Are You Getting These Nutrients? - Part 10

The advice following is very specific and should be followed. Vitamin Pills Vs Food: “It's very tempting when reading a list like this to think, "I'll just take a vitamin pill". I don't think this is a good conclusion to leap to. Why? Because we are finding out there are many nutrients in foods that we either didn't know about before, or that work together with the vitamins we know about. For example, scientists have now discovered tens of thousands of phytonutrients in the plant foods we eat, and we don't begin to understand the complexities of how they all interact and work together. There's evidence that there could be a similar situation with animal foods, although there isn't as much science in that area.”

Deficiencies vs. Dietary Intake: “I'm aware that there is a difference between having a diagnosed condition from a nutrient deficiency (e.g. rickets) vs. having a low blood level of a nutrient vs. not getting the recommended amounts in your diet. This article is strictly talking about the latter.”

How Laura Dolson Drew up This List: “The general "inadequate intake data" is from various scientific sources, including a study which looked at the intake of certain nutrients people were consuming before and during weight-loss diets (the A-Z Diet Study). I found their "baseline data" (before the diets started) to be illuminating, as, for example, most people were not eating enough vitamin E even before embarking on a weight-loss diet. Also, I drew on my own experience in designing low-carb menus which cover all the daily nutrient needs.”

Less-Studied Nutrients: “There are micronutrients which have been getting study and attention more recently that there isn't a lot of data for, with respect to how prevalent inadequate intake is. These include vitamin K2 and choline. This doesn't mean they aren't important, just that I don't know how much of a problem they are. (Educated guess is that low-carb diets would not tend impact those two particular nutrients adversely in most people, as some of the main sources are animal foods, e.g. egg yolks for choline.) Also, we have less information about the phytonutrients.”

Tim asked to come over after reading through this information. He said that he had some learning to do and now understood why I liked my cousin for nutrition. He said that they take a look at the nutrients and food and then try to give us the suggestions for foods that will replenish what we might be missing. I said that I am tested for most of the vitamins and minerals on the list and except for vitamin B12; none of the rest is suggested for supplements. Several years prior, I had been told to take a B complex pill for four weeks and then stop. My cousin knows my history and looks over my VA lab results to suggest food changes.

Tim asked if it would be a good idea to discuss this will all the new members and review this with the long-term members. I agreed and added that we should list my blogs and the sources of information and email this to all members or have a printed list to hand out. Tim agreed and we need to discuss with the members that if they haven't been tested for some of the vitamins and minerals in the blogs, then they should consider this and have the lab results available to either Suzanne or Allison to aid them in suggesting foods they should add to their food plan.

I asked Tim if he had done this in the past and he said no, but he always had the list of foods eaten each day available for them. He added that have some tests done needs to be suggested after he discusses this with both Suzanne and Allison. I suggested that he send a list of my blogs and the sources for their consideration and possible addition to the list. Tim agreed and said he would do this because of my cataract problem. I thanked him and said we still have the list for vegetarians and vegans. He said he would make sure to add the items to the list, because he did not want to wait too much after this blog was posted.

I said that for a few of them I might have copies for him to email if he wanted. Tim added that several blogs were longer than normal, but he could understand with the information we both wanted in them. We had discussed several of them after he had copies.

Are You Getting These Nutrients? - Part 9

Our bodies use calcium in so many ways; it's hard to list them all. Of course, we know about bone health. It's also vital for the functioning of our muscles and nerves, and maintaining the correct acid/base balance.

Low-carb sources include dairy products, sardines, canned salmon, tofu, and (as in almost everything) greens.

Calcium is the most abundant mineral in your body. It is essential for the development and maintenance of strong bones and teeth, where about 99% of the body's calcium is found. Calcium also helps the heart, nerves, muscles, and other body systems work properly. It is probably best known for helping prevent osteoporosis.

Your body needs several other nutrients in order for calcium to be absorbed and used properly, including magnesium, phosphorous, and especially vitamins D and K. Many factors, including age, disease states, and medications, can affect calcium absorption. Carbohydrates may enhance calcium absorption while coffee and cigarette smoke may impede it.

The best way to get calcium is through food. Many foods are fortified with calcium. But, some people may need to take calcium supplements to get the recommended amount. It is especially important for children to get enough calcium in their diets as they are growing and forming bone, and for older people as they start to lose bone.

