In this blog, I’m going to explain why so much of that is down to your levels of vitamin D, which is sometimes called the ‘sunshine vitamin’ (and hence a lack of it in winter).
We’ll look at all the stuff you really need to know about vitamin D (this is how I’m going to convince you that really is vital for life and you should get yourself tested if you don’t know your levels already). We’ll look at how you can tell if you might be a bit low, who should get tested, and where to have it done (and what to say to your doctor to have this done free of charge). Oh, and how to boost your levels naturally through food. Not gonna lie though, food sources will NEVER give you enough vitamin D in winter.
Vitamin D is a superstar vitamin. More correctly, it’s actually a hormone. If levels are too low, this is bad news for health. I’m talking cancer, osteoporosis, rickets in children, asthma, tuberculosis, multiple sclerosis (and other autoimmune diseases), heart disease, diabetes and dental problems [source: PLoS One. 2013;8(3):e58725.]
Sun cream. Your body makes vitamin D after contact with the sun’s UV rays but, as we’re a nation of sun cream fanatics (and this covers the skin, blocking the rays of sunlight from getting through), you might not be getting enough straight-up sun.
Age. Among other things that go a bit wrong as you get older, your body is less good at turning the rays from the sun into vitamin D. Specifically, the kidneys are less good with age at turning it to the active form of calcitriol.
Kidney or liver disease of any kind also means vitamin D is not converted to the active form.
Tummy troubles. Problems with the digestive system (and I’m not talking about disease here – just an imbalance that may cause anything from a few manageable symptoms to more serious trouble ‘downstairs’) mean the digestive tract does not absorb the vitamin D as well.
Obesity (technically that’s a BMI or body mass index of 30+) has the fat cells in your body hoover up the vitamin D. So then it’s stored – unusable – in your fat cells and is not whizzing around your body in your blood.
Lack of sleep. Just as you need sunlight to make vitamin D, you need sleep to actually use it.
Stress. The presence of the stress hormone cortisol reduces the uptake of vitamin D by special vitamin D receptors. It literally sits there, in the body, without being able to be used. What a waste!
Your skin colour. The darker your skin, the less vitamin D you will make. This is due to the higher levels of melanin in your skin that protect against UV light. By blocking the sun’s rays, it also curbs the body’s ability to make the pre-cursor to the active vitamin D.
Nightshift workers and anyone else who doesn’t spend much time in the sunlight, including children wearing sun cream all the time and babies. Quite simply, you need the sun on your skin.
Research shows you’re 11 times more likely to be depressed if you have low vitamin D than if you don’t. [Source: PLoS One. 2013;8(3):e58725.]
Vitamin D can put the brakes on the progression of Alzheimer’s disease. [source: MT Mizwicki, et al. Genomic and Nongenomic Signaling Induced by 1α,25(OH)2-Vitamin D3 Promotes the Recovery of Amyloid-β Phagocytosis by Alzheimer's Disease Macrophages. J Alzheimers Dis. 2012 Jan 1;29(1):51-62]
Depression or anxiety (including mood changes or irritability)
Bone softening (low bone density), fractures
Feeling tired all the time/ decreased performance
Muscle cramps and weakness
Joint pain (especially back and knees)
Difficulty regulating your blood sugar levels/ post lunch energy crash
Slow wound healing
Low calcium levels in the blood
Unexplained weight gain
Symptoms like these are commonly overlooked because they don’t feel life threatening, and they’re often dismissed as normal, everyday aches and pains you have to deal with. But you don’t have to put up with these symptoms of ill health!
If any of the above resonates with you, then you should definitely get tested. You might find your GP will do this for you. My experience is that they are usually amenable to this particular test.
If your doctor won’t test, consider getting it checked out privately. In the big scheme of things (like life and, you know, your health), the test is not expensive but it could change your enjoyment of your life.
