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Dr. Balz Frei is a Distinguished Professor of Biochemistry and Biophysics, and Director and Endowed Chair of the Linus Pauling Institute at Oregon State University. Dr. Frei’s research interests include the role of vitamins, micronutrients, and other dietary factors in health promotion and disease prevention.
Answers Author: Siamak T. Nabili MD, MPH
Title: Internist
Affiliation: Author, MedicineNet
A lack of iron can cause anemia, and iron deficiency is a very common cause of anemia. This is because iron is major component of hemoglobin and is essential for its proper function. Chronic blood loss for any reason is the main cause of low iron levels in the body as it can deplete its iron stores to compensate for the ongoing loss of blood. Anemia that is due to low iron levels is called iron deficiency anemia.
Women are more likely than men to have iron deficiency anemia because of the loss of blood each month through normal menstruation. This is generally without any major symptoms as the blood loss is relatively small and temporary.
Iron deficiency anemia can also be due to small repeated instances of blood loss, for instance from colon cancer or from stomach ulcers. Stomach ulcer bleeding may be induced by medications, even by very common over-the-counter drugs such as aspirin and ibuprofen (Advil, Motrin). In infants and young children, iron deficiency anemia is most often due to a diet lacking in iron.
A doctor's interpretation of complete blood count (CBC) results may give clues to suggest this type of anemia. For instance, iron deficiency anemia usually occurs with low mean corpuscular volume (microcytic anemia) in addition to low hemoglobin.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Medical Reference: Anemia.
Answers Author: Betty Kovacs MS, RD
Title: Nutritionist
Affiliation: Author, MedicineNet
Patients with celiac disease are at risk for some nutritional deficiencies, including folate deficiency, B12 deficiency, and iron deficiency. Celiac disease patients are also at risk of developing low bone mineral density (osteoporosis).
There are two reasons for nutritional deficiencies in celiac disease patients:
1. The diseased small intestine causes a lack of absorption of vitamins and nutrients.
2. Strict gluten restriction can also lead to nutritional deficiencies.
Many of the gluten-free foods are not fortified or enriched with vitamins or minerals. Studies have also shown that gluten-free products are often low in B vitamins, calcium, vitamin D, iron, zinc, magnesium, and fiber.
Fortunately, there are blood tests that your physician can do to determine if you are deficient in any nutrients. It's important to be aware of what deficiencies you are at risk for, and to make every effort to avoid these deficiencies.
The deficiency in nutrients does not mean a deficiency in calories. There is an increased incidence of obesity in persons with celiac disease who are following a gluten-free diet. The dietary goal is to follow a well-balanced diet, with appropriate supplements when needed, and an adequate amount of calories for maintaining a healthy weight.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Medical Reference: Gluten-Free Diet.
Answers Author: Pamela Peeke MD, MPH, FACP
Title: Nutritionist, WebMD Medical Expert
Affiliation: University of Maryland
As a 41-year-old-woman, when you think of supplements, you consider age, gender, family medical history, your medical history, and your specific lifestyle habits (exercise and nutrition). The key is to try to get what you can from whole foods in nutrition. And, to do regular exercise (optimally getting in about 30 minutes with some intensity, for sure). Why? This allows your body to optimize its own physiology so that you can boost immune function and live your best life.
That being said, studies show that it's tough for most people to get what they need from their usual sources of everyday nutrition. I'd definitely check in with your medical team and discuss supplements as they know your history and can help guide you.
And, as we get a bit older, we have special needs. So, a multivitamin that includes iron if you're still menstruating is a basic supplement for most women your age. Fish oil is excellent for many reasons and you want to add at the minimum 1000 mg. Your medical team may want to increase that based on your history (family and personal) of heart disease. Calcium fortified with Vit D is a must to prevent osteoporosis. Clearly you want to consume calcium-rich foods like dairy, but most women do need more and thus the supplement. I would add Vit D at 1000 IU as new studies have shown that our current RDA is probably too low. Vit D (as Vit D3 or cholecalciferol) has been shown to be remarkably helpful in boosting immune function all 'round.
These are the basics. Before taking anything more and turning yourself into a science fair project, sit down with your physician and discuss. And please get that physical activity and whole food lifestyle goin'.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Diet Community: Pamela Peeke, MD, MPH, FACP.
