Your body’s cells face threats every day. Viruses and infections attack them. Free radicals also can damage your cells and DNA. Some cells can heal from the damage, while others cannot. Scientists believe molecules called free radicals can contribute to the aging process. They also may play a part in certain health conditions, like cancer, diabetes, and heart disease.

Antioxidants are substances that help stop or limit damage caused by free radicals. Your body uses antioxidants to balance free radicals. This keeps them from causing damage to other cells. Antioxidants can protect and reverse some of the damage. They also boost your immunity.

Path to improved health

Free radicals are natural or man-made elements. They can be:

• Chemicals your body produces by turning food into energy.
• Environmental toxins, like tobacco, alcohol, and pollution.
• Ultraviolet rays from the sun or tanning beds.
• Substances found in processed food.

There are things you can do to help fight free radicals and reduce the damage they cause. You can stop smoking, get sun exposure safely, and eat healthy. Antioxidants may also help. Your body produces some antioxidants. The best way to get additional antioxidants is through certain foods and vitamins. Common antioxidants include:

• Vitamin A
• Vitamin C
• Vitamin E
• Beta-carotene
• Lycopene
• Lutein
• Selenium

You can get most of these antioxidants by eating a healthy diet. This includes a mix of colorful fruits and vegetables. Whole grains, seeds, and nuts also provide good nutrients.

• Vitamin A is in milk, butter, eggs, and liver.
• Vitamin C is in most fruits and vegetables. Fruits such as berries, oranges, kiwis, cantaloupes, and papayas provide essential antioxidants. Vegetables such as broccoli, bell peppers, tomatoes, cauliflower, Brussels sprouts, and kale are also great choices.
• Vitamin E is in some nuts and seeds. For example, almonds, sunflower seeds, hazelnuts, and peanuts contain vitamin E. It can also be found in green leafy vegetables, such as spinach and kale, as well as soybean, sunflower, corn, and canola oils.
• Beta-carotene is in brightly colored fruits and vegetables. Eat fruits such as peaches, apricots, papayas, mangoes, and cantaloupes. Eat vegetables such as carrots, peas, broccoli, squash, and sweet potatoes. It also is in some green leafy vegetables, such as beet greens, spinach, and kale.
• Lycopene is in many pink and red fruits and vegetables. This includes pink grapefruits, watermelon, apricots, and tomatoes.
• Lutein is in green leafy vegetables such as spinach, collard greens, and kale. You also can find it in broccoli, corn, peas, papayas, and oranges.
• Selenium is in pasta, bread, and grains, including corn, wheat, and rice. You can find it in animal products, like beef, fish, turkey, and chicken. You also can find it in many nuts, legumes, eggs, and cheeses.

Each antioxidant has a different chemical makeup. Each one provides different health benefits. Too much of one antioxidant can be harmful. Talk to your doctor before changing your diet or taking supplements.

Things to consider

Doctors recommend eating a balanced diet that include fresh fruits and vegetables. A lot of produce has natural antioxidants. It also contains important minerals, fiber, and other vitamins. Eating healthy can help lower your risk of certain diseases. However, antioxidants alone do not prevent chronic conditions.

Some people choose to take antioxidant supplements. However, many are not balanced. They are also not approved or regulated by the U.S. Food and Drug Administration (FDA). This means that the ingredients and suggested dose listed on the bottle may not be correct.

Your body responds to antioxidants in different ways. Some can cause health risks or negative effects on your health. For instance, people who smoke are in danger of getting lung cancer. Taking high doses of beta-carotene can increase your risk of this disease. Antioxidants also can interact with some medicines.

Talk to your doctor before taking high doses of antioxidants. They can help you determine what, if any, supplements are right for you.

Questions to ask your doctor

• What other antioxidants can I find in food?
• How many antioxidants should I try to consume every day?
• How do I know what types of antioxidants are good for me?
• Should I take antioxidant supplements if I’m a smoker?
• Should I take antioxidant supplements if I already have cancer?