The test is the 25-hydroxy vitamin D test (also known as the 25-OH vitamin D test or Calcidiol 25-hydroxycholecalciferol test). It’s the most accurate way to measure how much vitamin D is in your body.
Your doctor will want to know that there is a valid reason for having you tested. Go back through the list of symptoms and go in strong with this being the reason why you want to be tested.
If you’re the kind of person who doesn’t want to ask, feels uncomfortable asking or is just curious to know their levels, you can get the test done privately for £44. It’s a finger prick test, so you can do it easily at home, then get guidance on how much to supplement safely. If this is you, and you want to know more, just hit reply to this email and we’ll talk.
If you do take a test and you’re very low, you’ll need an intense 4-6 weeks supplementation at a high dose and then re-testing to see the impact it’s had. There is such a thing as too much vitamin D (known as vitamin D toxicity). You’d have to be going some way to get there, but it is possible, which is why it is essential you know your levels before you start guzzling any supplements.
I know what you’re thinking. Here’s a few of those ‘yes, buts’ you have going on…
I already take a vitamin D supplement.
I go out in the sun quite a bit
Wouldn’t my doctor ask to test me if they thought it were a problem?
I’m too busy to take time off to take a test.
I hear you. If you seriously have nothing wrong with you, if you didn’t identify with any of the symptoms in the list, then don’t bother. But if you did…
And here’s a cautionary tale… one of my clients [actually it’s me, this is true, but don’t tell anyone] enjoyed sunning herself in the garden this summer with no sun cream (except for her 2 week holiday in August). But in spite of it being mid summer, her levels were only ¼ of what they should have been. The moral of this story is, be tested.
Get yourself some sun. Recommended sunlight exposure is between 10 and 30 minutes a day with no sun cream.
If getting out in the sun is not an option, sit in front of a light box that supplies 10,000 lux of full-spectrum light for 30 minutes every morning. This is an especially good option for winter months, for night shift. Bit of a faff, but it’s an option.
Take a supplement. You can take a generic 1,000 IU dose as an adult (but not children without consulting your GP) BUT, if you’ve no idea what your blood levels are, how to you know how much you should be taking?
Eat naturally vitamin D-rich foods like oily fish (salmon, sardines, fresh tuna, trout, halibut, mackerel, et.), high quality cod liver oil, egg yolks and liver. Do not be fooled into thinking the fortified foods are the same or have similar benefits. Fortified foods (like cereals, margarine and some yoghurts) contain a synthetic version of the vitamin known as D2 (the natural form is D3). Research shows this is less effective at raising levels of vitamin D in the blood.
This summer I discovered a lovely little app for my phone called D minder. It helps you track your levels of vitamin D by entering your test results and filling in details like whether you supplement and how often you go out in the sun. It will track your sun exposure and it’s impact on your vitamin D levels. It’s a little technical (and by that I mean just a little – you won’t need a PhD to understand it) so it’s probably one for anyone with very low vitamin D or the geeks among you. (Not judging…)
1 leek, washed, cut in half and finely sliced
2 sprigs rosemary, leaves picked and finely chopped
a pinch of chilli powder (optional, to taste)
175g jumbo oats
200g mature cheddar, grated
Heat the oven to 180C/ fan 160C and line a shallow 22 x 30cm baking tin with baking paper.
Take a large deep frying pan with a lid, put over a high heat and leave for a few mins to get really hot to puff the amaranth quickly. Sprinkle just a few seeds into the pan and cover with the lid – they should pop in just 2-3 secs. If it takes any longer they will burn before they burst, so leave the pan to heat a little longer. Once the pan is hot enough, add a heaped tablespoon of the amaranth and cover. Shake the pan back and forth to swirl the seeds about as they pop and after a few seconds tip them into a bowl. Repeat until you have puffed all the amaranth.
Wipe out the pan then add the butter, leek and rosemary, seasoning with a little salt and pepper, and chilli powder, if using. Put back over a low heat and let the leek soften for 5 mins. Turn off the heat and stir through the popped amaranth, oats, cheese and eggs and mix together thoroughly. Tip the mixture into the prepared tin and press firmly down with the back of a spoon.
