NIFS Healthy Living Blog

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

The Role of Vitamin D

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

Vitamin D and COVID

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

Study Shows Decreased Risk for Adverse Affects

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

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

Another Study Finds Lower Levels of Vitamin D in Hospitalized Patients

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

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

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

Correlation Is Not Causation

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

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

Vitamin D Recommendations

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

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

Here are some Vitamin D–rich foods:

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

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

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

The Bottom Line

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

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

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

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

We have all heard the old sayings about fresh air and how it affects your well-being. It usually comes in the form of sage advice and sounds like something you can take with a grain of salt, but is there truth to this advice? There are times in our lives when we might not even see the sun, whether it’s because of our careers, lifestyles, or by choice. Although these reasons may have validity, there is some very good research that supports outdoor activities as a viable way to improve your overall health.

Are You Making the Most of Your Time Outside?

Of course you go outside as part of your daily routine, but are you making the most of your time outside? How can you make that time more productive? The reasons for going outside are numerous, whether it be for work, hobbies, recreation, exercise, or relaxation.

Health Benefits of Being Outside

During the daytime, sunlight can have some positive impacts on your body such as Vitamin D activation (and its wide range of benefits, like helping with everything from osteoporosis to decreasing depression). Researchers at Harvard University have laid out five important health benefits from being outdoors:

• Vitamin D enhancement: Benefits include disease-fighting properties, weight-management properties, and mental wellness properties.
• Opportunities to exercise: Being outdoors allows for a higher probability for physical activity and putting your body into movement.
• Mood enhancement: Light and fresh air have been shown to improve your mood. Smiling more also doesn’t hurt!
• Concentration and focus: Fresh air has also been shown to help individuals living with ADHD.
• Healing: Some studies have shown that individuals who had surgery or were experiencing pain had a less stressful experience when exposed to sunlight and fresh air.

How to Get Outside More

There are many opportunities to immerse yourself in outdoor activity. Simply going outdoors for a walk around the block is a great way to get the ball rolling. As you grow your outdoor experiences, you can branch off toward the many facets of wellness and fitness. A bootcamp workout with friends, reading a book by the canal, and walking your dog are just a few of the activities waiting for you outdoors. Don’t limit it to yourself; include others and inspire them to go outdoors with you.

As the summer continues, being outdoors becomes a highlight of the day. At NIFS, going outdoors to exercise could not be simpler, especially with the abundance of space and scenery at your fingertips. Several classes offered at NIFS, including NIFS Bootcamp, take advantage of open space near and around the facility. For more information about NIFS and exercise opportunities, please feel free to reach us at fitness@nifs.org or through our social media.

This blog was written by Thomas Livengood, NIFS Health Fitness Instructor and Personal Trainer. To learn more about the NIFS bloggers, click here.

It’s safe to say that 2020 has been one a heck of a year (and it’s barely half over!)—the good, the bad, the ugly. At times, it’s felt as if an entire decade has passed. No matter how you slice it, the fact that we’ve experienced something as novel as a global pandemic still feels weird to say, think about, and sometimes fully appreciate. It has been a tumultuous time outside of COVID-19 as well, and every person has had a unique experience, a unique perception, and unique challenges along the way.

We’ve all probably learned a thing or two about ourselves. We’ve had time to reevaluate what is important to us, and maybe find a few things that aren’t. Here are just a few things I’ve left quarantine with, in no particular order:

