Explore essential information about vitamins and minerals, focusing on commonly supplemented nutrients for the average adult. Shirley Siu, RD, CSOWM, talks about micronutrient-rich foods to incorporate into your daily diet and promote optimal health. View the PowerPoint: https://l.ead.me/ntf-vitamins-minerals
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Shirley Siu, RD, CSOWM, is a registered dietitian nutritionist and board-certified specialist in obesity and weight management. As a dedicated member of the multidisciplinary team at the Stanford Lifestyle Weight Management Center, Shirley provides personalized counseling to a diverse range of patients. Her expertise lies in developing tailored strategies that promote health and wellness, emphasizing individualized lifestyle modifications and practical nutrition plans that empower patients to achieve their goals.
This talk is part of the Nourish to Flourish series from the Stanford Lifestyle and Weight Management Center. Webinars are open to all adults seeking to enhance their knowledge and gain tools for effective weight management and improved well-being. Register for future webinars: http://l.ead.me/shl-events
Take 5 minutes for yourself. Check out Stanford Health Library’s free mindfulness and meditation resources including guided meditations to help ease pain, aid in healthful sleep, promote successful surgery, and more: http://l.ead.me/shl-mindfulness
All right. Hello everyone. Welcome to our Nourish to Flourish webinar. If this is your first time joining us, we’re so glad to have you. If you’ve joined us before, welcome back. My name is Kelsey and I’m one of the clinical dieticians with the Stanford Lifestyle and Weight Management Clinic and I’ll be your moderator for today’s session. Today’s webinar is being recorded and it will be posted on the Stanford Health Library under lifestyle and weight management recorded lectures along with PowerPoint slides. You’ll also receive an email after this session with a link to the recording. If you have any questions, please add them to the Q&A chat box located at the bottom of your screen and we’ll review those with our presenter during the Q&A portion of today’s webinar. Now, I have the pleasure of introducing my colleague Shirley Sue who is today’s presenter. Shirley is a registered dietician, nutritionist, and board certified specialist in obesity and weight management. As a dedicated member of our multidisciplinary team at the Stanford Lifestyle Weight Management Center for the past 6 years, Shirley has provided personalized counseling to a diverse range of patients. Her expertise lies in developing tailored strategies that promote health and wellness, emphasizing individualized lifestyle modifications and practical nutrition plans that empower patients to achieve their goals. Shirley is presenting to us today vitamins and minerals unpacked, your guide to the nutrient powerhouses. and we’ll explore some essential information about vitamins and minerals, focusing on commonly supplemented nutrients for the average adult, and learn more about micronutrients rich foods, um, and how to incorporate those into your daily diet and promote optimal health. So, with that, Shirley, um, take it away. Thank you for the introduction, Kelsey. I’m very excited about this topic today simply because it allowed me to deep dive and learn more about what vitamins and minerals really do. But before I get started, I’d like to take a poll from the audience. Which vitamin or mineral supplement do you take routinely? And you can join by the QR code scanning with your camera app or join by web using the uh pole.com and back/natalie dollar637. We’ll give you about one few minutes to join the poll. It appears that the um the poll is locked. Oh, and I’m not able to unlock it at this time. Maybe if people want to add some of their words to the chat box, I can read them aloud. Thank you, Kelsey. Apologize for that. All right. I’m hearing folic acid. I’m hearing multivitamins. I’m hearing creatine. I’m hearing some vitamin D as well. Sounds good. There’s there are some very popular vitamin supplements in there. Magnesium is definitely a very popular one these days. I apologize for the poll not working, but thank you Kelsey for uh letting us know what the responses would have been. Okay, with that let’s get the definition right. We for those of you who are familiar with what macronutrients are one of our previous webinars we talked about protein, carbohydrates and fat which are the macronutrients providing energy. So vitamins and minerals we consider micronutrients, right? We need them in very small amounts, but they are needed required by our bodies to carry out numerous essentially pretty much all the standard very important body functions. And we do need to derive it from diet meaning we are unable to really produce in either unable to produce at all or not in enough uh where it will m uh maintain the levels needed for health. And one really very important aspect I want to start