Dietary Supplement Advice That’s Not Hard to Swallow

If you haven’t received the memo yet, we are a far cry from meeting the nutrition and healthy eating objectives of the 2010 Dietary Guidelines for Americans (DGAs), according to studies. The DGA committee identified that many fall short of reaching minimal healthy levels of key nutrients including vitamins A, C, and E, calcium, magnesium, potassium, and fiber. One study showed that less than 5% of adult workers meet dietary fiber recommendations. This may explain why irritable bowel syndrome and sales of laxatives are on the rise.

In my new book, The Best Things You Can Eat, I talk about what foods can help bridge these short-gaps in nutrients. I’m sure this information will be helpful for many of my readers but I’m also a realist. Even those who follow a healthy diet (including myself) or have all the best intentions to do so, don’t always eat perfectly…everyday. That is one of the reasons I included information on dietary supplements in the new book and have always recommended dietary supplements for my patients, family and even myself.

Even if you are on a great supplement program, if you don’t take them, they aren’t going to do you much good. So what are some of the roadblocks to taking supplements? I asked Judy Blatman, senior vice president or communications from the Council of Responsible Nutrition (CRN), for her thoughts on why people either don’t take dietary supplements or why those who do may have a hard time sticking to their regimen. She mentioned that CRN conducted a consumer survey this year that investigated supplement habits of consumers and health professionals alike. “We did ask those who indicated that they didn’t always comply with their daily supplement routine, to select the main reasons why they didn’t,” says Blatman.  The top three answers were: 

1. I get busy and forget to take them
2. If they’re not in plain sight, I forget to take them
3. Some days, I just don’t feel like taking them.

These all make perfect sense to me. Even I forget to take my supplements for all the very same reasons! And to spin off the last reason of “Some days I just don’t feel like taking them”, swallowing huge capsules or tablets are a physical impossibility for me. Have you ever had a tablet or capsule get stuck in your throat? Owww! It’s painful and the most uncomfortable feeling I can possibly imagine. My solution? I chew EVERYTHING! Yup…that includes my fish oil capsules, too! Not pleasant, eh? So, it’s not surprising that even the espousers of dietary supplements don’t always take them if their own advice is literally “hard to swallow”!

Good news. I was approached earlier this year by the folks at Nature Made who clairvoyantly knew of my supplement plight. They were excited to announce that they created new lines of dietary supplements with the sole purpose of making the task of taking supplements doable if not downright pleasurable! I was all ears. Long story short, they sent a variety of products for the whole family to try out that included adult gummies, full strength minis and a new type of small tablets called vita melts that literally melt in your mouth! They were amazing and really solved my swallowing challenge. I liked them so much that I started working with Nature Made to spread the good news! So I thought I’d share what the Grottos are taking as a core program as a result of trying the new products. Of course, I would be remiss if I didn’t thow in a bit of advice to seek out a qualified health professional for dietary supplement guidance. Okay? Do it! I also provided links in the photos in case you want to know more about the supplements.

My three daughters, who are all in their teens, take the full strength minis. So does my wife Sharon.

This is my base program. I take the men’s full strength mini’s multiple plus two of the the smaller omega 3 supplement. I also take an additional 1000i.u. of vitamin D in the vita melt series. They taste GREAT!

Lastly, I wanted to share some cool gizmos and apps that address the first two reasons that folks don’t take supplements from the CRN survey.

I forgot:
CRN’s Life Supplemented campaign also designed a cool iphone app that can be used on your ipad as well. Besides reminding you to take your supplements, it eve has a restock reminder to tell you if you are getting low.

They don’t have an android version out yet but rumor has it that there may be one available in 2013. Meanwhile, I ran across another app that works great for android devices.

Having them visible.

“Having your supplements out on your kitchen counter, on your desk, in your pocketbook so they’re visible can really help,” says Blatman.  
Even for those times when your supplements aren’t in a direct line of sight, here’s a great carrier for them that will sounds an alarm when its time to take them. Cool eh?

