Q: Should I take my supplements with food?
– Steve in Loveland, Colorado

A: Yes. What you take your supplements with is more important than when you take them. Nutrients require digestive enzymes, small amounts of fat, and other food components to ensure absorption. So, take supplements with meals, not just with a doughnut and coffee. -Elizabeth Somer

Q: I’ve heard that calcium now comes in a chocolate candy. Is this a good supplement?
– Helene

A: Several brands of chewable chocolate-flavored calcium supplements are now available, including Viactiv Soft Calcium Chews, that tastes like a chocolate caramel. Each chew packs in 500 milligrams of calcium (more than two Tums and the same amount as most other supplements) and 100IU of vitamin D, to aid in calcium absorption. The chews don’t contain magnesium, a mineral also essential for bones, so make sure to keep eating those greens, beans, and nuts. Granted, each chew is sweetened with a teaspoon of sugar (as corn syrup) and they’re a bit pricey, but, for a few extra pennies, this is one supplement that tastes so good you’ll look forward to tomorrow’s dose. (Keep out of the reach of children, who might overdose on these tasty treats!) Look for Viactiv Chews or similar chocolate calcium supplements in your local grocery or drug store. -Elizabeth Somer

Q: What is the best supplement to take for a 45 year old woman of otherwise good health? I did the Real-Age test yesterday and was doing really well until it came to diet then I suddenly got much older! My weight is in the top of the normal range for my height.
– Barbara in Canada

A: The basic supplement program includes a moderate-dose multiple vitamin and mineral that supplies approximately 100% of the Daily Value for a wide range of nutrients. If you don’t consume daily at least three calcium-rich foods, such as nonfat milk and yogurt, and lots of magnesium-rich whole grains, wheat germ, soy products, and legumes, then consider supplementing your multiple with extra calcium and magnesium, since no one-pill multiple contains enough of these two minerals. In a few cases, you might want to tailor this basic program with a few other supplements to meet your personal needs, such as black cohosh if you’re battling menopause symptoms or glucosamine for arthritis. Two good generic supplements (you’d still need to take extra calcium and magnesium) are Centrum and Nature Made’s Essential Balance (take Centrum Silver or Mature Balance if you are post-menopausal.) The two best supplements can be obtained over the internet: NutriGuard’s Broad Spectrum (with iron if you’re premenopausal and without iron if you’re postmenopausal) or Metabolic Maintenance’s Basic Maintenance (again with or without iron). The last two are complete, so you don’t need to take anything else by those. – Elizabeth Somer

Q: What is the legal upper limit for folic acid in supplements?
– Marci in Santa Cruz

A: A level above 800mcg of folic acid is considered a prescription dose, so this is the upper limit for this B vitamin in over-the-counter supplements. Although usually you will find 400mcg in supplements for the general public and 800mcg in supplements for pregnant women, companies can add up to the 800mcg level in any supplement. Folic acid is relatively non-toxic, with levels of up to 10 milligrams given daily for four months with no harmful effects. Doses of 100 times the current recommended level (400mcg) can precipitate convulsions in people with epilepsy. And while large doses of folic acid could mask an underlying vitamin B12 deficiency, this is easily prevented by taking vitamin B12 along with folic acid. On the other hand, there is no reason to take more than 800mcg and no evidence that more is better unless prescribed by your physician for heart disease or possibly cervical cancer. The exception is for women with a previous history of neural tube defects where up to 4 milligrams a day are recommended to prevent future birth defects. -Elizabeth Somer

Q: I can’t tolerate milk products. What nutrients am I missing and what can I do to replace them other than taking supplements?
– Gity in New York

A: A person is hard-pressed to meet calcium needs (1,000 mg to 1,200 mg/day) when milk is avoided. At 300 milligrams a glass, no other food comes close to this level of calcium, except calcium-fortified soymilk and orange juice. Moderate sources include: canned salmon with bones (167 mg/3 ounces), cooked collard greens (145 mg/1 /2 cup), cooked spinach (106 mg/1 /2 cup), and cooked dried beans (45 mg/1 /2 cup). Milk (not cheese or yogurt) is the only reliable dietary source of vitamin D, a nutrient essential in calcium absorption and deposition into bones. Vitamin D-fortified soymilk and some fortified breakfast cereals are the only other dietary sources. Other than that, you must take a supplement to reach recommended daily levels of 200IU to 400IU. Milk also is an excellent source of vitamin B2 and other B vitamins, magnesium, zinc, and protein. -Elizabeth Somer

Q: Are supplements sold in liquid form better absorbed than regular supplement pills and tables?
– Laurain in New Orleans

A: There is no evidence that vitamins and minerals in liquid form are any better absorbed or utilized by the body than other forms of supplements. Despite the claims, liquid doesn’t mean these supplements are better absorbed, since the acidity of the stomach will rapidly and readily dissolve tablets and capsules. If you have trouble chewing or swallowing tablets, than turning to other forms of supplements, such as powders that can be mixed into juice or liquid supplements is one alternative. Even then, make sure the liquid supplement is well-designed and formulated. Liquid supplements are more likely than tablets to contain sugar or other ingredients to disguise sour or bitter tastes. – Elizabeth Somer

Q: Most doctors have no clue about nutrition and yet on a daily basis they consistently prescribe prescription drugs. Why is this a omission from medical training? I don’t believe drugs are always the answer to the problem. What’s your view point on natural medicine and food supplements, along with health food stores?
– Robert in Illinois

A: I’m in full agreement that most doctors know less than their many of their patients about nutrition. It’s particularly frustrating, since more often than not, to hedge their bets and protect their liability, you are told by other health-care professionals to “always talk to your doctor before taking supplements or beginning a new diet.” I don’t know why medical schools give prevention in general and nutrition more specifically so little attention. Seems like they focus more and more on medication dispensing and less and less on prevention. Even pregnant women get little or no nutrition counseling from their OBGYNs, according to the studies. There is a place for conventional medicine and there is a place for natural treatments. They are not mutually exclusive. You can’t cure cancer with vitamin supplements, but eating well is a huge contributing factor in the prevention of cancer and even in it’s treatment, along with conventional treatments such as chemo and radiation. On the other hand, some diseases such as Type II diabetes are almost completely preventable with lifestyle, and many, many cases of heart disease could be prevented and successfully treated with diet and exercise changes. – Elizabeth Somer