Kathryn Lost More Than 100 Pounds With Penn Medicine

To see Kathryn Naphy, you’d think she’s been thin and eating healthy, balanced meals all her life. But, the 33-year-old mom of two has a story behind what you see today.

“In 2006, I was diagnosed with pre-diabetes, my cholesterol was about 350 and my triglycerides were in the thousands,” remembers Kathryn. “I was only 26, a new mom and I was scared I wouldn’t be around to see my son grow up.”

Though Kathryn had been active her whole life, her weight had always been a struggle for her. Even while eating well and playing sports, she remained about 30 pounds overweight.

“After I had my first child, I hit my highest weight - about 240 pounds,” she remembers. “That, combined with learning about my health problems was a wake up call for me.”

Making the Weight-Loss Surgery Decision

Kathryn’s aunt had Roux-en-Y (gastric bypass) surgery with Penn bariatric surgeon Matt Kirkland, MD, and successfully lost weight – and gained her life back.

“Seeing my aunt’s success made me realize weight-loss surgery might be a tool I could use to get healthy again,” says Kathryn. “My aunt paved the way for me, and everyone in my family was supportive of my decision.”

Kathryn met with Dr. Kirkland to learn about her weight-loss surgery options at Penn.

“I knew gastric bypass was the surgery that would save my life.”

Kathryn fulfilled the necessary testing and nutrition requirements, and had her surgery
On July 5, 2006. Everything went smoothly.

“The biggest challenge was immediately after surgery,” remembers Kathryn. “It was difficult to lift my son in and out of the bathtub while I was recovering, but aside from that, my recovery was fairly easy.”

It wasn’t long before Kathryn lost more than 100 pounds going from her pre-surgery weight of 224 to 119 pounds.

“I was surprised at how fast the weight just came off,” she says. “In fact, I had to make a conscious effort to stop losing weight because I was getting so thin.”

Kathryn worked with Penn dietitians to maintain an eating program that would help her maintain her weight at about 130 pounds.

Pregnancy After Gastric Bypass Surgery

And then in 2009, she got pregnant with her second child. This pregnancy, she says, was a bit different than her first.

“I didn’t eat poorly like I did with my first pregnancy,” she says. “And I only gained 35 pounds. Overall, this pregnancy was easier because I wasn’t carrying all of that extra weight around.”

Kathryn breastfed and got back on track after she gave birth, and returned to her pre-pregnancy body in no time.

Today, Kathryn blogs about her weight-loss journey, and what it’s like to be a mom of two who’s had gastric bypass surgery.

She has also led by example, and changed the way her entire family eats by cooking fresh meals prepared with fruits, vegetables, lean meats and whole grains.

“I still eat small meals, five or six times a day,” she says. “Weight-loss surgery at Penn was the tool I needed to change my life and turn my health around for good.”

Connect with Kathryn on her blog, Eating After Gastric Bypass, or follow her on Twitter. 

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

7 Smoothies for Every Day of The Week

Registered dietitian and bariatrics program nutritionist Danielle Rosenfeld, MS, RD, LDN, gives us some ideas on refreshing and nutritious summertime smoothies to try. 


Smoothies can be an excellent way to boost your intake of fruits, veggies and protein. During the summertime, there are an abundance of in-season fresh produce, such as blueberries, raspberries, peaches, watermelon, cherries, basil, broccoli and strawberries. In-season produce are at their peak in terms of nutritional content and flavor profile and taste delicious blended in a refreshing smoothie.

In the colder months, check out frozen fruits to add to your shakes.

Don’t be afraid to get creative and experiment with your smoothies. Here are some unique and tasty options.

Note: Add 1 scoop of protein powder to any of these recipes for an extra 20 grams protein/serving.