off with which is a little sneak peek is the way that vitamins and minerals are managed in us is the absorption and the way that we utilize them are strongly influenced by how much that we have. So the concentration in our body tissues in order to maintain that balance, right? Uh with vitamins, vitamins are the organic comp compounds that are present in animal and plants. They are broken down into two categories which I’ll go over in a minute. And the minerals are actually the inorganic elements present in soil and water. typically in that case will be absorbed by plants and when we consume said plants and animals that’s where we’ll get the minerals as well. So through diet and through consumption the first category of fat soluble vitamins. So we call them fat soluble because we they are stored in their fatty tissues and liver at the same time in order to absorb them properly also requires uh source of dietary fat at the same time. So oftent times they are going to be in foods that are uh have already uh present in um foods that have fat in them. though there are sources of vitamin A and E in plant sources. So the four fats soluble vitamins is A, D, E and K or ADC for short. Uh we the amount of dietary reference intakes that are listed here are based on uh uh it’s a reference value used to plan and assess nutrient intakes for healthy people. Um so typically RDA is the recommended dietary allowance and so there’s two if there are levels established will be RDA and the other would be average uh average intake. So that’s the amount determined to that you need in a minimum amount to maintain health from from your diet. Uh so for vitamin A you can see some of the very important functions here. It’s involved in vision, you know, epithelial cell regulations, some more uh uh some wound healing, bone health and a lot of these are shared functions. If you look at the other fats, soluble vitamins as well like vitamin D also uh and there of course we know is very important in bone health, calcium absorption and pain. Actually they work synonymously together. uh vitamin E uh ma maintains uh cell membrane integrity you know keeping actually for helping to form the cells themselves of course having antioxidant properties so skin health and vitamin K bone health as well as you can see those four they all have um three out of four have bone health as as a very important function they’re part of and vitamin K additionally uh also blood clotting as Well, so because they are stored in fatty tissues and liver, excess intake of it typically from supplementation right separate and in generally in very high doses is available on the market uh have uh or can be toxic. Um but dietary intake of vitamin A and E you know in studies not supplements form have been studied and associated with reduced risk of cardiovascular disease. So all that says, you know, if you’re looking to if you’re taking fats soluble vitamins for health, reducing risk of disease and infections, that the food source of it has been shown to to help you reach that goal. Uh water soluble vitamins, there are many. They come down to the eight B vitamins which are probably better known uh with some of the names as a folate or biotin too that are very popular choices for supplementation. Uh and vitamin C as well is also very popular for supplementation. Um since these must be dissolved in water before absorption uh by the body it it they’re not they’re not stored right and ex excess amounts of it whether it’s um generally very high doses in supplementation really the unused amounts you most of it is going to be excreted through urine so they’re not stored that also means it requires regular consumption as part of your diet. Um for you know developed countries where you have you know sources of foods which we’ll go over in a minute is uh uh deficiencies are not very common uh with a for folks who are able to absorb nutrients and food uh normally. Um you can see the RDAs exist for most of them. They’re very similar, but the amounts are very very low. You know, they’re measured in milligrams and uh and for and then right now I only listed the the amounts dietary reference intakes for you know adult men and women uh between the ages of 19 and 50 because for older adults and of course children that amount is is a bit different. uh vitamin C, which I know many people take around the time where we’re near at uh flu season um to help boost their immune functions. It does have that property, but uh it’s been used a lot um and other B vitamins also heavily involved in immune function here. I once I started looking more into them and realized they all share some share multiple functions, right? So they do some of them work synonymously with each other such as folate and B12 or are uh cobbalamin they work together one feeds to uh is needed for maintaining the other. So a lot of them B vitamins work together this way. uh they are heavily involved in uh energy metabolism as well. So a lot of people take B vitamins for energy right