 These days, it’s smart to be prepared for anything and ensure you and your family are well-stocked. It’s a good idea to take a regular inventory of every cabinet, from the kitchen cabinet to the medicine cabinet, making sure they are well-equipped and contain the items you prefer.
In addition to the standard bandages, hydrogen peroxide, and antibiotic ointment for minor cuts and scrapes, here are some ideas of what to stock and keep on hand in your medicine cabinet:
References:
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 By Molly Knudsen, MS, RDN Some things never change: The kids go back to school in the fall, the leaves change color shortly after, the holiday season approaches with increasing speed every year, and the cold or flu always seems to hit a household when the holiday season is happening. We know from experience that the common cold and flu hit the hardest when the weather gets the chilliest, but why is that? And can probiotics really help support your immune health so you can enjoy the holidays approaching? Are the seasons actually connected to health? According to science, it turns out that there are three main ways that the seasons may influence health. Environmental factors: One of the main predictors of disease rates across the globe is temperature.1 For example, evidence shows that both the northern and southern hemispheres have higher rates of seasonal respiratory viruses during their respective winter months.1 In addition, lower humidity levels (so dryer climates) are also associated with higher rates of these viruses.1 Humidity is believed to influence a virus’ stability and its ability to pass the infection on.1 Although these trends of virus prevalence are well-observed, more research is needed in this area as to why. Gene expression: Studies have found that 94 DNA transcripts, the basis for gene expression, show seasonal variability.2 This variability was found in transcripts involved with immune function.2 If the gene expression for immune function isn’t functioning optimally, that person may be more susceptible to these seasonal conditions. Human behavior: Cold weather usually changes people’s routines. As temperatures drop, people are likely to spend more time indoors and in confined areas, so viruses can spread easily by contact. Because people are inside more often and the sun is shining less, vitamin D levels tend to drop in the winter.1 Vitamin D is also believed to play a role in the immune response.1  How can you use nutrition as a tool to support your immune system this season?Common colds are so common that, on average, adults usally experience two to three per year, and kids often contract more, making colds the main culprit for missed days of work and school.3 Maintaining proper immune system function is especially important during this time. There are many simple habits you can start today to help keep the cold and flu at bay. Key vitamins and probiotics may also play a role in maintaining immune health. The age-old remedy of drinking orange juice for immune health may actually hold some validity. Oranges are high in vitamin C, and this vitamin has been shown to be a powerful antioxidant that contributes to the body’s immunity.4 Not getting enough vitamin C can impair immunity and weaken your body’s immune defense.4 Foods that are high in vitamin C include guavas, red bell peppers, tomatoes, and the ever-popular orange juice. Vitamin D also plays an important role in immune function. Vitamin D receptors are expressed on various immune cells and can modulate immune response.5 It is common for vitamin D levels to drop in the winter months, and oftentimes people may not even be aware if they are deficient in this nutrient.1 Low vitamin D levels are also associated with impaired immune function.5 Foods that contain vitamin D include fortified dairy products and plant-based dairy alternatives, fatty fish like salmon, and eggs. Some orange juices are also fortified with vitamin D.  A staggering 70% of the immune system is located in the gut, and one not-so-intuitive habit to maintain your immune health, in addition to getting adequate amounts of these key vitamins, is to consider probiotics.6 Research shows that the probiotic strains Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 may help support immune function.7
These are the potential modes of action for how certain probiotics may support the immune response:8
References
 The female-centric 411 on this essential nutrient
