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4A Daily News – Tuesday, July 17, 2012 Vitalityfitness health Confusion about Vitamin A and calcium By Barbara Quinn McClatchy Tribune Christine P. writes: "Dear Barbara Quinn, My question concerns A-vitamin. I am taking a multivitamin for women over 50 that contains a large amount of vitamin A beta carotene. I am con- cerned that this might be too much. I am 70 years old and in excellent health. case of smokers or asbestos workers who take it in high doses. What is confusing is that nutrition labels often list vitamin A in IU's (international units) while nutrition experts consider RAE's (retinol activity equivalents). And RAE's are different based on the source of the nutrient. (Confusing, yes?) I also take a calcium supplement plus vitamin D and other medications to lower my cholesterol and blood pressure. I am considering to drop the calcium supplement, I heard a new study does question the absorption of calcium into the bones. I would like to have your opinion on the vitamin A and calcium." & Man's eating disorder sheds light Dear Christine, my opinion is this: As much as we try to simplify nutrition recommenda- tions, they are really quite complex. Hence the fol- lowing: Vitamin A is actually a group of related com- pounds that are essential for good vision, immune function and reproduc- tion. In food, vitamin A is in two major forms: "Pre- formed" (retinol or retinal ester) is found in fish oils, liver, and dairy foods. "Pro-vitamin A" (alpha- and beta-carotene) is found in orange, yellow and leafy green vegeta- bles, tomatoes and fruit) and is converted to active vitamin A in the body. Dietary supplements may contain both forms of vitamin A and the label should tell you that. This is important because excess "pre- formed" vitamin A (retinol) can be toxic and has also been associated with an increase in bone fractures. On the other hand, beta carotene is rarely toxic except in the James W. Tysinger, Jr. M.D. Eye Physician & Surgeon Fellow American Academy of Ophthalmology We accept Medical, Medicare & most Insurances Office Hours: Tues-Wed-Thurs 8am-4:30pm Mon & Fri 1pm-4:30pm For Emergencies, After Hours, Week-ends, Call 530-567-5001 345 Hickory St. Red Bluff Tel: (530) 529-4733 Fax: (530) 529-1114 In general, if your dietary supplement con- tains more than 10,000 IU's of "preformed" vita- min A (often listed as retinol or palmitate), that's too much. Many supplement labels will also list what portion of the vitamin A content is in the safer form of beta carotene. Regarding calcium, you may be referring to the recent draft (not set in stone) document by the US Preventive Ser- vices Task Force (USP- STF) that specifically addresses the use of cal- cium and vitamin D sup- plements to prevent bone fractures from osteo- porosis in woman past the age of menopause. This task force con- cludes "with moderate certainty" that a daily supplement less than 400 IU of vitamin D-3 and 1000 mg of calcium car- bonate does not appear to prevent a first-time frac- ture from osteoporosis in older women. And there is not enough evidence to support taking more than these amounts either. However ... this draft report says there is good evidence that vitamin D supplements can help prevent falls (that can lead to fractures) in peo- ple over the age of 65. Adequately confused? It's a good reminder to look closely at who and what is being studied. Better yet, get the advice of a nutrition profession- al who can personalize your dietary needs according to your unique health and medical con- cerns. Barbara Quinn is a registered dietitian and certified diabetes educator at the Community Hospital of the Monterey Peninsula. Email her at bquinn@chomp.org. CHICAGO (MCT) — Rob hated to run. But he hated to stop even more. That's when his dis- paraging inner voice, the one that had belittled him since seventh grade, would emerge. If he didn't keep going, it said, he was going to get fat. He would never have the shredded abs that taunted him from every fit- ness magazine. He would be just a regular guy _ not the superman he felt driven to become. even six hours a day of exer- cise weren't enough to quiet the voice, he started skip- ping meals too. While anorexia, bulimia and other eating disorders are potentially lethal — up to 5 percent of those suffer- ing from them die from sui- cide, substance abuse or medical issues, according to a study published in the American Journal of Psy- chiatry — they have tradi- tionally been viewed as women's problems. Researchers say only 10 percent of those who are treated for the conditions are male. So on he ran. And when evidence suggests that num- ber is misleading. A study published last year estimat- ed that males actually make up 40 percent of teens who have eating disorders. An earlier Harvard survey found that men account for 25 percent of adults with anorexia and bulimia. Some therapists say more men and boys are seeking help. Niquie Dworkin, who practices on the North Side, said males have been tormented by the same kind of unattainable body images that have long plagued women and girls. "Action figures used to look normal," she said. "Now they're superhuman with really cut abs and real- ly big shoulders. Even little boys are being exposed to images of men that are not realistic." But a growing body of While eating disorders in men and women appear to have similar roots in genet- ics, media messages, per- fectionism and low self- esteem, the symptoms are often different. Experts say one big contrast is that men usually focus on musculari- ty, not thinness, and they tend to manage their weight by working out to incredible extremes. self for his suffering with a giant piece of pie. MCT photo This 2009 photo shows Rob when he was very sick with both eating and exercise issues. Photo was taken in Florida when he was running about 2 hours a day. schoolmates