Green Machine

1 cup fresh baby spinach leaves + 1 1/2 cups chopped fresh honeydew + 1/3 cup nonfat vanilla Greek yogurt

162 calories
Source: Cooking Light

Berries and Beets

1 cup fresh blueberries + 1/2 cup fresh or frozen raspberries + 1/3 cup sliced, cooked beets + 1/4 cup nonfat Greek yogurt + 1/4 cup diluted fresh orange juice

219 calories
Source: Cooking Light

Ginger, Berries & Oats

1/4 cup prepared oatmeal + 1/4 cup fat-free milk + 1/2 teaspoon grated fresh ginger + 1 cup fresh blackberries + 1/2 cup sliced strawberries + 1/2 cup ice

179 calories
Source: Cooking Light

Peanut Butter Berry

1/4 cup 1% low-fat milk + 1/2 medium ripe banana + 1 tablespoon creamy peanut butter (or PB2 reduced calorie peanut butter) + 1 cup fresh or frozen raspberries + 1/2 cup crushed ice

237 calories
Source: Cooking Light

Watermelon with a Hint of Mint

2 cups seedless watermelon + 2 tablespoons fresh mint + 1/3 cup 0% plain Greek yogurt

98 calories
Source: Cooking Light

Creamy Mango, Avocado & Lime

1/4 cup sliced avocado + 1 cup sliced Champagne mango + 1 tablespoon lime juice + 1 tablespoon fresh mint + 2 cups crushed ice.

191 calories
Source: Cooking Light

Peach Cobbler Protein Shake

8 oz skim, 1%, Lactaid, soy or almond milk + 1 scoop of vanilla protein powder + 1/4 cup frozen sliced peaches + dash cinnamon & nutmeg + 2 to 3 ice cubes

185 calories, 17 g protein (when made with 1% milk)
Source: The World According to Eggface

Note: If you can’t find fresh fruit, frozen is a great option. Frozen fruit is often just as nutrient-packed as fresh—just make sure to choose those with no added sugars.

Also, If your smoothie does not have enough liquid, add cold water, skim milk or unsweetened soy or almond milk.

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

10 Summer Bucket List Ideas

Summer is halfway over, and it’s easy for the whole family to succumb to lazy summer days. And with high obesity rates ravaging our country, it’s more important than ever to keep active and healthy.

If you’re looking for ways to manage the amount of time your family spends in front of the TV, computer, and other electronics, coming up with a “summer bucket list” can help keep your family active and entertained. Here are 10 great ideas to help you get started on your own summer break to-do list.

1. Buy fresh produce at the farmers’ market
2. Play tag, hopscotch, four square, spud, or kickball
3. Go for a hike
4. Build a sandcastle at the beach
5. Pick berries or peaches at a farm
6. Go camping
7. Play Frisbee
8. Have a cartwheel competition
9. Play baseball
10. Go kayaking or canoeing

Lose Weight at Penn Medicine

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

3 Ways to Deal With a Weight-Loss Plateau

When trying to lose weight, staying motivated is one of the most important parts of success. So when the scale suddenly stops moving, it can be an incredibly frustrating time. If your weight loss has stalled in the past few weeks, here are three helpful hints to try to get the scale moving in the right direction again.

Write down everything that you’re eating

When our dieting choices start to become habit, it’s easy to slide in a few extra calories here and there. And while they aren’t much on their own, when you add the calories up over the course of the week, it could be enough to detriment your progress. On the other hand, you could be eating too few calories as well. Start writing down everything you eat and drink with specific portion sizes, either with a hand-written food journal or tracking application such as My Fitness Pal, and make a plan for how you can improve your nutrition intake.

Try a new exercise routine

Are you a regular on the elliptical machine at the gym? Spice up your workout by taking a Zumba or kickboxing class. De-stress with a yoga session. Incorporate strength training exercises. Go for a walk around your town instead of using a treadmill. By spicing up your usual exercise routine, you can banish workout boredom and jumpstart your weight loss.

Talk about it

Having a workout buddy or joining a weight-loss forum to talk to when you’re struggling means getting advice from other people who’ve hit similar weight loss plateaus. You’re likely to get a plethora of ideas and inspiration to get you over this bump in the dieting road.

