Getting the Nutrients You Need

Q: As someone who follows a kosher diet, I want to know, are there any vitamins and minerals that I should take?

A: There is nothing inherent in a Torah lifestyle that would preclude following a healthy diet. In fact, since we’re commanded to take care of our bodies, choosing nutritious foods while limiting less healthy ones would seem to be part and parcel of living a frum lifestyle. If you make sure to eat all of your servings of fruit, vegetables, grains, meat, and other healthy foods, there is probably no need for you to take any form of supplement. However, as a registered dietitian and an Orthodox Jew, I have observed that many frum Jews do not adhere to the healthy diet outlined above and therefore, supplements could be very useful.

Eat Your Veggies!
Fruits and vegetables are a rich source of vitamins and minerals in our diets. Yet according to 2005 survey results from the Centers for Disease Control and Prevention (CDC), only about one-third of adults in the US eat enough fruits and vegetables (at least 2 servings of fruit and 3 servings of vegetables per day). The figures are probably worse in the frum community, as the need to meticulously inspect vegetables discourages many from eating them. Those vegetables that do appear on our tables are often in the form of kugels, which are sometimes misnomers for cake.

To be sure, I have seen a positive shift in our community over the last few years with more healthy foods showing up in school lunchrooms, at social functions, and on individual tables. But if you are not eating your fruits and veggies, a general multivitamin and mineral supplement can help ensure that you meet your body’s basic nutrient needs. This is especially true if you’re trying to lose weight—when you cut down on your overall intake, it’s more likely that you’ll miss out on some important nutrients.

However, supplements can be a double-edged sword—they can help you obtain those hard-to-get nutrients, but at the same time, they can put you at risk for exceeding healthy limits. (For example, toxic levels of vitamin A may cause birth defects if pregnant or bone problems, according to the National Institute of Health.) Luckily, supplements list the percent of the “daily value” one serving provides for each nutrient. (Please note serving size on the label—it may be more than one pill.) Make sure no nutrient is present in amounts much larger than 100 percent of the daily value. Even though vitamins and minerals promote health, you really can get too much of a good thing.

Calcium is a mineral best known for its role in building strong, healthy bones, but it’s also crucial for life-sustaining functions like controlling your heartbeat and sending messages through the nervous system. While your multi-vitamin probably does contain some calcium, if it had enough calcium to meet most of your needs it would be too big to swallow!

Healthy adults under the age of fifty-one need 1,000 milligrams per day (the amount found in about 3 ½ cups of milk) while women over age fifty-one and both men and women over age seventy-one should take in 1,200 milligrams daily (about 4 cups of milk).

Dairy products like milk and yogurt are among the best sources of calcium in foods.

If you don’t take in enough calcium, choose either calcium carbonate or calcium citrate as a supplement. (Take calcium carbonate with meals; citrate can be taken anytime.) A good calcium supplement will also contain vitamin D, which boosts your body’s absorption of calcium. Your body will also absorb calcium better if you take no more than 500 milligrams at a time, so split your dosage throughout the day.

Vitamin D
Even though your body can make vitamin D from sun exposure, use of sunscreen as well as modest attire can block the sun’s rays, preventing synthesis of this essential vitamin. And since few foods naturally contain vitamin D (although it is commonly added to foods such as milk), many people still do not get enough of this vitamin.

Vitamin D plays a role in bone health, but its deficiency has been implicated in a plethora of other health conditions from cancer and diabetes to infections and even autism, according to the Vitamin D Council. According to the Institute of Medicine (IOM), however, these latter health effects are based on inconclusive studies. The IOM recommends 400 International Units (IU) daily for infants, 600 IU for most people including children, pregnant or breastfeeding women, and 800 IU for people over seventy years old. Some experts feel these recommendations are too low. The bottom line is, if you want to supplement with higher levels of vitamin D, check with your healthcare provider first.

Omega-3 Fats
These polyunsaturated fats with hard-to-pronounce names like docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are pretty famous for keeping your heart healthy. They’re found naturally in fish, which is why the American Heart Association recommends eating at least two servings (3½ ounces each) of fatty fish a week. While salmon and tuna fall into the fatty fish category, unfortunately gefilte fish does not. At lower intake levels—such as those obtained by just eating fish—omega-3s can protect from heart-related deaths, but with supplementation, omega-3 fats may help raise HDL (the good cholesterol), lower triglycerides (a type of fat in the blood linked to heart disease), and control blood pressure.

One gram of fish oil supplement every day would provide about the same benefits of eating fatty fish twice weekly, which is the current recommendation for preventing heart disease-related death. Higher doses may provide the additional benefits I mentioned, but the FDA still recommends no more than 2 grams per day of EPA and DHA for healthy adults because of the potential for omega-3s to increase bleeding.

During pregnancy and while breastfeeding, women should be cautious about consuming fish because of the potential deleterious effects of mercury on the developing baby.

Other Supplements
Certain conditions may call for other vitamin or mineral supplementation. For example, during pregnancy, women’s iron and folic acid requirements increase. Pregnant women should therefore select a prenatal multivitamin and mineral supplement that have been specifically formulated to meet those enhanced needs. Oftentimes when a woman has many children or has children very close in age, her body does not have a chance to replenish its nutrient stores between pregnancies, putting her at risk of vitamin deficiency. That’s why it is especially important for moms to take prenatal supplements while pregnant or breastfeeding, or even in between pregnancies.

Shira Isenberg is a registered dietitian and writer. She has a master’s degree in public health nutrition from Hunter College in New York.

This article was featured in the Winter 2011 issue of Jewish Action.
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