Victoria BC Dietitian (Dietician Nutritionist) Kristen Yarker, MSc, RD and 2 UBC Students Review The Evidence Behind Collagen Supplements for Skin Health and Beauty.Read More
Victoria BC Dietitian (Dietician Nutritionist) Kristen Yarker, MSc, RD Shares Key Information You Need to Make Sure That You and Your Child Are Taking the Right Vitamins (and Other Supplements).Read More
You asked me to cover probiotics. And sure, I know about probiotics. But instead of listening to me, I decided to reach out to a true, leading expert in probiotics. I'm proud to call Desiree Nielsen a friend. And, I can tell you that probiotics and gut health are her jams. She's who I turn to for keeping up on this topic that the scientific community is rapidly learning about. So, I wanted to share her directly with you. Just like me, she gives you the real goods. Enjoy this interview! And, if you want more of Desiree, check out her show Urban Vegetarian playing on Gusto TV!
Should Parents Be Giving Kids Probiotics?
If a child was born naturally and breastfed, eats a healthy diet and has no health issues, they may not need a probiotic daily. Of course, probiotics are a great choice when the time is right: the literature shows that probiotics may be helpful during cold and flu season to prevent respiratory infection or to prevent traveller’s diarrhea.
In addition, there are certain health concerns that are a clear indication for the use of probiotics daily such as colic, infectious diarrhea or tummy troubles like reflux or irritable bowel syndrome.
Should Us Adults Take Probiotics?
I always tend to err on the light side of supplementation but as adults, there are many reasons why a probiotic may be an excellent idea. Any chronic digestive or inflammatory concern, from IBS to eczema, is worth a three month trial of a clinical strength probiotic to assess improvement. If a probiotic works, you will feel it. I cannot tell you how often I have talked to someone who has been taking a probiotic for years with no result and when they make the right switch, they are shocked by how much better they feel. They can be taken therapeutically and discontinued when you improve…but for those with chronic concerns, I recommend continuing daily as part of lifestyle management.
Probiotics are also helpful on an 'as needed' basis for everything from recovering from food poisoning, prevention of side effects from antibiotics use and as a boost during cold and flu season. They are a great, natural remedy in the wellness toolkit.
For those who tend towards an ‘insurance’ mindset in supplementation, a small daily dose of an effective probiotic certainly doesn’t hurt and you may find an improvement in your day-to-day wellbeing.
What is the Difference Between Prebiotics and Probiotics?
Probiotics are live microorganisms that are part of the natural human microflora…and prebiotics help them thrive. Not too long ago, we would have said that prebiotics are non-digestible carbohydrates such as inulin. The low FODMAP diet for IBS works by drastically reducing these prebiotic compounds to alter fermentation in the gut.
However, the definition of a prebiotic is changing and it is thought that a whole host of compounds, from plant polyphenols to even the diabetes medication metformin, may help boost the growth of beneficial microbes.
Can We Get Probiotics from Fermented Foods, e.g. Yogurt? Or, Do We Need to Take Them as a Supplement?
Fermented foods are produced thanks to beneficial microbes…but not all fermented foods may contain truly probiotic microbes. This takes a bit of explanation: the definition of a probiotic is ‘a live microorganism, which when administered in adequate amounts, confers a health benefit on the host.”
So the issue with fermented foods is that in the fermentation, many of the microbes may die or there might not be sufficient amounts to actually have an effect. The research on fermented foods is surprisingly spotty, with kimchi and yogurt being two of the standouts. But the average yogurt contains about 1 billion live bacteria at manufacture (which may not be alive when you eat them) whereas most supplemental probiotics are in the tens of billions.
Eat fermented foods daily as part of a healthy diet…take a supplement when you need extra help.
What Should Someone Look for in a Supplement? There Are so Many Available, How Do You Choose?
It’s a tough call; in my mind, the only probiotics that someone should consider are those with high level evidence to support their use. They are very few in number and you can find them on a very helpful website called www.probioticchart.ca - choose one of the brands with level 1 or 2 evidence. Then, the decision becomes a lot easier. We can spend so much money on supplements but if they aren’t effective, we are better off spending our money on healthy food!
In general, good quality probiotics have enteric coated capsules (with a couple of exceptions for fresh or powdered formulas) with a minimum of 10 billion live active cells, guaranteed to a clearly marked expiry date.