Resources

National Cancer Institute: Antioxidants and Cancer Prevention

National Institutes of Health, MedlinePlus: Antioxidants

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What is adult ADHD?

Attention-deficit hyperactivity disorder (ADHD) is a neurological disorder represented by a group of behaviors. It used to be called attention deficit disorder (ADD). ADHD is not just present in children. Adults can be diagnosed with ADHD, too. As such, it is a disorder that is considered to affect a person across the lifespan. It is more common in adult men. People who have ADHD have trouble paying attention (executive function) at school, work, or home. Even when they try to concentrate, they find it hard to pay attention. It can interfere with relationships to a degree.

Symptoms of adult ADHD

Adults who have ADHD are more likely to be distracted, careless, or impulsive. Someone who finds it difficult to pay attention may have adult ADHD if they have 6 or more of the following symptoms:

• Has difficulty following instructions
• Has difficulty focusing on activities at school, work, and/or home
• Moves from one thing to another, sometimes without completing the first
• Loses things often
• Appears not to listen
• Doesn’t pay close attention to details
• Seems disorganized
• Has trouble with tasks that require planning ahead
• Forgets things
• Is easily distracted

Someone who is impulsive may have adult ADHD if they have the following symptoms.

• Makes decisions quickly, often without thinking them through
• Interrupts people
• Talks too much
• Fidgets or can’t be still
• Is always on the go
• Is impatient or has trouble waiting their turn

What causes adult ADHD?

People who have ADHD do not make enough chemicals in certain parts of the brain that help organize thoughts. This is thought to be the cause of ADHD. The shortage of chemicals may be due to a person’s genes. Research shows that ADHD is more common in people who have a close family member with the disorder.

Recent research suggests there are certain risk factors for ADHD, including:

• Smoking during pregnancy
• Substance abuse during pregnancy
• Exposure to environmental toxins (lead)
• Brain injury
• Low birth weight
• Genetics

How is adult ADHD diagnosed?

A person diagnosed with ADHD will have had symptoms for at least 6 months. You may have been diagnosed with ADHD as a child, or it may have gone undiagnosed. Some adults who have ADHD may be diagnosed when they find out their children have ADHD.

Talk to your doctor if you notice ongoing signs of adult ADHD. They will discuss your symptoms, lifestyle, and overall health. In order to be diagnosed with adult ADHD, you must have had symptoms prior to age 12.

Can adult ADHD be prevented or avoided?

You cannot prevent or avoid adult ADHD.

Adult ADHD treatment

Adults who have ADHD can help manage symptoms. Start by identifying the areas of your life that are most impaired by ADHD and then seek treatment to address them. Treatment options include medicine, therapy, and/or lifestyle changes.

Medicine

One type of medicine used to treat ADHD is called psychostimulants. This includes methylphenidate, dextroamphetamine, and a drug that combines dextroamphetamine and amphetamine. These medicines have a stimulating effect in most people. However, they have a calming effect in people who have ADHD. These medicines improve attention and concentration and decrease impulsive and overactive behaviors. Your doctor may consider other non-stimulant medicines, such as atomoxetine, clonidine, desipramine, imipramine, or bupropion.

All medicines have side effects. Psychostimulants may decrease your appetite and cause a stomachache or a headache. The loss of appetite can cause unplanned weight loss in some people. This side effect seems to be more common in children. Some people have insomnia (trouble sleeping). Other possible side effects include fast heartbeat, chest pain, or vomiting. To avoid or reduce the side effects of psychostimulants, follow these tips:

• Use the lowest possible dose that still controls the hyperactivity or inattention. Your doctor will tell you the right dose.
• Take the medicine with food if it bothers your stomach.
• Maintain a healthy diet.
• Ask your doctor if you can skip taking medicine on the weekends.
• If you take a long-acting medicine, do not crush, break, or chew it before swallowing it.

