Posts Tagged ‘healthy diet’

2019 Healthy Eating New Year’s Resolution

January 1, 2019

Andrew Siegel MD  1/1/2019  Happy New Year!

The last few months have been a difficult time of the year for staying fit and trim, with many factors conspiring to add inches to our waistlines. It starts off with Halloween sweets and shortly thereafter, the bounty of Thanksgiving. This segues into the December holidays, which provide ample and constant opportunities for over-indulging. The cold and dark season make it more challenging to exercise outside and fuel desire for comfort foods.  So, what to do?

No carb diet?Paleo diet?Keto diet?…really?  Are they sustainable?  Not a chance!

Today’s entry is about a healthy eating lifestyle—as opposed to a diet—that will help improve your shape and shed those excess pounds that crept on over the past few months. This is a style of eating that can be easily incorporated to replace calorie-rich, nutrient-poor diets that are overloaded with processed and refined junk and fast foods.  As opposed to many fad weight loss programs that are gimmicky, unbalanced, unhealthy, unsustainable and frankly ridiculous, this approach is a no-nonsense, intelligent one—clean, lean, with plenty of green—that will stave off hunger and hold caloric intake in balance with expenditure, making it effective and durable.

The keys are sensible and nutritious eating, substituting less caloric and healthier foods for more caloric and unhealthier alternatives as well as incorporating Michael Pollen’s philosophy, Mediterranean-style eating and an 80/20 strategy.


  • Seafood and lean poultry instead of red meat (when you do eat red meat, consume only the leanest cuts and grass-fed is preferable to corn-fed)
  • Lean turkey meat instead of beef for hamburgers, meatballs, chili, etc.
  • Vegetable protein sources (e.g. legumes—peas, soybeans and lentils) instead of animal protein sources
  • Avocados instead of cheese
  • Olive oil instead of butter
  • Real fruit (e.g. grapes, plums, apricots, figs) instead of dried fruit (raisins, prunes, dried apricots, dried figs) that are energy-dense
  • Real fruit (e.g. orange, grapefruit, apple, etc.) instead of fruit juice (OJ, grapefruit juice, apple juice, etc.) since real fruit has less calories, more fiber and phyto-nutrients and is more filling than the refined juice products
  • Whole grains (e.g. wheat, brown rice, quinoa, couscous, barley, buckwheat, oats, spelt, etc.) instead of refined grain products
  • Tomato sauces instead of cream sauces
  • Vegetable toppings (e.g. broccoli) on pizza instead of meat toppings (pepperoni)
  • Unshelled peanuts instead of processed peanuts (unshelled are usually unprocessed and are difficult to over-consume because of labor-intensity of shelling, the act of which keeps us busy and occupied)
  • Flavored seltzers or sparkling water instead of soda (liquid candy) with its empty calories
  • Baked, broiled, sautéed, steamed, poached or grilled instead of fried, breaded, gooey
  • Baked chips instead of fried
  • Bialys instead of bagels
  • Wild foods instead of farmed (e.g. salmon)
  • Plain Greek yogurt instead of sour cream on baked potatoes and instead of mayo in salad dressings and dips
  • Frozen yogurt bars, which make a delicious 100 calorie or so dessert instead of ice cream
  • Soy, rice, almond or other nut-based milks instead of dairy
  • Low-fat or non-fat dairy products instead of whole milk products

Michael Pollen’s philosophy can be summed up with his famous seven words: “Eat food, not too much, mostly plants.”  Food translates to real, natural, wholesome and unprocessed nourishment (as opposed to processed, refined, fast foods); not too much obviously means in reasonable quantities (as opposed to consuming massive quantities); and mostly plants emphasizes eating foods grown in the soil– whole grains, vegetables, fruits, legumes, seeds, nuts, etc. (with animal sources in moderation).

Mediterranean style eating is healthy, tasty, filling and enjoyable.  It incorporates an abundance of vegetables and fruits that are rich in phyto-chemicals (biologically active compounds such as anti-oxidants, vitamins, minerals and fiber), whole grains, legumes, nuts and seeds.  Seafood, legumes and poultry (in moderation) are the key sources of protein with red meat eaten on a limited basis. Healthy vegetable fats are derived from olives, nuts, seeds, avocado, etc., replacing animal fats (e.g. butter).  Herbs and spices are used to flavor food, rather than salt. Dairy products are eaten in moderation. The Mediterranean style drink of choice is red wine in moderation.