Postmenopausal women, people who consume large amounts of caffeine, alcohol, or soda, and those who take corticosteroid medications may need calcium supplements. Calcium deficiency can be found in people who don't absorb enough calcium, as can happen with Crohn's disease, celiac disease, and some intestinal surgeries.

The richest food sources of calcium include:

• Cheeses, such as Parmesan, Romano, gruyere, cheddar, American, mozzarella, and feta
• Low-fat dairy products, such as milk and yogurt
• Tofu
• Blackstrap molasses

Other good sources of calcium include – almonds, brewer's yeast, bok choy, Brazil nuts, broccoli, cabbage, dried figs, kelp, dark leafy greens (such as dandelion, turnip, collard, mustard, kale, and Swiss chard), hazelnuts, oysters, sardines, and canned salmon.

Foods that are fortified with calcium, such as juices, soy milk, rice milk, tofu and cereals, are also good sources of this mineral.

There are many forms of calcium available as dietary supplements. They differ in the amount of calcium they contain, how well the body absorbs them, and how much they cost. The two most popular forms are calcium citrate and calcium carbonate.

• Calcium citrate: Easily absorbed and digested by the body. It does not contain as much elemental calcium -- the amount your body actually absorbs -- as calcium carbonate. It is more expensive than calcium carbonate. Also, calcium citrate should not be used with aluminum-containing antacids.
• Calcium carbonate: Less expensive than calcium citrate and contains more elemental calcium. Requires a certain amount of stomach acid to be absorbed. So, it is usually taken with a glass of orange juice. Many antacids contain calcium carbonate.

Avoid calcium supplements that are derived from oyster shells, dolomite, and bone meal as they may contain lead, a toxic metal that can harm the brain and kidneys, cause anemia, and raise blood pressure.

Calcium supplements should be taken in small doses (no more than 500 mg at a time) during the day with 6 to 8 cups of water to avoid constipation.

The following are daily dietary recommendations from the Institute of Medicine.

Adult

• 19 to 50 years: 1,000 mg
• Women 51 years and older: 1,200 mg
• Men 51 to 70 years: 1,000 mg
• Men older than 70: 1,200 mg
• Pregnant and breastfeeding women under 19 years: 1,300 mg
• Pregnant and breastfeeding women 19 years and older: 1,000 mg

For prevention of colon cancer, some researchers recommend 1,800 mg per day. Speak with your doctor to determine the right dose for you.

Take dietary supplements only under the supervision of a knowledgeable doctor since there is a potential for side effects. Total calcium intake, from combined dietary and supplemental sources, should not exceed 2,500 mg per day.

Side effects can include constipation and stomach upset. Very high doses can cause nausea, vomiting, loss of appetite, increased urination, kidney damage, confusion, and irregular heart rhythm.

People with hyperparathyroidism, kidney failure, sarcoidosis, or cancer could be at risk for high levels of calcium and should not take calcium supplements.

People with a history of kidney stones should not take calcium supplements. However, some research suggests that calcium in foods may not increase the risk of kidney stones. If you have or have had kidney stones, talk to your doctor about whether you should limit calcium in your diet.

Some population studies suggest that getting high amounts (more than 2,000 mg per day) of calcium through the diet may increase the risk of prostate cancer. Two of these studies found that low-fat and nonfat milk, but not other dairy foods, was associated with a higher risk of advanced prostate cancer. But these studies don't prove that drinking low-fat or nonfat milk causes an increased risk of prostate cancer. And some research suggests that the amount of calcium in the diet isn't associated with prostate cancer risk. If you have prostate cancer, or are concerned about dairy products and prostate cancer risk, talk to your doctor.

Are You Getting These Nutrients? - Part 8

Up to 80% of people may not be eating the recommended intake of vitamin E. There are actually eight different forms, which is one of the reasons it's best to get vitamin E from foods, as supplements usually only contain one or two.

Low-carb sources include most nuts and seeds (sunflower seeds are especially rich in vitamin E), greens, avocado, peppers, and shrimp.

