Vitamins and minerals probably cause more "diet failures" than any other single factor. But this is only because people "take them for granted".
Most people don't know how many vitamins or minerals there are, much less how these substances will affect a weight-loss diet. Although there is nothing surprising about this ignorance, it's "a set-up for failure".
In modern societies, most of the vitamins and minerals really are "ultra-easy" to handle, if you know how. Several, however, are not so easy and they are the ones that cause 99% of the problems.
The lack of any vitamin or mineral will destroy a diet because this lack will trigger hunger (or some other "food-seeking" behavior), and you can't stay on a diet very long when you are constantly hungry or thinking about food.
So the general approach to vitamins and minerals is to make sure you get enough of each of them. But on a diet, this won't just happen by itself. (It often doesn't happen by itself even in "ordinary life".) Instead, you must do specific things to make sure it happens.
Officially, there are 13 vitamins and 15 minerals (28 total). But for dieters, the "vitamin vs. mineral" distinction is not very important.
What is important -- and it is very important -- is the "macromineral" vs. "vitamin/trace element" distinction.
Of the 28 known vitamins and minerals, 21 are vitamins and "trace elements". These are substances your body needs in very small quantities. "Small", in this case, means less than one milligram per day. This means you can take a single multivitamin/mineral supplement tablet and get your full daily requirement of each of these 21 with no further fuss or bother.
The remaining 7 of the 28 are "macrominerals" -- and they are different. Your body needs them in large quantities -- 1000 or more milligrams per day (magnesium excepted). You cannot take these amounts together in a single tablet because the pill would probably be too big to swallow (and there could be other problems as well.)
Because the macrominerals are needed in such large quantities, you often won't get enough of them just from food, because on a diet you aren't eating much food and only a very few foods have them in high enough concentrations to make up for these small quantities.
Therefore you need an eating technique that makes sure you get enough.
Vitamins, trace elements, and ultra-trace elements are nutritional substances required in relatively small amounts. Together, they represent a fascinating subject to which general information does a terrible injustice—it mostly ignores them. We don’t do this out of disrespect for them, however. We do it simply because science and technology have created a simple solution to the practical problems of these substances for dieters:
Take a good multi-vitamin/mineral tablet every day and you can assume that you have eliminated 97.5% of your risk that any “subclinical” deficiency of vitamins and trace elements will create hunger.
“Good” does not mean most expensive or best known. It simply means that the tablet(s) have 100% of the RDI of the most vitamins and microminerals.
This simple technique effectively eliminates about one-half of the total number of nutritional inadequacies that could wake The Beast and destroy your diet. (You’re not “home-free”, of course, because any one of the others can still create hunger and destroy your diet all by itself.)
The above point about “simple solutions” for vitamins and trace elements does not apply to the “macrominerals”—which are the seven minerals required by the body in relatively large amounts (arbitrarily defined by professionals as more than 100 mg per day). Macrominerals require serious attention if you wish to prevent “diet-destroying” problems. The main purpose of this chapter is to provide you with the best knowledge currently available to do the job.
The basic issue with the macrominerals is that either too little of them or too much of them is known to disturb many physiologic functions (particularly cardiac function).
Therefore, getting too little of them can not only create hunger but can actually be dangerous if you happen to be able to keep doing it for a long time. Any diet on which you either ignore the macrominerals (and become mineral deficient) or on which you “overenthusiastically” supplement minerals (and create a toxic condition), can eventually get you into serious trouble. (Of course, if you do either of these things, you’re no longer on this diet at all. Instead, you’ve put yourself on some sort of “Heroic” Diet of your own devising.)
Macromineral supplementation while dieting is important for everyone. But if you are one of the heavier readers of this diet (e.g. a BMI over 30), it is especially important for you. The reason for this is that you will probably find that you have no difficulty staying on the diet for as long as you need while steadily losing weight.
Of course, losing weight is a good thing and it’s the reason you’re reading this. But, if you fail to supplement the macrominerals—or if you supplement them in a haphazard way—you will almost certainly become dangerously deficient in one or more of them over the relatively long time you are dieting. And you may not notice that this is happening. THIS IS NO-KIDDING DANGEROUS! A prolonged drain of any of the seven macrominerals will eventually cause serious and life-threatening cardiac arrhythmias.
Even if you are not very heavy, the same thing could still happen to you if you are in a marginally deficient state with one or more of the macrominerals when you start dieting. Many large and well-funded population surveys have shown that certain marginal mineral deficiencies are quite common even in “advanced industrial societies”. (See below.)
Please take this issue very seriously. I want you to lose that fat, not your health.
The various official organizations that create the RDIs have simplified these issues for us by taking such factors into account as much as currently possible when they set the RDI amounts for each individual mineral. (That’s why scientists get the “big bucks”.)