but again going back to it’s really rare to have deficiencies when you eat get you know when you only need a very small amount of it to maintain maintain that normal level. Uh so any extra you take in through whether it’s you know your uh you take your vitamins or in vitamin water and various things really is just going to be wasted. However, um on the next category here lastly is you know common and trace minerals, right? Often times vitamins and minerals are in the same conversation, the same supplements. So you look at a typical multivitamin, they of they might have some minerals, but majority of them are going to be predominantly the two different types of vitamins we’ve talked about so far. Whereas minerals, there’s I did not list all of them here, but the core ones were most familiar with like calcium, potassium, sodium, and magnesium, otherwise known as electrolytes. We require a the a good amount of because it’s constantly being used in just maintaining almost every single function that we have available. Fluid balance. Uh it’s it they they aren’t they are stored but within you know intra and extracellular inside our cells in body tissues and they are heavily regulated by our our endocrine and intestinal system to maintain that balance because it is so crucial that that balance is achieved otherwise some very uh it’s significant health issues will occur when the uh when or common minerals and electrolytes are out of balance, right? Uh the trace minerals are the iron, zinc, copper, many others such as fluoride, manganese needed in much much smaller amounts but also and of course very important for many of you know as iron. It’s important for maintaining uh oxygen transport, you know, red blood cell health, so many other different things. uh we need them in very small amounts. Now the trace minerals they actually interact with one another and also with the electrolytes or the common minerals themselves. So it’s I often caution for mineral trace minerals to really uh be careful how much that you choose to supplement. If you do choose to supplement, uh we have just such a an um the system of maintaining this and it can definitely be toxic, right? Um majority of it we’re going to get from again the plants which the plants have absorbed a lot of it from the soil and of you know animals who consume said plants. So that amount can vary but we need a very very small amount of it know milligrams of it per day. Uh you can easily uh you can easily uh consume that amount for most people to to prevent deficiencies which is the goal here preventing deficiencies ultimately uh to protect your health. Okay. So food sources after all of that about the functions and what it really does like okay where where are they really they they’re in our food they’re in plants they’re in animals but as I was putting together this list and there are a lot of tables telling you which food has what. But if you look at each category and I base this on the US uh DA um dietary guidelines and categorizing the foods um on a balanced diet, if you look at each category, vitamins, minerals, both both uh water soluble and fat soluble vitam they are present in each category meaning following the general guidelines and in and consuming whole food sources you know quality sources of food uh different types of protein varying your protein uh the different types of fats and oils nuts and seeds included you can see how you can uh uh you know uh be able to get the right amount of vitamins and minerals uh to maintain your own health. Now my the message I really wanted to get across is in this current climate where you know groceries and there’s so much more increased costs like there are certain things that focusing on for your health which is you know you want to be able to prioritize maintaining your health with both eating a wellbound balanced diet in it which will give you what you need in terms of minerals and vitamins. Well balanced diet following the my plate method a variety half your plate of fruits, vegetables, whole fruits varying different colors of vegetables because some vegetables have higher vitamins and higher minerals but you also of course get all the other components for uh for health as well. uh and uh the grains different types of grains and also varying your protein and really focusing on that balance. Now that is if you’re of course you know I do it you know it is understood that not everyone is able to consume the a balanced plate you apply to most of the population. So supplements exist, they do exist for a good reason where some people are not able to uh consuming the right amounts of food or for some reason just cannot absorb that. So who would that be? Most of these in most of the uh uh broken down into people with chronic health conditions, a lot of it has to do with is going to come down to people with uh uh who cannot absorb due to you know having had gastrointestinal surgery such as weight loss surgery or have some chronic gastrointestinal disorders where you you are