We’ve all heard that Vitamin D and Calcium are important for our health, and that we can get them from being out in the sun and eating dairy products.
But some scientists argue that protecting yourself from UV Rays is actually bad for your health. While others say, dairy may not be the best source for calcium at all.
So what`s the truth?
Dr. Sonny Saggar is in today on News 11 at noon, to sort it out for us all.
1. Why are Vitamin D and Calcium important?
Getting enough vitamin D and calcium are two of the best things you can do to keep your bones healthy.
These two nutrients work together to make you less likely to break a bone or get osteoporosis, a disease that weakens them and can lead to small and not-so-small fractures.
To protect your bones you do (1) need calcium in your diet, but you also (2) need to keep calcium in your bones.
2. How Much Vitamin D and Calcium Do You Need?
Vitamin D is measured in international units (IU). The Institute of Medicine recommends getting this 600IU vitamin D every day for most adults, with smaller amounts for kids and the elderly:
3. How Can You Get Vitamin D and Calcium?
Unlike a lot of the traditional advice you may get, I`m not a big supporter of calcium from dairy consumption. Dairy products do contain calcium, but this calcium is accompanied by animal proteins, lactose sugar, animal growth factors, occasional drugs and contaminants, and a substantial amount of fat and cholesterol.
The most healthful calcium sources are green leafy vegetables and legumes, or “greens and beans” for short.
Collards, Oatmeal, Broccoli, Brussels sprouts, Kale, mustard greens and other greens are loaded with highly absorbable calcium and a host of other healthful nutrients. The exception is spinach, which contains a large amount of calcium but tends to hold onto it very tenaciously, so that you will absorb less of it.
Beans are humble foods, and you might not know that they are loaded with calcium. There is more than 100 milligrams of calcium in a plate of baked beans. If you prefer chickpeas, tofu, or other bean or bean products, you will find plenty of calcium there, as well. These foods also contain magnesium, which your body uses along with calcium to build bones.
If you are looking for a very concentrated calcium source, calcium-fortified orange or apple juices contain 300 milligrams or more of calcium per cup in a highly absorbable form.
Although many people think of dairy calcium in the diet as good protection for their bones, this is not completely true. In fact, in a 12-year Harvard study of 78,000 women, those who drank milk three times a day actually broke more bones than women who rarely drank milk.
Similarly, a 1994 study of elderly men and women in Sydney, Australia, showed that higher dairy product consumption was associated with increased fracture risk. Those with the highest dairy product consumption had approximately double the risk of hip fracture compared to those with the lowest consumption.
4. Exercise and stay active, so that calcium has somewhere to go.
Exercise is important for many reasons, including keeping bones strong. Active people tend to keep calcium in their bones, while sedentary people lose calcium.
5. Get vitamin D from the sun or supplements if you need them.
Vitamin D controls your body’s use of calcium. About 15 minutes of sunlight on your skin each day normally produces all the vitamin D you need. If you get little or no sun exposure, you can get vitamin D from most multi-vitamins.
Very small amounts of sun exposure provide all the vitamin D the body can manufacture. Even when you wear sunscreen, some UV reaches the skin, and this may be plenty, at least for fair-skinned individuals. Greater exposure adds nothing to vitamin D stores, while increasing DNA damage in a linear fashion, many dermatologists will argue.
Also, it can be hard to make enough vitamin D from the winter sun, depending on where you live.
If you’re not getting all the vitamin D and calcium you need from food, talk with your doctor about taking a multivitamin or supplements.
6. How to Keep The Calcium from being wasted away.
It’s not enough to get calcium into your bones. What is really critical is keeping it there. Here’s how:
6a. Reduce calcium losses by avoiding excess salt.
Calcium in bones tends to dissolve into the bloodstream, then passes through the kidneys into the urine.
High sodium (salt) in the foods you eat can greatly increase calcium loss through the kidneys. If you reduce your sodium intake to one to two grams per day, you will hold onto calcium better. To do that, avoid salty snack foods and canned goods with added sodium, and keep salt use low on the stove and at the table.
6b. Get your protein from plants, not animal products.
Animal protein, fish, poultry, red meat, eggs, and dairy products tends to leach calcium from the bones and encourages its passage into the urine. Plant protein in beans, grains, and vegetables does not appear to have this effect.
6c. Don’t smoke.
Smokers lose calcium, too. A study of identical twins showed that, if one twin had been a long-term smoker and the other had not, the smoker had more than a 40 percent higher risk of a fracture.
Steroid medications, such as prednisone, are a common cause of bone loss and fractures. If you are receiving steroids, you will want to work with your doctor to minimize the dose and to explore other treatments.
Alcohol can weaken your bones, apparently by reducing the body’s ability to make new bone to replace normal losses. The effect is probably only significant if you have more than two drinks per day of spirits, beer, or wine.
A lower than normal amount of testosterone can encourage osteoporosis. About 40 percent of men over 70 years of age have decreased levels of testosterone.
