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What Time Of The Day Should You Take Multivitamins And Supplements – Morning Or Evening?

The Kashmir Monitor

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Whether multivitamins and other dietary supplements are necessary for the general population is a source of debate. Supplements remain recommended for certain populations with specific conditions – such as pregnant women who should take folic acid to reduce the risk of neural tube defects, or children in developing countries whose diets do not provide enough vitamin A and iron. But recent studies have found there is insufficient evidence to recommend multivitamin supplements to the average healthy American, and that in fact, taking too much of certain vitamins can cause harm.

These studies seem to have little effect on the global supplement industry, which is worth an estimated $128 billion, according to 2017 data from the Nutrition Business Journal, or on the American public. Fifty-two percent of respondents to the 2011-2012 U.S. National Health and Nutrition Examination Survey reported using dietary supplements – unchanged from the 1999-2000 survey.

As a registered dietitian, I believe a nutritious diet is the best way to achieve a healthy foundation. Supplements (as the name suggests) can be used as a complement to help a person with certain deficiencies meet their nutrient needs. If you’re taking a supplement because of such a deficiency, you should try to take it in a way that could promote optimal absorption. Supplement timing can seem complicated, so let’s simplify when to take some of the most common dietary supplements and why.
When to take supplements

 

There is debate about whether taking your vitamins in the morning or at night is best. The theory goes that because you’re getting nutrients throughout the day from food, having your nutrition supplements at night helps your body get some nutrition as you sleep.

But Jeffrey Blumberg, a professor of nutrition science and policy at Tufts University in Boston, says, “Digestion slows down during sleep, so taking your nutrient supplement late at night would not be associated with an efficient absorption.”

Neil Levin, a clinical nutritionist at NOW Foods, agrees that morning is best for multivitamins and any B vitamins. “Multivitamins tend to do best when taken earlier in the day, as the B vitamins in them might stimulate metabolism and brain function too much for a relaxing evening or before bed,” Levin says.

Although morning is probably ideal, the best time of day is the time you’ll remember. Put the supplement bottles on your kitchen counter next to your coffee maker, so they jog your memory when you reach for your morning cup. Or keep them in your lunch bag or briefcase so you’ll remember them.

With food or without?

Most supplements should be taken with food to reduce the chances they’ll upset your stomach and to stimulate digestion and improve absorption. For a select few, it really doesn’t matter if you take them on an empty stomach. So which ones should you pay attention to?

Iron, magnesium and fish oil supplements are the most common culprits for digestive upset when taken on an empty stomach, so take extra care to have these with a meal or snack.

Fat-soluble vitamins A, D, E and K are better absorbed when you have them with a meal or snack that contains at least a teaspoon of fat, about 5 grams. The same goes for your multivitamin, which contains these vitamins. For example, if you’re taking your multivitamin with your breakfast, make sure you’re having some almond butter with your oatmeal or avocado with your eggs and toast.

For probiotics, preliminary research suggests taking them with a meal or 30 minutes before a meal could be better than taking them after eating.

Hydration is also important, Blumberg says. “Fluid intake is especially important for the disintegration of the supplement tablet or capsule and for dissolution of water-soluble nutrients such as vitamin C and B vitamins,” he says. So be sure to wash down all supplements with a tall glass of water.

The main exception to the “take with food” rule for dietary supplements is with certain types of minerals. Only chelated mineral supplements can be taken without food, Levin says. Chelation occurs when a mineral has been bound to an acid, so it doesn’t rely on your stomach acid to break it down. Calcium citrate and magnesium glycinate are the main examples. (If this level of detail is overwhelming, take your supplements with food to cover your bases.)

Better together

Some nutrient dynamic duos include vitamin D to boost calcium absorption and vitamin C to boost iron absorption. That’s why taking in these nutrients simultaneously via supplements or boosting with food sources is ideal. A classic example is having your iron supplements with a glass of orange juice to get the absorption-boosting effects of the vitamin C.

Better apart

Calcium can affect your body’s absorption of iron, zinc and magnesium. I recommend taking any calcium supplements at a different meal than any iron supplements or your multivitamin. Also, your body absorbs calcium more effectively when you take 600 milligrams or less at a time. If you’re taking more than that per day, you’ll want to split up the dosage into morning and evening doses.

Fiber is another nutrient you’ll want to take apart from other supplements and medications because it interferes with absorption. I recommend doing so before bed if you aren’t taking anything else at that time.

Here’s a sample schedule for optimal absorption of the supplements named.

With breakfast

Multivitamin or prenatal multivitamin/folic acid

B vitamins
Omega-3s
Probiotics
With lunch
Calcium
Vitamin D
With dinner
Iron
Vitamin C
Before bed

Fiber supplement (with a large glass of water)

If it isn’t practical for you to remember to take supplements at lunch or other points during the day, don’t worry. Have your multivitamin and any fat-soluble vitamins (A, D, E and K) with food that contains some fat, keep your calcium and iron separate, and you’ll be fine. You’ll be even better off if you focus on eating nutritious whole foods, because science suggests that this, rather than supplements, is the optimal way to get your nutrients.Morning or night? With food or without? Answers to your questions about taking supplements


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Health

Hepatitis A Causes and Symptoms

The Kashmir Monitor

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Generally speaking, hepatitis A is more common in parts of the planet that are developing. It’s for the fact that sanitation and food handling practices are by and large poor. However, medical experts say that living in developed countries can also put you at risk of having hepatitis A, but it’s really a rare occurrence.

