 You’ve probably heard that vitamin C supports your immune system. This essential micronutrient seems to be everywhere! And it’s a good thing because, unlike most mammals, humans can’t synthesize vitamin C on their own.1 Also, vitamin C is water-soluble, which means the body quickly loses this essential vitamin through urine, so it’s important to make vitamin C a daily part of your diet.1 Having extremely low levels of vitamin C for prolonged periods can result in scurvy, a historical disease linked to pirates and sailors who faced long journeys at sea without fresh fruits and vegetables. While cases of scurvy in the United States are rare, a recent study reported that 31% of the US population are not meeting the daily recommended intake of vitamin C.1 Greater than 6% of the US population are severely vitamin C deficient, while low levels of vitamin C, associated with weakness and fatigue, were observed in 16% of Americans.2 As a whole, 20% of the US population showed marginally low levels of this essential micronutrient.2 How much vitamin C do I need?The US recommended daily dietary allowance of vitamin C is 75 mg for women and 90 mg for men.3 Experts recommend an estimated 200 mg of vitamin C daily for favorable health benefits.4 Adults can take up to 2,000 mg of vitamin C per day; however, high doses of vitamin C may cause diarrhea, nausea, and stomach cramps.5 Due to the varying health needs of individuals, it’s always a good idea to work with your healthcare practitioner to ensure that you are getting the right amounts of micronutrients in your daily diet. Where can you find this marvelous, multifaceted micronutrient?   Ready to add vitamin C to your daily regimen? Talk to your healthcare practitioner about how much would be right for you.
References: 1. Granger M et al. Adv Food Nutr Res. 2018;83:281-310. 2. Schleicher RL et al. Am J Clin Nutr. 2009;90(5):1252-1263. 3. https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/. Accessed August 3, 2021. 4. Frei B et al. Crit Rev Food Sci Nutr. 2021;52(9):815-829. 5. Hathcock JN et al. AM J Clin Nutr. 2005;81(4)736-745. 6. Ashor AW et al. Eur J Clin Nutr. 2017;71(12):1371-1380. 7. Mason SA et al. Free Radic Biol Med. 2016;93:227-238. 8. Chen S et al. Clin J Pain. 2016;32(2):179-185. 9. Carr AC et al. J Transl Med. 2017;15(1):77. 10. Dionne CE et al. Pain. 2016; 157(11):2527-2535. 11. Chin KY et al. Curr Drug Targets. 2018;19(5):439-450. 12. Ratajczak AE et al. Nutrients. 2020;12(8):2263. 13. Dixit S et al. ACS Chem Neurosci. 2015;6(4):570-581. 14. Monacelli F et al. Nutrients. 2017;9(7):670. 15. Johnston CS et al. J of Nutr. 2007;137(7):1757–1762. 16. Johnston CS et al. Nutr Metab (Lond). 2006;3(35):1743-7075. 17. Moores J. Br J Community Nurs. 2013;Suppl:S6-S11. 18. Carr AC et al. Nutrients. 2017;9:1211. 19. Shaw G et al. Am J Clin Nutr. 2017;105(1):136-143. 20. Ratajczak AE et al. Nutrients. 2020;12(8):2263. 21. Ashor AW et al. Nutr Res. 2019;61:1-12. 22. Moser MA et al. Int J Mol Sci. 2016;17(8):1328. 23. Wu JR et al. J Cardiovasc Nurs. 2019;34(1):29-35. 24. Akolkar G et al. Am J Physiol Heart Circ Physiol. 2017;313(4):H795-H809. 25. Cook JD et al. Amer J Clin Nutr. 2001;73(1):93-98. 26. Saunders AV et al. Med J Aust. 2013;199(S4):S11-S16. 27. Amr M et al. Nutr J. 2013;12:31. 28. Consoli DC et al. J of neurochem. 2021;157(3):656-665. 29. Bajpai A et al. J Clin Diagn Res. 2014;8(12):CC04-CC7. 30. Koizumi M et al. Nutr Res. 2016;36(12):1379-1391. 31. Whyand T et al. Respir Res. 2018;19(1):79. 32. Azuma A et al. Tairyoku Kagaku Japanese J of Phys Fit and Sports Med. 2019;68(2):153-157.
