Last Wednesday our blog started out with a common scenario in our office:
A gentleman called to ask if we could help him with his supplementation. “I take lots of supplements but when the doctor tested some of my vitamin and mineral levels, they were low. I don’t understand how that is possible,” he declared. When he arrived, he had a grocery bag full of supplements in one hand and carrying a box also full of supplements in the other hand. Which ones should he take?
We considered supplements versus a whole food plant-based diet. Next, let’s consider how nutrients are absorbed in the body.
Absorption
After the food is broken down in the stomach, it is passed into the intestines. Over 90% of nutrient absorption happens in the small intestines. The small intestine is characterized by an enormous absorptive area and has an extensive length of 10-12 feet. This area is covered with fingerlike projections called villi, producing an enormous absorptive surface area of 750 feet,(6) maximizing nutrient absorption. Nutrients are absorbed through the intestinal walls and enter the circulation. The blood stream carries the nutrients to the cells or to storage.
The large intestine is responsible for absorption of extra water, sodium, and vitamins K, B12, thiamin and riboflavin.
If you are deficient in a particular nutrient a registered dietitian can help you know the best foods and ways to absorb the deficient nutrient. In most cases we can supplement by increasing the foods, in their whole form, that are high in the nutrient that is deficient.
Now what are two supplements that most people need to take?
Exception #1:
One exception is Vitamin B12. Vitamin B12 is actually bacteria, and like other helpful bacteria it is absorbed in the large intestine. Its absorption in the gut is dependent on intrinsic factor and on folate and other B vitamins. Vitamin B12 is necessary for red blood cell production and DNA production, cognitive function, memory and mood, and nerve regulation. Because Americans eat mostly a highly processed diet and get minimal contact with nature and dirt(7), Americans are often lacking sufficient vitamin B12. Vegetarians and vegans also tend to be low in this good bacterium. The best way to take vitamin B12 is sublingually (under your tongue) or a liquid that you hold in your mouth for 30 seconds before swallowing. In this way it can be absorbed directly into the blood stream. This method bypasses the digestive tract where intrinsic factor is needed to successfully absorb vitamin B12 and the intrinsic factor has to stay connected with the vitamin B12 all the way to the end of the large intestine in order to be absorbed into the bloodstream. Vitamin B12 should always be taken with a meal to the best assimilation into the system.
Exception #2:
Another vitamin many Americans are often deficient in is vitamin D. Vitamin D is a hormone that we absorb from direct sunlight. Those living north of Atlanta, GA, cannot absorb enough vitamin D from the sun during winter months, thus making a vitamin D supplement necessary during the late fall to early spring months. Vitamin D helps regulate our calcium and phosphorus absorption, helps maintain the health of our bone and teeth. A low vitamin D level can negatively affect our mood, cholesterol, and immune system, decreasing our ability to fight off diseases such as cancer and auto-immune disease.(8) Take vitamin D with meals for proper absorption.
To know if Vitamin D and B12 are supplements you will need, we recommend you get a blood test first.
Vitamin D and B12 were among the supplements that were recommended to the gentleman who didn’t understand why his vitamins and mineral level could be low.
To know what supplement are best for you and your situation, we recommend
scheduling an appointment with our dietitian.
References:
1. Whitney, E. and Rolfes, S. Understanding Nutrition. 6th edition. West Publishing Co. 1993.
2. White, E. Counsels on Diets and Foods, Review and Herald,
3. Ferrell, V. and Cherne, H. Natural Remedies Encyclopedia. 5th edition. Harvestime Books. 2008.
4. Garnsey, C. Life and Health. 1936.
5. Are you eating enough to loss weight? Version 3. The Full Plate Diet. 2012.
6. Mahan, L. and Escott-Stump, S. Krause’s food, nutrition, and diet therapy. 9th edition. W.B. Saunders Co. 1996.
7. Campbell, T. C., Campbell, T. M, The China Study. BenBella Books, Inc. 2006.
8. Ware, M. Vitamin D: Health Benefits, Facts and Research. Medicalnewstoday.com. April 7, 2016.