, if you are overweight or if you eat a lot of fatty foods.

You can lower your cholesterol by exercising more and eating more fruits and vegetables. You also may need to take medicine to lower your cholesterol.

Classification of total cholesterol

  • Desirable level is less than 200 mg/dL
  • Borderline level is between 200-239 mg/dL
  • High level if it is more than or equals 240 mg/dL

Symptoms of High Cholesterol in blood

High blood cholesterol usually has no signs or symptoms. Thus, many people don’t know that their cholesterol levels are too high.

Weight Management

If you’re overweight or obese, losing weight can help lower LDL cholesterol. Maintaining a healthy weight is especially important if you have a condition called metabolic syndrome.

Metabolic syndrome is the name for a group of risk factors that raise your risk for heart disease and other health problems, such as diabetes and stroke.

The five metabolic risk factors are a large waistline (abdominal obesity), a high triglyceride level, a low HDL cholesterol level, high blood pressure, and high blood sugar. Metabolic syndrome is diagnosed if you have at least three of these metabolic risk factors.

Physical activity

Routine physical activity can lower LDL cholesterol and triglycerides and raise your HDL cholesterol level. People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. The more active you are, the more you will benefit.

Diet Modification

Dietary modification holds an important role in the control of high cholesterol. In other words, high cholesterol can be controlled by following a proper nutritious diet which is low in dietary fat.

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Ulcerative Colitis: Ulcer of the Colon

Ulcerative colitis is a chronic inflammatory disease of the gastrointestinal (GI) tract, called inflammatory bowel disease (IBD). Ulcerative colitis most often begins gradually and can become worse over time.

Cause of Ulcerative Colitis

The exact cause of ulcerative colitis is unknown. Researchers believe the following factors may play a role in causing ulcerative colitis:

  • overactive intestinal immune system
  • genes
  • environment

Signs and Symptoms

The most common signs and symptoms of ulcerative colitis are diarrhea with blood or pus and abdominal discomfort. Other signs and symptoms include

  • an urgent need to have a bowel movement
  • feeling tired
  • nausea or loss of appetite
  • weight loss
  • fever
  • anemia—a condition in which the body has fewer red blood cells than normal

The symptoms a person experiences can vary depending on the severity of the inflammation and where it occurs in the intestine.

People who have ulcerative colitis for 8 years or longer also have a greater chance of getting colon cancer. The longer you have had ulcerative colitis, the greater your risk

Everyone is different, (different tolerances, different likes and dislikes, different locations for their disease in the GI tract), nutritional approaches must be customized to fit every individual.

When you are in remission, you can best help yourself by eating a well-balanced diet. There is no need to avoid any particular kind of food or to follow a restrictive diet. However, there are certain foods that people find harder to digest, such as foods containing insoluble fibre, seeds and nuts, and raw fruits and veggies.

During a flare-up, you may want to modify your diet to avoid aggravating an already sensitive gut. There are certain things that you can to do help you through an acute flare up.

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The pancreas is a large gland behind the stomach and next to the small intestine. The pancreas has 2 main functions:

  • It makes enzymes, which help digest proteins, fats, and carbohydrates before they can be absorbed in the intestine.
  • It makes hormones (chemicals made from glands), the most important of which is insulin, which control how the body uses and stores sugar (glucose), its main source of energy.

Pancreatitis is a disease in which the pancreas becomes inflamed. Pancreatic damage happens when the digestive enzymes are activated before they are released into the small intestine and begin attacking the pancreas.

There are two forms of pancreatitis – Acute and Chronic.

Chronic pancreatitis is inflammation of the pancreas that does not heal or improve – it gets worse over time and leads to permanent damage. Chronic pancreatitis eventually impairs a patient’s ability to digest food and make pancreatic hormones. Chronic pancreatitis often develops in patients between the ages of 30 and 40, and is more common in men than women.

Whereas there are causes of chronic pancreatitis that are unknown; several factors have been identified to cause chronic pancreatitis:

  • Heavy alcohol use
  • Autoimmune conditions (when the body’s immune system attacks its own body)
  • Genetic mutations due to cystic fibrosis
  • Blocked pancreatic duct or common bile duct
  • Familial pancreatitis (runs in the family—with 2 or more immediate family members with a history of pancreatitis)

Symptoms of Chronic Pancreatitis

Most individuals with chronic pancreatitis experience upper abdominal pain, although some have no pain at all. The pain may spread to the back, become worse with eating or drinking, and become constant and disabling. Other symptoms include the following:

  • Nausea
  • Vomiting
  • Losing weight without trying
  • Oily, smelly stools (steatorrhea)

Individuals with chronic pancreatitis frequently lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally, leading to malnutrition.

