Nutrition & Physical Activity

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Kickstart for getting healthy eating and exercise plan in gear?

Dear In dire need of a diet/workout routine,

While you may be low on motivation right now, don't fret; it's never too late to get back on track.

Instead of thinking about the negatives related to lack of exercise and poor diet (excess weight, feeling sluggish), thinking about the positive benefits of healthy exercise and eating patterns may help your motivation return. Exercise and a healthy eating plan can help promote long-term health, but they also have more immediate effects. Exercise helps relieve stress and causes the brain to release mood-improving compounds called endorphins. Time spent on exercise is time spent on you, time for you to consider the issues of the day or to simply clear your head. Working out improves sleep quality, so we have more energy to take on work, school, and the next workout. In the past, what positives have you experienced from exercising and eating well?

Having established some pros, you may want to consider the barriers that are keeping you from eating healthily and doing regular physical activity. One example might be that you don't see healthy lunch options at your workplace or school. Another could be that some fitness center memberships are too pricey. What are all the barriers you can think of? (Hint: start writing them down!) Once you know what you're up against, you can brainstorm solutions and take a step-by-step approach to implement your solutions. For example, with the lunch time conundrum, would it work to pack a healthy lunch two or three times per week? Or could you start to scour the menu and deli shelves for healthy options that may be hidden away? Some folks find that rewards are part of the solution. What are some non-calorie rewards that would give you the incentive you need to stay active and eat well?

Feeling sluggish can be related to giving your body more fat, sugar, and calories than it needs. An energy boosting, balanced diet includes plenty of fruit, veggies, low-fat dairy, lean proteins, and whole grains. Look at the related Q&As, or visit the Academy of Nutrition and Dietetics or Choosemyplate.gov web sites for tips and guidelines that will help you to put together a healthy and tasty eating plan. As you change your eating patterns, you may even chart your moods in a daily organizer, to see the foods that are making a difference.

Another great way to get back on track with exercise and healthy eating is to gain the support of an ally. Working out with a buddy will make it easier and more enjoyable, and will keep you accountable for those days when you want to skip your exercise. By varying the time of your workout and/or the activity you do, you can prevent getting bored with your same old routine. Sharing a home-cooked meal with a friend can be fun and healthy.

If you prefer, you could also get a professional perspective. If you belong to a gym, you might consider scheduling time with a personal trainer. For healthy meal planning, consider making an appointment to speak with a registered dietitian. Above all, be realistic, have fun, take small steps toward your goals, and you'll be on your way to getting big rewards!

Alice

For more information or to make an appointment, check out these recommended resources:

Columbia Health Nutrition Services (Morningside)

Dodge Fitness Center (Morningside)

Medical Services (CUMC)


Eating healthy at the campus dining hall?

Dear Hungry,

Going off to college opens many opportunities for learning — in this case, how to make healthy food choices on your own. Relatively balanced meals, possibly planned by parents who were watching out for their childrens' health, are replaced by a smorgasbord of dining hall offerings. And while the "First-Year 15" are largely a myth (most college students don't gain 15 pounds, or any weight, during their first year), having unlimited access to a variety of foods the first year of college is a new challenge for many students.

The foods that you mention — pizza, Chinese food, and tacos — are not inherently unhealthy. Each contains foods from important food groups and provides energy that will fuel your brain during long study sessions. Sometimes these foods are prepared in such a way that they are high in fat, which is a nutrient that helps us to feel full, but also provides extra calories. These foods can be part of a filling and balanced meal, but only if they share the plate with side dishes that are low in fat, high in fiber, and nutrient dense.

