Does Being Healthy Mean You Have To Be Miserable?

boy-and-vegetablesYes. But like anything else that’s good for you, you’ll get over it. Then, you won’t be miserable any more. And you’ll be healthy and live long enough to pay your grandkids’ college bills. But do you really have to avoid the cookie tray and get a yearly physical?  This is an important question. However, a mere “yes” or “no” does not suffice an answer.

This is the time of year for the most decadent foods, especially the sweets. We can’t convey the difficulty with which we write about avoiding the cookie tray. If ever we deemed a gift to come directly from heaven, the cookie tray is it. Black, white, green or red; sparkles, sprinkles, powdered or granulated, we love ‘em all. Artificial this and imitation that belong in the gar-bazh’. Butter is preferred and real sugar is divine, the former actually a health food and the latter not so much. Maybe by some stroke of divine intervention the two can cancel each other out and render a neutral in the gustatory debauchery to which we incline ourselves.

Being a sugar addict is a pursuit without benefits…except for the haberdasher who sells you a bigger pants size. (Now, there’s an interesting word with a scanty etymology.)  If the burgeoning waist becomes a progressive reality, it’s time to take control of things. First of all, anything labeled “fat free” or “low fat” is likely to be loaded with a sweetener to make up for the lost mouthfeel, which is the culmination of a food’s chemical and physical interaction inside the mouth. Mouthfeel has quite a few characteristics, including density, dryness, velvety texture, uniformity, chew and more. Without fat, frankly, you just don’t have mouth. Sooo… the sugar causes you to eat more to make up for the lost pleasure. A fake sweetener will only tell your body to make insulin to carry the “sugar” into a cell to be used for energy. The problem arises when the body realizes it’s been faked out, and makes you hungry so you’ll get enough carbohydrates to make enough glucose so that the insulin has something to do. Got it? Eat enough sugar long enough, become addicted, and initiate a cycle of runaway proportions (Colantuoni, 2002) (Avena, 2012).

One way to reduce sugar cravings is to cut back on caffeine. This you hear from an inveterate coffeeist. Researchers from the University of Guelph, in Canada, found that caffeine impairs insulin sensitivity in a dose-dependent manner in both sexes (Beaudoin, 2013). How sad! This was learned from healthy people. How about those with type 2 diabetes? We checked. Impaired glucose management in men with type 2 diabetes is noticeable and remarkable in the presence of caffeine (Robinson, 2004). Drat!  Nothing was mentioned about women. These scientists showed that caffeine can increase blood glucose by 24%, so when blood sugar dips back down after the caffeine wears off, you crave sweetness.

To get a hold of the sweet tooth, natural sweeteners with little or no effect on blood glucose are out there. Among the more popular is stevia, a member of the sunflower family that’s purported to lack the aftertaste of artificial sweeteners. But, like anything else, sweet perception—and aftertaste— is in the lingual papillae of the beholder.  Sugar alcohols are available as well, such as xylitol, sorbitol or erythritol. Mostly, they’re incompletely absorbed into the blood stream from the small intestine, so they have a lesser effect on glucose levels. Erythritol, however, is absorbed, but excreted unchanged in the urine. Compared to real sugar, sucrose, the alcohols have about half or less the calories with a considerable fraction of the sweetness. Of course, you could cast discretion to the wind and make up for it later…maybe.

The other part of the question mentions the annual physical checkup. It might be a source of reassurance for some of us, and a pain in the sitting place for others because of the time it steals from the, ahem, golf course and gym. The idea behind the yearly exam was to identify problems and to fix them before they got out of hand. Most of the time, no problems were found. Gradually, we have come to realize that the routine physical did nothing to improve health outcomes, which would then make it a waste of time and money. Today we concentrate on those little things that can be altered to improve outcomes. Hey, there are pieces in the popular press telling us that the most august medical groups find routine exams to be a bore. You won’t find much information about this in scientific papers, such as those at Pub Med, but you will find articles by physicians at legitimate sites that include “Science-Based Medicine,” here
http://www.sciencebasedmedicine.org/overdiagnosis/ , and here,
http://www.sciencebasedmedicine.org/re-thinking-the-annual-physical/. In Canada, the province of Ontario lowered the fee it pays doctors for annual checkups and told doctors to perform fewer. Canadian physicians agree that eating healthy, getting some exercise and quitting tobacco can do more to benefit one’s health. From MSN News in Canada: http://news.ca.msn.com/local/pei/some-doctors-say-annual-checkups-a-waste-of-time.

