Energy drinks have been around for a long time. In fact, it has been approximately 72 years since the first energy drink was introduced in the US. Dr Enuf (weird name, I know) was introduced in 1949. However, the ‘energy drink era’ didn’t officially kick off until around 1962 when a Japanese company named Taishe released ‘Lipovitamin D’ (Chatterjee and Abraham, 2019). It was marketed as a medicinal tonic and contained had added taurine and niacin to enhance the improvement of energy and concentration. The well-known Red Bull was later introduced in Australia in 19897 and the US in 1997 (Manchester et al., 2017) . Today there are over 500 different types of energy drinks and energy shots available (Seifert et al., 2011).
Energy drinks are promoted for their ‘claimed’ beneficial effect on physical and mental alertness. They are commonly used by athletes due to their high sugar content, but it’s become more and more common for non-athletes to drink large amount. Especially teenagers and young adults. However, data has shown that consuming large volumes of energy drinks can be potential harmful because of increased cardiac workload and decreased blood flow to the brain which has been observed in multiple studies on the health effects of energy drinks (Grasser et al., 2014).
Energy drinks don’t just contain a lot of sugar because you can get sugar free versions. They also contain caffeine amongst other chemical compounds. Most energy drinks contain like if not more caffeine than a cup of strong coffee.
The European Food Safety Authority (EFSA) conducted a study that looked at energy drink consumption (Cikaric, 2021). They found that a whopping 68% of teenagers (aged 10 -18 years old), 30% of adults and 18% of children under 10 consumed energy drinks daily. The average daily consumption from children under 10 was about 500ml (that’s 1 can) and the average daily consumption for teenagers was 2 litres (that’s 4 500ml cans). I don’t know about you, but those numbers are scary! Especially when you see all the health implications that come with energy drink consumption.
First let’s look at caffeine. Caffeine is the worlds most popular drug. Yes, caffeine is a drug. It increases energy metabolism in the brain, but, at the same time it causes vasoconstriction meaning it reduces blood flow to the brain…. you don’t need a medical degree to know that that’s not good. It basically makes your body work harder while reducing blood flow.
It is also a stress stimulator meaning it increases levels of the stress hormone cortisol. Cortisol is the ‘fight or flight’ hormone and our body is not equipped to deal with increased levels of cortisol for long periods of time. Caffeine also increases levels of anxiety and interferes with sleep. Caffeine does improve alertness and if you’re feeling tried and need a pick me up it might help, but in the long run you’d really be better figuring out why you’re so tired. Maybe getting that pick me up from some healthy carbs? Taking a nap? Both these options have zero health implications…
Now let’s look at why energy drinks are so harmful to our health.
• Cardiovascular – So the health scares that seem to be sending people to A&E are heart issues. Energy drinks increase heartrate and arterial blood pressure about 1 hour after consumption (Grasser et al., 2014). This is attributed to the caffeine content. Recent reports have demonstrated a strong relationship between energy drink overconsumption and arterial dilatation, aneurysm formation, dissection, and rupture of large arteries (Alsunni, 2015).

• Neurological and Psychological effect – Studies have shown that more than 200mg of caffeine causes caffeine intoxication (like you’re drunk on caffeine instead of being drink on alcohol). Caffeine intoxication can lead to insomnia, anxiety, Gastrointestinal upsets, muscle twitching, restlessness, periods of inexhaustibility and acute and chronic headaches. That a long enough list for you??? There have actually been four caffeine induced psychiatric disorders that are recognised by the Diagnostic and Statistical Manual of Mental Health Disorders (Jones and Fernyhough, 2009). These are;
Caffeine intoxication
Caffeine induced anxiety
Caffeine induced sleep disorder
Caffeine related disorder
Caffeine intake and violent behaviours in young teenagers has also been linked. Several reports state that energy drinks may contribute to ischemic stroke and lead to epileptic seizures. Also note that over 300mg of caffeine can lead to hallucinations. This could be since cortisol (the stress hormone I mentioned earlier) enhances the psychological effect of stress resulting in a greater tendency for hallucinations.

