If Your First Steps Are Painful...
24/04/11 14:15
Pain in the heel can occur due to bone spurs, inflammation of the plantar fascia (known as plantar fasciitis) or impingement of the small nerves in the foot.
Symptoms of plantar fasciitis include pain on or around the heel when weight is placed on the foot. This is usually worst in the morning, especially with the first few steps after getting out of bed. In most cases, there is no pain at night since the fascia tightens up overnight. Morning motion causes pulling of the fascia and results in pain that can be described as sharp, burning or stabbing. Pain usually reduces during the course of the day as the tissue warms up. Prolonged standing, walking or getting up after long periods of sitting usually irritate the fascia.
Common causes of heel pain include:
• Excessive running or jumping
• Overload of physical activity (especially for athletes)
• High arches, flat feet, abnormal gait
• Wearing improper shoes while walking or running
• Diabetes contributes to heel pain in the elderly
• Recent weight gain or pregnancy
In most cases, plantar fasciitis does not require surgery and can be treated conservatively. However, every individual heals at a different pace.
If you suffer from heel pain, the first thing you need to do is determine the cause. For example, you may need to replace your old, worn out shoes. You may need to rest if there has been a significant increase in your activity levels.
The next thing to do is to call your physical therapist. You may even need to see a doctor or podiatrist. Your doctor may prescribe anti-inflammatory medications and physical therapy to help you reduce pain and inflammation and resume daily activities without pain. In some cases, your doctor may give you a cortisone shot to address excessive inflammation.
Most people with heel pain get better with physical therapy. Therapy usually includes stretching the calf muscles (on the back of the lower leg) to take the tension off the plantar fascia. If your calf is really tight, the doctor may order a night splint (to be worn while you sleep at night). This will place a mild stretch on the calf muscles and the plantar fascia.
This helps reduce morning pain.
Patients with plantar fasciitis are commonly prescribed physical therapy. Our therapists design exercises to improve flexibility in the calf muscles and the plantar fascia. Treatment helps control pain and swelling. We may use ultrasound, electrical stimulation, ice packs and soft-tissue massage to help you recover as fast as possible. We may even recommend the use of an orthotic depending on the anatomy of your foot.
Symptoms of plantar fasciitis include pain on or around the heel when weight is placed on the foot. This is usually worst in the morning, especially with the first few steps after getting out of bed. In most cases, there is no pain at night since the fascia tightens up overnight. Morning motion causes pulling of the fascia and results in pain that can be described as sharp, burning or stabbing. Pain usually reduces during the course of the day as the tissue warms up. Prolonged standing, walking or getting up after long periods of sitting usually irritate the fascia.
Common causes of heel pain include:
• Excessive running or jumping
• Overload of physical activity (especially for athletes)
• High arches, flat feet, abnormal gait
• Wearing improper shoes while walking or running
• Diabetes contributes to heel pain in the elderly
• Recent weight gain or pregnancy
In most cases, plantar fasciitis does not require surgery and can be treated conservatively. However, every individual heals at a different pace.
If you suffer from heel pain, the first thing you need to do is determine the cause. For example, you may need to replace your old, worn out shoes. You may need to rest if there has been a significant increase in your activity levels.
The next thing to do is to call your physical therapist. You may even need to see a doctor or podiatrist. Your doctor may prescribe anti-inflammatory medications and physical therapy to help you reduce pain and inflammation and resume daily activities without pain. In some cases, your doctor may give you a cortisone shot to address excessive inflammation.
Most people with heel pain get better with physical therapy. Therapy usually includes stretching the calf muscles (on the back of the lower leg) to take the tension off the plantar fascia. If your calf is really tight, the doctor may order a night splint (to be worn while you sleep at night). This will place a mild stretch on the calf muscles and the plantar fascia.
This helps reduce morning pain.
Patients with plantar fasciitis are commonly prescribed physical therapy. Our therapists design exercises to improve flexibility in the calf muscles and the plantar fascia. Treatment helps control pain and swelling. We may use ultrasound, electrical stimulation, ice packs and soft-tissue massage to help you recover as fast as possible. We may even recommend the use of an orthotic depending on the anatomy of your foot.
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Obesity and the Aging Population: What Are the Dangers and How You Can Get Healthier
16/04/11 10:12
Nearly 70 percent of adults over age 60 are overweight or obese, putting them at higher risk of diabetes and other diseases, according to a new study published in the Journal of the American Medical Association.
