NIFS Healthy Living Blog

Sodium is a mineral and electrolyte that helps balance the amount of fluid and other minerals in your body. It also plays an important role in nerve and muscle function. The terms “sodium” and “salt” are typically used interchangeably; however, sodium is a mineral and one of the chemical components found in salt (also called sodium chloride). Sodium is found naturally in some foods, and added to others for flavor or preservation.

While some sodium is necessary for the body to function (~500 mg/day), over time consuming too much sodium can have undesirable health effects. One of the most notable consequences of consuming too much sodium is high blood pressure. High blood pressure can increase your risk of heart disease and stroke, the two leading causes of death in the U.S., as well as kidney disease, loss of vision, and many more health complications.

Where Is Sodium Found in Foods?

Although most people believe their sodium intake mainly comes from salt they add to food by hand, only around 10% of the average American’s sodium intake comes from salt added while cooking or eating. Instead, more than 70% of the sodium consumed by Americans is from packaged and processed foods and food from restaurants. According to the Dietary Guidelines for Americans, the largest contributors of sodium in the American diet include sandwiches (including burgers and tacos), pasta and other grain dishes, soups, pizzas, and meat and seafood dishes.

How Much Sodium Can I Consume?

The American Heart Association recommends consuming no more than 2,300mg (1 teaspoon) of sodium per day; however, consuming less than 1,500mg is preferred, especially in those with preexisting high blood pressure. Despite these guidelines, the average adult in the U.S. consumes close to 3,400mg of sodium each day.

How Can I Reduce My Sodium Intake?

To help reduce your sodium intake and promote overall health, try some of the following suggestions:

• Compare Nutrition Facts labels of various packaged foods and choose the one with the lowest sodium content.
• Select canned foods, such as vegetables and beans, with “no salt added” or “low sodium” listed on the label.
• Use herbs, spices, and other sodium-free seasonings to add flavor to food, rather than salt and salty seasoning blends.
• Limit foods that are pickled, cured, or smoked, as these tend to be high in sodium. Foods that are grilled, poached, or roasted may be better options.
• Choose whole, unprocessed foods such as fruits, vegetables, and whole grains. These foods tend to be very low in sodium.
• Minimize the amount of salt added during cooking and at the table.
• If you currently eat a lot of salt/sodium, try gradually reducing your intake to give your taste buds time to transition.

Sodium and Exercise

The recommendation to consume less than 1,500mg per day does not apply to everyone, particularly individuals who lose excess amounts of sweat, such as competitive athletes or outdoor construction workers. Sodium and potassium are the two major electrolytes lost in sweat, although the amount lost varies from person to person. Typically, it is appropriate to replenish these electrolytes after intense exercise (typically >60 minutes) or excessive sweat loss.

When choosing electrolyte replacement drinks, select one with about 14–16g of carbohydrates and between 100 and 165mg of sodium per every 8 ounces for optimal recovery. And as always, it is important to talk with your physician or registered dietitian to determine how much sodium is appropriate for you based on your health status and other contributing factors.

This blog was written by Lindsey Recker, MS, RD, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

While having a New Year’s Resolution to “lose more weight” isn’t a bad thing, it’s not easy. And depending on how much you want to lose and in what time frame, it’s not always realistic. To benefit your overall health without focusing on your weight, try setting (and sticking to) some of the following nutrition-related resolutions going into 2023.

Eat More Fruits and Vegetables

About 80 percent of the US population doesn’t meet their fruit intake recommendations, while close to 90 percent do not meet their suggested vegetable intake. The Dietary Guidelines for Americans encourage adults to consume around 2–2.5 cups of fruit per day and 2.5–3 cups of vegetables per day. Although this may be a lot for some, simply aiming to eat one additional fruit or vegetable each day is still beneficial.

Drink More Water

Water is essential for the body. It aids in digestion, regulates body temperature, cushions joints, and helps remove wastes from the body. Not drinking enough water increases the risk for dehydration, which can cause dizziness, confusion, fatigue, headaches and dry skin and mouth. A general rule of thumb is to consume at least 1 milliliter of water for every 1 calorie consumed. For example, if you consumed 2,200 calories per day, you would want to aim to consume 2,200ml, or 2.2 liters of water per day.