One easy tip for healthy "all you care to eat" dining: When you place food on your lunch or dinner plate, make sure half the plate is filled with different colored steamed, grilled, broiled, or raw vegetables. One fourth of the plate should contain lean proteins, such as beans, grilled skinless chicken, or baked skinless fish. The remaining fourth of the plate can hold whole grains, such as 100 percent whole wheat bread or brown rice. For example, in order to balance a plate that includes pizza, choose one slice with chicken and veggies on whole wheat crust (if available) and fill the rest of your plate with a salad. Or on taco night, grab one taco with the meaty, cheesy, or beany filling of your choice and fill up the rest of your plate with steamed or grilled veggies and brown rice. For flavor fiends, look around for condiments like hot sauce, mustard, fresh salsa, and other seasonings. More information on dividing up your plate can be found on the United States Department of Agriculture's (USDA) MyPlate website.

If you find yourself stuffed after a dining hall meal, here's another tip: Fill only one plate and don't go back for seconds. You could even skip using a tray, to avoid filling too many plates and grabbing too many calorie-rich beverages. If you're still hungry after letting your food settle, grab some fruit; high in fiber and deliciously sweet, fruit can be a filling and satisfying second course. Making regular meals of a plate full of fruit, veggies, lean protein, and whole grains can fill and satisfy, and leave plenty of wiggle room for the occasional treat, such as french fries or ice cream.

Depending on the layout of your dining hall, you may need to poke around to find the healthiest options, but it's likely there are plenty of grilled, steamed, baked, or broiled veggies and proteins and whole grain carbs to fill your plate. Healthy dining options to look out for include:

  • A salad bar
  • Whole grain bread and/or bagels near the toaster
  • Entree options without any breading
  • Cooked veggies without any batter or heavy sauces
  • Broth-based soups (rather than cream-based)
  • Low-fat milk or yogurt for cereal or granola
  • Whole pieces of fruit or fresh fruit salad
  • Seltzer water or diet soda from the soda machines
  • A choice in plate, bowl, and cup size

For recommendations tailored to individual dietary needs, food experiences, and taste preferences, you can meet with a registered dietitian. Columbia students can make an appointment by contacting Medical Services (Morningside) or the Student Health Service (CUMC). The staff at the dining hall are also a great resource, as they are familiar with the menus. They may be able to answer your questions regarding foods that are  prepared in a healthier manner, and the concerns of other students trying to eat a balanced diet.

Bon appétit!

Alice

Lactobacillus acidophilus for diarrhea?

Dear Reader,

Lactobacillus acidophilus is bacteria, not the pathogenic type that causes illness, but actually one of several kinds of beneficial bacteria called probiotics. These helpful bacteria are normally found in the intestine and the vagina. They are also naturally available in cultured or fermented dairy products, such as yogurt that contain live active cultures and acidophilus milk. Probiotics are also sold as nutritional supplements. Since the U.S. Food and Drug Administration (FDA) does not regulate dietary supplements, the presence and/or amount of live active cultures in supplements is not guaranteed.

Probiotics appear to offer various health benefits. They create a more acidic environment in the intestine and vagina, which helps keep harmful bacterial growth in check. This natural balance can be disrupted, however, by antibiotic use and illness. In these cases, the bad bacteria proliferate, usually causing conditions such as diarrhea or vaginal infections. Taking probiotics may help reduce the symptoms of diarrhea and treat vaginal infections.

Other possible benefits include enhancement of the immune system, helping the digestion process, production of antimicrobial substances, and protection against certain chronic illnesses, such as cancer, among other possibilities. However, more research is needed to definitively demonstrate that probiotics have these favorable actions.

To answer your question: There has been some research to suggest that L. acidophilus (commonly combined with another probiotic) may reduce the risk and/or duration of of some cases of diarrhea if used as a preventative measure. More specifically, a few studies have shown that the use of this probiotic has reduced the risk and incidence of diarrhea associated with antibiotic use and chemotherapy. In another study, a combination of probiotics that included L. acidophilus resulted in a shorter duration of acute diarrhea in children. While these findings are promising, there is currently no consensus on whether L. acidophilus alone or in combination with other probiotics would be effective for the prevention or treatment of traveler’s diarrhea.