The study followed more than 4,000 men and women for 18 years and found that those who were overweight, measured by a body mass index (BMI) of 25-29, or obese, with a BMI of 30 or higher, were more likely to develop type 2 diabetes.
"As you age, your body changes," ABC News senior health and medical editor Dr. Richard Besser said this morning on Good Morning America. "Your metabolism slows down."
Type 2 diabetes has doubled in the U.S. in the past 15 years, and is highest among adults over age 65, according to the Centers for Disease Control and Prevention. And diabetes is a well known risk factor in heart disease, kidney disease, stroke and other serious medical conditions.
However, keeping a diet rich with greens can prevent excess weight gain, said Besser. “If you don't cut back what you put in your body, you'll gain weight," he said. "It's that simple."
Besides eating well, even light physical activity can significantly contribute to a healthier lifestyle for many elderly adults, according to Besser.
Lower impact activities such as walking, swimming, and bicycling are generally safe for many older adults, even those who have chronic conditions such as heart disease or high blood pressure, Besser said on Good Morning America. In fact, many studies show that regular aerobic exercise can lower blood pressure, decrease the symptoms of chronic conditions, and can improve brain function. But the key is to start slowly, he said.
"Just ask your doctor how to do that," he said. Exercise is only good for you if you are feeling well, according to Besser. If you have a cold or the flu, wait to exercise until you feel better.
Warming up and cooling down by walking and stretching before and after each session is important to minimize any soreness or potential injury, he said.
*Original article: http://abcnews.go.com/Health/OnCall/elderly-obesity-older-adults-face-weight-issues/story?id=10985159
The study followed more than 4,000 men and women for 18 years and found that those who were overweight, measured by a body mass index (BMI) of 25-29, or obese, with a BMI of 30 or higher, were more likely to develop type 2 diabetes.
"As you age, your body changes," ABC News senior health and medical editor Dr. Richard Besser said this morning on Good Morning America. "Your metabolism slows down."
Type 2 diabetes has doubled in the U.S. in the past 15 years, and is highest among adults over age 65, according to the Centers for Disease Control and Prevention. And diabetes is a well known risk factor in heart disease, kidney disease, stroke and other serious medical conditions.
However, keeping a diet rich with greens can prevent excess weight gain, said Besser. “If you don't cut back what you put in your body, you'll gain weight," he said. "It's that simple."
Besides eating well, even light physical activity can significantly contribute to a healthier lifestyle for many elderly adults, according to Besser.
Lower impact activities such as walking, swimming, and bicycling are generally safe for many older adults, even those who have chronic conditions such as heart disease or high blood pressure, Besser said on Good Morning America. In fact, many studies show that regular aerobic exercise can lower blood pressure, decrease the symptoms of chronic conditions, and can improve brain function. But the key is to start slowly, he said.
"Just ask your doctor how to do that," he said. Exercise is only good for you if you are feeling well, according to Besser. If you have a cold or the flu, wait to exercise until you feel better.
Warming up and cooling down by walking and stretching before and after each session is important to minimize any soreness or potential injury, he said.
*Original article: http://abcnews.go.com/Health/OnCall/elderly-obesity-older-adults-face-weight-issues/story?id=10985159
High Blood Pressure and Seniors
10/04/11 10:00
According to the National Heart, Lung, and Blood Institute, one in four adults, have a continuously elevated pressure of the blood moving through their arteries. For adults aged 70 and older, that number rises dramatically to two out of three. High blood pressure significantly increases your risk for getting heart disease and/or kidney disease, and for having a stroke. While there may be no symptoms, and people affected by high blood pressure may feel fine, some may experience dizziness, palpitations, sweating, and headaches.
Blood pressure is typically recorded as two numbers — the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats). The Merck Manual on Medical Information defines high blood pressure as a systolic pressure at rest that averages 140 mm Hg or more, a diastolic pressure at rest that averages 90 mm Hg or more, or both. Usually both the systolic and the diastolic pressures are elevated. However, in the elderly, only the systolic pressure may be elevated, which nevertheless can cause medical problems down the road.
Special Factors for the Elderly:
Many Americans tend to develop high blood pressure as they get older, but this is not a part of healthy aging. About 60% of all Americans age 60 and older have high blood pressure. Only a fraction of those who have high blood pressure actually know it and are actively treating it.