Answers Author: Brunilda Nazario MD
Title: Endocrinologist, WebMD Medical Expert
Affiliation: Medical Editor, WebMD
For a mother's health, and the health of her baby, she is advised to take prenatal vitamins during pregnancy. These are specially formulated multivitamins that make up for any nutritional deficiencies in the mother's diet. While the supplements contain numerous vitamins and minerals, their folic acid, iron, and calcium content are especially important.
Look for a prenatal vitamin that includes approximately:
- 400 mcg of folic acid
- 400 IU of vitamin D
- 200 to 300 mg of calcium
- 70 mg of vitamin C
- 3 mg of thiamine
- 2 mg of riboflavin
- 20 mg of niacine
- 6 mcg of vitamin B12
- 10 mg of vitamin E
- 15 mg of zinc
- 17 mg of iron
Your doctor or midwife can also advise you on certain brands. In some cases, your GP will give you a prescription for a certain type of prenatal vitamin.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: http://www.webmd.com/baby/guide/prenatal-vitamins
Answers Author: Jonathan L. Gelfand MD
Title: Pulmonology, WebMD Medical Expert
Affiliation: Frankford Hospital
Folate (or folic acid) helps support growth and development and prevents certain birth defects. Calcium is not only important to bone health but also overall health.
The recommended level of daily folate intake in women is 400 micrograms daily. In terms of daily calcium requirements, women aged 11-24 need 1,200 to 1,500 milligrams; age 24 to 50, 1,000 milligrams; after age 50, 1,000 milligrams if you are taking hormone replacement therapy, and 1,500 milligrams if you are not. Women should also get adequate amounts of vitamin D to help the body use calcium.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Reference: Frequently Asked Questions About Women's Health.
Answers Author: Richard Weil Med, CDE
Title: Exercise Physiologist, WebMD Medical Expert
Affiliation: Author, MedicineNet
Protein is the building block of muscles and essential for repair and growth of muscle after exercise. Whenever you exercise, and particularly during resistance exercise, you cause microscopic damage to the myofibrils of muscle fiber (myofibrils are small protein filaments in the muscle fiber that help the muscle contract). This isn't the type of damage that you go to the doctor for, but normal biological damage called catabolism. The effect creates a stimulus and environment for muscle repair and growth. The body responds to the damage by sending nutrients, including protein and other growth factors like testosterone, to the muscle to help it grow. Contrary to what many people think, protein is not used by the muscles for fuel unless the circumstances are extreme (for example, starvation). Instead, fat and carbohydrate are the main fuels.
Research shows that protein consumed before exercise and within 30 minutes of finishing your workout will help with growth and recovery. The guideline for protein consumption after exercise is 1 gram for every 3-4 grams of carbohydrate. Peanut butter has 9 grams of protein per 2 tablespoons. Yogurt is another good source of protein. The guidelines for quantity of protein before exercise are not as clear as after, but you can experiment and see if you notice any difference.
You probably won't notice much difference using protein supplements unless you are malnourished or an elite athlete doing tremendous amounts of aerobic or resistance exercise. That's because most Americans, including athletes, get enough protein in their diets. Excess protein is not used by the body; instead, it is excreted in urine. Discuss your recommend protein intake with a doctor or registered dietitian.
Here's one way to calculate your protein needs:
1. Divide your weight by 2.2 to calculate your weight in kilograms.
2. Multiply your weight in kilograms by 0.8-1.7 gm/kg (depending on factors mentioned above).
Here's an example if you weigh 200 pounds and consistently do heavy resistance exercise:
200/2.2 = 91 kg
91 kg x 1.4 = 127 grams of protein per day
Again, keep in mind that most Americans get enough protein in their diets.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Ask the Experts: Fitness Q&A by Richard Weil.
Answers Author: Richard Weil Med, CDE
Title: Exercise Physiologist
Affiliation: Author, MedicineNet
Creatine is a compound that has been shown to speed up recovery in adults after short (generally 10 seconds or less), high intensity bouts of exercise like a set of weight lifting. There are no endurance performance benefits from creatine use.
Strength gains and increases in mass associated with creatine use occur because it enables athletes to do more work with less fatigue in a specific period of time due to the improvement in recovery time. There are no steroid-like effects with creatine that directly cause increases in protein synthesis, increases in testosterone availability or synthesis, or other anabolic processes, and only minor side effects seem to be reported (gastrointestinal discomfort and cramping being the two main complaints).