by Ashley Jordan Ferira, PhD, RDN Overview Vitamin D research and daily news headlines are ubiquitous. PubMed’s search engine contains over 81,400 articles pertaining to vitamin D.1 Information abounds on vitamin D, but the vetting and translation of that information into pragmatic recommendations is harder to find. Evidence-based takeaways and female-centric recommendations are crucial for healthcare practitioners (HCPs), their female patients and consumers alike. Women are busy, multi-tasking pros, so practical, personalized takeaways are always appreciated. In other words, women need the “411” on vitamin D. Merriam-Webster defines “411” as “relevant information” or the “skinny”.2 So for all of you busy women, here’s the skinny on vitamin D. Let’s explore common questions about this popular micronutrient. Q: Is vitamin D more important for younger or older women? A: All of the above. Vitamin D plays a critical role in women’s health across all life stages, from fertility/conception, to in utero, childhood, adolescence, adulthood, older adulthood, and even in palliative care. Vitamin D is converted by the liver and kidneys into its active hormone form: 1,25-dihydroxyvitamin D. This dynamic hormone binds nuclear receptors in many different organs in order to modulate gene expression related to many crucial health areas across the lifecycle, including bone, muscle, immune, cardiometabolic, brain, and pregnancy to name a few.3 Q: I am a grandmother. Are my vitamin D needs different than my daughter and granddaughter? A: Yes, age-specific vitamin D recommendations exist. As an essential fat-soluble vitamin, women need to achieve adequate levels of vitamin D daily. Age-specific Recommended Dietary Allowances (RDA) from The Institute of Medicine (IOM),4 as well as newer clinical guidelines from The Endocrine Society,5 provide helpful clinical direction for daily vitamin D intake and/or supplementation goals. The IOM RDAs4 are considered by many vitamin D researchers to be a conservative, minimum daily vitamin D intake estimate to support the bone health of a healthy population (i.e. prevent the manifestation of frank vitamin D deficiency as bone softening: rickets and osteomalacia): Infants (0-1 year): 400 IU/day Children & Adolescents (1-18 years): 600 IU/day Adults (19-70 years): 600 IU/day Older Adults (>70 years): 800 IU/day The Endocrine Society’s clinical practice guidelines5 recommend higher daily vitamin D levels than the IOM, with a different end-goal: raising the serum biomarker for vitamin D status [serum 25-hydroxvitamin D: 25(OH)D] into the sufficient range (≥ 30 ng/ml) in the individual patient: Infants (0-1 year): At least 1,000 IU/day Children & Adolescents (1-18 years): At least 1,000 IU/day Adults (19+ years): At least 1,500 – 2,000 IU/day Q: I am a health-conscious woman who eats a nutritious, well-rounded diet. I should not need a vitamin D supplement, right? A: Not so fast. Daily micronutrient needs can be met via diet alone for many vitamins and minerals. Vitamin D is one of the exceptions, which is why an alarming number of Americans (93%) are failing to consume the recommended levels from their diet alone.6-7 Very few foods are endogenous sources of animal-derived vitamin D3 (cholecalciferol) or plant-derived vitamin D2 (ergocalciferol). Some natural vitamin D sources include certain fatty fish (e.g. salmon, mackerel, sardines, cod, halibut, and tuna), fish liver oils, eggs (yolk) and certain species of UV-irradiated mushrooms.8 In the early 20th century, the US began fortifying dairy and cereals with vitamin D to help combat rickets, which was widespread. For example, one cup (8 fluid ounces) of fortified milk will contain approximately 100 IU of vitamin D. Even though some food sources do exist, the amounts of these foods or beverages that an adult would need to consume daily in order to achieve healthy 25(OH)D levels (> 30 ng/ml) is quite unrealistic and even comical to consider. For example, you would need to toss back 20 glasses of milk daily or 50 eggs/day to achieve 2,000 IU of vitamin D! In contrast, daily vitamin D supplementation provides an easy and economical solution to consistently achieve 2,000 IU and any other specifically targeted levels. Q: I enjoy the outdoors and get out in the sun daily, so I should be getting all of the vitamin D that I need, correct? A: Vitamin D is a highly unique micronutrient due to its ability to be synthesized by our skin following sufficient ultraviolet (UV) B irradiation from the sun. Many factors can result in variable UV radiation exposure, including season, latitude, time of day, length of day, cloud cover, smog, skin’s melanin content, and sunscreen use. Furthermore, medical consensus advises limiting sun exposure due to its established carcinogenic effects. Interestingly, even when dietary and sun exposure are both considered, conservative estimates approximate that 1/3 of the US population still remains vitamin D insufficient or deficient.9 Q: What factors can increase my risk for being vitamin D deficient? Are there female-specific risk factors? A: Although the cutoff levels for vitamin D sufficiency vs. deficiency are still debated amongst vitamin D researchers and clinicians, insufficiency is considered a 25(OH)D of 21-29 ng/ml, while deficiency is < 20 ng/ml.5 Therefore, hypovitaminosis D (insufficiency and deficiency, collectively) occurs when a patient’s serum 25(OH)D falls