Vitamin E is a fat-soluble vitamin found in many foods, fats, and oils. It is also an antioxidant, a substance that may help prevent damage to the body's cells. Antioxidants may provide protection against serious diseases including heart disease and cancer.

Vitamin E is also important in helping your body make red blood cells, and it helps the body to use vitamin K.

People who can't absorb fat properly may develop vitamin E deficiency. Symptoms of serious vitamin E deficiency include:

• Muscle weakness
• Loss of muscle mass
• Abnormal eye movements
• Vision problems
• Unsteady walking

A deficiency that lasts a long time may also cause liver and kidney problems. Although most people in the United States aren’t seriously deficient in vitamin E, many people may have slightly low levels.

The richest source of vitamin E is wheat germ. Other foods that contain a significant amount of vitamin E include – liver, eggs, nuts - almonds, hazelnuts, and walnuts, sunflower seeds, mayonnaise, cold-pressed vegetable oils - including olive, corn, safflower, soybean, cottonseed, and canola, dark green leafy vegetables like spinach and kale, greens - beet, collard, mustard, turnip, sweet potatoes, avocado, asparagus, and yams.

There are natural and synthetic forms of vitamin E. Health care providers usually recommend natural vitamin E (d-alpha-tocopherol) or natural mixed tocopherols. Some prefer mixed tocopherols because it most closely represents whole foods. The synthetic form is called dl-alpha-tocopherol. Dosages are usually listed in international units (IU).

Most vitamin E supplements are fat-soluble. However, people who have trouble absorbing fat, such as those with pancreatic problems or cystic fibrosis, can take water-soluble E.

Vitamin E is available in softgels, tablets, capsules, and topical oils.

Doses for oral vitamin E generally range from 50 - 1,000 IU. Experts recommend getting vitamin E mostly from food rather than supplements.

The Food and Nutrition Board of the Institute of Medicine has set an upper tolerable intake level (UL) for vitamin E at 1,000 mg (1,500 IU) per day for supplemental vitamin E.

Based on clinical trials, the dose often used for disease prevention and treatment for adults is 400 - 800 IU per day. As with all supplements, you should check with a doctor before giving vitamin E to a child.

Daily intakes of dietary vitamin E are listed below. (Note: 1 mg vitamin E equals 1.5 IU.)

Adult

• Older than 18 years: 22.4 IU
• Pregnant females: 22.4 IU
• Breast-feeding females: 28.4 IU

Always check with your doctor before taking vitamin E supplements. Vitamin E may increase the risk of bleeding, especially if you are taking blood-thinners such as warfarin (Coumadin), aspirin, or clopidogrel (Plavix).

Are You Getting These Nutrients? - Part 7

Lower-than-optimal blood levels of vitamin D is becoming more common. It is thought this may be because people are spending less time outside (especially in winter and in areas far from the equator) and wearing more sunscreen. It is difficult to get enough in the diet. Very important for our bones, but is turning up as a factor in many aspects of health.

Low-carb sources include salmon, tuna, eggs, yogurt, and liver.

Vitamin D is a fat-soluble vitamin that plays a role in many important body functions. It is best known for working with calcium in your body to help build and maintain strong bones. Vitamin D is also involved in regulating the immune system and cells, where it may help prevent cancer.

Your body stores vitamin D and can make it when your skin is exposed to sunlight. Vitamin D is also found in some foods, mostly ones like milk that have been fortified with vitamin D. There are two forms of vitamin D: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Some research suggests that cholecalciferol is better at raising levels of vitamin D in the blood.

In children, a vitamin D deficiency can cause rickets, a disease that results in soft, weak bones. In adults, many people may not be getting enough vitamin D, especially those who live in northern areas (like the northern half of the U.S.) and the elderly. People with dark skin do not absorb sunlight as easily as those with light skin, so their risk of low vitamin D is even higher. One study of childbearing women in the Northern U.S. found that 54% of African-American women and 42% of white women had low levels of vitamin D.

That’s important because researchers are beginning to find that low levels of vitamin D may be linked to other diseases, including breast and colon cancer, prostate cancer, high blood pressure, depression, and obesity. The evidence doesn’t prove that too little vitamin D causes these conditions, but that people with higher levels of vitamin D are less likely to get these diseases.

