Embracing A Healthier Summer


This past winter was one of the harshest and snowiest experienced in recent years, making this summer much anticipated. Here we explain how you can be sure to stay healthy as you embrace the warmer weather.

Longer Days

Compared to only nine hours of daylight in the depths of winter, the height of summer yields approximately 15 hours of daylight. That extra six hours of light each day affords us more opportunities for outdoor activities that are normally only possible on the weekends. Earlier sunrises and later sunsets give us the option of a walk or bike ride before or after work. Chores that may have occupied your Saturday can now fit into a weekday and leave you more time for fun and adventure on the weekend. Make a commitment to use the extra daylight to be more active outside and less sedentary. As the old saying goes, “Make hay while the sun shines.”

Sunshine and Vitamin D

When you speak of sunshine, an endocrinologist will automatically think of vitamin D, also known as the sunshine vitamin because sunshine (specifically UVB radiation from 290 – 315 nanometers) enables your skin to produce vitamin D. This is the primary source of naturally occurring vitamin D, since very few foods normally contain the substance.

Summer affords us the opportunity to boost the levels of this important hormone. Just 10 to 15 minutes of sun exposure without sunscreen is sufficient for most people to generate healthy levels of vitamin D (darker-skinned individuals may need more time in the sun to get the same benefits).

Inadequate levels of vitamin D – diagnosed as a deficiency below 15 nanograms per milliliter (ng/ mL) and vitamin D insufficiency for levels between 15-20 ng/mL – can increase the risk of bone loss, osteoporosis and fractures. Its role in other disease states such as cancer, heart disease, infection, neurological disease and immune disorders is being studied. Levels of vitamin D between 20- 40 nanograms per millileter (ng/mL) are generally considered adequate for healthy individuals and 30-50 ng/mL is considered optimal if you have bone loss.

During winter months, the sun’s position in the sky doesn’t allow for the optimal exposure to UVB sunlight to generate vitamin D in our skin. For example, sun-exposed skin can’t synthesize vitamin D in Boston from November through February. The problem gets worse as you move farther north. This can result in seasonal vitamin D deficiency for large parts of North America.

It’s prudent to note there is serious potential for harm from excessive sun exposure, including the risk of skin cancers (including melanoma), sun damage and premature wrinkling. Always protect infants and small children who are at highest risk for the damaging effects of the sun. Be sure to use sunscreen with at least SPF 30 UV protection. Wear a hat when in direct sunlight, and avoid activity during the hottest parts of the day. Be sure to get plenty of fluids to prevent dehydration.

Fresh Air

The chances are pretty good that when you were a child your mother told you to go outside and get some fresh air. Belief that exposure to fresh air, nature and outdoor activities is healthful has been an article of faith since the 18th century. Now there is mounting scientific evidence that your mother was absolutely right.

Several years ago, socio-biologists coined the term “nature deficit disorder” to describe the negative health consequences of not being outdoors in natural settings. These consequences include “diminished use of the senses, attention difficulties, and higher rates of physical and emotional illnesses.” This is particularly true of children who increasingly replace “green space” outside with “screen space” indoors.

Physical activity has been shown to have many significant health benefits including:

  • Weight loss
  • Reduced blood pressure
  • Decreased risk of heart attack and stroke
  • Decrease in symptoms of erectile dysfunction
  • Increased “good” cholesterol (HDL)
  • Reduced risk of type 2 diabetes
  • Possibly reducing risk of breast and colon cancers
  • Decrease in constipation
  • Strengthening of muscles and bones
  • Decrease in arthritic symptoms
  • Reduced risk of osteoporosis and hip fractures
  • Reduction in stress, insomnia and depression
  • Improved sense of well-being
  • Increased life expectancy

The best remedy for nature deficit disorder is nature. Summer brings with it opportunities to spend time in the back yard, visit a local park or hike the trails near your home. Make a list of city or state parks in your area and see how many you can visit this summer. Buy a fishing license and use it. Put binoculars or a magnifying glass in your backpack and use them to rediscover birds, insects or other flora and fauna that you’ve been missing. Turn off the TV and tell the kids to power off the Xbox. Don’t send them outside for some fresh air — take them with you and head outdoors. It will do everyone a world of good.

Fresh Fruits and Vegetables

Nothing says summer more than the season’s bounty of fresh fruits and vegetables. Although our global economy makes it possible to have a variety of vegetables or fruit year-round, locally grown produce always tastes better.

Use this summer season to sample some of the healthy food choices grown in your area. Visit a local farmers market to have a chance to meet the growers and producers themselves. Take a trip to the country to a “pick-it-yourself” farm or orchard. Try your hand at growing your own small herb garden or vegetable plot.

Don’t be afraid to try new foods. Remember, there are no bad foods, only bad ways to prepare them. Rather than condemn Brussels sprouts forever because someone in your family didn’t know how to cook them, try a new recipe. In most cases you’ll be able to reclaim a food you had once shunned and be healthier for it in the end.

Remember that a healthy diet consists of vegetables covering half of your plate, with the rest being divided between lean meats or fish and carbohydrates. Two to three servings of fruit the size of a tennis ball will balance things off without calorically dense snacks and sweets that are less healthful.

Hot Weather Hazards

With summer’s hot weather comes the risk for heatrelated injury. Common sense will go a long way in preventing a hot day from turning into a situation that threatens your health.

Check the weather forecast and UV index in your area and dress appropriately. Wear a hat and sunglasses to protect your eyes. Never go barefoot. Take sandals to the pool/beach and socks and good shoes on your hikes to avoid blisters and sprains. Apply sunscreen before you leave the house and reapply periodically throughout the day, especially after coming out of the water. Drink plenty of fluids. Avoid strenuous activity during the hours when the sun is at its peak intensity. Consider less physically demanding activities on days with extreme heat or humidity. If you feel dizziness, nausea or headache, then get out of the sun and cool your body down, as these could be signs of heat exhaustion. If untreated, the condition could progress to heat stroke, in which altered mental status and organ damage occurs.

Pump Holiday

Summer brings a number of challenges for patients with type 1 diabetes. If your summer vacation includes a trip to the beach or on an extended camping trip, you may want to consider a pump holiday. Waterproof features on a pump are no consolation if it falls off while you are wakeboarding and winds up in the bottom of a lake.

For patients who wish to take a pump holiday, start a few days before your vacation to allow you time to troubleshoot the new regimen before the unpredictability of your vacation begins. Talk to your endocrinologist about your transition. You will need prescriptions for needles and both rapid-acting and long-acting insulin for your pump holiday. Endocrinologists generally will prescribe pens for ease of on-the-go dosing and portability reasons. However, you can use a vial and syringe if you prefer.

If you are in extreme heat, you should store your insulin in a cooler to prevent it from overheating, but never use dry ice to keep your insulin cool. Many meters won’t work if they get too hot, so store your meter in a cooler place as well. Never leave your insulin in the car, as the heat of summer can rapidly reach temperatures that will denature and inactivate your insulin.

Getting healthier in the process of embracing summer will not only rejuvenate your body and spirit during this wonderful time of the year, but it will keep you going for many months to come. After all, winter will come soon enough.