The part we as dieters must still do for ourselves is to learn to combine the foods we eat and the supplements we take to achieve the approximate RDI amounts of each macromineral without either overshooting or undershooting the proper amounts too much or too often. Fortunately, it’s not difficult to do—with a little knowledge and technique.
There are a number of food factors known to have some of the characteristics of essential nutrients. For various reasons they are not (yet) officially considered essential. I take no position on these factors other than to say that if you know about them and decide to take them as supplements, be sure to count any calories that may come with them. If you don’t take them, it probably won’t matter because most of them seem to be needed in quantities so small they can almost drift in on the dust you breath.
As I mentioned in Part One, the diet view of vitamin and mineral supplements is that they are the dieter’s second most valuable tool for success (the first is knowledge). When you restrict food in order to lose weight, you are—by definition—restricting nutrients of all sorts, not just Calories. Your body can easily do without the Calories because it has an “ample adipose accretion” of them in reserve.J But it’s likely to get very unhappy about doing without some of the other nutrients—because it probably doesn’t have ample reserves of those. If it gets unhappy, it’s likely to create hunger to try to make you go get what it needs. But since hunger is not smart enough to do this without getting lots of calories besides, you get caught in a vicious circle. The way to break out of this circle is to first restrict food (and the calories it contains) and then to intelligently use supplements and certain concentrated natural foods to add back the non-energy nutrients that you still need.
The vitamins and trace elements are easy—they can be supplemented in the form of a single “multi-vitamin/mineral” tablet daily. The macrominerals, however, take up too much space to fit in a single tablet, so we have to “supplement the supplement”, and that takes some know-how.
A review of the medical literature (see below) shows that, in general, with the macrominerals:
It is possible to poison yourself by supplementing macrominerals at high levels for long periods. Potassium is especially dangerous in this regard, the others less so.
It is both easy and common to get marginally too little of several macrominerals—even during “normal” eating. (This is called a primary deficiency). Calcium and magnesium, as well as the trace elements iron and zinc, almost always show up on surveys measuring these sorts of issues.. Simpleminded low-Calorie or low fat dieting can easily make the situation much worse.
Getting too much of some macrominerals can probably cause relative deficiencies of others even when you are getting RDI amounts of these others. This happens because of their metabolic effects on each other (see below). The threshold theory suggests that relative deficiencies will create hunger just as primary deficiencies will.
The following sections give you basic information about what supplements are available, what the food sources are, and other useful information.
Note: I have not provided information on interactions between macrominerals, because interpreting this information is a problem even for researchers.
One of the issues is that different forms of each mineral may interact differently. For example, magnesium carbonate and magnesium oxide are two (among many) different forms of magnesium. Each of them may interact in a completely different way with the various chemical forms of other macrominerals. Therefore when researchers and others say that (e.g.) magnesium may interfere with the absorption of zinc, they are probably correct—for some forms of these minerals. Other forms of them probably won’t interfere with each other at all—and outside of a testing lab there’s probably no way to know for sure. Until more research gives us better information, we just have to accept this uncertainty.
Blood levels of potassium, calcium, phosphorus, magnesium, sodium, and chloride can all be measured by commonly performed, relatively inexpensive medical tests. For you, these tests are a simple matter of your doctor’s office drawing a blood sample and sending it off to the testing lab they use.
If you ever have reason to believe you are in either a deficient or toxic state with respect to any of these macrominerals, you should not hesitate to suggest such tests to your doctor as a starting point for discussion and diagnosis.
As always, if you know, believe, or even suspect that your health is less than excellent, you should make your doctor aware of your intention to diet and to take mineral supplements before you start doing it.
1000-mg is the Daily Value (DV) for calcium set by the U.S. Food and Drug Administration (FDA). The Food and Nutrition Board set the official scientific U.S. RDA for calcium at between 800-mg and 1200-mg for adults depending on age and sex. Virtually all specialists consider a total intake of up to 2000-mg per day to be safe. The healthy adult human body normally contains a total of about 1,200,000-mg (1,200-g) of calcium. The chemical symbol for Calcium is “Ca”.
A lack of sufficient dietary calcium is a serious problem for most people. Numerous dietary surveys have shown that almost no group of people in the U.S. routinely gets enough calcium. For example, the USDA’s Nationwide Food Consumption Survey showed that the average for all people was about 750-mg per day. This is below the minimum recommended 800-mg. By diet logic, this means hunger is almost certainly awake making these people eat too much (or too often) in its attempt to get them enough calcium to keep them healthy. We need to learn to help hunger do a better job than it can do on its own.