It’s important to take the medicine the way your doctor prescribes it. Follow their advice, even if you think the medicine isn’t working. Medicines used to treat ADHD have been shown to improve a person’s ability to do specific tasks. This includes paying attention or having more self-control. The length of time a person will need to take medicine depends on each person. Some people only need to take medicine for 1 to 2 years. Others need treatment for longer.

Therapy

If your doctor thinks you have adult ADHD, they may suggest therapy. This could include individual counseling and/or support groups. Your doctor also may recommend testing and counseling with someone who specializes in treating ADHD. You can learn ways to change your work environment and keep distractions to a minimum. Organizational tools can help you learn how to focus on activities at work and at home. Many people who have ADHD find counseling helpful.

Lifestyle changes

It is important to make some personal changes to help improve your condition. These may include:

• Setting a schedule and sticking to it. Having a set schedule can keep you organized, focused, and on track.
• Thinking before you act. If you know you tend to be impulsive, try to put more thought into decisions. Think about pros and cons as well as possible risks or consequences. Think about how it could affect others, not just yourself.
• Maintaining a healthy, well-rounded routine. Try to be consistent with your diet, exercise, and sleep. Avoid substances or situations that trigger negative actions.

Living with adult ADHD

People who have ADHD should visit their doctor for regular checkups. A lifetime of ADHD behaviors can cause social problems, such as low self-esteem, trouble learning or working, and problems with relationships. ADHD can put you at risk of addiction. Some people who have ADHD may have problems sleeping or eating. They may have related health conditions as well (which can be mistaken for adult ADHD). These could include:

• Anxiety
• Depression
• Bipolar disorder
• Oppositional defiant disorder (ODD)
• Tourette syndrome
• Learning disabilities
• Substance abuse

Questions to ask your doctor

• If I am diagnosed with ADHD as a child, will I have it as an adult?
• What medicine is best for me? What are its side effects?
• Will I always have to take medicine?
• Do I have to take the medicine consistently for it to work?
• Are there diet or lifestyle changes I can make to help with ADHD?
• Can counseling help with relationship issues?

Resources

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD): For Adults
National Institute of Mental Health: Attention-Deficit/Hyperactivity Disorder

National Institute of Mental Health: Could I Have Attention-Deficit/Hyperactivity Disorder in Adults: What You Need to Know

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Energy drinks were first sold in the United States in the 1990s. Now, there are hundreds of options. Related products have been made, like energy shots, chews, and snacks.

Energy product companies target kids and teens under the age of 18. College students also use a high amount of energy drinks. A lot of companies are known to give products to kids for free. Some drinks even taste like candy so kids like the taste. This makes them more common and attractive. However, energy drinks can cause harmful health issues.

What are energy drinks?

Energy drinks differ from soft drinks and sports drinks. Soft drinks have a lower amount of caffeine. Sports drinks can have vitamins, carbs, and sugar. You should drink them after an intense workout to restore the fluid balance in your body.

Most energy drinks list caffeine and vitamins as the main ingredients. This makes them sound healthy and attractive, but that is false. Energy drinks claim to increase focus and improve performance. They contain a lot of added stimulants, such as:

• An herb used to prevent tiredness and improve mental speed. It also is used to promote weight loss and increase sexual desire. Guarana also contains caffeine. That makes the total amount of caffeine in the energy drink even higher.
• A supplement used to improve memory and endurance.
• An herb used to help reduce stress, strengthen muscles, and improve endurance.
• Synephrine (bitter orange). An herb used to promote weight loss.
• L-carnitine l-tartrate (LCLT). A supplement used to increase energy, memory, and speed. It also is used to break down fat.
• Yerba mate. An herb used to prevent tiredness and improve mood.
• An herb used to increase focus and prevent tiredness.
• John’s Wort. An herb used to reduce stress and improve mood.