My Quarantine Takeaways

• I needed to uncouple productivity from self-worth. In working from home, I found that I accomplished most tasks in spurts. I’d work for 2 hours straight, then go for a walk, then jot down ideas for projects for 30 minutes, then get in a lift, then eat while watching a show, and on and on. Other days I just wouldn’t have it—no juice, no gas in the tank. Responding to emails felt like a win. And then the eventual guilt would sink in. Why didn’t I do more? How is this all that I got done today, this week? After a few weeks of this cycle, I finally told myself, “STOP.” It’s okay that there are things left on your to-do list. Its okay that you’re not motivated every second of every day. What we lived through, and are still living through, is something that we have literally never seen or experienced (at least I haven’t!). So give yourself some slack, be a little more forgiving, and start each day fresh.
• My “best days” involved some semblance of structure. Don’t get me wrong, I love a little bit of spontaneity. But for much of quarantine, I found that my good days involved a level of consistency. When I woke up gradually with coffee and water, got a little bit of work done first thing, cleaned up the bedroom/loft, got in a workout, completed any errands like grocery shopping, blocked off time for reading, and got outside for some vitamin D, I felt energized. I felt accomplished. Obviously, there were variations. But blocking off time, working through chores and work intermittently, taking time for myself with activity and self-care—more often than not these days fell into the “good” category. On days where I had no schedule, stayed up too late and slept in too long, binged a TV show, or had little activity, I felt like garbage by the end. I can still hear my high school statistics teacher saying, “correlation does not imply causation,” but at least my chances for a good day skyrocketed with a little routine.
• The importance of “idle time.” Full disclosure: I’m not sure that working from home always meshed with my personality or temperament. I would check my email every five seconds, even though I just cleared my queue seconds before. I would write down three sentences, hear the ping of a new email dropping into my inbox, and lose my complete train of thought. I would sometimes go for a walk and feel myself getting tempted to check in. Like many of us, I’m already addicted to my phone, feeling incomplete if I leave a room without it (unhealthy, I know; I’m working on it). But I found that literally scheduling in time to do nothing did wonders for my focus. I wasn’t scatterbrained when I returned to writing or working on a project. In fact, just sitting doing nothing, or having a casual conversation with my housemates, seemed to just calm my nerves and anxious thoughts in general. Just 5-minutes of unplugged silence was powerfully calming as well. Moral of the story? Sometimes doing nothing is more productive than trying to do 42 things at once.
• The power of connection. I’m sure by this point, most of us have come to a conclusion similar to this, so I’ll keep it brief. You don’t need to be in close proximity to be close to those you love and appreciate. Some of my simplest joys came from FaceTimeing with family or having a quick phone call with a friend. It’s a quick recharge for the mental and emotional batteries.
• It feels great to make your bed first thing. It’s simple. It’s quick. It sets your day in motion on the right foot. And at the very least, you have a tidy place to come home to when you’re ready to hit the sack for the night. It just feels good.
• My mood is correlated to the amount of news and social media I consume. See #3 from above, and you’ll get the idea. A little news is okay. Knowing what is going on in the world around us is crucial in my mind. But the constant onslaught of “breaking news” hour after hour, minute to minute, is completely exhausting. When I limited my consumption to short periods, one stint in the morning (after coffee of course) and one in the evening, I found that my day’s trajectory was a lot more positive overall.
• Whether good or bad, this too shall pass. No matter how large my to-do list was, no matter how much uncertainty and worry crept into my thoughts, and no matter how cathartic a workout I had, every day came to an end eventually. Sometimes I found myself muttering “this too shall pass” under my breath when I would be feeling a particular amount of anxiety or stress. And you know what? It actually did help put things in perspective. Take the good with the bad, because it’ll all be over eventually one way or another.
• It's okay if you binged that show or played that video game. Hey, we’re all human. Don’t beat yourself up for indulging a little bit here and there! (Refer to #1 as well!)
• Take advantage of the sunny days. Growing up in Michigan, the second most cloudy state in the US (for real!), I had a bit of a head start on this lesson. But the pandemic sure as heck hammered it home. When it was a beautiful, sunny day, I made sure to get outside for some amount of time, even if it was only 20 minutes on the back deck in between meetings. It boosted my mood, calmed me down, and made me take a second to just have a little gratitude for the simple things.
• There is a feeling of zen I have when lifting. I know: this is an obvious one coming from a coach. But that’s also why I left it until the other insights had their time to shine. Everyone has their own interests, their own ways to unwind, and for me that is under a barbell or with a couple of dumbbells in hand. My brain shuts off, the music blares, and I can just get lost in it. If you haven’t found something, some activity that brings you a sense of calm, I highly encourage you to start exploring! Hobbies and interests shouldn’t be left by the wayside just because they’re not your main hustle.

Lessons We Will Take with Us

I’m sure that everyone will leave quarantine changed in some way, shape, or form. And the lessons you’ll leave with will be completely unique to your experience. Whether positive or negative, try to carry these into your life post-pandemic. Because more often than not, they’ll help you in the long run moving forward.

This blog was written by Lauren Zakrajsek, NIFS Health Fitness Instructor, Personal Trainer, and Internship Coordinator. To learn more about the NIFS bloggers, click here.

The glorious return to summer is upon us, and if you are like me, you will be spending as much time as possible soaking up sunshine as you take your leisure outdoors, take up hobbies in the yard and garden, and engage in group fitness bootcamp classes in the park. The sunshine feels good and has many benefits, including mood enhancement, vitamin D production, and even treatment for a number of skin conditions such as psoriasis and acne. There are, however, some dangers associated with extended sun exposure that can be limited with the use of sunscreen, most notably skin cancer.

