A caucasion will have sufficient sun exposre if they are in direct sunlight on average for 15 minutes three times per week with their lower legs, arms and face exposed. That should give you an idea, it doesn't really take all that much and is easily done in the summer by most people. African Americans or any other person with dark skin will require a longer exposure as the melatonin in their skin defects UV light.
In the winter it can be difficult to achieve enough exposure. I want to say, vitamin D stores are good up to 2-3 months (I could be wrong on that but I should be close), so people that have cold temps and minimal daytime >2-3 months tend to get low by the end of the season.
Most knowledgeable doctors do test for vitamin D deficiency in the right setting. Unfortunately, this is not the only factor. For older women, the bigger issue is estrogen deficiency which, as you may know, is not readily correctable without causing other problems. All post menopausal women should have adequate vitamin D intake...they do not necessarily need to be tested.
A prescription to a tanning salon is not a good idea on several fronts. One its more expensive than the easiest solution, just take the correct calcium with vitamin D supplement twice a day. Its also a waste of time and gas to go to a tanning salon unnecessarily. A large 100+ tab bottle of supplements costs like $6. Second, UV ray exposure causes damage to the skin.
Sounds like she needs to find a decent doctor...not just half-way decent.
I'm a physician. I know a few dermatologists. None would suggest there is such a thing as a healthy tan. I'm not sure how you define 'normal exposure'. Also, cancer is not the only end point. Most would agree appearing young later in life is also an important endpoint. There is plent to suggest that sun exposure causes direct damage to the skin and this effect is additive over the years. That can readily be observed under a microscope in any given person.
A caucasian receives adequate vitamin D synthesis after 15 minutes of sun exposure to arms lower legs and face three times per week. This is far less, I think, than what most would consider 'normal'. Also, supplementing with vitamin D is both safe and effective
If you want to keep a dermatologist well funded and busy later on in life, go ahead and believe that regular sun exposure is healthy, but that is all it is, a belief.
In a caucasian, 15 minutes of sunlight 3 times per week of the arms, legs and face is thought to be enough to synthesis a good level of vitamin D. Most people will easily get this much in the summer. It is the older population (such as in nursing homes) and those who have long winters will run low. In addition, african americans tend to run low. Those at risk should make up for it with diet or supplementation. Adequate vit D is not part of most peoples diet and supplementing the minimum dose is safe. Thus, I suggest to my patients a calcium with vitamin D tablet twice daily with 600mg calcium and 400 IU vitamin D.
Most multivitamins do not provide sufficient vitamin D. Heck many calcium and vitamin D supplements do not provide enough, ie. oscal D only provides 500mg calcium and 200 IU vitamin D.
As a physician, I suggest anyone that is not regularly outside take Calcium 600mg with vitamin D 400 IU twice daily. Taking 800 IU of vitamin D daily is the minimum needed to maintain a healthy level without sun exposure. Up to 2000 IU a day is thought to be safe. vitamin D3 is actually superior to D2, although anything is better than not enough. In the winter, I take Caltrate D twice a day (actually I take the generic version from Kroger which is much cheaper but has vitamin D3).
There are some dietary sources of vitamin D but most Americans fall far short of consuming enough to make up for no sun exposure so these recommendations should always be adjusted according to diet and amount of sun exposure.
Content protection sucks for us consumers and I agree that its an uphill battle for companies to do this. However, I'm not sure all is lost for the content protectors out there. Last time I check the P4 and greater smart cards used by directv have not been cracked despite a huge demand for it. If I'm wrong please correct me.
Finding a given test that is useful for 100% of the population is extremely difficult is very rare in medicine. BMI has to be used in the right context which is true of just about every blood test and imaging study I order.
If someone is using BMI out of the right context, it is not the medical communities fault.
Just because % body fat seems to make sense does not mean it is a good tool. For all I know its been looked at but not been found very useful (I've never looked into that specific test so I can't say much about its strengths and weaknesses).
