You Ask, I Answer: Calcium Supplements

I take a pill that [contains] 600 mg Calcium and 400 IU vitamin D.

I'm a 26 year old female. Is this a good decision?

-- Anonymous
Via the blog

If you find that your diet does not provide sufficient calcium, then supplementing it is certainly a good decision.

Having Vitamin D in the same pill as calcium is particularly smart, as this helps facilitate absorption.

However, 600 milligrams is too much for the body to absorb at once. I recommend a supplement containing no more than 500 milligrams.

Also, be sure to check your supplement’s bottle for the amount of “elemental calcium” – this tells you how much of the calcium in the supplement is “up for grabs.”

Some not-so-trustworthy companies advertise themselves as offering large amounts, but read the fine print and you'll see that each pill doesn't offer that much absorbable calcium.

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You Ask, I Answer: Vitamin E

[In your multivitamin posting you mentioned excessive Vitamin E being harmful]. What kind of harm [specifically]?

I've been taking 1/2 a teaspoon full of wheat germ every day for the past 6 months or so.

Should I be worried? Scale it down a bit?

-- Anonymous
Via the blog

Although Vitamin E is an antioxidant, large amounts have been found to increase heart disease risk and act as pro-oxidants.

That said, let's put all this information into numbers.

The Recommended Dietary Allowance for Vitamin E is 10 milligrams per day. Negative health consequences are seen with megadoses of 180 milligrams or more a day. That figure may sound absurdly high, but you will find supplements offering that amount.

Which brings me to another point -- you will often see Vitamin E listed in International Units.

When dealing with synthetic forms of the vitamin (supplements), you convert from IUs to milligrams by multiplying the IU value times 0.45. So, 180 milligrams is equal to 400 IUs.

Onto your other question.

Half a teaspoon of wheat germ contains approximately 0.4 milligrams, so it is by no means cause for concern.

I would suggest having an entire tablespoon each day -- it covers 20% of your daily requirement.

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In The News: Battling With Leptin

The Wall Street Journal is reporting the findings of a recent Columbia University Medical Center brain scan study which found that "when humans (and rodents) lose 10% or more of their body weight, [a hormone known as] leptin falls rapidly and sets off a cascade of physiological changes that act to put weight back on. Skeletal muscles work more efficiently, thyroid and other hormones are reduced -- all so the body burns 15% to 20% fewer calories, enough to put back 25 pounds or more a year."

This partially helps to explain why crash diets never work long-term. They are such a sudden shock to the body that our metabolism starts working against – rather than with – the weight loss.

This also makes the case for long-term approaches to weight loss that implement behavior modification and a slow but steady overhaul of eating habits and dietary patterns.

The important of physical activity is also front and center here, since all forms -- and especially weight-bearing exercises -- prevent basal metabolic rate from slowing down.

As lead author Michael Rosenbaum states, "Anybody who has lost weight and kept it off will tell you that they have to keep battling. They have essentially reinvented themselves."

Thank you to Fred Tripp for forwarding me this article.

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Numbers Game: Answer

Nutrition plays an important role in three of the Top 3 causes of death in the United States.

Those three being -- in order -- heart disease, cancer, and stroke.

Looking at the entire top ten, nutrition is a risk increaser or decreaser -- depending on what you're doing -- for half of it (diabetes comes in at #6 and kidney disease takes the #9 spot.)

Although I suspect the majority of the population is aware of the link between food and health, nutrition is too often taken seriously only when a problem is well underway (after a heart attack, once diabetes has been diagnosed, etc.)

In simple terms, a lot of this comes back to education. More specifically, the lack thereof.

When I say "education," I am not referring to socioeconomic status or Ivy League diplomas. I am actually talking about a public education system that largely ignores a little something known as "life skills."

There are two subjects that should be part of every high school curriculum (not only in this country, but around the world): personal financing (so people know what to do -- and NOT do -- with their money when they start earning it) and nutrition.

I don't expect a room of tenth graders to understand carbohydrate metabolism or explain the causes of sarcopenia among the elderly.

But how about teaching them the tools to choose a healthier meal at McDonald's? Helping them understand why Oreos don't make for a good breakfast? Letting teenage girls know that having nothing but a medium frozen yogurt all day is not a healthy way to lose weight?

Otherwise, we're just going to be in an eternal game of catch up with diseases and conditions that are years in the making.

Image: Nutrition Matters, a free newsletter distributed in Toronto, Canada (produced by the Toronto Public Health Department and written by Registeed Dietitians.)