• Gastrointestinal and Metabolic effects – These energy drinks usually contain large amount of sugar, and a lot of calories. Remember calories = energy. So, if you aren’t burning off that excess energy then it’s stored in your body as fat. It is thought that high sugar drinks are one of the main causes of childhood and adolescent obesity worldwide (WHO, 2019). Monosaccharides sucrose, glucose and high fructose corn syrup are the main energy sources you’ll find in energy drinks and it’s been found that they may have negative effects on intestinal bacteria activity, diversity, and gene expression. This results in an increase risk of obesity and Irritable Bowel Syndrome (IBS) (Greenblum et al., 2012).
Large volumes of caffeine can also reduce insulin sensitivity leading to a 5.8% increase in the amount of insulin required for every mgkg of caffeine (Lee et al., 2005). Basically, the more caffeine you consume the less effective the insulin your body produces becomes, meaning it needs to produce more and more.
There was also a case where a young woman presented to A&E with jaundice, abdominal pain and highly elevated liver enzymes after consuming a large volume of energy drinks (Vivekanandarajah et al., 2011). The same thing was also reported in a 34 year old male (Huang et al., 2014).

• Renal – Caffeine is a diuretic, meaning it makes you lose more water through urination (Alsunni, 2015). These means energy drinks are not great at hydrating you. They should be avoided during prolonged periods of physical activity, especially in a hot environment as they could cause dehydration. Caffeine also promoted the excretion of sodium in the urine (natriuresis), which effects the plasma volume of the blood. This can cause adverse cardiac performance during exercise and can lead to sodium imbalance; both can be life-threatening.

• Dental – Well this one is obvious. What happens when you consume a high sugar and a low pH (acidic) drink? Dental erosion, your enamel corrodes, also cavities and other dental issues are caused by energy drinks (as well as other soft drinks).

Some popular energy drinks include Red Bull, Monster, Rockstar, CELCIUS, 5-hour energy shots, but like I said there is a wide range of energy drinks out there to choose from. Red Bull is probably the most popular and most well studies energy drink to date.
What’s the difference between an energy drink like Red Bull and a soft drink like Coke? Both contain a lot of sugar, and both are caffeinated (355ml of coke contains 114mg of caffeine, same as a 500ml can of Red Bull). However, you don’t hear of people being rushed to A&E for irregular heartbeats or heart attacks caused by drinking too much Coke. Yeah over time the extra calories from the sugar may catch up with you, and your teeth won’t thank you, but drinking a litre of coke in 24 hours aside from maybe making you feel a bit unwell won’t put you in the hospital…or in a coffin. There are four ingredients that are in pretty much most energy drinks. Sugar, caffeine, guarana, Taurine and Ginseng. This would make one think that it isn’t just the caffeine and the sugar causing these health issues.
This theory was put to the test in one study where they split 18 young healthy adults with no previous health conditions and who weren’t on any medication. One group drank 946ml of energy drink containing 320mg of caffeine daily for six days. The other group was given a placebo of sugared water with the same 320mg of caffeine added. The group who received the energy drink had a significantly higher QT interval prolongation and systolic blood pressure than the control group.
The QT interval is graph on an ECG and an increased QT interval for a prolonged period is a recognised marker for an increased risk for fatal arrythmias…yes…fatal as in you could die. Prolongation of QT interval by 60 ms from baseline is a marker for life threatening arrythmias. The energy drink caused a prolongation of around 10 ms2 hours after consuming the energy drink. This doesn’t seem too bad, but actual medications that were showing promise have been pulled from the market for safety reasons for showing a 5 to 10 ms QT interval prolongation.
Another much larger meta-analysis study done on one million people showed that an increase of 3 to 4mm Hg in Systolic blood pressure leads to a 20% increased risk of stroke mortality and 12% increased risk of ischemic heart disease mortality (Shah et al., 2016). Pretty much all energy drinks studies showed an increase in Systolic Blood Pressure by 3 or more mm Hg.
Another scary thing about energy drinks is the amount of people who consume them with alcohol. Energy drinks mask thee sign of alcohol inebriation. So when you’d normally be what we’d refer to as ‘blind drunk’ barely able to stand etc, with energy drink you wouldn’t start feeling like this until you’ve consumed a dangerous amount of alcohol that would cause alcohol poisoning. People who regularly consume energy drinks are also more likely to drink large amounts of sugary drinks, smoke, binge drink, smoke marijuana, abuse steroids and other drugs (Ali et al., 2015).
In 2019 the FDA stated that 34 deaths caused by overconsumption of energy drinks occurred. There has also been a large increase in the number of people hospitalised or rushed to A&E due to either consuming energy drinks with alcohol, or just over consuming energy drinks. You’d think with all the evidence showing the any life-threatening health risk the energy drinks because they’d at least be regulated in some way? Maybe banned for under 18’s? To date England has banned the sale of energy drinks to under 16’s. Lithuania and Latvia have also banned the sale of energy drinks to minors. France, Denmark, Norway, and Uruguay outlawed Red Bull outright because of concerns over taurine, but they were forced to lift the ban in 2008 as EU law states that a product made or sold in other EU countries cannot be banned unless a health risk is proven. In 2009 Germany banned the sale of Red Bull cola when it found trace amounts of cocaine in it. Red Bull claimed they only used the cocoa leaves for flavour and any active cocaine was removed.
The FDA imposes a limit of 71mg of caffeine per 12floz in soft drinks, but energy drink claim to be ‘natural dietary supplements’ so they’re regulated to the same extent as other health supplements like protein powders, which isn’t very much to be honest.
Energy drinks are advertised at athletes claiming to improve athletic performance, but there is actually very little solid evidence backing up these claims. In fact, one study showed that aside from having no ergogenic potential for performance enhancement from Red Bull when compared to drinking sugared water with caffeine. Red Bull also caused increased levels of inflammation which would hinder athletic performance (Phillips et al., 2014).
I honestly try to be open minded when I research anything. Put my true feelings aside. My true feeling on energy drinks have always been that they should be banned outright for everybody and after reading all the horror stories and studies carried out backing up these horror stories my opinion has not changed one little bit.
I understand if you’re tired, maybe you work shifts, you need a quick boost of energy. Maybe you don’t have time to have a quick nap or to sit down and eat something substantial. Energy drinks are probably your go to, but please reconsider. Even swapping from energy drinks to coffee! Not ideal but it’s a start. If you’re always tired and never seem to be able to focus you need to find the root cause. Are you not sleeping well? That could be caused by energy drinks even if you don’t drink them straight before bed. Are you eating right? You could be deficient in essential nutrient that are making you feel constantly fatigued. You need to give your body what it needs and wants, and I guarantee you that’s NOT a can of Monster or Red Bull or any of those energy drinks out there.

