Promising to Make 2014 a Healthier, more Nutritious Year
New Year’s Eve has passed. Now it is time to honor those resolutions! Like many people, I committed (in my head and now publically) to exercise more regularly and to improve my fitness (code for shrinking my waistline). Because a BIG part of my goal is balancing calories to manage weight, I will adhere to the 2010 Dietary Guidelines. This means reducing my daily sodium intake, consume less than 10% of calories as saturated fat, less than 300 mg cholesterol daily, keeping trans fatty acids to a minimum, and drinking alcohol in moderation.
However, good health isn’t just a matter of calorie consumption and weight management. Unfortunately, overnutrition (too many calories for my activity level) and undernutrition (inadequate intake of essential micronutrients) co-exist. Increasing my vegetable and fruit intake, consuming whole-grains, choosing lean protein sources, especially omega-3 rich fish sources, will help address nutrient shortfalls. However, history (and National Health and Nutrition Evaluation Surveys) shows that most of us will not consume recommended amounts of vitamin D, vitamin E, dietary fiber, potassium and calcium.
I am a firm believer in the value of fortified foods. Nutritionally, fortified foods are the best option when trying to meet nutrient requirements within a daily caloric goal (say 2000 calories). Research (Fulgoni et al. 2011) shows that people using dietary supplements are most likely to meet their nutrient requirements. Second place goes to those who choose fortified and enriched foods. Last place (in terms of meeting nutrient requirements) goes to those eating only naturally-enriched foods.
Still, it isn’t easy. For example, food sources of vitamin D are limited. If I was a vegetarian, it would be worse because most sources of vitamin D are animal foods. So the solution is to supplement with vitamin D. There isn’t any difference in the availability of vitamin D from fortified foods vs dietary supplements (with the understanding that vitamin D3 is more potent than vitamin D2). I will continue with my vitamin D supplement.
Vitamin E is another matter of personal concern because most likely I am one of the 93% of Americans not consuming the Estimated Average Requirement (EAR). The Alpha-Tocopherol Beta-Carotene Study (ATBC) found that total mortality from cardiovascular disease and cancer was ~50% lower in people with a serum α-tocopherol of 30 µmol/L vs those at 16 µmol/L. Since most food sources of vitamin E are also rich in fats and calorie-dense, a vitamin E supplement is a good solution for me.
In fact, when trying to balance calories and nutrition, dietary supplements can be a cost-effective option with few calories. While I like oily fish, as Julia Bird (@juliakbird) blogged yesterday, not everyone does. Fish oil supplements ( 396 mg EPA + 250 mg DHA) are as effective as eating salmon daily to improve long-chain polyunsaturated fatty acid (PUFA) status.
In pursuing my 2014 goals, I will not be dissuaded by headlines like “Don’t Take Your Vitamins” or editorials like “Enough is Enough: Stop wasting money on vitamin and mineral supplements”. I will trust registered dietitian Elizabeth Sommer as she discusses the importance of eating well and supplementing responsibly. The guidance of @elizabethsomer is founded in experience with people like myself rather than ivory tower assumptions. As Colby Vorland (@nutsci) writes in the American Society for Nutrition (ASN) blog “Multivitamins: Is the Debate Over?” , it is ideal to obtain nutrients from food but it is unreasonable for me to assume I am one of 0.5% of Americans achieving my Dietary References Intakes (DRIs) for all 21 nutrients when the average person meets the DRI for 11. The average person fails with respect to vitamin D, vitamin E, dietary fiber, potassium and calcium DRIs, and probably more depending upon my food preferences. These are the statistics to remember.
At just over 7 cents a day, multivitamin supplements are a safe, inexpensive, simple insurance plan.
Wright ME, Lawson KA, Weinstein SJ, Pientinen P, Taylor PR, Virtamo J, Albanes D. Higher baseline serum concentrations of vitamin E are associated with lower total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. 2006 Am J Clin Nutr 84(5): 1200-1207.
Djuricic ID, Mazic SD, Kotur-Steveuljevic JM, Djordjevic VR, Sobajic SS.Long-chain n-3 PUFA dietary recommendations are moderately efficient in optimizing their status in healthy middle-aged subjects with low fish consumption: A cross-over study. 2014 Nutr Res doi:10.1016/j.nutres.2013.12.008
Heaney RP, Recker RR, Grote J, Horst RL, Armas LAG. Vitamin D3 is more potent than vitamin D2 in humans. 2010 JCEM 96:E447.
Fulgoni VL, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: where do Americans get their nutrients? 2011 J Nutr doi: 10.3945/jn.111.142257