Humans can usually absorb only about 20% to 40% of the calcium in food. This is not as high a percentage as with most of the other macrominerals and makes it somewhat more difficult to get enough useable calcium. There are also several substances, including other macrominerals, which may further reduce the “absorbability” of calcium, thereby aggravating the problem (see below).
The calcium RDIs take this known low absorbability into account (they are much higher than they would be if they assumed 100% absorbability).
If you are getting enough calcium in your food, your body can prevent an excess of calcium by changing absorption and excretion through the intestines and kidneys, respectively.
Symptoms of possible calcium deficiency can be any of the following: muscle weakness or twitching; muscle pains and cramps; brittle nails; numbness; stiffness and tingling in hands and feet; lower back pains; insomnia; irritability; depression.
Note that your body has a very large reserve of calcium in your bones. When the body lacks enough dietary calcium for metabolic requirements, it withdraws the calcium it needs from bone. This weakens the bone. It seems likely that if all other dietary conditions are correct, the body can put calcium back into the bone later. But meeting all such conditions may not happen very often. There is no scientific consensus on this and we should not count on it.
Symptoms of possible calcium excess can be abdominal pain, nausea, constipation, and muscle weakness.
Meat, fish, poultry, and most of the other high-protein foods are negligible sources of calcium. Fresh fruit is also a generally poor source. Much of the calcium in vegetables is unavailable because it is locked up in phytates, oxalates, and other unabsorbable forms. Dairy foods are the way most people usually get most of their calcium, but except possibly for skim milk, you probably won’t be eating much dairy food while dieting. Therefore, it is very important to supplement calcium when you are dieting.
There are many types of calcium supplement available and they are all adequate for dieters. The calcium in most of them is absorbed about as well as the calcium from milk. Calcium tablets are the most convenient and are available in supermarkets, drugstores, and health-food stores. Dolomite powder (calcium and magnesium carbonate) generally has a good cost/effectiveness ratio and more calcium by weight than more expensive formulations. A level teaspoon of dolomite has approximately the RDI amounts of both calcium and magnesium in approximately the proper (2:1) ratio to each other. It is much better absorbed when taken with food. Mixing it into skim milk works well. (For a review of standard calcium supplements, see Levenson and Bockman 1994) Dolomite is usually only stocked in health-food stores.
Vigorous supplementation of calcium is probably justified on almost all weight-loss diets. If you are like most people, your normal diet is probably at least marginally deficient in calcium. The usual Heroic Diets only make this worse. Even typical foods on this diet can be poor sources of calcium. Therefore supplementing calcium is important when you are dieting.
400-mg is the Daily Value (DV) for magnesium set by the U.S. Food and Drug Administration. The Food and Nutrition Board set the official scientific US RDA at 4.5-mg magnesium per kg of body weight. The healthy adult human body contains 20,000- to 30,000-mg (20–30 g) of magnesium. The chemical symbol for magnesium is “Mg”.
The FDA’s Total Diet Study showed normal U.S. intakes of magnesium intakes to be in the 200-mg to 300-mg range. This is probably submarginal for most people. The U.S. Third National Health and Nutrition Examination Survey (NHANES III) also shows that U.S. adults over the age of 16 usually do not get enough magnesium in their normal diets. Marginal magnesium deficiency is therefore considered to be common.
About 50% of dietary magnesium can typically be absorbed by the small intestine. The kidney can easily excrete any excess that may be absorbed. Together these two organs can maintain tight homeostatic control over very wide dietary intake ranges. Because of this, it is considered extremely unlikely that anyone would get too much magnesium from food alone.
Known magnesium deficiency symptoms include: weakness, tiredness (lack of energy), dizziness, nervousness, irritability, muscle cramps, tremors, twitching, unsteady walking, irregular heartbeat, loss of hair, mental confusion, disorientation. (Magnesium supplements will reverse these clinical signs within a few days.)
Known magnesium toxicity symptoms include nausea, vomiting, slowed breathing, and coma. However, a toxic condition is difficult to achieve without taking pure magnesium salts.
The protein foods you eat on the diet are relatively poor sources of magnesium. Fish, meat, milk, and most commonly eaten fruits have relatively little of it.. Vegetables and unrefined grains are somewhat better. However, in many such foods, the magnesium is in the outer skin or husk. Food processing techniques tend to remove this and thereby reduce the amount of magnesium available. It is not usually added back during enrichment. Diuretics, including alcohol and caffeine, also cause increased magnesium losses.
Fortunately, magnesium supplements are easily available: dolomite, magnesium carbonate, magnesium citrate, magnesium aspartate, magnesium fumarate and magnesium amino acid chelates. (Note: the magnesium from magnesium oxide and magnesium hydroxide is not well absorbed, so these forms are more usually used as laxatives or antacids.) Magnesium tablets are available in supermarkets, drugstores, and health-food stores. The tablets that combine calcium and magnesium are usually the most convenient.