Bonus Tip: Don’t forget to measure your loss in other ways

Just because the scale isn’t moving right now doesn’t mean your diet isn’t paying off. Have you lost inches? Can you fit into an old pair of jeans that were too tight to close last month? Celebrate those milestones as well – you’ve worked hard to get them!

Lose Weight at Penn Medicine

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Why is Olive Oil Good for You?

Did you know the United States is the third largest global consumer of olive oil? As the world continues to recognize all the health benefits that olive oil offers, the Mediterranean diet and lifestyle are becoming more and more popular, and with good reason. Olive oil is one of the healthiest oil options for cooking, as well as having a variety of other health and beauty uses.

Piling on the polyphenols

Olive oil is a fantastic source of polyphenols, which are a type of antioxidant, which has anti-inflammatory properties and help protect cells from damage. Because of this, olive oil is good for your heart, bone, and digestive health. Scientists have also begun researching the oil’s capabilities of improving memory, cognitive function, and cancer prevention.

Headlining the Mediterranean diet

Olive oil remains one of the biggest elements in the Mediterranean diet, which has commonly been linked to individuals in the best health. The diet is rich in monounsaturated fats, fish, olives, fruits and vegetables, and has been thought to lead to long healthy lives and lower rates of chronic diseases, like obesity and type 2 diabetes.

Beauty on a budget

Olive oil is also an effective supplement for skin care, thanks to its antioxidant properties. Found in hundreds of beauty products, from moisturizers to nail care, olive oil can be applied directly to the body to heal dry skin, remove eye makeup, or as an inexpensive hair mask.

Good for you, but watch the calories

Olive oil is a prime example of the phrase “too much of a good thing” when it comes to dieting. While the oil is full of health benefits, it also packs a caloric punch, at a whopping 120 calories per tablespoon. So, even though olive oil is a better choice than other saturated fats, it’s important to remember that a little goes a long way.

Lose Weight at Penn Medicine

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

3 Tips for Working Out in the Heat

Just because it’s hot outside doesn’t mean it’s time to stop exercising and spend all day laying in the air conditioning!

Before you begin exercising this summer, here are three tips for working out and staying healthy in the heat.

Stay hydrated and replenish electrolytes

One of the most important things to do while exercising in the heat is drinking water, water, and more water! Dehydration can cause light-headedness and nausea, and can lead to bigger health problems like kidney failure. Make sure to take plenty of water breaks and watch for any signs of dehydration.

While it’s crucial to drink enough water while working out in the heat, making sure you maintain your body’s balance of electrolytes and salt is important too. Bringing along a sugar-free sports drink, like G2 Gatorade can help avoid confusion, nausea  and muscle cramps associated with low electrolytes.

Avoid temperature peaks and heat advisory days

Working out in the morning, before the sun has a chance to kick up the heat is the best. If you can’t work out in the morning, avoid exercising during the hottest part of the day, which is from 10 am to 3 pm.

Always check the weather forecast before leaving for a workout. If there is a heat advisory in effect, keep your exercise session indoors.

Use sunscreen and shade

There’s no sense in heading outdoors to get in shape and getting skin cancer, right? It’s important to wear sunscreen every time you exercise outside, even on cloudy days. Look for places with ample shade for your work out: not only will you protect your skin, you’ll stay cooler too.

Bonus tip: Hit the pool

Who says exercising can’t be fun? Stay cool and tone your body by doing laps around your local pool, bring a friend and race each other, or check out a water aerobics class at the YMCA.

Lose Weight at Penn Medicine

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

How Much Weight Can You Expect to Lose With Weight-Loss Surgery?

Here’s an exercise:

Imagine losing 1/3 of your weight.

Take your weight and multiply it by .30. Now subtract that number from your current weight. Imagine what your life would be like if you weighed that number.

Could you move easier? Would your knees still hurt? Could you keep up with your kids or grandchildren?

Would you be able to stop taking some of the medications you take every day? What would it be like to regain your health?

