Vitamin D is essential to help your body absorb calcium. Your body needs calcium in order to build strong bones and teeth. Children who do not get enough vitamin D are at risk for Rickets. Rickets is a disorder that affects the bones, causing them to soften, become misshapen, and break easily. Rickets can cause growth retardation, bone pain, and muscle weakness. It can also cause dental problems (cavities). Adults with vitamin D deficiency are at risk for osteoporosis (weak/thin bones) and osteomalacia (weak bone and muscles). Vitamin D deficiency may increase a person’s risk for certain cancers, diabetes, kidney disease, and heart disease.

Those at higher risk for vitamin D deficiency include: breastfed infants, older adults, people with limited sun exposure, dark skinned individuals, people with fat malabsorption (diseases such as cystic fibrosis, Crohn’s disease), people who have undergone gastric bypass surgery, and the obese.

Your body creates vitamin D after you are exposed to sunlight. Sunlight stimulates the conversion of a naturally occurring compound in the skin to an active (usable) form of the vitamin. 10 minutes of sunshine 3- 4 times per week may be enough to help your body create the vitamin D it needs.

Children from birth to 18 years of age need 400 IU of vitamin D daily. Breastfed babies may need a prescription vitamin supplement with vitamin D (from your physician) because human milk only has a small amount of vitamin D. Once the child is weaned, he/she should consume > 1 liter/day of vitamin D fortified formula or whole milk. Always ask your physician before giving your child any vitamin supplements.

Adults need at least the following amounts of vitamin D:

• <50 years of age: 200 – 400 IU daily
• 50 – 70 years of age: 400 – 600 IUdaily
• >70 years of age: 600 – 800 IU daily

Children and adults who do not get any sunshine may need 800 – 1000 IU daily.

Foods such as fish, fish oil, eggs, and cheese naturally contain vitamin D. You can purchase vitamin D fortified milk, orange juice, yogurt, margarine, and cereal. Vitamin D supplements are available over the counter or by prescription.

The real truth about weight loss = balanced diet and regular exercise. Here are some simple things you can do to reach and maintain a healthy weight.

Be active. Get 30 minutes of exercise 4 – 5 times per week. Try and do something active every day. Take a walk. Take the stairs. Clean the house. Do some gardening. Take surfing lessons. Take an exercise class. Take dance lessons. Get the kids away from the television and video games and enroll them in organized sports. Take the kids to the YMCA.

Watch what you drink. Avoid soft drinks, cream coffees, alcohol, fruit juices/drinks, energy drinks, sweetened iced tea, and flavored milk. Water is a great way to keep your stomach full without taking in extra calories.

Do not skip meals. Regular meals increase your metabolism. Skipping meals causes your body to go into protective/hibernation mode, making weight loss harder. Eat a healthy breakfast. People who skip breakfast tend to weigh more.

Avoid fast food. Fast food such as hamburgers, chicken nuggets, french fries, pizza is high in calories and can cause weight gain. Pack a healthy lunch instead of eating out. This way you can control what and how much you eat.

Don’t grocery shop when you are hungry.

Chew sugar-free gum between meals to cut down on snacking.

Eat a lot of fruits and vegetables. Aim for 3 cups of vegetables and 2 cups of fruit daily.

Do not eat in a hurry. Chewing your food and eating slowly helps the digestive process. Eating slowly will help stop over-eating. It takes time for your stomach to signal your brain that you are full.

Consider joining a weight management group such as Jenny Craig or Weight Watchers. Receive encouragement and support from others.

International travel can be exciting and adventurous, leading to wonderful new experiences and treasured memories. Unfortunately, travel can also lead to unpleasant and even life-threatening health problems. Before you travel, seek consultation with your physician for travel advice that is individualized for you. Planning ahead and taking precautions can help create a pleasant and memorable travelling experience, instead of remembering how ill you became when visiting a particular country. Your doctor’s medical advice depends on your individual medical conditions, your trip itinerary, and the potential exposures/hazards present in your country of destination. Seek a travel consultation at least 8 weeks before travel.

Be prepared when you visit your physician with the following information: countries/regions that you will visit, duration of travel, season of travel, planned activities (scuba diving, hiking, etc). Bring a copy of your vaccine record if available. Once your physician evaluates your overall health and assesses your travel plans, he/she can provide information about the health risks that you could potentially encounter and give advice to minimize these risks. A travel consult should provide you with peace of mind while travelling.

Vaccines – Vaccines provide valuable protection for people who wish to travel in good health. Your physician will determine if you need any vaccines. The vaccines you received in childhood may need to be updated. Depending on your destination, you may need vaccines for some of the following: Hepatitis A and B, Influenza, Japanese encephalitis, MMR, meningitis, pneumococcal, polio, rabies, tetanus, typhoid fever, chicken pox and yellow fever.

Food and water safety – precautions are necessary in areas where sanitation and personal hygiene is poor. Drink water from commercially-sealed bottles, carbonated beverages, and beer/wine. Use bottled or boiled water when brushing teeth. Steaming-hot, well-cooked food is safest. Avoid street vendors, raw/uncooked seafood or meat, unpasteurized dairy products. Peel fruits yourself. Do not eat raw vegetables.

Malaria prevention – Malaria is a serious infection spread by the bite of an infected mosquito. Antimalaria medication is recommended if travelling to certain areas.

Insect and tick bites – Insects and ticks can transmit potentially life-threatening infections. Avoid insect-infested areas. Use repellent containing DEET or picaridin. Wear protective clothing such as long sleeves and pants. Follow good personal hygiene. Certain areas may need mosquito netting over the bed.

Personal medications – Bring enough medication for your entire trip, in their original containers. Place in your purse or carry-on to avoid loss/theft. Obtain a letter from your physician documenting medical need if you require syringes to administer medication.

Bring a first-aid kit – consider including: your personal medications. An antibiotic in case of traveler’s diarrhea. Pepto Bismol, Imodium. Cough and cold medicines. Pain medicine such as Tylenol or Advil. Allergy medication. Benadryl in case of allergic reaction. Sunscreen. Antibiotic ointment, bandages. Hydrocortisone cream. Moleskin. Motion sickness medication such as Dramamine. Altitude sickness medication such as Diamox depending on travel destination. Scissors, tweezers, pocket knife, thermometer, mirror, nail clippers. Hand wipes, sanitizers.

Sexually transmitted diseases – STDs such as HIV, hepatitis B, gonorrhea, Chlamydia, syphilis, herpes are all transmitted by sexual contact. These STDs are often more prevalent in developing countries. Use barrier methods such as condoms to reduce the risk of STDs. Avoidance of sexual contact eliminates the risk of acquiring STDs during travel.

Blood clots – for flights longer than 6 hours, precautions should be taken to avoid getting blood clots. Sitting for prolonged periods may cause blood pooling in the legs, increasing the risk of developing a blood clot. Stand up and walk around every hour, stretch frequently, avoid dehydration, consider wearing compression stockings. Avoid medications that impair your ability to move around (sleep aids, alcohol).

Avoid transportation problems/accidents – avoid night driving, wear your seat belt, do not drink alcohol and drive, be familiar with local driving customs/laws, wear a helmet on motorized cycles.

You may consider purchasing extra traveler’s health insurance. Check your health insurance policy and know your coverage.

There are additional travel considerations necessary for people travelling with medical conditions such as pregnancy, Diabetes, HIV. Ask your physician for advice or refer to the CDC website below.

Further information can also be obtained at The Center for Disease Control and Prevention (CDC) website, www.cdc.gov/travel/. The World Health Organization (WHO) has a similar site: www.who.int/ith/.