The document provides an overview of key nutrients that are important for bone health, including calcium, phosphorus, vitamin D, magnesium, and fluoride. It discusses the roles and functions of these nutrients in bone growth, maintenance, and repair. Deficiency and toxicity risks are addressed for each nutrient. Dietary sources and intake recommendations are also reviewed.
Proper nutrition is an integral part of maintaining healthy bones and preventing falls.
Learn more about Nutrition Services at Burke:
http://www.burke.org/rehab/patientinfo/nutrition-dietician-consult
Slide set that accompanied a public lecture on Nutrients and Bone Health held in London September 2011. The lecture focused on the importance of diet and lifestyle in maintaining healthy bone and preventing osteoporosis. Aspects of diagnosis are reviewed and the use of bone markers to indicate bone turnover are discussed in relation to monitoring the response to treatment.
Basic Nutrition gives an overview of the classification of nutrients and the deficiency diseases one can develop if unable to take a balanced diet.
The knowledge can be used to promote healthy nutritional practices in the community and participate in prevention of nutrition related illnesses in adults, children, adolescents, the sick and the , elderly
Presentation covers the chapter in CBSE curriculum in detail about forms of nutrients and where we can get those.
PPT can be coupled with relevant worksheets from the syllabus.
Nutrition in older age. Adequate nutrition, especially in older age, aids in the maintenance of health and in decreasing the onset of chronic diseases, contributes to vitality in everyday activity, to energy and mood and helps in maintaining functional independence.
Proper nutrition is an integral part of maintaining healthy bones and preventing falls.
Learn more about Nutrition Services at Burke:
http://www.burke.org/rehab/patientinfo/nutrition-dietician-consult
Slide set that accompanied a public lecture on Nutrients and Bone Health held in London September 2011. The lecture focused on the importance of diet and lifestyle in maintaining healthy bone and preventing osteoporosis. Aspects of diagnosis are reviewed and the use of bone markers to indicate bone turnover are discussed in relation to monitoring the response to treatment.
Basic Nutrition gives an overview of the classification of nutrients and the deficiency diseases one can develop if unable to take a balanced diet.
The knowledge can be used to promote healthy nutritional practices in the community and participate in prevention of nutrition related illnesses in adults, children, adolescents, the sick and the , elderly
Presentation covers the chapter in CBSE curriculum in detail about forms of nutrients and where we can get those.
PPT can be coupled with relevant worksheets from the syllabus.
Nutrition in older age. Adequate nutrition, especially in older age, aids in the maintenance of health and in decreasing the onset of chronic diseases, contributes to vitality in everyday activity, to energy and mood and helps in maintaining functional independence.
The "Nutrition Basics: Macronutrients" lesson will introduce and explain the three most calorie-dense foods-- fats, proteins, and carbohydrates. You will get an understanding of what most foods are made of and why they are important.
I created and presented a PowerPoint to those attending the CHIP program at the Walla Walla General Hospital. It was about anti-inflammatory diets and was based on current scholarly research articles
This presentation shows the importance of having balanced Diet.The importance of having the combination of variety of nutrients.This presentation also describes the different dividions of food and their sources,Carbohydrates,Proteins,Fat,Vitamins and Minerals etc...
http://curegoutpainnow.com
The best long term results are obtained by eating a properly planned uric acid diet. Any diet plan that is prescribed for gout patients must be able to reduce the level of uric acid in the blood.
Diet for pco women- Polycystic ovary syndrome | food habits should follow | t...martinshaji
it is necessary to maintain a good diet in pcod women , a perfect diet plan in pcod may helps to get better management ....this is prepared as per opinion of dietician and gynecologist .............
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Learn about the uses and benefits of meal replacements and protein shakes!
Meal replacements and protein shakes are popular and versatile dietary supplements used by a wide variety of people, for a number of health goals. For example: by athletes and body-builders for a protein boost, to support their recovery times and performance; by slimmers, looking for low calorie, nutrients-fortified meal substitutes; by those suffering with food allergies or intolerances, such as coeliacs; and by those on low-protein diets, such as vegans and vegetarians.
Specialist Supplements Ltd is a premium supplier of health supplements, including dairy-free, gluten-free and vegan meal replacement shakes and protein powders. We are based in the UK and all of our products are manufactured here under quality assured standards (including ISO 9001).