because all of the nutrients I mentioned earlier vitamins and minerals uh rely on our intestinal tract to to properly facilitate an an complex system to get it to the place that it will be used. Um kidney disease also is uh one of the where uh one of the health conditions where supplementation may be necessary. Uh uh certain medications as well. So it’s really um individuals who already hopefully should be being monitored uh and their care is managed by a health care team that they will be able to tell these uh and help each person uh figure out whether they need that supplement essentially under a health care provider guidance. Right? sometimes um and for some individuals for with dietary restrictions where there are multiple uh food allergies where entire fruit groups may be uh eliminated or they’re not able to tolerate. Uh the third category very commonly is pregnancy or lactation where there higher needs of certain nutrients that becomes a little more difficult. You want to make sure both you know maternal and fetal health is maintained. So you want to uh so things like prenatal vitamins are necessary. Folate for those who are considering bearing children to help with the neuro tube prevent neurot defects. Lastly is also known history of deficiencies and it may have may be from due to one or more of these particular examples but there is known history of deficiencies whether or not that’s been um that has been uh uh whether whether or not the the reasons for that deficiency has been determined is something that requires um monitoring at the same time you start a supplement, it requires monitoring and likely continue supplement until that cause is determined and corrected. Some of these are commonly B12, iron, vitamin D, which many people are um I think nine out of 10 uh um clients I meet with have tend to have a low vitamin D because there there’s not a lot of dietary sources for that. Um, okay. So, if you’ve been counseledled or you have a history of deficiency, you’ve been advised to advised by your health care team or your doctor or your dietitionian that you should take a supplement. Hopefully, they gave you some guidance as to how much. But as you’re shopping, there’s on the internet, there’s so many different types. When I go down uh walk down, you know, drugstore, large grocery stores, there’s entire aisles of this. Like, what do you do? How do you pick the one that is a good product? Unfortunately, supplements, you know, vitamin supplements in the supplement category is not uh regulated like medications or food. their sources aren’t you know tracked or traced um or tested before being released to the market. So you know it’s should you should be cautionary uh and choose reputable companies meaning long as the companies that’s been around for a while where you can actually look to see if they have any uh concerning uh previous products perhaps. um try to find one that has a third party uh third party testing label. So these are some of the uh uh the labels you may find on some of these products. This is USP verify where you know the essentially it’s saying that uh a product that’s been USP verified has been declared like uh the potency has been declared as free from harmful contaminants. it doesn’t contain unsafe levels of certain contaminants such as heavy metals. There’s when I when I picked up a a bottle of a vitamin and mineral, I I don’t many of them often don’t have one of these. So, if you’re able to, you want to choose one that has uh one of these certifications that they’ve been tested. Assuma Labs also one and NSF as well. And uh hopefully if you’ve been advised to take a supplement to help treat or to prevent a deficiency, you’ve been provided a amount or recommended dosage. So you want to find the amount that is that’s been recommended to you. So you take the serving size the amount that’s been recommended for you because your health care team has determined that is the amount that will maintain your health or uh improve your levels. Um this part is a little bit tricky but if you are on multiple medications there are at times some supplement medication interaction. Now pharmacists are do have that long uh interaction uh print out that they give with medications do offer some uh guidance on that. So it is worth it to either take a look at that or ask if you’re starting medication or if you’re starting a supplement and you are on a few medications you want to know if they’re interacting. They don’t always cuz they don’t know since supplements aren’t tracked necessarily in your health record because you take it over the counter. Your pharmacist won’t know versus uh you know when you take medications if it’s at the same source they can they can check that interaction for you. So it’s important that you know your care teams aware when you start a supple and you’re thinking about starting a supplement. Lastly, continuing following up because if you’re treating a deficiency or asked to take a supplement or recommended to uh uh uh to uh to