Just like what’s mentioned earlier, hepatitis A is caused by the hepatitis A virus or HAV. It can be spread around by someone who has hepatitis A because he or she is a carrier of the virus behind it. It is said that a person with hepatitis A is most infectious about 2 weeks before he or she begins to experience signs and symptoms.

Here are some of the ways that hepatitis A is spread around:

 

Consumption of food that is prepared by a person who has hepatitis A. This is most especially true if he or she has not properly washed his or her hands.

Drinking of water that is contaminated with the hepatitis A virus.

Intake of raw or undercooked seafood obtained from contaminated water.

Close contact with someone who has hepatitis A. This includes having sexual intercourse with an infected person, especially when the rectal or anal area has been touched with the fingers, mouth or tongue.

Using illegal drugs, especially when paraphernalia contaminated with the hepatitis A virus are used.

Symptoms

Medical experts say that it may take a while before the various signs and symptoms associated with hepatitis A show up. They say that someone may experience them about 4 weeks after getting infected. It’s even possible for someone with hepatitis A to not experience any sign and symptom at all.

Some of the initial signs and symptoms of hepatitis A include:

Tiredness and malaise
Achy muscles and joints
Pain in the upper right section of the abdomen
Loss of appetite
Mild fever
Headaches
Sore throat
Diarrhea or constipation
Hives or raised rash that’s itchy

These initial signs and symptoms associated with hepatitis A can last anywhere from a few days only to a couple of weeks. Afterwards, as the infection of the liver progresses, the following may be experienced by the individual:

Jaundice, which is the yellowing of the skin as well as the whites of the eyes (sclera)

Pale colored stools
Dark colored urine
Skin itching

Tenderness and swelling of the upper right section of the abdomen

Although it rarely happens, hepatitis A can cause liver failure. When such develops, the person who is infected may experience severe vomiting, frequent bruising, bleeding of the nose and gums, drowsiness and confusion.

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Health

Busting myths around blood donation

The Kashmir Monitor

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As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

Contrary to the myth about blood donations making a person weak or anaemic, the body replenishes the lost blood in a matter of a few days, say experts.

“A healthy bone marrow makes a constant supply of red cells, plasma and platelets, so there is no question of becoming weak, much less anaemic. It is a myth and should not deter people from donating blood,” says Dr RK Singal, chairman, internal medicine department, BLK super-speciality Hospital.

 

The donors can give either whole blood or specific blood components, as there is sophisticated equipment available these days that extract relevant components from blood and the rest of the blood can be transfused back to the donor.

As per the World Health Organisation (WHO) norms, ideally, one per cent of the total population should regularly donate blood to meet the requirements, which is anywhere between 1% and 3% of country’s population that would require blood in a year.

About 65% of India’s population is young and if this section donates blood regularly, chances of the country facing blood shortage will be remote. Hence, there is all the more reason for people, especially youngsters, to come forward and be regular blood donors.

How to prepare

Have enough fruit juice and water in the night and morning before you donate

Have a full meal 3 hours before donation; never on an empty stomach

Have some rest for about 10-15 minutes after donation

Have some snacks or a juice with high sugar content after donation

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Health

Erectile dysfunction’s connection with lifestyle

The Kashmir Monitor

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By Dr Anjani Kumar Agrawal

healthy-lifestyle-can-reverse-effects-of-hypertensionAll over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED).

All over the world, but perhaps more so in India, men are embarrassed to admit that they may have a problem getting or keeping an erection — a condition known as erectile dysfunction (ED). From my research, I have found a strong link between ED and stress. Other major causes include smoking, drinking, diabetes, hypertension or high blood pressure and cholesterol levels. My advice to these patients is — do not get even more stressed over this situation. Instead, focus on taking the right medication and making some changes to your lifestyle, so you can once again enjoy a satisfactory sexual life.

 

DIAGNOSIS OF ED

We normally diagnose ED and its underlying causes by asking the patient a few questions about his medical and sexual history. This is sometimes done by sharing a questionnaire with the patient. The questions that we ask are designed to help us understand the cause of ED in the particular patient.

We also do a physical exam, ask for certain blood tests to rule out other medical conditions responsible for erectile dysfunction, and recommend imaging tests (if required) to determine whether the person is physically able to have an erection or not.

SHORT-TERM SOLUTION, LONG-TERM CURE

Underlying medical conditions such as diabetes, hypertension and hypercholesterolaemia (high cholesterol levels) can cause ED. In these cases, ED can be reversed once the patient starts treatment.

In my experience, many men suffer from ED because of work stress, family pressure and anxiety. So, changes in lifestyle with regular exercise, yoga, abstaining from alcohol and smoking, and proper counselling help in treating ED. Along with this, medicines for ED are usually prescribed for about 3 to 6 months by which time lifestyle changes start to take effect and the patient is physically and mentally healthier, which helps resolve the problem.

An estimated 16% to 25% of men experience ED at some point in their lives. I would urge them not to be embarrassed about it. Seek medical help from a urologist or andrologist; get the necessary advice/medication; and go on to enjoy a healthy, fulfilling sexual life.

The author of this article is Dr Anjani Kumar Agrawal, head, andrology, department of urology sciences, Max Smart Super Speciality Hospital, Saket

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