I hope that helps break down some barriers to taking your supplements regularly. Have you found any supplements, apps or supplement carriers that you would recommend that make taking supplements easier? I’d love to hear from you!

Thank you to my intern, Jamie Digiovanni, who helped me with this story.

1. Kachan D, Lewis JE, Davila EP, Arheart KL, LeBlanc WG, Fleming LE,
Cabán-Martinez AJ, Lee DJ. Nutrient intake and adherence to dietary
recommendations among US workers. J Occup Environ Med. 2012 Jan;54(1):101-5.

2. J Am Coll Nutr February 2009 vol. 28 no. Supplement 1 69S-72S

Is It Too Late?

Photo courtesy of www.fatbellyexercises.com As featured in the Real Nutrition section on WebMD By David Grotto, RD, LDN As promised, I offer you  part deux of  Houston, I Don’t Think I Have a Problem…yet… Some of you were kind  enough to share a bit of your own weight management struggles with me last  week, and I really appreciate that. But I couldn’t help but sense that there   are those of you who are still quietly waiting in the wings, hovering between   pre-contemplation and contemplation, trying to figure out if you even have a  problem or not. And if you do realize that you have health problems, many of   you might be figuring out what your problems might be and then pondering what  you can realistically do about them. All of this can be quite a pain and   perhaps you are feeling one of those big “why bother?” moments coming on.   You’ve been down this path before and the odds seem like they are always   stacked against you. You lose a pound only to gain back two. I get it…totally   frustrating. Is it even worth trying anymore? Do we have a hope of ever  getting back to the glory days state of health we once enjoyed? If you read The Fat Trap by Tara Parker-Pope in the New York Times, you may have come away with the feeling that when it comes to losing weight   for many of us, the only real “losing” that will be happening in your future  will be that of hope…a total downer for sure. But thankfully, in come the  cavalry of science, common sense and hopefulness. I read a very eloquent   retort to Jessica Parker-Rope’s article from David Katz, MD, MPH featured in  the Huffington Post in which he pointed out that when we ask: “Our bodies: with us or against us?” we are asking the wrong question. I asked the   optimistic yet pragmatic Dr. Katz to weigh in on our ‘health state of the  nation’ and to also expound upon some of the challenges and solutions that he  discussed in his article. Have we thrown in the proverbial towel? Are we in the right mindset to make serious changes at this  time? What will it take before we act? Dr. Katz: The one word answer is passion.  When enough of us are passionate about this cause, we will turn the tide. I’m  not sure we’re there yet – but I think we’re getting there. You spoke of an  “optimal environment that works with our natural traits and tendencies” in  your rebuttal to the Fat Trap featured in the Huffington Post. Describe what  you mean by an “optimal environment.” Dr. Katz: Up to a point, we might contend that a Stone Age environment is optimal for our native traits. But that point   would be a life span of about 40 years, MAX! One of the problems with invoking our native Paleolithic environment is that Stone Age humans died at 20 on average, and rarely made it past 40. Still, that is the environment to which we are adapted – so it’s a starting point. The true optimal is a   modified Stone Age environment: one in which food is direct from nature,  there’s routine physical exertion, clean air and water – enhanced by  protection from the elements and predators and pathogens. In essence, we need wholesome food close to nature, the conditioning daily exercise native to our animal vitality, adequate sleep, avoidance of toxins, control of stress and loving relationships in our lives. These are our