Finding the Balance Between Healthy Sun Exposure and Overdoing It

After a long winter or even a rainy spring, predictably, we will want to get out and about on the very first day possible. The first exposures to the summer sun usually leave us with a surprisingly red glow, the first sunburn of the year. For some people, this sunburn is a rite of passage for the season. As I noted before, there are some dangers with overexposure to the sun that have more serious consequences than a simple sunburn. According to the Cleveland Clinic, skin cancer is the most common form of cancer, and the number of cases is on the rise. This cancer forms when prolonged exposure to the sun is accumulated over time.

The old saying “too much of a good thing” really resounds as we try to find the balance between healthy sun exposure and overdoing it. For many people, using sunscreen is a way to find a happy medium so that they can enjoy the outdoors. Scientists at Harvard have some healthy tips for those who may have reservations using sunscreen (such as developing acne and exposure to chemicals) and warn that the alternative to sunscreen usage is much, much worse. The biggest takeaway, though, is that sunscreen, by itself, will not be enough if limited prolonged overexposure to the sun is not your priority.

Tips for Staying Safe in the Sun

Here are some pointers that will take your sun safety to the next level.

1. Be aware of the dangers of overexposure. There are many sources to help educate yourself about these dangers and the ways you can limit and prevent serious damage to your body.
2. Sunscreen is good, but it’s not the only tool in the toolbox. You will also need sun-protective gear and clothing to stay safe.
3. Use sunscreen correctly. When using sunscreen, make sure you know the specific rating and reapply regularly.
4. Watch for skin changes. See your doctor if you develop any abnormal skin (always be safe, not sorry).

Prepare for Sun Exposure

Take time to treat your skin, your body, and your mind. We need sunlight to live, but we need to respect it. As we move into summer, more and more fitness classes are held outdoors. Make sure you are preparing for the sun. Ask your facility whether they provide sunscreen; NIFS provides stations at the entrances for your convenience.

If you have questions regarding health and wellness, NIFS staff members are available for consultation and can provide information regarding workout planning, fitness testing, and nutrition consultation with a registered dietitian. As always, muscleheads rejoice and evolve!

This blog was written by Thomas Livengood, NIFS Health Fitness Instructor and Personal Trainer. To learn more about the NIFS bloggers, click here.

Even though I grew up in a northern snow belt along the Great Lakes, cold weather is not my thing. In fact, I really don’t like anything about it. And often along with the winter blues comes a decrease in health and fitness due to the lack of motivation. To counteract that feeling, let’s look at ten tips that can help you be healthier this winter.

1. Work out. I know it’s easy to lose motivation to keep working out when it’s cold out, it’s dark by 5, and you have to put on your snow boots and warm up the car before going to the gym. But working out actually helps to build your immune system and keep you healthy. So make sure that you build those workouts into your schedule.
2. Eat well. It’s important to make sure that you stick to clean eating, especially through the holidays. All the additional sweets, snacks, drinks, and other goodies that come with the holidays are sometimes hard to resist; do your best to stay focused on your goals.
3. Drink lots of water. Being sure that you have proper hydration is always important regardless of the time of year. Carry around a water bottle everywhere you go and make sure you keep drinking.
4. Cover your head in outdoor workouts. If you do decide to work out outdoors, be sure to wear a hat or something to cover your ears. Making sure you stay warm and don’t catch a cold will be vital to your winter wellness success. (Here are some more tips for dressing warmly for winter workouts.)
5. Get some sun if possible. Studies show that getting your vitamin D is essential. If you can dress appropriately, try to get outside on a nice day or plan that beach vacation during the cold winter months.
6. Wash your hands. I know this is the standard thing you see in every public bathroom or on the back of the stall doors. But for real, wash your hands to help prevent you from getting the flu or other illnesses going around. Catching something could really set you back in getting in your workouts and healthy eating.
7. Set a goal for the spring. Have a goal in place as the winter months start so that you can keep it on the forefront as something to work toward.
8. Get a trainer or workout buddy. There is no better time to treat yourself to some additional accountability. Hire a trainer for the winter months or find that accountability partner to keep you in check!
9. Watch your intake. You must be mindful, especially around the holidays, of what you are taking into your body. Also, keep in mind that drinks add a lot of unwanted calories, so watch what enters the black hole!
10. Join something. The options are endless…group exercise, HIT classes, group training, a training program of some sort, co-ed sports…the list can go on. Find something you like and sign up to keep you engaged.

Whatever emotions the winter months may bring you, use these tips to be successful with your winter fitness and wellness!

This blog was written by Amanda Bireline, Fitness Center Manager. To find out more about the NIFS bloggers, click here.