Free State Nutrition, LLC - Video Blog

Tea Time: Vitamin D (and sunscreen!)

4/25/2019

Role in the body
- helps absorb calcium
- promote bone growth
- helps regulate the immune system and neuromuscular system
- plays a role in the life cycle of human cells
Signs/symptoms of deficiency
- Rickets
- Osteomalacia (misshapen bones)
- Associated with breast, colon, prostate cancer, heart disease, depression, weight gain
Vulnerable populations
- those living in northern lattitudes
  - only those south of LA and Columbia, SC can get vit D all year round from the sun
- those with dark skin
- those who wear sunscreen (or don't go outside)
- those who don't eat fatty fish
- those with absorption issues (IBD, liver disease, celiac, bariatric surgery patients)
- breastfed babies
- older adults
Lab values to measure deficiency
- 25(OH)D better measure than 1, 25(OH)2D
- Deficiency likely at <30nmol/L (12ng/mL)
- Some could be at risk at 30-50nmol/L (12-20ng/mL)
- Most will be sufficient at >50nmol/L (20ng/mL)
RDA
- infants - 400IU
- children and adults - 600IU
- >70yo - 800IU
Sources
- The sun (our bodies make vit D with sun exposure
  - lots of variables affect synthesis
  - it can be stored
- Food
  - Milk - 100IU/cup
  - Yogurt - 80IU/6oz
  - Salmon - 450IU/3oz
  - Tuna - 155IU/3oz
  - Sardines - 23IU/sardine
  - Egg - 40IU/egg
  - Cod Liver Oil - 1360IU/Tbsp
- Supplements
  - D2 or D3

Tea Time: Vitamin B12

4/16/2019

Role in body
- red blood cell formation
- cell metabolism
- nerve function
- production of DNA
Vulnerable populations
- Vegans
- Older adults
- Those with undiagnosed or poorly managed celiac
- Other conditions that affect absorption of nutrients
- Bariatric surgery
- Renal disease
- Those taking certain medications
  - metformin
  - PPIs
  - Colchicine for gout
  - aminosalicylic acid
RDA for adults: 2.4mcg (Excess is not absorbed)
Signs of deficiency
- weakness, tiredness, lightheadedness
- palpitations, shortness of breath
- pale skin
- constipation, diarrhea, loss of appetite
- numbness or tingling, muscle weakness
- vision loss
Sources
- Animal products
  - Meats (red meat, poultry, fish)
  - Eggs
  - Dairy
Vitamin C can interact

Tea Time: Iron Deficiency Anemia

4/9/2019

Symptoms
- Fatigue
- Shortness of breath
- Brittle nails
- Pale skin
- Swelling of the tongue
- Cold intolerance
- Trouble concentrating
- Dizziness
- Pica
Tests used to dx
- CBC
  - RBC, Hgb, Hct, MCV
- Iron (might not be low)
- Ferritin (stored iron)
- Reticulocyte count (very young RBCs)
Contributing factors
- GI bleeding
- Von Willebrand syndrome
- Hemophilia
- Frequent blood donation
- Inflammation
Vulnerable populations
- Infants age 7-12 months (stores from birth are depleted)
- Toddlers, especially if they drink a lot of milk
- Teens, who have increased needs
- Older adults, who have decreased intake
- Children with high lead levels
- Vegetarians/vegans
- Endurance athletes
- Women with heavy periods
- Pregnant/breastfeeding women
- Picky eaters
RDA
- 7-12 mo: 11mg
- 1-3yo: 7mg
- 4-8yo: 10mg
- 9-13yo: 8mg
- 14-18yo: 11mg (boys), 15mg (girls)
- 19-50yo: 8mg(men), 18mg (women)
- Pregnant: 27mg
- BF teen: 10mg, BF adult: 9mg
- 51+: 8mg
Types/sources of iron
- Heme iron
  - Meats (beef, chicken, turkey)
  - Salmon
  - Eggs
- Non-Heme Iron
  - Beans, peas, lentils (1.5-8.8mg per cup)
  - Dried fruit (1.5mg per 1/2c)
  - Dark leafy greens (3.2mg per 1/2c boiled)
  - Tofu (3.4mg per 1/2c)
  - Nuts
  - Blackstrap molasses (3.5mg per tbsp!
  - Fortified cereals and breads (1-18mg; 10mg per 1cup fortified oatmeal)
Supplements
- Only if diagnosed and recommended by MD
- May be necessary to replenish stores
- It can take 3-6 months to replenish
- Side effects
  - Metallic taste
  - Vomiting
  - Diarrhea
  - Constipation
  - Upset stomach
- Take with food
- Lower dose
- Time-release
- Take with vitamin C
- Avoid taking with calcium
- Avoid black tea