Acute Pancreatitis

Acute pancreatitis is an inflammatory condition of the pancreas that is painful and at times deadly. Diagnosis of pancreatic problems is often difficult and treatments are therefore delayed because the organ is relatively inaccessible.

Causes and Symptoms of Acute Pancreatitis

The most common cause of acute pancreatitis is stones in the gallbladder. Gallstones pass through the common bile duct to enter the small intestine. At the entry of the small intestine, the main pancreatic duct joins or lies immediately next to the common bile duct. It is believed that stones that get stuck in the common bile duct impinge on the main pancreatic duct, causing an obstruction of the normal flow of pancreatic fluid and leading to pancreatic injury. Another way that a stone can cause pancreatitis is by causing a backflow of bile into the pancreatic duct, resulting in pancreatic injury

Acute pancreatitis usually begins with gradual or sudden pain in the upper abdomen that sometimes extends to the back. The pain may be mild at first and become worse after eating. The pain is often severe, constant, and commonly lasts for several days in the absence of treatment. A person with acute pancreatitis usually looks and feels very ill and needs immediate medical attention.  Other symptoms can include:

  • Swollen and tender abdomen
  • Nausea and vomiting
  • Fever
  • Rapid pulse

Nutrition plays a very important role for patients suffering from pancreatitis.

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Vitamin D Deficiency: Is the sun shining enough on you


An increasing emphasis on the hazardous effects of the sun or more specifically, the UV rays of the sun in the last couple of decades has shifted our attention from the beneficial effects of the sun: the ‘Sun Vitamin’ or Vitamin D. Deficiency in Vitamin D has been a persistent problem since a very long time, a situation that strongly contradicts all the medical advances the world has seen, with over a billion people worldwide suffering from this condition.

Vitamin D, also described as “the Sun Vitamin” is a steroid with hormone like activity. It regulates the functions of over 200 genes and is essential for growth and development. It helps ensure that the body absorbs and retains calcium and phosphorus, both critical for building bone. Laboratory studies show that vitamin D can reduce cancer cell growth and plays a critical role in controlling infections.


Why so many people are at risk of Vitamin D deficiency

Exposure to sunshine each day helps the human body to manufacture the required amount of vitamin D. To prevent deficiency, one should spend 15 to 20 minutes daily in the sunshine with 40% of the skin surface exposed. However, due to fear of developing skin cancer and to avoid other damaging effects of the sun on the skin, most people avoid sun exposure. High concentration of melanin in the skin also slows the production of vitamin D; similarly aging greatly reduces skin production of vitamin D. Use of sunblock, common window glass in homes or cars and clothing, all effectively block UVB radiation – even in the summer. People who work indoors, wear extensive clothing, regularly use sunblock, are dark skinned, obese, aged or consciously avoid the sun, are at risk of vitamin D deficiency.

This major public health problem affects individuals across all life stages, especially pregnant women, neonates, infants, children and the elderly. Vitamin D3 deficiency can result in obesity, diabetes, hypertension, depression, fibromyalgia, chronic fatigue syndrome, osteoporosis and neuro – degenerative diseases including Alzheimer’s disease. Being “D-deficient” may even contribute to the development of cancers, especially breast, prostate, and colon cancers, as well as infectious diseases, such as tuberculosis and even the seasonal flu. Indeed, in industrialized countries, doctors are even seeing the resurgence of rickets, the bone-weakening disease that had been largely eradicated through vitamin D fortification. 

Current research indicates vitamin D deficiency plays a role in causing seventeen varieties of different cancers as well as heart disease, stroke, autoimmune diseases, birth defects, and periodontal disease.


How to ensure proper intake of Vitamin D

Vitamin D is both a nutrient we eat and a hormone our bodies make. Its status depends on the production of vitamin D 3 in the skin under the influence of ultraviolet radiation from sun and vitamin D intake through diet or vitamin D supplements. Usually 50 to 90% of vitamin D is produced by sunshine exposure of skin and the remainder comes from the diet. Natural diet, most human consume, contain little vitamin D. Traditionally the human vitamin D system begins in the skin, not in the mouth.

However, important sources of vitamin D are egg yolk, fatty fish such as salmon and tuna, fortified dairy products and beef liver.

Long term strategies to address this deficiency problem should include public education, national health policies for screening and prevention through food fortification, and treatment with vitamin D supplementation.

With respect to preserving many aspects of our health, it is like poet and writer Walt Whitman had once said, “Keep your face always toward the sunshine – and shadows will fall behind you.”

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