Individuals using creatine should drink six to eight glasses of water a day while taking creatine to prevent dehydration. Among individuals who take creatine, 30% do not see any benefit. If no benefit is observed after four to six weeks of use, then it would be prudent to stop taking it, if for no other reason than to save money.
If the weight lifters are teenagers, they should know that the safety and efficacy of creatine has not been established in adolescents. The American College of Sports Medicine has recommended that creatine not be used by anyone younger than 18 years old, and furthermore, collegiate trainers and coaches are forbidden from recommending or supplying creatine, or other supplements for that matter, to their student athletes.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Ask the Experts: Fitness Q&A by Richard Weil.
Answers Author: Stanley A. Cohen MD
Title: Pediatric Gastroenterologist
Affiliation: Children's Healthcare of Atlanta
Absolutely. All of my patients work with a registered dietitian to ensure the missing nutrients from the eliminated food is supplied by other foods or dietary supplements. This is especially important when there are multiple allergies or when dairy is limited or eliminated because it is the best source of calcium in the diet.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Expert Q&A: Eating With Food Allergies.
Answers Author: Kathleen M. Zelman MPH, RD, LD
Title: Nutritionist, WebMD Medical Expert
Affiliation: American Dietetic Association
The best food sources naturally rich in vitamin D are cod or fish liver oils, salmon, tuna, sardines, mackerel, and shrimp. Vitamin D is also found in egg yolks, beef liver, and mushrooms. Fortified foods -- such as milk, some yogurts, cereals, and orange juices -- also provide vitamin D.
Another option to increase vitamin D levels is to take dietary supplements to fill in the nutritional gaps; however, experts say to be careful.
“Manufacturers are putting more vitamin D in multivitamins and there are some single 5000 IUs vitamin D supplements that exceed the safe upper limit,” says University of Cincinnati bone health expert Nelson Watts, MD.
“Buy from reputable companies and don’t exceed the safe upper limit unless you are under a physician's care,” says Michael Holick, PhD, MD, author of The Vitamin D Solution and vitamin D researcher. He recommends children take 1000 IU and teenagers and adults 2000-3000 IUs supplements daily.
The body makes vitamin D when exposed to sunlight. But the IOM committee didn't factor that into the recommendations, because many factors (including, skin color, and geographic location) affect that process. Nor did the committee make any recommendations regarding supplements.
“Individuals need to discuss supplementation with their health care provider,” says Harvard’s JoAnn Manson, PhD, MD, and member of the IOM vitamin D and calcium committee.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Feature: "New Vitamin D and Calcium Recommendations: Experts Weigh In."
Answers Author: James Beckerman MD, FACC
Title: Cardiologist, WebMD Medical Expert
Affiliation: Providence St. Vincent Heart Clinic, Portland, Ore.
Two important lifestyle factors can affect your body weight more than any others.
The first is work-related physical activity. Individuals who walk and stay mobile as part of their jobs are less likely to be overweight. The second factor is dietary fiber.
If you are mostly stationary during your work day, it's a good idea to look at how much fiber you are getting in your diet.
Fiber serves two main purposes that affect your health. Soluble fiber -- in foods like oat bran, nuts, beans, and some fruits and vegetables -- helps prevent your body from reabsorbing bile acids in your gastrointestinal tract, which can help lower your cholesterol without medication.Insoluble fiber -- found in wheat bran, whole wheat bread, and many vegetables -- absorbs water in your colon and can help keep you regular. Because fiber absorbs water, it can also help you feel fuller after taking in fewer calories.
Most of us get fewer than the 25 grams of daily fiber recommended by the American Heart Association. Consuming this recommended amount can help you lose weight while improving your heart health.
You can bulk up on fiber pretty easily by increasing your intake of fruits and vegetables, and making a point of trying higher fiber breads, cereals, and rice. In some cases, you can meet your fiber goals with the use of a fiber supplement, but talk to your health care provider first about that. Making some simple changes in your shopping patterns can help you reach the recommended amount of daily fiber and reduce your risk of heart disease ... and stay regular
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Heart Disease Community With James Beckerman, MD, FACC.
Answers Author: Brunilda Nazario MD
Title: Endocrinologist, WebMD Medical Expert
Affiliation: Medical Editor, WebMD
The amount of calcium you need depends on your age. It is recommended that adolescents get 1,300 milligrams of calcium a day. Adults should receive 1,000 milligrams up to age 50 and 1,200 milligrams after age 50.
