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It is the time of the year to relax and get some sun and sand as summer approaches! In Australia, exposure to sunlight is our prime source of vitamin D. When sunlight falls on our skin, a cascade of complex chemical reactions take place on our skin to form vitamin D3 and D2. These vitamins are then transported to the liver and kidney respectively to produce the active form of vitamin D.
Despite our plentiful sunshine, evidence suggests that large numbers of Australians are vitamin D insufficient. In 2007, van der Mei et al., showed in their study amongst Australian women that 40.5% in southeast Queesland, 37.4% in the Geelong region and 67.3% in Tasmania are vitamin D insufficient. This was a shocking revelation! It is estimated that 1 in 5 people in the general community are vitamin D deficient which is much worse than a state of insufficiency! This is because deficiency states lead to rickets (characterised by bow legs and knock knee) in children and osteoporosis and osteomalacia in adults. All these conditions lead to increased risk of bone fracture. Thus the big fallacy that Australians receive adequate vitamin D from casual exposure to sunlight has been dispelled.
In 2007, a study by Creighton University published that a significant supply of vitamin D can reduce the risk of certain cancers by more than 75%. Now, this should make us sit up and take note. Getting sufficient vitamin D can actually save our lives!
The current vitamin D recommendations for Australians are as follow:

1. Infants, children and adults < 50 years – 5 micrograms/day
2. 50 to 70 years – 10 micrograms/day
3. >70 years – 15 micrograms/day
This begs the question, how much sunlight do we actually need? We need approximately 20 minutes sun exposure in winter and 10 minutes in summer, most days of the week, to achieve minimum vitamin D levels. In dark skinned individuals, the length of exposure may even need to be doubled!
Since most of us do not get adequate vitamin D levels from the sun, let’s explore foods sources of vitamin D. Vitamin D is mostly found in fatty fishes, fortified milk, eggs and margarines. The table below lists some of the best food sources:

With minimal sun exposure, how much vitamin D-rich food must one consume each week to meet minimum vitamin D requirements? Approximately:
• 1 cup of milk/day
• 1-2 teaspoons fortified margarine/day
• 3-4 serves of fatty fish per week
• 3-4 whole eggs each week.
Bon appétit!

References
1. DeLuca HF, Zierold C. Mechanisms and functions of vitamin D. Nutr Rev 1998; 56: S4-S10.
2. Pasco JA, Henry MJ, Nicholson GC, et al. Vitamin D status of women in the Geelong Osteoporosis Study: association with diet and casual exposure to sunlight. Med J Aust 2001; 175: 401-405.
3. Diamond TH, Levy S, Smith A, Day P. High bone turnover in Muslim women with vitamin D deficiency. Med J Aust 2002; 177: 139-141.
4. Dawson-Hughes B, Harris SS, Dallal GE. Plasma calcidiol, season, and serum parathyroid hormone concentrations in healthy elderly men and women. Am J Clin Nutr 1997; 65: 67-71.
5. Koutkia P, Chen TC, Holick MF. Vitamin D intoxication associated with an over-the-counter supplement. N Engl J Med 2001; 345: 66-67.
6. Ingrid A. F. van der Mei, Ponsonby A, Engelsen O, Pasco J, McGrath J, Eyles D., Blizzard L, Hwyer T, Lucas R. The high prevalence of vitamin D insufficiency across Australian populations is only partly explained by season and latitude. Environmental Health Perspectives 2007, 115: 8.
7. Lappe JM, Travers-Gustafson K, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomised trial! American Journal of Clinical Nutrition, 2007; 85: 1586 – 91.

In the following video set, I show you how to prepare a quick, tasty and healthy vegetarian meal - choy sum and garlic stir-fry with cashews.  You can prepare this meal in a couple of minutes.  It is rich in anti-oxidants and fibre.  Most people do not eat enough nuts, this is one way you can include more nuts in your diet.  It is delicious.  One 10 year nurses study showed a 40% reduction in cardiovascular disease amongst nurses who eat 450g of nuts a week.  So, tuck in! Hope you like it.  Your feedback is welcome – is this useful, do you need more/less information?