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 By Michael Stanclift, ND The rich orange color of turmeric is a signature of this powerfully healthy Indian spice. Even if you don’t dig the flavour of it in food, you might take turmeric in one of its many supplement forms for health benefits. Curcuma longa is the Latin name for turmeric and also hints at the name of the most talked about molecule in it, curcumin. Many people use “turmeric” and “curcumin” interchangeably, but surprisingly there isn’t that much curcumin in turmeric—curcumin makes up only about 3% of dried turmeric.1 But when we’re talking about the health benefits of turmeric, we’re usually really referring to its famous derivative, curcumin, which is the most studied component. So why has this orange molecule become the darling of healthy living? Curcumin offers a host of health perks, is safe, and is well-tolerated by nearly every patient I’ve recommended it to. Many of the effects essentially boil down to curcumin’s ability to function as an antioxidant or balance the immune response to cellular injury.2 It can improve markers of oxidative stress and increase circulating antioxidants, such as superoxide dismutase, sometimes referred to as SOD.2 Curcumin can block the activation of NF-κB, which is involved in the immune response and can lead to undesirable effects.2 So how are these effects meaningful? Here are some of the research-backed ways I’ve utilized curcumin with the patients I’ve seen:
Before you get started There are a few things you should know about curcumin before you run out and start taking it. First, curcumin isn’t very well absorbed, so it is often combined with other natural substances to help improve absorption. I have used it in formulations where it is combined with a black pepper extract (piperine), which can increase the availability about 20 times, and a fenugreek extract, which can increase the availability about 45 times.2,6 The second thing to know is that while curcumin has a great safety record, there have been cases of people taking a curcumin supplement experiencing liver injury.7,8,9 There’s some speculation that the effect may have come from another ingredient, not the curcumin, and many of the products involved contained piperine, the black pepper extract.7,9,10 In response to these concerns, I found a 90-day study of healthy volunteers who were investigated for signs of toxicity when the subjects were given highly bioavailable curcumin (with fenugreek extract).11 With this formulation no adverse effects were noted in the study, and liver enzymes remained within the normal range.11 There are two morals to this story: Always look for manufacturers with a solid reputation and transparent quality testing for their products, and seek the guidance of an experienced healthcare provider to ensure you’re taking the proper precautions and monitoring. In healthy individuals, doses between 150-1,500 mg have been studied and appear to be beneficial, well-tolerated, and safe.5 The European Food Safety Authority (EFSA) is a bit more conservative and established an acceptable daily intake (ADI) of curcumin at 3 mg/kg/day.9 For readers in the United States, that translates to roughly 1.36 mg/lb/day or a dose equivalent to about 205 mg/day of curcumin per day for a 150-pound person. Turmeric, along with its most active component curcumin, is clinically versatile and offers a wide range of health benefits. These qualities make it an attractive candidate to include in your healthy lifestyle. Ask your healthcare provider if you might benefit from turmeric or curcumin! References:
 By Maribeth Evezich, MS, RD If you’re not monitoring your intake, sugar could be sabotaging your health and weight. Because when it comes to sugar, ignorance is not bliss. Here’s why. Not long ago, added sugars were only a concern due to being “empty calories” promoting obesity and dental cavities. While considered an “unhealthy indulgence,” sugar’s only known risks were to our teeth and waistline and perhaps inadequate nutrition. But then the research started piling up. Today we know better. Over-consumption of added sugar is recognized as an independent risk factor for cardiovascular disease as well as many other chronic diseases, including diabetes mellitus, liver cirrhosis, and dementia—and is linked to dyslipidemia, hypertension, and insulin resistance.1 So the concern related to added sugar over-consumption has broadened to our whole body with potential health issues from head to toe, literally. In fact, according to UCSF School of Medicine professor Dr. Laura A. Schmidt’s invited commentary in JAMA Internal Medicine, “Too much sugar does not just make us fat; it can also make us sick.”1 Further, excess sugars are associated with premature aging as their by-products build up in connective tissue, promoting stiffness and loss of elasticity.2,3 Think wrinkles. How much is too much? Not surprisingly, major health institutions, such as the