Who is Desiree Nielsen? Bio:
Desiree Nielsen is a dietitian based in Vancouver, Canada. She is the author of Un-Junk Your Diet: How to shop, cook and eat to fight inflammation and feel better, forever! and the host of Urban Vegetarian, a cooking show on Gusto TV. Passionate about integrative therapeutic approaches to nutrition, Desiree maintains a nutrition practice, with a focus on digestive health, plant-based diets and anti-inflammatory nutrition. Her new app, MyHealthyGut is an evidence-based resource for those looking to improve their digestive health.
I heard back from a lot of folks thanking me for my recent blog post about whether adults should take a multivitamin. So I knew that I needed to answer: should kids take a multivitamin.
Just like I said in my adult post, first I need to tell you that when it comes to nutrition, one size doesn’t fit all. Each child has different nutrition needs – based on age, health concerns, eating habits, etc. That’s why I always include a nutrition assessment when I start to work with individual picky eaters. It’s from the results of my nutrition assessment that I create your child’s individual action plan. So, without doing an individual nutrition assessment, I can’t really answer whether your child, specifically as an individual, should take a multivitamin.
However, I can share my thoughts on multivitamins for kids in general for you to consider.
Should Kids Take a Multivitamin?
I don’t have strong feelings either way about whether kids should take a multivitamin (I’m talking toddlers, preschoolers, and school-age kids). It’s not likely to hurt. But there isn’t great evidence that it offers a lot of nutritional benefit for kids. Particularly the gummy multivitamins, for them to taste good, many of the nutrients need to be taken out. Also for safety reasons, most kids multivitamins don’t have iron in them. Concern that kids aren’t eating enough iron (e.g. when picky kids don’t eat meat or plant-based high iron foods) is one of the reasons that I may recommend a multivitamin for kids. But you have to go out of your way to find a kids’ multivitamin that contains iron.
There are two exceptions to my recommendation:
- Babies receiving a combination of solid foods and breastmilk/ formula don’t need a multivitamin. But I do recommend continuing 400 IU of vitamin D drops for babies receiving breastmilk.
- If your daughter has started menstruating, I do recommend a multivitamin made for women. I get into the reasons why in my adult post.
Kids and Multivitamin - Pitfalls to Avoid
An important pitfall that you want to avoid is teaching your kids that their vitamins are candy. That safety reason (that I mentioned above) regarding why most kids multivitamins don’t contain iron is because there is a history of kids climbing up into cabinets and taking the whole bottle of vitamins – because they wanted to eat the “candy”. An overdose of iron by taking too many vitamins can cause serious harm, even kill, a child.
So, keep multivitamins up out of reach of kids. And, teach kids the difference between vitamins and candy.
Other Vitamins for Kids
There are other vitamins that I do recommend for kids:
Vitamin D for Kids
The vitamin D recommendation for kids (12 months – adulthood) is 600 IU per day. The vitamin D recommendation for babies from birth – 12 months is 400 IU per day. There are very few food-based sources of vitamin D. For example, milk and plant-based milk alternatives have about 100 IU per cup. 6 cups of milk a day would certainly crowd out other healthy foods. Vitamin D is known as the sunshine vitamin. And yes, we do make it through our skin. But only during the months of March - October (fewer months in northern BC). And, windows, clothing, sunscreen, pollution, and darker skin pigment all block the ability to make vitamin D from the sun. So I do recommend giving a vitamin D supplement daily in the range of 400 IU – 600 IU (depending on your child’s vitamin D intake from food sources).
For babies, breastmilk is typically very low in vitamin D. Formula does have ample vitamin D for most babies. Therefore, the recommendation is that all babies who are breastfed or fed a combination of breastmilk and formula, receive 400 IU of vitamin D daily.
Omega-3 (Fish Oil) For Kids
The evidence isn’t super strong, but I do have a soft recommendation of omega-3s for kids (toddlers – teens). The evidence is mixed regarding its benefit for brain health and general inflammation, so I don’t have a firm recommendation.
If your child eats fatty fish (e.g. salmon, sardines) twice a week, then they may be getting enough of these healthy fats.
Many kids don’t eat fatty fish that often (if at all), so I do recommend a fish oil supplement. You can get liquid supplements in quite lovely flavours. Follow the directions on the bottle for the age of your child.
If you don’t like the idea of your child consuming fish, look for an algae-based omega-3 supplement. There are lots of these on the market now.
I’ve noticed that some of the kids' omega-3 liquid supplements include vitamin D, so you may be able to get both in at the same time.
Eating nuts, seeds, and their butters (e.g. almond butter) daily is also a great way to contribute to a healthy ratio of omega-3:omega-6 fats.
I write this blog to be of service to you. So I love it when readers write in with topic ideas. What’s on your mind that I can answer? I want to thank the community member who asked me to address: should I take a multivitamin. Here’s what I think about multivitamins.
