Micronutrients: How Much Do I Need? | QA

Micronutrients: How Much Do I Need? | QA

Question:

Good evening. I am a 53-year-old male and I was hearing that I should be taking fish oil, a multivitamin, B-12, vitamin D, magnesium, and creatine. Do you agree? And what do you recommend in terms of dosage for the fish oil, vitamin d, magnesium and creatine? Do you recommend any others as well? 

Thank you for your time.

– Jeff 

Answer:

If your multivitamin (usually has minerals too) supplement provides close to 100% of the Daily Value for micronutrients, then you probably don’t need additional vitamin B12 or D. Most “once daily” multi’s are meant to cover the bases of micronutrient needs, but they vary greatly. A quick glance at a few widely available products (Centrum for Men, One a Day Men’s Formula, Nature Made Multi for Him) reveals they are rather low in magnesium, which is on purpose because the risk of toxicity is greater from supplemental magnesium than from foods. Though the Daily Value for magnesium is 420 mg for men, the maximum advised from supplements is only 350 mg daily1. Get the remainder of your magnesium intake from good sources such as almonds, spinach, cashews, peanuts, shredded wheat cereal, soymilk, black beans, edamame, peanut butter, wheat bread, avocado, baked potato, brown rice and plain yogurt1. 

Fish oil contains the omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). There is no set Adequate Intake for EPA and DHA, only for another omega-3: alpha lipoic acid (ALA) from plant sources2. It’s recommended to eat fish twice per week and walnuts, chia seed or flaxseed daily to obtain omega-3 naturally from the diet. Generally, a combined EPA+DHA dose of 300-500 mg per day is suggested for anti-inflammation but higher levels may be warranted for certain health conditions. For cardio protection there may be benefit for African-Americans and non-fish eaters to take 1,000 mg supplemental omega-3 daily3, and higher doses by prescription. 

Creatine works by providing ready energy for muscle contractions in the form of ATP. Whether or not you’d benefit from a creatine supplement depends on your exercise routine and goals. About 3-6 grams pre-workout has been shown to increase creatine stores and affect strength gains accompanying weight training4, and is relatively safe to take. You can get creatine from protein-rich foods and your body makes some, thus it’s not worth supplementing if you don’t participate in short duration high-intensity resistance exercise.  

References: 

  1. Magnesium – Health Professional’s Fact Sheet. (October 11, 2019) Retrieved from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/  Accessed 12.30.2019
  2. Omega 3 Fatty Acids – Health Professional’s Fact Sheet. (October 17, 2019) Retrieved from https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/ Accessed 12.30.2019 
  3. Harvard Women’s Health Watch (April, 2019) Should You Be Taking An Omega-3 Supplement? https://www.health.harvard.edu/staying-healthy/should-you-be-taking-an-omega-3-supplement  Accessed 12.30.2019 
  4. Hall, M and Trojian, TH. Creatine Supplementation. Current Sports Medicine Reports. July/August 2013; 12(4): 240–244.  doi: 10.1249/JSR.0b013e31829cdff2 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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What to Do When Weight Loss Stalls | QA

What to Do When Weight Loss Stalls | QA

Question:

Are you able to help me with calorie recommendations? In the last 8 months I have lost almost 60 pounds through diet. I started going to the gym 4-5 days a week and seeing a trainer 1 day a week. My weight loss has virtually stalled in the past month. I don’t know if my calories are too high or too low.   

I am a 57-year-old male and I currently weigh 254 pounds. I am eating between 1,400 and 1,800 calories a day. Based on the online diet calculations I should be eating 1,900 calories a day to lose 2 pounds a week. I use Apple Watch to track calories and usually burn between 400 and 800 calories a day more in exercise calories. I never eat back the exercise calories. Thanks for your thoughts. 

Doug S. 

Answer:

A brief month stall is a blink in your profound progress over the last year, Doug. It sounds like your metabolism has adapted to the diet and exercise routine you’ve set up. Time to shake things up!  

What your calories are comprised of makes a big difference in whether you’ll store or burn fat. Since you’ve already done the math and determined your intake is lower than suggested, I’d say try adding a couple hundred calories in vegetables, legumes and pre-workout shakes or recovery drinks on exercise days. Don’t add more if you feel satisfied at your present intake. 

Assuming your training workouts are progressing, focus on amping up your gym visits on the other days. You may benefit from a new exercise like a high intensity interval training (HIIT) class, harder weights/resistance, or increased cardio duration. Also look at your daily activity outside the gym and try to increase movement whenever possible.  

Remember that weight loss and body composition change aren’t linear, but usually occur with ups and downs. The fact that you are consistent in your exercise routine and dietary tracking means you’re very likely to see results again soon. Read more about overcoming plateaus in the Living Healthy blog, here and here. 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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Which Supplements Can I Take as a Diabetic? | QA

Which Supplements Can I Take as a Diabetic? | QA

Question:

As a newly diagnosed diabetic, what supplements can I take that will not spike my blood sugar? 2 months ago, I started a cardio program at home, but I want to start weight training.

-Jose

Answer:

Kudos to rounding out your exercise routine!

To narrow down an answer, I’ll have to assume you are asking about pre-workout powders, meal replacement bars, recovery shakes and other sports/body-building supplements with macronutrients (carbohydrate, fat, and protein) not individual compounds, like stimulants. Caffeine may reduce sensitivity of insulin and raise blood sugar levels.  