The other element is the 80/20 (or 85/15 or 90/10 or 95/5) strategy.  This means that 80-95% of the time you adhere to a healthy eating style, but 5-20% of the time you give yourself a break, temporarily jump off the wagon and indulge in limited amounts of whatever temptation indulgence you would like. This avoids deprivation and serves as “an inoculation to prevent the disease.”  On the limited list are sweets including cookies, cakes, donuts, candy, etc. and liquid carbohydrates such as sugary drinks including soda, ice tea, lemonade, sports drinks, fruit juices, etc.

Additional Valuable Nuggets of Advice

  • Pathway to a healthy weight is slow and steady, demanding patience and time
  • Cook healthy meals at home instead of dining out
  • Eat slowly, deliberately and mindfully
  • Eat as if you were dining with your cardiologist and dentist
  • Get sufficient quality and quantity of sleep to help keep the pounds off
  • Avoid late night meals and excessive snacking
  • Eat only when physically hungry with the goal of satiety and not fullness
  • Stay well hydrated as it is easy to confuse hunger with thirst
  • Exercise portion control, especially at restaurants where portions are often supersized
  • Order dressings and sauces on the side to avoid drowning salads and pasta meals in needless calories
  • Do not skip meals
  • Keep healthy foods accessible
  • Perishable food with a limited shelf life is much healthier than a non-perishable item that lasts indefinitely, as do many processed items
  • Read nutritional labels as carefully as if you were reading the label on a bottle of medicine
  • Avoid foods that contain unfamiliar, unpronounceable, or numerous ingredients
  • Avoid foods that make health claims, since real foods do not have to make claims as their wholesomeness is self-evident
  • Avoid food with preservatives, hormones, antibiotics, pesticides, artificial colors, etc.
  • Plants that are naturally colorful are usually extremely healthy
  • “Organic” does not imply healthy or low-calorie
  • Use small plates and bowls to create the illusion of having “more” on your plate
  • Let the last thing you eat before sleep be healthy, natural and wholesome (e.g., a piece of fruit)—you will feel good about yourself when you get into bed and even better in the morning

Wishing you the best of health and happiness in 2019,

2014-04-23 20:16:29

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery.  He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community.  He is the author of 5 books, including PROMISCUOUS EATING: Understanding and Ending Our Self-Destructive Relationship with Food

Promiscuous Eating



Game Plan for Healthy Sexual Functioning

September 20, 2014

Andrew Siegel MD

shutterstock_side view manjpeg

Know the Fundamentals:

Erections are not on the basis of a bone in the penis as they are in many mammals. Erections occur when blood fills the erection chambers of the penis and is trapped in place. The blood pressure within the penis elevates so high that it is in hypertension range, giving rise to a bone-like rigidity and hence the slang term, boner.

The penis is a marvel of hydraulic engineering, uniquely capable of increasing its blood flow 50 times over baseline within nanoseconds of sexual stimulation, transforming its shape, size and constitution. This is accomplished by smooth muscle relaxation within the penile arteries and within the sinuses of the erection chambers.

Once the blood fills the erection chambers, closure of the penile veins and contractions of the pelvic floor muscles effectively trap the blood in the penis and maintain the high blood pressures necessary for a sustained erection.

Know the Statistics:

The Massachusetts Male Aging Study showed that after age 40 there is a decline in all aspects of sexuality. Erectile dysfunction (ED) is present in about 40% of men by age 40 with an increase in prevalence of about 10% for each decade thereafter. Although there are many causes of ED, the common denominator is insufficient blood flow to fill the erection chambers of the penis, or alternatively, sufficient inflow but poor venous trapping, both often caused by a decline in smooth muscle relaxation with aging. As one of my patients referred to his penis: “It’s like walking around with a dead fish.”

Know the Score:

Performance ability with any physical activity declines as we get older and this explains why most professional athletes are in their twenties or thirties. Although everything eventually goes to ground, hopefully it will do so slowly. Young men can achieve a rock-hard erection simply by seeing an attractive woman or thinking some vague sexual thought. As we get older, it is not uncommon for erotic thoughts or sights to no longer be enough to provoke an erection, with the need for direct touch. Some of the common male sexual changes that occur with aging are: diminished sex drive; decreased rigidity and durability of erections; decrease in volume, force, and trajectory of ejaculation; decreased orgasm intensity; and an increase in the time it will take for recovery before being able to get another erection.