Bake in the oven for 25 mins until deep golden brown. Carefully lift the flapjack out of the tin – holding onto the baking paper – onto a chopping board. Cut into 16 pieces and allow to cool.
Eating food you have cooked or prepared at home is healthier for you. It is also considerably cheaper. The key to this is planning. You’ve probably heard the saying ‘failing to plan is planning to fail’. Without a weekly food plan, it will be pure luck if you end up with the right foods in the fridge or cupboard. And, without planning your time, you won’t always make the time to enjoy breakfast or make that lunch. You could be saving a LOT of money each and every week by following these tips.
Be honest with yourself about your spending and shopping habits. That starts with looking into how much you spend each week on take-out coffee, croissants and other breakfasts; lunchtime salads, soups and sandwiches; snacks and other food treats; and ready meals, takeaways or last-minute meals out. Make a note every time you buy something (not the main food shop) to eat out of the house. Do this for a week, then multiply by 4 to give you an approximate monthly total.
Log into your banking app (or go online) and make a note of how much you spent over the last month on food.
Add the two figures together. This gives you your total for how much you are spending on food each month. I suspect you will be shocked. Most people are.
Commit to saving a certain amount each week or month. Decide what that is. Commit to it and write it down. What will you do with that extra money? Where can you economise?
Become a planning ninja. The thing about planning is that you need to actually plan to plan. It’s easy to get derailed by events, situations, relationships and tasks that insert themselves into our already busy lives.
Choose a time when you know you will be free every week to plan your meals – breakfasts, lunches and dinners. Ideally plan midweek for the following week. Put a reminder alarm on your phone. If this planning job doesn’t get done, you will have no choice but to shop on a day-to-day basis, which is much more expensive.
Turn these meal plans into a shopping list.
Also create a master list of what you already have in your freezer, fridge and cupboards.
Cross anything you already have off your shopping list.
As an experiment, spend at least one week only allowing yourself to buy what is on your shopping list. No extras! The planning and shopping discipline may take a little time to get used to, but it is worth persevering.
Off-list shopping and impulse buys are the biggest enemy for anyone wanting to keep to a budget. Do not go to the supermarket hungry. You are more likely to shop off-list when you do.
A huge amount of food is thrown away, because we’re not sure what to do with leftovers. Make a commitment to using yours and prepare to save money. There is a bank of resources online to help you find easy recipe suggestions for pretty much anything you may have lurking in the fridge.
This will feel uncomfortable at first. You will be making some meals you have definitely not tried before!
Try the following:
Tesco Meal Planner Left Over Tool (https://realfood.tesco.com/meal-planner/leftover-tool.html)
Protein keeps energy levels stable and is essential for the body’s growth and repair, and healthy skin and nails. Protein is found in meat and poultry, fish, seafood, eggs, lentils, beans, pulses (like chickpeas), quinoa, nuts and seeds. Protein should make up a quarter of your meal (about the size of a clenched fist). Many people do not have protein-based breakfasts. How can you change yours?
MONEY-SAVING TIP: the cheapest sources of protein are vegetarian sources, like beans and lentils. Consider going meat-free one or two days a week. Eggs sold as ‘mixed sizes’ are cheaper than buying all M or L.
That means lots of vegetables – likely more than you are currently eating. The recommendation is 5 portions of vegetables and 2 portions of fruit (ideally low sugar fruit like berries, apples, pears, plums – anything grown in the UK) a day. Fibre keeps energy levels constant, balances your hormones, fills you up, keeps you regular and those fruit and veg contain many immune-boosting plant chemicals. Aim to eat a rainbow of colours over the course of the week.