Consume Less Alcohol

Excess alcohol intake has both short- and long-term health consequences. In the short term, drinking too much can result in risky behaviors, injury, or violence. Over time, excessive alcohol use can lead to the development of high blood pressure and heart disease, certain cancers, weakened immune system, learning and memory issues, and social problems. Most professional health organizations such as the CDC and WHO agree that men should limit alcohol intake to less than two drinks/day, while women should aim for less than one drink per day.

Decrease Sodium Intake

The Dietary Guidelines for Americans suggest consuming less than 2,300mg of sodium per day to promote optimal health and reduce the risk of heart disease, the leading cause of death for adults in the US. However, in the US, the average sodium intake for individuals older than 1 year of age is ~3,400mg/day. Strategies for reducing sodium intake include cooking at home more often, using herbs and spices to season foods rather than salt, and consuming fewer packaged/prepared foods.

Limit Saturated Fat Consumption

Like sodium, excess saturated fat consumption is linked to an increased risk for heart disease. The Dietary Guidelines for Americans suggest limiting saturated fat intake to less than 10% of daily calories, while the American Heart Association recommends even less, at less than 5–6% of daily calories from saturated fat per day. Saturated fat is found in most animal-based foods such as beef, poultry, pork, full-fat dairy products, and coconut and palm oils. To cut back on saturated fat, reduce your intake or eat smaller portions of the foods listed above and replace them with healthier options, such as fat-free or low-fat dairy and lean cuts of meat.

This blog was written by Lindsey Recker, MS, RD, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Summer is perfect for being active outdoors and grilling some healthy items for cookouts. Getting together with family and friends is a wonderful way to spend a weekend afternoon and evening. Unfortunately, some barbecues can turn into really unhealthy meals quickly. Here are some simple tips to ensure you keep up healthy eating while enjoying a cookout.

• Better your burger. Consider topping your burger with fresh and flavorful veggies such as onions and tomatoes versus higher-fat options like mayonnaise and cheese. Also, grab a whole-wheat bun to increase the fiber, or a sandwich thin to keep calories lower. Seek out lower-fat ground beef to make your burgers, such as Laura’s Lean Beef, or grab a turkey burger or a plant-based burger to grill. 
• Select sides wisely. Coleslaw, potato salad, and macaroni salad are typical staples of most cookouts. However, these mayonnaise-based options are loaded with fat and calories that aren’t necessarily the best for a balanced plate. Choose a serving the size of a tennis ball to keep portions in check, or choose oil-and-vinegar or yogurt-based dishes if available. 
• Fill up on fruit. This time of year is full of almost every fruit in its peak season. Load up on filling berries, cherries, and melons. Make a giant fruit salad or kabobs, or toss some peaches or pineapple on the grill and top with nonfat vanilla yogurt. If fruit pies are on the menu for dessert, choose the option with a bottom crust only and stick to one slice!
• Don’t forget the veggies. A lot of times veggies are completely forgotten at a barbecue, but these can be super tasty and easy to fix when done on the grill. Zucchini, squash, eggplant, mushrooms, and peppers are great on the grill and can easily be made into fun kabobs. Corn on the cob is technically a starchy vegetable, but it’s still a vegetable! Just be cautious with the amount of butter and salt that you load on top of it. Instead, try grilling it in foil with a touch of olive oil and squeeze a lime on it before eating. You won’t even miss the butter and salt!
• Be careful not to burn your meat. Two compounds found in charred and overcooked meats are known carcinogens. Always make sure to clean your grill to get rid of preexisting charred food bits before you start grilling, or grill on top of foil or a grill mat. Another great idea is to marinate your meats before throwing them on the grill. Not only will it increase the flavor, but it can reduce the presence of the carcinogens. Grab a meat thermometer and make sure beef, pork, fish, veal, and lamb reach 145 degrees and poultry reaches 165 degrees.
• When you are finished, go play. Challenge the kids to a game of cornhole or horseshoes. Start tossing the ball around or choose another outdoor game. The point is to not just to jump around and “burn off” dinner, but to get up and moving and away from the tempting chips and other snacks!
  