Part of the reason BMI is useful is it is simple to do and easily reproducible. If its too complicated it will fail as a matter of practicality as a useful screening test.
Just because it is imperfect does not make it a bad measure. Very rarely in practice do I have to note that a patient has such a muscular body habitus that the BMI in not helfpul. I can think of 2-3 of my clinic patients off hand and I have 1000 patients.
Picking on BMI in the midst of a huge obesity epidemic is like focusing on one tree in a forest. That, and its simply not the problem.
Using one study sited in a mainstream article is pretty useless. How many times are mainstream articles sited her and generally agreed upon to be way off base. I'm actually going to find the original study because that is what I do. Quite honestly, I doubt it will change my opinion much base on what I've read already would suggest that is not true.
I love how I've been modded down by making a completely factually correct statement that is more correct and informative than any other comment in this discussion about BMI.
The difference is testosterone. You have it. She doesn't. You have more muscle mass as a result. More muscle mass equals higher metabolic demands. This is well known. Women have always put on weight easier than men and have also had a harder time losing it. If you two don't mind her with some facial hair, try some testosterone injections. (not that I would really suggest it).
Not quite that simple. obesity is undeniably likely with hypertension, hypercholesterolemia and diabetes. Those three things can be entirely cured in many obese individuals by reducing their weight alone.
Losing 10 pounds in an obese person is just as effective at lowering blood pressure as taking one anti-hypertensive medication daily. This is fact.
Yes, skinny does not in and of itself imply health. Anorexic skinny is not healthy of course. I'm considered skinny in today's society but I'm around my ideal body weight. The word 'skinny' is very ambiguous so not very useful for this discussion.
A person at their ideal body weight on average will be more healthy than their obese counterpart.
Aspartame in high quantities causes lupus-like symptoms. Any reliable sources on this? In my research on this topic about 6-7 months ago I found no credible sources to substantiate any ill effects linked to aspartame. (www.aspartaminesucks.com, wikipedia or any other such website doesn't count, I'm talking peer reviewed well done analysis here)
you can use wikipedia all you want for your sources. Frankly, the medical info is frequently inaccurate or just plain wrong. Personally, I'm a doctor and its just not good enough (go figure). I use pubmed.gov. I'd guess my sources are better.
BMI is frequently used in practice to assess the degree of obesity in an individual for both studies and practice.
Obesity runs in families usually because obese kids grow up with obese parents and adopt the same activity habits and eating habits of their parents. More often than not, its environmental factors, not genetic.
Erectile dysfunction from obesity and the other co-morbidities that go along with it such as diabetes and hypertention generally doesn't show itself until the late 30's or 40s at the earliest. Most people aren't reproducing by that age historically or in the present so I'd argue that obesity has very little direct effect on the ability to procreate early on in men. Not to mention Viagra and the likes usually fixes ED.
In women obesity can be associated with polycystic ovarian syndrome (PCOS) which can cause irregular cycles in women and limit their ability to get preganant, but most of the obese women I've seen do not have PCOS and even those with PCOS will still get pregnant.
Thus, I'm not sure how much obesity would effect the obese populations ability to procreate in general. I'm sure there is some effect but I doubt would be large.
not sure why this is modded as a troll. is is harsh? yes. is it wrong? no Its more accurate than all the low metabolism excuses being thrown around here and then modded up.
or maybe because she is a ballet dancer, she burns many more calories due to the activity involved. Same applies to the endurance guy. The only thing unusual about them is their drive to be so active. Nothing at all is out of the ordinary with their metabolism.
I agree. The broad problem is consumption, period. Whether it is fat people eating more, rich people flying around on a whim in airplanes, people driving around in SUVs for show rather than necessity, people driving 50 miles each way to work, or the steady increase of the worlds population. The more we consume, the more we will strain our environment.