Your normal diet may well be marginally deficient in magnesium. A reducing diet will likely make this worse unless you supplement magnesium in some way. Therefore, a supplement of one-half the RDI is probably a minimum supplement. If you somehow get too much, your kidneys can usually remove it, so it probably isn’t dangerous. But don’t routinely overdo, because if your body has to excrete large amounts of magnesium, it may have to use up too much calcium, phosphorus, or other such resources in the process—and this can cause relative deficiencies of these things.
1000-mg is the Daily Value (DV) for phosphorus as set by the FDA. The Food and Nutrition Board set the official scientific US RDA at 800-mg to 1200-mg. The phosphorus RDA is intended to equal the calcium RDA for any given individual. There are between 500,000- and 650,000-mg (500–650 g) of phosphorus in the healthy adult human body. The chemical symbol for phosphorus is “P”.
In “normal life”, there is only a very small possibility of a phosphorus deficiency because phosphorus is both abundant and widely distributed in most foods. The various food additives in processed foods are also major sources and may contribute up to 30% of total phosphorus in a diet based heavily on convenience foods. However, on a diet, there is a greater chance of phosphorus deficiency because less total food is eaten and very little of it is the usual type of “processed” food.
Phosphorus (as phosphate) is more efficiently absorbed in the small intestine than most other minerals. Between 50% and 90% is absorbed depending on the need. This is much higher absorption percentage than for either calcium or magnesium and further reduces the likelihood of phosphorus deficiency under normal conditions.
The kidneys easily control the blood phosphorus level and efficiently excrete any excess phosphorus. Therefore, under normal circumstances, phosphorus toxicity is also unlikely.
Phosphorus deficiency is often characterized by weakness, malaise, stiff joints, and bone pain. It may also cause glucose intolerance, irregular heartbeat and difficulty breathing. Phosphorus deficiency results in bone loss just as calcium deficiency does.
Phosphorus toxicity probably results in twitching, jerking, and convulsions.
1000-mg is the Daily Value (DV) for phosphorus as set by the FDA. The Food and Nutrition Board set the official scientific US RDA at 800-mg to 1200-mg. The phosphorus RDA is intended to equal the calcium RDA for any given individual. There are between 500,000- and 650,000-mg (500–650 g) of phosphorus in the healthy adult human body. The chemical symbol for phosphorus is “P”.
In general, good sources of protein (meat, poultry, fish, and milk) are also good sources of phosphorus. Cereal grains are also considered good sources. However, vegetables and fruits are much lower in available phosphorus, probably because in vegetables, much of the phosphorus occurs in the form of phytate. Humans lack the required enzyme (phytase) to digest phytate.
Phosphorus supplements come in the form of ammonium phosphate, bone meal, calcium phosphate, dicalcium phosphate, lecithin, monosodium phosphate, and various amino acid chelates. They are usually available in health-food stores but not supermarkets or drugstores. You may have to ask for them. They are often not big-selling items.
Phosphorus is common both in your normal diet and in the high-protein foods you will be eating on the diet. However, because you eat less total food on this diet, it is still a good idea to supplement phosphorus. 50% of the RDI as a supplement is probably more than sufficient.
3500-mg is the Daily Value for potassium set by the U.S. Food and Drug Administration. The Food and Nutrition Board did not set an official scientific US RDA but it did estimate that a “Safe and Adequate Intake” range would be between about 2000-mg and 3500-mg per day. It also stated that the higher figure was probably closer to the optimal amount. The healthy adult human body contains a total of about 180,000-mg (180-g) of potassium. The chemical symbol for potassium is “K”.
Surveys show the normal adult dietary intake of potassium at between 1950-mg and 5900-mg per day 3400-mg/day is typical of the young adult age group and other age groups are generally below this amount. People who eat large amounts of fruit and vegetables may have potassium intakes as high as 8,000–11,000-mg per day
Intestinal absorption of potassium is very efficient—more than 90% is absorbed. Excretion of excess is also very efficient—therefore the kidneys can regulate blood concentrations effectively over very wide intake ranges. However, the kidneys do not conserve potassium as well as sodium.
A primary dietary deficiency of potassium is not considered likely during normal eating because potassium is so widely distributed in foods. However, with a few exceptions, the overall effect of food processing has been to reduce the amount of potassium and increase the amount of sodium in modern food supplies. Alcohol and coffee will also increase the normal losses of potassium.
Your goal is to keep your average potassium intake (from both food and supplements) at about 3500-mg per day.