In many of the remaining cases, the causes are excessive calcium losses and inadequate vitamin D.
First, avoid animal protein, excess salt and caffeine, and tobacco, and to stay physically active in order to reduce calcium losses.
Second, take vitamin D supplements as prescribed by your physician. The usual amount is 600 IU (5 micrograms) per day, but it may be doubled if you get no sun exposure at all.
Finally, the risk of skin cancer, based on your skin tone and family history, should be borne in mind, when you weigh the relative risk of not wearing sunscreen to not getting enough Vitamin D.
The typical co-pay for going to the emergency room is now more than $200. Is it always the best place to go if you have a cut or even a fracture that might be smallbut needs to be seen right away?
Doctor Sonny Saggar talked with Elliot Weiler about how to decide when to go to the ER or somewhere else.
1. WHEN SHOULD SOMEONE ALWAYS GO TO THE EMERGENCY ROOM OR CALL 911 FOR AN AMBULANCE?
Hospital emergency rooms (ERs) are set up to focus on medical emergencies. As emergency physicians and nurses would love to tell you, the ER is NOT set up to focus on routine health care. Examples of true emergencies are:
● Chest pain that could be a heart attack
● A sudden numbness or weakness that could be a stroke
● Not being able to breathe
● Major trauma
● Probably immediate hospitalization or immediate surgery
● Uncertainty about whether it`s actually an emergency
2. So here`s a silly question: why do ERs have Waiting Rooms with so many people waiting in them?
If you think about it, an Emergency Room shouldn`t have a Waiting Room at all: why would you be asked to wait more than a couple of minutes if you have an emergency?
Most ER physicians and nurses, even in busy trauma centers would be quick to tell you that over 80% of ER patients don`t actually have true medical emergencies, and could have been seen either at another place or even at a later date.
The 911 service brings patients to the ER. To use the ER for anything other than a true emergency is just anti-social in my opinion.
Remember the following, if you go to the ER for a problem that is not an emergency:
● It will cost a lot more than it would at your doctor’s office or a walk-in clinic. A trip to the ER for an earache, for example, may cost three to four times as much as it would at your doctor’s office.
● You will probably spend a lot more time there than you would at an urgent care or doctor’s office.
● You will get care from a doctor or nurse practitioner who has probably never seen you before. It’s always best to get as much of your care as you can from a doctor who knows and understands you.
Definitely go to the ER if you think you are having a medical emergency. That’s what the ER is for. Otherwise, call your primary care office first, or go to an urgent care clinic. It will save you money and time.
3. What are the alternatives to the ER?
Your Primary Care Physician or Primary Care Nurse Practitioner or your friendly neighborhood Urgent Care Clinic – and there are quite a lot of them around now.
4. So what kind of situations can go to these alternative places instead of the ER?
Urgent Cares can routinely take care of the following:
● Lacerations that need stitching up
● Minor fractures and dislocations
● Lab work
● Nebulizer breathing treatments
● Incision and drainage of abscesses
● IV fluids and IV medications, and of course,
● Transfer you to the ER if you do in fact come in with a real medical emergency
Most health problems are not emergencies. You may want to take care of the problem right away because you feel sick or uncomfortable, but often nothing bad is going to happen to you if you wait a bit. Then again, you don’t always know that for sure. Some problems that seem minor can become serious if you ignore them. And it may be even harder to know what to do when a child is sick.
One good question to ask yourself is, “Am I thinking about going to the ER because it’s convenient or because it’s necessary?” If you are choosing the ER because you can get in without an appointment, keep in mind the high price you will pay for that convenience. You may also have to wait a long time before you are seen by a doctor. And you may have other options. You can always call your doctor’s office or a nurse line or another service, such as ContactADoc.com, for help.
5. It`s been argued that many people go to the ER because they have no health insurance or any kind of assistance. Do these people have an alternative if they have a minor problem?
Free Urgent Care Clinics have actually been recently opened by Grace Hill, Myrtle Hilliard Davis and Family Care Health Centers. These are federally-funded. They provide a great service and often have more resources than the private urgent care centers, such as CT and MRI scanners.
The St. Louis Integrated Health Network is at stlouisihn.org, and helps coordinate how all the money is spent on the indigent and uninsured.
These free clinics have been paid millions of dollars to ensure good access to health care for uninsured and underinsured children and adults through increased integration and coordination of a safety net for health care.
These new free urgent care clinics are a tremendous development to take the burden away from the ERs in St. Louis and therefore, they actually help all of us in the community, and not just the uninsured.
Integrated Health Network providers serve 200,000 individuals in the St. Louis region, according to their website.
You can find out more at http://www.stlouisihn.org or by calling Grace Hill at 314-814-8778 or Myrtle Hilliard Davis at (314) 633-6363
Dr. Saggar is an emergency physician, as well as an internist and urgent care specialist. He is also the Medical Director of the four privately owned St. Louis Urgent Care Clinics in St. Louis.