Your body make vitamin D when your skin is exposed to the sun. The color of your skin affects the production of vitamin D. A fair-skinned person may need only about 45 minutes of sunlight a week to get enough vitamin D, while a person with dark skin may need up to 3 hours.

Clouds, smog, clothing, sunscreen, and window glass all reduce the amount of sunlight that actually reaches the skin. In northern areas, it is hard to get enough vitamin D from sunlight during the winter, so people living there may need to take vitamin D supplements. In the U.S., people who live above a line running from Los Angeles to South Carolina may not get enough vitamin D in winter.

Vitamin D is included in many multivitamins. It can be found alone as softgel capsules, tablets, and liquid in over-the-counter strengths from 50 - 1,000 IU. Higher doses are also available, but it is best to ask your doctor what the safest, most effective dose for you would be. For those who have trouble digesting fat, vitamin D injections are also available by prescription.

Recommended dietary allowances for vitamin D are listed below. Seniors and people who don’t get exposed to much sunlight may need to take supplements. Seniors may be at risk of developing vitamin D deficiency because, as we age, the body does not make as much vitamin D from sunlight, and it has a harder time converting vitamin D into a form it can use.

If you are concerned about your vitamin D levels, ask your doctor whether you should take a supplement, and how much.

Adult

• 19 - 50 years: 600 IU (recommended dietary allowance)
• 70 years and older: 800 IU (recommended dietary allowance)
• Pregnant and breastfeeding females: 600 IU (recommended dietary allowance)

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable doctor.

Taking too much vitamin D can cause several side effects. However, scientists don’t all agree on how much is too much.

Side effects may include - being very thirsty, metal taste in mouth, poor appetite, weight loss, bone pain, tiredness, sore eyes, itchy skin, vomiting, diarrhea, constipation, a frequent need to urinate, and muscle problems.

You cannot get too much vitamin D from sunlight, and it would be very hard to get too much from food. Generally, too much vitamin D is a result of taking supplements in too high a dose.

People with the following conditions should be careful when considering taking vitamin D supplements - high blood calcium or phosphorus levels, heart problems, kidney disease, sarcoidosis, and tuberculosis.

Are You Getting These Nutrients? - Part 6

Iron is extremely important to our health, for without it our cells cannot get oxygen. And yet, especially for women of childbearing age, it's a fairly common mineral deficiency, and people on low-carb diets tend to eat less of it. Women of childbearing age need to get 18 mg per day in their diets, while others only need about 8 mg.

Low-Carb Sources of Iron

Chicken Liver, 3 oz - 11 mg iron

Beef Liver, 3 oz - 5.2 mg iron

Soybeans, cooked, 1/2 cup 4.4 mg iron, 3 gm net carb

Spinach, cooked, 1/2 cup - 3.2 mg iron, 2 gm net carb

Roast Beef, 3 oz 3.1 mg iron

Asparagus, 6 spears - 2 mg iron, 2 gm net carb

Iron is an essential mineral that is required for human life. Iron is found in the body's red blood cells, which carry oxygen-rich blood to every cell in the body. Iron is also involved in producing adenosine triphosphate (ATP), the body's energy source. Extra iron is stored in the liver, bone marrow, spleen, and muscles.

Not having enough iron can lead to anemia. The most common symptoms of anemia are weakness and fatigue. One reason people who are iron deficient get tired easily is because their cells do not get enough oxygen. Pregnant women, young women during their reproductive years, and children tend to be at highest risk of iron deficiency. Iron deficiency anemia in children is associated with poor neurodevelopment. Anemia may be mild, moderate, or severe. It can be caused by blood loss, such as that from a bleeding ulcer, menstruation, severe trauma, surgery, or a malignant tumor. It can also be caused by an iron-poor diet, not absorbing enough dietary iron, pregnancy, and the rapid growth that takes place during infancy, early childhood, and adolescence.

On the other hand, too much iron in the body can lead to a condition known as hemochromatosis, which can cause diabetes, liver damage, and discoloration of the skin. Unlike other nutrients, excess iron cannot be excreted by the human body. For that reason, you should not take iron supplements without asking your doctor if you need extra iron.

According to the World Health Organization (WHO), iron deficiency is the number one nutritional disorder in the world. Up to 80% of the world's population may be iron deficient, and 30% may have iron deficiency anemia.