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Survey Results: Multivitamins

The latest Small Bites survey found that 45% of respondents pop a multivitamin every day, while 31% feel no need to supplement their diet with an "all in one" pill.

An additional 17% reported taking multivitamins not on a daily basis, and 5% are only concerned with getting specific vitamins and minerals in pill form.

Although vitamin supplementation has its place (i.e.: Vitamin D for almost everyone, several key nutrients for the elderly and people on very low calorie diets, Vitamin B-12 for some vegans, folate for women planning to get pregnant, etc.) it can also lull many people into a fall sense of security.

I recall a conversation with someone who told me he didn't feel the need to eat fruits or vegetables since she was getting every single vitamin and mineral in pill form every day.

Not quite. Many people forget that:

1) No multivitamin offers 100% of every nutrient. Calcium, for instance, takes up a lot of space, so any pill offering an entire day's worth (1,000 milligrams) would be too big. Besides, the body can only assimilate 500 milligrams of calcium at one given time, so a single dose of 1,000 milligrams is ineffective.

2) Since multivitamins fall into the "supplement" category, they are not regulated by the Food & Drug Administration. In other words, the label may say 100% of 23 vitamins and minerals, but no entity is making sure such a statement is accurate.

3) Multivitamins do not offer the hundreds of phytonutrients found in fruits, vegetables, and whole grains. These phytonutrients play important roles in health promotion and help certain vitamins and minerals operate efficiently in the body. Oranges, for instance, aren't just about Vitamin C; they also provide flavonoids that help with blood sugar and cholesterol regulation.

4) Intake does not equal absorption. Synthetic forms of vitamins and minerals are less bioavailable than their naturally occurring brothers and sisters. According to estimates, absorption of most nutrients in multivitamins does not go above the 50% mark.

5) More is not always better. Some multivitamins contain excessive amounts of Vitamin E, which have been show to cause more harm than good.

6) Nutrition and health go beyond simply getting enough vitamins and minerals. Calories, added sugars, saturated and trans fats, and fiber are just as worthy of attention. Getting a day's worth of a handful of vitamins and minerals isn't that spectacular if you aren't consuming enough fiber and eating an overabundance of calories.

I don't think standard multivitamins as insurance for a balanced and adequate diet are cause for alarm, but anybody looking to get optimal nutrition should really look to food first (Vitamin D is the only nutrient I think everybody should be supplementing in their diet).

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Crush Now, Cook Later

It is no surprise that garlic contains a wide variety of beneficial enzymes and compounds.

Did you know, though, that you are cheating yourself out of these if you throw freshly chopped garlic into a stir fry?

A study conducted by Claudio Galmarini and colleagues in Argentina and the United States (published in the Journal of Agricultural and Food Chemistry last year) looked into alliinase, an enzyme in garlic that "catalyzes the formation of allicin, which then breaks down to form a variety of healthful organosulfur compounds."

Allicin, by the way, has been linked to decreased rates of both stomach and colon cancer.

Here's the catch -- heat renders alliinase useless.

That doesn't, however, necessarily mean raw garlic is the only way to capture all the health benefits.

Galmarini and his team found that "allowing crushed garlic to stand for 10 minutes before cooking may further enhance formation of [allicin] before heat inactivates alliinase."

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Denny's The Menace

Last week Denny's introduced "after dark munchies" -- dishes served exclusively between 10 PM and 5 AM.

Included in that roster? Sweet Ride Nachos and Potachos (pictured at right.)

The Houston Chronicle gives us the, pardon the pun, skinny on these two items.

"Sweet Ride Nachos [are] tortilla chips tossed in cinnamon sugar, then smothered with strawberry topping, raspberry sauce, seasonal fruit, hot fudge, caramel, white chocolate chips and whipped cream."

That plateful of processed goodies adds up to 1,840 calories!

Meanwhile, Potachos (get it, a mixture of potatoes and nachos?) consist of "kettle-cooked potato chips, covered with crumbled sausage, bacon, bell peppers, onions, cheese sauce and grated cheddar cheese."

Might as well have called it the Friday Night Frathouse Special.

Anyhow, if you think heart health is overrated and can afford an extra 2,080 calories, dig right in!

By the way, if these two "all-stars" don't jump out at you, you could always go for the Smokin' Q Four Pack ("four mini burgers topped with sweet & tangy BBQ sauce, crispy onion rings, Cheddar cheese and bacon; served with a double portion of onion rings.")

Is a standard cheeseburger no longer enough to please the late night post-bar crowd?

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