below 30 ng/ml. The goal is 30 ng/ml or higher. Ideally, vitamin D intake recommendations4-5 and therapy are personalized by the HCP based on patient-specific information, such as baseline vitamin D status, vitamin D receptor single nucleotide polymorphisms and other pertinent risk factors. Common risk factors for vitamin D deficiency to look out for include: -Overweight/obesity -Older age -Regular sunscreen use -Winter season -Frequent TV viewing -Dairy product exclusion -Darker skin (more melanin) -Not using vitamin D supplements -Malabsorption disorders (e.g. bariatric surgery, IBD, cystic fibrosis) -Liver disease -Renal insufficiency -Certain drug classes: weight loss, fat substitutes, bile sequestrants, anti-convulsants, anti-retrovirals, anti-tuberculosis, anti-fungals, glucocorticoids -Lastly, additional female-specific risk factors to look out for include exclusive breastfeeding while mother is vitamin D insufficient (can result in infant being vitamin D deficient) and certain cultural clothing that covers significant amounts of skin surface area (e.g. hijab, niqab). Key Takeaways
Ashley Jordan Ferira, PhD, RDN is Manager of Medical Affairs and the Metagenics Institute, where she specializes in nutrition and medical communications and education. Dr. Ferira’s previous industry and consulting experiences span nutrition product development, education, communications, and corporate wellness. Ashley completed her bachelor’s degree at the University of Pennsylvania and PhD in Foods & Nutrition at The University of Georgia, where she researched the role of vitamin D in pediatric cardiometabolic disease risk. Dr. Ferira is a Registered Dietitian Nutritionist (RDN) and has served in leadership roles across local and statewide dietetics, academic, industry, and nonprofit sectors.  Have you ever stood before the wall of vitamins at the drugstore or your healthcare practitioner’s office, wondering what you should take? Choosing supplements can be a daunting experience: Some boxes are orange. Some bottles are silver. Some contain iron, while others do not. Which one is right for you?
Start the selection process by getting specific about your particular stage of life. From young adulthood to the childbearing years and into menopause, each life stage may require greater emphasis on different nutrients to help your body get what it needs for optimal wellness. Young, ambitious, and carefree! Does this ring true for you? Women in their late teens or early 20s are going off to college, choosing a career path, and just beginning to explore adulthood. This is a time to be mindful of getting the appropriate nutrients you need to create a healthy foundation for the years ahead. Calcium. This mineral is important for women of all ages, but especially so in your 20s when bone mass reaches its peak. After this time, the risk of losing bone mass increases as a woman moves into her 30s and beyond.1 Taking a calcium supplement can help the body build bone, especially when paired with vitamin D3, which is known to enhance absorption of this vital mineral.2 Iron. Iron is important for young ladies, as menstruation is one of the ways this mineral is depleted from the body. In fact, menstruation increases the average daily iron loss to about 2 mg per day in premenopausal female adults,3 with excessive menstrual blood loss as the most common cause of iron deficiency in women.3 Baby, it’s you!The time of a woman’s life when she can become pregnant and have a baby is very special. It is also especially important to consider which nutrients are needed before conceiving and to ensure a smooth pregnancy and delivery. Folic acid. This vitamin (known as folate in its natural form) is needed before and during pregnancy. If you are considering getting pregnant, it is smart to increase folic acid intake before conceiving—there is strong evidence that taking folic acid prior to conception and during the first trimester of pregnancy can reduce the risk of neural tube defects of the brain, spine, or spinal cord by up to 70%.4Additionally, folic acid requirements are 5- to 10-fold higher in pregnant women than nonpregnant women,5 so get your folic acid going! Iron. Iron supplementation in pregnancy is often recommended. During pregnancy, the body’s iron requirements progressively increase until the third month.6 This is because more iron is needed for the growing fetus and placenta, as well as to increase your red blood cells.7 Calcium. Calcium is essential for fetal development, and this requirement increases during pregnancy (from 50 mg/day at the halfway point up to 330 mg/day at the end) and lactation.6 Iodine. During pregnancy, iodine is needed in the production of fetal thyroid hormones (the fetus’ thyroid begins functioning as early as 12 weeks in the womb!) and should be increased by about 50%.6 Vitamin D. Vitamin D (mostly vitamin D3, as it’s the predominant form in mom’s blood) is needed in the first stage of pregnancy, as