to treat a deficiency or prevent that um reerveillance that is you know re uh followup blood testing is needed. So don’t forget to do that so that we know if the amount is working because sometimes um necessarily the the way that vitamins and minerals are are managed in antibodies it’s sometimes the amount that’s recommended may not be sufficient to uh to help correct some of those deficiencies. So then thank you for listening to that. Is there um opening up for questions? Thank you, Shirley. That was very helpful um and parring down some of that information that is sometimes overloaded um with online and social media and what you should and shouldn’t take. Uh we do have a couple of questions in the Q&A box, but if you have any others, feel free to type them in and I’ll I’ll share them with Shirley. Um, the first one is, “I take zero supplements and I get all nutrients from your vitamin or from food sources. Often a number of my vitamin and minerals go above the RDA. Are there any I should be concerned about overdosing on from food?” Ah, that is a good question. So, you’re not taking any supplements that you feel like you’re um getting above the RDA. Uh I would say the risk is low on that. Um as I said at the in the first in the beginning when you’re the when you get the levels in your body is sufficient normal the absorption the the way that our the system works is you know the absorption is reduced and it’s when it’s from food because the amounts are so small your body is able to manage it. when it’s in a supplement form is a lot harder uh not always able to manage and reduce that absorption but from food I think that uh that risk is going to be lower. Great. Thank you Shirley. Um the next question we have is could you discuss the different types of magnesium supplements? I’ve heard that it’s good for sleep and leg cramps. Um you know I delve into that a bit uh at various points. Um, I want to say the the research on that is as with most supplements is uh it’s it’s not quite clear and not always conclusive. I would say is one thing is with magnesium um that you the dose that you choose uh is should not uh be higher starting than 250 since you know the adverse effects of uh dosing higher magnesium is uh starts has been shown to occur at you know above 250 which are rather it can be rather unpleasant But there are different types of magnesium. It just sounds like the question you’re asking. I can’t say for sure which each of them they uh it’s like magnesium glycinate. I you know when someone wants to start a product I I look to see if there are uh some of them are a little more absorbable. Um but ultimately they are supposed to tell you the amount of elemental magnesium that is in each product regardless of the type. So, uh, when I say 250, I mean the elemental amount that’s listed on the supplement. So, regardless of the type, some of them may be designed to be more absorptive, but uh, I don’t know offhand whether which particular form of salt that is in is better than in another. Thank you. Um, another question is, “Is there any recommendation for anti-aging supplements or maybe some supplements that will help us age better?” Uh, honestly, I wish they were. uh but to uh if you know anti-aging in a type of we’re talking herbal vitamins and minerals here you know the the topic being what it is um that’s a very complex and broad uh condition where we’re trying to you know fight aging um which is ultimately Having a a good diet and physical activity, wellness really has more uh of had been has been shown to to promote health and including the effects of aging more so than any supplements I had ever had heard of. You know, perhaps at some point uh a team or a scientist will discover that magic ingredient, but for now it is I would still strongly encourage you know wellness, you know, emotional health as well, sleep, stress, uh uh uh in a good balanced diet with whole food sources. Yep. I wish there was a better vitamin for that as well. we’d all be on it. Um, another question is, uh, recent DEXA scan showed some loss of bone, um, especially over the last few years. Um, they’re taking, uh, vitamin D with calcium and focusing on weightbearing exercises. What else should we do? Is there anything else that they can add in? H um I think also having quality protein sources. So it’s would be important as well. Uh this the way that resources are managed including bone mass and a portion of it uh if you are diet is is poor in a way or and being undernourished that will uh that will that can way directly affect whether your bone mass is in um in a good place. But vitamin D and sources of calcium from your food primarily is the recommendation here to uh to help you know slow that process. But typically if it’s with it’s sta identified depending on the stage of bone loss uh I know that their medical uh pharmarmacology um usually managed by your endocrine uh provider to help slow that down. But from a diet perspective, it’s about um weightbearing exercises and adequate