Comments Off on #Shorehealthcareheroes: Shore Physicians Group’s Certified Medical Assistants
Bethel Road Office: Left to Right, Gyorgi Szaniszlo, Victoria Carrero, Lisa Nickel, Theresa Grey, Kerry Burns, Patricia Taylor
We are proud to celebrate Shore Physicians Group’s Certified Medical Assistants who have been true #shorehealthcareheroes throughout the pandemic. The traditional responsibilities of these healthcare professionals include a variety of clinical and administrative functions to help our patients and assist our providers. With the pandemic, however, “traditional” was no longer an option, and they had to adapt and react to a new set of rules and expectations. In a matter of days, SPG consolidated its offices, and telehealth became the primary conduit for patient/provider interaction.
“When we initially consolidated offices and transitioned to 70 percent of our patient interactions via telehealth, our certified medical assistants didn’t skip a beat,” explains Lindsay Richter, Director of Operations for Shore Physicians Group. “Our Certified Medical Assistants were responsible for transitioning all office appointments to virtual appointments and assisting our patients with connecting to their providers. In addition, they were supporting the providers who continued to see patients in the office.”
Practically overnight, the medical assistant staff had a complete change in workflow. Everyday tasks became more complex with technology being the new way to deliver service to patients. They were doing most of their work virtually rather than seeing patients in the office, performing intakes, prepping charts and more. They even helped troubleshoot when patients had difficulty connecting via telehealth with their providers.
“We have an incredible team of Certified Medical Assistants, who adapted, came together and persevered through teamwork,” added Richter.
On June 1, Shore Physicians Group opened all of its offices, and once again the Certified Medical Assistants needed to switch gears and readjust to another “new normal” and brand-new set of challenges.
“Now that we are seeing 70 percent of our patients in the office, our medical assistants are screening patients, disinfecting surfaces and equipment, escorting patients in and out of the building, while completing their everyday tasks,” said Richter. “Even now, they do not go to the lobby to bring the patients to the exam room like they used to do. They go to our patients’ cars, and take their temperatures and screen them prior to them entering the building. They still manage to care for our patients who are on site and off site with a positive attitude, despite the increased workloads.
“Their ability to adapt has been incredible, and we are so proud of them. We would never have been able to support our providers and patients, along with keeping our facilities safe for us all, without our incredible medical assistants. They are all #shorehealthcareheroes.”
Comments Off on Do You Have Antibodies to Covid-19?
Much has been discussed about the role of antibodies to the COVID-19 virus. But what are antibodies?
Shore Physicians Group Primary Care Physician Dr. Michael Giunta answers these questions and more.
Infection with COVID-19, like other viruses, produces an antibody response. Antibodies are proteins that are produced by the immune system to help stop intruders from harming the body. There are several types of antibodies that form either by exposure to a specific “intruder” or through vaccination. For example, the measles vaccine is given so the body generates a defense (antibodies) against measles, should you come into contact with that threat.
Similarly, there is now testing available at Shore Medical Center that can detect the presence of antibodies. All asymptomatic patients are eligible to have this testing performed. It is a blood test that the FDA has made available under an Emergency Use Authorization (EUA). Antibodies most commonly become detectable 1-3 weeks after symptom onset.
According to the American Medical Association, serology tests should not currently be used as the basis for any “immunity certificates,” to inform decisions to return to work, or to otherwise inform physical distancing decisions. Doing so may put individuals, their household and their community at risk. Serology tests should also not be used as the sole basis of diagnosis of COVID-19 infection.
The American Medical Association has provided additional guidance for antibody testing: Use of serology tests should currently be limited to population-level seroprevalance study, evaluation of recovered individuals for convalescent plasma donations, and in other situations where they are used as part of a well-defined testing plan and in concert with other clinical information by physicians well-versed in interpretation of these results.
COVID 19 presents many unknowns. It is best to discuss any testing decisions with a healthcare provider in the proper clinical setting. We have providers readily available to discuss any concerns you have!
Dr. Giunta, and all Shore Physicians Group Primary Care providers are available for appointment to discuss COVID-19 antibody testing with you. For an appointment with Dr Giunta, who treats patients at the Shore Physicians Group office located at 401 Bethel Road in Somers Point, call 609.365.6200.