it contributes to embryo implantation and the regulation of several hormones.6 Choline. Choline is an important nutrient for the health of women throughout their lifetime, and in particular during pregnancy. Choline is also vital for early brain development.8 The change of lifeAs your body progresses toward menopause, it produces less estrogen, opening up a world of change. It is during this time that certain nutrients can help support you in the management of symptoms like hot flashes and mood fluctuations, as well as help stave off concerns about bone mass loss. Calcium and vitamin D. In menopause, calcium remains a top nutrient to support the maintenance of bone mass. Bone turnover increases at this time, while the creation of new bone does not, which can lead to bone mass loss. Along with calcium, vitamin D is an important factor in helping to support bone health, which has been shown to help prevent bone mass loss in perimenopausal and menopausal women.9 Vitamin K and vitamin D. It has been shown that Vitamin D and K are both important nutritional factors in supporting mineralization and healthy structure of bones.10 Vitamin B12. When it comes to menopause, the B’s have it! Vitamin B12 plays a key role in energy metabolism, something we all need more of during menopause.11 Where to begin?Your healthcare practitioner is the best person to ask about which nutrients you may need. So get out of the vitamin aisle and in to see your doctor! This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
 By Whitney Crouch, RDN & Kirti Salunkhe, MD
What is stress? Stress can be defined as a constellation of events, starting with a stimulus or stressor that causes a reaction in the brain leading to the stress response commonly known as the “fight-or-flight” reaction that can affect many body systems.1 Unfortunately, stress is a fact of life that we all experience at some time or another. Stressors that are acute, or short-lived, are often physical or physiological. Psychological or emotional stress is usually chronic in nature. The immune system and stress The immune system is made up of cells, tissues, and organs working together as the body’s defense mechanism to protect us from illness. Scientists say short-term stress (lasting from minutes to a few hours) may be beneficial for our immune health, as it stimulates immune activity and prepares us for possible periods of longer stress—a “fire drill” of sorts. However, chronic stress is actually harmful.2 White blood cells (WBC) are critical for the body’s immune response to foreign invaders. These cells are produced, and stored, in many areas of the body including the spleen, bone marrow, and thymus (a small gland found behind the sternum and between the lungs).3 There are two types of WBCs associated with the immune system: Phagocytes, which actively attack foreign organisms, and lymphocytes, which remind the body to recognize previous invaders and help destroy them.4 The main phagocyte is the neutrophil. Neutrophils primarily fight bacteria and infections. The main lymphocytes are the B lymphocytes or B-cells and T lymphocytes or T-cells. B-cells start out and mature in the bone marrow. T-cells start out in the bone marrow but mature in the thymus. These two cell types are the “special ops” of the immune system and have specific functions. B-cells make antibodies to fight bacteria and viruses and T-cells directly attack invading organisms.4 Acute stress and the immune response One of the most familiar reactions to acute stress is the “fight-or-flight” response. This physiological reaction usually occurs during an emergency or a fearful mental or physical situation.3 When a threat is perceived, there is a release of hormones to prepare you to either stay and deal with the threat or to run away to safety. It represents choices our ancient ancestors made when faced with dangerous situations. Nowadays, it’s more likely those dangerous situations are ones leading to a wound or infection, but our body reacts the same way.3 During periods of short-term stress, our sympathetic nervous system releases “stress hormones:” epinephrine (adrenaline) and norepinephrine (noradrenaline), as well as corticotropin-releasing hormone (CRH), adrenocorticotropin (ACTH), and cortisol from the adrenal glands.3 These work together to prepare the body for “fight-or-flight” by increasing alertness, focusing the mind, elevating heart and breathing rates, as well as increasing blood flow to skeletal muscles and brain.4 Interestingly, research has shown acute stress activates the immune system. Immune activation is critical to respond to immediate demands of a stressful situation that may lead to a wound or an infection. Acute stress triggers immune cells and stimulates production of proteins known as cytokines. The two major types of cytokines are: pro-inflammatory cytokines and anti-inflammatory cytokines. The pro-inflammatory cytokines process the pain often found