A potassium deficiency may cause all or some of the following symptoms: low energy level, muscle weakness (skeletal, intestinal, heart, and respiratory muscles); difficult breathing; irregular heartbeat; listlessness; drowsiness; irritability; swollen abdomen; nausea; vomiting; diarrhea; paralysis. Potassium deficiencies are known to occur on poorly constructed weight-loss diets.
Excesses (as well as deficiencies) of potassium can also cause irregular heartbeat. Many people can feel this as a difficult-to-describe “sensation” in the chest. Abdominal discomfort and diarrhea is often the main symptom of a single large dose of a potassium supplement.
Excessive levels of potassium in the blood can cause cardiac arrest. The Food and Nutrition Board has stated that this level of acute toxicity will result from sudden increases in potassium intake to about 18 grams (18,000-mg) per day for an adult. A fatal heart attack can be the result. This means that taking a large single dose of a potassium supplement (which may enter the blood very rapidly) is incredibly foolish. (This is also one of the reasons that supplement manufacturers generally do not make potassium supplements available in amounts greater than 99-mg per tablet.)
Tomato sauce, dehydrated fruits (prunes, raisins, dates, etc.), beans, lentils, wheat bran, and banana are very good sources of potassium. Beef, veal, potatoes, and spinach are fair sources. Most vegetables (except spinach) and fruits (except banana) are fair to poor sources of potassium.
Potassium supplement tablets typically come in the form of potassium gluconate. Supermarkets often carry (in the salt section) a 50/50 mixture of potassium chloride and sodium chloride (table salt) as a “Lite” salt substitute. One-half of a level teaspoon (2.8-g) of this mixture contains about one-quarter of the recommended amounts of both potassium and sodium (about 700-mg and 600-mg respectively). This makes it a convenient way to add potassium and sodium to low-Calorie diet food. (Keep in mind the above and below warnings about too much at one time, and too much continuously over a long time—I don’t want you to hurt yourself.)
Potassium gluconate supplements are typically available as tablets containing 99-mg of potassium each. This means that five (5) tablets contain approximately the same amount of potassium as one medium banana (7–8 inches long, 467-mg potassium, 108 Calories). The “Lite” salt substitute (potassium/sodium chloride) is usually available in supermarkets. Potassium gluconate tablets are usually available in supermarkets, drugstores, and health-food stores.
During normal eating, it is not likely that many people will experience primary dietary deficiencies of potassium—too many foods have potassium in them. However, when dieting, a primary potassium deficiency becomes easy to create. Your body needs more potassium daily than any other mineral. And even though many foods have lots of potassium, dieters don’t eat “many foods”, they eat smallish amounts of a smallish selection of low-fat, low-Calorie foods. Often these foods in these amounts won’t provide enough potassium.
Therefore, supplementing foods to ensure you get approximately the RDI of potassium is very important. Please take this point very seriously. A small daily potassium deficiency can add up (over a period of time) to a sudden attack of cardiac arrhythmia, which will—at minimum—scare the hell out of you! (This point applies to a lesser degree to the other macrominerals as well.)
Additionally, because large amounts of sodium are often added to foods (causing increased potassium excretion), it is possible that relative short-term potassium deficiencies are common for many people even during “normal” eating. In diet terms, this means they are hungry, making them eat too much—which in turn makes them get too fat. Obviously, on the diet, you won’t be adding large amounts of sodium to your food so this is particular issue will not be a problem. (However, please read the warning about too little sodium below.)
Because of the efficient absorption of potassium and the dangerous effects of suddenly raising blood levels of it too high, it is particularly important to (1) never take too much at once and (2) drink sufficient water so that the kidneys can excrete any excess and manage blood levels properly. (See more on… water.)
Note that a daily excess of potassium (meaning more than the kidney can excrete daily) will eventually cause a toxic buildup of potassium in the tissues. This can be as dangerous over time as a daily deficiency. Even while dieting, you will probably get in the range of 1500- to 2500-mg of potassium from food. So I suggest that you do not ever take more than 1500-mg of potassium per day as a supplement unless you are using a food composition table to monitor the total amounts of potassium you are actually getting from your food.
2400-mg is the Daily Value for sodium set by the U.S. Food and Drug Administration. As with potassium, The Food and Nutrition Board did not set an official scientific US RDA but did estimate the “Safe and Adequate Intake” range at between 500-mg and 2400-mg per day. The healthy adult human body contains about 85,000-mg (85-g) of sodium. The chemical symbol for sodium is “Na”.
Surveys show that the sodium intake range is typically from 1800-mg to 5000-mg of sodium per day with 3900-mg per day being the average. This represents between about ¾ teaspoon and 2 teaspoons of salt (sodium chloride) per day. (Sodium chloride is 39% sodium by weight.) Most of this sodium is added to food in processing and at serving time.
Many of the surveys on which these estimates are based are believed to underestimate the total amount of sodium eaten because of various difficulties in study design.