Our other product ranges include digestive aids, colon cleansers, probiotics, cleanse and detox, antioxidants, superfoods, organic products, weight management support supplements, sports and muscle mass products and vegetarian and vegan supplements.
Visit us today at: http://www.specialistsupplements.co.uk
The "Nutrition Basics: Macronutrients" lesson will introduce and explain the three most calorie-dense foods-- fats, proteins, and carbohydrates. You will get an understanding of what most foods are made of and why they are important.
I created and presented a PowerPoint to those attending the CHIP program at the Walla Walla General Hospital. It was about anti-inflammatory diets and was based on current scholarly research articles
This presentation shows the importance of having balanced Diet.The importance of having the combination of variety of nutrients.This presentation also describes the different dividions of food and their sources,Carbohydrates,Proteins,Fat,Vitamins and Minerals etc...
http://curegoutpainnow.com
The best long term results are obtained by eating a properly planned uric acid diet. Any diet plan that is prescribed for gout patients must be able to reduce the level of uric acid in the blood.
Diet for pco women- Polycystic ovary syndrome | food habits should follow | t...martinshaji
it is necessary to maintain a good diet in pcod women , a perfect diet plan in pcod may helps to get better management ....this is prepared as per opinion of dietician and gynecologist .............
please comment
thank you ...
Learn about the uses and benefits of meal replacements and protein shakes!
Meal replacements and protein shakes are popular and versatile dietary supplements used by a wide variety of people, for a number of health goals. For example: by athletes and body-builders for a protein boost, to support their recovery times and performance; by slimmers, looking for low calorie, nutrients-fortified meal substitutes; by those suffering with food allergies or intolerances, such as coeliacs; and by those on low-protein diets, such as vegans and vegetarians.
Specialist Supplements Ltd is a premium supplier of health supplements, including dairy-free, gluten-free and vegan meal replacement shakes and protein powders. We are based in the UK and all of our products are manufactured here under quality assured standards (including ISO 9001).
Our other product ranges include digestive aids, colon cleansers, probiotics, cleanse and detox, antioxidants, superfoods, organic products, weight management support supplements, sports and muscle mass products and vegetarian and vegan supplements.
Visit us today at: http://www.specialistsupplements.co.uk
Hinduja hospital conducts regular webinars and tweetinars for online users where they can seek advice from expert doctors of hinduja hospital for free. Above is the webinar conducted by hinduja hospital on Osteoporosis where issues like osteoporosis symptoms, osteoporosis prevention, osteoporosis treatment were discussed successfully by Spine Consultant, Dr. Uday Pawar.
To know more about such upcoming webinars and tweetinars from hinduja hospital, visit http://www.hindujahospital.com/communityportal/
ACHONDROPLASIA -CASE REPORT & REVIEW OF LITERATURE/ dental implant coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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An introduction about DMT, its chemical structure, mode of action, effects and much more.
The presentation's effects and the video can't be displayed here.
MINERALSclassificationMajor mineralsneeded in the bo.docxannandleola
MINERALS
classification
Major mineralsneeded in the body in the largest amounts
requirements >100 mg/day
calcium, sodium, potassium, phosphorus
There are many more minerals and trace elements, however, we will be focusing on the ones that are the most problematic in human nutrition and those which are important for chronic disease prevention.
*
Calcium
Main functions:bone/tooth formationregulation of nerve transmission, blood clotting, contraction of muscleshelps maintain normal blood pressure
Stored in:99% of the total calcium in the body is stored in the bones1% of the total calcium in the body is found in the blood
*
Calcium stored in the bones serves as a reservoir of calcium. Its there to help maintain blood calcium levels when intake of calcium is low.
A chronically poor intake of calcium, over a number of years, causes a lot of calcium to removed from the bones to supply the blood (which is used for more immediate needs like muscle contraction, nerve transmission, etc).
Eventually, calcium loss from the bones results in reduced bone density and this condition is known as osteoporosis. We will discuss osteoporosis in a bit.