On average, someone who undergoes weight-loss gastric bypass surgery can expect to lose approximately 30 percent of his or her starting weight. Most of this loss is experienced during the first few months following surgery with the weight loss continuing for 12 to 18 months after surgery.

Weight loss associated with the adjustable gastric band and sleeve gastrectomy may not be as rapid and the weight loss may not be quite as great.

Each person’s weight-loss progress is different, but one thing is clear: healthy eating habits, exercise and ongoing support are critical for continued success.

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Beach and Boardwalk "Dos" and "Don'ts" for Staying on Track

What should you pick while strolling the boards? And what foods should you steer clear of all together? Here’s a list of “dos” and “don’ts” sure to fit any vacation.

Do eat before you hit the boardwalk.

If you can, try to have a healthy dinner before you stroll the boardwalk at sunset. Not only will you avoid greasy and fatty fried foods for dinner, you’ll get some exercise after dark.

Don’t be too hard on yourself.

If you’ve spent the entire year dreaming about having a funnel cake at your favorite local carnival, go for it! But do it wisely. Share it with a couple of other people. You’ll still get the taste, but without all the calories. Also, remember that one funnel cake has almost 800 calories and 44 grams of fat.

Do keep journaling and tracking your food.

One of the great things about tracking your food and calories is that is keeps you accountable of everything that goes in your mouth. If you want that funnel cake and want it all for yourself, just make sure you account for the 800 extra calories you’re eating.

Do choose pizza over cheese fries.

Sure pizza may not be the healthiest thing to eat when you are trying to lose weight, but compared to corn dogs, nachos, cheese fries and other traditional theme park fare, pizza isn’t too shabby. Try to choose vegetable toppings and avoid high-fat toppings like pepperoni and sausage.

Don’t waste calories on cotton candy.

Cotton candy has absolutely no nutritional value – it’s all spun sugar with a bit of food coloring to make it look fun. But the good news is that there aren’t too many calories (about 200) and it has 0 grams of fat.

Don’t pick fried.

It probably goes without saying, but fried foods can sabotage any diet. What’s worse is there seems to be a trend of “fried anything” at carnivals and theme parks. Fried Oreos®, Twinkies®, pickles – you name it, and someone has tried to fry it. While it’s tempting to see what these things taste like, try to remember that cravings don’t last forever.

If you can walk past the fried Oreos, you’ve won the battle.

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Is Bottled Water Good for Weight Loss?

Water is the best beverage for staying hydrated and avoiding extra calories, but it’s not necessary to buy it in a plastic bottle. The bottled water industry promotes bottled water as being healthier, yet the reality is that bottled water is less regulated for quality than tap water. Plus it is more expensive and can be environmentally unfriendly, too.

Before buying bottled water, consider these facts:

• Bottled water can cost nearly 2,000 times as much as tap water.
• Environmental Protection Agency (EPA) guidelines for regulating municipal tap water are far more rigorous in terms of control, disinfection and monitoring than those used by the U.S. Food and Drug Administration (FDA) to oversee bottled water. In fact, a National Resource Defense Council (NRDC) study of the bottled water industry, tested over 1,000 bottles of water, and concluded that bottled water is not guaranteed to be any cleaner or safer than tap water. The study found that approximately 25 percent of bottled water was tap water packaged in a bottle and 22 percent of the samples contained chemical contaminants above the strict state limits on municipal tap water.  
• Bottled water companies are not required to disclose information about their products. A recent report released by the Environmental Working Group (EWG) indicates that more than half of the bottled water products surveyed failed EWG's transparency test. According to the report, 18 percent of the companies failed to reveal the source of the water and another 32 percent did not disclose any information about the treatment or purity of the water.
• Studies have also shown that chemicals called phthalates, which disrupt testosterone and other hormones, can leach into bottled water over time.  Although there are regulatory standards limiting phthalates in tap water, there are no legal limits for phthalates in bottled water.  
• Although plastic bottles are recyclable, nearly 90 percent of them end up as litter or garbage contributing more than 2 million tons of plastic to landfills each year. 