Some people really do have serious glandular problems or diseases causing obesity. My cousin was a beautiful young woman until she developed lupus... she went from somewhere around 120 pounds to, well, I'm not going to speculate. I'm not sure what exactly caused the obesity, it could have been anything from hormonal changes to medications she had to take, but I know her house isn't exactly filled with twinkies. If I was to guess, she probably had to take corticosteroids for the Lupus, which dramatically increases a persons appetite and leads to weight gain.
no, the doctor that told you that is stupid. BMI is useful for 99% of the population that is not predominately muscle. (that or you have a distorted image of your body which happens too). Any doctor should know BMI should only be used in context of the average person that isn't predominantly muscle. BMI is a tool just like any other in medicine that is helpful in the right context. Using it incorrectly, just like any other measurement or test, can lead to problems.
corticosteroids (such as those used for asthma) cause weight gain by increasing the appetite and thus increasing the amount of calories a person consumes. They do no decrease metabolism and they do not break the laws of thermodynamics.
Thus your friends with steroid dependent asthma may be gaining weight, but they are not eating 1/4 the calories you are.
I think its safe to say I wouldn't read much into this yet. How many times has medicine been burned by animal studies and other type of non-randomized lower quality studies in the past, only to have well done follow-up studies disprove the originals.
Time and time again I would witness doctors pop in on a patient infected with MRSA or something else and fail to put on a mask or gown up, because they were only going to be there for a minute, then they would move on to the next patient. Worse they would have all their residents in tow, who were now learning the same behaviour. And it's not just doctors, some nurses were doing it as well. Granted 95% of the time most healthcare workers did take the basic precautions 95% of the time, but that is simply not good enough. Until 100% of hospital staff observes basic precautions 100% of the time, this line of research will be interesting but ultimately fruitless in the fight against the spread of superbugs.
This is a great example of a system problem. Obviously, if many people are doing something wrong, there is usually a reason people aren't doing what they're supposed to. Physicians, for example, have a million things on their mind at any given time and are usually pressed for time so its too easy to miss things. Providing sanitizing cleaner in the hallways, entrances and in the rooms greatly improves the rate at which all health care providers properly clean their hands, including physicians. This is proven. Having the appropriate equipment put at the doorway automatically built into the system when a patient is on some sort of precautions is another example. Many hospitals and health care systems are just now started to look at these things as systems problems rather than individual mistakes and finally real solutions are being developed.
Slashdot Mirror
A caucasion will have sufficient sun exposre if they are in direct sunlight on average for 15 minutes three times per week with their lower legs, arms and face exposed. That should give you an idea, it doesn't really take all that much and is easily done in the summer by most people. African Americans or any other person with dark skin will require a longer exposure as the melatonin in their skin defects UV light.
In the winter it can be difficult to achieve enough exposure. I want to say, vitamin D stores are good up to 2-3 months (I could be wrong on that but I should be close), so people that have cold temps and minimal daytime >2-3 months tend to get low by the end of the season.
Most knowledgeable doctors do test for vitamin D deficiency in the right setting. Unfortunately, this is not the only factor. For older women, the bigger issue is estrogen deficiency which, as you may know, is not readily correctable without causing other problems. All post menopausal women should have adequate vitamin D intake...they do not necessarily need to be tested.
A prescription to a tanning salon is not a good idea on several fronts. One its more expensive than the easiest solution, just take the correct calcium with vitamin D supplement twice a day. Its also a waste of time and gas to go to a tanning salon unnecessarily. A large 100+ tab bottle of supplements costs like $6. Second, UV ray exposure causes damage to the skin.
Sounds like she needs to find a decent doctor...not just half-way decent.
I'm a physician. I know a few dermatologists. None would suggest there is such a thing as a healthy tan. I'm not sure how you define 'normal exposure'. Also, cancer is not the only end point. Most would agree appearing young later in life is also an important endpoint. There is plent to suggest that sun exposure causes direct damage to the skin and this effect is additive over the years. That can readily be observed under a microscope in any given person.