The best way to figure out if you're getting enough calcium is to add up the amount of calcium in the foods you eat. For example, an 8-ounce glass of milk has nearly 300 milligrams of calcium, an 8-ounce cup of yogurt has between 250 and 400 milligrams of calcium, and 1.5 ounces of cheddar cheese has about 300 milligrams of calcium. Check the labels. Then compare what you're getting to the recommended amounts of calcium for your age group.
Read food labels and select foods that contain 10% or more of the Daily Value for calcium. When food shopping, look for terms such as "high in calcium," "fortified with calcium," "calcium-rich," or "excellent source of calcium."
If you're coming up short, talk to your doctor about ways you can boost your calcium levels, like changing your diet or taking supplements. But don't assume that more calcium is always better. Some studies have shown that women who take a lot of calcium supplements are at higher risk of developing kidney stones. The recommendation for the highest tolerable intake of daily calcium is 2,500 milligrams of calcium a day. More than this amount may increase your risk of kidney stones and other problems.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: http://www.webmd.com/osteoporosis/osteoporosis-questions-answers
Answers Author: Elaine Magee MPH, RD
Title: Nutritionist, WebMD Medical Expert
Affiliation: Author, Tell Me What to Eat If I Suffer From Heart Disease
Half of us are taking dietary supplements on a daily basis but what you may not know is that some of them come with a kick of caffeine -- and it may not even be listed on the label.
Agricultural Research Service (ARS) scientists analyzed a number of caffeine-containing products including supplements. You see, caffeine is a natural alkaloid in more than 60 plants (including tea and coffee) and in plant derivatives known as "botanicals." These botanicals, such as guarana, yerba mate, kola nut, and green tea extract, are common dietary-supplement ingredients and are printed on the label's ingredient list -- although you might not see any amount of caffeine listed on the label. According to the Agricultural Research Service online report on "Caffeine In Selected Dietary Supplements," there is no requirement to state the amount of caffeine present in a food, beverage, or supplement on the product's label. If caffeine in its pure form is added to a product, however, there is a requirement to add the word "caffeine" to the label's ingredient listing, the report explains.
Dietary supplements -- predominantly weight-loss and sports-nutrition products containing at least one caffeine-containing ingredient -- were chosen for the ARS analysis. Here's what they found:
[Note: According to the Nutrient Data Laboratory, one 8-ounce cup of coffee (240 milliliters) contains about 95 milligrams of caffeine.]
Of the 53 products analyzed, 27 products provided -- by way of a daily serving defined on the label -- the caffeine equivalent of about one to two cups of coffee.
Eleven products had caffeine equivalents ranging from two to four cups of coffee.
Eleven more products had equivalents ranging from four to six cups of coffee.
Four products provided an amount of caffeine ranging from seven to eight cups of coffee.
Of the 28 analyzed products that voluntarily listed a caffeine amount on the label, 25 were found to contain caffeine levels within 20% of the label amount.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Blog: Food and Cooking.
Answers Author: Betty Kovacs MS, RD
Title: Nutritionist
Affiliation: Author, MedicineNet
The expiration date on vitamins is there for a reason. The date lets you know when the vitamins will no longer be effective. You should not take them past the expiration date. If you find that your vitamins are expiring before you are able to finish them, you would be better off buying them in smaller quantities. You want to get all of the vitamins and minerals from your supplement, so take them as instructed before they lose their effectiveness.
Medical Reviewer: David Kiefer, MD, August 6, 2011
Source: WebMD Ask the Experts: Diet and Nutrition Q&A by Betty Kovacs.
Answers Author: Laura J. Martin MD, MPH
Title: Internist, WebMD Medical Expert
Affiliation: Medical Editor, WebMD
Nowadays, everything from bottled water to orange juice seems to have souped-up levels of vitamins and minerals in it. That may sound like a way to help cover your nutritional bases, especially if your diet is less than stellar.
But are you in danger of getting too much of these important nutrients? And can these overloads hurt you?
Yes, if you're routinely taking megadoses. For instance, too much vitamin C or zinc could cause nausea, diarrhea, and stomach cramps. Too much selenium could lead to problems including hair loss, gastrointestinal upset, fatigue, and mild nerve damage. Too much vitamin B6 may adversely affect your nerves, and there are suspected risks with too much vitamin E.
Most people don't realize there's no real advantage to taking more than the recommended amounts of vitamins and minerals, and they don't recognize there may be disadvantages," says Johanna Dwyer, DSc, RD, a senior research scientist with the National Institutes of Health's Office of Dietary Supplements.
Medical Reviewer: David Kiefer, MD, August 19, 2011
Source: WebMD Feature: Getting Too Much of Vitamins and Minerals.
Answers Author: John P. Keenan MD
Title: Opthamologist, WebMD Medical Expert
Affiliation: American Academy of Ophthalmology
Before you ask your doctor about taking mega-doses of vision supplements, take a look at the multivitamin you're taking now. You'll probably find you're already taking several of the following nutrients for healthy eyes. If not, look for these nutrients, in at least these amounts, when you buy a multivitamin or supplement:
- Vitamin C, 250 mg
- Vitamin E, 200 mg
- Beta-carotene, 5,000 IU
- Zinc, 25 mg
- Zeaxanthin, 500 mcg
- Selenium, 100 mcg
- Lutein, 10 mg
- Calcium, 500 mg
- Thiamin, 2 mg
- Folic acid, 800 mcg
- Omega-3 essential fatty acids (including flaxseed oil), 2,000-3,000 mg
- N-acetyl cysteine, 100 mg
- Alpha lipoic acid, 100 mg
If you can't find a single product that contains all or most of these nutrients, they are available individually.
Medical Reviewer: David Kiefer, MD, August 19, 2011
Source: Supplements for Vision and Healthy Eyes.http://www.webmd.com/eye-health/vision-supplements
Answers Author: Betty Kovacs MS, RD
Title: Nutritionist
Affiliation: Author, MedicineNet
You heard right, not all calcium supplements are the same. The supplements will differ by the kinds of calcium that they contain, the amount that they contain, and anything else that is added to them (other minerals or vitamins). Along with that, there are other factors that will affect how much of the calcium you will actually absorb, including medications that you are taking, your age, your vitamin D levels, the amount of calcium that you are taking and if you are pregnant. If you have any concerns over any of these, it would be best to speak with your doctor before taking anything. And remember, all calcium supplements should be taken separately from other medications or supplements so they don't compete with their absorption. The most common forms of calcium in supplements are calcium carbonate and calcium citrate. The differences between the two are:
Calcium carbonate
- Less expensive
- Don't need to take as many pills to get your calcium requirements.
- If you have low acid in your stomach (achlorhydria), you will have trouble with absorbing this substance.
- May be constipating at higher doses.
Calcium citrate
- More expensive.
- You will need to take more pills to meet your calcium requirements.
- Should be taken with meals to improve its absorption.
- This does not need acid to be absorbed, so it works well for anyone with achlorhydria.
- When choosing your supplement, you will need to check out the label to see how much elemental calcium is in it. This is the actual amount of calcium that your body absorbs. You will not want to take in more than 500 mg of calcium at one time, including that from food and supplements. The Recommended Adequate Intake for calcium is based on your age:
• 0 to 6 months -- 210 mg
• 7 to 12 months -- 270 mg
• 1 to 3 years -- 500 mg
• 4 to 8 years -- 800 mg
• 9 to 13 years -- 1300 mg
• 14 to 18 years -- 1300 mg
• 19 to 50 years -- 1000 mg
• 51+ years -- 1200 mg
While it is important to get an adequate amount of calcium in your diet, you do not want to go overboard and take excessive amounts. Many people follow the thought that if something is good for you then more is better, but that is not always the case with vitamins and minerals. In fact, excessive amounts of some vitamins and minerals can end up damaging your health.
For this reason, Tolerable Upper Limit (UL) levels have been established to let people know the number that you do not want to go beyond when taking supplements. The UL for calcium for children over 1 and adults is currently set at 2500 mg/day. Going beyond that can interfere with your body's ability to absorb other minerals (iron, phosphorus, zinc, and magnesium), it can impair how your kidneys function, it can elevate your blood levels of calcium (hypercalcemia), and it could end up interfering with other medication that you are taking. Sticking with the Recommended Adequate Intake levels is your safest bet.
