Vitamins, minerals & supplements Archive

Make sure your diet meets the recommended mineral targets.

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Gold, silver, and platinum get all the attention as the world's most precious metals. But they're more precious for the global economy than for human health. Instead, other metals and minerals (metals are one type of mineral) are more important for our health (see "What essential metals do for us"). Indeed, some of them are so important that we can't live without them. "Each one plays a role in hundreds of body functions. It may take just a very small quantity of a particular mineral, but having too much or too little can upset a delicate balance in the body," says Dr. Bruce Bistrian, chief of clinical nutrition at Beth Israel Deaconess Medical Center.

They're packed with nutrients but high in starchy carbohydrates.

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Root vegetables — like turnips, rutabagas, and parsnips — may not be the sexiest foods on the table. But they're big celebrities in a number of cuisine trends like the "vegetable forward" movement (which elevates vegetables into creative entrees and side dishes) and root-to-stem cooking (which uses every part of a vegetable, including the tops, stems, and skins).

While it's fun to use old standbys in more interesting ways (like roasted parsnips with pistachio and lemon), it's important to eat root vegetables judiciously. "They are so high in carbohydrates that they are more like grains than greens. It makes more sense to put them in the same category as breads, rice, or pasta," says dietitian Teresa Fung, adjunct professor in the nutrition department at the Harvard T.H. Chan School of Public Health.

Observe these caveats if you use over-the-counter drugs or dietary supplements to help you sleep.

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It's 2 a.m. and you can't sleep. Is it okay to take a nonprescription remedy? "They're not meant for the long term, but it may be okay for an occasional night of problems with sleep," says sleep expert Dr. Lawrence Epstein, an instructor in medicine at Harvard Medical School.

But which option should you reach for? Drugstore shelves are lined with a dizzying array of products promising a good night's sleep. They fall into two categories: nonprescription medications and dietary supplements.

A new study raises questions about whether they're truly equivalent to the brand-name versions.

You've no doubt seen them in the grocery store — typically drab-looking packages on the bottom shelf containing lower-priced generic versions of popular brand-name products. Some shoppers look at them with skepticism: Are they really as good? Or does cheaper just mean lower quality?

Many people have the same questions about generic prescription medications, says Dr. Niteesh K. Choudhry, professor of medicine at Harvard Medical School and executive director of the Center for Healthcare Delivery Sciences at Brigham and Women's Hospital. Are generic drugs really the same quality, or is it better to spend more for the name-brand version?

Each one can have a different timetable. Find out in advance what you should expect, and then track your symptoms.

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When your doctor prescribes a new medication, you may expect to start feeling the effects right away. But some drugs can take time to make a difference. "It depends on how quickly your body absorbs the medication, how your body distributes it, and how your body breaks down or metabolizes it," says Laura Carr, a pharmacist at Harvard-affiliated Massachusetts General Hospital.

Giving it time

Some medications start working on the first day. These include drugs that treat high blood pressure, like the beta blocker metoprolol (Toprol, Lopressor), which slows down the heart and reduces the force of its contractions; or H2 blockers such as famotidine (Pepcid) and ranitidine (Zantac), which treat heartburn by blocking the stomach's acid-secreting cells from making acid.

Most older adults take some kind of over-the-counter dietary supplement. But are these products right for everyone?

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Over-the-counter dietary supplements are big business — more than 90,000 products generate about $30 billion every year in the United States. Older adults make up a big part of these sales, too. A survey of almost 3,500 adults ages 60 and older published Oct. 1, 2017, in The Journal of Nutrition found that 70% use a daily supplement (either a multivitamin or individual vitamin or mineral), 54% take one or two supplements, and 29% take four or more.

But are these pills good medicine, or a waste of money?

Ask the doctor

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Q. I have high blood pressure and have been checking my blood pressure more often since my doctor added another drug. But lately, my readings have been all over the place. For example, one morning it was 127/70, but then it was 170/100 in the late afternoon. What's going on?

A. You may have a condition known as labile hypertension, which refers to blood pressure that fluctuates far more than usual. Everyone's blood pressure rises and falls many times during the course of a single day, sometimes even within minutes. Many factors contribute to these changes, including physical activity, emotion, body position, diet (especially salt and alcohol intake), and sleep deprivation. However, there is no clear definition or standard criteria to distinguish between normal and abnormal fluctuations.

An ad for an arthritis medication seems to suggest that taking it will alleviate or even eliminate morning stiffness, allowing you to hop out of bed. Like most drug ads, this one has unspoken messages and glosses over questions about side effects and cost.

In the 1950s, doctors offered mainly morphine and bed rest — a far cry from the many procedures and medications provided today.

During a round of golf one autumn afternoon in 1955, President Dwight Eisenhower experienced what he assumed was indigestion. After he awoke at 2 a.m. the following morning with severe chest pain, his personal physician administered several shots of morphine. It wasn't until 1 p.m. that afternoon that an electrocardiogram revealed that the president had experienced a heart attack.

Cardiologist Dr. Thomas Lee, professor of medicine at Harvard Medical School, detailed Eisenhower's experience in the Oct. 29, 2020, issue of The New England Journal of Medicine. His piece focuses mainly on how Eisenhower's cardiologist, Paul Dudley White, communicated the event to the public. As Dr. Lee wrote, "Heart attacks became less mysterious and frightening to millions of Americans that day."