In an effort to understand a vegetarian family member's persistent anemia and osteopenia, i came to suspect that they could be inter-related. Nutrition was defiinitely an under-represented component in my training.
Calcium supplementation in clinical practice: a review of forms, doses, and indications.
"Most Americans do not meet the adequate intake (AI) for calcium; calcium supplements can help meet requirements...Calcium carbonate, the most cost-effective form, should be taken with a meal to ensure optimal absorption. Calcium citrate can be taken without food and is the supplement of choice for individuals with achlorhydria or who are taking histamine-2 blockers or protein-pump inhibitors...The maximum dose of elemental calcium that should be taken at a time is 500 mg. U.S. ..Absorption from calcium-fortified beverages varies and in general is not equal to that of milk...The risk of advanced and fatal prostate cancer has been associated with calcium intakes from food or supplements in amounts >1500 mg/d."
The inhibitory effect of dietary calcium on iron bioavailability: a cause for concern?"high intakes of dietary calcium can inhibit iron absorption if both are present in the same meal. The mechanism for the calcium-iron interaction is not known. A recent study has demonstrated that separating foods high in calcium from meals high in iron can prevent some of the calcium-induced inhibition of iron absorption."
Effect of tea and other dietary factors on iron absorption.
Several dietary factors can influence this absorption. Absorption enhancing factors are ascorbic acid and meat, fish and poultry; inhibiting factors are plant components in vegetables, tea and coffee (e.g., polyphenols, phytates), and calcium.
People participate in journal clubs or book clubs. Geek Club is my affectionate term for documenting summaries of all the geeky stuff I read. I work as a physiatrist at the East Orange VA hospital in NJ. This may also serve as a resource for the residents who rotate through there.
Thursday, December 27, 2007
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1 comment:
It is very useful information. It is practical. The poor knowledge of MD's is a matter of jokes on radio and TV shows. People with no medical degrees talk like experts, and doctors listen to them privately while traveling to their office.Our poor knowledge about nutrition is shameful. Keep doing this good work.
Harish
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