First I need to tell you that when it comes to nutrition, one size doesn’t fit all. We each have different nutrition needs – based on our sex, age, physical activity, health concerns, etc. And, our eating habits vary widely. That’s why for my 40 Days to a Happy, Healthy You weight loss program, the first thing I do is a nutrition assessment of you. It’s from the results of my nutrition assessment that I create your individual action plan. So, without doing an individual nutrition assessment, I can’t really answer whether you, specifically as an individual you, should take a multivitamin.
However, I can share my thoughts on multivitamins for adults in general for you to consider.
I do recommend a daily multivitamin if you’re a woman of childbearing age.
Who is that? Girls and women from first period to last period. The reason is that it’s estimated that 50% of pregnancies are unplanned. Also, the risk of spina bifida is greatly reduced (although not 100% preventable) when women take 400 micrograms of folic acid (also called folate) in those first few days of pregnancy (i.e. before most women know that they’re pregnant). An unplanned pregnancy can be stressful enough. An unplanned pregnancy with a child who has a significant medical condition that could have been prevented – significantly more stressful. Even if you don’t ever get pregnant, folate is a B-vitamin that’s good for our own health too.
Sure, you could take folate on it’s own. But multivitamins designed for women under 50 will have 400 micrograms of folic acid in them. Getting some extra vitamins and minerals (e.g. iron, calcium) along with your folic acid is probably a good thing.
I do recommend a daily multivitamin for women and men 50 and up.
Why? For the vitamin B12. At first, low B12 causes you to feel tired, lethargic, dragging. Often people think that they may be feeling this way because they have low iron. But it’s rare for men to have low iron. And, it’s rare for women who aren’t menstruating to have low iron. If your vitamin B12 levels get even lower, it causes permanent cognitive impairment. Let me repeat and clarify that. If your B12 levels get too low, you get memory loss that doesn’t return even if you raise your B12 levels back up again. Yikes! Why the concern after 50 years old? After 50, many of us have a decreased ability to absorb the vitamin B12 that we get through food. This is particularly true if you take medications for acid reflux (heart burn), and is a side-effect of a number of other medications. Getting vitamin B12 in the form of a supplement doesn’t require the same stomach function as vitamin B12 through food. We don’t have recommendations on how much you should get in a supplement. It’s somewhere around 2.4 micrograms daily.
Sure, you could take vitamin B12 on it’s own. Some people choose to get vitamin B12 shots (injections). But multivitamins designed for adults 50+ have vitamin B12 in them. Getting some extra vitamins and minerals (e.g. calcium) along with your vitamin B12 is probably a good thing.
What if I’m not in those two groups?
Then I don’t have strong feelings either way about whether you should take a multivitamin.
Want to know more about what vitamins you, as an individual, should take? Check out my Individual Nutritional Assessment Service (including individual action plan) today.
Something that I’m noticing in working with clients who are 50 or older is that most don’t know that they should be taking B12 by supplement. This is not a new recommendation, but it is little-known.
B12 is required for our brain’s function. If our B12 is low, we lose cognitive function. The scary thing about B12 is that even if we get our B12 back up to healthy levels, any cognitive function lost is lost forever. It never comes back. Less scary, but still important, low B12 makes us have low energy and feel tired.
The recommendation for B12 is:
- 2.4 micrograms for men & women 19 years & older
- 2.6 micrograms for pregnant women
- 2.8 micrograms for breastfeeding women
B12 is found in dairy foods, meat, poultry, seafood, and eggs. As such, vegans of all ages are recommended to take a B12 supplement. Either as a vitamin or nutritional yeast.
The first step in absorbing B12 from the food we eat requires our stomach acid. In a significant portion of people over 50 years old, stomach acid weakens. The result is that they can’t absorb the B12 from the food they eat. Currently there isn’t a test to find out who has this lower stomach acid and who’s stomach acid is normal. Because of the scary consequences of low B12, it’s recommended that everyone over 50 years old take a B12 supplement. B12 from supplements doesn’t require the stomach acid step for absorption.
If you take a multivitamin for 50+ you’re likely already getting B12. The B12 is one of the differences that makes vitamins specific for 50+. To be sure, check your vitamin’s label. Don’t take a multivitamin? Look for a B12 vitamin or B complex with approximately 2.4 micrograms of B12. It’s one of the easiest steps for brain health.
Curious about how I can help you achieve your health and nutrition goals? Schedule a (free) call to find out.