Getting back to the sweet tooth for a minute, we need to tell you that sugar pushes magnesium out of the body through the urine (Fuchs, 2002) (Djurhuus, 2000) (Milne, 2000)  This mineral, the second most plentiful cation in the intracellular fluid, is essential to human nutrition, but most Americans are low. Magnesium is used in more than three hundred cellular reactions besides being important to bone. Nerve and muscle electrical potential depend on it. We realize that chocolate-covered spinach or halibut is not a palate pleaser, but these foods, sans the coating, contain enough magnesium—about a third of a day’s need—to help overcome the negatives of sweet overconsumption. On the other hand, pumpkin seeds and almonds might render that neutral condition mentioned in the second paragraph. Choose wisely.

References

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Avena NM, Bocarsly ME, Hoebel BG.
Animal models of sugar and fat bingeing: relationship to food addiction and increased body weight.
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Beaudoin MS, Allen B, Mazzetti G, Sullivan PJ, Graham TE.
Caffeine ingestion impairs insulin sensitivity in a dose-dependent manner in both men and women.
Appl Physiol Nutr Metab. 2013 Feb;38(2):140-7.

Butt AL, Anderson HA, Gates DJ.
Parental influence and effects of pro-smoking media messages on adolescents in Oklahoma.
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Chang JC, Wu MC, Liu IM, Cheng JT.
Increase of insulin sensitivity by stevioside in fructose-rich chow-fed rats.
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Colantuoni C, Rada P, McCarthy J, Patten C, Avena NM, Chadeayne A, Hoebel BG.
Evidence that intermittent, excessive sugar intake causes endogenous opioid dependence.
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S. Djurhuus
Hyperglycaemia enhances renal magnesium excretion in Type 1 diabetic patients
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Nan Kathryn Fuchs, Ph.D.
Magnesium: A Key to Calcium Absorption
http://www.mgwater.com/calmagab.shtml. November 22, 2002

A. Hodgkinson and F.W. Heaton
The effect of food ingestion on the urinary excretion of calcium and magnesium
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Kaya CA, Unalan PC.
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David B. Milne, PhD and Forrest H. Nielsen, PhD
The Interaction Between Dietary Fructose and Magnesium Adversely Affects Macromineral Homeostasis in Men
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Robinson LE, Savani S, Battram DS, McLaren DH, Sathasivam P, Graham TE.
Caffeine ingestion before an oral glucose tolerance test impairs blood glucose management in men with type 2 diabetes.
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Shivanna N, Naika M, Khanum F, Kaul VK.
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*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.

Wintertime Depression

concerned-young-manWhen the winter solstice occurs and the sun is above the Tropic of Capricorn, do you turn from Prince or Princess Charming into an ogre? It’s the time of year when people report feeling more depressed—overwhelmed by the impending holidays, bothered by dried out bank accounts, disconcerted by situations at work. Folks get irritated by things that don’t raise a hackle the rest of the year. They get testy, feel low or inferior, and lose energy, concentration and drive. This relationship among body, mind, and environment is called seasonal affective disorder (SAD). Blame it on the sun, or rather its scarcity, and the shortage of what the sun provides…vitamin D, the sunshine vitamin.

Are You Vitamin D Deficient?

Even in the sunniest places on the planet, people are deficient in vitamin D. You’d think that in Oman, at twenty-one degrees north of the equator, just within the tropical zone, the people’s vitamin D stores would be sufficient to prevent signs of deficit. In that part of the world it’s significant that women are covered, and for various reasons avoid sun exposure. This interrupts the complex relationship of sunlight, cholesterol and other factors that cause the body to manufacture vitamin D. (Alshishtawy. 2011) Likewise, in Bangkok, Thailand, whose latitude is even closer to the equator, vitamin D levels are surprisingly low. People living in Thailand’s municipal areas have lower circulating vitamin D than those in the rural areas. (Chailurkit. 2011) Might there be a connection between vitamin D levels and the seasonal blues?

It’s accepted that vitamin D deficiency is rampant, and that for a variety of reasons. People fear skin cancer, so they slather themselves with sun blocker or stay indoors or under cover. Some lack the physiological ability to manufacture vitamin D, perhaps with a cholesterol level insufficient to do the job. If brain development depends on ample vitamin D stores, then brain function seems to follow, especially in the realm of cognition and behavior as they relate to the presence or absence of pro-inflammatory molecules that are modulated by the vitamin. (McCann. 2008) Because seasonal affective disorder is often recurrent and predictable with the change of seasons, internal mechanisms related to circadian rhythms that are directed by vitamin D activity have been evaluated in aspects of SAD related to the major monoamine neurotransmitters, serotonin, norepinephrine, and dopamine. More than one vulnerability factor is suspected, including the environment and genetic susceptibility. (Levitan. 2007)

