A girl smiling at the camera drinking milk in front of a hedge

Are Vitamin D supplements needed in winter?

Many of us may know that vitamin D is important for keeping our bones and teeth strong as it helps us to absorb the calcium in our foods.  However, it is lesser known that vitamin D plays a crucial role in managing our immune system and because of this it is protective against respiratory infections like coughs and colds.   It has also been suggested that vitamin D can be protective against covid 19 – but science behind this isn’t established yet.

As such the government advises that everyone over 4 years to take a supplement of vitamin D3 of 10 micrograms μg (400 IU) per day during winter.

Why the winter months?  Because the majority of vitamin D is produced in our skin after sun or UV light exposure, and we all know we have less of that during winter!  Additionally, while some foods contain vitamin D there aren’t any foods rich in vitamin D.

A positive side effect of sunbathing is that it boosts your vitamin D levels.  But, you don’t need to sunbathe to produce vitamin D, it is produced on a sunny day on any exposed skin – our faces, arms and legs.  

Unfortunately, using sunscreen or sun block stops us producing vitamin D.   Melanin, the brown pigment in our skin, also stops us making vitamin D.  So, the darker your skin tone the less vitamin D you produce and the more likely you are to be deficient. Furthermore, if your skin is covered by clothing, you don’t tan and you don’t make vitamin D either.  

There are foods that provide some vitamin D in our diets, examples are

  • oily fish – such as salmon, sardines, herring and mackerel
  • liver (avoid liver if you are pregnant)
  • red meat
  • egg yolks

Fun fact:  mushrooms left with the brown gills facing upwards on a sunny windowsill for a few hours also make vitamin D!

A recent study showed that all babies born in the UK in winter are vitamin D deficient.

So, it seems that there is something in the age old tradition of taking cod liver oil to ward off colds!  And if you don’t like cod liver oil it is wise to take that daily 10 μg (400 IU) vitamin D3 supplement.

Previous Topic of the Month

Topic of the Month - How to make “Fortified Milk”

If you have had unintentional weight loss or are struggling to eat enough to maintain your weight, fortifying your milk is an excellent way to help you consume more energy and protein. 

By fortifying your milk, you can increase your protein and energy intake, without needing bigger portions of food. 

1.    Add 4 tablespoons of dried milk powder e.g. MarvelTM, Plus pintsTM or supermarket’s own brands, to a splash of milk and mix into a paste

2.    Stir in the rest of the 1 pint of whole milk and mix well. Stir it again before each use.

Skimmed milk powder is usually found with the same aisle as long-life milk or eggs in supermarkets. If you don’t consume dairy products, you can use soya milk, fortified with soya milk powder. 

Fortified Milk can be used to make:

  • Coffee, hot chocolate and malted milk
  • Porridge or add to breakfast cereal
  • Custard or other milk puddings. 
  • White sauces, cheese sauce
  • In mashed potato 

You can find a link to a video recipe here: https://www.nelft.nhs.uk/waltham-forest-nutrition-dietetics-nutrition-support  

Find out more ways to support your nutritional intake here: https://www.nelft.nhs.uk/waltham-forest-nutrition-dietetics-nutrition-support  

Topic of the Month - Healthy Packed Lunches

Packed lunches can be easy, healthy and exciting!

Top Tips:

  • Variety : Lots of foods can be used to make a packed lunch varied and tasty
  • Healthy : Try and make healthier choices more often and limit snacks high in sugar, salt or fat.
  • Balance: Remember to include something from each of the main food groups, as well as water, and you’ll not only have a meal to look forward to, but a lunchbox packed full of all the right nutrients to fuel your body for the rest of the day.
  • Food Safety: Remember to keep your lunch cool and safe use a cool bag, an ice pack or freeze a carton of juice and place it with food to keep cool. Keep lunch in the fridge until morning if you make it the night before. Don’t store your lunch next to a radiator or in direct sunlight.

Carbohydrates and Fibre

One of the most important foods for a balanced diet is carbohydrates. Often people think carbohydrates are bad, but they should make up just over a third of the food you eat.

Carbohydrates help with concentration, memory and performance. They also provide fibre, calcium, iron and B vitamins. Including different food containing carbohydrate in the diet gives you lots of opportunities to eat fibre. Fibre helps your bowel function, gut and digestive system, and helps you to feel full after your lunch. Here are some easy ways to include carbohydrates in your lunches:

  • Bread: Try keeping a selection of breads in the freezer for sandwiches and choose wholegrain options. Using different breads can make sandwiches more interesting. Try pitta, bagels, seeded loaves, wholemeal chapati, roti, parathas and multigrain rolls. Why not dunk bread into soup
  • Potatoes: You could cook a couple of extra jacket potatoes at dinner time or the night before work. Pack them up with tasty toppings and reheat in the microwave. Remember the skin is the most fibrous part - and is tasty! Sweet potatoes are also full of healthy fibre and other nutrients.
  • Pasta, rice, couscous: These are cheap and easy to prepare. Wholegrain varieties contain more fibre. Add these into soup or a salad, or stuff or fill cooked peppers, potatoes or aubergines. For example, couscous, leftover chopped veggies, meat or alternative, seeds and a lemony dressing
  • Beans and other pulses are a source of fibre, especially paired with jacket potatoes at lunch. Try adding other canned beans to your lunch box, Try baked beans or Mexican chilli on a jacket potato, chickpeas in your salad, soups, lentils in curry, and hummus (chickpeas) in sandwiches.
  • Nuts and seeds: Add these to your salads to bring texture, flavour, fibre and crunch to your lunch.