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: WebMD Ask the Experts: Diet and Nutrition Q&A by Betty Kovacs, MS, RD
Answers Author: Mikio A. Nihira MD
Title: Obstetrics & Gynecology, WebMD Medical Expert
Affiliation: Medical Reviewer, WebMD
Even if you watch your diet, it can be difficult to get the amount of folic acid you need from food alone. This is especially important for women.
Taking a daily vitamin can help. Most multivitamins contain the recommended amount of folic acid. If you're not sure which vitamin to take, read the label. It should say that the vitamin contains 400 mcg or 100% of the daily recommended value of folic acid.
If you're trying to get pregnant or are already pregnant, your doctor may prescribe a prenatal vitamin, which will contain all the folic acid you'll need (unless you've already had a baby with a neural tube defect, in which case your doctor will prescribe a much higher dose of folic acid).
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: WebMD Medical Reference: Folic Acid and Pregnancy.
Answers Author: Jay W. Marks MD
Title: Gastroenterologist, WebMD Medical Expert
Afilliation: Medical Editor/Author, MedicineNet
Fiber is defined as material made by plants that is not digested by the human gastrointestinal tract. Fiber is one of the mainstays in the treatment of constipation though it also may have additional uses such as the treatment of diverticular disease of the colon, cholesterol problems, or diabetes. Many types of fiber bind to water and keep the water within the intestine. The fiber and water adds bulk (volume) to the stool, and the water softens the stool. Increased gas (flatulence) is a common side effect of high-fiber diets. The gas occurs because bacteria within the colon, unlike the intestine of humans, are capable of digesting fiber to a small extent. The bacteria produce gas as a by-product of their digestion of fiber.
There are different sources of fiber, and the type of fiber varies from source to source. Some types of fiber are digested to a greater extent by colonic bacteria than other types of fiber. The better-digested fiber produces more gas.
All fibers, no matter their source, can cause flatulence; however, since bacteria vary in their ability to digest different types of fiber, different sources of fiber may produce different amounts of gas. To complicate the situation, the ability of bacteria to digest one type of fiber can vary from individual to individual. This makes the selection of the best type of fiber for each individual (i.e., a fiber that improves the quality of the stool without causing flatulence) more difficult. The choice becomes a matter of trial and error.
Types of fiber can be categorized in several ways, for example, by their source. The most common natural sources of fiber include fruits and vegetables as well as wheat or oat bran. These fibers are most likely to cause flatulence. Fibers used medicinally to treat constipation include psyllium seed, synthetic cellulose (methyl cellulose), and calcium polycarbophil. (A lesser known source is an extract of malt; however, this extract may soften stools in ways other than by increasing fiber.) Psyllium and methyl cellulose (and probably calcium polycarbophil) do not increase the production of gas; however, they still may result in the sensation of bloating. This may be due to an effect of these fibers that slows the transit of gas through the intestine.
The different sources of fiber should be tried one by one. The fiber should be started at a low dose. The dose should be increased every 1-2 weeks until either the desired effect on the stool is obtained or troublesome bloating or flatulence (or other gastrointestinal symptoms) supercedes. (Fiber does not work overnight!) If bloating or flatulence occurs, the dose of fiber can be reduced for a few weeks, and then the higher dose can be re-instituted. (It generally is said that the amount of bloating or gas that is produced by fiber decreases when it is ingested for a prolonged period of time; however, this has never been carefully studied or proven.) If bloating or flatulence remains a problem and prevents the dose of fiber from being raised to a level that affects the stool satisfactorily, it is time to try a different source of fiber.
When using increasing amounts of fiber, it is recommended that increasing amounts of water be ingested, presumably to provide water for the fiber to bind and prevent "hardening" of the fiber and obstruction of the intestine. This is simple and reasonable advice; however, it has never been shown that the amount of ingested water has any beneficial effect. (There is a lot of water in the normal intestine, and extra water is just absorbed and excreted in the urine.) Despite the lack of demonstrated benefit, it probably is a good idea not to become dehydrated while taking fiber supplements.
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: WebMD Ask the Experts: Digestion Q&A by Jay W. Marks, MD.
Answers Author: Louise Chang MD
Title: Internist, WebMD Medical Expert
Affiliation: Medical Editor, WebMD
Probiotics can be effective when consumed either in food, pill, or powder form, according to probiotic microbiology consultant Mary Ellen Sanders, MS, PhD.