Know the Opponents: Gluttony and Sloth:

 Healthy eating habits, exercise, adequate quality and quantity of sleep, tobacco avoidance, use of alcohol in moderation, stress avoidance, and a balanced lifestyle will optimize sexual potential. Abide by the “Golden Rule of the Penis”: Treat your penis nicely and it will be nice to you in return; treat your penis poorly and it will rebel.

Fuel for Performance:

A healthy diet will reduce the risk of sexual dysfunction. Eat a variety of wholesome natural foods including fresh vegetables and fruit, plenty of fiber, lean protein sources, legumes and healthy fats including nuts, avocados and olive oil. Avoid eating processed foods and minimize sugar, refined carbohydrates and highly saturated animal fats.

Stay in Peak Form:

Try to achieve “fighting weight” to maximize your performance in the sexual arena.

Train for Performance:

Exercising—including cardio, core, and strength training—is vital for health in general and sexual health in particular. When it comes to sexual health, it is vital to focus on the all-important pelvic floor muscles (PFM). PFMT (pelvic floor muscle training) will help optimize erectile function and prevent/treat ED.

To understand why PFMT can help your performance in the bedroom, it is necessary to have some understanding of what the PFM do. When you have an erection, the bulbocavernosus muscle and ischiocavernosus muscles engage. Contractions of these muscles not only help prevent the exit of blood from the penis, enhancing rigidity, but also increase blood flow to the penis—with each contraction of these muscles, a surge of blood flows into the penis. Additionally, they act as powerful struts to support the roots of the penis (like the roots of a tree), the foundational support that, when robust, will allow a more “skyward” angling erection (like the trunk of a tree). The bulbocavernosus muscle also serves the role as “motor” of ejaculation, pushing semen out of the urethra when it contracts rhythmically at the time of sexual climax.

If you increase the strength, tone and condition of these muscles through PFMT, they will function in an enhanced manner—namely more powerful contractions with more penile rigidity and stamina as well as improving ejaculatory issues including premature ejaculation.

The Private Gym is a comprehensive, interactive, easy-to-use, medically sanctioned and FDA registered follow-along exercise program that helps men strengthen the PFM. The PFM—as with all skeletal muscles—adapt and increase in strength in direct proportion to the demands placed upon them, enhancing their strength, tone, durability and responsiveness.

The Basic Training exercise program strengthens the pelvic floor muscles with a series of progressive “Kegel” exercises and The Complete Training program provides the maximum opportunity for gains through its use of the Private Gym’s resistance equipment. Think of the Private Gym as “Penis 90X.”

For great content on exercises to improve your sex life, see slide show written by Lisa Jey Davis for LiveStrong:

Talk to your Private Gym Coach:

Go to the Private Gym website: where you can have a private chat session with a trainer.

Wishing you the best of health,

2014-04-23 20:16:29

Andrew Siegel, M.D.

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Author of Male Pelvic Fitness: Optimizing Sexual and Urinary Health:

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Key to a Healthy Life

November 2, 2013

Andrew Siegel MD  Blog #126

My oldest cousin, who is in his late 60’s and resides in London, recently had a total knee replacement for disabling arthritis that interfered with his quality of life.  Even though this is a very tough operation in terms of recovery and rehabilitation, he did remarkably well.  He sent me an email about his situation and I would like to share his sage words as they provide meaningful advice regarding the key to a healthy life.

“Three months ago I had a total knee replacement surgery on my left knee.  The operation was a success, and with lots of hard work, rehab, improved diet and a positive attitude, I have made a remarkable recovery.  Last weekend I took a 3-mile walk with Monika, and didn’t suffer any knee pain or even tightness.  In fact, my operated knee appears to be stronger than my other knee.

From my own life experience, I have understood that the key to a healthy life involves the following

1- Eating a healthy diet

2- Regular exercising

3- A positive attitude, including coping with stress

4- Educating yourself regarding your health problems, being an advocate and involving yourself with your medical treatment and actively participating in the healing process 

I incorporated all these principles concerning my knee surgery, and credit these efforts with aiding my remarkable recovery.”

Facebook Page: Our Greatest Wealth Is Health

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Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food:

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Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health; in press and available in e-book and paperback formats in January 2014.

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Prostate Cancer: Can Diet And Lifestyle Make A Difference?

September 30, 2011

September is National Prostate Cancer Awareness Month, so I thought that a discussion of prostate cancer and preventative measures would be an appropriate topic to write about as the month approaches its end.  As a urologist and a wellness advocate, this subject is very dear to my heart.