Generally, single servings of products with only protein and fat shouldn’t raise blood sugar levels. Many “keto-safe” protein shakes, powders and bars fall into this category. Still, they are designed for fast digestion and absorption, making a quicker impact on insulin levels than whole foods which take longer to consume and digest. Consider making your own protein beverages to drink pre and post workout. 

Products with any sugar present should also have fiber plus a balance of protein and fat, to prevent blood sugar spikes. Check the nutrition facts panel for gram levels of these. There are no magic numbers, but I would recommend avoiding products with half of total carbohydrates from sugar and those with more than 10 grams of sugar per serving. You should look at what you’re eating between meals, too. Several snack bars are promoted for those with diabetes. 

Unfortunately, there are no guarantees how your blood sugar will respond to even the most low-risk caloric supplement. No matter what supplements you take, always follow the usage directions on the product package. 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

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Have a nutrition question? Our registered dietitian is ready to help!

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Is Keto for Everyone? | QA

Is Keto for Everyone? | QA

Question:

Is the Keto diet recommended for everyone?

-Kim

Answer:

NO. A ketogenic diet is one in which carbohydrates are severely restricted (nearly eliminated), fat consumption is high and protein intake is moderate-low. The body’s process of converting its metabolism to fat-burning ketosis is a survival mechanism when carbohydrate supply is inadequate and dietary fat is plenty. [It shouldn’t be confused with diabetic ketoacidosis which also produces ketones, but with extremely high blood sugar.] Despite its short-term effectiveness for weight loss, I rarely recommend a Keto diet. Looking at all the available evidence, my professional opinion is that such an extreme approach is in opposition to a sustainable eating style that supports the whole body across one’s entire lifetime.

Following a ketogenic diet can cause long-term adverse effects such as hepatic steatosis, hypoproteinemia, kidney stones, and vitamin and mineral deficiencies1. Since the ketogenic diet is very high in fat, those with gallbladder, kidney, liver, or pancreatic disease or problems with delayed gastric emptying should not follow it. Just as they shouldn’t be consuming a high sugar/refined carb diet, pregnant or nursing women also should not be on a keto diet. It may be ideal for certain populations, though. Healthcare practitioners may prescribe a classic or modified ketogenic diet for patients with epilepsy2. It may be prescribed for morbidly obese patients in the weeks leading up to bariatric surgery3 and for some patients with Type 2 Diabetes4.  

References: 

  1. Masood W, Uppaluri KR. Ketogenic Diet. [Updated 2019 Mar 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/ Accessed 12.26.2019 
  2. Roehl K, Sewak S. Practice Paper of the Academy of Nutrition and Dietetics: Classic and Modified Ketogenic Diets for Treatment of Epilepsy. Journal of the Academy of Nutrition and Dietetics. 2017; 117:1279-1292. 
  3. Leonetti F, Campanile FC, Coccia F,et al. Very Low-Carbohydrate Ketogenic Diet Before Bariatric Surgery: Prospective Evaluation of a Sequential Diet. Obesity Surgery. 25, 64–71 (2015) doi:10.1007/s11695-014-1348-1 
  4. Azar ST, Beydoun HM, Albadri MR. Benefits of Ketogenic Diet For Management of Type Two Diabetes: A Review. Journal of Obesity & Eating Disorders. 2016; 2:2. doi: 10.21767/2471-8203.100022 

– Debbie J., MS, RD

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

Ask our Dietitian

Have a nutrition question? Our registered dietitian is ready to help!

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What is the Best Beginner’s Diet? | QA

What is the Best Beginner’s Diet? | QA

Question:

What is the best method of dieting for a beginner who began going to a gym and wants to lose weight in a quick but safe fashion that it will stay off?

– Joseph

An “ideal” diet plan for a beginner would depend on his or her lifestyle and commitment level. Some people do well with an extreme change – starting with a clean slate and following strict rules – while others get more results from incremental smaller modifications they can live with long-term. A person can start changing their eating habits for the better by beginning anywhere.   

According to the National Weight Control Registry, people that have successfully lost weight and kept it off mostly report following a low fat, reduced calorie diet with high activity levels. About half did it on their own while half enrolled in some type of weight loss program. Actions that losers often had in common were that they: 1) participate in regular exercise, 2) track weight routinely, 3) eat breakfast daily; and 4) watch less than 10 hours of video/TV per week.  

I’d trim out any extras that you can already identify such as late-night eating, second helpings, alcoholic beverages or desserts. As wholesome fresh food is always best, decide if you can dedicate additional time in the kitchen or need to purchase starter meals that you assemble. Whether or not to follow a specific diet plan, macronutrient ratio or preset menus depends on your interest level and food preferences.   

We’ve lots more beginner weight loss advice in the Living Healthy Blog – check how to create your own meal plan and how to achieve quick weight loss. 

This article should not replace any exercise program or restrictions, any dietary supplements or restrictions, or any other medical recommendations from your primary care physician. Before starting any exercise program or diet, make sure it is approved by your doctor.

Some questions have been edited for length and/or clarity.

Ask our Dietitian

Have a nutrition question? Our registered dietitian is ready to help!

Email nutrition@lafitness.com or submit your question below and it may be featured in an upcoming article!

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