I was planning to write about a different topic today. But a conversation that I had last night with a parent was a conversation that I have very frequently with parents. It inspired me to change my plans and make it the topic that I address today. This topic is vitamin D. Particularly, that kids need vitamin D supplements. It’s quite an interesting situation really. Almost every parent I speak to knows that their baby needs vitamin D if they’re breastfed or fed a combination of breast milk and formula. Many of the adults take vitamin D themselves. But somewhere along the way as their little one started to eat more solid foods and stopped breastfeeding, they stopped giving their little one vitamin D. When you step back and look at it from that perspective – that babies and adults both need vitamin D supplements, it’s not surprising that kids need vitamin D too. Yet almost no parents I speak to are giving it to their kids.
Here’s the current recommendations*:
- Babies 0 – 6 months: 400 IU (safe upper limit 1000 IU)
- Babies 7 – 12 months 400 IU (safe upper limit 1500 IU)
- Kids 1 – 3 years 600 IU (safe upper limit 2500 IU)
- Kids 4 – 8 years 600 IU (safe upper limit 3000 IU)
- Kids 9 years – adults 70 years 600 IU (safe upper limit 4000 IU)
- Pregnant and breastfeeding women 600 IU (safe upper limit 4000 IU)
What about natural sources of vitamin D? Vitamin D is found in very few foods. One serving of salmon has an awesome 600 IU. Other fatty fish are excellent sources too. If you experienced the pleasure (not) of taking cod liver oil, you were getting a rocking 1360 IU in each tablespoon. The problem is that few of us eat fatty fish every day (or expose ourselves to the torture of cod live oil). People often think of milk when I talk about vitamin D but a glass of milk only has 100 IU. If a child is drinking 6 glasses of milk a day to get their vitamin D, they’re drinking so much milk that it’s crowding out other healthy foods (like vegetables and fruits) that provide other important vitamins, minerals and other nutrients.
The other natural source of vitamin D of course is sunlight. You likely know vitamin D as the sunshine vitamin. The problem is that here in Canada we don’t make vitamin D from October through March, even on sunny days, because the light’s wavelengths aren’t right. In the summer, clothes, sunscreen, shade, smog, and window glass all block our ability to make vitamin D from the sun.
Because vitamin D exists in few foods, and because of our indoor/sun safe lifestyles, supplements play an important role. If you are currently giving your child a multivitamin (such as a gummy), check the label to see how much vitamin D it contains. Some fish oil liquids contain vitamin D. If you give your child fish oil, check the bottle’s label to see if it contains vitamin D. Vitamin D drops are tiny and have no flavour so they’re a super simple way to give your kids (even picky eaters) vitamin D.
In summary, few kids meet their vitamin D needs through natural sources alone. There’s a number of ways to give your child enough vitamin D through supplements. Choose amongst the options of multivitamins/gummies, fish oils and/or vitamin D drops.
* Research is happening into whether the vitamin D recommendations should be higher. Until lots of large studies have been completed, as well as studies of the safety of higher doses, I recommend keeping within the range listed here.
It’s that time of year. Colds are going around. With the holidays picking up we’re going to be susceptible to more of them as we gather for events, get even less sleep, and travel in airplanes, on ferries, etc. Last week I was inspired by some clients to check into what the scientific literature says about supplements and the prevention and treatment of colds. Here’s what I found out about a number of commonly used remedies. An important note is that these results and advice are for adults. Often there isn’t enough evidence regarding effectiveness and safety for kids.
Taking vitamin C daily doesn’t likely reduce the risk of getting a cold for most people. But there is evidence that athletes (i.e. those experiencing extreme physical stress) may get fewer colds. I don’t know about you but I would call lack of sleep and/or travelling to be “extreme physical stress”. As such, I think that taking some extra vitamin C during these times may help reduce the chances of getting a cold. If you do get a cold, taking 200mg or more of vitamin C may reduce how long your cold lasts.
Zinc lozenges likely help reduce the length of a cold. Take 75mg or more of zinc via lozenges starting within 24 hours of your cold symptoms and continue to take them until you feel better. Don’t take high doses of zinc long-term. There isn’t evidence that zinc helps to prevent colds. And, high doses of zinc can interrupt the absorption of other important nutrients.
Taking North American ginseng once you feel a cold coming on may decrease the length of time that your cold lasts. Taking ginseng doesn’t seem to reduce the risk of getting sick.
Taking probiotics strengthens the immune system and can decrease the length of time that you’re sick.
Other Supplements Can Fight Colds
The scientific evidence isn’t supportive for the following. This doesn’t necessarily mean that they don’t work. It may mean that there haven’t been enough studies done, that there are problems with the design of studies, or that there are so many types of a supplement that we can’t make a clear decision based on the studies done to date.
- Echinacea purpurea