Vitamin Information Center

Behavioral Patterns
MARTIN SIEPMANN
Forschungsverbund Public Health Sachsen-
Sachsen Anhalt e.V., Medizinische Fakultät,
Technische Universität, Dresden, Germany
martin.siepmann@tu-dresden.de
Definition
Behavioral patterns such as tobacco smoking, excess
alcohol consumption,  substance dependence, inappropriate
nutrition, lack of  physical activity, failure
to use safety equipment including automobile seat belts,
certain  sexual practices, and failure to follow preventive
guidelines and  disease screening are all associated
with elevated risk of disease or death. Causal conclusions
have been strengthened, dose/response relationships
have been clarified, the influence of many of these
behaviors on overall public health has been quantified,
and scientific guidelines have been formulated.
Basic Characteristics
Risk behaviors rarely occur in isolation, but cluster in
patterns that in combination influence a person’s risk of
disease. Thus, a sedentary life-style in industrial societies
connotes a pattern of mutually influencing behaviors
such as taking little exercise, eating foods of poor
nutritional value, consuming caloric drinks and possibly
also smoking cigarettes. While these factors do
not determine disease in an inevitable sense, they place
the person at elevated risk of  obesity, high blood
pressure, and subsequently of cardiovascular disease as
well as impairment of  musculoskeletal health. Other
unhealthful behavioral patterns include the connections
among smoking behavior,malnutrition, and drug taking,
and those among  alcoholism, aggression, violence
and suicide. Each of these patterns is reinforced
by membership in a social milieu that brings similar
people together, as well as by individual personal traits.
Each pattern also trends to correspond to personal values
and beliefs, which form the connection between
behavior and culture.
Two general explanations have been suggested for
unhealthy behavior. The first theorizes that some people
are unaware about the harmful effects of substance
abuse, smoking and obesity. An alternative explanation
emphasizes that people engaging in unhealthy behaviors
do not correctly weigh the health/lifestyle pros and
contras regarding these behaviors (Wagner et al. 2005).
It seems doubtful that the first explanation is reasonable.
For example, virtually all women and most
men recognize that lowering weight is desirable from
a health perspective. While it is clear that obese people
often differ in their energy metabolism from thin
people, it is also obvious that some of the obesity in
the developed countries results from eating foods considerably
in excess of the amount that is known to be
healthy. The attempt to control food intake by dieting is
nearly universal at some point in the lifetime of women
in the US and Northern Europe. Studies of incoming
college freshmen women demonstrate that only 8–13%
of women do not adhere to a diet (Krahn et al. 1992).
With the median age of onset of dieting close to age 12,
it is unlikely that the message is not getting to young
women or is reaching them too late (Drewnowski and
Hann 1999). Whether food preferences reflect dietary
habits is an interesting issue. Data from epidemiological
studies suggest that food consumption patterns show
parallel influences of age, sex, health status, education,
and income (Harnack et al. 1997). Generally, age influences
both food preferences and food intake patterns in
the direction of more healthful diets (Block and Subar
1992).
In the area of substance abuse, there is even more
convincing data, documenting that knowledge is not
the key problem. Studies of several school-based substance
abuse prevention ( prevention and health promotion)
programs found that these programs definitely
increased student’s knowledge regarding the health
risk of these substances but, unfortunately had no effect
or even increased the rate of substance abuse (Hansen
1992). Therefore, it appears unlikely that a simple lack
of knowledge is what prevents people from avoiding
harmful behavior.
Another area of research has examined the tendency to
novelty seeking. For example, many adolescents begin
smoking as novel behavior that seems to offer relief
from thinking they are not as “with it” (Pomerleau et al.
1992). People who evidence early alcoholism are significantly
higher on the dimension of novelty than are
other individuals (Cloninger 1987). At the other end
of the spectrum are those who are focused on avoiding
harm (Harkness et al. 1995). Those high in novelty
seeking and low in harm avoidance are thought to
be most impulsive. People who are highly impulsive
tend to be vulnerable to the short-term rewards offered
by many high-risk behaviors (Newman and Wallace
1993). In a laboratory reward versus risk situation,
highly impulsive people behave more quickly and give
themselves less time to consider options. Behavioral
intervention programs aim at introducing some delay
in decision-making, so that the participants have some
time to reflect on short-term benefits versus long-termharm.
Cross-References
 Alcoholism
 Disease Screening Practices
 Musculoskeletal Health
 Obesity
 Physical Activity
 Prevention and Health Promotion
 Sexual Practices
 Smoking Behavior
 Substance Dependence
 Suicide
References
Block G, Subar AF (1992) Estimates of nutrient intake from
a food frequency questionnaire: the 1987 National Health
Interview Survey. J Am Diet Assoc
Cloninger CR (1987) Neurogenetic adaptive mechanisms in alcoholism.
Science 236:410–416
Drewnowski A, Hann C (1999) Food preferences and reported
frequencies of food consumption as predictors of current diet
in healthy women. Am J Clin Nutr 70:28–36
Hansen WB (1992) School-based substance abuse prevention:
a review of the state of the art in curriculum, 1980–1990.
Heal Educ Res 7:403–430
Harkness AR, Tellegen A, Waller N (1995) Differential converge
of self-report and informant data for multidimensional personality
questionnaire traits: implications for the construct
of negative emotionality. J Personality Assess 64:185–204
Harnack L, Block G, Lane S (1997) Influence of selected environmental
and personal factors on dietary behaviour for chronic
disease prevention: a review of the literature. J Education
Nutr 29:306–312
Krahn DD, Kurth C, Demitrack M, Drewnowski A (1992) The
relationship of dieting severity and bulimic behaviors to alcohol
and other drug use in young women. J Subst Abus 4:341–
353
Newman JP, Wallace JF (1993) Psychopathy and cognition. In:
Kendall PC, Dobson KS (eds) Psychopathology and cognition.
Academic Press, New York, NY, pp 293–349
Pomerleau CS, Pomerleau OF, Flessland KA, Basson SM
(1992) Relationship of tridimensional personality questionnaire
scores and smoking variables in female and male smokers.
J Subst Abus 4:143–154
Wagner N, Meusel D, Kirch W (2005) Nutrition education for