A caucasian receives adequate vitamin D synthesis after 15 minutes of sun exposure to arms lower legs and face three times per week. This is far less, I think, than what most would consider 'normal'. Also, supplementing with vitamin D is both safe and effective
If you want to keep a dermatologist well funded and busy later on in life, go ahead and believe that regular sun exposure is healthy, but that is all it is, a belief.
In a caucasian, 15 minutes of sunlight 3 times per week of the arms, legs and face is thought to be enough to synthesis a good level of vitamin D. Most people will easily get this much in the summer. It is the older population (such as in nursing homes) and those who have long winters will run low. In addition, african americans tend to run low. Those at risk should make up for it with diet or supplementation. Adequate vit D is not part of most peoples diet and supplementing the minimum dose is safe. Thus, I suggest to my patients a calcium with vitamin D tablet twice daily with 600mg calcium and 400 IU vitamin D.
Most multivitamins do not provide sufficient vitamin D. Heck many calcium and vitamin D supplements do not provide enough, ie. oscal D only provides 500mg calcium and 200 IU vitamin D.
As a physician, I suggest anyone that is not regularly outside take Calcium 600mg with vitamin D 400 IU twice daily. Taking 800 IU of vitamin D daily is the minimum needed to maintain a healthy level without sun exposure. Up to 2000 IU a day is thought to be safe. vitamin D3 is actually superior to D2, although anything is better than not enough. In the winter, I take Caltrate D twice a day (actually I take the generic version from Kroger which is much cheaper but has vitamin D3).
There are some dietary sources of vitamin D but most Americans fall far short of consuming enough to make up for no sun exposure so these recommendations should always be adjusted according to diet and amount of sun exposure.
Content protection sucks for us consumers and I agree that its an uphill battle for companies to do this. However, I'm not sure all is lost for the content protectors out there. Last time I check the P4 and greater smart cards used by directv have not been cracked despite a huge demand for it. If I'm wrong please correct me.
Finding a given test that is useful for 100% of the population is extremely difficult is very rare in medicine. BMI has to be used in the right context which is true of just about every blood test and imaging study I order.
If someone is using BMI out of the right context, it is not the medical communities fault.
Just because % body fat seems to make sense does not mean it is a good tool. For all I know its been looked at but not been found very useful (I've never looked into that specific test so I can't say much about its strengths and weaknesses).
Part of the reason BMI is useful is it is simple to do and easily reproducible. If its too complicated it will fail as a matter of practicality as a useful screening test.
Just because it is imperfect does not make it a bad measure. Very rarely in practice do I have to note that a patient has such a muscular body habitus that the BMI in not helfpul. I can think of 2-3 of my clinic patients off hand and I have 1000 patients.
Picking on BMI in the midst of a huge obesity epidemic is like focusing on one tree in a forest. That, and its simply not the problem.
Using one study sited in a mainstream article is pretty useless. How many times are mainstream articles sited her and generally agreed upon to be way off base. I'm actually going to find the original study because that is what I do. Quite honestly, I doubt it will change my opinion much base on what I've read already would suggest that is not true.
I love how I've been modded down by making a completely factually correct statement that is more correct and informative than any other comment in this discussion about BMI.
Must be slashdot.
I'm 31 and just out of residency so I'm about as fresh as they come. I'd be happy to read up on your sources if you have something better.
The difference is testosterone. You have it. She doesn't. You have more muscle mass as a result. More muscle mass equals higher metabolic demands. This is well known. Women have always put on weight easier than men and have also had a harder time losing it. If you two don't mind her with some facial hair, try some testosterone injections. (not that I would really suggest it).
Not quite that simple. obesity is undeniably likely with hypertension, hypercholesterolemia and diabetes. Those three things can be entirely cured in many obese individuals by reducing their weight alone.
Losing 10 pounds in an obese person is just as effective at lowering blood pressure as taking one anti-hypertensive medication daily. This is fact.
Yes, skinny does not in and of itself imply health. Anorexic skinny is not healthy of course. I'm considered skinny in today's society but I'm around my ideal body weight. The word 'skinny' is very ambiguous so not very useful for this discussion.