You know I just love an old health fad bust! Of course, I do all my research before putting something down as ‘useless’, no matter how sceptical I am. There have been times I’ve been pleasantly surprised at how much truth there is to some of these fads. Sadly, this is a rare occurrence.

There are plenty of ‘health foods’ out there that are seen as ‘magic pills’ Sorry to burst your bubble, but when it comes to health unfortunate there is no such thing as a magic pill. There are loads of things you can do to stay healthy and happy. A lot of the time these things can vary from one person to the next whether it’s regarding nutrition, fitness, mental or emotional wellbeing. The best thing you can do is listen to YOUR body. Don’t follow trends unless you know they are backed by good science. Also, even if something is proven to be good for your health if you don’t enjoy it, whether it be a food item, a physical activity, or a relaxation technique, don’t do it!

Apple Cider Vinegar

The first item on the menu is Apple Cider Vinegar. This health fad is mainly used for those looking to lose weight, but of course it claims to do much more.

Aids weight loss

Help with blood glucose control

Acts as a food preservative

Control high blood pressure

Improves gut health

Can cure (or help treat) some forms of Cancer

Are you getting excited reading these claims? I know I was! That is, until I actually started looking for some good old scientific trials to back these claims and found…well…very little to be honest. It’s good to be an optimistic person, but when it comes to nutrition and the many health fads out there, I want you to ask yourself this duration. “Does it sound too good to be true?” If the answer is “Yes” then it probably is. If you do your research, you may find a few of the claims are legit though so just be weary.

First let’s look at the weight loss claim. Vinegar is naturally very low in calories with a tbsp only containing 3Kcals. Vinegar is a dilute solution of acetic acid and the body needs energy to metabolise this, thus, activating an enzyme called AMPK. AMPK is kind of like the fuel gage in your car. When it senses we’re low in energy it amps up energy production and tells our body to start burning fat instead of storing it (Hardie and Ashford, 2014). Basically because vinegar (any kind of vinegar) is dilute acetic acid it also activates this AMPK enzyme in some body tissues (McCarty, 2014).