Comments Off on Diet and Wellness Tips for You and Your Family
During these challenging times many of us are struggling with a mixture of emotions, lack of routine and structure, and stress. How we manage these emotions and stressors can impact our overall mental, emotional, and physical health as well as our susceptibility to illness.
Tiffany Rios, Shore Physicians Group’s Registered Dietician and Certified Diabetes Educator, shares with you some tools and strategies to manage your nutrition and wellness during this difficult time.
If you find yourself mindlessly eating or emotionally eating in response to stress, create a list of non-food related rewards. Things like going for a walk, hugging your children, journaling, facetime with a friend/family member, or listening to your favorite music, are all examples of activities that can help us with soothing difficult emotions.
Before you eat do a “gut check”: Rate hunger levels before eating, try to eat when you’re a 3 (Hungry but not starving) and stop when you’re a 6 (satisfied but not stuffed). If you are finding you are not a 3 and reaching for food, try one of the soothing/non-food related rewards. Drink 16 ounces of water with lemon and wait 30 minutes. If you’re still reaching for food- check again to see what level your hunger is at.
Try Downloading helpful apps to manage stress such as: Headspace / Eat Right Now. Both aimed at improving awareness, mindfulness, and supporting reduction in emotional eating.
If you’re cooped inside with kids, see if you can cook meals together and learn new recipes. This may serve as a great distraction and family activity.
Exercise is imperative for our mental and physical health, aim to move for 30 minutes a day, outside if possible to maximize Vitamin D.
Try adhering to an eating schedule; Eating 3 balanced meals daily about 4 hours apart. An example might be: breakfast and 9, lunch at 1 and dinner 6-7, can promote normalcy and help balance blood sugars. Avoid eating meals late at night which can impact sleep ( a very important piece of health)
With limited visits to the Supermarket, you may need to make your groceries stretch. In addition to fresh produce, try purchasing some healthy items with longer shelf lives such as: frozen fruit/vegetables, canned beans/tuna, and dry oats/unsalted mixed nuts, and protein powder. Have a mixture of healthy pantry items to whip up a healthy meal.
Do one thing for someone else daily. Research shows helping others builds positive emotions.
Make sure to get ample Vitamin C and D, both important for our immune system. Oranges, Broccoli, and peppers are high in Vitamin C, whereas egg yolks, salmon/sardines, and Greek yogurt boost our Vitamin D levels.
Stay connected with friends and family- having a sense of community is a known factor in mental and emotional health.
Finally, we all know these are challenging and unprecedented times. Each day give yourself credit for one positive thing you did for your health that day. With all of the negative going on it’s important to remember to encourage ourselves to continue doing positive.
I hope you will find these tips to be helpful. And, from me and my family, thank you to all of our healthcare workers!
Comments Off on IMPORTANT MESSAGE FOR SHORE PHYSICIANS GROUP PATIENTS
Your provider is now accepting Telehealth visits. Call your SPG providers office for an appointment.
Shore Physicians Group has consolidated its offices to best serve our patients during this time. For an appointment time and nearby location call your provider’s office.
Shore Urgent Care in Northfield is open Monday through Friday, 8am to 8pm and Saturday and Sunday from 9 am – 5 pm. We ask that you please call Shore Urgent Care at 609.365.5333 prior to your visit.
We are reminded constantly to check food labels and calorie counts of what we eat. Reading labels is a good thing, but should you take food labels for gospel? Tiffany Rios, Registered Dietitian and Certified Diabetes Educator with Shore Physicians Group, said that while there can be an incremental increase or decrease from what is listed, food labels are useful guidelines to follow for calories. But, she added that people will metabolize food differently, and that can impact the number of calories a person gets from a particular food.
What is a calorie? According to the National Institute of Health (NIH), a calorie is a unit of energy and is the amount of heat necessary to raise the temperature of one gram of water by one degree Celsius. The average calories in food are determined by three factors: fats, carbohydrates and proteins. The calories in food provide the energy or the heat so that a body can function. The body stores as well as burns calories as fuel. Food that is listed as having 100 calories is describing how much energy the body will get from that food.