A person at their ideal body weight on average will be more healthy than their obese counterpart.
you can use wikipedia all you want for your sources. Frankly, the medical info is frequently inaccurate or just plain wrong. Personally, I'm a doctor and its just not good enough (go figure). I use pubmed.gov. I'd guess my sources are better.
BMI is frequently used in practice to assess the degree of obesity in an individual for both studies and practice.
Obesity runs in families usually because obese kids grow up with obese parents and adopt the same activity habits and eating habits of their parents. More often than not, its environmental factors, not genetic.
Erectile dysfunction from obesity and the other co-morbidities that go along with it such as diabetes and hypertention generally doesn't show itself until the late 30's or 40s at the earliest. Most people aren't reproducing by that age historically or in the present so I'd argue that obesity has very little direct effect on the ability to procreate early on in men. Not to mention Viagra and the likes usually fixes ED.
In women obesity can be associated with polycystic ovarian syndrome (PCOS) which can cause irregular cycles in women and limit their ability to get preganant, but most of the obese women I've seen do not have PCOS and even those with PCOS will still get pregnant.
Thus, I'm not sure how much obesity would effect the obese populations ability to procreate in general. I'm sure there is some effect but I doubt would be large.
not sure why this is modded as a troll. is is harsh? yes. is it wrong? no Its more accurate than all the low metabolism excuses being thrown around here and then modded up.
or maybe because she is a ballet dancer, she burns many more calories due to the activity involved. Same applies to the endurance guy. The only thing unusual about them is their drive to be so active. Nothing at all is out of the ordinary with their metabolism.
I agree. The broad problem is consumption, period. Whether it is fat people eating more, rich people flying around on a whim in airplanes, people driving around in SUVs for show rather than necessity, people driving 50 miles each way to work, or the steady increase of the worlds population. The more we consume, the more we will strain our environment.
no, the doctor that told you that is stupid. BMI is useful for 99% of the population that is not predominately muscle. (that or you have a distorted image of your body which happens too). Any doctor should know BMI should only be used in context of the average person that isn't predominantly muscle. BMI is a tool just like any other in medicine that is helpful in the right context. Using it incorrectly, just like any other measurement or test, can lead to problems.
corticosteroids (such as those used for asthma) cause weight gain by increasing the appetite and thus increasing the amount of calories a person consumes. They do no decrease metabolism and they do not break the laws of thermodynamics.
Thus your friends with steroid dependent asthma may be gaining weight, but they are not eating 1/4 the calories you are.
Here's a link to the actual article:
http://www.jneuroinflammation.com/content/5/1/12
I think its safe to say I wouldn't read much into this yet. How many times has medicine been burned by animal studies and other type of non-randomized lower quality studies in the past, only to have well done follow-up studies disprove the originals.
Time and time again I would witness doctors pop in on a patient infected with MRSA or something else and fail to put on a mask or gown up, because they were only going to be there for a minute, then they would move on to the next patient. Worse they would have all their residents in tow, who were now learning the same behaviour. And it's not just doctors, some nurses were doing it as well. Granted 95% of the time most healthcare workers did take the basic precautions 95% of the time, but that is simply not good enough. Until 100% of hospital staff observes basic precautions 100% of the time, this line of research will be interesting but ultimately fruitless in the fight against the spread of superbugs.
This is a great example of a system problem. Obviously, if many people are doing something wrong, there is usually a reason people aren't doing what they're supposed to. Physicians, for example, have a million things on their mind at any given time and are usually pressed for time so its too easy to miss things. Providing sanitizing cleaner in the hallways, entrances and in the rooms greatly improves the rate at which all health care providers properly clean their hands, including physicians. This is proven. Having the appropriate equipment put at the doorway automatically built into the system when a patient is on some sort of precautions is another example. Many hospitals and health care systems are just now started to look at these things as systems problems rather than individual mistakes and finally real solutions are being developed.