Calcium has a low bioavailability so anything that you can do to enhance, and therefore, improve calcium absorption is important.These are factors which enhance calcium’s bioavailability:Vitamin D: fortunately one of the best sources of calcium (milk) also contains Vitamin D. Women taking calcium supplements should also consider taking a calcium supplement that has some Vitamin D to help with absorption.Lactose: again, milk, our best calcium source also contains lactose. (What is lactose?)Gastric acid: is the acid secreted in your stomach for digestion; calcium absorption is enhanced in an acidic environment—since acid is secreted whenever you eat food, its best to take a calcium supplement with food.Need: any time you body needs more calcium, during pregnancy and periods of active growth such as infancy and adolescence, for example, our bodies can absorb more calcium
Factors which decrease Calcium absorptionToo much fiber in the diet>35 gms/dayfor most Americans, this is not a problem, since the average fiber intake is ~10-15 gms/dayAgeAs we age, we produce less gastric acidExcess use of laxativesToo much phosphorus in the dietOur main source of phosphorus is soda—and we drink a lot of soda, especially children and teens—which could be putting thier bones at risk, especially when they substitute soda for milkVitamin D deficiencyToo much coffee, tea
Osteoporosis
a chronic, degenerative diseasecharacterized by: bone lossdecrease in bone density2001: 1.5 million fractures annuallycosts $17 billion/yr ($47 million per day) prevention is key
. Bone loss from
osteoporosis
Normal bone
Bone loss occurs primarily in the
hips, spine and wrist
A DEXA scan is used to measure
bone density
Osteoporosis is a major public health threat for an estimated 44 million Ameri ...
The relation of milk and bone remodling with age in orthodontic treatmentDr.Sarah Al-khateeb
Milk Basic Protein (MPB) :- is a fraction of whey protein found in milk through the process of fractionation ,it is a functional compound and consist of several milk proteins which are biologically active The composition is approximately 54% lactoferrin and 41% lactoperoxidase with the other active proteins making up the the reminder of the fraction
MPB is the most important element in milk that affect the bone remodeling .MBP promote the bone formation and inhibit the bone resorption thus maintaining the bone strength and resistance in each age group throughout life ,reduce the loss of bone and osteoporosis that occurring with age
Natural ways to build healthy bones - health information martinshaji
Bone health is important throughout life. While you can never regain the bone density you had in your youth, you can help prevent rapidly thinning bones, even after your diagnosis. Calcium is a crucial building block of bone tissue. Vitamin D helps the body absorb and process calcium. Together, these two nutrients are the cornerstone of healthy bones.
this is a brief study for healthy bones .................................................
for any doubts or questions you can mail me @
martinsuja369@gmail.com
please comment
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Global Medical Cures™ | Calcium and Vitamin D at Every Age
DISCLAIMER-
Global Medical Cures™ does not offer any medical advice, diagnosis, treatment or recommendations. Only your healthcare provider/physician can offer you information and recommendations for you to decide about your healthcare choices.
Calcium is an essential mineral for women to help in their bone development. Every woman needs adequate amounts of calcium, especially during her formative years to increase bone density and keep problems like osteoporosis at bay.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
9. Please note that due to differing operating systems, some animations will not appear until the presentation is viewed in Presentation Mode (Slide Show view). You may see blank slides in the “Normal” or “Slide Sorter” views. All animations will appear after viewing in Presentation Mode and playing each animation. Most animations will require the latest version of the Flash Player, which is available at http://get.adobe.com/flashplayer.
14. Please note that due to differing operating systems, some animations will not appear until the presentation is viewed in Presentation Mode (Slide Show view). You may see blank slides in the “Normal” or “Slide Sorter” views. All animations will appear after viewing in Presentation Mode and playing each animation. Most animations will require the latest version of the Flash Player, which is available at http://get.adobe.com/flashplayer.