Institute of Medicine, World Health Organization (WHO), and the United States Department of Agriculture (USDA) Dietary Guidelines recommend limiting added sugars. Further, the American Heart Association (AHA) has set specific daily limits (see graphic).4 However, while the WHO echoes these guidelines, it encourages further limitation to 5% of daily calories for additional health benefits. That’s 6 teaspoons, 100 calories, 25 grams for a 2,000 calories diet.5 How are we doing? Not well! According to the USDA Dietary Guidelines, on average we’re eating almost 270 calories, or more than 13 percent of calories per day, in added sugars. That’s about 17 teaspoons (approximately 1/3 cup) of added sugars per day, about double the AHA guideline.6 Concerned about your weight? Do the math. That’s 11 teaspoons over the WHO’s more conservative recommendation. So, by simply reducing your added sugars to the lower WHO recommendation, you could be 9 kg lighter a year from now. Where is all this added sugar coming from? Most added sugar comes from processed and prepared foods. Beverages (soft drinks, fruit drinks, sweetened coffee and tea, energy drinks, alcoholic beverages, and flavored waters) are the biggest culprit. For example, with as many as 11 teaspoons (46.2 grams) of added sugar in one 350 ml. soda, a single serving is close to double the recommended limit for women and children. The other major “sugar bombs” are snacks and sweets (grain-based desserts, dairy desserts, puddings, candies, sugars, jams, syrups, and sweet toppings).7 Further, sugar is pervasive in our food supply. You’ll find it lurking in some not-so-obvious places, including savory foods, such as bread and pasta sauce, fruit juices, and bottle sauces, dressings, and condiments, such as ketchup. In fact, you’ll find added sugar in 74% of packaged foods sold in supermarkets, including those marketed as “healthy,” “natural,” “low-fat,” or “gluten-free.”7 They’re everywhere. The only way to keep them at a minimum is to eat whole, minimally processed foods. In the next post in this series, we’ll look at why sugar cravings are so tough to conquer and help you identify hidden sugars in your diet. REFERENCES
 "I'm addicted to sugar"
We’ve all heard or thought this before. Considering the American palate for highly processed, overly sweetened foods and the ubiquitous nature of sugar in advertising, we see evidence of a concerning shift. Sugar’s role in the American diet has moved beyond a character actor and into a starring role. Further, as discussed in the previous post, Sugar. How Much Is Too Much?, we consume far more sugar than is recommended for our health. But the question remains—are we addicted? More please: How sugar affects the brain While an ICD-10 code for “sugar addiction,” has yet to be established, an increasing body of research tells us that sugar has addictive effects on the brain.1,2 Like sex and drugs, consuming sugar stimulates the release of dopamine, a neurotransmitter that gives us a sense of euphoria and controls the reward and pleasure centers in the brain. But what may have evolved as a survival mechanism has gone rogue. The caveman sweet tooth From an anthropological perspective, we are hard-wired for sweetness. The pleasing taste of sweet foods was a conditioned reward, one which could increase early man’s survival odds. In times of food scarcity, a preference for more nutritionally dense foods might have provided the energy required to continue the hunt, outrun a predator, or simply avoid starvation. Flash forward a few hundred thousand years, and sugar is exponentially more abundant. Consistent intake of concentrated sugar can lead to changes in the brain’s dopamine receptors. Similar to increased drug or alcohol tolerance, over time, more sugar is needed for the same “high.” Cookies and cocaine So, the more you eat, the more you want. But, as for being “addictive” animal studies have shown sugar consumption to have drug-like effects. These include sugar-related bingeing, craving, tolerance, and withdrawal. In fact, according to a Connecticut College study, Oreo cookies cause more neural activation in the brains of rats than cocaine.3 Taking control For many individuals, the only way to stop over-consuming sugar is to stop the cravings. But the only way to end the cravings is to stop feeding them with sugar. So, in addition to cutting out the obvious forms of sugar—candy, baked goods, etc.—it is important to be aware of the less obvious forms of sugar in your diet. Over the course of a day, small quantities can add up, keep your cravings alive, and thwart your efforts to take control of sugar. So become a sugar sleuth. Here are five tips to get you started. 5 Tips for Identifying Added Sugars
The journey to a healthy relationship with sugar starts with awareness. Watch for the next post in this series, which will feature strategies for taking control of sugar. References
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