Ferrous sulfate is the most common type of iron supplement. Other available forms include ferrous fumarate, ferrous succinate, ferrous gluconate, ferrous lactate, ferrous glutamate, ferric ammonium citrate, and ferrous glycine.

In severe cases of anemia from low levels of iron, or if there is rapid blood loss leading to iron deficiency, iron and blood are administered intravenously (IV) in hospitals.

Recommendations for iron are provided in the Dietary Reference Intakes (DRIs), developed by the Institute of Medicine of the National Academy of Sciences.

Adult

Eat a well-balanced diet, and only use iron supplements under the direction of a physician.

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a doctor.

The most common side effect from iron supplements is stomach upset, including discomfort, nausea, diarrhea, constipation, and heartburn. Taking iron supplements will often darken stool color.

Although the evidence is not clear, there may be an association between high iron stores and the risks of heart disease, cancer (such as breast cancer), and Alzheimer disease. In people with inflammatory bowel disease (Crohn's disease and ulcerative colitis), the parts of the intestine that are inflamed appear to have higher amounts of iron.

Iron overload disease is usually due to an inherited condition called hemochromatosis. But it may occur in people who take large amounts of iron over a long period of time. Symptoms include skin discoloration, diabetes, and liver damage, among other potential complications. According to the U.S. Food and Drug Administration (FDA), taking up to 45 mg of iron per day is safe. Whether taking more than that over a long period of time is safe is unknown. Severe iron overdose occurs with amounts of iron 50 to 100 times greater than the recommended dietary dose. Such iron toxicity can destroy cells in the gastrointestinal tract, which can cause vomiting, bloody diarrhea, and even death. Iron poisoning is the most common accidental poisoning in children. Keep iron supplements in childproof bottles and out of reach of children.

Intravenous (IV) iron, given in hospitals to treat severe anemia, can lead to headache, fever, swollen lymph nodes, painful joints, hives, and worsening of rheumatoid arthritis. In rare instances, it can cause anaphylaxis, a life-threatening allergic reaction.

Are You Getting These Nutrients? - Part 5

Magnesium is a mineral that many people do not eat enough of - some estimate that 30-50% of Americans don't reach the 400 mg recommended by the FDA. Unfortunately, people on low-carb diets may fare even worse - in one study, 70% of those 8 weeks into the Atkins diet were not eating sufficient magnesium. Worse, people with diabetes who respond to low-carb diets may need magnesium even more than others, since it is important in glucose metabolism and blood sugar control. Other functions of magnesium include participating in protein synthesis, bone development and maintenance, DNA synthesis, and cell function.

Low-Carb Sources of Magnesium

Pumpkin Seeds - 1 oz kernels, roasted - 156 mg magnesium, 2 gm net carb 

Spinach (also chard), 1/2 cup cooked - 78 mg magnesium, 2 gm net carb

Soybeans (try black soybeans), 1/2 cup cooked - 74 mg magnesium, 3 gm net carb

Almonds, 1 oz - 77 mg magnesium, 3 gm net carb

Peanuts, 1 oz - 52 mg magnesium, 4 gm net carb

Flax seed, 1 tablespoon - 40 mg magnesium, scant carb

Also: legumes, fish, green vegetables, and yogurt

Every organ in the body, especially the heart, muscles, and kidneys, needs magnesium. This mineral also contributes to the makeup of teeth and bones. Magnesium activates enzymes, contributes to energy production, and helps regulate levels of calcium, copper, zinc, potassium, vitamin D, and other important nutrients in the body.

You can get magnesium from many foods. However, most people in the U.S. probably do not get as much magnesium as they should from their diet. Foods rich in magnesium include whole grains, nuts, and green vegetables. Green leafy vegetables are particularly good sources of magnesium.

Although you may not get enough magnesium from your diet, it is rare to be deficient in magnesium. However, certain medical conditions can upset the body's magnesium balance. For example, an intestinal virus that causes vomiting or diarrhea can cause a temporary magnesium deficiency. Some health conditions can lead to deficiencies, including - gastrointestinal diseases, such as irritable bowel syndrome (IBS) and ulcerative colitis, diabetes, pancreatitis, hyperthyroidism (high thyroid hormone levels), kidney disease, and taking diuretics

Other factors that can lower magnesium levels include - drinking too much coffee, soda, or alcohol, eating too much sodium (salt), heavy menstrual periods, excessive sweating, and prolonged stress.