Recalculating nuts KIND, the manufacturer of KIND Bars, recently changed the label on its health bars to reflect a reduction in the calories of almonds. Their decision to change the label was based on recent research that scrutinized how calories are calculated on food items. Looking at newer information on how the nuts are metabolized and often not fully digested resulted in the calorie count going from 170 down to 130. Debbie Pettipain, a dietitian as well as a spokesperson for the Academy of Nutrition and Dietetics, said of the KIND Bar and other nut products can have calorie variations. “One package could have two or more almonds than the other, and technically that would change the caloric count.” She added that the change for almonds is a modest drop, and it is worth keeping in mind that almonds, like all nuts, are calorie-dense foods, and it does not take much to overdo it. That small decline in calories does not make nuts into celery either.
Labeling food Referring to the Nutrition Labeling and Educational Act that requires companies to include the calorie count on labels, Pettipain said it does not dictate how they come up with the numbers, but it does hold them accountable for the numbers being accurate. The Food and Drug Administration (FDA) has rules about how far off the calories can be from the label, mostly because food is an agricultural product and not always exactly the same size or grown in the same conditions. They permit up to 20% more or less than what is listed on the label to still comply with regulations, adding that while that may seem like a wide margin, the labels are still a good guideline for the food we consume.
The best food has no labels Tiffany Rios has a healthier plan when it comes to looking at calories. “It would be healthier if we ate more food without labels, like whole foods and grains that burn more calories than processed food. The body uses whole foods more efficiently than processed foods,” said Rios. “There is a whole cascade of hormones that send signals to let the brain know they are full. With fruits, vegetables, and grains that signal is clear, but with processed foods that are normally high in sugar or carbs, that ability to feel full is not so clear and does not happen as quickly. The result is often consuming more than necessary before that feeling of being full occurs.”
The registered dietitian explained the thermic effect of food is basically telling the consumer the number of calories that will be expended to break down food. “While counting calories is initially a good thing to gain awareness of what you are eating, it is best to include more fresh foods, and that means to eat more foods with no labels,” said Rios. “Eventually, that honeymoon phase of counting calories will be over. The healthier way is to shop the perimeter of the grocery store where you find the fresh and unprocessed foods, lean meats and fish.” She suggested it is wise to stay away from the middle of the store where there are cookies, chips, and products made with white flour and sugars.
Don’t be intimidated-shop with an agenda She admitted some people might feel a little intimidated initially, but lean protein such as fish, eggs, tuna, and even no sugar added Greek yogurt are important parts of a healthy diet. “I tell all my patients to have a recipe in mind when they go to the grocery store. Go in with an agenda, think about what you would like to make, and that will allow you to focus.”
As a registered dietitian, Rios said she helps patients with their meal planning to create a healthier future where they rely less on the calories on the label and more on consistently incorporating lean meats, fruits and vegetables into their diet.
To make an appointment with Tiffany Rios at the Shore Physicians Group office in Northfield, call 609-365-5300.
Comments Off on What Does Your Bad Breath Say About Your Health?
Close talkers beware – your breath may be telling people something about your overall health. Bad breath is an occasional fact of life for most people. It might stem from too many onions on that salad at lunch or too much garlic in the spaghetti sauce, but when it is a consistent problem unrelated to a recent meal, it might be wise to seek some answers from your healthcare professional.
Cindy Nunan, DNP, FNP-BC, Nurse Practitioner with Shore Physicians Group in its Northfield office, said, “Bad breath or halitosis is a sign that something else is going on in the mouth, the GI tract or even in the sinuses. Though sometimes it could be a case of less than perfect oral hygiene and not brushing and flossing as recommended, halitosis could stem from a multitude of other factors.”
Bacteria is the culprit
The real issue is that bacteria sits in the mouth and covers the tongue, teeth and gums, Nunan indicated. Bacteria causing halitosis consists of the breakdown of food debris, sugars and proteins. The odor eventually forms from the breakdown of proteins into amino acids, according to Aylikci and Colak, 2013. Treatment of course is directed at the cause. But to prevent halitosis or bad breath make sure to brush after eating and floss daily.