(NaturalNews) Women who do not get enough vitamin D while pregnant place their children at increased risk for tooth enamel defects and early childhood tooth decay, according to a study conducted by researchers from the University of Manitoba, Canada, and presented at the General Session of the International Association for Dental Research in Toronto.

Researchers measured the vitamin D blood levels of 206 women in the second trimester of pregnancy. Only 10.5 percent had sufficient levels. Of 135 infants studied, 21.6 percent suffered from enamel defects, and 33.6 percent suffered from early childhood tooth decay.

While low maternal vitamin D levels were correlated with enamel defects, this correlation did not reach statistical significance. Insufficient maternal vitamin D was also correlated with higher levels of early childhood tooth decay, a relationship that was found to be statistically significant. The researchers also found that infants who had enamel defects were more likely to go on to have early childhood tooth decay than children with healthier enamel.

The study was funded by Dairy Farmers of Canada, the Dentistry Canada Fund, the Manitoba Institute of Child Health, the Manitoba Medical Service Foundation and the University of Manitoba. The researchers warned that because 90 percent of study participants were urban aboriginal women, caution should be used in generalizing the study’s results.

Vitamin D is naturally produced by the body upon exposure to sunlight. It is essential in helping the body absorb calcium, a critical component of healthy bones and teeth. Recent research has also suggested that the vitamin might play critical role in the health of the immune system, and may help prevent not only osteoporosis but also high blood pressure, cancer and certain autoimmune diseases.

The average light-skinned person can get enough vitamin D from 15 minutes of sun on the face and hands each day, while a darker-skinned person needs twice as much. This may not be sufficient for people living in extreme latitudes, however, especially during the winter.

Sources for this story include: www.washingtonpost.com; www.reuters.com.