native tonics. How do we go about achieving this environment? Dr. Katz: Incrementally – one paving stone,  sandbag, program practice, and policy at a time. We don’t need a Stone Age  environment to get exercise every day – but we need incremental modifications  of the built environment and daily routine to move us in that direction. We don’t need mammoth meat or Stone Age plants to chew on – but we do need to eat more plants and foods closer to nature in general. We have the means at our disposal to do that—we just need to apply them. Do you feel our present dietary guidelines are appropriate? What would happen if we actually followed them re: rates of obesity, heart disease, diabetes, longevity, etc.? Dr. Katz: They are appropriate – although not optimal. Let’s acknowledge that they are devised by government agencies with a need to keep large corporate interests placated. The Dietary Guidelines are openly a blend of science and politics, not pure public health science. But despite their limitations, they are much better than the typical American Diet. So yes, were we to better approximate them, rates of heart disease, cancer, stroke, diabetes, sleep apnea, arthritis and so on would come down substantially. If we got to truly optimal diets, exercised routinely, and avoided tobacco – we could eliminate fully 80% of the entire chronic disease burden.  ‘Tis a consummation devoutly to be wished! Do you feel that the food industry is doing enough to change the environmental landscape? If not, what needs to change here? They are not doing nearly enough. What needs to change is that they must take responsibility for creating the prevailing preferences for copious additions of sugar and salt and fat. As is, they tend to throw up their hands and argue they are just trying to keep the customer satisfied. But they had a hand in creating the palate that prevails in the USA—in essence, they cultivated the addictions and now provide the fixes! They should work a whole lot harder to help cure the addictions. They should stop using marketing to distort accepted truths about nutrition (what on earth is “enhanced” water?). And they should embrace measures of nutritional quality developed by objective 3rd parties, not their own hired guns. What changes would you like to see to promote more physical activity? Dr. Katz: Programming adapted to every setting and ability level. Programs that fit into every school and work day.  Ways to be active all at once; in small doses; in planes, trains and automobiles. We are not going back to the Stone Age, so we have to engineer solutions that fit into the modern world as it is. Our ‘abe’ for fitness   program is an example of what I mean. So is our school program, ABC for   Fitness. Is there enough consumer awareness to drive change? Is it out of our hands at this point? Have we reached the point where we can no longer decide for ourselves what’s best for us? Dr. Katz: Consumer awareness is not enough – but consumer passion is [enough to drive change]. It is not out of our hands. Demand trumps supply and if every loving parent and grandparent in the country came together around causes devoted to protecting the health of children, no special interest group could withstand our collective might. We have the power – but we need common cause. It begins with common understanding – so we professionals have our work cut out for us. We must   cultivate the common will so we come together to pave the way. I think what Dr. Katz  proposes will take nothing short of a massive collective effort requiring many intricate wheels to turn simultaneously to work. I agree that we do have many of the tools, the power, and the knowhow at our disposal to make real change for the better happen. But I do wonder, as Dr. Katz mentioned, if we have enough passion to pull it off. Your thoughts? Do we have what it takes to turn the boat around?