It’s important to note that for ventilator-dependent patients, being vigilant about good oral hygiene is imperative. According to Nunan, oral bacteria can lead to ventilator-associated pneumonia Hua, et al, 2016
What is causing that bad breath?
A dental or periodontal infection-(The infection may increase the amount of bacteria in the mouth, and the result could be halitosis)
Inadequate oral hygiene and extensive plaque build-up
Acid reflux or gastroesophageal reflux disease or GERD – (The odors from recently consumed foods may easily make their way back up the esophagus and out the mouth, causing bad breath)
Thrush- (A yeast-like fungus that can form in the mouth)
Medications – (Some cause dry mouth, or some inhaled steroids can cause excessive dry mouth or xerostomia)
Tobacco use (Increases the user’s risk for oral cancer)
Inadequate cleansing of dental appliances or dentures
Strep throat- (May decrease saliva production, which may trigger halitosis)
Reduced access to oral health care will eventually result in halitosis
Certain foods like onions and garlic
Take Some Good Advice
Nunan offers the following suggestions to keep that halitosis or bad breath at bay:
Make sure to brush after eating and floss every day.
May sure to stay hydrated.
Regularly change out your toothbrush.
Schedule dental checkups twice a year.
If bad breath persists, discuss it with your primary care doctor.
Nurse Practitioner Cindy Nunan, DNP, sees patients at Shore Physicians Group’s Northfield office. To schedule an appointment with Nunan, call 609-365-5300 .
Comments Off on Does Coloring Your Hair Increase Your Breast Cancer Risk?
Maintaining that youthful look and getting rid of those telltale gray hairs may come with a hidden cost. In December, the International Journal of Cancer published a study undertaken by the National Institute of Environmental Health that followed 46,709 women who had a sister previously diagnosed with breast cancer. (A family history of cancer indicates a higher risk).
The results of the study concluded that women who use permanent hair dye have a 9% higher incidence of developing breast cancer that those women who do not. That number was significantly higher for African American women, who had a 45% higher incidence of being diagnosed with breast cancer, though fewer used hair dye.
General Surgeon Dr. David May, MD, FACS and President of Shore Physicians Group who specializes in breast surgery looked into the recently released study. Dr. May said, “There is clearly an association between the use of hair dyes and hair relaxer, as the women in the study had much higher rates of breast cancer compared to women not using the products.” He noted that particularly interesting was the greater risk for African American women using hair dye and for white women using hair relaxer, and that semi-permanent or temporary hair dyes showed no correlation to an increase in breast cancer. Less frequent use of the products also showed no correlation. Those in the study were using permanent hair dye or hair straightener every four to six weeks.
Before women consider their use of hair products, Dr. May advised that although these findings are significant, they do not prove causation. “It only proves that the use of these products was associated with a higher risk of cancer. There can be many other associated findings with women that use hair dyes such as the use of other hair products as well that theoretically could be the carcinogenic agent,” said Dr. May.
As far as seeing this in his own practice, Dr. May said it could be something quite difficult to see or prove. He said, for example, the number of women that may be affected could be significantly small and/or the frequency with which women use these products fairly high that it would be difficult to ascertain in your own practice whether one of your patients has actually been affected by the hair products.
Dr. May said that clearly this information is sound enough that all women should consider their breast cancer risk in the face of using these types of products. But he added that there are many other agents that have an even closer association with breast cancer or are clearly causative such as tobacco products, alcohol use, and even working primarily during night shifts. There are other risk factors as well, such as early menarche, late menopause or never having children or breast-feeding. Obviously the risks for breast cancer are many and varied and it is difficult to put into perspective for most women.
Dr. May also discussed the role that permanent hair dye may play as an endocrine disruptor, possibly increasing the risk of cancer. According to Dr. May, an endocrine disruptor is a chemical that interferes with the normal endocrine or hormonal function of your body. With regards to breast cancer, there are normal interactions of estrogen and progesterone on breast tissue that if interfered with by an exogenous chemical such as the hair dyes or hair relaxer, may either stimulate the creation of cancer cells or drive the growth of cancer cells by functioning as a “substitute” of a hormone such as estrogen.