Tea Time: Fatigue and Food

3/26/2019

What contributes to low energy
- Talk to a doctor to rule out medical conditions (thyroid, diabetes, HTN, Seasonal Affective Disorder, allergies)
- Hormonal changes
- Lifestyle factors
  - Being overworked
  - inadequate sleep
  - stress
  - lack of exercise/movement
  - inconsistent eating
  - inadequate caloric intake
  - low iron/anemia
  - vitamin/mineral deficiencies
What you can do (after you see your doctor)
- Manage stress!
- Manage sleep with sleep hygiene
- Get moving - start slowly
- Take a multivitamin/mineral (with iron if warranted)
- Eat regularly throughout the day
- Eat a balance of carbs/protein/fiber
  - whole grains
  - protein sources (meats, dairy, nuts/seeds, legumes)
  - fruits/veg
- Eat iron sources regularly (avoid calcium at the same time, take with vitamin C)
  - lean meats
  - beans
  - tofu
  - nuts
  - eggs
  - fortified foods like cereals, breads
  - leafy greens like spinach

Tea Time: Reflux

3/19/2019

Definition
- Stomach acid comes up into the esophagus
Symptoms
- heartburn
- sour or bitter-tasting acid coming up into your mouth
- bloating
- coughing
- burping
- difficulty swallowing
- bloody/black stools
- nausea
Causes
- H.pylori
- Hiatal Hernia
- Stress/anxiety
- Smoking
- Pregnancy/hormones
- NSAIDs
- SIBO
- Gastroparesis
Dietary Modifications
- Smaller, more frequent meals
- Avoid/limit spicy foods, greasy foods, caffeine, alcohol, onions/garlic, tomatoes, citrus, mint
- apple cider vinegar
Other lifestyle modifications
- Stay upright for 2-3 hours after eating
- Don't wear tight fitting pants/belts
- Raise the head of your bed 6-8 inches
- Don't exercise right away after eating
- Sleep on your left side
- Stress management

Tea Time: Electrolytes Take 4 - Sodium

3/12/2019

Roles in the body
- Fluid balance
- Send nerve impulses
- muscle contraction
- blood pressure (salt sensitive)
Recommended amount
- 2300mg (average intake is 3400mg)
- 1500mg?
Sources
- Salted/cured meats, cold cuts
- Frozen dinners, pizza, burritos, etc
- Canned foods - raviolis, chili, soups
- Breads/rolls
- Cheese
- Savory snacks
- Fast food/restaurant food
Ways to decrease intake
- fresh foods vs processed
- low-sodium options (frozen foods, canned foods, restaurant foods)
- avoid or limit sauces when out
- choose smaller portions
https://www.nhlbi.nih.gov/.../Choose-Foods-Low-in-Sodium.pdf

Tea Time: Electrolytes Take 3 - Magnesium

2/26/2019

Magnesium

What it does
- Cofactor for enzymes
- Aids in energy production
- Aids in bone development
- Helps transport calcium and potassium into cells
How much we need
- Toddlers - 80mg
- Young kids - 130mg
- Pre-teens - 240mg
- Teens - 360mg (girls), 410mg (boys)
- Similar for adults
Where to get it
- Leafy greens
- Legumes
- Nuts, seeds
- Whole grains
- Milk, yogurt
- Fortified foods like cereal
- Supplements

Tea Time: Electrolytes Take 2b - Calcium Supplements

2/19/2019

Calcium Supplements
- Reading food labels for elemental calcium...
  - %DV is based on 1000mg
  - Supplement labels also report elemental calcium
- Calcium Carbonate
  - caltrate, viactiv, os-cal, tums/rolaids
  - take with food
  - might cause gas, bloating, constipation
- Calcium Citrate
  - citrical
  - Might need to take more pills
- No more than 500mg at a time
- Make sure to get enough vitamin D
- Avoid taking at the same time as iron, zinc, levothyroxine
Benefits
- Prevent osteoporosis
- Lower BP
- Prevent preeclampsia

Tea Time: Electrolytes Take 2 - Calcium

2/13/2019

Tea Time: Electrolytes Take 1 - Potassium

2/8/2019

What are electrolytes
When do we worry about elecrolyte imbalance
- Exercising - after the first hour
- Excessive sweating
- Dehydration
  - GI bug
  - Flu
  - Breastfeeding

Potassium

What it does
- Help with cellular fluid volume
How much we need
- Toddlers - 3000mg
- Young kids - 3800mg
- Pre-teens - 4500mg
- Teens and adults - 4700mg
Where to get it
- Fruits (dried fruit, orange juice, bananas)
- Vegetables
- Legumes
- Potatoes
- Meat and fish
- Dairy (milk)
- Nuts
- Supplements
Benefits
- Decreased risk of HTN
- Maybe improved bone health

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Heather Fiore, Registered Dietitian Nutritionist

785-331-6435 - heatherfiorerd AT gmail DOT com - 543 Lawrence Ave, Ste D, Lawrence, KS

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