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HPRC Fitness Arena: Nutrition
Vitamin D is actually a hormone that your body produces when your skin is exposed to sunlight, earning it the nickname “sunshine vitamin.” It plays key roles in reducing your risk of many health conditions, including depression, cancer, heart disease, osteoporosis, and others. Spending 10 to 15 minutes outside on a sunny day with your arms and legs uncovered can provide nearly all the vitamin D most people need—challenging when you’re wearing a long-sleeved uniform or working inside all day—but you can also get some vitamin D in your diet from fatty fish (such as salmon), mushrooms, and many fortified foods.
The Recommended Dietary Allowance for most individuals is 600 IUs. People who have a vitamin D deficiency or certain medical conditions might require supplemental vitamin D but only under the supervision of their healthcare provider. That’s because excess vitamin D can be stored in your body, putting you at risk for toxicity. Over time, too much vitamin D can lead to irregular heart rhythms, kidney damage, and other serious health problems. If you take large doses of supplemental vitamin D and eat foods that are fortified with it, you could easily obtain more than recommended amounts.
Despite the risk for toxicity, nearly one-fourth of people living in the U.S. have low vitamin D levels, so all adults and children should have their vitamin D status checked by their healthcare provider. For more information about vitamin D, read this fact sheet from the Office of Dietary Supplements.
Operation Supplement Safety (OPSS) is a joint military initiative between the Human Performance Resource Center (HPRC) and the Department of Defense (DoD) to educate service members and retirees, their family members, leaders, healthcare providers, and DoD clinicians about dietary supplements and how to choose them wisely.
OPSS has partnered with Natural Medicines Comprehensive Database (NMCD) to provide all DoD personnel with access to evidence-based information on dietary supplements, including Natural Medicines Brand Evidence-based Ratings (NMBER)®.
Now there is an Operation Supplement Safety & Natural Data (OPSS & ND) app available that can help you make an informed decision by giving you:
- Dietary supplement safety and effectiveness (NMBER) ratings.
- Interaction ratings between drugs and natural medicines, known as “adverse reactions.”
- Effectiveness ratings for natural medicines by medical condition and more.
To access the app you must first visit HPRC’s link to NMCD and sign up for your free account. Click on the Warfighter version and use your valid .mil email address. Once you’ve created your free account you will have access to the full version of the app. Up-to-date reviews of commercially available products, Natural Medicines Brand Evidence-based Ratings (NMBER)® for commercially available products, an Effectiveness Checker, and more will be at your fingertips.
If you have questions, please use the “Ask the Expert” button on the OPSS home page.
The Food and Drug Administration (FDA) is warning consumers about powdered pure caffeine, particularly as sold in bulk on the Internet. At least one death has been associated with the use of such products, and FDA advises consumers about the potency of powdered pure caffeine. See FDA’s Consumer Advice, which includes information about how to report an adverse event.
According to this consumer resource from FDA, you should limit your caffeine intake to just 100–200 mg per day (about 5–10 ounces of coffee). Taking large doses of caffeine—roughly 400–500 mg—at one time can result in a serious condition known as “caffeine intoxication.” Some symptoms of caffeine intoxication are minor and include nausea, vomiting, agitation, nervousness, or headache. Other symptoms can be more life-threatening, such as rapid heartbeat, electrolyte imbalance, very high blood sugar, or high levels of acid in the blood, which can cause seizures. See the OPSS FAQ to help you avoid hidden sources of caffeine.
Omega-3 fatty acids make up a family of polyunsaturated fatty acids. They are important to our health, and since our bodies can’t make them, we need to obtain them from the foods we eat. Omega-3 fatty acids may reduce the risk of heart disease and play an important role in our cell membranes. So, eating more can benefit the body in many ways.
The most widely available dietary source of EPA and DHA is cold-water oily fish such as salmon, herring, mackerel, anchovies, and sardines. Other oily fish such as tuna also contains omega-3 fatty acids but in lesser amounts. Some other sources of ALA are walnuts and canola, soybean, flaxseed/linseed, and olive oils. For additional information, including health benefits of omega-3 fatty acids, read this fact sheet; and for omega-3 content in various foods, try this infosheet from HPRC.
A key step toward achieving and maintaining a healthy weight is learning to accurately gauge how much you’re eating. In other words, how big are your portions? The most accurate way to gauge your portions is to measure or weigh your food, but who wants to take measuring cups and a scale to the chow hall? A more practical way to gauge your portion sizes is to “eyeball” them—that is, to visually compare your food portions to a familiar frame of reference. Of course, you might have larger or smaller hands, but generally speaking your hand size equates to your body size and, as a result, your portion needs. This infographic from HPRC uses your hand as your guide—a “handy” way to keep portion sizes in check, which can mean a leaner, healthier, better-performing you.
Iodine is an essential nutrient. It plays a key role in how well your thyroid functions and is particularly important during pregnancy and breastfeeding for the development of your baby’s brain. The Recommended Dietary Allowance for iodine for most adults is 150 micrograms (mcg). But women who are pregnant or breastfeeding need slightly more: 220 mcg and 290 mcg daily, respectively.
Iodine is present in some foods such as fish, dairy products, fruits, vegetables, and grains. Iodine is also added to table salt—referred to as “iodized salt.” Although most Americans eat too much salt, much of it comes from processed foods and typically isn’t iodized. Consequently, many women who are pregnant are iodine-deficient. If you’re pregnant or breastfeeding, the American College of Obstetrics and Gynecology and the American Academy of Pediatrics recommend taking a prenatal vitamin to ensure you’re getting enough of all your vitamins and minerals, including iodine. In addition, if you’re vegan or you don’t eat dairy products or fish, talk to your doctor about your iodine status.