But should women avoid the use of permanent hair dye or straightener? Dr. May advised that the study involved woman of average risk of breast cancer and the use of the hair dyes and relaxers drove the risk of breast cancer to an increase of 50 to 75%. “I would therefore advise essentially all women that they should evaluate their use of hair dyes and hair relaxer with regards to their future risk of breast cancer. I would also recommend they evaluate their other habits such as the use of tobacco, alcohol, estrogen replacement and other potential carcinogens that may increase their risk as well,” said Dr. May. Further, Dr. May said to keep in mind that the general population risk for breast cancer over a lifetime is approximately one in eight or 12%. In the case of the hair dye there was an observed 50% increased risk of subsequent breast cancer which means the women increased their risk by 6% to an overall risk of 18%. While any increase is significant, it is certainly not a guarantee of developing cancer.
In conclusion, Dr. May said that although this study is fairly significant and has robust findings, he would recommend taking it with a “grain of salt.” “There are many studies the come out seemingly every week which report some association with risks of cancer. It becomes very alarming and paralyzing if one takes them all at face value. It may be more prudent to have an overall evaluation of your exposure to everyday chemicals such as tobacco and alcohol as well as these more specialized types of chemicals such as hair dyes and relaxers and even more dangerous chemicals such as pesticides, lyes and herbicides.
To make an appointment with Dr. David May at his 649 Shore Road office, call 609-365-6239.
Comments Off on How Dangerous is Plastic to Our Food?
It is nearly impossible to avoid plastic, it is everywhere. The food we eat is packaged in it, the water we drink is frequently in a plastic bottle and even the toothbrush we use twice a day has plastic. There are many different kinds of plastic products that we come in contact with constantly. Although plastics have made life more convenient, could there be a downside to having them just about everywhere?
One area of research is looking at how ongoing contact with plastic may unknowingly be causing harm to the human body. Primary care physician Dr. Lawrence Anastasi of Shore Physicians Group in Margate said exposure to plastic, especially BPA, a suspected endocrine disruptor, is something people need to consider. An endocrine disruptor is a chemical that interferes with the normal endocrine or hormonal function of your body.
Bisphenol A or BPA is of particular concern. Dr. Anastasi explained that BPA is a chemical used to harden plastics in the manufacture of plastic containers. Drinking bottles, infant bottles, drinking cups and food storage containers are but a few of the products Dr. Anastasi mentioned that may contain BPA.
Is there potential danger in using plastic for food storage or cooking? “Some research has shown BPA can leech into food, raising concerns of possible health effects on the brain and prostates of infants, fetuses and children and may have a possible effect on children’s behavior,” said Dr. Anastasi. He referenced a Mayo Clinic study by Dr. Brent Baurer that shows BPA may also increase the risk of cancer, infertility, fetal development, heart disease, diabetes and may also cause weight gain, acting internally as a hormone.
Asked if nutritional value is lost during microwaving, Dr. Anastasi said that while it can affect the nutritional content to a certain extent, it does depend on how long it is microwaved. “Any form of cooking depletes nutrients in some way, as some are heat sensitive,” said Dr. Anastasi. “Microwaves use less heat than conventional methods and it involves shorter cooking times, thus generally have the least destructive effects.” Microwaving in plastic containers is not suggested as fatty foods may leech more from the plastic at high temperatures.
Dr. Anastasi also said that some plastic containers are safer than others. He suggested the use of Pyrex glass containers with lids as a good alternative. He added that if forced to use plastic when microwaving, follow the manufacturer’s directions carefully. Dr. Anastasi suggested that if plastics are going to be used in the kitchen, stick to products with recycle codes 1, 2, 4, and 5 as they are the safest. Products marked with recycle codes 3 or 7 may contain BPA.
Are we not taking the potential dangers of plastic seriously? Dr. Anastasi said most people are mindful of the plastics that come in contact with food. Further he said, The U.S. Food and Drug Administration has said that BPA is safe at the very low levels that may occur in some foods and that the FDA continues to monitor all research related to BPA effects.