Only a few decades ago, the medical community treated the elderly differently when it came to high blood pressure. Since prescription drug interventions could prove risky, only those seniors with extremely high blood pressure were treated. According to the Society of
Geriatric Cardiology, there are now numerous safe and effective blood pressure medications available. “It has been shown that the majority of older patients adhere and respond to treatment as well as or better than younger patients,” the Society notes.
Since the elderly have fluctuations in their blood pressure throughout the course of the day and may have adverse interactions with other medications, doctors should carefully monitor and adjust a senior’s medication. The Society of Geriatric Cardiology recommends that at least two or three blood pressure readings should be taken at different times to establish a diagnosis of hypertension.
Prevention:
The best way to prevent high blood pressure is by adopting a healthy lifestyle:
◦ Following healthy eating patterns: emphasize fruits, vegetables, and low-fat dairy foods; eat foods low in saturated fat, total fat,
and cholesterol; eat whole grains, poultry, fish, and nuts; reduce fats, red meats, sweets, and sugared beverages. (see The
DASH Diet under “Sources” for more information)
◦ Reducing salt and sodium in your diet: reduce salt intake to less than six grams (one teaspoon) per day from all sources.
◦ Maintaining a healthy weight: since blood pressure rises as weight increases, reducing your weight can improve your
hypertension, as well as reduce your risk for heart disease and diabetes.
◦ Being physically active: even the lowest level of physical activity can have a positive impact on health and well-being.
◦ Limiting alcohol intake: if you drink alcoholic beverages, have only a moderate amount — one drink a day for women; two drinks
a day for men.
◦ Quitting smoking: smoking injures blood vessels and speeds up the hardening of the arteries.
Original article: http://www.ec-online.net/knowledge/articles/bloodpressure.html
Blood pressure is typically recorded as two numbers — the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats). The Merck Manual on Medical Information defines high blood pressure as a systolic pressure at rest that averages 140 mm Hg or more, a diastolic pressure at rest that averages 90 mm Hg or more, or both. Usually both the systolic and the diastolic pressures are elevated. However, in the elderly, only the systolic pressure may be elevated, which nevertheless can cause medical problems down the road.
Special Factors for the Elderly:
Many Americans tend to develop high blood pressure as they get older, but this is not a part of healthy aging. About 60% of all Americans age 60 and older have high blood pressure. Only a fraction of those who have high blood pressure actually know it and are actively treating it.
Only a few decades ago, the medical community treated the elderly differently when it came to high blood pressure. Since prescription drug interventions could prove risky, only those seniors with extremely high blood pressure were treated. According to the Society of
Geriatric Cardiology, there are now numerous safe and effective blood pressure medications available. “It has been shown that the majority of older patients adhere and respond to treatment as well as or better than younger patients,” the Society notes.
Since the elderly have fluctuations in their blood pressure throughout the course of the day and may have adverse interactions with other medications, doctors should carefully monitor and adjust a senior’s medication. The Society of Geriatric Cardiology recommends that at least two or three blood pressure readings should be taken at different times to establish a diagnosis of hypertension.
Prevention:
The best way to prevent high blood pressure is by adopting a healthy lifestyle:
◦ Following healthy eating patterns: emphasize fruits, vegetables, and low-fat dairy foods; eat foods low in saturated fat, total fat,
and cholesterol; eat whole grains, poultry, fish, and nuts; reduce fats, red meats, sweets, and sugared beverages. (see The
DASH Diet under “Sources” for more information)
◦ Reducing salt and sodium in your diet: reduce salt intake to less than six grams (one teaspoon) per day from all sources.
◦ Maintaining a healthy weight: since blood pressure rises as weight increases, reducing your weight can improve your
hypertension, as well as reduce your risk for heart disease and diabetes.
◦ Being physically active: even the lowest level of physical activity can have a positive impact on health and well-being.
◦ Limiting alcohol intake: if you drink alcoholic beverages, have only a moderate amount — one drink a day for women; two drinks
a day for men.
◦ Quitting smoking: smoking injures blood vessels and speeds up the hardening of the arteries.
Original article: http://www.ec-online.net/knowledge/articles/bloodpressure.html
Lumbar Spinal Stenosis and Seniors
03/04/11 13:53
The most common indication for surgery in persons aged over 60 in the United States is Lumbar Spinal Stenosis (LSS). Currently, it is estimated that as many as 400,000 Americans, most over the age of 60, may already be suffering from the symptoms of lumbar spinal stenosis [The American Association of Neurological Surgeons (AANS) and The Congress of Neurological Surgeons (CNS)] and this number is expected to grow as members of the baby boom generation begin to reach their 60s over the next decade.