Question: I take an antibiotic every day (Septra) because I get chronic urinary tract infections. I also take a diuretic (Lasix) for high blood pressure. In the last few months, I have felt depressed and developed weird nerve pain in my hands and legs. Could it be my medicine? What can I do for this? The doctor wants to put me on Lyrica for the nerve pain and Wellbutrin for the depression. J.A., Orlando, Fla.

Answer: This has vitamin B6 deficiency written all over it. Your antibiotic and diuretic may be the source of your misery because both of those medications are drug muggers of vitamin B6. A drug mugger is a drug that mugs your body of a vital nutrient, reducing natural levels of your vitamins or minerals. In this case, sulfa antibiotics and water pills may have caused a B6 deficiency. The end result leaves you stressed out, tired, depressed, irritable and more prone to heart disease.

This vitamin is so effective at boosting mood, I often suggest it to women who have PMS issues, particularly breast tenderness, depression or tearfulness. Try about 50 to 100 mg per day, two weeks before your cycle begins. B6 protects your nerves, too, and a deficiency may
cause weird neurological sensations like pins and needles, numbness, even carpal tunnel
pain. Other medications on the drug mugger list for vitamin B6 include HCTZ, Vaseretic, Dyazide, Maxzide, Evista, hormone replacement drugs containing estradiol and birth control pills.

So what can you do? Put these vitamin B6-rich foods on your plate: spinach, greens, baked yellowfin tuna or cod, cauliflower, beans, bananas, raw celery, asparagus, broccoli, garlic, turmeric, watermelon and nuts.

By Jean Carper
Anti-Aging Expert, Best-Selling Author and USA Weekend Columnist
Vitamin D is the hottest nutrient in medical circles now. It has been credited with fighting everything from cancer to chronic pain. The latest news:

Cuts heart attacks. Men with low levels of vitamin D are about two times more apt to suffer a heart attack than men with sufficient D, Harvard researchers say. Their theory: Vitamin D lessens inflammation, high blood pressure and vascular calcification, all factors in cardiovascular disease.

Curbs cancer. A research team at the University of California-San Diego says that 2,000 IU of vitamin D daily could reduce breast cancer rates by half and slash the risk of colon cancer by two-thirds.

Prevents diabetes. Men with blood richest in vitamin D were 72% less apt to develop type 2 diabetes after age 40 than men with the least vitamin D, says a new Finnish study.

Boosts brain. Older people with depression or dementia may benefit from extra vitamin D, Dutch researchers say. Men and women over 65 with major or minor depression had 14% lower vitamin D levels than their non-depressed peers. And among Alzheimer’s patients, those with higher vitamin D levels scored better on tests of cognitive function.

RELATED PRODUCTS: Our Multi Nutrient Formula contain 1,000 IU of vitamin D. In 2007, we increased the amount in our formulas from 600 IU to 1,000 IU, in response to research indicating that the RDA for vitamin D is far too low for most adults.

A friend recently told me about how his uncle had heard that garlic could help lower his high blood pressure. So the uncle generously added garlic salt to his diet.

A little knowledge can kill you.

A similar misunderstanding appears to be spreading about vitamin D. More and more people are realizing that they are lactose intolerant. So they eliminate milk from their diets.

People also are worried about sun exposure and skin cancer, so they slop on sunscreen whenever they go out or otherwise avoid direct sunlight. And mercury is scaring folks away from eating fish.

As a result, some people are losing all sources of vitamin D. For the first time in a century, doctors are seeing a resurgence in rickets, that bone-deforming disease once endemic to wobbly-kneed child laborers in the Victorian era who never saw the light of day.

Pediatricians in Philadelphia have reported more than 150 new cases in the past three years, up from about zero. Washington, D.C., and other areas with large African-American populations are reporting the similar increases.

No formal studies have found the precise cause of the rickets — be it less milk consumption, less sun exposure, or other factors — but it does appear that Americans in general aren’t getting enough vitamin D.

Vitamin Q and A

Vitamin D is a complicated essential micronutrient. The National Institutes of Health convened a panel of experts last September to establish nutritional guidelines. As revealed in the official meeting proceedings, published in the August 2008 issue of the American Journal of Clinical Nutrition, they couldn’t come to any consensus. The published overview is essentially a collective shrug of the shoulders.