vitamin D and getting enough calcium from calcium food sources. Um you’re not able to reach that at least a thousand. Um we believe that it’s actually higher if you’re depending on what age you are. Uh then a small supplement is uh it can be indicated as well. Great. Thank you, Shirley. Um, another question, sometimes supplements uh can make you feel nauseous. Um, any any suggestions for helping with that nausea or avoiding it? Yeah. Um, I would first look at what kind of supplement it is. Uh it is a multivitamin which by the way has not really been shown to improve health but you know unless you need the multivitamin for reasons that you have multiple deficiencies or you have a mal sort of condition in that case if they are causing you nausea uh I would take a look at what type they’re in uh uh because at times if it’s a one a day you can break that down into lower doses and a lot of times it’s the iron content content. You know, iron seems to be an often offender. It causes a lot of the uh in multivitamins most of the uh gastrointestinal symptoms. So, removing set iron and then having lower doses of that can be very effective there. Uh also taking you know supplements with food depending on again what type of supplement uh certain foods that will um there are a few that actually certain foods will you know affect the absorption of said um vitamin and mineral supplements. So I would take a look at what type it is as well. But usually a lower dose uh there are some liquid ones out there that may also be easier. They can also they’re also easier to to reduce the dose on until you find where um where that uh those symptoms start to occur as well. But if you can take it with food, taking it with some food will you know it’s the slowing of that slower absorption uh when you are taking in that concentrated dose of that vitamin mineral that causes that symptom. So, you know, having the food in there uh essentially slows down that absorption and should alleviate and oftentimes can alleviate a lot of these symptoms. Yeah, great tips, Shirley. Um, we can take a couple more questions. We’ve got one. Um, which type of calcium is going to be the the best absorbed or the best one to take? Uh I am a big proponent of citrate um because it it has as it’s more easily absorbed um whether you take it with or without food. Um I also would suggest using starting with a lower dose as well to maxim if you depending the amount that you’ve been recommended to add you know trying to get again some of it from food and then starting with say 250 uh and not taking more than you know 500 at one time but citrate is has a more absorbable form. does cost a little bit more. Uh if cost is an issue, other forms are also okay in which case taking a chewable form uh you know non-gummy or liquid form uh is can also be likely be easier to absorb. uh it can cause you know calcium carbonate which is the the um more economical choice um has a little bit more incidence of constipation uh and uh versus you know calcium citrate as well. So that’s what I would vote for. Great. Thank you. Um and one more um this question asks is CoQ10 plus pepper preferred over CoQ10 without? Um, but I think just kind of opening up that question too, you know, are there certain uh vitamins that might be better absorbed with additional nutrients paired alongside them? There are there are um notably um iron is absorption of that is enhanced by vitamin C foods or presence of acid. So citrus uh having a citrus um alongside if you’re taking an iron supplement or you’re eating an iron rich food help enhance absorption of that. Um other things include you know mentioned earlier uh A D E and K those you’re taking and taking vitamin D supplement take it with a meal that has some dietary fat doesn’t mean it needs to be a lot of fat just any food that contains fat which is you know it can be a plant source ideally a plant source um but also you know also meat as well it just needs a little bit of fat and it will help enhance the absorption of that. Um sure there are others. Those are the two that um you know most commonly uh um I can think of right now. Um yeah. All right. Great. I know there’s a lot of questions and we can’t get to them all today. Um and there’s so much to talk about um when it comes to vitamins and minerals. So, thank you so much, Shirley, for helping us navigate, you know, even just this little corner of it, which was so helpful. Um, thank you everybody for attending. Um, and a big thank you to Shirley for her engaging talk. U, as mentioned earlier, this recording will be posted next week on the Stanford um, health library webinar under lifestyle and weight management recorded lectures. We look forward to seeing you again for uh, next month for our next webinar. Um, as a reminder, our webinars occur the third Wednesdays of every month from 5 to 5:45 or so. Um, so join us on November 19th for Harvest Feast, low carbohydrate fall sites um with our wonderful colleague Marian. Thanks for joining everybody. Thank you.