There was one study carried out on overweight Japanese students (KONDO et al., 2009). In Japan their BMI of ≥25kg/m^2 is seen as obese. In Europe and most of the rest of the world a BMI of ≥30kg/m^2 is seen as obese. The study investigated the effects of vinegar intake on the reduction of body fat mass. So, it didn’t just look at weight loss, it also looked at body measurements. It was a 12-week trial and there were three groups.

High intake 30mls Apple Cider Vinegar (1500mg acetic acid) Showed the most weight loss (average of 1.9-2.2kg) and most loss of inches around the abdomen (average of 1.9” – 2.1”)

Low intake 15mls Apple Cider Vinegar (750mg acetic acid) Lost an average of 1 – 1.2kg of weight and 1.3 – 1.4” around the abdominal area

Control group Received a drink that looked and tasted like Apple Cider Vinegar but was not, so it contained no acetic acid (placebo) Lost no weight or inches, in fact some did gain weight over the course of the 12 weeks

No other diet or lifestyle changes were made, and the participants were monitored carefully regarding their calorie intake and exercise to ensure they didn’t deviate from their usual. Also, when the trial finished, and the participants stopped taking Apple Cider Vinegar they did start to gain weight again. This is only one study though, but it is a pretty good one with promising results.

Another possible reason that Apple Cider Vinegar could hep with weight loss is that vinegar has been shown to act as a natural appetite suppressor. Now, I know what your thinking. Does this mean if I drown my chips in vinegar I’ll eat less? Possibly. A study done in England which looked at the palatability of vinegar concluded that ingesting vinegar did increase satiety (feeling full), but this was largely due to poor tolerability (Darzi et al., 2014). Meaning large amounts led to feelings of nauseas and when you feel nauseated you don’t tend to feel like eating. Another study showed that taking vinegar with a high carb meal leads to increased feelings of satiety, leading to the consumption of 200-275 fewer calories throughout the day (Östman et al., 2005). However, the Japanese study made sure the three groups each ate approximately the same number of calories.

Next claim is Blood glucose control. There was a very small study that did show that consuming Apple Cider Vinegar did significantly lower post-prandial blood sugar levels (Mc Donald, 2018)(that’s your blood sugar levels after you’ve eaten). Once again, this was a VERY small study. So, don’t go swapping out your insulin for a spoonful of Apple Cider Vinegar if you’re a Diabetic! Also be aware the Apple Cider Vinegar can have some adverse reactions with certain medications and if you have kidney disease you need to avoid consuming it.

Over 2000 years ago the ‘Father of Medicine’ Hippocrates, used vinegar to clean wounds, like an antiseptic. Vinegar has been shown to kill harmful bacteria. It can be used to clean and disinfect , treat fungal nails, lice, warts and even ear infections (Gunnars, 2020). It can also be used as a food preservative, so that claim is true. It can inhibit the growth of E.coli, Salmonella and other food borne diseases (Park et al., 2016; Yagnik et al., 2018; Yucel Sengun and Karapinar, 2005). Apple Cider Vinegar could help prevent you from getting food poisoning from salad (Yucel Sengun and Karapinar, 2005). In 2005 a study showed that both lemon juice and vinegar decreased the growth of salmonella to undetectable levels on Rocket and spring onion (salad veg). Fruits and vegetables are best eaten raw if you’re looking at it from a nutritional point of view. Cooking them can cause the, to lose some of their important vitamins and minerals. However, from a food safety point of view is fruits and vegetables that are eaten raw are now kept grown, harvested, and stored in a clean and hygienic environment with under correct storage conditions they can cause food poisoning. Salad green can carry Salmonella, Listeria and E. coli. Using Apple Cider Vinegar in a nice homemade dressing would be a great way to make a low-calorie dressing. However, do no disregard food hygiene thinking the Apple Cider Vinegar will kill all bacteria!

As for the blood pressure claim. It is 100% false! There is no evidence to prove Apple Cider Vinegar helps lower high blood pressure.

