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+ Have a nutrition question? Answers From WebMD

Can lack of iron in the diet cause anemia?

Are there any dietary deficiencies associated with celiac disease?

I'm a woman, 41, and eat a balanced diet and take a multivitamin. Do I need fish oil and calcium, too?

What are prenatal vitamins?

Why are folic acid and calcium so important for women?

What are the benefits of protein supplements with regard to exercise?

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.

Is it safe for weight lifters to take creatine supplements?

If you can't eat certain foods due to allergies or intolerances, should you worry about missing nutrients?

What are the best sources of vitamin D, and should I take supplements?

How can fiber help me lose weight?

Am I getting enough calcium, and how much is too much?

Do your dietary supplements contain caffeine?

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.

Must I throw out my vitamins by their expiration date?

Should I worry about taking too many vitamins?

Which supplements should I take for healthy eyes and vision?

Are some over-the-counter calcium supplements better than others?

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

Should I take folic acid supplements?

Is there a product that will help increase fiber but not increase gas?

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.

Are probiotic supplements worthwhile?

What is daily value?

I see lots of vitamin supplements for the "golden years". Are they necessary?

For omega 3s, should I take fish oil or flaxseed?

Why is vitamin D so critical for good health?

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.

Do I need calcium supplements for bone health?

Beyond a daily multivitamin/mineral, what other supplements are recommended for healthy adults?

Pfizer Consumer Healthcare ©2012 Pfizer. This site is intended for residents of the United States.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

All nutritional data will be sourced from Axxya Systems – Nutritionist Pro™ Knowledge Base database Data provided by Axxya Systems -- Nutritionist Pro copyright 2012