This blog was written by Angie Scheetz, RD. To find out more about the NIFS bloggers, click here.

Did you know the human body is composed of about 50 to 60 percent water? Throughout the day, your body uses and loses fluid by way of natural body processes such as sweating, breathing, creating saliva, making and excreting urine, and having bowel movements. Losing more water than you consume can quickly lead to dehydration, which typically presents as excess thirst, headache, dizziness, weakness, digestion problems, and/or nausea. These symptoms typically resolve once you rehydrate your body.

How Much Water Do I Need Each Day?

The amount of water needed each day is different for everyone and varies depending on your age, gender, weight and height, activity level, and health status. For example, women who are pregnant or breastfeeding or those with chronic diarrhea often have increased fluid needs, while some individuals, such as those with kidney disease or congestive heart failure, may need less. Consuming alcohol and caffeine may also increase fluid excretion, thus requiring an increase in fluid intake.

There is no one-size-fits-all approach to hydration because you can achieve normal hydration status with a wide range of total water intake. Total water intake includes plain drinking water, water in beverages, and water that is found in food sources, such as in watermelon or cucumbers. On average, close to 20 percent of total fluid intake comes from food sources.

Instead of an established recommended intake level for water consumption, an Adequate Intake level for total water was set to prevent dehydration and its side effects. The Adequate Intake for total water for adult men and women is 3.7 liters and 2.7 liters each day, respectively. However, water consumption below the adequate intake doesn’t automatically put you at risk for dehydration. A good rule of thumb is to consume HALF of your body weight in OUNCES of water. For example, an individual who weighs 150 pounds should aim to consume 75 ounces of water each day (150 pounds / 2 = 75 ounces).

For more individualized fluid recommendations, please speak to your physician or a registered dietitian (RD/RDN).

How Do I Know If I’m Drinking Enough?

The simplest way to determine your hydration status is by looking at the color of your urine. Pale urine is typically indicative of proper hydration and gets darker the less hydrated you become. It is possible to consume too much water, so if you’re urinating frequently or your urine is clear, you may be drinking too much.

Suggestions for Staying Hydrated

Here are some tips for increasing your fluid intake.

• Purchase a reusable water bottle.
• Opt for water rather than soda and/or sugary drinks.
• Wear clothing that is made of moisture-wicking material and fits loosely, to help you keep cool.
• Bored of water? Add fruit to still or sparkling water. Try out some of these suggestions: Mint, lemon, and strawberry slices; cucumber and melon slices; orange and lime slices; apple slices and cinnamon sticks; cranberry and orange slices; orange slices and cloves; pineapple slices and raspberries.
• Consume foods with a high water content such as watermelon and cantaloupe; strawberries; grapes; lettuce, cabbage and spinach; celery and carrots.

This blog was written by Lindsey Recker, MS, RD, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

In today’s busy world, it’s easy to put self-care on the back burner. When there are seemingly endless deadlines at work that must be met, household chores to tackle, and a calendar that is jam-packed it can be extremely difficult to even think about taking time out for ourselves. This is why we must take just a few minutes out of our days. And, as Millennial as it may sound, we need to begin to give some love to ourselves so that we not only exist, but live life to the fullest.

Why Is Self-care Important?

There are many reasons to take care of yourself:

• Increase self-worth: Confidence, self-esteem, and feeling positive emotions about yourself can do wonders for you and those around you.
• Reduce stress: Constant stress can take a huge toll on your mind and body.
• Achieve work-life balance: You may find taking small breaks out of the day to focus on yourself not only helps you focus better on the task at hand, but also puts joy back into life outside of work.
• Improve physical health: There is no question that self-care is good for you mentally, but it’s important physically as well. Getting better sleep, eating more healthfully, being more active—all deliver numerous physical benefits.

As a dietitian, nutrition is one aspect of self-care that is extremely important to me. For some, this could mean eating a little dark chocolate every night, buying a new water bottle to drink ice-cold water all day, or making a smoothie every morning in place of the usual breakfast.

Ways to Care for Yourself

But what are some other ways you can practice self-care that aren’t nutrition-related?