Vitamin D Deficiency Research

Studies at the University of Texas uncovered an association of high vitamin D levels to low scores on standardized measures of depression. Persons with a history of depressive symptoms were found to have lower levels of vitamin D. (Hoang. 2011) Also in 2011, Dutch scientists found similar relationships between vitamin D deficiency and depression, observing that a poor diet and lack of sun exposure were common elements. (Koater. 2011) The geriatric population is even harder hit with SAD. Their failure or inability to maintain healthy eating habits, and their often self-imposed seclusion prevent them from attaining optimal vitamin D levels through what may be considered normal daily activity by other groups. (Stalpers-Konijnenburg. 2011)

Reports abound that recommend the testing of vitamin D levels for individuals affected by depressive symptoms of any kind, including SAD. The research finds this to be a cost-effective and simple way to effect a therapy that would improve long-term health outcomes and quality of life. (Penckofer. 2010) (Humble. 2010) Additional study has tentatively linked vitamin D deficiency to autism and schizophrenia, the incidence of both hypothetically linked to developmental (prenatal) vitamin D deficiency. (Humble, Gustafsson, et al. 2010)

How To Increase Your Vitamin D Intake

Vitamin D is usually obtained from the skin through the action of ultraviolet-B radiation on a kind of cholesterol, called 7-dehydrocholesterol, after which time it gets metabolized to 25-hydroxyvitamin D (the stuff measured in a blood test). It gets further metabolized to the hormonal form, 1,25-hydroxyvitamin D. Although genetics may play a part in vitamin D blood levels, adequate calcium intake, exercise, and less obesity can help to support them. (Mason. 2011)

Almost everyone decries going to bed in the dark and then waking in the dark. Exposure to bright light in the morning can get you revved up for the day. The problem is that, when you awake in the dark, the eye sends a message to the pineal gland that it’s time to go to sleep, and melatonin is made. That resets the sleep-wake cycle. But this is supposed to happen at night. Light therapy is accepted as an effective treatment for the winter time blues. (Virk. 2009) (Pail. 2011) You can buy lamps that radiate the full spectrum of sunlight. Even your incandescent reading lamp can help. (Szadoczky. 1991) After a couple of weeks of daily use, linked with vitamin D supplementation, you’ll feel better than new.

References

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Regional variation and determinants of vitamin D status in sunshine-abundant Thailand.
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Association between low serum 25-hydroxyvitamin d and depression in a large sample of healthy adults: the cooper center longitudinal study.Mayo Clin Proc. 2011 Nov;86(11):1050-5.
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Depression is associated with decreased 25-hydroxyvitamin D and increased parathyroid hormone levels in older adults.
Arch Gen Psychiatry. 2008 May;65(5):508-12.Humble MB, Gustafsson S, Bejerot S.
Low serum levels of 25-hydroxyvitamin D (25-OHD) among psychiatric out-patients in Sweden: relations with season, age, ethnic origin and psychiatric diagnosis.
J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):467-70.
Humble MB.
Vitamin D, light and mental health.
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Kuningas M, Mooijaart SP, Jolles J, Slagboom PE, Westendorp RG, van Heemst D.
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The circadian basis of winter depression.
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Lewy AJ, Emens JS, Songer JB, Sims N, Laurie AL, Fiala SC, Buti AL.
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Levitan RD.
The chronobiology and neurobiology of winter seasonal affective disorder.
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Mason RS, Sequeira VB, Gordon-Thomson C.
Vitamin D: the light side of sunshine.
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McCann JC, Ames BN.
Is there convincing biological or behavioral evidence linking vitamin D deficiency to brain dysfunction?
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Pail G, Huf W, Pjrek E, Winkler D, Willeit M, Praschak-Rieder N, Kasper S.
Bright-light therapy in the treatment of mood disorders.
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Penckofer S, Kouba J, Byrn M, Estwing Ferrans C.
Vitamin D and depression: where is all the sunshine?
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Privitera MR, Moynihan J, Tang W, Khan A.
Light therapy for seasonal affective disorder in a clinical office setting.
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Shipowick CD, Moore CB, Corbett C, Bindler R.
Vitamin D and depressive symptoms in women during the winter: a pilot study.
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Stalpers-Konijnenburg SC, Marijnissen RM, Gaasbeek AB, Oude Voshaar RC.
Can I have some sunshine to cheer me up? vitamin D deficiency and depression in the elderly.
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Szádóczky E, Falus A, Németh A, Teszéri G, Moussong-Kovács E.
Effect of phototherapy on 3H-imipramine binding sites in patients with SAD, non-SAD and in healthy controls.
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Virk G, Reeves G, Rosenthal NE, Sher L, Postolache TT.
Short exposure to light treatment improves depression scores in patients with seasonal affective disorder: A brief report.
Int J Disabil Hum Dev. 2009 Jul;8(3):283-286.

*These statements have not been evaluated by the FDA.
These products are not intended to treat, diagnose, cure, or prevent any disease.