with inflammation; the anti-inflammatory cytokines work by controlling, or limiting, the spread of inflammation. Both are necessary for normal healing.3 While acute, or short-term, stress acts as an “immune stimulator,” readying the body’s immune system for an adverse situation, situations involving long-term or chronic stress actually suppress and dysregulate the body’s immune responsiveness, leading to illness and poor outcomes.3 Chronic stress and the immune response Just as we all have differing genetic and biochemical composition, we also have varying perceptions of stress and individual responses to how we process and cope with it.5 Occasionally, there can be a crossover between the mind and body, as in the “fight-or-flight” response. A mentally stressful situation may require a physical response or action, but what about those psychological or emotional stressors that may be difficult but don’t actually pose any pressing physical dangers? Stressors related to pressures of a work project requiring focused concentration over long days and nights, or the continual emotional drain from a difficult relationship or other similar circumstance? Studies have shown prolonged mental stress can adversely affect regular lifestyle routines, including decisions we make about sleep, nutritional intake, and exercise and can even persuade us to use poor judgement regarding alcohol and drug intake.5,6 These studies have also shown the adverse effects (acute and chronic) that mental and emotional stress places on physical health and wellbeing and have been directly linked to suppression of the immune system.5 How acute mental stress affects physical health was seen in a recent study of college students during their final exams.7 To understand the link between mental stress and changes in blood biomarkers, researchers took blood samples and administered questionnaires about anxiety and depression to 24 college students during finals week. Baseline values had been established by prior blood draws and questionnaires completed midsemester. When compared to baseline levels, during finals week, there were elevations in pro-inflammatory cytokines along with increased reports of anxiety and stress.7 Other studies have noted increased stress can lead to prolonged wound healing time with reduced levels of anti-inflammatory cytokines and increases in pro-inflammatory cytokines.6 Multiple studies have evaluated the immune response in conditions of long-term and emotional stress. These conditions are similar to those found with caregiving of an ill or elderly relative, experienced after a difficult divorce and have even been reported as related to loneliness.7-9 Findings from these studies showed links between emotional stress and increased risk for viral illness, reemergence of latent viruses (Epstein-Barr, herpes simplex, and cytomegalovirus), and onset of autoimmune disease.5,10,11 Other studies have shown long-term psychological stress was linked to detrimental cardiovascular health12-14 as well as increased risk for immunologic conditions including inflammatory bowel disease, allergies, atopic dermatitis, and celiac disease.15-18 Even the most vulnerable members of the population, our children, can be affected by psychological stress that results in a reduced immune response. Investigators evaluated children who had a history of recurrent colds and flu and reported higher levels of psychological stress. The data demonstrated the children had reduced salivary immunoglobulin ratios (IgA/albumin). A reduction in this ratio supports a potential link between reduced immune function with a greater susceptibility to colds and flu.19 Lifestyle approaches to stress management While the effects of stress can be useful on some occasions, adverse effects of stress can play a role in both acute and chronic illness. While there are a number of strategies that come into play with stress management, evidence supports the benefits of lifestyle modification and improved dietary or nutritional intake as a part of a comprehensive strategy. Recommended lifestyle modifications:
This information is for educational purposes only. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Individuals should always consult with their healthcare professional for advice on medical issues. References:
Whitney Crouch, RDN, CLT Whitney Crouch is a Registered Dietitian who received her undergraduate degree in Clinical Nutrition from the University of California, Davis. She has over 10 years of experience across multiple areas of dietetics, specializing in integrative and functional nutrition and food sensitivities. When she’s not creating educational programs or writing about nutrition, she’s spending time with her husband and young son. She’s often found running around the bay near her home with the family’s dog or in the kitchen cooking up new ideas to help her picky eater expand his palate. |
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