According to the U.S. Census Bureau, people over 60 will account for 18.7% of the domestic population in 2010 versus 16.6% in 1999.
According to the United Nations' Population Division, Department of Economic and Social Affairs, the trend is global with the number of persons aged 60 years or older estimated to be nearly 600 million in 1999 and is projected to grow to almost 2 billion by 2050, at which time the population of older persons will be larger than the population of children (0-14 years) for the first time in human history. The majority of the world's older persons reside in Asia (53 per cent), while Europe has the next largest share (25%).
The prevalence of musculo-skeletal disorders and the cost to treat them led the World Health Organization and the United Nations to declare 2000-2010 be the Decade committed to improving quality of life to people with bone and joint disease and injuries throughout the world.
Physical Therapy for Spinal Stenosis
Physical therapy consisted of exercises, soft tissue manipulation, and other treatment modalities, such as hot and cold packs. The purpose of exercises is to strengthen the abdominal muscles and promote mobility of the lumbar paraspinal muscles, thus minimizing lordosis.
Lordosis can be reduced by up to 7%, which is sufficient to relieve pain. 50 Trunk strengthening exercises were also prescribed to build up the abdominal and lumbar muscles, “thereby creating a corset of muscles to support the lumbar spine” and to build conditioning and increase walking distance.
Exercises that encourage lumbar flexion and flattening of the lumbar lordotic curve can be of a clinical benefit to patients suffering from lumbar spinal stenosis. An exercise program must be used 4 to 5 times a week to be beneficial, and any early signs of improvement are observed 4 to 6 weeks after the program has begun.
Original article: http://www.spinalstenosis.org/
According to the U.S. Census Bureau, people over 60 will account for 18.7% of the domestic population in 2010 versus 16.6% in 1999.
According to the United Nations' Population Division, Department of Economic and Social Affairs, the trend is global with the number of persons aged 60 years or older estimated to be nearly 600 million in 1999 and is projected to grow to almost 2 billion by 2050, at which time the population of older persons will be larger than the population of children (0-14 years) for the first time in human history. The majority of the world's older persons reside in Asia (53 per cent), while Europe has the next largest share (25%).
The prevalence of musculo-skeletal disorders and the cost to treat them led the World Health Organization and the United Nations to declare 2000-2010 be the Decade committed to improving quality of life to people with bone and joint disease and injuries throughout the world.
Physical Therapy for Spinal Stenosis
Physical therapy consisted of exercises, soft tissue manipulation, and other treatment modalities, such as hot and cold packs. The purpose of exercises is to strengthen the abdominal muscles and promote mobility of the lumbar paraspinal muscles, thus minimizing lordosis.
Lordosis can be reduced by up to 7%, which is sufficient to relieve pain. 50 Trunk strengthening exercises were also prescribed to build up the abdominal and lumbar muscles, “thereby creating a corset of muscles to support the lumbar spine” and to build conditioning and increase walking distance.
Exercises that encourage lumbar flexion and flattening of the lumbar lordotic curve can be of a clinical benefit to patients suffering from lumbar spinal stenosis. An exercise program must be used 4 to 5 times a week to be beneficial, and any early signs of improvement are observed 4 to 6 weeks after the program has begun.
Original article: http://www.spinalstenosis.org/
Glaucoma and Aging
31/03/11 07:36
The leading causes of glaucoma, diabetic retinopathy, and macular degeneration tend to come on silently, without pain or other symptoms in the earliest stages. The later an eye problem is diagnosed, the harder it becomes to treat. In some cases, any vision that has slipped away may be gone forever.
Experts say that skipping regular and thorough eye exams is chief among the barriers to early detection. It's important to have your eyes regularly checked through dilated pupils so doctors can get a good three-dimensional view of the optic nerve and retina. For a dilated exam, an eye specialist places drops in the eye to enlarge the pupils.
If you ignore symptoms of glaucoma and fail to get treatment, the damage can be permanent and blindness is more likely. There are eye drops and medications that can be used to treat mild cases of glaucoma. Lumigan and Travatan are two that treat elevated eye pressure. For people in the more advanced stages of the disease, surgery is a necessary measure that many doctors recommend.