A comprehensive list of the tap-water contaminants in your area is available on the EPA website. If you are concerned about the quality or flavor of your tap water, purchase a water filter to put on your tap. It is both easier on your wallet and on the environment. To keep filtered water accessible to drink when you’re on the go, put it in your own reusable bottle to carry with you throughout the day.  

• Complete guide to purchasing a water filter 
• More details on the NRDC study results

- Cara Stewart, RD, LDN

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Healthy Recipe: Grilled Halibut with Peach and Pepper Salsa

A fresh fruit salsa is a lovely accompaniment to grilled fish in the summer; try it also with striped bass or arctic char. Here, the season's juiciest peaches pair with fiery Habanero pepper for a sweet-spicy flavor. Leave the peaches unpeeled for more color and texture.

Yield: 4 servings (serving size: 1 fillet and about 2/3 cup salsa)

Grilled Halibut with Peach and Pepper Salsa

From Jeanne Kelley, Cooking Light
JUNE 2010 

Ingredients

Salsa:

• 1 1/3 cups coarsely chopped peeled yellow peaches (about 1 pound)
• 1 cup chopped red bell pepper (about 1 medium)
• 1/3 cup thinly sliced green onions
• 1/3 cup chopped fresh arugula
• 1/4 cup fresh lemon juice (about 2 lemons)
• 4 teaspoons chopped fresh oregano
• 1/8 teaspoon salt
• 1/2 Habanero pepper, seeded and minced
• 1 garlic clove, minced

Fish:

• 4 teaspoons fresh lemon juice
• 4 teaspoons olive oil
• 1/2 teaspoon paprika
• 1 garlic clove, minced
• 4 (6-ounce) skinless halibut fillets
• 3/8 teaspoon salt
• 3/8 teaspoon freshly ground black pepper
• Cooking spray

Preparation
1. To prepare salsa, combine first 9 ingredients; toss gently. Let stand 30 minutes before serving.
2. Prepare grill to medium-high heat.
3. To prepare fish, combine 4 teaspoons juice, oil, paprika, and 1 garlic clove in a large, shallow glass baking dish, stirring with a whisk. Add fish to juice mixture; turn to coat. Cover and let stand 15 minutes.
4. Remove fish from marinade; discard marinade. Sprinkle fish evenly with 3/8 teaspoon salt and black pepper. Place fish on a grill rack coated with cooking spray; grill 3 minutes on each side or until desired degree of doneness. Serve fish with salsa.


Nutritional Information
Amount per serving
Calories: 267
Fat: 8.6g
Saturated fat: 1.2g
Monounsaturated fat: 4.6g
Polyunsaturated fat: 1.8g
Protein: 35.3g
Carbohydrate: 11.8g
Fiber: 2.3g
Cholesterol: 52mg
Iron: 2mg
Sodium: 389mg
Calcium: 104mg

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Vitamin D - Are You Getting Enough?

Karen Buzby, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, discusses vitamin D, and how to tell if you’re getting enough vitamin D. 

Vitamin D is essential for the absorption of calcium and building and maintaining strong bones. Individuals who do not get enough vitamin D may develop soft, thin, and brittle bones, a disease called rickets in children and osteomalacia in adults.

Vitamin D is also required for the healthy functioning of muscles, the nervous system, and the immune system.

This essential nutrient may also play a role in the risk of developing many chronic diseases such as diabetes, hypertension, autoimmune disease and some forms of cancer.
How can you make sure you get enough vitamin D?

Vitamin D is unique among the nutrients required for good health because it can be made by the body when our skin is exposed to sunlight. When the ultraviolet – B (UV B) radiation of the sun penetrates our uncovered skin, vitamin D synthesis is triggered.

How much sunlight is too much or too little?

It is hard to say.

The amount of sunlight needed to make enough vitamin D depends on a number of factors:

• Time of day: For the sun’s UV B rays to adequately penetrate the skin the sun must be directly over head.