“The good news,” according to Dr. Anastasi, “due to rising concerns of BPA, plastic makers are now responding by producing a wide variety of BPA-free products. In addition, most food cans are no longer lined with BPA.” In our modern society, it is quite challenging to have a plastic-free kitchen but remember to always follow the manufacturers directions. Dr. Anastasi reminds all to be mindful of the recycle numbers on the plastic containers as a guide.
To contact or make an appointment with Dr. Larry Anastasi at his Margate office, newly relocated to 9501 Ventnor Avenue, call 609-823-6161.
Comments Off on Vascular Surgeon Dr. Matthew Lawrence, DO, FACOS, to Join Shore Physicians Group in January
Shore Physicians Group announced today that board certified vascular and general surgeon Dr. Matthew Lawrence has joined its surgical division in Somers Point and will begin seeing patients in January. Dr. Lawrence comes to Shore Physicians Group with more than 20 years’ experience in vascular and general surgery, serving most recently as a surgeon and faculty member at Hahnemann University Hospital and Drexel University College of Medicine.
Dr. Lawrence completed his undergraduate at Elizabethtown College and received his D.O. from the Philadelphia College of Osteopathic Medicine (PCOM). During his residency through PCOM he was named the H. Jefferey Tourigian, DO, Surgery Resident of the Year for three consecutive years. He maintains his certification as a Registered Physician in Vascular Interpretation, and is currently a member of the American College of Osteopathic Surgeons, the American Osteopathic Association, and the Society of Vascular Surgeons.
With extensive experience in endovascular surgical procedures using minimally invasive techniques, Dr. Lawrence is an expert in treating a wide range of vascular conditions. He specializes in treating leg pain and cramping from peripheral artery disease, venous insufficiency and other lower extremity arterial diseases as well as non-healing leg wounds, renal artery stenosis, hemodialysis access, carotid stenosis and aortic aneurysms.
Mark Stephens, chief administrative officer of Shore Physicians Group, says the addition of Dr. Lawrence will greatly expand its vascular surgery services.
“Dr. Lawrence is an exceptional and highly skilled vascular surgeon, particularly in complex endovascular procedures. His expertise in this area will help to make Shore Physicians Group’s Surgical Division a leader in treating patients with vascular diseases.”
If you would like to schedule an appointment with Dr. Lawrence, contact Shore Physicians Group’s surgical division at 609-365-6239. The office is located at 649 Shore Road, Suite O, across from Shore Medical Center.
Comments Off on Supplements Do You Really Need Them?
Have you ever stood in the vitamin and supplement aisle and felt totally overwhelmed by the rows upon rows of bottles claiming to help with every malady? These supplements are regulated by the Food and Drug Administration as food and therefore the labels may claim some health benefits. However, if you’re getting what your body requires from the food you eat, then these supplements may not be necessary. We spoke with Shore Physicians Group Hospitalist Dr. Sridevi Yangala to learn more about vitamins and supplements, when you should take them – and when to leave them on the shelf.
Vitamins in the diet
Dr. Yangala says that deciding which supplements are necessary should be determined on an individual basis with each patient.
“Vitamins are organic compounds essential for normal metabolism. They need to be ingested in the body since they cannot be synthesized in the body, with the exception of vitamin D, which comes into the body with the help of sunlight as it is made in the skin upon exposure to sunlight.”
In her opinion, Dr. Yangala says a healthy adult who consumes a well-balanced diet that includes a variety of fruits, vegetables, grains, nuts and dairy products does not need to take a multi-vitamin. But if a patient prefers to take one multivitamin tablet, it is not a bad thing.
Vitamins, as Dr. Yangala explained, are classified according to their solubility and are fat or water soluble. The fat soluble vitamins are vitamins A, D, E, and K. The water soluble vitamins are C and B complex. Water soluble vitamins are eliminated from the body through urine. Fat soluble vitamins are absorbed along with fat in the diet and stored in the liver and fatty tissue.