• Call a loved one to chat for a few minutes.
• Practice saying “no” to avoid overextending yourself. (On the other hand, practice saying “yes” if you feel that a healthy dose of socializing would be good!)
• Take a stroll midday or once you get home—no matter the weather—and listen to an audiobook.
• Take deep, cleaning breaths—in through the nose, out through the mouth—before bed.
• Journal at the end of the day, even if it’s just a few quick notes.
• Sip a glass of hot tea and stare out the window.
• Listen to your favorite music while you take a hot shower or bath.
• Go get a massage.
• Sign up for a painting class with a friend.
• Book one of the less-expensive midweek flights to Florida for some sunshine.
• Visit the new restaurant you’ve been wanting to try.
• Take a drive with the windows down and music blasting (once it has warmed up).
• Visit a library and get lost reading a good book.
• Declutter your room and make your bed.
• Work on a puzzle or a coloring book.

Try to think of easy ways to practice self-care on your own. Items on this list might be relaxing for one person but could be a total nightmare for another. There is no right or wrong way to go about self-care. Just do what makes you happy. And remember, self-care is not indulgent. It is a must and it matters. Make sure some of your self-care techniques are easy to start and just take a few minutes of your day so that you can incorporate them into your daily schedule consistently.

This blog was written by Lindsey Hehman, MA, RD, CD. To learn more about the NIFS bloggers, click here.

Let’s be real: a health journey is not always linear and not always easy. Sometimes it can be overwhelming and mucky. What do you do? Where do you start? What if you backslid and need to get back on track? There is so much to health, right? If you try to fix it all at once, you might become overwhelmed and at a greater risk of failure.

Small Actions That Will Have a Big Impact on Your Health

Start with the things that seem small but make the most impact on your health.In this blog I identify five areas that will give you the biggest results for your efforts. Spoiler alert: none require silly supplements, tummy wraps, or popular diets such as Keto or Paleo.

Get 7–8 hours of sleep each night.

Sleep is our body's cheat code for restoration, rebuilding, and recovery from all of the sources of stress. You can eat all the nutritious foods in the world and exercise for hours, but if you are not sleeping, hormone imbalance starts working against you and halts your physical goals.

Fun Fact: A study at UC San Francisco found that those who sleep less than 5 hours are 4.5 times more likely to develop the common cold compared to those who sleep 7 hours. So hit the hay and keep infection at bay! Your body will thank you later.

Manage stress and mental health.

We all have stress. It’s important to manage the stress instead of using negative coping mechanisms, such as overeating, sleeping all day, isolating ourselves, and falling into the “I can’t change this” trap.

YOU CAN CHANGE THIS. You can get through this, and you can manage the stress in your life. Coping has its place in the health cycle, but ultimately, we want to shift into the “stress management” part of the cycle sooner rather than later. Coping is when we put up with the stress, live with it, and accept that it’s just the way it is (nothing can “lessen” the stress). Managing stress is when we try to lessen the stress by adjusting our thoughts and actions; we find a way to make it better. Examples include music, therapy, exercise, time management, making lists, saying “no,” nature, yoga, meditation, stepping away from toxic relationships, and doing a hobby.

Start dialing in on your nutrition.

What we eat fuels our physical, mental, emotional, and social health. Because of this, nutrition can get a bit complicated sometimes. So, start with small but significant changes and build from there. My suggestion is to start by practicing the 80/20 rule and having a consistent meal pattern.

So what does 80/20 mean? We all know it’s important to eat nutritious, whole foods. But what about those foods we love that aren't necessarily the best for our physical health but are good for our mental and social health (such as sweets, chips, pizza, eating out with friends, holiday food, etc.)? It’s unrealistic to cut these foods and events out of our lives—let’s be real, we have all tried this and failed. It's time to find a balance, one that will still keep you on track for hitting your health and fitness goals.

Here are the #dEATS: 80% of your food intake should be from nutritious, whole foods such as fruits, vegetables, lean proteins, legumes, whole grains, and high-quality dairy (if you’re not lactose intolerant). The other 20% of intake (calorie intake) should be from the foods you love and can't live without, but maybe aren't the greatest for your physical health. Use this 20% when going out with friends once a week, enjoying a sweet treat every other day, or grabbing a small bag of chips to compliment your chicken sandwich.