"Food sources of probiotics have the advantage in that they offer good nutrition along with the probiotic bacteria," she says. Still, supplements can be more convenient for some people and may provide higher levels of probiotic, depending on the product in question, she says.
"The most important consideration is that the product -- food or supplement -- deliver adequate numbers of efficacious probiotics for your needs," Sanders says.
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: WebMD Feature: Answers to Your Questions About Probiotics.
Answers Author: Brunilda Nazario MD
Title: Endocrinologist, WebMD Medical Expert
Affiliation: Medical Editor, WebMD
Daily value shows the percentage of a certain nutrient in a food, based on a 2,000-calorie diet. The daily value gives you an idea of a food's nutrient contribution to your diet; 5% or less is considered low for that nutrient, and 20% or more is high.
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: http://www.webmd.com/food-recipes/definitions-glossary
Answers Author: Michael W. Smith MD
Title: Internist, WebMD Medical Expert
Affiliation: Chief Medical Editor, WebMD
Our nutritional needs change as we age.
Many of us don't eat as well, plus certain vitamins and nutrients can be more easily depleted from our bodies as we age. These include vitamin B12 (our ability to absorb it from foods can be reduced with aging); calcium (our needs go up as we get older); vitamin D (our skin doesn't absorb it as well when we are older); and vitamin B6 (which may be needed to keep red blood cells healthy and strong).
According to the experts at the National Institutes of Aging, any multivitamin that offers the minimum daily requirement will do the trick.
You also don't need megadoses. In fact, when taken in very large doses some supplements can harm you. Moreover, if you are taking any prescription medications, check your supplement choice with your doctor. Some nutrients may interfere with certain medications.
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: WebMD Medical Reference: Answers to 10 Questions About Healthy Aging.
Answers Author: Brunilda Nazario MD
Title: Endocrinologist, WebMD Medical Expert
Affiliation: Medical Editor, WebMD
There are several types of omega-3 fatty acids. Two crucial ones -- EPA and DHA -- are primarily found in certain fish. Plants like flax contain ALA, an omega-3 fatty acid that is only partially converted into DHA and EPA in the body.
Experts say that DHA and EPA -- from fish and fish oil -- have better established health benefits than ALA. Too little of ALA actually converts to DHA and EPA in the body.
DHA and EPA are found together only in fatty fish and algae. DHA can also be found on its own in algae.
Medical Reviewer: David Kiefer, MD, August 19, 2011.
Source: http://www.webmd.com/healthy-aging/omega-3-fatty-acids-fact-sheet
Answers Author: Pamela Peeke MD, MPH
Title: Nutritionist, WebMD Medical Expert
Affiliation: University of Maryland
Many of my colleagues and I began to believe that the current RDA of vitamin D (200 IU), which was set in 1997, may be too low to accommodate our current lifestyles. No sooner did we all utter those words than a new Institute of Medicine (IOM) report was issued increasing the RDA to 600 IU, and 800 IU for people over 70 years of age. Frankly, many doctors and scientists felt that the recommendation is still too low.
Vitamin D is one of the fat-soluble vitamins (e.g. A, D, E, K). Make sure to eat some fat-containing food (e.g. nuts, low-fat dairy) for optimal absorption. There are two main forms of the vitamin: D2 (ergocalciferol) and D3 (cholecalciferol). Catching ultraviolet B rays will increase your D3 levels. Fatty fish, mushrooms, eggs and meat are rich in D, as well as foods specifically fortified with D. Vitamin D is essential for the proper absorption of calcium and phosphate. That’s why vitamin D is so critical for bone health.
What you may not know is that recent research has also shown that adequate vitamin D levels are necessary for optimal immune, brain, nerve, and muscular function, and for control of genes that can influence our tendency toward certain diseases. Research in these areas is still evolving.
How does someone become vitamin D deficient? Remember the age-old recommendation to get your 15 minutes of daily sunshine? Well, as it turns out, that may not be enough. A study of young Hawaiian skateboarders and surfers found that over 50% of them had vitamin D levels lower than average. Slathering on sunscreen could be an issue in blocking adequate absorption. What was really interesting was that the vitamin D levels of these tropical sun-bathing folks were compared to levels among Wisconsin residents who were taking vitamin D supplements and who aren’t riding waves or boogying down the sidewalk on their boards. Guess who had better levels? Yep, it was the pale-skinned Midwesterners. Apparently outdoor training and recreation wasn’t cutting it for maintaining adequate vitamin D levels.