MONEY-SAVING TIP: Greengrocers are often the cheapest places to buy your veg. Also consider basing meals around special supermarket deals (example Aldi’s Super 6), and don’t rule out the basics and essentials ranges of veg (usually just means they are not regular shapes and sizes). Don’t rule out frozen veg either. It’s cheap, often frozen soon after picking so it’s very fresh, and offers the ultimate convenience. And you are likely to waste less.
Eating fat doesn’t make you gain fat or otherwise put on weight, but some fats are healthier than others. The body loves omega 3 fats, which boost mood and support the stress response, and reduce inflammation. They are found in oily fish (salmon, trout, halibut, cod, fresh tuna, mackerel, sardines), flaxseeds, chia seeds, hemp seeds and walnuts. Other healthy sources of fat are avocados, olive oil, coconut oil, nuts and seeds.
MONEY-SAVING TIP: Frozen fish is a far cheaper option than refrigerated. Don’t be fooled into thinking it’s inferior. Often supermarket ‘fishmonger’ counter fish has been frozen.
Many diets rely heavily on white, pasta, bread, rice and potatoes, but these (especially when eaten without protein) can unbalance your blood sugar levels and cause you to store fat. Swap to healthier wholegrain alternatives; brown rice, wholemeal pasta and bread, and sweet potatoes, and ensure this element takes up no more than a quarter of your meal.
MONEY-SAVING TIP: Many people bulk up meals with starch, especially on a budget. Your body will love you for bulking meals up with veg instead. Eating large portions of starchy foods will have you craving more food than if you had more modest portions.
Most people have an understanding that sugar is not good for them. Eating sugary food is like a treadmill, with one biscuit creating the need for the next. Sugar creates a blood sugar or energy imbalance, fuels inflammation in the body, and makes you put on weight.
MONEY-SAVING TIP: Consider that the more sugar you eat, the more you need to eat. Sugary ‘treats’ soon become a three times a day habit. Depending what you’re snacking on, cutting it out (or cutting down) could save several ££ each day.
Economy Gastronomy by Allegra McEvedy & Paul Merrett
Save with Jamie by Jamie Oliver
Eat, Shop, Save by Dale Pinnock
Eat Well for Less (various different books) by Greg Wallace & Chris Bavin
Whether or not you should eat dairy products is one of the things that people most ask me about as a nutrition professional.
There’s the argument from the dairy industry and conventional medicine that, if you don’t eat dairy, you’re putting your bone health at risk.
Other health professionals (often in what we used to call ‘alternative medicine’) have long argued that consuming dairy products causes low-grade inflammation in the body, may increase the risk of cancer, drain your energy and give you spots.
Vegans also argue that eating dairy isn't natural for humans, and that dairy farming involves cruelty to animals many of us are unaware of, plus it significantly contributes to global warming.
In this newsletter, I want to give you all the details on what’s good and not so good about dairy, and the positive benefits of giving up milk-based products. If you’re even considering ditching dairy, there is one really important thing you need to do. I’ll tell you about that, too.
Dairy products contain a range of beneficial nutrients. Of course, there’s calcium, but it’s also a good source of protein, vitamins D and B12 and phosphorus.
Let’s talk about the calcium in dairy, because this is the thing you are told you will miss most if you stop consuming milk-based products.
When you get past 30, your process of bone breakdown is a bit speedier than new bone being made, so you need to make sure you’re getting good levels of this important mineral to fortify your frame. Although you can get calcium from other foods, the reason why dairy is touted as being the best source, is that the calcium from milk-based foods are more readily absorbed by the body*. Skip down to the bottom of the story to find out how you can safely choose not to have dairy in your life. There are some specific foods you will need to eat.
Cow’s milk also contains the omega 6 fatty acid conjugated linoleic acid (CLA), which is considered to have health benefits. It is also contained in grass-fed beef. Studies suggest CLA can help with weight loss, and that people who have lot of foods containing CLA have a lower risk of diabetes and cancer**.