If you have a calorie goal, track these calories and make them part of your regimen to meet your daily caloric goal. If you do not have a calorie goal, practice portion control. Regardless, be sure to have a consistent meal pattern (3 meals and 2 snacks daily). Remember, there is more to health than just our physical bodies. The two other realms of health are mental and social. Food plays a big role in all three realms that make up health. Therefore, you must have a food plan that meets the needs of all three.

Increase your daily steps or non-exercise activity.

Get up and moving. I know it’s hard to do this, especially for those with desk jobs. But take a 10–15-minute break to walk in place, stretch, and do some deskercise. If you can get out and take a walk with some coworkers during the day or your family at night, do that! This gets your body moving and your metabolism going. You may be surprised at what some extra movement does for your mental and physical health.

Exercise 150–300 minutes per week.

Aside from trying to move throughout your day, plan to exercise 150–300 minutes each week. This exercise should be moderate to high-intensity. Be sure to consult a personal trainer if you are unsure what is best for you. Find something you enjoy and start there.

Incorporate Changes to Your Routine and Then Build on It

These are some starting points. Pick a few and get started. Do not overcomplicate this. No, you do not need a fad diet. No, you do not need a ton of supplements. No, you do not need to overcomplicate the timing of meals or workouts. These BIG FIVE are some of the most important things you can do to improve your health. What you need is to find a routine with all five of these points and build consistency over time. Once these become a part of your everyday life, you can dig deeper into other things, such as supplements, meal timing, and specific exercise movements.

As always, NIFS professionals are here to help! Reach out if you need help implementing any of these big 5 health improvements.

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Cranberries and cranberry-derived products are commonly used as a remedy for urinary tract infections, especially among women. Cranberries contain proanthocyanidins (PACs), specifically A type (PAC-A). It is argued that this component of cranberries fights and prevents UTIs, just as an antibiotic would. However, there is much controversy on this topic.

Clinical Trials and Studies on Cranberry for UTIs

Freire Gde C. completed a large review of 24 studies totaling 4,473 participants. In the research, there was minimal evidence suggesting that cranberry products prevented UTIs. Within those studies, cranberry juice decreased the number of UTIs in women who had recurring UTIs; however, the studies that showed a significant efficacy were small trials. When studies grew in size, the difference between the placebo groups and the cranberry groups shrank.

Furthermore, a Stapleton AE et al study completed a randomized control trial of 176 participants, of whom 120 were taking cranberry juice and 56 were given the placebo over the course of 168 days. The adherence to instruction was similar between both groups (91.8% and 90.3%). However, cranberry juice did not significantly reduce UTIs.

The Maki KC et al study argues that cranberry juice intake does indeed lower the number of UTI episodes in women with a UTI history. In their RCT, 185 women were given 240-mL cranberry juice each day for 24 weeks, while 188 women were given the placebo. The cranberry group had 39 UTIs, while the placebo group had 67 UTIs. This makes the differences significant, meaning cranberry juice did indeed work.

So, why do some trials show significance while others do not? Occhipinti A et al¹ suggests this is due to the lack of authentication of cranberry products used (some are not really cranberry-derived). Thus, the products used do not contain PACs-A, which are what scientists claim fight the UTI. In their study, they authenticated and measured the PCAs-A in the cranberry product given. They gave one group a cranberry product with 36 mg PACs-A two times daily and another group with the same number of participants a product with no PACs (placebo). After 7 days, a significant difference in colony forming unit/mL counts (via urine cultures) was found between the placebo and the PACs-A group. The PACs-A group had significantly fewer colonies. The argument here is that for cranberry products to work, the cranberry product must be carefully authenticated to ensure that it indeed contains PACs-A, which is a component typically lost in processing.

The argument here is that for cranberry products to work, the cranberry product must be carefully authenticated to ensure that it indeed contains PACs-A, which is a component typically lost in processing.