Top Tip: Be mindful of how much butter spread or mayonnaise you use and opt for less Spread only one side of the sandwich or try something new like using hummus as an alternative.  

Fruits and vegetables

Try including a variety, as different fruits and vegetables will give you different types of antioxidants. Fruit and vegetables may reduce your risk of heart disease, stroke and some types of cancer. Here are some ideas to include them at lunch:

  • Sandwiches: Add cucumber, lettuce, tomato or avocado.
  • Salad is a great way to eat more vegetables at lunchtime. Add a dressing, hummus, pieces of chicken, baked tofu, dried fruits, seeds, butter beans, cheese, cottage cheese, or cream cheese to make it exciting.
  • Cooked vegetables can be enjoyed in a soup in a flask or pack sliced raw vegetables e.g. carrot sticks, peppers, cucumber, cherry tomatoes. These can be great for dipping in hummus, guacamole or cottage cheese.
  • Fruit: Pack an apple, grapes, banana or kiwi fruit. Opt for dried fruits such as raisins or apricots. Tinned fruit in natural juice is a great option as the fruit is always perfectly ripe. Tie your lunchtime fruit in with plain yoghurt – it’s a healthier alternative to ready-made fruit yoghurt.

Top Tip: Salads and dressings: Making your own dressing. Using a teaspoon of olive oil with vinegar and herbs is a healthy way to dress your salad. Oily fish such as Salmon or mackerel, avocado or hummus are delicious options to incorporate healthy fats.

Protein

Protein is essential for the growth and repair of our body. Here are some options for both animal and plant-based protein. Try to include beans, pulses, eggs, nuts, fish, dairy and lean meat in your lunchbox such as:

  • Beans in salads and soups, lentil soups, dahl with roti bread or wholemeal wraps, hummus in salads or on sandwiches, peas in pasta/soup. 
  • Greek style or plain yoghurt, peanut (or another nut) butter, quark or cottage cheese with fresh fruit and nuts.
  • Tuna, salmon or sardines seasoned with herbs or spices with bread or pasta, or with a salad containing cucumber, pepper, sweetcorn, tomato or greens.
  • Seasoned chicken, turkey or minced meat kebab paired with bread (wholemeal, wraps, chapati) or pasta, couscous or salad (cucumber, pepper, sweetcorn, tomato or greens) Add hard-boiled eggs to your lunchbox. Omelettes can be enjoyed cold in sandwiches, or try making egg fried rice to pack into your lunch box.
  • Plant-based options aren’t necessarily a healthy choice. Mock meats contain protein but may be packed with salt, additives, and fat - check food labels.

Dairy

Milk and dairy products, such as cheese and yoghurt, are sources of protein and calcium. They can form part of a healthy, balanced pack lunch. Here are some ideas:

  • Cheese in soups, sandwiches, salads (green salads or pasta /rice salads) is a good way to add protein and dairy. Vary cheeses often in your lunch. Try soft cheeses like Brie or camembert, goat milk cheese, or soft, blue-veined cheese, such as Roquefort.
  • Many plant-based alternatives to dairy products in the UK are fortified with calcium - find out more in our Calcium fact sheet. Calcium - British Dietetic Association (BDA)  
  • Check the labels on yoghurts - sometimes they have lots of sugar, especially if you choose low-fat yoghurt. Plain yoghurt with fresh fruit is a healthier option. Rice pudding is also a tasty and easily-packed lunch dessert.

Snacks  

Don't make certain foods "off-limits", just try and make healthier choices more often. If you opt for high sugar, salt or fat snacks, keep it to once or twice a week and aim for about 100 calories worth of energy from these foods- check out this link Healthier snacks - Food facts - Healthier Families - NHS (www.nhs.uk)

Opting for crackers, fruit and veggie sticks more often, rather than crisps, chocolate, and pastries (e.g. sausage rolls/pasties) is a great way to be more mindful of fat in the diet.

Hydration

It is important to stay hydrated during the day. Current guidance is for women to drink 1.6 litres and men 2 litres of water per day. Remember your body may need more water in warm weather or when you do a lot of physical exercise. It is a good idea to bring a drinks bottle in your lunch box. Avoid soft or fizzy drinks that are high in added artificial sweeteners and sugars. Choose from:

  • Water (plain water or sparkling water).
  • Milk (dairy: skimmed or semi-skimmed) or plant-based alternatives.
  • Pure fruit juice or smoothie. One portion is 150ml and counts as one of your five-a-day - but it will only ever count one portion no matter how much you drink.
  • Flasks of soup and hot drinks whilst vegetables and fruits are not a drink, they contribute to keeping you hydrated.

Top Tips: Check out these links to Healthy Packed Lunch Recipes: