Author: Monica Reinagel, MS, LDN

Why isn’t my Vitamin D working?

by Monica Reinagel, MS, LDN

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Q. When I saw my doctor for my annual physical, he did a blood test for vitamin D and it came back deficient. Although live in Southern California, I tend to avoid the sun and keep covered when I am out in it. But my daily multivitamin contains 1,000 IU of vitamin D.  My doctor recommended adding another 1,000 IU to that. My question is, why didn’t the vitamin D in my multivitamin work? 

A. When you are deficient in vitamin D, it can take a surprisingly high dose of oral vitamin D to correct it. (Exposure to sunlight is much more efficient .) My guess is that the 1,000 IU in your multivitamin simply wasn’t enough to dig you out of the hole you’d dug yourself into, thanks to your diligent avoidance of UV rays.

But 2,000 IU may not be enough either. Effective protocols for treating vitamin D deficiency often involve taking 10,000 IU per day for 2-3 months. Fortunately, high doses of vitamin D are quite safe.

Hopefully, your doctor will order another blood test to check your vitamin D levels again before too long. If they haven’t moved (which is fairly likely), he may suggest a higher dose or even give you an injection.

Once you get your vitamin D levels up where they should be, 1,000 to 2000 IU per day should be more than enough to keep you there.

 

Calcium Supplements: Safe or Not?

by Monica Reinagel, MS, LDN

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The National Osteoporosis Foundation published a new report this week, insisting that calcium supplements are safe for your heart. Two weeks ago, Johns Hopkins cardiologist Erin Michos published a paper saying the opposite.

She notes that the NOF review (which was funded by a pharmaceutical company that makes calcium supplements) omitted certain studies (such as the ones she included in her own review) that might have changed the conclusion.

These are just the latest two volleys in a five-year-long tennis match between experts on whether you should or shouldn’t take calcium supplements.  And you thought politics was divisive.  Continue reading “Calcium Supplements: Safe or Not?” >

Does glucosamine increase diabetes risk?

by Monica Reinagel, MS, LDN

Q. I have osteoarthritis but Type 2 diabetes also runs in my family. I know my own fasting glucose tends to edge up if I am not careful about my diet. Is there evidence that I should avoid glucosamine?

A. As the name suggests, glucosamine is a type of sugar. And there was some early research (mostly in animals) that raised concerns. The studies suggested that glucosamine might cause higher blood sugar and/or reduce the body’s response to insulin. Either one of these could raise the risk of diabetes or exacerbate the condition.

Subsequent research put these concerns largely to rest. However, if you have diabetes or a predisposition (including family history), it’s definitely worth running this one by your doctor. No study, no matter how large, can predict with 100% accuracy how your body might respond to a treatment. If nothing else, she can check your blood sugar periodically to be sure that glucosamine is not having any adverse effects.

See also: Does glucosamine really work?

 

How much would you pay to lose 5 pounds?

by Monica Reinagel, MS, LDN

supplementsBeth writes:

“A 2011 study published in The American Journal of Medicine showed that taking 1800mg of alpha lipoic acid a day increased weight loss in subjects on a restricted calorie diet compared to controls.  This seems promising, but the supplement is expensive. I am interested in your take on the research and whether or not the benefits justify the cost.”

 

In the study Beth cited, the subjects (all of whom were overweight) were cutting their caloric intake by about 600 calories a day and taking either a placebo or alpha-lipoic acid supplements.  Over the course of 20 weeks, those taking a placebo lost 0.94% of their body weight. So, someone who started the study at 200 pounds lost a little under 2 pounds.

Those who were taking 1800 mg of alpha lipoic acid lost 2.74% of their body weight. For a 200 person, that amounts to 5 1/2 pounds–an additional 3 1/2 pounds.  The researchers concluded that alpha-lipoic can enhance weight loss from calorie restriction.

My question is: Why did these subjects lose so little weight?? Continue reading “How much would you pay to lose 5 pounds?” >

Should you wash meat before cooking it?

by Monica Reinagel, MS, LDN

chickenQ. When I buy chicken or meat, I like to wash it under cold running water before cooking. A friend of mine claims the chicken or meat must be washed in boiling water to clean it.  Is one method better than the other? Is either necessary? 

A. Not only is it not necessary to wash raw meat before cooking, it’s not a very good idea.

According to the USDA’s Food Safety Information Service:

Washing raw poultry, beef, pork, lamb, or veal before cooking it is not recommended…Some consumers think they are removing bacteria and making their meat or poultry safe. However, some of the bacteria are so tightly attached that you could not remove them no matter how many times you washed. But there are other types of bacteria that can be easily washed off and splashed on the surfaces of your kitchen. Failure to clean these contaminated areas can lead to food-borne illness. Cooking (baking, broiling, boiling, and grilling) to the right temperature kills the bacteria, so washing food is not necessary.

The article also has some useful food safety tips about brining meat, washing eggs, and cleaning raw produce.

  • Brining: Keep raw meat in the fridge while soaking and take care not to let the brine splash onto other surfaces as it may harbor bacteria; wash brining vessel thoroughly after use.
  • Eggs: Don’t wash them!
  • Fruits and Vegetables: Wash with water and a brush; avoid vegetables soaps and detergents.

See also: How to Kill E. coli on Vegetables.

Thanks for the great question!

Product Review: TrueSelf Low FODMAP bars

by Monica Reinagel, MS, LDN

banana_largeAs the low FODMAP diet continues to gain popularity and credibility as a way to reduce the misery of Irritable Bowel Syndrome (IBS), it was only a matter of time before low FODMAP products started showing up in the market place.

TrueSelf Foods recently sent me samples of their new line of low FODMAP snack bars to review. The bars come in 4 flavors and can be purchased on the company’s website. A box of six costs US$15.

The bars are oat-based, sweetened with brown rice syrup, and feature a variety of seeds (chia, sunflower, pumpkin, poppy), fruits (banana, blueberries) and spices (cinnamon, ginger, lemon, nutmeg). Also some quinoa, just for good measure. Continue reading “Product Review: TrueSelf Low FODMAP bars” >

Which is worse: Glucose or fructose?

by Monica Reinagel, MS, LDN

David posted the following interesting question on the Nutrition Diva Facebook page:

“Your podcast on nutritional trade-offs made me think of the following question: I try very hard to limit my intake of sugar. But some foods do need some kind of sweetener, and so I’m wondering about what alternatives to table sugar you recommend. Some are higher in glucose, and that brings with it a higher glycemic index. Others have a lower glycemic index, but are higher in fructose, which experts say to avoid. What do you think?”

Most sweeteners, including table sugar, honey, maple syrup, agave nectar and so on, contain glucose and fructose in varying amounts. Table sugar is half glucose and half fructose. Agave nectar on the other hand is about 70% fructose and only 30% glucose.

These two sugars are metabolized through different pathways. Glucose is absorbed into the blood stream and fructose is metabolized in the liver. So agave nectar is going to cause a lower rise in blood sugar than table sugar. On the other hand, studies in rats suggest that too much fructose can increase the amount of fat stored in the liver and that’s not good.

So are you better off with a sweetener that’s higher in glucose or one that’s higher in fructose? Continue reading “Which is worse: Glucose or fructose?” >