Vitamin D is crucial for calcium metabolism — namely, the making of strong bones — and likely for immune function, heart health, cell proliferation and cancer and diabetes protection, at a minimum. An independent study from Johns Hopkins University, published in the current issue of the Archives of Internal Medicine, associated lower levels of vitamin D in the blood with a higher risk of death.

Yet the experts couldn’t agree to any details. The current recommendation is to get 400 IU of vitamin D daily. Many say this isn’t enough, but no one knows how much more is too much.

Complicating issues further is the fact that vitamin D is the only nutrient that can be made entirely in the skin upon exposure to sunlight, yet this varies greatly with skin color and latitude. It’s hard to assess your daily dose. Few foods other than fish contain vitamin D. Milk is fortified with it, but you need four glasses to get 400 IUs.

Out of Africa

Lighter skin is more efficient at producing vitamin D. So African-Americans are at a double disadvantage for synthesizing vitamin D from sunlight — in the United States. Their darker skin blocks the ultraviolet light that triggers this chemical reaction. In their native lands, closer to the equator where sunlight is more direct, their darker skins would have enough sun exposure to synthesize vitamin D.

Peoples in high northern latitudes, such as Europeans, slowly developed lighter skin over tens of thousands of years to adapt to the weaker sunlight to generate enough vitamin D to survive. African-Americans forced migration from Africa occurred over a period of only a few hundred years.

Also, most African Americans — and most of the world, actually — are lactose intolerant and cannot digest cow milk well. So many do not drink enough milk. Natural sources of vitamin D include cod liver oil (as if anyone can stomach this, let alone find it outside their great-grandmother’s cupboard) and salmon and mackerel (tasty, but expensive).

In Philadelphia many rickets cases involve children of Black Muslims, and the culture of conservative clothing likely played a role.

Yet doctors wonder whether the African-American communities are providing a warning call for all of America, as kids of all races drink less milk, the primary albeit artificial source of vitamin D for most clothed, non-farming residents of North America.

Killer rays

More sunlight isn’t the answer. Humans evolved to frolic naked in the sun but also to live about 30 years or so in Africa. Take your fair skin better suited for Scandinavia and place it in Miami for several summers, and you’re going to get skin cancer.

Regardless, for latitudes north of New York City, and considering how people bundle up during winter, there’s not enough sunlight year-round to satisfy the daily vitamin D requirement.

Milk fortification works well. But all vitamin D supplementation and fortification is essentially created equal. Look for new vitamin D recommendations later this year that try to make sense of the ambiguous NIH report.

Chronic kidney disease patients may see their risk of death drop by one quarter if they take a form of vitamin D, a new study says.

In a study of more than 1,400 people with chronic kidney disease, those that were taking the drug calcitriol, a form of activated vitamin D, had a 26 per cent reduction in their risk of death versus those who were not on the drug. Overall, the patients on calcitriol had their risk of either death or dialysis due to a loss of kidney function fall by 20 per cent.

The study is published in the Journal of the American Society of Nephrology.

A healthy human body uses first the liver and then the kidneys to convert vitamin D obtained through diet and sunlight into an active form that the body can use. However, it is believed that patients with chronic kidney disease are unable to do complete the second step.

They are often prescribed activated vitamin D to help lower elevated levels of the parathyroid hormone, which can lead to a weakening of the bones. However, people with kidney disease often suffer from calcified, or stiff, blood vessels, which can lead to a host of cardiovascular problems. Vitamin D increases calcium levels in the blood, which doctors fear could exacerbate this problem.

“We did find that people who got the activated vitamin D drug did have a higher risk of having a high calcium level in the blood,” study author Dr. Bryan Kestenbaum of the University of Washington told Ctv.ca.

“But the overall amount of people that that happened to was relatively small, and the overall balance was that people who got the activated vitamin D drug survived longer.”

Kestenbaum speculated that vitamin D leads to decreased mortality rates because of its known ability to lower risk factors for cardiovascular disease, including high blood pressure, diabetes and inflammation.