Virtually all sodium is readily absorbed from the intestinal tract. Internal sodium balance is efficiently maintained over a wide range of dietary intakes by the kidneys as long as they have sufficient water to excrete any excess. This means that sodium deficiency does not normally occur.
Sodium deficiency symptoms include muscle weakness, muscle cramps, abdominal cramps, headache, sweating, nausea, vomiting, diarrhea, apprehension, and confusion. Deficiencies can and do happen on strict diets.
Sodium toxicity symptoms include firm rubbery tissue-swelling, dry, sticky mucous membranes, agitation, and hypertension.
Protein foods have more (natural) sodium than vegetables and grains. Fresh fruit has almost no natural sodium. Foods that contain added salt (sodium chloride, which is about 40% sodium) provide the primary source of sodium for most people. Most is added during commercial processing.
Table salt is the main supplemental source of sodium. A teaspoon (6-g) of table salt contains 2360-mg of sodium. You should make sure you get at least this amount per day. (Table salt is so common it seems strange to call it a “supplement” at all, but we can hardly call it a “natural” form.) A single bouillon cube contains about 1000-mg of sodium—and this is often a more pleasant way to ensure you get sodium without calories.
The best way to get your RDI of sodium is to spread a teaspoon of salt (2400-mg sodium) through your day’s meals. (See also the discussions of “lite” salt above.) A very simple and convenient way is to dissolve half a teaspoon of salt (1200-mg sodium) in a large glass of water and drink it. It is important not to ignore sodium or to take it for granted. You do need it and when dieting it is very easy to get too little. Note that both calcium and potassium supplements can cause a relative deficiency of sodium so it is worthwhile to keep in mind that 2400-mg (the RDI) may not be enough sodium if you are somehow getting large total amounts of these other minerals.
Since this is primarily a diet article, I try not to discuss other health effects of the various nutrients. Such discussions would easily add another thousand pages to the manuscript (and my evil-cyborg editors would squirt green hydraulic fluid out of their ears).
However, for years sodium has gotten such extreme “bad press” as a presumed cause of high blood pressure that dieters often unconsciously avoid it when they are dieting.
This is a serious mistake! Doing this can destroy a diet for all the reasons I’ve already stated. Therefore I will hammer the point by restating: avoiding sodium while you are dieting is a serious mistake. Sodium is a vital nutrient and too little of it causes even worse problems than too much. Keep in mind that in ordinary eating most people get far more than the RDI (2400-mg) of sodium every day—and it does them no harm.
Additionally, the science behind the “sodium/blood-pressure” relationship is nowhere near as “settled” as you may assume. (In fact there is a ferocious scientific controversy going on over it.) Some of the most interesting recent research suggests that excess sodium causes high blood pressure only when there is also an existing deficiency of other macrominerals, (particularly calcium, but possibly also magnesium, phosphorus, or potassium.) When there is no such deficiency, sodium may even help to lower blood pressure. I take no position on this, but those who wish to investigate the issue further should start with McCarron 1997and Taubes 1998 which explain the situation and provide further references.
In any case, you should know that the statistical correlation between obesity and high blood pressure is much stronger than the correlation between sodium and high blood pressure. This means that losing weight will probably lower your blood pressure far more effectively than lowering your sodium intake.
I have also been told by several dieters that they seemed to get better control of weight loss with more than 2400-mg RDI of sodium per day, so I suggest that you keep an open mind and be prepared to experiment to see what works for you.
Taken together, the above points mean that using this diets techniques to ensure that you get proper amounts of all of the macrominerals (including sodium) while also restricting Calories is likely to have a much more positive effect on your blood pressure than simply “limiting sodium”. Obviously, gobbling huge amounts of sodium (or anything else) is a bad idea, but do not make the mistake of ignoring the need to get enough sodium while you are trying to lose weight.
The dietary requirements for chloride are unknown. (Chloride is the metabolic form of the element chlorine.) The Food and Drug Administration has set a Daily Value for chloride of 3400-mg. The Food and Nutrition Board did not set an official scientific US RDA but did suggest that the minimum amount was 750-mg per day for adults. The healthy adult human body contains about 100,000-mg (100-g) of chlorine as chloride. The chemical symbol for chlorine is “Cl”.
The usual intake amounts of chloride are very high because they closely correlate with those of sodium. By weight, sixty percent of table salt is chloride.
Chloride is almost completely absorbed in the small intestine. Excess intake is probably common but is easily handled by the kidneys as long as sufficient water is available.
Chloride deficiency is characterized by slow and shallow breathing, listlessness, muscle weakness, and cramps. There are no known chloride toxicity symptoms.
Table salt (see the previous section on sodium).