Original article: http://seniorhealth.about.com/library/vision/bl_eye_exam.htm
Experts say that skipping regular and thorough eye exams is chief among the barriers to early detection. It's important to have your eyes regularly checked through dilated pupils so doctors can get a good three-dimensional view of the optic nerve and retina. For a dilated exam, an eye specialist places drops in the eye to enlarge the pupils.
If you ignore symptoms of glaucoma and fail to get treatment, the damage can be permanent and blindness is more likely. There are eye drops and medications that can be used to treat mild cases of glaucoma. Lumigan and Travatan are two that treat elevated eye pressure. For people in the more advanced stages of the disease, surgery is a necessary measure that many doctors recommend.
Original article: http://seniorhealth.about.com/library/vision/bl_eye_exam.htm
Avascular Necrosis and the Elderly
23/03/11 16:48
From the Mayo Clinic:
Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, avascular necrosis can lead to tiny breaks in the bone and the bone's eventual collapse.
The blood flow to a section of bone can be interrupted if the bone is fractured or the joint becomes dislocated. Avascular necrosis is also associated with long-term use of high-dose steroid medications and excessive alcohol intake.
The most common joint affected by avascular necrosis is the hip. Avascular necrosis worsens with time, so managing it is a lifelong process.
Avascular necrosis typically causes pain and reduced range of motion in the affected joint. The most common joints affected by avascular necrosis include:
• Hip. In addition to pain in the hip joint itself, pain also may radiate into your groin or go down your thigh to your knee.
• Knee. In avascular necrosis of the knee, the pain occurs most often on the inside of the knee and worsens with activity.
• Shoulder. Several bones come together at the shoulder, but the one most commonly affected by avascular necrosis is the upper
arm bone.
Some people experience avascular necrosis bilaterally — for example, in both hips or in both knees. Signs and symptoms may appear suddenly if caused by an injury. In other cases, the pain and stiffness may build up slowly over several months. Some people with avascular necrosis experience no symptoms at all.
Other joints that are affected by avascular necrosis include:
• Ankles
• Feet
• Hands
• Jaw
• Spine
• Wrists
* See your doctor if you experience persistent pain in any joint. Seek immediate medical attention if you believe you have a broken bone or a dislocated joint.
*Original article: http://www.mayoclinic.com/health/avascular-necrosis/DS00650/DSECTION=symptoms
Avascular necrosis is the death of bone tissue due to a lack of blood supply. Also called osteonecrosis, avascular necrosis can lead to tiny breaks in the bone and the bone's eventual collapse.
The blood flow to a section of bone can be interrupted if the bone is fractured or the joint becomes dislocated. Avascular necrosis is also associated with long-term use of high-dose steroid medications and excessive alcohol intake.
The most common joint affected by avascular necrosis is the hip. Avascular necrosis worsens with time, so managing it is a lifelong process.
Avascular necrosis typically causes pain and reduced range of motion in the affected joint. The most common joints affected by avascular necrosis include:
• Hip. In addition to pain in the hip joint itself, pain also may radiate into your groin or go down your thigh to your knee.
• Knee. In avascular necrosis of the knee, the pain occurs most often on the inside of the knee and worsens with activity.
• Shoulder. Several bones come together at the shoulder, but the one most commonly affected by avascular necrosis is the upper
arm bone.
Some people experience avascular necrosis bilaterally — for example, in both hips or in both knees. Signs and symptoms may appear suddenly if caused by an injury. In other cases, the pain and stiffness may build up slowly over several months. Some people with avascular necrosis experience no symptoms at all.
Other joints that are affected by avascular necrosis include:
• Ankles
• Feet
• Hands
• Jaw
• Spine
• Wrists
* See your doctor if you experience persistent pain in any joint. Seek immediate medical attention if you believe you have a broken bone or a dislocated joint.
*Original article: http://www.mayoclinic.com/health/avascular-necrosis/DS00650/DSECTION=symptoms
If Your World is Spinning...
21/03/11 09:39
Almost everyone experiences a few seconds of dizziness at some point in their lives. Do you remember your childhood days when you would spin round and round until you got dizzy and had to wait a few seconds till the “world stopped spinning”? It was fun back then, but when it occurs “out of the blue”, it’s something to be concerned about.