These aren’t always harmful by themselves. When combined with caffeine, they can cause health issues.

Why it’s important

A big problem with energy drinks is there is little control from the U.S. Food and Drug Administration (FDA). This means that a lot of the ingredients haven’t been fully tested. Also, there are no laws on the product labels. So drinks may not list the correct amount of caffeine.

Soft drinks have about 30 milligrams (mg) of caffeine per serving. Coffee has about 100 mg of caffeine per cup. Energy drinks can have anywhere from 100 to 400 mg of caffeine per serving.

Energy drink companies don’t help. Their advertising can be forceful and dishonest. Some ads promise that energy drinks make you popular. For instance, Red Bull says their drink “gives you wings.” Rockstar invites users to “party like a rockstar.” Amp suggests that it is “energy you need, flavors you crave.” These claims make energy drinks seem safe and stylish.

Doctors worry about the dangers of energy drinks. Side effects differ based on the person, type, and amount used. Reactions to energy drinks include:

• Headaches, stomachaches, or diarrhea
• Chest pain
• Anxious or nervous feelings
• Dizziness or lack of focus
• Inability to fall asleep
• Weight gain or diabetes due to the sugar and calories of energy drinks
• Dental issues

Severe health issues also can occur from using energy drinks, such as:

• Addiction and withdrawal
• High blood pressure
• Seizures
• Heart problems. Many people report rapid heartbeat. Major use has been linked to uneven heartbeat or heart failure. Rare cases have been linked to death.

Children tend to be more sensitive to caffeine. It can be harmful to their growth. People who have heart conditions or asthma also are at greater risk.

Path to improved health

The American Academy of Family Physicians (AAFP) states that the FDA should set guidelines. Labels should be standard and truthful. Products should be tested and controlled. AAFP also is against marketing and selling energy products to kids under 18 years old.

Until this happens, there are precautions we can take. You should be aware of these risks and talk to your kids about them. Promote a healthy diet with regular sleep and exercise. People who do this should have enough natural energy. Having one energy drink now and then might be OK. But drinking them all the time could affect your health.

Schools also can help fight the use of energy drinks. The Centers for Disease Control and Prevention (CDC) states that schools should offer healthy drinks only. Energy drinks should not be an option. The National Federation of State High School Associations (NFHS) also states that student athletes should not use energy drinks. They can make kids sick and unable to perform. Some ingredients in energy drinks can show up on drug tests.

Things to consider

There is another dangerous trend with energy drinks. It has become common to mix them with alcohol. Mixing them can make you feel less drunk than you are. It also affects your ability to make good choices. The same is true if you mix energy drinks with illegal drugs or certain medicines.

Talk to your doctor if you or your child has any health issues from consuming energy drinks. They will need to stop using them. They also may need treatment for their symptoms.

Questions to ask your doctor

• How much caffeine can I safely have every day?
• How many energy drinks is too many?
• How do I know if my health issues are caused because I drink energy drinks?

Resources

American Academy of Family Physicians, American Family Physician: The Potential Adverse Health Effects of Energy Drinks

Centers for Disease Control and Prevention, CDC Healthy Schools: Energy Drinks

National Institutes of Health, MedlinePlus: Caffeine

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Vitamin D is an important nutrient. It helps your body build strong bones and teeth. Maintaining an adequate level of vitamin D is important for all stages of life. It is especially important for children while their bones and teeth are developing. Vitamin D has other health benefits, as well. Vitamin D may protect against various health conditions, such as some cancers, muscle weakness, mood disorders, diabetes, kidney disease, heart disease, and high blood pressure.

Path to improved health

You can get Vitamin D from certain foods, sunlight, and dietary supplements.

Vitamin D is sometimes called the “sunshine vitamin.” That’s because your body creates its own vitamin D when you are exposed to sunlight. Depending on where you live, you might only need 10 minutes of sunshine 3 to 4 times a week to help your body create the vitamin D it needs. This can happen while you’re taking your dog for a walk or your children to the park. During certain times of the year, especially in northern states, there may not be enough of the right sunlight to make vitamin D. This is true even if you are outside all day.