Despite this research, if you are considering using L. acidophilus or other probiotics, consult your health care provider before doing so. Those who are pregnant or immune-compromised will need to determine whether or not it's medically safe to take probiotics. Adverse effects include gas and/or bloating, irritation, sensitivities or allergies, and interactions with over-the-counter or prescription drugs and/or other dietary supplements.

There are other remedies for diarrhea, including antidiarrheal and antimicrobial medicines, but these are not recommended in all cases. When the cause is food poisoning, it’s best to let the illness run its course. Antidiarrheals can delay the time it takes for food-borne microorganisms to leave the body.

Hope this helps!

Alice

Skipping meals leads to headaches?

Dear Reader,

Without knowing your health history or your lifestyle habits, it is difficult to know which one of the many possible physiological explanations is the cause of your headaches. However, research has shown that there is a significant connection between food, or lack thereof, and headaches and migraines. Some common reasons why people get headaches from skipping meals are:

HypoglycemiaThis basically means low blood sugar. By skipping a meal your blood sugar levels may drop to a level that causes your body to release hormones that are compensating for depleted glucose levels, this in turn can cause an increase in blood pressure and can narrow your arteries. The result can be headaches and migraines. 

Dehydration — Not drinking enough fluids can cause the constriction of the meninges, which are thin layers, or several thin layers, of tissue that line your brain and spinal cord. They constrict from lack of hydration, and because the meninges have pain receptors, this causes headaches. This is often what happens after a long night of drinking and is also known as the morning after hang over. 

CaffeineThis is a common stimulant that has been linked to headaches. Going through caffeine withdrawals can cause your arteries to dilate and can create an excessive blood flow to the head, and you guessed it, can cause headaches.

You can prevent or combat the causes of these headaches by drinking enough water (it does a body good), eating smaller meals four to six times a day, and moderating your intake of caffeine. If you're often too busy to sit down for a meal, you may want to try carrying around snacks with you to hold you over until you're able to have something more substantive. In addition to snacks, having a refillable bottle for water makes it more convenient to stay hydrated and saves you money since you won't have to buy bottled water.

What it comes down to is this — your body is telling you something when you skip meals. You may want to try out the suggestions listed above and see if the frequency of headaches decreases. You may not only prevent the onset of headaches, but also find that you feel more energetic and healthy overall.

Alice

I'm worried about my friend who may have bulimia

Dear Reader,

Your friend is lucky to have a friend like you, who observed a change that concerned you enough to ask for help and learn more about what could be going on. A twenty-five pound weight loss in one month is definitely cause for concern. Losing that much weight in such a short period of time could indicate a medical problem. Has your friend seen a health care provider recently? If not, you may consider urging her to schedule an appointment with a medical provider for a physical exam to make sure she is okay. This may or may not be an easy thing for you to do. Strategies to consider when encouraging a friend to see a health care provider include:

Validating your friendship
Convey that you care for her and that your concern is genuine. You can say, "I value our friendship, and I hope you know that I care about you."
 
Thinking about your approach
Plan what you will say. Be direct with your concern, and focus on your friend's health rather than on her weight. Sometimes it's easier to identify an aspect of someone's health or behavior. For example, "I've noticed that you seem tired all the time"; or, "I've noticed that you seem kind of blue lately." If she's an athlete, you might be able to comment on her decreased performance. Whatever you choose to say, keep the emphasis away from weight, appearance, and food, because sometimes the most seemingly innocent statement can be misinterpreted and unwittingly close a door you had planned to open.
 
Offering a plan with options
Sometimes it's not enough to express concern. Follow up your observation with action-oriented ideas. For instance, "Is there a health care provider you feel comfortable scheduling an appointment with? If not, I'd be happy to help you find one." Or, "I can go with you to your appointment with the health care provider, if you like, or perhaps there is someone closer to you whom you might like to go with instead."
 
Recognizing your own limitations
Perhaps going to a health care provider with your friend is outside of your comfort zone. That's okay. It's important to know what you feel comfortable with so you avoid overextending yourself. Maintain whatever boundaries you need to so as not to get stressed out. Choosing to stay within your limits doesn't mean you're not supporting your friend.

It is not clear whether or not your friend has bulimia; however, you have noticed that she is in a serious situation and needs to be seen medically, since her health may be at risk. If you think your friend has an eating disorder, consider the following:

  • Individuals with bulimia nervosa tend to be of normal to slightly overweight range. Bulimia typically involves regular and repeated, often secretive binge eating bouts followed by purging, or other compensatory behaviors, to prevent weight gain. In general, purging is accomplished by self-induced vomiting and/or misuse of laxatives, diuretics, or enemas (purging type). People with bulimia may resort to other extreme behaviors, such as excessive physical activity or self-induced starvation (non-purging type) to avoid weight gain. Bulimia is highly correlated with substance abuse. People with bulimia often have a history of misusing alcohol and/or other substances.
     
  • Anorexia nervosa is characterized by an unwillingness and inability to maintain a healthy body weight. Typically, someone with anorexia is at 85 percent or less of her/his healthy body weight. S/he has a severe fear of fat and weight gain, and has a distorted body image. The seriousness of the significant weight loss is often denied by someone with anorexia.
     
  • Binge eating disorder is similar to bulimia nervosa in that it is typically characterized by regular and repeated binge eating episodes. An episode of binge eating involves rapidly and uncontrollably eating a large amount of food in a single time period at one sitting until uncomfortably full. Unlike bulimia nervosa, binge eating disorder does not include purging or other compensatory behaviors. Affected individuals are usually obese and have had problems with fluctuations in their body weight. For a majority of these individuals, binge eating begins during a diet.
     
  • Eating Disorders Not Otherwise Specified (EDNOS) describes individuals who show signs of anorexia and/or bulimia, but do not fully exhibit the behaviors necessary to be clinically diagnosed with anorexia or bulimia. Someone with EDNOS may purge but not binge eat, or binge eat less than twice per week. So someone with disordered eating may not fit into the category of anorexia or bulimia, but still have an eating disorder that requires treatment.

A medical problem can trigger such significant weight loss in a short period of time, and so can depriving and/or ridding one's body of calories. Body weight remains stable when people eat just enough food to give their bodies the energy (calories) that they need for daily activity — calories taken in or ingested need to equal calories out or expended for weight maintenance. People gain weight if they consume more calories than their bodies need and use. If people eat fewer calories than they need and use, their bodies will take the energy from their storage, body fat, and will lose weight. Significant weight loss indicates that there may be multiple factors involved.

Based on your observations, the sooner you take action, the better. If you're comfortable, consider your approach if/when you talk with your friend. Timing is important, so choose when you two can sit in a relaxed environment that allows enough time to talk. Think about what you will say without coming across in a threatening or accusatory manner. Use "I" statements to express your feelings about what you've noticed that seems to be happening with her: "I'm worried that something is going on with your health." Try not to let the discussion turn into an argument or power struggle. If the conversation becomes hostile, back off and resume after you both have had time to calm down and think. Be prepared for rejection the first, fifth, or tenth time you express your concern with her. Persistence could pay off at some point, as the road to recovery is a process. If your friend denies she has a problem, a common reaction, don't take it personally; at least your friend now knows that she can come to you if/when she's ready to ask for or to get help.

If you're a college student, you can get help and support for your friend and even for you in dealing with your friend, from your resident adviser (RA) or residence hall director (RD), dean, advisor, or from someone in the Counseling Department. As you can see, there are many opportunities to begin to get the help you need to be able to help your friend. It is important to remember that she needs medical care, and that you alone cannot fix her. She's lucky to have someone like you who cares enough to reach out.

In an emergency situation, however, you need to involve your friend's RA, RD, and/or dean to make sure she gets appropriate help immediately. Signs that indicate an urgent situation include sleeping all day, blacking out, suicidal thoughts or attempts, or significant weight loss, such as in this case. You may feel reluctant to blow the whistle on your friend, but you will be a better friend by helping her get the assistance she needs than by respecting her privacy in this specific situation.

Alice

Unscrambling conflicting info about eggs

Dear Not yet an Eggspert (but hopefully soon-to-be one),

You're right — eggs are a great form of protein, among other nutrients. The reason you hear different recommendations is because they vary depending on a person's health. Each person responds to dietary cholesterol differently, meaning that eggs may have more of an effect raising one person's blood cholesterol than another's. Unfortunately, we can't tell who will be affected in advance. If you're a healthy person, the American Heart Association says you should consume 300 mg or less of dietary cholesterol per day. If you have any of the following risk factors, 200 mg or less is recommended:

  • Family history of heart disease
  • Total cholesterol over 240 mg/dl
  • High blood pressure
  • Diabetes
  • You smoke

One whole egg contains between 213 - 220 mg of cholesterol. The fat, cholesterol, and most of the vitamins and minerals are found in the yolk. By the way, the saturated fat content of an egg is less than 2 grams, which is low. If you are in good health and know that your total blood cholesterol is below 200 mg, it is probably okay to have one whole egg a day if you limit other sources of cholesterol. The American Heart Association recommends 3 - 4 egg yolks per week for healthy individuals, probably because they expect that people will eat other foods that have cholesterol — these include all other animal-based products, some containing more cholesterol than others. To give you an idea:

  Food Item

Dietary Cholesterol (mg)
  whole milk (1 cup)   35
  skim milk (1 cup)   4
  cheese (1 oz.)   20 - 30
  butter (1 T.)   35
  beef (3.5 oz.)   70 - 100
  chicken (3.5 oz.)   75 - 90
  shrimp (3.5 oz.)   215
  cod (3.5 oz.)   65


If you're eating eggs and other high cholesterol foods often, it would be wise to have your blood cholesterol levels checked regularly to be sure that they don't suddenly rise.

Whipping up omelets using one whole egg and two or more egg whites is a good idea. This will give you a nice, fluffy dish with flavor, too. If you're looking for other low-cost nutritious foods, try preparing simple bean dishes. Since the fiber in beans helps to lower blood cholesterol levels, this could be a healthy alternative for egg-less times.

Have an egg-cellent day,

Alice

Eating at night = weight gain: Myth or fact?

Dear Reader,

You and your friends have picked up on a popular debate. One aspect of weight management that is vital to understand is that we gain and lose weight over periods of time — weeks, months, years — not hour by hour. This happens as we take in more calories than we expend. Another important fact of metabolism is that our bodies do not stop working, even when we are sleeping! Hearts are beating, blood is circulating, lungs are functioning, brains are even working. This all takes energy — meaning we are still burning calories.

There is no magic time after which the body stores fat. For instance, if you eat the same exact meal at 6 pm or at 8 pm, is one more caloric than the other? No, each meal has the same number of calories. What really matters is the total amount of food and drink you have over the course of a week, or a month or longer, and how much energy you expend during that timeframe. Excess calories will be stored as fat over time, regardless of whether they are taken in during the day or night.

When it comes to eating late at night and the potential for weight gain, there are several considerations:

  • Portion sizes — waiting to eat could lead to consuming larger portion sizes.
  • Quality of food — after a long day of work or school, a few slices of pizza or a fast burger may seem easier than steamed vegetables and broiled fish.
  • "Mindless snacking" — evenings spent studying, going out, or watching TV may lead to excess calories from fast, sugary, on-the-go options.
  • Health concerns — consistent periods of going without food followed by a large meal can negatively impact the interaction between blood sugar and insulin and make you more vulnerable to Type 2 diabetes.