Symptoms of magnesium deficiency may include - agitation and anxiety, restless leg syndrome (RLS), sleep disorders, irritability, nausea and vomiting, abnormal heart rhythms, low blood pressure, confusion, muscle spasm and weakness, hyperventilation, insomnia, poor nail growth, and seizures

Many herbs, spices, and seaweeds supply magnesium, such as - agar seaweed, coriander, dill weed, celery seed, sage, dried mustard, basil, fennel seed, savory, cumin seed, tarragon, marjoram, and poppy seed.

Magnesium is available in many forms. Recommended forms include magnesium citrate, magnesium gluconate, and magnesium lactate, all of which are more easily absorbed into the body than other forms. Time-release preparations may improve absorption. Ask your doctor.

Other familiar sources are magnesium hydroxide (often used as a laxative or antacid) and magnesium sulfate (generally used orally as a laxative or in multivitamins, or added to a bath). Some magnesium, such as Epsom salts, can be absorbed through the skin. Preliminary research suggests Epsom salts can relieve swelling, inflammation, and ease muscle aches and pains.

Be sure to check with your health care provider before taking magnesium supplements and before giving them to a child. Under certain circumstances, such as certain heart arrhythmias or preeclampsia, a doctor will give magnesium by IV in the hospital.

It is a good idea to take a B-vitamin complex, or a multivitamin containing B vitamins, because the level of vitamin B6 in the body determines how much magnesium will be absorbed into the cells.

Dosages are based on the dietary reference intakes (DRIs) issued from the Food and Nutrition Board of the United States Government's Office of Dietary Supplements, part of the National Institutes of Health (NIH).

Adult

• Males, 19 to 30 years of age: 400 mg daily
• Females, 19 to 30 years of age: 310 mg daily
• Males, 31 years of age and over: 420 mg daily
• Females, 31 years of age and over: 320 mg daily
• Pregnant females, 19 to 30 years of age: 350 mg daily
• Pregnant females, 31 and over: 360 mg daily
• Breastfeeding females, 19 to 30 years of age: 310 mg daily
• Breastfeeding females, 31 years of age and over: 320 mg daily

A person's need for magnesium increases during pregnancy, recovery from surgery and illnesses, and athletic training. Speak with your doctor.

Because of the potential for side effects and interactions with medications, you should only take dietary supplements under the supervision of a doctor.

Since magnesium is excreted by the kidneys, people with heart or kidney disease should not take magnesium supplements except under their doctors' supervision.

It is very rare to overdose on magnesium from food. However, people who ingest large amounts of milk of magnesia (as a laxative or antacid), Epsom salts (as a laxative or tonic), or magnesium supplements may overdose, especially if they have kidney problems. Too much magnesium can cause serious health problems, including – nausea, vomiting, severely lowered blood pressure, confusion, slowed heart rate, respiratory paralysis, deficiencies of other minerals, coma, cardiac arrhythmias, cardiac arrest, and death.

More common side effects from magnesium include upset stomach and diarrhea.

Magnesium competes with calcium for absorption and can cause a calcium deficiency if calcium levels are already low. Some medications may lower magnesium levels in the body. These include - chemotherapy drugs, diuretics, digoxin (Lanoxin), steroids, and certain antibiotics.

Are You Getting These Nutrients? - Part 4

Probably the most well known vitamin, vitamin C performs many functions in our bodies, from helping to make neurotransmitters in our brains to protecting our cells from damage, to building connective tissue. Vitamin C is easily degraded during storage and cooking. Keep your produce cool, and don't overcook it. Aim for at least 90 mg daily for adult males, 75 mg for females.