Most people get very little vitamin D from the foods they eat. That’s because there are very few foods that contain vitamin D. Foods that naturally contain vitamin D include fatty fish, fish oil, eggs, cheese, and butter. There are also foods and drinks that have been fortified with vitamin D. These include milk, milk alternatives, some brands of orange juice, and some vitamin-fortified breakfast cereals. Read the food nutrition labels to learn if the products you choose are sources of vitamin D.

Vitamin D is available over the counter and by prescription. If you are concerned that you are not getting enough vitamin D, talk to your doctor. They will ask you about your diet and your exposure to sunlight. Your doctor also will consider other risk factors you may have.

Your doctor may want to test your level of vitamin D. This can be done through a blood test (inserting a small needle into your vein and taking a sample of blood to send to a lab). This will help determine if you need a supplement and, if so, how much. If you are a senior, a vegetarian or vegan, a nursing mother, or a pregnant woman, talk to your doctor about whether you should take a vitamin D supplement.

Things to consider

A low level of vitamin D in the body is called a vitamin D deficiency. Children who don’t get enough vitamin D are at risk for rickets. Rickets is a disorder that affects the bones. It causes bones to soften and break easily. Vitamin D deficiency can delay a child’s growth. And it can lead to cavities and problems with teeth structure. Adults who do not get enough vitamin D are at risk for osteomalacia (weak bones), osteoporosis (thin bones), and muscle weakness. This can increase the risk of bone fractures and falls.

The amount of vitamin D your body needs can vary depending on several factors, including:

• Weight
• Genetics
• Skin color
• Chronic conditions
• Where you live
• Sun exposure

Adults 70 years old and younger need 600 international units (IU) of vitamin D a day. Adults over the age of 70 need 800 IUs of vitamin D a day. For children between the ages of 1 and 18, the recommended daily dose is 600 IU. For children from birth to 12 months of age, the recommended daily dose is 400 IU.

If you breastfeed your baby, your doctor may prescribe a vitamin D supplement. Breast milk only has a small amount of vitamin D. Talk to your family doctor before giving older children vitamin supplements.

Vitamin D deficiency risk factors:

Some people are at higher risk for vitamin D deficiency than others, including:

• Infants who are only breastfed
• Babies and toddlers who are given non-milk food products or foods that are not fortified with vitamin D
• Seniors or older adults
• Darker-skinned people
• Those with limited exposure to sunlight (this includes people who are homebound)
• People who have difficulty absorbing dietary fat (because of conditions such as colitis, inflammatory bowel disease, and cystic fibrosis)
• Vegans, ovo-vegetarians, and those with other dietary restrictions such as milk-allergies and lactose-intolerance
• Obese people with a body mass index (BMI) greater than 30
• People with kidney disease, including kidney transplant recipients
• Those on medicines called glucocorticoids

People who live in northern states can also be at high risk. This is especially true during winter months. The farther south you live, the easier it is to get your vitamin D from sun exposure all year round.

Questions to ask your doctor

• Can a vitamin D deficiency make you feel overly tired?
• Can too much vitamin D be bad for your health?
• Are there any side effects to vitamin D dietary supplements?
• Can you get adequate sunlight by sitting near a window?

Resources

National Cancer Institute: Vitamin D and Cancer Prevention

National Institutes of Health, Office of Dietary Supplements: Vitamin D

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Vegans avoid eating all animal products, including meat, eggs, and dairy. They also don’t eat food that has an animal source, like gelatin and honey. For many, veganism is about more than food choices. People choose to be vegan for health, ethical, and/or environmental reasons. Strict vegans do not use any products made from animals. This includes materials, such as leather, fur, silk, or wool. They also avoid using certain soaps and cosmetics.