None. Chloride intake and use are bound so closely to that of sodium and potassium that there is virtually no chance of any important deviation provided you are drinking enough water.
Neither the FDA nor the Food and Nutrition Board has made any official RDI recommendations for sulfur. The daily nutritional requirement for sulfur is unknown and there is very little discussion of the issue in most nutrition texts.
However, sulfur must be considered an important macromineral based on its known metabolic uses and the amounts normally present in the body. Virtually all nutrition texts simply assume (probably correctly) that an adequate intake of protein will also provide sufficient sulfur because sulfur is contained in protein’s constituent amino acids cystine, cysteine, and methionine.
The USDA Nutrient Database does not report the amounts of sulfur in various foods so it is difficult for individuals to track the amounts eaten. The healthy adult human body contains approximately 180,000-mg (180-g) of sulfur. The chemical symbol for sulfur is “S”.
Like most of the macrominerals, sulfur is absorbed primarily in the small intestine and excreted by the kidneys.
A lack of sulfur prevents growth, probably due to the associated lack of protein. Toxicity symptoms are unknown.
Meat, poultry, fish, eggs, and protein foods in general are considered good sources of sulfur. Dried beans, broccoli, and cauliflower are also good sources. I know of no available sulfur supplements. The amino acids cystine, cysteine, and methionine are assumed by almost all specialists to provide sufficient sulfur if an adequate amount of protein is eaten.
There seems to be no reason to believe that the usual assumption of adequate sulfur intake from protein is not accurate. Therefore since you will be paying strict attention to protein while on this diet, you should not have a problem with sulfur. (See more on… protein.) Sulfur supplements are unavailable (and we wouldn’t know how much of them to take if they were), so if you feel uncomfortable with the above assumption I suggest simply including several servings per week of dried beans, cauliflower, or broccoli in meals. These foods are always included on lists of “high-sulfur” foods, though the exact amounts of sulfur contained in them are rarely mentioned.
Since your internal sulfur balance, like that of the other macrominerals, is chiefly maintained by the kidneys, it is important to drink enough water to allow the kidneys to eliminate any excess properly.
You should develop a solid, convenient routine for taking supplements. This counteracts the very common tendency to begin to forget to take them after a while.
The important thing about a routine is that it be convenient. If it’s not convenient for your situation and lifestyle, then it’s the wrong routine for you and you should modify it until it is convenient. The only imperative is to somehow make sure that between food and food supplements you make sure you get approximately the RDI of all the vitamins, trace elements, and macrominerals (and the other vital factors).
One simple and convenient routine is to use the tablet form of vitamin & mineral supplements and keep them next to your toothbrush. Take the appropriate amount of each first thing in the morning. An exception is sodium because of course it’s easier (and more pleasant) to simply spread a teaspoon of salt through meals.
Note that this particular routine means that you will probably take supplements on an empty stomach. Most people do not find this to be a problem. However, if you find that it is, you can usually minimize it by making sure you eat something within about 15–20 minutes afterwards. Or you simply can take supplements only with meals.
This routine is just your starting point. Please do not blindly follow it on my say-so. If it happens to really work for you, that’s fine. If not, dump it and develop your own. And remember that no routine is a substitute for “keeping your eyes on the prize”. The prize, in this case, is making sure you have gotten approximately the RDI of each vitamin and mineral by the end of each day. Routines (and supplements themselves) are merely routes to that goal.
This diet approach to dietary supplements is to consciously ensure that you stay reasonably “close” to the RDI amounts of all vitamins and minerals. How close is “close”? The American Medical Association’s Council on Scientific Affairs reviewed the issue in 1987 and stated that “dietary supplement” amounts could be defined as amounts between 50% and 150% of the RDI of each nutrient. Higher amounts (in the range of two to ten times the RDI) were defined as “therapeutic agents” and were not recommended without a doctor’s supervision. This supplement standard is also what we suggest as the general ideal for dieters. However, keep in mind that potassium, because of its special dangers, should usually be supplemented at less than 50% of its RDI.
You’ve probably already noticed that you are eating a substantial amount of protein foods on this diet. These protein foods have considerable amounts of some of the macrominerals in them—and hardly any of some of the others. If your proper requirement of protein is contained in, for example, 12-16 ounces of beef, it is good to know about how much potassium, phosphorus, etc., you will also get from this—because it will make supplementing minerals much more accurate. (Note: You calculated your protein requirement in Table 16: Your Protein Food Requirement.)
To find out how much of each macromineral you get from the usual protein foods, use Table 22 and Table 23. Table 22 provides the reference data, and Table 23 is where you calculate the amounts that you need.
(Note: If you haven’t read more on… protein, you should do so now. The next few paragraphs could be mildly confusing otherwise.J)
In column two of Table 23 below, write down the number of ounces of each protein food that you calculated for yourself back in Table 16.