Drug Interactions, Additive Effects and Side Effects

Lexicomp, a drug database used by medical professionals, still advises people to monitor cranberry intake while taking warfarin; however, there is little research to suggest the two adversely interact. Since cranberry juice is acidic, it is important to avoid drinking it within 2 hours of taking erythromycin, a common antibiotic, because it will decrease metabolism of the drug.

Common side effects of cranberry are nausea, vomiting, tightness in the chest, itching, cough, swelling of the face or lips, seizures, GI upset, and loose stools.

The Clinical Bottom Line

There is little evidence that suggests cranberry products decrease UTIs, mainly because the PACs-A have been lost in the processing. Although people are welcome to use cranberry-derived products, I would warn about the GI upset that can occur with excessive use, the cost of cranberry tablets, lack of authentication of the products, and added sugar content in the juices. Because of the lack of evidence, I would not advise individuals to spend their money on cranberry tablets. I would also argue that the risks associated with added sugars in the juices outweigh the small chance of preventing a UTI. If you insist on using cranberry for UTIs, be sure that it contains the bioactive PACs-A.

Further Research Is Needed

Much of the research done to prove cranberry juices and products prevent UTIs fails to address the authentication of the products used, and whether they even contain the bioactive PACs-A. I think further research should include authentication of the products used. If they do that, they may see that cranberry can indeed reduce and treat UTIs.

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Healthcare providers and scientists are all working diligently to find ways to prevent, treat, and cure COVID-19. Many of us are eager for answers and probably getting tired of not knowing what to believe. One of the hot topics floating around is about Vitamin D’s role in preventing COVID-19. Can Vitamin D really protect us against COVID-19 or at least lessen the effects? Let’s take a look.

The Role of Vitamin D

Vitamin D serves many purposes in the body, the most commonly known purpose being assisting calcium absorption and bone mineralization for good bone health. It is less well known that Vitamin D plays an essential role in immunologic function—keeping your immune system strong. Vitamin D inhibits both B cell and T cell (lymphocyte) proliferation/rapid increase, affects T cell maturation, and facilitates the induction of T regulatory cells. It also helps regulate monocytes production of inflammatory markers and inhibits dendritic cell (DC) differentiation and maturation. All of this leads to a decreased production of inflammatory markers and an increase in anti-inflammatory markers. In short, it has an anti-inflammatory role.

Vitamin D and COVID

Now that you understand the role of Vitamin D in immune support, let’s look at the link between that and COVID-19. When healthcare providers check your Vitamin D levels, they request a lab called 25-hydroxyvitamin d. This is the circulating Vitamin D in your body. Ideally, we want to see that number be at least 30 ng/dL. In theory, having enough circulating Vitamin D should reduce complications by preventing the “cytokine storm” that providers are seeing in response to COVID-19 infection. The cytokine storm is when the level of inflammatory proteins rapidly rises to dangerously high levels. It is what leads to complications such as ARDS, myocarditis, and acute renal and heart failure, especially in those elderly patients with previous cardiovascular comorbidity. Researchers have started requesting this lab from patients with COVID-19.

Study Shows Decreased Risk for Adverse Affects

One cross-sectional study of 235 individuals showed that patients with at least 30 ng/dL had a significantly decreased risk for adverse effects, such as hypoxia (low oxygen levels), death of individuals over 40, and unconsciousness. Serum C-reactive protein (an inflammatory marker) was lower and lymphocyte percentage was higher in Vitamin D–sufficient COVID-19 patients. In the study, 67.2% of the 235 COVID patients had Vitamin D levels less than 30 ng/dL. The study saw no significant difference in hospitalization duration, ICU admissions, Acute Respiratory Distress Syndrome (ARDS), and intubation between insufficient and adequate Vitamin D levels.

Similarly, a study showed Vitamin D levels were significantly lower in COVID patients with severe symptoms than those with mild symptoms or no COVID at all. Of the symptomatic patients, 54 were admitted to the ICU due to ARDS—all of whom had lower Vitamin D levels than the patients not needing the ICU. Sadly, 19 patients died, and again they found that these patients had lower Vitamin D levels than the ones who survived.