Path to improved health

A well-planned vegan diet can offer you the fulfillment of following your beliefs and may give you the enjoyment of living a longer, healthier life. The vegan diet may provide health benefits, including: 

• Lower cholesterol levels
• Lower blood pressure
• Lower intake of saturated fats
• More vital nutrition
• Decreased risk of type 2 diabetes, heart disease, and certain cancers
• Healthier body weights

The vegan lifestyle requires careful attention. It can be hard to get enough of the vitamins and minerals found in animal products. You have to eat a balance of foods to avoid health risks. Focus on including the nutrients below in your diet.

• Iron plays a key role in the production of red blood cells. These cells help carry oxygen throughout your body. Good sources of iron include beans, broccoli, raisins, wheat, and tofu. Iron-fortified cereals also are a good source. Iron found in non-meat sources is harder to digest. You should eat foods rich in vitamin C, such as oranges and broccoli. They help your body absorb iron.
• Protein is an important component for almost every part of your body. Your skin, bones, muscles and organs need protein to be healthy. Amino acids are the building blocks of protein. Without meat and dairy, you still need to consume essential amino acids. Vegans can get protein from nuts, peanut butter, seeds, grains, and legumes. Non-animal products like tofu and soymilk also provide protein. Vegans have to consider getting enough “complete proteins.” A complete protein contains all the amino acids your body needs to help maintain your metabolism.
• Calcium builds strong bones and helps prevent osteoporosis. This is a disease that weakens your bones and can cause breaks. Soybeans and dark leafy greens, like broccoli, bok choy, and kale, contain calcium. You also can drink fortified soymilk and juices. Calcium supplements also are available.
• Vitamin D also plays an important role in bone health. It helps your body absorb calcium and promote bone growth. Your body produces some vitamin D in response to sunlight. You should get 10 minutes of sun exposure 3 to 4 times a week, if possible. Based on where you live, this should be all the vitamin D you need. Make sure you always use safe practices in the sun. If you need more vitamin D, look for fortified products. This includes soymilk, rice milk, and some cereals.
• Vitamin B12 helps produce red blood cells and prevent anemia. Vitamin B12 is mainly found in fish, shellfish, meat, and dairy products. Try to eat products fortified with this vitamin. This includes soymilk and some cereals. Talk to your doctor about taking a B12 supplement. Check the label to make sure it doesn’t contain animal products.
• Zinc is vital to your immune system. You can find it in beans, nuts, and soy products.
• Omega-3 fatty acids improve your heart health and brain function. Flaxseed meal and oil are two sources. You also can look for food products fortified with omega-3 from a plant source. Talk to your doctor about taking an omega-3 supplement. Check the label to make sure it doesn’t come from fish oil.

Vegans need to pay close attention to labels. This applies to food and supplements. Be aware of the following “small print” ingredients:

• Carmine/cochineal is a common food coloring. It comes from crushed beetles.
• Shellac is a glaze that comes from beetles. It is often found on shiny hard candies and sprinkles.
• Casein is a milk product sometimes found in protein shakes.
• Whey is a dairy product. It appears as an additive in a wide variety of foods.

Things to consider

As a vegan, you can have a lifetime of good health. However, this requires making balanced choices. Try not to indulge in junk foods. You should eat high quality foods with nutrients your body needs. Keep an eye out for signs of nutritional problems. This includes changes in your weight, skin, or hair.

If you have questions or concerns, talk to your family doctor. If you have special health needs, such as diabetes, consult your doctor before starting a new diet. They can help you make the best nutritional choices for your health.

Questions to ask your doctor

• What are the side effects of switching to a vegan diet?
• Can a vegan diet help manage certain diseases and conditions?
• Can I follow the vegan diet if I am pregnant or breastfeeding?
• Are there any medicines that might have animal products in them?

Resources

The Vegetarian Resource Group: Veganism in a Nutshell

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