According to the National Institutes of Health (NIH), about 90 million Americans (more than a third of the population) report bouts of dizziness at some point in their lives. Of those, 76 million suffer from inner-ear disorders, which can be caused by:
1. Whiplash (neck injuries)
2. Blows to the head
3. Viral infections
4. High doses of certain antibiotics
5. Stroke
6. Degeneration of the inner ear's balance function, also known as the vestibular system (often deteriorates with age).
Inner-ear problems can manifest themselves in different ways. Some symptoms include dizziness, nausea and blurred vision. It’s not uncommon for individuals with dizziness to go from one doctor to another in an attempt to find a solution.
According to the National Institutes of Health (NIH), about 90 million Americans (more than a third of the population) report bouts of dizziness at some point in their lives. Of those, 76 million suffer from inner-ear disorders, which can be caused by:
1. Whiplash (neck injuries)
2. Blows to the head
3. Viral infections
4. High doses of certain antibiotics
5. Stroke
6. Degeneration of the inner ear's balance function, also known as the vestibular system (often deteriorates with age).
Inner-ear problems can manifest themselves in different ways. Some symptoms include dizziness, nausea and blurred vision. It’s not uncommon for individuals with dizziness to go from one doctor to another in an attempt to find a solution.
Importance of Vitamins and Aging
03/02/11 10:24
There has been recent evidence that as one ages one needs different dietary and dietary supplements. This should not come as a surprise - we are not the same when we age as when we were once young. As we age, we tend to eat less (but that does not mean we won't gain weight - but, that's another topic). Eating less and the changes in our digestive system and skin all have effects on our vitamin levels. It had been estimated that almost one-third of elderly people have deficiencies in vitamins and important minerals.
What Changes Elderly Needs for Vitamins As mentioned above, older citizens tend to eat less and less balanced meals. This is a major cause for possible vitamin depletion. Also many medicines that one takes can change the absorption of vitamins. Some people develop gastritis or bowel changes that also adversely affect the absorption of vitamins. Vitamin D is dependent on exposure to sunshine (not a problem for most of us at Seabrook) and in someone is not out in the sun and coupled with the changes to everyone's skin as we age, sufficient vitamin D may not be made. For this reason the daily requirement for vitamin D is greater in elderly than younger people. Even people who take vitamin supplements may take the pill at night or in the morning without food, and most of the vitamins require fat in our diet to help get optimal absorption. The point here, is take your supplement with your biggest meal of the day.
Some Problems with Vitamin Deficiency Vitamin D is necessary for the health of our bones. If we have insufficient levels of vitamin D this can lead to brittle bones. It is important to also take a supplement of calcium to maintain bone density and help prevent osteoporosis in patients who are developing this with age. Vitamin B--12 is important in maintaining mental function. Vitamin B12 is found naturally in lean red meat, chicken and skim milk. Folate and vitamins B6 and B12 are required for homocysteine metabolism and have been shown to reduce heart disease if ingested in appropriate concentrations. The antioxidants potentially reduce the incidence of several chronic illnesses. The point is that vitamins are important in maintaining our health.
Original article: http://www.muschealth.com/healthyaging/vitamins.htm
What Changes Elderly Needs for Vitamins As mentioned above, older citizens tend to eat less and less balanced meals. This is a major cause for possible vitamin depletion. Also many medicines that one takes can change the absorption of vitamins. Some people develop gastritis or bowel changes that also adversely affect the absorption of vitamins. Vitamin D is dependent on exposure to sunshine (not a problem for most of us at Seabrook) and in someone is not out in the sun and coupled with the changes to everyone's skin as we age, sufficient vitamin D may not be made. For this reason the daily requirement for vitamin D is greater in elderly than younger people. Even people who take vitamin supplements may take the pill at night or in the morning without food, and most of the vitamins require fat in our diet to help get optimal absorption. The point here, is take your supplement with your biggest meal of the day.
Some Problems with Vitamin Deficiency Vitamin D is necessary for the health of our bones. If we have insufficient levels of vitamin D this can lead to brittle bones. It is important to also take a supplement of calcium to maintain bone density and help prevent osteoporosis in patients who are developing this with age. Vitamin B--12 is important in maintaining mental function. Vitamin B12 is found naturally in lean red meat, chicken and skim milk. Folate and vitamins B6 and B12 are required for homocysteine metabolism and have been shown to reduce heart disease if ingested in appropriate concentrations. The antioxidants potentially reduce the incidence of several chronic illnesses. The point is that vitamins are important in maintaining our health.
Original article: http://www.muschealth.com/healthyaging/vitamins.htm