mocked him for supposedly being fat. Vowing to gain the same kind of lean, athletic physique one of his tormen- tors had, he started doing 100 pushups a night. He then moved to the weight room, and when he entered high school, the cross-coun- try team. His parents were delight- ed. The other runners were laid-back, friendly and sup- portive, and Rob's grades improved after he joined the team. He cut junk food from his diet and worked out with a vengeance. Not even a downpour could keep him from his training. "All the way around, it seemed like a really good thing," Rob's mother recalled. "We didn't think anything of it." dread. skip a workout or ease up on its intensity, even when he was sprinting at a 4-minute- mile pace on a treadmill set to a 12 percent incline. If he backed down, his inner voice told him, something indefinably bad would hap- pen. But it was far worse to So he absorbed the pain, and after noticing an odd relief in hunger, he began skipping meals too. Master- ing his body allowed him to feel as though he could manage a life that had become lonely and socially awkward. Rob's family, long in denial, knew he was in trou- ble. He knew it too. But even though he had begun to see a therapist, it was eas- ier to follow his compul- sions than resist. "We would have these breakthrough moments where he would say, 'I know I have a problem, but I'm not ready to give it up yet,'" his sister said. "I always knew when he stopped call- ing that he was getting worse. Because then he wasn't ready to hear it." In November 2011, Rob sustained another leg frac- ture, the result of what doc- tors said was a lack of calci- um in his bones. Though he was ordered to rest for a month, he became so fren- zied from inactivity that he grabbed his crutches and did hobbled laps around his parents' kitchen table. It turned out to be his moment of clarity. He called the eating disorders recov- ery center at Alexian Broth- ers Behavioral Health Hos- pital in Hoffman Estates, Ill., and had himself admit- ted. When Rob healed enough to run, his routines grew ever more punishing, his body ever lighter _ sometimes dipping below 100 pounds on his 5-foot-7 frame. A photograph taken of him at a swimming pool in July 2009 shows deep hollows beneath his cheek- bones. Striated ropes of muscle press through his skin. His arms and legs appear as thin and brittle as sticks. Almost imperceptibly, though, his routines grew longer. A coach at a sum- mer running camp preached maximum effort — when you're not running, another guy is, and he's going to beat you — and Rob took it to heart. By the time he was a senior, he made excuses to leave practice early so he could work out even harder alone. That's what happened with Rob, 24, a young man from Elgin, Ill., who asked that his last name not be used. Experts said his case was typical of men with eat- ing disorders. His trouble began at age 14, not long after bullying "I wanted to make a name for myself, be some- thing," he said recently. "Working harder than any- one else in the group made me better. That's what I thought." Strange thing, though: Rob didn't care that much about winning races or set- ting records. He didn't really even like running. Thinking about the hours of exercise that awaited him after school filled him with JOIN THE NEW GENERATION OF GOOD LISTENERS Wednesday July Every 18 & 25 Daniel Le Grange, direc- tor of the eating disorders program at the University of Chicago Medical Center, said it's common for people who suffer from the disor- ders to express a desire for control and self-affirmation. But any contentment that emerges from starvation and hellish exercise doesn't last long, he said. "We have patients who are bleeding because they're on the carpet doing a thou- sand pushups and situps a day," he said. "It never gives you that feeling that you're yearning for, that you feel good about yourself." Rob's intense exercise led to stress fractures, and he decided not to join the cross-country team when he went to college in fall 2006. But he didn't let up on his body. Instead he rose at 6 a.m. for a quick breakfast before heading to the gym for a four-hour workout, includ- ing 90 minutes on an ellipti- cal machine and an hour of weights. In the afternoon, after skipping lunch, he walked for two hours before doing repeats on the library steps. He picked at his din- ner before rewarding him- eventually convinced Rob that he needed to change. He yielded to the program and spent a few weeks putting on weight before transferring to Rogers Memorial Hospital near Milwaukee, home to a rare males-only eating disorders program. Therapy and reflection excavate the psychological turmoil that lay beneath his behavior — the desire for control, the need to feel spe- cial, even the fear of becom- ing an adult — and reset his mind and body to healthy habits. His task there was to In his three months at Rogers, Rob said, he learned to take a more real- istic view of himself and gain more control over his eating and exercise habits. He put on about 45 pounds in treatment and now fol- lows a diet worked up by a nutritionist, dining at appointed times even if he isn't hungry. He works out cautiously, lifting weights with his father lest he get carried away. On a recent Sunday morning he went for a slow walk around the block, the only form of cardiovascular exercise he allows himself. Lic. #525002331 TUESDAY, JULY 24, 2012 • 6:00PM Lassen House Assisted Living & Memory Care EDUCATIONAL SEMINAR Alzheimer's Association Discussing: Approaches To Communication And Challenging Behaviors Speaker: BECKY ROBINSON Director, North Valley Area 705 LUTHER RD., RED BLUFF, CA 96080 (530) 529-2900 705 Luther Road • Red Bluff • (530) 529-2900 www.Emeritus.com redbluff.mercy.org www.redbluff.mercy.org Pine Street Plaza 332 Pine Street, Suite G Red Bluff, CA Stacy L. 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