Prostate cancer is the second leading cause of cancer-related deaths among men in the USA.  The burden of this disease is felt not only by those men diagnosed with this disease, but also by their partners, relatives and friends who are key elements in their emotional support system.

Prostate cancer is the most common non-skin malignancy among men in most Western populations (240,000 estimated new cases in 2011 in the U.S.), and is the second leading cause of cancer death among U.S. men (34,000 estimated deaths in 2011). To put this in perspective, heart disease causes more than 800,000 deaths per year in American men and is the leading cause of death in men with prostate cancer.  Many more men die of heart disease than of prostate cancer, and even in the population of men with prostate cancer, many more men die with it than of it.

The three major risk factors for prostate cancer are age, race, and family history. The likelihood of developing prostate cancer increases with the aging process, thought to be on the basis of gradual accumulation of DNA mutations due to incremental oxidative damage (literally “rusting”) of prostate cells. With each decade of aging, the incidence of prostate cancer increases appreciably.

In terms of race, African-American men have the highest reported incidence of prostate cancer in the world, with an incidence of 1.6 times that of Caucasian men in the United States; additionally, mortality is 2.4 times higher for African American men. On a worldwide basis, the highest incidence is in North America and Scandinavia and the lowest incidence is in Asia.

Prostate cancer tends to run in families, so it is prudent for male children of those with prostate cancer to be checked on an annual basis starting at age 40 (with a PSA blood test and digital rectal exam). With respect to familial prostate cancer, risk increases according to the number of affected family members (the more affected, the higher the risk), their degree of relatedness (brother and/or father affected confer a higher risk than cousin and/or uncle), and the age at which they were diagnosed (relatives of patients diagnosed younger than 55 years old are at highest risk). Generally speaking, if you have a brother or a father with prostate cancer, your risk of developing it is doubled. If you have three family members with prostate cancer, or if the disease occurs in three generations in your family, or if two of your first-degree relatives have been diagnosed at an age younger than 55 years, then you have a good likelihood for hereditary prostate cancer, which confers a 50% risk of developing the disease.

My father, a retired urologist, was diagnosed with prostate cancer at age 65 and underwent curative surgery and is currently 80 years old and thriving. For this reason, I have been very diligent in seeing my internist annually for a prostate examination and a PSA blood test. Additionally, I have been proactive in taking a medication to decrease my risk of prostate cancer.

Prostate cancer is unique among solid tumors in that it exists in two forms: a latent form (evident on autopsy studies, but not causing an abnormal digital rectal exam or PSA), which is present in 60-70% of men older than 80; and a clinically evident form (causing an abnormal rectal exam or elevated PSA), which affects approximately 1 in 6 men in the United States. Overall, men have an approximately 17% chance of being diagnosed with prostate cancer and a 3% chance of dying from it. This high ratio of prostate cancer incidence to mortality suggests that a portion of the cancers are minimal or indolent, non life-threatening conditions.

Currently, most prostate cancers are detected on the basis of a PSA elevation ranging from 2.5-10 ng/ml. Widespread PSA testing has resulted in the increased diagnosis of prostate cancer and a downward stage migration to non-palpable, organ-confined cancer with a parallel reduction in deaths—as opposed to the pre-PSA era, when most cancers were detected on the basis of a palpably abnormal digital rectal exam and were at a more advanced stage at presentation.

It is very important to know that when detected early, prostate cancer is highly curable. In the USA, more than 90% of men diagnosed with prostate cancer survive at least 10 years after the diagnosis is made. Even when not discovered early, it is a very manageable condition. In general terms, prostate cancer is a relatively slow-growing process.   Although most prostate cancers diagnosed at an early stage often have an indolent course, local tumor progression and metastases may certainly develop in the long term; therefore, early treatment is an important consideration for men with a general life expectancy exceeding 10 years.

Localized prostate cancer typically causes no symptoms and is typically diagnosed by a biopsy done because of a PSA elevation, an accelerated increase in the PSA over time, or an abnormal digital rectal examination. Non-palpable cancers, i.e., those picked up by virtue of a PSA elevation or accelerated PSA velocity, now account for 75% of all newly diagnosed prostate cancers. Although screening for prostate cancer remains somewhat controversial because of a lack of studies demonstrating a decrease in mortality in screened populations, the observed trends in PSA-driven detection of prostate cancer at earlier stages and declining mortality where screening is common provide strong inferential evidence that screening is beneficial.