Low-Carb Sources of Vitamin C

Red Bell Pepper, 1/2 cup raw - 95 mg vitamin C, 3 grams net carb

Green Bell Pepper, 1/2 cup raw - 60 mg vitamin C,

Brussels sprouts, 1/2 cup cooked - 48 mg vitamin C, 3 grams net carb

Broccoli, 1/2 cup cooked - 51 mg vitamin C, 3 grams net carb

Strawberries, 1/2 cup sliced - 49 mg vitamin C, 4 grams net carb

Cauliflower, 1/2 cup cooked - 44 mg vitamin C, 2 grams net carb

Grapefruit, 1/2 medium - 44 mg vitamin C, 9 grams net carb

Cabbage, 1 cup, raw, chopped - 33 mg vitamin C, 3 grams net carb

Also: kale and other greens, raspberries, green beans, cantaloupe are good sources of vitamin C. Almost all fruits and vegetables have some vitamin C. Do not consume grapefruit if you take medications for cholesterol, blood pressure, and heart problems as it can cause some of these medications to become toxic. Talk to your doctor if you like grapefruit as sometimes medications can be changed to avoid this problem.

Vitamin C is a water-soluble vitamin, meaning that your body doesn't store it. You have to get what you need from food, including citrus fruits, broccoli, and tomatoes.

You need vitamin C for the growth and repair of tissues in all parts of your body. It helps the body make collagen, an important protein used to make skin, cartilage, tendons, ligaments, and blood vessels. Vitamin C is needed for healing wounds, and for repairing and maintaining bones and teeth. It also helps the body absorb iron from nonheme sources.

Vitamin C is an antioxidant, along with vitamin E, beta-carotene, and many other plant-based nutrients. Antioxidants block some of the damage caused by free radicals, substances that damage DNA. The build up of free radicals over time may contribute to the aging process and the development of health conditions such as cancer, heart disease, and arthritis.

It’s rare to be seriously deficient in vitamin C, although evidence suggests that many people may have low levels of vitamin C. Smoking cigarettes lowers the amount of vitamin C in the body, so smokers are at a higher risk of deficiency.

Signs of vitamin deficiency include dry and splitting hair; gingivitis (inflammation of the gums) and bleeding gums; rough, dry, scaly skin; decreased wound-healing rate, easy bruising; nosebleeds; and a decreased ability to ward off infection. A severe form of vitamin C deficiency is known as scurvy.

Low levels of vitamin C have been associated with a number of conditions, including high blood pressure, gallbladder disease, stroke, some cancers, and atherosclerosis, the build up of plaque in blood vessels that can lead to heart attack and stroke. Getting enough vitamin C from your diet, by eating lots of fruit and vegetables, may help reduce the risk of developing some of these conditions. There is no conclusive evidence that taking vitamin C supplements will help or prevent any of these conditions.

Excellent sources of vitamin C include oranges, green peppers, watermelon, papaya, grapefruit, cantaloupe, strawberries, kiwi, mango, broccoli, tomatoes, Brussels sprouts, cauliflower, cabbage, and citrus juices or juices fortified with vitamin C. Raw and cooked leafy greens (turnip greens, spinach), red and green peppers, canned and fresh tomatoes, winter squash, raspberries, blueberries, cranberries, and pineapple are also rich sources of vitamin C. Vitamin C is sensitive to light, air, and heat, so you'll get the most vitamin C if you eat fruits and vegetables raw or lightly cooked.

You can purchase either natural or synthetic vitamin C, also called ascorbic acid, in a variety of forms. Tablets, capsules, and chewables are probably the most popular forms, but vitamin C also comes in powdered crystalline, effervescent, and liquid forms. Vitamin C comes in doses ranging from 25 - 1,000 mg.

"Buffered" vitamin C is also available if you find that regular ascorbic acid upsets your stomach. An esterified form of vitamin C is also available, which may be easier on the stomach for those who are prone to heartburn.

The best way to take vitamin C supplements is 2 or 3 times per day, with meals, depending on the dosage. Some studies suggest that adults should take 250 - 500 mg twice a day for any benefit. Talk to your doctor before taking more than 1,000 mg of vitamin C on a daily basis and before giving vitamin C to a child.

Daily intake of dietary vitamin C (according to the National Academy of Sciences) is listed below.

Adult

• Men over 18 years: 90 mg
• Women over 18 years: 75 mg
• Pregnant women 14 - 18 years: 80 mg
• Pregnant women over 18 years: 85 mg
• Breastfeeding women 14 - 18 years: 115 mg
• Breastfeeding women over 18 years: 120 mg

Because smoking depletes vitamin C, people who smoke may need an additional 35 mg per day.