New Dietary Guidelines Suggest Getting “Real”…Food That Is!

Eat less calories, sodium, sugar, sat and trans fat and eat more plants and drink water instead of sugary sodas. Oh yeah…and Move! That’s basically the new Dietary Guidelines for Americans distilled down to a sound-bite. So, for those of you who just wanted the “low-down”, you are free to bail on me now. For all others, behold! For here they are in all of their glory…

Enjoy your food, but eat less.

Avoid oversized portions.

Make half your plate fruits and vegetables.

Switch to fat-free or low-fat (1%) milk.

Compare sodium in foods like soup, bread, and frozen meals – and choose the foods with lower numbers.

Drink water instead of sugary drinks.

This may surprise you but I embrace these new guidelines…I really do. In fact, I also believe they are based on good science and NOT the result of special interest lobby groups’ efforts (oh how we love a juicy conspiracy story!).

Take the dairy message for example; I’m not too sure how the dairy folks feel about “Switch to fat-free or low-fat (1%) milk” as part of the new guidelines. I know I’m thinking “How many people are getting in too much saturated fat and calories because they are drinking 2% or whole milk?”  According to 2005-2006 NHANES data, only 60% of Americans consume the recommended amount of milk and milk products. And out of all milk products consumed, only 1/3 is consumed as a milk beverage. So it seems that whole milk as an ingredient may be more at issue and not because people are buying too much 2% and whole milk. Anyhow, I digress…a little…

What I really like about the Dietary Guidelines for Americans is that it establishes dietary goals for better health. Who can’t get behind “Make 1/2 Your Plate Fruits and Vegetables”? But what I really loathe about the guidelines is that in their history, the majority of the population has never achieved all of the recommendations! Yet every 5 years, we are compelled to “raise (or lower in the case of “nutrients of concern”, i.e. sodium, sat and trans fat, cholesterol) the bar” despite how successful we as a society were in achieving the prior guidelines. Ah, but should we shoot the messenger? Is it the guidelines that I loathe or our inabilities to achieve them?

Guidelines without real teeth for implementation will always be just “guidelines”. It’s how we tackle them as a society that will change lofty guidelines into a roadmap for health. So I want to present for discussion how we might just go about making these guidelines “real” for everyone concerned. And I like approaching health “one delicious bite at a time” so let’s tackle what I consider the most important guideline of them all.

Task:. Make Half of Your Plate Fruits and Vegetables.

Solution?

I turned to blogger friend Jenna Pepper for some help on this one. You see, Jenna is a mommy blogger who has a kid-focused blog called Food with Kid Appeal. She already has been working on this project for as long as her kids could eat solid foods. What’s more is that Jenna also has taken her mission from the family kitchen table to the school cafeteria in the “Eat to Learn” program at Sherwood Elementary School in Houston Texas. She shared with me how this program is really making a difference in her community.

Q. What is the Eat to Learn Program?

Jenna: Eat to Learn is a year-long food education program that strives to make a connection with kids between food and learning, as well as increase consumption of fruits and vegetables in the school cafeteria. The program is not only for students at school, but also involves parents in several events. Eat to Learn was a grant proposal submitted to National Parent Teacher Association for a $1,000 grant award.  Sherwood did not receive a grant award.  We were able to fund the program with parent and community donations.  Events in the program include: 

• daily morning announcements that connects 21 fruits and vegetables served in the cafeteria to learning
• a parent meeting to educate parents on the nutrients a learning brain needs
• Turkey Trot that links physical activity to improved learning
• Lunch tray evaluations – students get to grade their lunch tray or lunch box selections
• Taste Off – a campus wide food tasting competition
• Monthly Eat to Learn flyers sent home with students for parents to read the content contained in the morning announcements.

Q. Why Sherwood Elementary?

Jenna: My sons both attend Sherwood Elementary.  Our school principal, Stefanie Noble, is supportive of building better eating habits in the student body as well as increasing student success by way of real food. Without a principal who believes in educating the whole child; including academics and wellness, the students at Sherwood would not be receiving education about real food and how it helps them succeed at school.  Ms Noble was receptive to the program from the beginning. 

Q. Tell me about the “Taste Off” competition.

Jenna: The Taste off Competition was a campus wide event, where each Sherwood student received a punch card with 9 foods listed: celery, cucumber, carrots, green beans, pears, oranges, beans, broccoli and spinach.  Each child was offered 9 types of produce and given an opportunity to taste them.  Tasters received a punch on their card.  After the tastings, students got to decide their favorite and least favorite item tasted by placing a sticker on a poster to build two Decision Charts for each grade.  After the tastings, students got to jump rope, dance, hula hoop or play soccer.   In the weeks following the taste off, each class room will receive their punch cards to build graphs and interpret the tasting data. They will also be writing journal entries and essays about the Eat to Learn program. The Eat to Learn program was designed to tie into math and language arts curriculum. 

Q. Of the 400 kids, how many tried the various produce offerings?

Jenna: 82% of the students tried all 9 items.  I saw a couple of punch cards with 3 tastes (the lowest), but of the 18% who didn’t taste all the foods, most tasted 7-8 items.   Surprisingly, raw spinach and broccoli were tasted by 95% of kids.

Q. What were the results?

Jenna: 48% selected one of the vegetables as favorite, 52% selected a fruit as their favorite.  25% preferred a green vegetable out of all nine foods offered.