What should your vitamin D level be? Here’s the rub. The IOM panel recommends 20 ng/mL as a sufficient level, while some vitamin D advocates, including the Endocrine Society and the International Osteoporosis Foundation, note that 30 ng/mL is necessary for optimal bone health. Can you have too much? Evidence suggests that levels above 50 ng/mL may pose an increased cancer risk. But that’s not the problem for most of the population. Not having enough D on board is the critical issue.
The good news is that emerging information about vitamin D’s potential has prompted excellent new research studies. For instance, the National Institutes of Health has initiated a study to include 20,000 men and women over 60 years old to study whether 2,000 IU of vitamin D, omega-3 fatty acids from fish oil, or placebo will lower the risk of heart disease. Stay tuned!
Meanwhile, what should you do?
1. Get your vitamin D level checked. This is especially important for those people who are getting little sun, are at risk for osteoporosis, may have inadequate dietary intake, and are either taking no vitamin supplements or are taking them sporadically. It’s just good to get a baseline. Knowledge is power.
2. Discuss your vitamin D status and supplements with your medical team. Because there is controversy surrounding the IOM report regarding what is a normal D level and supplement intake, you need to talk with your medical professional about your individual situation. Your gender, age, level of physical activity, nutrition intake, bone status, osteoporosis risk, and sun exposure are all factors that must be considered. Then add to this your D level and you can have a comprehensive discussion about next steps to optimize your D status.
3. Add up your daily D. Just for grins, whip out your supplements and add up how much D you’re actually consuming. Multivitamins contain D at varying levels, while calcium supplements are usually fortified with D. Check out how much D you’re consuming from foods sources including fortified dairy and cereals. This will help you monitor your total intake. And it will be helpful to share this information with your medical team when you’re deciding how much D you need on a daily basis.
4. Soak up a few rays. Even though we now know that 15 minutes in the sun is probably not enough to bump your D levels sky high, it’s still good to get outdoors to reap whatever benefit you can from the sun, as well as enjoy your external environment while staying physically active. Just remember to smooth on that sunscreen after 15 minutes of exposure or you’ll never hear the end of it from your dermatologist.
5. Eat D-licious foods. You saw the laundry list of natural food sources for vitamin D. If you eat salmon, try to get the wild (not farmed) type, as it has fewer contaminants. I’m increasing my egg consumption and integrating more mushrooms into my daily salads and side dishes.
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: WebMD Expert Blogs: Everyday Fitness With Pamela Peeke, MD, MPH, FACP.
Answers Author: Celia Esther Dominguez MD
Title: Endocrinologist, WebMD Medical Expert
Affiliation: Emory University
Osteoporosis is often a silent disease -- you don't know your bones are weak until you break one.
Start by seeing your doctor. Together, you can discuss your diet and work out a rough estimate of your calcium intake. If you're coming up short, then you either need to improve your diet or take calcium and vitamin D supplements for bone health.
Keep in mind that the numbers may not tell the whole story. Even if it looks like you're getting enough calcium, you might not be absorbing enough of this mineral. That can be due to many factors, such as smoking, using certain medications, and many health conditions. So make sure to have a frank discussion with your doctor about any other factors that might increase your risk of osteoporosis.
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: WebMD Feature: Boning Up on Calcium.
Answers Author: Kathleen M. Zelman, MPH, RD, LD
Title: Nutritionist, WebMD Medical Expert
Affiliation: American Dietetic Association
Once-daily multivitamins/minerals geared for age and sex should take into account the changing needs of adult men and women. If you cannot tolerate dairy and do not eat calcium-fortified foods, you may need additional calcium beyond a multivitamin.
During childbearing years, it is essential for women to get adequate folate and iron in their diets or through supplements. Pregnant and lactating women have increased needs that require a special supplement during these times.
Vegetarians may need to add supplements, depending on the foods excluded in their diets. Smokers require an additional 40 milligrams of vitamin C that can easily be obtained from fruits or vegetables. In addition, some adults -- depending on their diet, health history, and where they live -- may require more vitamin D than the amount in a standard multivitamin.
Medical Reviewer: David Kiefer, MD, August 6, 2011.
Source: WebMD Medical Reference: Frequently Asked Questions About Diet and Nutrition.
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