Elizabeth lends her advice to KABC Los Angeles:

With no obvious indicators we’re deficient, it is a silent crisis. Dietitian Elizabeth Somer points out who among us is more at risk.

“As we get older we get less and less efficient at making vitamin D,” said Somer. “Most of us wear sunscreen because we’re concerned about getting skin cancer. So as you get older, if you’re skin is dark, if you wear sunscreen or your indoors a lot, it’s just a given you’re going to be vitamin D deficient.

View the video here.

Q: What vitamins do your recommend for women after age 50?
– Patricia in San Diego

A: You can get the basic vitamins and minerals from three supplements. First, take a moderate-dose vitamin and mineral supplement that supplies a wide variety of nutrients in doses of about 100% of the Daily Value as listed on the label. Second, take a calcium-magnesium supplement with a ratio of 2:1, or about 500 milligrams of calcium and 250 milligrams of magnesium. Third, take 100IU to 400IU of vitamin E. You shouldn’t spend much more than $10 a month for this supplement plan, but can rest assured that you are getting the vitamins and minerals in the right proportion. Of course, supplements alone won’t guarantee wellness. You must eat really well and supplement responsibly to ensure optimal nutrition. -Elizabeth Somer

Nine out of ten women think they eat well. Most of them are singing those praises to the wind. In researching my latest book – Nutrition for Women, 2nd edition (Owl Books 2003), I found that only 1 percent of us meet even minimum standards of a balanced diet. According to a USDA study, less than 19 percent of women who rated their diets as excellent, actually ate reasonably well.

Women’s eating styles are more like an hour-glass than a pyramid. We eat unprecedented amounts of sugar and fat from the top of the Food Pyramid and platters of refined grains from the bottom tier, but are sorely lacking in the vegetables, fruits, milk products, and other nutritious foods in the middle of the Pyramid. It’s not that we don’t know better. The majority of women know it’s important to cut back on sugary and fatty foods, yet only a third of us meet the recommendations to keep fat at no more than 30 percent of calories and the average woman consumes 158 pounds of sugar each year. We also are whole-grain phobic, including less than one serving of brown rice, whole wheat, quinoa, or any other real grain in our daily diets.

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Q: Are water-soluble vitamins better than regular vitamins?
– Phil in Louisville

A: Vitamins are classified as either water-soluble or fat-soluble. The B vitamins and vitamin C are naturally water-soluble and are essential nutrients in the daily diet. The fat-soluble vitamins are vitamins as A, D, E, and K. Unless you have a diagnosed fat-absorption problem, such as cystic fibrosis or Tropical Sprue, you do not need expensive water-solublized fat-soluble vitamins. A regular multiple vitamin and mineral supplement that provides 100% of the Daily Value for vitamins A, D, E, and K is all you need. -Elizabeth Somer

Q: What is the best time of day to take my multi-vitamin?
– Dave in Santa Fe, New Mexico

A: It doesn’t matter when you take your supplement, as long as you take it with food to maximize absorption. (Women also don’t want to take a multi-supplement at the same meal that they drink tea or coffee, since tannins in these beverages will block iron absorption.) Studies have not proven that taking your supplement at one time of day or another or even that taking a single nutrient, such as calcium, at a particular time of day has any effect on its absorption and use in the body. -Elizabeth Somer

Q: What are the best vitamins and dietary habits for people with rheumatoid arthritis?
– Rahul

A: Diet is linked to arthritis in two ways. First food components might provide allergic responses and second, diet can alter immune and inflammatory responses. Although diet is only one factor in the development, progression, and treatment of rheumatoid arthritis (RH), there are some habits that might help. People with RH often consume inadequate amounts of vitamin D, folic acid, vitamin B6, vitamin C, iron, copper, selenium, and zinc. Whether these deficiencies are a cause or result from the disease is unclear. However, a few studies have found that increasing intake of nutrients, such as folic acid, alleviates some symptoms such as joint tenderness. Antioxidants, such as vitamin E and selenium, reduce free radical damage to joint linings. Finally, fish oils found in salmon and other fatty fish or taken as capsules have shown promise in reducing symptoms of morning stiffness. -Elizabeth Somer

Q: I just found out I’m pregnant. I have been taking iron supplements and prenatal vitamins. Could I be taking too much iron?
– Melissa from Bolivia

A: Possibly, but probably not. Most women approach pregnancy marginally nourished in iron and then pregnancy just adds to the body’s iron needs. Pregnant women can take between 30mg and 60mg of supplemental iron usually with no problem. But, to be safe, you should have your iron status measured, and not just for anemia, which is the final stage of iron deficiency. For weeks and months prior to becoming anemic, a women can be iron deficient with similar symptoms of fatigue, poor concentration, and increased susceptibility to colds. So besides the tests for anemia (hemoglobin and hematocrit tests), ask you physician for a serum ferritin test and a total iron binding capacity (TIBC) test. Then ask for the results. If your serum ferritin is below 20, or your TIBC is above 450, you are iron deficient. If not, or if your serum ferritin is above 200, then you should cut back on supplemental iron. -Elizabeth Somer