49. Pre-2010 Dietary Intake Guidelines Life Stage (Ages) Infants & Children Men & Women Pregnancy & Lactation Birth – 13 5 mcg (200 IU) 14 – 18 5 mcg (200 IU) 5 mcg (200 IU) 19 – 50 5 mcg (200 IU) 5 mcg (200 IU) 51 – 70 10 mcg (400 IU) 71 + 15 mcg (600 IU)
50. 2010 UPDATED Dietary Intake Guidelines NEW RECS: 400 IU (Infants) 600 IU (Adults) 800 IU (70+ years) Life Stage (Ages) Infants & Children Men & Women Pregnancy & Lactation Birth – 12 months 10 mcg (400 IU) 1– 18 yr 15 mcg (600 IU) 15 mcg (600 IU) 19 – 50 yr 15 mcg (600 IU) 15 mcg (600 IU) 51 – 70 yr 15 mcg (600 IU) 71 + yr 20 mcg (800 IU)
Page 387 – think there may be a typo/confusing wording in this sentence: High calcium carbonate or citrate supplements can bind the low food phosphorus in the intestine, thus inhibiting its absorption
Figure 10.14
Table 10.4
SLIDE 30: DIETARY INTAKE GUIDELINES This Table contains the Dietary Reference Intakes are the Adequate Intakes (AIs) for Vitamin D (Food and Nutrition Board, Institutes of Medicine, National Academies). Vitamin D is represented in this table as cholecalciferol. The conversion is 1 μg cholecalciferol = 40 IU vitamin D. SCRIPT: 1. In the US, the most current DRIs for Vitamin D were published on January 1, 1997 and remain the current guidelines until further notice. 2. Note that the above DRIs for vitamin D are based on the assumption that the vitamin is not synthesized by exposure to sunlight. 3. Interestingly enough, in the fall of 2008, the Institute of Medicine (IOM) initiated a study to review the Dietary Reference Intakes (DRIs) for vitamin D and calcium, with a report expected for release in the spring of 2010. The review comes as a response to relevant new research on bone health as well as the growing interest in the connection between vitamin D intake and cancer and other chronic disease. 4. Note that the American Academy of Pediatrics has recently updated there guidelines – see next slide
New vitamin D recommendations By Rob Stein Despite mounting pressure to urge many Americans to sharply boost their vitamin D levels, new official recommendations are not advocating a huge increase in the amount of the "sunshine vitamin" that people get. The United States and Canada asked the Institute of Medicine, which is part of the National Academy of Sciences, to update the official vitamin D recommendations for the first time since 1997. A 14-member expert committee convened for the task concluded that most Americans and Canadians up to age 70 need no more than 600 international units of vitamin D per day. The elderly may need as much as 800, the committee concluded. Previously, experts called for children and younger adults get 200 international units a day, adults ages 50 to 70 get 400 and the elderly to get 600. But a flurry of research indicating that vitamin D may have a dizzying array of health benefits, and that many people may have insufficient levels , had reignited an intense debate over whether federal guidelines were outdated, leaving millions unnecessarily vulnerable to heart disease, cancer, diabetes, the flu and other ailments. Some doctors have begun routinely testing their patients' vitamin D levels and recommending that people should routinely consume 2,000 or 3,000 international units a day. Sales of vitamin D supplements have increased sharply in recent years. Vitamin D may no longer be called the sunshine vitamin. (Jupiter Images) After reviewing nearly 1,000 published studies along with testimony from scientists and others, the expert committee concluded that vitamin D and calcium play an important role in creating and maintaining strong bones. But the committee concluded that while further research was warranted into vitamin D's role in other health issues, at this point the evidence is mixed and inconclusive. The committee noted that other nutrients, such as vitamin E, were thought to have a host of health benefits, an idea which was later disproved and in some cases found to be dangerous. So the committee recommended that 600 international units a day met the need for almost everyone in the United States and Canada, though people age 71 and older may need as much as 800. The committee also concluded that available evidence does not indicate there are widespread deficiencies, as some have suggested, requiring routine screening. In addition, contrary to what some vitamin D proponents have been urging, the committee did not recommend people increase their sun exposure, citing concerns about skin cancer. Scientists have long known that vitamin D is a vital nutrient that the skin produces when hit by sunlight. The amount varies, depending on where the person lives, skin pigment, age and other factors. With people spending more time indoors and covering up and using sunblock when they do go outside, the amount of vitamin D people create in their bodies has been thought to be falling. But the committee concluded that most people can get sufficient vitamin D from their diets or by taking vitamin D supplements. Milk and other foods are fortified with vitamin D and it occurs naturally in others, such as fatty fish. The recommendations disappointed many proponents of higher vitamin D intakes. Michael Holick of Boston University, one of the leading proponents of the supposed benefits of vitamin D, said he was pleased that the committee recommended higher levels than the previous guidelines. But Holick and others argue that there is more than enough evidence to support taking much more on a routine basis to reduce the risk for a host of health problems. Holick, for example, says he personally takes 3,000 international units a day and advises his patients to do so as well. Holick noted that the committee increased the upper limit of what was considered a safe level of vitamin D to 4,000 for adults. 