Apple Cider Vinegar, and any vinegar, is made in a process called fermentation. We’ll not get into that (it’s a long process). If you are looking into taking Apple Cider Vinegar you’ve probably heard of the ‘Mother’. The ‘Mother’ is a combination of yeast and bacteria formed during the fermentation process. It causes the Apple Cider Vinegar to be cloudy. Many people believe the health benefits of Apple Cider Vinegar come from this ‘Mother’. Truth is that it is a probiotic and probiotics do help with gut health. You can read my blog on probiotics here or check out my YouTube video explaining Probiotics and Gut Health .

Moving on to the claim that every health food seems to have. Curing, preventing, or helping to treat cancer. There are no human trials to prove this. A few studies show it may have anti-cancer properties, probably because it does contain antioxidants from the apples. As we know, antioxidants fight free radicals which can cause inflammation and chronic diseases including cancer. However, it’s no better that just eating some nice (tasty) fruit and veg or a smoothie.

In conclusion. Apple Cider Vinegar may help with weight loss, but only if you keep taking it. It doesn’t exactly taste great. You could use it in cooking and as a salad dressing. It’s an antibacterial and antifungal and the ‘mother’ acts as a probiotic. There still has been very limited research done on Apple Cider Vinegar and its effects on health so more is needed before you can have a definite answer.

References

Darzi, J., Frost, G.S., Montaser, R., Yap, J. and Robertson, M.D. (2014) Influence of the tolerability of vinegar as an oral source of short-chain fatty acids on appetite control and food intake. International Journal of Obesity (2005), 38(5) 675–681.

This diet was created by a naturopathic physician named Peter J. D’Adamo. He wrote a book in 1996 entitled ‘Eat Right for Your Type’, this book has sold over 7 million copies to date and made the New York Times bestseller list.

Usually when I write this type of blog that looks at different diets, I try to stay open minded. My personal belief is that restricting yourself to a certain diet for whatever reason is not necessary. Eating a balanced diet, only removing foods that you know you are allergic or intolerant to (i.e. you have been tested and the test result show this), allowing yourself to enjoy the food you love while being aware of your portion sizes, staying active and looking after your mental health is all you have to do!

However,when researching this diet…I have never seen a bigger con in all my life! So, if you are a firm believer in the blood type diet a fair bit of warning, this blog should make you rethink a few things.

First let’s look at the theory behind the Blood Type Diet which is that your blood type reveals the dietary habits of our ancestors and will determine what kind of food we should eat, what supplements we should take and even what type of exercise we should do to maintain a healthy weight and reduce our risk of developing chronic diseases. D’Adamo claims that foods react chemically with your blood type. So following the diet best suited to your blood type will help you digest food more efficiently, have more energy and be at lower risk of developing diseases (Watson, 2016).

There are two main classification systems for blood types. The ABO system has four types. Type A, type B, type AB and type O. The Rhesus system and blood types are classified as Rhesus positive or Rhesus negative (e.g. type A+ or Type A-). Blood group classification was one of the first recognizable genetic variants in humans. So, you will have the same blood type as either your biological mother or father. There have also been studies that show your blood type can be associated with your risk of developing Cancer, Malaria, cholera or cardiometabolic diseases (Liumbruno and Franchini, 2013). This is what D’Adamo formed his hypothesis surrounding blood types, diet, and exercise on. A hypothesis is basically a set of observations that haven’t yet been proven. He proposed that that certain sugar binding protein components in foods called lecithin bind with the antigens on the blood cells and this may lead to agglutination (clumping together of blood cells) and disease.

So, what can you eat on this diet? It depends on your blood type.

Blood type A diet is a mostly a vegetarian diet, high in carbohydrates and low in fats. Plenty of fruits & vegetables, ideally fresh and organic Animal products (meat, poultry, fish, eggs, dairy).

Blood type B diet is high in protein, low in carbohydrates. Green vegetables, eggs, certain meats, and low-fat dairy. Corn, wheat, buckwheat, lentils, tomatoes, peanuts, sesame seeds and for some reason chicken is ‘problematic’ (D’Adamo’s words not mine!).

Blood type AB diet includes tofu, seafood, dairy, and green vegetables Caffeine, smoked/cured meat, and alcohol.