Q. How do the results of this project apply to kids across America?

Jenna: Many kids do not eat vegetables, and many kids do not prefer vegetables.  Liking a vegetable and preferring a vegetable are two different things. Many kids never learn to eat items they don’t prefer. The vast majority of their diet on a daily basis is made up of various preferred items. Training taste buds starts with mindset.  If mom believes that her kiddo can learn to like vegetables, and she follows up that belief with similar thoughts (jr tasted broccoli today, that’s progress.) and actions (serving vegetables on a regular basis) and expectations (I expect that my child will learn to eat vegetables because we value food that nourishes the body) then in most cases a child will learn to eat vegetables.  What happens with mom’s mindset is more like this “Picky eaters don’t usually like vegetables.”  What do her thoughts, actions and expectations look like?  What are the results? I’m not saying that an open mindset enables every kid to eat every vegetable, but that mindset sets kids up for success with healthy eating habits.

Studies have shown that kids have more taste buds than adults.  This means they taste “bitter” much more intensely than adults do.  Some bitter vegetables are often unloved by kids until they are older and have lost some of their taste buds.  If a child has a strong reaction to a bitter vegetable at age 3, that broccoli or leafy green may forever be labeled as “unacceptable” by the child. When in reality, that same flavor could be adopted with practice or in time, as taste buds decrease, become palatable. Another issue is mindset.  How many parents would end up with literate kids if we doubted our child’s ability to learn to read?  Kids learn to read because we know they are capable of it, we expect it and our actions are in agreement with our mindset. The results (literacy or adventurous eating) fall out of the mindset.

• Mindset matters.  Believe that your child will learn to like vegetables the same way he learns to ride a bike, read or write.  With lots of practice, with parents who believe he can.
• Control of the menu.  Remove processed food from the menu, and see what kids eat.  When crisp steamed broccoli sits next to boxed macaroni and cheese, it’s hard for a palate to appreciate the broccoli.
• Make vegetables relevant to kids.  Kids want to eat foods that help them grow, learn and move.  What is it that your kids do with their mind and body?  Make sure they know that vegetables help them do what they love.
• Be consistent with your actions. Offer a variety of veggies often and in a variety of ways on a regular basis.  Some kids will eat raw spinach vs. cooked spinach.  Some kids prefer carrots cooked to raw.  Try lots of veggie salads, lots of veggies sides, roast veggies, steam them, and serve raw veggies with dips like salad dressing or hummus.  If you don’t cook, make sure you expose your child to lots raw veggies in their lunch box and select vegetables in restaurants.  Menus are full of delicious salads and side vegetable items.
• Communicate your expectations to your kids. Let kids know that nourishing their body is a value your family holds.  Let them know you expect them to nourish their body with plenty of wholesome food. Teach kids they don’t have to love vegetables or prefer them to eat them.  They can just be “acceptable”, or “not yucky.”  With so many processed foods that are chemically engineered to taste amazing, it’s hard for young eaters to accept a food item that doesn’t create a party in their mouth. 

Q. I heard a poem was written about the health benefits of eating produce and was shared with the kids at Sherwood Elementary. Can you share it with us?

Jenna: Sure!

Spinach makes memorizing math facts a breeze,
B vitamins bring oxygen to the brain helping it breath.
Antioxidants prevent brain cell death by the hour,
more brain cells = more spelling power.
Folic acid has the brain instruct your face to smile
while you put facts and figures in a huge brain file.
The iron in spinach will fuel you with energy,
run, swing, climb, slide and be done with lethargy.
Eat the spinach sitting there on your lunch tray
you’ll grow a big brain the Sherwood way.

Thanks Jenna! I like the “…and be done with lethargy” part. Hopefully this new set of Dietary Guidelines for Americans will inspire all to work together to improve the health of our nation. And maybe we will finally be done with apathy, too!

I’d love your thoughts about the new guidelines and want to hear about your efforts on the home front, at schools, in industry, etc. to make them come alive deliciously on the plate. Comment away!