4 nutritional must-haves
Susan Biali, MD
In a research world mired in controversy regarding the effectiveness of different vitamin and mineral supplements, almost all scientific groups recommend supplementation with calcium and vitamin D.
For the last eight years I wrote a monthly column for The Medical Post, educating Canada’s physicians and health professionals on a topic that my medical training taught me very little about: nutrition. Luckily, I’d completed a degree in dietetics before going to medical school.
After writing almost 100 columns on the latest research and trends, I found myself constantly repeating the same mantra: your best bet is to eat a well-balanced diet of fresh, whole, organic foods. In this complicated world of wellness fads and advice, I still believe that a simple, healthy diet is one of the few things that will guarantee good results; that said, I did discover some supplement superstars along the way.
Before I share them with you, I’d like you to keep in mind that just like any medication, even these respected supplements should be taken only after considering your own unique situation. Do consult first with a knowledgeable practitioner regarding safe doses, potential side effects, and interactions.
Calcium and vitamin D
In a research world mired in controversy regarding the effectiveness of different vitamin and mineral supplements, almost all scientific groups recommend supplementation with calcium and vitamin D. Both are essential to keeping our bones strong and preventing osteoporosis (and easily broken bones) later in life.
Most of us get some calcium in our diets, particularly if we consume dairy products. If you’re like me (I’m both lactose intolerant and milk protein allergic) and have to avoid all things dairy, choose a dairy substitute, such as soy milk, that is fortified with calcium. Other dietary sources of calcium include fortified tofu, canned salmon (with bones), and spinach.
For an idea of how much calcium you’re getting on an average day, search online for a table of dietary sources of calcium. Count the average number of cups of milk, dairy products, and other nondairy calcium sources that you eat in a typical day. Compare this to the recommended calcium intake for your age group, and make up the rest with a supplement. Calcium citrate is the best choice, as it is most easily absorbed by the body.
If you live up here in Canada you almost certainly would benefit from supplementing your diet with vitamin D, as vitamin D makes it possible for your body to absorb calcium, and helps that calcium mineralize and strengthen your bones. Unfortunately, very few foods actually contain vitamin D, and most people make their own vitamin D through a chemical reaction created by strong sunlight on the skin. Milk and nondairy substitutes are often fortified with vitamin D.
If you live in the Great White North, are over 50, or have dark skin, it puts you at increased risk of vitamin D deficiency. And that’s not just bad news for your bones: growing evidence suggests that vitamin D might play a role in preventing the development of diabetes, high blood pressure, and multiple sclerosis.
I wrote a Medical Post column about vitamin B12 back in 2005 and was shocked by what I discovered. Almost a third of people over age 50 may be deficient in this essential vitamin, because as we get older it gets harder for our bodies to separate and absorb vitamin B12 from foods.
Normally our bodies are able to store several years’ worth of B12 , but if you’re not eating it or aren’t able to absorb it, you can get into trouble. We normally get B12 from animal sources such as fish, meat, and dairy, so if you’re a strict vegetarian and are avoiding these foods in your diet, you may be at risk.
Vitamin B12 helps us maintain healthy nerves and blood cells and is even used to make DNA. If you have even a slight deficiency, you might develop neurologic or psychiatric symptoms, including shakiness, weakness, vision problems, memory loss, poor concentration, and mood disturbances such as depression.
Some people at high risk for deficiency get regular B12 injections from their physicians, but various studies have demonstrated that a simple B12 oral supplement is sufficient and well-absorbed in the majority of situations. Even though I’m still on the young side of 50, I take a daily supplement with a small amount of B12 — just in case!
Almost everyone has heard of probiotics, or good bacteria, by now. I’ve been a fan, and have been writing about their benefits, for years. These live microscopic organisms, which are similar to the beneficial bacteria that populate our digestive system, may provide our bodies with a long list of benefits.
I frequently use information and summaries from the National Institutes of Health (NIH) to obtain evidence-based information on what’s been proven and what hasn’t. In the world of nutrition, their expert panels sort through hundreds, if not thousands, of studies looking for results that stand up to repeated scrutiny.
In 2005 NIH’s National Center for Complementary and Alternative Medicine sponsored a conference in conjunction with the American Society for Microbiology to explore the evidence behind probiotics.
Among other findings, they concluded that there was encouraging evidence supporting the ability of probiotics to prevent and treat infections of the urinary system and the female reproductive system, and also to prevent and manage eczema in children. This latter discovery is extremely important, as eczema is such a widespread condition with very few, if any, truly effective medical treatments.
Probiotics are also important for anyone who has ever taken, or is taking, a broad-spectrum antibiotic, as these medications wipe out the natural healthy bacterial flora.
Take care when choosing a probiotic, as I’ve seen several reports of probiotic formulations that didn’t contain adequate amounts of active, live bacteria. Stick to reputable brands, and as always, ask for advice from a knowledgeable, trusted health practitioner.
Fish oil/omega-3 fatty acids
Over the last few years fish oil and the omega-3 essential fatty acids have gotten plenty of well-deserved hype from the health media. We’ve got strong scientific evidence demonstrating that these fatty acids can help to reduce blood pressure as well as the fatty, heart-disease-producing triglycerides in our blood.
According to the NIH, fish oil supplements are associated with improved blood vessel function and a lower resting heart rate. Perhaps even more importantly, there’s good evidence that the omega-3 fatty acids reduce general inflammation in our bodies. General inflammation is now thought to be at the root of a long list of diseases and conditions, including heart disease, arthritis, diabetes, and possibly even cancer.
Whether or not you should consider supplementing with fish oil will depend on how much fish, particularly salmon, that you regularly eat. The less fish you eat, the more likely you would benefit from a supplement. Do note that, as with any good thing, it’s possible to take too much. Again, consult a professional to determine the appropriate dose and form for you.
Recommended nutrient intakes
|19-50 years||1,000 mg||400 IU|
|51-70 years||1,500 mg||800 IU|
Suggested supplement doses
|Vitamin B12||Fish Oil or Omega 3||Vitamin D|
|For adults over 50: 25 to 100 mcg/day||Depends on composition of supplement, as content varies||Depends on composition of supplement, as content varies|