Blood type O diet includes lean meat, poultry, fish, and vegetables, and light on grains, beans, and dairy Wheat and most other grains

If you’ve read some of my earlier blogs looking at Low Carb Diets Atkins and Keto and the Paleo/Hunter gatherer Diet. The recommendations for blood type B and type O closely resemble them. One thing all the blood type diets have in common is cutting out processed food and that HAS got scientific evidence backing it’s beneficial effects on weight and overall health, but none of this evidence states that your blood type dictates which diet would work best for you.

The Blood type diet also tells you which type of exercise you should be doing in order to stay healthy, depending on your blood type.

• Type A – Gentle exercise like yoga or tai chi

• Type B – moderate swimming or walking

• Type O – vigorous aerobic exercise such as jogging or cycling for up to an hour every day!

I don’t know about you, but I wouldn’t like to be type O!

A major red flag for me when it comes to recognising a ‘fad diet’ or ‘bad’ dietary advice is when there’s no scientific evidence to back the claims. In 2013 there was a systematic review carried out on 1000 scientific papers looking at whether blood type influences what we should be eating (Cusack et al., 2013). They found no evidence at all supporting the claim that blood type has anything to do with what diet a person should follow for optimal health. Ten years before this systematic review (in 2003) The Norwegian medical Association released numerous scientific papers in which researchers tried to determine whether there was any truth to this claim as at this point over 40,000 copies of the book ‘Eat Right for Your Type’ had been sold in Norway. They also concluded that the claim was utter “Nonsense” (Greger, 2015).

Now you’d think by now the Dr Peter J. D’Adamo would have something to say? Well he did. In fact he said quote “there is good science behind the blood type diet, just like there was good science behind Einstein’s mathematical calculations” (Greger, 2015). Basically, he’s saying that if the Blood Type theory was tested, he would be proved right. He claims there is no available money to fund the trials. He has sold over 7 million copies of his book worldwide, if he really believed that proper scientific testing would show the world his theory is correct why can’t he fund his own research like the Atkins foundation did?

Back in 1996 he when his book was released, he did claim to be in the eighth year of a ten year clinical trial, meaning the results should have been available in 1998…twenty-three years later and still no sign of them.

As well as selling the book he also has his own line of supplements which he recommends for anyone who wants to follow the Blood Type Diet (another red flag for a ‘fad diet’ is selling expensive supplements that cannot be found elsewhere and the you ‘must have’ to be successful in the particular diet). He also recommends a lot of speciality and organic foods that can be pricey.

The big question is, does it work. The answer is complicated. The different diets do have different health benefits that have been proven. For example, the Type A diet is mainly plant based and we know a plant-based diet has many health benefits especially your cardiometabolic health. The Type AB diet is also rich in plant-based foods and has been linked to favourable health benefits. Even though it does contain some animal proteins including fish, eggs, and dairy. The Type O diet has been associated with reduced triglycerides. However, there is absolutely no evidence showing that your blood type has any effect at all o which of these diets would work for you.

References

Cusack, L., De Buck, E., Compernolle, V. and Vandekerckhove, P. (2013) Blood type diets lack supporting evidence: a systematic review. The American Journal of Clinical Nutrition, 98(1) 99–104.

With the whole world in the grip of a pandemic people are desperate to find something that will help protect them and their loved ones from the virus. Thankfully a vaccine is now available and being rolled out, but it’s still so important to take the necessary precautions like wearing your mask in public, keeping your distance, washing your hand regularly.

There has been a lot in the media about the benefits of vitamin D, and how it could possibly help prevent you from becoming very ill from Covid-19, or even from getting it at all. Is there any truth to this? First let’s look at what the functions of vitamin D are, and the main sources.

Vitamin D is a fat-soluble vitamin that occurs naturally in only a few foods but can be used to fortify many types of food. The main sources of vitamin D are.

• Oily fish (mackerel, salmon, herring)

• Liver

• Red meat

• Egg yolks

• Some mushrooms that are exposed to sunlight make vitamin D

• Fortified foods such as cereals, other dairy products.

• Supplements

• It’s produced in the skin through UV radiation from the sun

One important function of vitamin D is aiding the absorption of Calcium in the gut, helping to maintain normal levels of Calcium and Phosphate concentrations for strong bones and teeth. It also prevents Hypocalcaemia; this is when there are low blood calcium levels and the muscles begin to involuntarily cramp and spasm.