More is not always better
Vitamin A is generally not prescribed in developed countries like the United States since we get enough of it directly from the foods that we eat, like milk, butter and eggs. But is taking more of a vitamin a good thing? Not necessarily according to Dr. Yangala. “There is some evidence that higher Vitamin A intake is a risk factor in osteoporosis and fractures. So for patients who consume foods high in Vitamin A, there is no need for them to take a Vitamin A supplement.”
Vitamin D is a commonly prescribed fat soluble vitamin that helps in maintenance of skeletal health, preventing falls and osteoporosis. It also helps the body’s absorption of calcium. According to Dr. Yangala, calcium levels as well as vitamin D levels should be checked in high risk individuals that include post-menopausal women, elderly patients, those with limited exposure to sunlight and patients who have a known malabsorption problem, such as those patients who have had gastric bypass surgery, and supplement accordingly.
The recommended daily allowance of Vitamin D is 600-800 IU per day. The American Geriatrics Society and National Osteoporosis Foundation recommend 1000 IU per day for people 65 and above. “Several studies show that there is a reduction in the risk of falls in the elderly following Vitamin D supplementation. The World Health Organization identified an association between Vitamin D deficiency and an increased risk of colorectal cancer, and also cognitive impairment in Alzheimer’s dementia,” said Dr. Yangala. “Recommended blood levels of Vitamin D is about 30-40 ng/ml. There is a risk of Vitamin D toxicity if the levels exceed 60-80 mg.”
When it comes to calcium, the daily recommended intake for individuals under the age of 65 is 600-800 mg. That amount increases to 1000 mg daily over the age of 65. Dr. Yangala said for women 50 and over and men over 70 it is recommended they take up to 1200 mg/day, including any calcium derived from their daily dietary intake.
She suggested patients look at their diet and see how much calcium they are getting and added, “There is no need for additional calcium supplements if they are getting adequate calcium via diet.”
Vitamin C may not cure the common cold but it is touted as protection against immune system deficiencies, eye disease and skin wrinkling, but again, too much is not a good thing. Dr. Yangala said that excess vitamin C can lead to kidney stones.
Vitamin B 12 is naturally found in animal products only. The only source for people on a vegetarian diet is the milk and fortified cereals. Deficiency causes anemia, neuropathy and gait problems. Vitamin B 12 supplementation is necessary in people on vegan diets as well as those who had bariatric surgery.
Antioxidants
“We come across the word antioxidant in the health and nutrition world but most people do not know what they are. The most common nutritional antioxidants are Vitamin C, Vitamin E, and Beta Carotene,” said Dr. Yangala. She pointed out that “free radicals” is another buzz term in the world of health and nutrition that most people are not quite sure what they are. “Free radicals are formed in the body and have been linked to cancer and premature aging. The antioxidants neutralize these free radicals and prevent cellular damage.”
Get what you need from food
“I would not recommend supplements to my patients,” said Dr. Yangala. “My advice: eat plenty of fruits and vegetables, yellow and orange fruits and veggies, green leafy vegetables, citrus fruits, tomatoes, nuts, oils, fish, seeds and all types of berries.” She suggested getting antioxidants from certain flavonoids like cocoa and dark chocolate.
The few supplements that Dr. Yangala did suggest would be glucosamine and chondroitin daily because it has been shown to have positive effects in delaying the progression of osteoarthritis of the knee. She added that there is limited evidence that turmeric may provide some relief of osteoarthritis. Dr. Yangala did say that patients who suffer with anemia or a low blood count will benefit from supplementing iron and that alcoholics will often need to take a Vitamin B and possibly folic acid because many tend to not eat a balanced diet.
Nutrient rich foods
Dr. Yangala suggested that before reaching for supplements, there are foods readily available that should provide what the body needs to remain healthy. Get the iron needed to fuel your body from oysters, white beans, soy beans, dark chocolate, liver, lentils, spinach and sardines. Vitamin B 12 is plentiful in beef, liver, chicken, fish, eggs, cheese and milk. Get the recommended dose from green leafy vegetables, salmon, liver, eggs, and legumes like lentils, beans, and chick peas.
Dr. Sridevi Yangala is a Hospitalist with Shore Physicians Group at Shore Medical Center in Somers Point.
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