2010 11 30 00 01 By Rob Stein | November 30, 2010; 12:01 AM ET http://voices.washingtonpost.com/checkup/2010/11/new_vitamin_d_recommendations.html New vitamin D recommendations: What they mean A new report from the Institute of Medicine is causing people to reconsider the essential nutrient. Here's what the expert panel said, and why it reached its conclusions. December 06, 2010|By Melissa Healy, Times Staff Writer Every once in a while, some unsung nutrient gets rediscovered and, in the course of a few short years, is rendered virtually magical in the eyes of health professionals and consumers. Foods containing the nutrient come into vogue and supplement use soars. Then, seemingly overnight, the spell is broken. Last week, it was vitamin D's turn to fall from grace. The comedown came courtesy of an expert panel convened by the Institute of Medicine, which advises the government on health issues. The panel's exhaustive report concluded that levels of vitamin D are — thank you very much — just fine in virtually all healthy North Americans. That was surprising to the legions of people who believed that high doses of the vitamin could prevent a laundry list of chronic conditions, including type 2 diabetes, cardiovascular disease, depression, certain cancers, preeclampsia and low birth weight. Their faith in vitamin D, derived from a heap of preliminary studies, prompted many to take mega-doses of the nutrient daily. But the expert panel was unconvinced. It noted that the scientific evidence has been mixed. Moreover, it worried about the risk of undesirable side effects, such as kidney stones, that might come with high levels of supplementation. In short, the jury's still out on the benefits of vitamin D beyond its traditional role in promoting the absorption of calcium for healthy bones. To do that job, virtually all healthy people need only 600 international units (IUs) of vitamin D a day — and those older than 70, 800 IUs. More does not make your bones healthier. So, after all the hype and hope surrounding vitamin D, what's a consumer to do now? Here's a look at what the expert panel said, and why it reached its controversial conclusions. How much vitamin D did the experts say is necessary? For most children, teens and adults, a daily dose of 400 international units (IUs) of the vitamin is sufficient, and 600 IUs recommended. Seniors older than 70 should ideally receive 800 IUs of vitamin D a day, the panel determined. For babies less than 1 year old, the panel considered 400 IUs of vitamin D enough. Those levels are somewhat higher than the ones set in 1997, the last time a government panel examined vitamin D intake. But they are far below what many doctors and supplement advocates had been urging. Why weren't they higher? The idea that people could benefit from daily doses as high as 2,000 IUs is based on the belief that vitamin D can reduce the risk of many chronic diseases, including type 2 diabetes, cardiovascular disease, metabolic disturbances, depression and certain cancers. A slew of recent studies have linked low levels of vitamin D to an increased incidence of these health problems. But the expert panel concluded that the studies were not convincing — many, in fact, showed no such connection — so it based its recommendations only on the amount of vitamin D needed to maintain bone health and prevent fractures. Does that mean I should give up my vitamin D supplements? Maintaining a healthy level of vitamin D through diet alone has become much easier since manufacturers began fortifying foods with the nutrient. Fortified foods — including virtually all milk, many brands of orange juice, and some cheeses, yogurts, margarines and breakfast cereals — are now some of the richest dietary sources of vitamin D. High levels exist naturally in fatty fish such as tuna, salmon and mackerel, and it's also present in egg yolks and beef liver. But there are a lot of people who may still need to add a vitamin D pill to their daily diet. For instance, people who follow a vegan diet need to look hard for supplemental sources of Vitamin D, as do those with milk allergies, lactose intolerance, and people who rarely eat fish. "We didn't actually say in the report that supplementation is verboten," said Dr. Glenville Jones, an endocrinologist at the University of Queensland in Canada who was on the expert panel. So I should keep on buying foods fortified with vitamin D? Definitely, says Katherine Tallmadge, a registered nutritionist and spokeswoman for