Research has also shown that vitamin D plays a key role in immunity. Many studies have shown it can help reduce the risk of getting influenza, but there are also studies that contradict this. Vitamin D improves cellular immunity, partly by controlling inflammation provoked by the innate immune system. The innate immune system produces pro-inflammatory and anti-inflammatory cytokines in reaction to viral and bacterial infections, such as Covid-19.

People with chronic illness and the elderly are deemed as ‘high risk’. Studies have shown that people with chronic illnesses tend to have lower serum vitamin D concentrations than healthy people. Now, it hasn’t been proven that the reason this virus seems to affect this category of people worse is linked with vitamin D concentrations, it’s merely an observation at present.

The elderly is another group who have been hit hard by Covid-19. It has been shown that serum concentrations of vitamin D do tend to decrease with age. Many elderly people who are unable to get much sunlight due to being immobile, hospitalized or maybe in a nursing home would tend to have lower vitamin D levels.

Vitamin D deficiency is a very common problem in Ireland. Vitamin D deficiency has been linked to an increased risk in acquiring acute respiratory infections and community acquired pneumonia. Supplements have been shown to reduce this risk, and it has been recommended that in Ireland everyone should be taking a vitamin D supplement, especially for the autumn and winter months when not only is there less sunlight, but the UV rays are not as efficient for producing vitamin D. This could be why influenza is most common during the winter months. A study carried out in 2019 with 21,000 subjects showed that those deficient in vitamin D had a 64% increased risk of getting community acquired pneumonia.

Another sign that points to vitamin D’s effectiveness at protecting against Covid-19 is that countries that are more ‘northernly’ seem to be hit hard by the virus. There is a 4.4% increase in deaths from Covid-19 for each degree latitude north of 28’, this link remained even after it was adjusted for the age of the population.

The EU recommendations for how much vitamin D a person should consume per day is illustrated in the table below.

Table 1: EFSA recommendation for vitamin D intake for males and females

Age Minimum Maximum

Infants 7-11 months 10µg/day 35µg/day

Children 1-10 years 15 µg/day 50 µg/day

Teenagers 11-17 years 15 µg/day 100 µg/day

Adults ≥18 years 15 µg/day 100 µg/day

Pregnant - 15 µg/day 100 µg/day

Lactating - 15 µg/day 100 µg/day

The best way to get your recommended amount of vitamin D is through food and getting enough sunlight without harming your skin but as there are very limited food sources of vitamin D, taking a daily supplement will help ensure you are getting enough. You can get vitamin D supplements over the counter in your chemist, or at your local health food shop. Just be careful to read the dosage instructions and follow them. Vitamin D toxicity is very rare but can be very severe. You can only get vitamin D toxicity from overuse of supplements, and I mean taking over 1000µg/day for several weeks. If you are on other medications or have any medical conditions, it’s a good idea to consult your doctor before starting any kind of supplements.

Finally, if Vitamin C also plays an important role in immunity. We know the main ‘high risk’ groups for becoming very ill with Covid-19 are the elderly, people with chronic illnesses such as diabetes and people who are overweight or obese. It has been shown that these people usually have lower vitamin C serum levels than normal due to excess inflammation which increases the vitamin C requirement (Feyaerts and Luyten, 2020). Drug abusers and alcoholics also have lower than normal vitamin C serum levels (Feyaerts and Luyten, 2020). Studies have shown that 1-2mg/day of vitamin C can lessen the severity and duration of the common cold. Ongoing clinical trials should hopefully provide more definitive evidence as to whether vitamin C has any effect on Covid-19 (Feyaerts and Luyten, 2020).

In conclusion, I believe Vitamin D and vitamin C strengthens your immune system and being deficient in either of them makes you more susceptible to infections and viruses. It’s not difficult to get your recommended amount of vitamin C per day if you eat a balanced diet with fruit and vegetables, and taking a daily vitamin D supplement or including more vitamin D rich foods in your diet will strengthen your immune system. I don’t recommend discarding all other protective measures such as wearing a mask, washing your hands and keeping your distance from others, Making yourself healthier in general by eating healthier, exercising, looking after your mental health will help keep your immune system strong and ready to fight if needs be!

References