Wouldn’t it be wonderful if we could prevent the occurrence of prostate cancer? It certainly would make my job a whole lot easier. Unfortunately, we are not there yet—but we do know a thing or two about lifestyle measures that can be pursued to maintain health and wellness in general and to help mitigate the chances of developing prostate cancer.

When Asian men (the ethnic group that has the lowest incidence of prostate cancer) migrate to Western countries, their risk of prostate cancer increases substantially over time.  So it is clear that environment plays a strong role in the genesis of prostate cancer and it is not just a simple matter of genetics.

Unquestionably, a coronary artery-clogging Western diet high in animal fat and highly processed foods and low in fruits, vegetables, legumes and whole grains is associated with a higher incidence of many preventable chronic health problems including cancer.  A heart-healthy, colon-healthy diet is a prostate-healthy and life-healthy diet.  A healthy diet combined with a healthy lifestyle, will afford us our best opportunity at minimizing heart disease, diabetes, and a host of cancers. This means weight management; the avoidance of obesity; healthy eating with abundant fruits and vegetables (chock full of antioxidants, vitamins, minerals and fiber) and real food as opposed to processed foods; consumption of animal fats and dairy in moderation; avoidance of tobacco and excessive alcohol; and plenty of exercise. And if we do develop prostate cancer, we will be in stellar physical shape and will heal that much better from any intervention necessary to treat the prostate cancer. Good nutrition and exercise helps in part by inhibiting oxidation and inflammation, factors that contribute not only to prostate cancer but also to conditions such as heart disease and osteoarthritis.

Michael Pollan, a journalism professor at the University of California, Berkeley and author of The Omnivore’s Dilemma, summarized in a most succinct way the answer to the question of what humans should eat, in his seven words: “Eat food. Not too much. Mostly plants.” By food, he means a nutritional substance that your grandmother would recognize as food, not a food-like highly processed substitute. Not too much is pretty obvious. A mostly plants-based diet will result in the consumption of a moderate amount of calories and plenty of fiber and anti-oxidants.

In addition to recommending a regimen of healthy eating and regular participation in exercise, there are medications that can help prevent the occurrence of prostate cancer. The presence of precursor lesions such as high grade prostate intraepithelial neoplasia (HGPIN) many years before the onset of prostate cancer, coupled with the increasing prevalence of prostate cancer with the aging process, suggest that the process of developing cancer takes place over a protracted interval of time. In fact, it is estimated that it takes many years—often more than a decade—from the initiation of the initial mutation to the time when prostate cancer becomes clinically manifest with either a PSA elevation or an abnormal digital rectal examination. In theory, this provides the opportunity for intervention before the establishment of a cancer.

The Prostate Cancer Prevention Trial was a clinical trial that tested whether Finasteride, which induces a deficiency of the enzyme 5-alpha reductase, would prevent prostate cancer. This trial was based upon the fact that prostate cancer does not occur in the absence of testosterone and that men with a congenital absence of 5-alpha reductase (that functions to convert testosterone to the activated form, dihydro-testosterone) do not develop benign or malignant prostate growth. This 7-year study involved almost 20,000 men who were randomly assigned to Finasteride or placebo. The study was terminated 15 months early because a 25% risk reduction for prostate cancer was achieved on Finasteride. The other finding was that the prevalence of higher-grade cancers was slightly higher in the Finasteride group (6.4% vs. 5.1%); however, Finasteride is known to change the pathological appearance of the prostate in such a way as to make determination of an accurate grade difficult.

A number of years ago, I was given the disheartening news that I had sunburn on my crown!  A balding pate frankly did not appeal to my sense of vanity!   After topical Minoxidil (Rogaine) proved ineffective, I started taking Propecia (a.k.a. Finasteride) every morning. Lo and behold, my thinning crown filled in and ultimately I had a full re-growth of hair.  When the Prostate Cancer Prevention Trial report came out revealing a 25% risk reduction for prostate cancer associated with the use of Finasteride, this cinched it—particularly insofar as my father had been diagnosed with prostate cancer.  Finasteride is a drug that fixes my bald spot, shrinks my prostate, and helps prevent prostate cancer, for which I have a family history. It seemed like a win-win situation, a no-brainer!