Stir-fried Choy Sum and Garlic with Cashews Ingredients

• 2 bunches choy sum
• 5 garlic cloves, crushed
• 2 teaspoons sesame oil
• ½ teaspoon salt
• 1 tablespoon peanut oil
• Roasted, unsalted Cashews

Wash choy sum, separate the stems from the leaves and chop them into 10cm pieces. Heat oil in a hot wok, add garlic, stir-fry till slightly golden brown. Add choy cum stems. Fry till stems are slightly soft and then add leaves, stir in sesame oil and salt. Lastly, add roasted cashews before serving.

Disclaimer The views represented in the publication may not be shared by all the Accredited Practising Dietitians of the Dietitians Association Australia or General Practitioners of the Australian Medical Association.  The information contained in this publication represents cutting edge research in specific fields that may not be mainstream practices just yet.  However, it is intended to assist the Australian public to make healthy food choices and enhance public health outcomes.  It includes general statements based on scientific and policy research and stakeholder interviews.  Readers are advised that they need to be aware that this information may be incomplete or unsuitable for use in specific situations.  Before taking any action or making any decision based on the information in this publication readers should seek expert scientific/ medical advice from leading researchers, General Practitioners or consult an Accredited Practising Dietitian.  To the extent permitted by law, Concept Nutrition and the author do not assume responsibility of any kind resulting from any person’s use or reliance upon contents of this publication.

Did you know that all of us have cancer cells in our bodies but not all of us will develop cancer?  In fact, cancer cells lie dormant in everyone as our bodies are making defective cells all the time.  We now know our remarkable immune system is equipped with a number of mechanisms that can detect and keep these cells in check.  That way only 1 in 4 of us will die of cancer in the West while the rest of us will die of other causes as our defense mechanisms will hold out. 

So what can we do to protect ourselves and reduce our chances of ever developing the illness?  If we already have developed cancer, what can we do to increase our chances of recovery from it?  Along with conventional treatments like surgery, radiotherapy and chemotherapy, a host of other factors like environmental toxins, nutrition, emotions and physical activity come to play together in providing a more well-rounded approach to defeating the disease.

While there is some great research coming out of prestigious journals such as Lancet, Science or Nature that explore the mind-body or nutritional approaches to fighting cancer, this research is often not considered key to fighting cancer.  Generally, not until they have been the subject of large scale human studies, are these avenues noted and explored.  Meanwhile, these major breakthroughs may enable us to protect ourselves long before they become the new drug or protocol for the mainstream treatments of tomorrow.

It is an established fact that chronic inflammatory states are directly linked to cancer development.  This is true for the following cancers:

The above table demonstrates that it appears cancer cells need to produce inflammation to sustain their growth. The key enzyme for the inflammatory process is COX-2 produced by cancer cells.  Along side this enzyme, other highly inflammatory substances like cytokines, prostaglandins and leukotrienes, commonly seen in natural wound healing process, are also produced providing the fertile ground for cancer cell reproduction.  Here we see an entire lesion repair mechanism being exploited to reproduce and spread cancer cells leading to the formation of metastases or secondary tumours.

Scietific interest is just warming up to this concept as I write.  This is one of the reasons why taking control of inflammation could be key in cancer prevention and treatment.

References

1. M. Hedelin, ‘Association of frequent consumption of fatty fish with prostate cancer risk is modified by COX-2 polymorphism’ International Journal of Cancer, 120(2), 2006: 398 – 405. 
2. F. Balkwill, A.Mantovani, ‘Inflammation and cancer: back to Virchow?’ Lancet, 357(9255), 2001: 539-45.
3. R. M. Peek, Jr., S. Mohla, R. N. DuBois, ‘Inflammation in the genesis and perpetuation of cancer: summary and recommendations from a national cancer institute-sponsored meeting’ Cancer Research, 65(19), 2005: 8583-6.
4. J. Marx, ‘Cancer research: Inflammation and cancer: the link grows stronger’ Science, 306(306), 2004:5698-966.
5. A. M. Al Murri, J. M. S. bartlett, P.A. canney, J. C. Doughty, C. Wilson, D.C. McMillan, ‘Evaluation of an inflammation-based prognostic score (GPS) in patients with metastatic breast cancer’ British Journal of Cancer, 94(2), 2006:227-30.M. Karin, F. R. greten, ‘NF-kappa B:linking inflammation and immunity to cancer development and progression’ Nature Reviews Immunology, 5(10), 2005:749-59.

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