Another Study Finds Lower Levels of Vitamin D in Hospitalized Patients

A study of 216 COVID-19 patients and 197 population-based controls saw significantly lower levels of Vitamin D in the patients hospitalized due to COVID-19 than the controls (of similar age and sex), which lines up with the previous studies. On the contrary, they did not find a relationship between severity of infection and Vitamin D levels like the other studies found.

Study Finds People with Vitamin D Deficiency More Likely to Test Positive

Another study of 489 patients found that those with Vitamin D deficiency (<20 ng/dL) were 1.77 times more likely to test positive for COVID-19 than those with sufficient Vitamin D levels. The study above by Hernandez et al supports this finding, showing that 82.2% of COVID-19 cases were deficient in Vitamin D compared to the population-based controls, where only 47.2% were deficient (which is significant).

Correlation Is Not Causation

Something to note: These studies are observational studies. Thus, we cannot determine a cause-and-effect relationship between vitamin D deficiency and COVID-19 infection outcomes. Correlation is not synonymous with causation. So, while these results are important and useful, we must be careful to not go as far as saying, “Vitamin D can protect me from COVID-19 or lessen the impact if I get sick with COVID-19.”

Further research is being conducted since we do have strong observational support that suggests low Vitamin D levels may favor respiratory dysfunction and even death in those with COVID-19. Several Randomized Control Trials are in process. Many are trialing high-dose Vitamin D in those with COVID-19, such as the registered study by University Hospital in Angers (France). One has already concluded, but it was small with only 50 hospitalized patients being given a high dose of Vitamin D (calcifediol) and 26 not given a high dose of Vitamin D. Only 1 of the 50 high-dosed patients needed ICU treatment, whereas 13 of the 26 not given Vitamin D needed ICU treatment. 

Vitamin D Recommendations

Let me be real clear: You do not need to start taking a megadose of Vitamin D! Doing so can actually lead to toxic effects because it is a fat-soluble vitamin. The goal is to prevent deficiency to help keep your immune system strong.

I do suggest reflecting on your Vitamin D intake and exposure. Do you get out in the sun 10–30 minutes several times weekly? Sun exposure is less common in the winter, which hints at why more people are Vitamin D deficient in the winter months. When the sun’s UV rays hit our skin, Vitamin D3 (cholecalciferol) synthesis can occur. Do you eat Vitamin D–rich sources? If not, start to add some foods that are rich in Vitamin D. This will help you reach the RDA of 600 IU for young adults under 70 years old and 800 IU for adults older than 70 years old.

Here are some Vitamin D–rich foods:

• Trout, rainbow, cooked (3 oz = 648 IU)
• Pink salmon, cooked (3 oz = 444 IU)
• Halibut, Atlantic or Pacific, cooked (3 oz = 196 IU)
• Portobello mushrooms (1/2 cup = 316 IU)
• Canned tuna (3 oz = 228 IU)
• Milk, whole, 1%, 2%, and nonfat (1 cup = 115–128 IU)
• Yogurt, various types and flavors (8 oz = 80–120 IU)
• Soy milk (1 cup = 116 IU)
• Orange juice, fortified (1 cup = 100 IU)
• Eggs (1 large = 44 IU)

If getting your RDA by eating these foods is not realistic for you, I would suggest a Vitamin D3 (cholecalciferol) supplement to help increase your intake. A Registered Dietitian can help you adapt your nutrition regimen to meet Vitamin D requirements.

Finally, speak with your healthcare provider. They can always request that your 25-hydroxyvitamin d (circulating Vitamin D in your body) lab be checked. If you’re found to be deficient, you may require larger doses for treatment.

The Bottom Line

We do have strong observational support that suggests low Vitamin D levels may favor respiratory dysfunction and even death in those with COVID-19. However, we simply do not have enough strong data to conclude that Vitamin D sufficiency can treat or prevent COVID-19 infection until Randomized Control Trials are complete.

In the meantime, the best thing to do is continue to stay healthy (or improve your health) and keep your immune systems strong, which includes eating enough Vitamin D or having adequate Vitamin D exposure.

As always, please reach out to a NIFS Registered Dietitian for any nutrition support you need.

This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

• “I am going to eat a salad because I’m on a diet.”
• “I am going to eat a salad to clean my pipes.”
• “I am going to eat a salad because that’s the only way I know how to eat my veggies.”
• “I am going to eat a salad because I hear that’s how I can be healthy.”