• Your location: Individuals living in more northern latitudes, where the sunlight is less intense, may not synthesize vitamin D in the winter months. But vitamin D synthesized during exposure at other times of the year can be stored in the liver and fat.
• How much of your skin is exposed: The more skin surface area exposed, the shorter the time needed to meet your vitamin D needs.
• How easily you get sun burned: The melanin pigmentation of dark-colored skin prevents UV B light penetration and limits vitamin D synthesis. Darker skin needs more sun exposure, lighter skin less time in the sun is needed to produce vitamin D.
• Factors that block UV rays: Sunscreen, with a SPF of 8 or more, will block the vitamin D – producing UV rays.

According to the National Institutes of Health, less than 30 minutes of sun exposure (without the use of sunscreen) twice a week to arms, legs or back is sufficient to maintain adequate vitamin D levels.

Getting Vitamin D Without the Sun

When sun exposure is limited it is important to include good food sources of vitamin D (e) in the diet or to take a supplement. Fish liver oils are the best sources of vitamin D. Fatty fish, such as salmon, tuna and mackerel are also good sources. Foods of animal origin contain vitamin D3 or cholecalciferol.

Most of the vitamin D in our diet comes from fortified milk and breakfast cereals. The milk supply in the United States is fortified with approximately 100 IU vitamin D per 8 ounces. Some brands of breakfast cereal, orange juice, yogurt, margarine and soy beverages contain added vitamin D. Food labels do not list vitamin D unless the food has been fortified.

Vitamin D from planted-based foods is in a different form called vitamin D2 or ergocalciferol. Vegetables are poor sources of vitamin D. Some mushrooms, however, contain vitamin D2. The amount of vitamin D2 in these mushrooms can be increased by exposing them to UV light. A dried ground mushroom powder containing 600 IU of vitamin D per teaspoon is now available and can be added to food to increase dietary vitamin D.

How much dietary vitamin D is needed for good health?

According to the Institute of Medicine1 during the first year of life infants require 400 International Units (IUs) per day. Infant formula is fortified with vitamin D. Since breast milk is not a good source of vitamin D, breast-fed infants require a daily vitamin D supplement.

The requirement for vitamin D increases to 600 IU for children one year of age and older and for adults up to 70 years. To maintain healthy bones, the vitamin D requirement goes up to 800 IU in adults 71 years and older.

Over the counter vitamin D supplements are available in a range of doses. Both ergocalciferol and cholecalciferol are effective in raising vitamin D levels. Taking a large amount of vitamin D can be harmful so it is recommended that you check with your health care professional before beginning a vitamin D supplement. The safe upper limit for vitamin D is 4000 IU/day (for children 9 years and older and adults). Vitamin D is also found in most multivitamin supplements and calcium supplements. Be sure to include these sources of vitamin D when calculating the total amount you are taking daily.

Symptoms of vitamin D deficiency in adults include osteomalacia, causing bone pain and muscle weakness. Vitamin D deficiency can be determined by checking the concentration of 25-hydroxyvitamin D in the blood. If a deficiency or insufficient amount is found, a prescription form of vitamin D is required. It takes several months to treat vitamin D deficiency.

Food sources of Vitamin D

Foods containing Vitamin D and International Units (IUs)/serving

Cod liver oil, 1 Tablespoon 1,350 IU
Salmon, sockeye, canned, 3 ounces 715 IU
Dole Portobello Mushroom Powder, 1 teaspoon 600 IU
Mackerel, Atlantic, raw, 3 ounces 547 IU
Swordfish, raw, 3 ounces 474 IU
Sardines, canned, 2 ounces 150 IU
Tuna, light, canned in water, 3 ounces 40 IU
Egg, 1 large (vitamin D found in the yolk) 40 IU

Foods Fortified with Vitamin D

Milk, skim, reduced fat and whole, fortified, 8 ounces 115 - 124 IU
Yogurt, fortified, 8 ounces 120 IU
Margarine, fortified, 1 Tablespoon 50 IU
Orange Juice, fortified, 1 cup 100 IU
Fortified, Ready to eat cereal ¾ - 1 cup 40 -100 IU

1. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010.
2. U.S. Department of Agriculture, Agricultural Research Service, 2011 USDA National Nutrient Database fir Standard Reference, Release 25. Nutrient Data Laboratory Home Page, http://www.ars.usda.gov/ba/bhnrc/ndl


NOTE: While time in the sun is good for vitamin D production, it does increase the risk of developing skin cancer so it is prudent to wear protective clothing and sun screen with an SPF of 8 or more when in the sun for any length of time. Anyone with a history of skin cancer should avoid the sun exposure and protect themselves from UV rays.

25 Creative Ways To Say "No, Thank You."

High calorie food and drinks are usually in an abundant supply at holiday gatherings. If you are trying to eat healthier, control your calories, or recently had weight-loss surgery and can only eat small portions, finding gracious ways to say “no” to family members, friends or co-workers offering food and beverages can be challenging.

Start with a direct, “No thank you!” If that does not work, here are 25 more ways to respond to summer barbeque “food pushers."

1. Thank you, but I already ate.
2. It looks delicious, but I’m already too full!
3. Looks too good to eat!
4. Thank you, but I am trying to eat healthier.
5. Thanks, but I’m getting a jumpstart on my New Year’s resolutions!
6. I don’t have any room on my plate.
7. I worked out earlier, and am trying to stay on track tonight.
8. I’m saving my calories for _____ (insert other food).
9. I’ll have some later!
10. I’m so proud of my weight loss; I’m going to stay on my diet plan!
11. Did you know I’ve already lost 25 pounds?
12. I just had some of your amazing ________(insert other food) and it was great!
13. I’ve been cooking myself all day; I need a break from food!
14. I’m so close to my goal!
15. I have a weigh-in tomorrow, and I’m on my best behavior tonight.
16. I have to drive (for drinks).
17. I’ve already tried a bite of everything.
18. I’m allergic to that ingredient.
19. For some reason, I’m not that hungry!
20. I ate some when I got here.
21. I filled up on veggies earlier.
22. No thank you, but I’d love that recipe!
23. I’m good, thanks!
24. I’m trying to pace myself, but thank you!
25. No thanks, but my husband/wife/partner/friend would love to try it!

Can you add any creative ways to say, “No, thank you!” to food or drinks you do not want to eat?

Lose Weight at Penn Medicine

Penn can help you lose weight.

Learn about medical weight loss in Philadelphia, and the Penn Bariatric and Metabolic Surgery Program at a free information session about weight-loss surgery in Philadelphia.

There, you will hear about your weight-loss surgery options, and how Penn can help you lose weight and get healthy for good.

Register for a free information session today.

Get Movitated with Penn Weight Loss

Research has shown that support on social networks such as Facebook and Twitter, helps people lose weight, gain confidence, and meet others just like them who are trying to lose weight.

Today more and more people are sharing everything on line – from births and new jobs, to what they had for breakfast and what they did for exercise.

Now you can share your weight-loss successes… and challenges with Penn Medicine!


Follow Penn Medicine Weight Loss on Facebook for daily inspiration, conversation and healthy tips for weight loss and exercise.

Join the conversation with Penn Weight Loss on Twitter for up-to-date conversation and tips in the Twittersphere.

And if you are a “pinner” follow Penn Medicine’s boards on Pinterest . You’ll find information, tips and recipes for healthy eating, as well as information about other Penn Medicine services.

Are you on Facebook and Twitter? Leave a comment below with your handle, so Penn Medicine can follow you back!

Imagine Losing 1/3 of You!

On average, someone who undergoes weight-loss gastric bypass surgery can expect to lose approximately 30 percent of his or her starting weight.

Learn if bariatric surgery is right for you by attending a free information session about the Penn Metabolic and Bariatric Surgery Program.

Learn more about weight-loss surgery at Penn at this free session, and meet physicians and team members from the Penn Metabolic and Bariatric Surgery Program

Register for this free event here.