Bottom line:  Prostate cancer is very prevalent in men, involving one in six men in the USA.   When picked up on a timely basis via screening with the digital rectal exam and blood PSA test, it is eminently treatable and has an excellent prognosis, with only 3% of deaths in the USA attributable to prostate cancer.  There are both genetic and environmental factors at work in the genesis of prostate cancer.  We are not in control of our genetics, but we are in command of our lifestyle.  Maintaining a healthy lifestyle—including rational food choices—can help mitigate our chances of developing prostate cancer.

Andrew Siegel, M.D.

September 30, 2011

For more information on prostate cancer:

American Cancer Society:

American Urological Association Foundation:

Cancer Care:

National Cancer Institute:

National Prostate Cancer Coalition:

Prostate Cancer Foundation:

Prostate Cancer Research and Education Foundation:

Us TOO Prostate Cancer Education and Support Network:

To Vitamin Supplement Or Not…That Is The Question

August 27, 2011

When I turned 50, I started taking a multivitamin and mineral supplement, not previously having taken a vitamin since I took Zestabs or Chewable Chocks as a kid.  I figured I was on the back nine of life and needed all the help I could get.  Being the value-oriented consumer that I am, I headed over to Costco and picked up One-A-Day Men’s Health Formula that claimed to support prostate health, heart health and healthy blood pressure…sounded really good to me!  Each tablet contained Vitamins A, C, D, E, K, B1, B2, B3, B6, folic Acid, B12, biotin, calcium, pantothenic acid, iron, magnesium, zinc, selenium, copper, manganese, chromium, potassium and lycopene.  It seemed like a lot of bang for the buck.

I continued taking the vitamins for a year or so, but did not notice any tangible kind of benefit—I did not feel better, was not more energized, stronger, more potent in any way imaginable, did not get less colds, and my annual blood chemistries were unchanged.  I came to the realization that I derived a lot more benefit from my morning caffeine infusion than from the daily vitamin!  Frankly, I had felt pretty good before starting the vitamin and mineral supplement and since I felt absolutely no different after using them, I stopped taking them and have never looked back.  That stated, I eat a very healthy diet with an abundance of vegetables, fruits, legumes, whole grains, and lean sources of protein and have little doubt that my diet leaves me in good shape in terms of sufficient vitamin and mineral intake.

Approximately one in three Americans use multivitamins and mineral supplements on a regular basis.  There is no question that we need these micronutrients in sufficient quantity to sustain our health.  A nutritious and well-rounded diet should most certainly provide these essential micronutrients.  The exceptions to this are the following: If your diet is poor; if you are pregnant; if you are a child; or if you are ill or immuno-compromised due to certain medical conditions.  Under such circumstances, supplementation is important.  According to Tufts University Professor of Nutrition Susan Roberts, “multivitamins can fill in the gaps if you get too little of some vitamins and minerals from your food.”  Specifically, there are five micronutrients that many Americans do not get enough of: vitamin D, folic Acid, B12, iron and calcium.

Vitamins and minerals that exist within vegetables, fruits or other nutrients are advantageous because these foods contain important enzymes, peptides, and phyto-nutrients that are necessary to the utilization of the vitamins and minerals.  Many scientific studies have concluded that vitamins and minerals derived from dietary sources are superior to synthetic or formulated vitamin pills.  Bioavailability, as defined in Mosby’s Medical dictionary, is the degree of activity or amount of an administered drug or other substance that becomes available for activity in the target organ/tissue.  In short, the bioavailability of the vitamins and minerals within a multivitamin is often very much less than that of the vitamins and minerals in their natural form.

The other issues aside from bioavailability are that multivitamins vary greatly in quality, some have only trivial amounts of some micronutrients, and many have claims that are not clinically proven.  Nobody even knows if the recommended quantities (the RDA or Recommended Dietary Allowances) are accurate or relevant.  Another point is that the fat-soluble vitamins D, E, A, and K are stored in the body, and excessive quantities can be problematic.  On the other hand, excessive intake of the water-soluble vitamins B and C end up being urinated out into the toilet bowl.

The Bottom Line:  In my humble opinion: If you eat a healthy, well-balanced diet that includes fruits, vegetables, lean protein, and whole grains, don’t waste your dollars on a multivitamin or mineral supplement.  You are better off spending your money at Starbucks!  However, this does not refer to children, pregnant women, those suffering certain illnesses and those with a poor diet.  If you are deficient in D, B12, folic acid, iron or calcium, it is of paramount importance to supplement your diet appropriately.

Andrew Siegel, M.D.