Come on. We've all heard this before—from friends, from coworkers, and possibly from our own mouths. I swear, salads are easily the most famous “diet food.” Why is that? Do we really have to eat salads to lose weight, clean out our “pipes,” or be healthy? In this blog I break down each of these claims and then talk about ways to improve your veggie game!

“I am going to eat a salad because I’m on a diet.”

This is usually said when someone is trying to lose weight or be “super healthy.” First, to lose weight, it is widely understood that we must burn more calories than we eat. Thus, we try to minimize our calories to lose the weight. Second, people think that if they eliminate all “processed foods,” they will automatically become healthy. The idea behind salads is that they’re “healthy,” “low-calorie,” and blah blah blah.

Guess what? Salads can quickly turn into a high-calorie snack or meal and become full of unhealthy saturated fats and sodium. For example, let’s look at the Southwest Avocado Chicken Salad from Wendy’s. Sounds healthy, right? They even market this salad as healthy. A full salad has 530 calories with 34 grams of fat, only 15 grams of carbs, 43 grams of protein, and 1060mg of sodium. First off, that’s not a big salad for all those calories—which will make maintaining a caloric deficit (for weight loss) difficult. Finding foods that can be eaten in large volumes for lower calories tends to help satiety during weight loss attempts. Also, 34 grams of fat is a lot for one meal. The RDA for a full day is 44–77 grams for someone eating 2,000 calories. Now look at the sodium: 1060 mg of sodium is close to half of the RDA for sodium. Yikes. Hey, at least the salad has protein. They got that part right.

In addition, health is not just about physical well-being. Salads, if built correctly, can most certainly offer physical benefits. But health includes mental and social well-being too. Think for a moment. Does the salad taste good? Am I satisfied? Can I keep this up forever? Am I happy with this? If the answer is “no,” consider a different approach. Any change you make should be one that is sustainable for life. In the midst of making these changes, you must evaluate your physical, mental, and social health at all times. How can you improve one part of well-being without sacrificing another? Finding that balance is the key to SUSTAINABLE, healthful lifestyle changes, which ultimately leads to lifelong results.

“I am going to eat a salad to clean my pipes.”

Fiber does wonderful things. There are two types of fiber: soluble and insoluble. Soluble fiber is found in oats, beans, peas, berries, apples, plums, and sweet potatoes—all of which can be found in salads. This type of fiber helps absorb water, which adds bulk to stools. There is also insoluble fiber, which helps to get things moving in the GI system, thus helping to relieve constipation. Insoluble fiber is typically found in whole grains, the skins of fruit, skins of beans, seeds, spinach, carrots, cucumbers, lettuce, celery, zucchini, and tomatoes. These foods are even more common in salads, which gives you a hint as to why having a bowel movement after eating salad is not uncommon.

Fruits and vegetables, particularly lettuce, have high water content. It’s no secret that water assists in the digestion process. In this case, fiber works best when it absorbs water. This makes your stool soft and bulky.

“I am going to eat a salad because that’s the only way I know how to eat my veggies.”

This is valid. Vegetables can be super boring. Finding new ways to enjoy veggies can be a challenge. However, there are ways to eat veggies without having to eat a salad. Raw veggies with dip, grilled, steamed, and roasted are all ways to have veggies. Do not skimp on the spices and seasonings, such as garlic powder, onion powder, cumin, Italian seasoning, and ginger. I promise that makes the veggies taste 100,000 times better.

“I am going to eat a salad because I hear that’s how I can be healthy.”

Read above. I think you got the point.

Bottom line: You do not need a salad to be healthy, lose weight, or clean your pipes. If you like salads, eat them! But be careful of the added fats that tend to sneak into salads. If you do not like salads, find another way to eat your vegetables. Roasted, steamed, raw, and grilled are all yummy ways to eat veggies. Check out my recipe page for more ways to cook veggies. Remember, it’s important to like and enjoy the foods you eat.

This blog was written by Sabrina Goshen, Registered Dietitian. To learn more about the NIFS bloggers, click here.