Read all prenatal dietary supplement labels carefully—whether they’re prescription or over-the-counter—so you can be certain your prenatal vitamin contains sufficient iodine to meet your needs during pregnancy and breastfeeding. Also, be sure to look for one that is third-party certified. For more information about iodine, read this fact sheet from the National Institutes of Health’s Office of Dietary Supplements.
Have you heard of Total Force Fitness, but you aren’t sure what it is? It’s a framework for building and maintaining health, readiness, and performance in the Department of Defense. It views health, wellness, and resilience as a holistic concept that recognizes “total fitness” as a “state in which the individual, family and organization can sustain optimal well-being and performance under all conditions”—a connection between mind, body, spirit, and family/social relationships. Total fitness shifts the perspective from treatment to wellness and focuses on prevention and strengths.
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury created a slide presentation for units and groups on Total Force Fitness: A Brief Overview that describes what TFF is, its core components, and each of its eight “domains” (behavioral, social, physical, environmental, medical and dental, spiritual, nutritional, and psychological). For more in-depth reading, check out the original Military Medicine Supplement that started it all, including a scholarly chapter for each domain.
Red yeast rice is a product of rice fermented with Monascus purpureus yeast. It has been used as food and/or medicine for many centuries in parts of Asia, but it is also available as a dietary supplement. It contains a substance known as monacolin K, a naturally-occurring substance that works like lovastatin, a type of statin. Statins are drugs prescribed to reduce blood cholesterol by limiting the amount of cholesterol produced by the liver. Red yeast rice that contains large amounts of monacolin K can lower blood cholesterol levels, but the amount of monacolin K in red yeast rice ranges from very high to none at all.
The Food and Drug Administration has warned consumers that if a red yeast rice dietary supplement product contains monacolin K, it is considered an unauthorized drug and taking it can carry the same risks—some serious—as the drug lovastatin. As the consumer, you really have no way to know whether a red yeast rice product does or does not contain monacolin K, and therefore no way of knowing if the product is safe, effective, or legal. In addition, red yeast rice (as either a food or dietary supplement) can be contaminated with a form of fungus that can cause kidney failure. You can learn more about the safety and effectiveness of red yeast rice from this National Center for Complementary and Alternative Medicine web page.
Olive oil is known for its flavor, versatility, and health-promoting qualities. Nutrition experts think olive oil may be partly responsible for the many health benefits associated with the “Mediterranean diet,” an eating pattern that emphasizes fruits, vegetables, whole grains, beans, nuts, and “healthy” fats. Olive oil is a monounsaturated fat—one of the healthy fats. It contains vitamins A, E, and K, plus many other beneficial compounds that might reduce your risk of heart disease.
Heating olive oil or holding it at high temperatures for long periods of time can reduce its beneficial qualities. If you use olive oil for deep-frying, it should be discarded after one or two uses.
Interestingly, olives can “pick up” airborne toxins present in smoke from fires, car exhaust, and other pollutants. So it might be a good idea to choose olive oils produced from olives grown in areas where air quality is good most of the growing season. This is likely true for all edible oils.
Olive oil can be used in countless ways: Drizzle on pasta or bread, brush lightly on meats or fish, coat vegetables for roasting, or use nearly any way that butter or other fats can be used—even baking! Of course, as with all fats, be sure to use olive oil in moderation to avoid gaining weight.
Wheat products such as bread and pasta are mainstays of our diets. However, some people are sensitive to gluten, a blend of two proteins found in wheat and other grains such as rye and barley. Three distinct conditions caused by gluten sensitivities have been identified: wheat allergy, celiac disease, and non-celiac gluten sensitivity.
Wheat allergy is more common in children than adults, and many children outgrow the condition. Symptoms include hives, itchy throat or eyes, and difficulty breathing. Wheat allergy can be life threatening and requires immediate medical attention—an especially serious consideration for Warfighters in the field.
Celiac disease is an autoimmune disorder that affects the small intestine. When a person with celiac disease eats foods containing gluten, his/her immune system attacks the small intestine, impairing the way the body digests food. Symptoms include bloating, gas, diarrhea, abdominal pain, lactose intolerance, and anemia. If not treated, celiac disease can cause neurological disorders, osteoporosis, and other autoimmune disorders such as type 1 diabetes. About three million people in the U.S. have celiac disease.
In non-celiac gluten sensitivity, or NCGS, a person is sensitive to gluten but—as the name suggests—does not have celiac disease. Symptoms include diarrhea or abdominal pain and vague, non-intestinal symptoms such as bone or joint pain, leg numbness, or skin rashes, making diagnosis difficult. About 18 million people in the U.S. have NCGS.
The only way to treat gluten sensitivities is to adhere to a strict gluten-free diet. Things to avoid include:
- Wheat, rye, and barley
- Flours made from wheat: self-rising flour, graham flour, cake flour, pastry flour
- Oats, unless certified gluten-free
- Communion wafers and matzo
- Soy sauce
Even if a product label says it is “wheat free” it might contain rye or barley. FDA has established guidelines for labeling gluten-free foods.
Gluten-free foods can become “contaminated” with gluten in home kitchens, so be sure to use clean tools for preparing and serving gluten-free foods, and designate appliances, such as a toaster, for use with gluten-free products only.
Many people with gluten sensitivities are deficient in calcium, folate, iron, and certain B vitamins. They should have their vitamin and mineral status monitored by a doctor.
Although following a gluten-free diet can be challenging at first, with a little practice it can become second nature. There are many gluten-free products on the market and many bakeries now offer gluten free selections. People who follow the diet typically experience significant improvements in their health and quality of life that make the effort worth the challenges. You can learn more about celiac disease and gluten-free diets from the Academy of Nutrition and Dietetics.