The bottom line is that human beings weren’t designed to drink milk of any kind after the weaning period (around two years old). Not human milk, and certainly not milk from cows, sheep or goats. Some cultures have embraced drinking dairy products, and people in those cultures have genetically adapted to tolerate it. Others haven't and for those people in particular, eating dairy can cause problems. Two of the biggest problems associated with dairy are digestive and skin issues.
Let’s have a look at the bad stuff in dairy products…
They contain growth hormones, which may be linked to increased risk of disease and some cancers.
And other hormones, too, like oestrogen. Small amounts, true, but still oestrogen. Some cancers and medical conditions like endometriosis, PMS, fibroids and even menopause are linked to a dominance of oestrogen compared to progesterone.
As well as having more naturally occurring sugar than you’d think. A cup of milk has about three teaspoons. Sugar, I hear you say. Where? The type of sugar in milk is called lactose. You might be tempted to say, ‘I’ll have lactose-free milk then’. Lactose-free milk has had the milk sugars broken into galactose and glucose. Same amount of sugars, different currency. However, the milk sugar is often the ingredient people do not tolerate, so a lactose-free milk can provide the benefits of regular milk without the dodgy tummy.
Non-organic dairy products contain antibiotic residues, so if you are eating dairy, make sure it’s organic.
Drinking it may raise your risk of certain types of cancer, but the evidence occasionally contradicts itself. You can read more where you see this sign at the bottom***.
And you’re more likely to get spots or have acne. **** The research stacks up that that’s the case, but scientists aren’t 100% sure of the reason dairy triggers acne, though it’s likely to be something to do with the hormones present in milk. Another theory is that dairy products disrupt insulin levels and make skin more prone to acne.
Everyone will be a little different but these are some of the reported benefits of ditching dairy:
Less nasal congestion and stuffiness.
Reduction in bloating/ other digestive symptoms.
I’m not going to go into the impact on the environment of consuming less dairy, and the animal welfare argument. Too many variables. I’ll leave you to just ponder that.
Use these in porridge, overnight oats smoothies and the like.
My favourite non-dairy milks are almond, coconut, soya, oat, rice – pretty much in that order and largely based on levels of sugars (naturally occurring). You’ll want to choose the unsweetened varieties if there is an option.
You’ll be missing out on calcium for bones, so you’ll need to find it some place else. That means letting more of these foods into your diet on a daily basis: cabbage, spring greens, boy choy, kale, broccoli, okra, almonds, soya (edamame) beans and tofu, and fish where you eat the bones (like tinned sardines).
The RDA (recommended daily allowance or how much a healthy person needs to eat to not get sick) is 700mg a day.
A fist-sized serving of tofu can be between 200mg and 800mg. One serving in a stir fry at night could get you your calcium fix for the day.
Small can of sardines has 351mg.
2tbsp sesame seeds have 280mg.
Soy milk fortified with calcium contains the same amount as a glass of cow’s milk – about 250mg in a 200ml glass of milk.
2tbsp chia seeds has 179mg.
A cup-ful of cooked kale has 177mg. Raw (because less fits in the cup), it’s 53mg.
A small handful (about 35g) almonds has nearly 100mg.
A cup of broccoli has 43mg.
Some – like spinach or chard – contain oxalic acid, which binds to calcium and can mess with your body’s ability to absorb it properly. Turns out Popeye was eating the wrong sort of greens because, even though spinach technically has a lot of calcium, it’s only a tenth as bioavailable as that from milk due to the oxalic acid.
But, wait, I couldn’t give up…
You don't have to. If you love pizza, try giving up dairy but having an exception for pizza. Although going completely dairy-free would be the goal, even taking most of the dairy out of your diet can still bring benefits. For most dairy products, there is an excellent dairy alternative. Some are most surprising. I wonder whether you have experienced the delicious creaminess a handful of cashews can bring to a soup, for example. However, there are some groups of people who really should give it a miss; those who have an intolerance to dairy would do well to remove it entirely for at least three months to heal the gut. And, if you have a true allergy to dairy (IgE), you will want to steer clear forever.