He said that the next step in this field of research would be to conduct randomized clinical trials to confirm vitamin D’s effect on survival rates among patients with kidney disease.

ATLANTA, April 14 (UPI) — U.S. researchers say they are learning how vitamins and minerals can stimulate or prevent the development of colon cancer.

Emory University researchers in Atlanta find in a study of 92 patients that supplementing a diet with calcium and vitamin D appears to increase the levels of a protein call Bax — which controls programmed cell death — that may push pre-cancerous cells to self-destruct.

In another, 200-patient, case-control study, led by Dr. Robert Bostick of Emory University, high levels of calcium and vitamin D together are associated with increased levels of E-cadherin, which moderates colon cells’ movement and proliferation.

A third study on the same 200-patients shows high levels of iron in the diet are linked to low levels of APC, a protein whose absence in colon cancer cells leads to their runaway growth.

All three studies — scheduled to be presented at the American Association for Cancer Research meeting in San Diego — use colorectal biopsy samples and are part of a larger effort to identify a portfolio of measurements which taken together could predict the risk of colon cancer.

“We want to have the equivalent of measuring cholesterol or high blood pressure, but for colon cancer instead of heart disease,” Bostick says in a statement.

ATLANTA, April 14 (UPI) — U.S. researchers say they are learning how vitamins and minerals can stimulate or prevent the development of colon cancer.Emory University researchers in Atlanta find in a study of 92 patients that supplementing a diet with calcium and vitamin D appears to increase the levels of a protein call Bax — which controls programmed cell death — that may push pre-cancerous cells to self-destruct.

In another, 200-patient, case-control study, led by Dr. Robert Bostick of Emory University, high levels of calcium and vitamin D together are associated with increased levels of E-cadherin, which moderates colon cells’ movement and proliferation.

A third study on the same 200-patients shows high levels of iron in the diet are linked to low levels of APC, a protein whose absence in colon cancer cells leads to their runaway growth.

All three studies — scheduled to be presented at the American Association for Cancer Research meeting in San Diego — use colorectal biopsy samples and are part of a larger effort to identify a portfolio of measurements which taken together could predict the risk of colon cancer.

“We want to have the equivalent of measuring cholesterol or high blood pressure, but for colon cancer instead of heart disease,” Bostick says in a statement.

Want to live longer? Get moving

The report was published in the Journal of the American Medical Association.

In a 1996 survey, however, when 1,009 Americans were asked which of five foods–lettuce, asparagus, navy beans, brown rice, and oatmeal–provided the best source of cholesterol-fighting soluble fiber, many missed the mark. While Americans may know they need fiber, they aren’t getting enough fiber in their diets is an essential element of a healthy diet.Some fibers are soluble in water and others are insoluble. As it passes through the gastrointestinal tract, soluble fiber binds to dietary cholesterol, helping the body to eliminate it. Antioxidants help prevent cholesterol from being moved out of the blood and into the lining of the blood vessels.

Weight loss is reverting back to a fiber diet. Diets low in saturated fat and cholesterol and rich in fruits, vegetables, and grain products that contain fiber, particularly soluble fiber, may reduce the risk of coronary heart disease. The following is a guideline for your cholesterol levels. Acceptable blood cholesteral-180-199. Borderline high blood cholesterol-200-219. 220 or higher-then your blood cholesterol level is too high. If your total blood cholesterol level is greater than 200 (and especially if it is over 220), you should have another test to see what type of cholesterol is high. Fresh fruits, vegetables and unprocessed grain products such as whole-grain breads and cereals are naturally low in fat, cholesterol-free, but rich in starches and dietary fiber. Including more starches and fiber in your diet can help you lower your cholesterol level as well as reduce your risk for obesity, cancer, high blood pressure and other maladies.

This information will guide you towards a fiber rich liquid vitamin with a minimum of 4 grams of fiber per ounce. Do not ignore this, as it is the basis for good health and well being! Today’s liquid vitamin nutrition is essential for protecting you & your family against disease.