Multiply this number by the amount of each macromineral in one oz of that protein food. (You get this from Table 22.)
Write the amounts of each macromineral you calculated in the appropriate column of Table 23 for future reference.
These results are the amounts of each mineral you will get from eating your proper amount of this particular protein food.
Since these protein foods will probably make up about one-half of the total food Calories you eat daily, this calculation is very important to helping you to know whether you are getting too much or too little of the RDI of each macromineral. I strongly encourage you to take the time to do this calculation.
|
Table 22: Macrominerals in Protein Food AMOUNTS OF MACROMINERALS IN |
||||||
|---|---|---|---|---|---|---|
| Food | Amt | K (mg) |
P (mg) |
Na (mg) |
Ca (mg) |
Mg (mg) |
| Lobster (cooked) | 1 oz | 100 | 52 | 108 | 17 | 10 |
| Crab (cooked) | 1 oz | 74 | 79 | 304 | 17 | 18 |
| Shrimp (raw) | 1 oz | 52 | 58 | 42 | 15 | 10 |
| Scallop (raw) | 1 oz | 91 | 62 | 46 | 7 | 16 |
| Chicken (cooked) | 1 oz | 73 | 65 | 21 | 4 | 8 |
| Tuna (canned) | 1 oz | 67 | 61 | 14 | 4 | 9 |
| Cottage Cheese (2%) | 1 oz | 27 | 42 | 115 | 19 | 2 |
| Salmon (canned) | 1 oz | 92 | 93 | 21 | 60 | 10 |
| Beef (cooked) | 1 oz | 63 | 35 | 14 | 8 | 5 |
| Egg (1 Jumbo) | (2.3oz) | 79 | 116 | 82 | 32 | 7 |
| Milk (skim) | 1 fl oz | 51 | 31 | 16 | 38 | 3 |
| (Data is from the USDA Nutrient Database for Standard Reference (R12)) | ||||||
|
Table 23: Your Macrominerals from Protein YOUR MACROMINERALS |
||||||
|---|---|---|---|---|---|---|
| FOOD | Your Amt. | K (mg) |
P (mg) |
Na (mg) |
Ca (mg) |
Mg (mg) |
| RDI | — | 3500 | 1000 | 2400 | 1000 | 400 |
| Lobster (cooked) | ||||||
| Crab (cooked) | ||||||
| Shrimp (raw) | ||||||
| Scallop (raw) | ||||||
| Chicken (cooked) | ||||||
| Tuna (canned) | ||||||
| Cot. Cheese 2% | ||||||
| Salmon (canned) | ||||||
| Beef (cooked) | ||||||
Warning: You may notice a tendency over time to begin to stop supplementing this or that macromineral and also to fail to ensure that you get at least the RDI of it in some other way. This can happen with any macromineral, but very often it’s potassium or sodium.
I warn you about this tendency so you can resist it if it begins to happen. Allowing this to happen on a diet is dangerous! If you both restrict food and fail to supplement one (or more) of the macrominerals, there is a good chance that over a period of weeks you will become gradually deficient in it. Then one day you may begin to feel those cardiac arrhythmias that a chronic lack of the macrominerals can produce. (It’s even more dangerous if you develop arrhythmias but don’t feel them.) Please pay attention to this! If you do not consciously ensure that you are getting approximately the RDI of each essential nutrient, then you are on a Heroic Diet of your own devising, not this diet. But more importantly, you are hurting yourself! This situation is easy to prevent with supplements and food-nutrient composition tables, but you cannot safely ignore it while you are dieting.
There never seems to be any shortage of “therapists” of one sort or another ready to tell you that some of the supplement amounts discussed in this chapter are “too much”. In my always-humble opinionJ this represents nothing more than a knee-jerk Jurassic “bias” against supplements that has been widespread in the some portions of the professional nutrition community for several decades.
While I agree that fools and faddists often misuse supplements, it is an equally foolish over-reaction to “throw out the baby along with its bath water”.
Used properly, dietary supplements are one of the dieter’s most powerful tools for staying nutritionally healthy and on track in the otherwise stressful dieting situation. So if you hear such nonsense, smile politely and point out that this diet’s nutritional goals are nothing more nor less than the official Recommended Dietary Intake (RDI) amounts.
The RDIs have long been accepted as both safe and reasonable by the American Medical Association, the National Academy of Sciences, the Food and Drug Administration, the National Institutes of Health, other U.S. government agencies, and equivalent organizations in all other countries. They are even written into the U.S. Code of Federal Regulations (e.g. 21CFR101.9) which is available on the Internet at:
http://www.access.gpo.gov/nara/cfr/index.html
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