the American Dietetic Assn., which endorsed the panel's report. In fact, the fortification of foods probably contributed significantly to the panel's finding that most North Americans get enough of the nutrient, even as they raised the recommended daily levels. Can't I get some of the vitamin D I need from the sun? Indeed, the sun is a free, plentiful source of vitamin D. When the sun shines on human skin for at least five to 15 minutes, the body produces the nutrient. But with people spending more time indoors and using sunscreen to prevent skin cancer, this source has fallen on hard times. In fact, the panel didn't even factor in vitamin D from sun exposure when it made its recommendations. Does that mean I should lay off the sunscreen? The sun can be a powerful manufacturer of the nutrient: In 15 minutes, a light-skinned person wearing a bathing suit outside in early July will produce 15,000 to 20,000 IUs of Vitamin D. The body stores excess vitamin D in fat, and some research suggests that it is released as needed. But there's debate about how well that happens, so the panel members suggest that daily dosing of vitamin D is a better bet. Besides, even 15 minutes without sunscreen won't fly with dermatologists. They warn that prolonged exposure to ultraviolet light — either from the sun or in a tanning both — elevates a person's risk of developing melanoma, the deadliest form of skin cancer. So, by all means, slather on that sunscreen. Are there any groups of people for whom the need for vitamin D supplementation is likely to be higher? While the Institute's report assumed away the sun as a source of Vitamin D, they acknowledged that "incidental exposure" plays a role in propping up everybody's levels of the nutrient. For the elderly, that added buffer is largely lost. So among healthy people, those older than 70 need to take in more vitamin D. Breast milk is not a source of vitamin D, so breastfed babies — particularly those who are dark-skinned — should be considered candidates for supplementation from the first week of life. Formula is typically fortified with vitamin D. Patients with kidney disease, including those on dialysis, are at particular risk of vitamin D deficiency — although they'll need to be very careful if they already have an elevated risk for kidney stones, as levels that are too high can exacerbate that risk. Some prescription medications, including the anti-seizure drugs Phenobarbital, Dilantin and Tegretol, appear to depress levels of circulating vitamin D, suggesting that some people with epilepsy should consider supplementation. Diuretics called thiazides, which are used to treat high blood pressure and kidney stones, can increase levels of Vitamin D in the bloodstream. I was told I was deficient in vitamin D. Is it true? Vitamin D deficiency has been defined and tested in widely varying ways. Labs tests for the nutrient have used different standards, different methods and sometimes test for different indicators of vitamin D deficiency. So the first things to ask are: Who told you were deficient, and what measure did they use? Physicians and dieticians reading the IOM report's specialized appendices may be reconsidering what constitute sufficiency in the coming months. Is there such a thing as too much vitamin D? The expert panel's comprehensive report is unlikely to lay this question to rest, although its advice was clear: Taking more than 4,000 IUs of vitamin D a day is risky. Too much Vitamin D can cause kidney stones and hypercalcemia, which in turn can lead to headaches, anxiety, depression, fatigue, stomach pain, cardiac arrhythmia, muscle weakness, aches, pains and fractures. Daily doses above 10,000 IUs a day are known to cause tissue and kidney damage, the panel said. In thinking about the safe upper limit that the panel proposed, keep in mind that the experts were looking for the amount needed by healthy people to maintain their bones. Since the panel wasn't convinced that higher levels of vitamin D could prevent or treat other diseases, it had little tolerance for the risks associated with mega-doses. What are the prospects for clearing up this confusion? In coming years, research will begin to clarify both sides of that equation and draw a clearer picture of the risks that kick in at higher levels of supplementation, as well as the conditions that such supplementation can treat or prevent. Harvard University researchers are enrolling 20,000 subjects for a study to compare rates of cancer, heart disease, diabetes, cognitive decline, depression and respiratory diseases in people randomly chosen to receive a daily dose of 2,000 IUs of vitamin D versus other subjects who get a placebo. Ongoing trials in Israel and India will assess how a year's worth of monthly supplementation with 10,000 IUs of vitamin D affects the development of insulin resistance, metabolic syndrome and diabetes in obese women, and with what side effects. A University of Colorado study will compare rates of respiratory infections among elderly nursing home patients taking as much as 4,000 IUs of vitamin D a day compared to those taking a smaller dose of 400 to 1,000 IUs daily.