So, to settle the debate, you are correct that late-night calories won't change your metabolism or magically count more than calories eaten during the day. However, limiting late-night meals and snacks may be an effective weight management strategy for some because it helps them to control their overall calorie intake. Some people find that if they set a time that they can't eat past, it helps minimize or eliminate the possibility of munching on a lot of high calorie foods. Another useful tip may to be to eat four or five smaller meals and snacks spread evenly throughout the day so you don't become overly hungry at any point. Following these tips can keep your energy levels consistent for work and play and can provide some long-term benefits to help you reduce your chances for diabetes or other health issues. 

Bon appétit! 

Alice

June 29, 2007

21199
Dear Alice,

Though your metabolism IS constantly at work, it does slow down later in the day, especially if you are just dieting and not exercising. When you exercise your heart rate and...

Dear Alice,

Though your metabolism IS constantly at work, it does slow down later in the day, especially if you are just dieting and not exercising. When you exercise your heart rate and metabolism both increase. In addition it is better to eat more meals and take in the same amount of calories because in doing so you keep your metabolism working. On the other hand if you eat less or worse starve yourself for several hours your metabolism slows down and potentially puts your body into a "starvation mode" where more insulin is released causing the body to store more fat. This is the most simple answer to this question.

Coach withholds water during practice — Help!

Dear Thirsty one,

Yo, what's up with your coach? We're talkin' school sports, not the Marine Corps. Perhaps your coach thinks that drinking water during practice will cause cramps and impair performance, or maybe s/he does not want to take time away from practice by having water breaks. Or, is s/he withholding water as a form of cruel and unusual punishment? Either way, withholding water from the team players is unhealthy and unethical. From your description, you and your teammates are exhibiting signs of dehydration. By the time you are thirsty, you already need fluids.

Water is vital to life for many reasons. Adult bodies are made up of about 55 to 60 percent water — children's bodies have an even higher percentage. This fluid is needed to:

  • Transport nutrients to organs and muscles
  • Carry waste products out of the body
  • Provide an environment for chemical reactions to occur
  • Act as a lubricant around joints
  • Work as a shock absorber inside the eyes and spinal cord
  • Serve as the solvent for minerals, vitamins, amino acids, glucose, and lots of other substances
  • Help regulate body temperature

In carrying out our normal body processes, we lose about 2.5 quarts of water a day. That's why we need to drink eight to ten cups (one cup = 8 ounces) of water every day. You need more if you exercise and sweat. The good news is that any non-caffeinated beverage counts, too.

To determine how much more fluid you need, follow this simple advice: weigh yourself before and directly after practice. Any difference reflects your fluid loss from sweating. For each pound you lose, you need two to three cups (16 to 24 oz.) of liquids. Even a modest two percent loss of body weight results in impaired sports performance. For a 125 lb athlete, this is as little as 2.5 pounds! A four to five percent loss in body weight (e.g., five to six pounds for a 125 lb person and six to seven pounds for a 150 lb person) can result in flushed skin, nausea, difficulty in concentrating, and an increased effort to be able to run, jump, and do just about anything physical. Once you lose more than six percent of your body weight in sweat, you risk dizziness, slurred speech, mental confusion, increased pulse rate, and other signs of heat illness. These effects are additive, meaning that dehydration can occur over time if you don't rehydrate on a daily basis.

You don't have to lose six percent of your body weight in one day. Your best strategy is to spread out your fluid intake over the course of a day. Some of this may be in the form of juice or milk. Ideally, drink two cups of water before exercise, then about two ounces every ten or fifteen minutes during exercise. Stay away from caffeinated beverages, which increase fluid loss.

Now that you're in the know, you can bring this data to your coach. If y'all are still denied the water you need and deserve, speak with your parents, teachers, athletic director, and physician about your coach's philosophy. Enlist their help in insisting that water or other sports drinks be available to you and your teammates during practice. If your coach is concerned about time, bring a bottle of water with you to practice, taking drinks during five-second breaks or whenever you have a chance.

Alice

What's spinning?