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable doctor. Vitamin C supplements have a diuretic effect, meaning the help the body get rid of excess fluid. Be sure to drink plenty of fluids when taking them.

Most commercial vitamin C is made from corn. People sensitive to corn should look for alternative sources, such as sago palm.

Vitamin C increases the amount of iron absorbed from foods. People with hemochromatosis, an inherited condition where too much iron builds up in the body, should not take vitamin C supplements.

Vitamin C is generally considered safe because your body gets rid of what it does not use. But at high doses (more than 2,000 mg daily) it can cause diarrhea, gas, or stomach upset. If you experience these side effects, lower the dose of vitamin C.

People with kidney problems should talk to their doctor before taking vitamin C.

People who smoke or use nicotine patches may need more vitamin C because nicotine makes vitamin C less effective in the body.

Are You Getting These Nutrients? - Part 3

The nutrient for this discussion is folate (vitamin B9), which is found in whole foods. Folic acid is found in supplements and fortified foods. Folic acid is more bioavailable to be used by the body, so the recommended amounts are a little complicated, but basically the recommended daily allowance is 400 mcg (also called DFE) for adults.

Folate is best known for preventing a type of birth defect called a neural tube defect. It is used in many chemical reactions in the body, and its functions include cell formation, especially red blood cells.

Low-Carb Sources of Folate

Basically liver and anything green will give you lots of folate.

Chicken Livers - 3.5 oz. - 578 mcg folate - 1 gram carbohydrate

Asparagus - 6 spears - 134 mcg folate

Spinach - 1/2 cup cooked - 131 mcg folate

Brussels sprouts, 1/2 cup cooked - 78 mcg folate

Avocado - 1/2 cup sliced - 59 mcg folate

Romaine Lettuce - 1 cup - 64 mcg - half a gram net carb

Broccoli - 1/2 cup chopped - 52 mcg folate

Also: salmon, crab, lamb, and most green vegetables

Vitamin B9, also called folate or folic acid, is one of 8 B vitamins. All B vitamins help the body convert food (carbohydrates) into fuel (glucose), which is used to produce energy. These B vitamins, often referred to as B-complex vitamins, also help the body use fats and protein. B-complex vitamins are needed for a healthy liver, and healthy skin, hair, and eyes. They also help the nervous system function properly. Folic acid is the synthetic form of B9, found in supplements and fortified foods, while folate occurs naturally in foods.

All the B vitamins are water-soluble, meaning the body does not store them.

Folic acid is crucial for proper brain function and plays an important role in mental and emotional health. It aids in the production of DNA and RNA, the body's genetic material, and is especially important when cells and tissues are growing rapidly, such as in infancy, adolescence, and pregnancy. Folic acid also works closely with vitamin B12 to help make red blood cells and help iron work properly in the body.

Vitamin B9 works with vitamins B6 and B12 and other nutrients to control blood levels of the amino acid homocysteine. High levels of homocysteine are associated with heart disease, however researchers are not sure whether homocysteine is a cause of heart disease or just a marker that indicates someone may have heart disease.

It is fairly common to have low levels of folic acid. Alcoholism, inflammatory bowel disease (IBD), and celiac disease can cause folic acid deficiency. Also, certain medications may lower levels of folic acid in the body. Folic acid deficiency can cause - poor growth, tongue inflammation, gingivitis, loss of appetite, shortness of breath, diarrhea, irritability, forgetfulness, and mental sluggishness.

Daily recommendations for dietary folic acid are:

Adult

• Men and women, 19 years and older: 400 mcg (RDA)
• Pregnant women: 600 mcg (RDA)
• Breastfeeding women: 500 mcg (RDA)

Most people (except pregnant women) should be able to get enough folic acid from their diets. Check with a knowledgeable doctor before taking folic acid supplements or giving them to children.

Because of the potential for side effects and interactions with medications, you should take dietary supplements only under the supervision of a knowledgeable doctor.

Folic acid comes in tablets. It usually is taken once a day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take folic acid exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

If you are taking folic acid to treat a deficiency, you probably will feel better quickly, often within 24 hours. However, do not stop taking this drug until your doctor tells you to do so.