Dear Reader,

Spinning® (it is a registered trademark name when referred to as the exercise) is generically known as indoor, stationary cycling. Originated by Johnny G. (for Jonathan Goldberg, the Spinning guru) in 1987, these high intensity classes have sprung up all over the United States. Although gyms are calling these classes by various other names, most offer similar workouts.

An instructor leads the typically 45 - 60 minute class, usually to some sort of motivating music. Participants ride on specially designed stationary bikes and are able to control their own resistance, or level of difficulty. Some instructors take the class on an imaginary ride, describing changing scenery, such as mountains or flat roads. Other leaders encourage the class through various cycling techniques. Often the music inspires participants to work towards a high level of fitness.

These classes can be very challenging. A good instructor should be able to help beginners adapt the exercises to suit their ability. Since these bicycles are much different than outdoor ones, it takes a few classes to get the feel of them. When trying an indoor cycling class, it is recommended to:

  • Arrive early for your first class. If it's your first time, tell the instructor and have him or her help you set up the bike. You need to properly adjust the seat and handlebar heights, as well as the distance between the seat and handlebars.
  • Ask the instructor to review proper form. Avoid leaning on the handlebars — it puts too much pressure on your shoulders and wrists.
  • Bring a full bottle of cold water with you, along with a towel — you'll sweat a lot!
  • Go at your own pace — don't try to "compete" with others. Even if the instructor acts like a drill sergeant, take it easy until you are comfortable with the techniques involved. You will undoubtedly be sore after the first few classes.
  • Wear bike shorts or some sort of long shorts or knee-length leggings.
  • Have fun and enjoy, but don't overdo it — overuse training injuries can occur with this activity, as with any other form of exercise.

Happy cycling!

Alice

Time-release dietary supplements

Dear Reader,

It's easy to become confused with the whole array of dietary supplements on the shelves nowadays. One form may claim superiority in advertisements, but how are you to know for sure which ones are right for you?

First of all, vitamins and minerals are needed in our bodies in relatively small amounts. Vitamins may be present in our blood, organs, or other tissues. Although each micronutrient (scientific term for vitamins and minerals) has a specific function, here's a brief overview by category:

  • Water-soluble vitamins (all the B vitamins and vitamin C) and many minerals act as co-enzymes, meaning they aid in chemical reactions in the body. Excessive amounts don't make reactions occur faster or more efficiently than adequate or recommended amounts. Plus, too much of one mineral may actually inhibit the absorption and effectiveness of another.
  • Fat-soluble vitamins (vitamins A, D, E, and K) are involved in specific roles of maintenance and repair of body cells and tissues. Unlike water-soluble vitamins, extra amounts of fat-soluble vitamins are not excreted, so over-saturation of these may lead to toxicity.
  • Minerals have a variety of functions, ranging from water and acid-base balance, to bone structure and co-enzyme activity, as mentioned before.

As long as you consume a sufficient vitamins and minerals, a constant influx is not necessary, and may also be harmful. For example, time-release niacin is not recommended because it can cause liver damage. Time-release iron supplements are ineffective because the point of release in the intestinal tract does not absorb this mineral efficiently. Some time-release supplements contain coatings that prevent the absorption of fat-soluble vitamins. As you can see, time-release nutritionals are certainly not worth the extra money manufacturers often charge for them. Besides, Mother Nature has already provided us with a way to time-release our nutrients... by getting them from a variety of foods, eaten at various times throughout the day.

To get to your last question, you are among quite a number of men and women who have expressed concern over whether their multi-vitamin "works" or "doesn't work"; that is not really the point of these supplements. Their purpose is to help certain people fill in nutritional gaps when they are unable to eat enough food or obtain adequate vitamins and minerals from their diet. Multi-vitamins also might be recommended for some vegetarians, dieters, and others who have food allergies, intolerances, or other problems associated with eating particular foods. A supplement may benefit the elderly, too, because sometimes older people can't absorb nutrients as well as they did in their youth. Remember, the meaning of a dietary supplement is to add to a diet, not to take the place of food!

Alice

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