Eating Enough? How to consume sufficient nutrients on your special diet By Kelly Dorfman, M.S., L.N.D. Published February/March 2012 – Living Without Magazine One of the common worries when eliminating problem ingredients from the diet is whether people can get enough nutrients from the foods that are left. Fear not, most nutrients have numerous food sources. Removing a food or food group need not lead to nutritional downfall as long as you avoid the common traps of poor substitutions and picky eating. And if you’re avoiding dairy, take calcium and maybe vitamin D. Poor Replacements Your doctor has told you that you can’t eat gluten. You miss your favorite breads, pancakes and cookies so you fill up on clever replacements made primarily with white rice flour, tapioca starch or cornstarch. These ingredients offer calories but few other nutrients. White wheat flour isn’t much better but the law requires that manufacturers add some nutrients back. This fortification process doesn’t apply to non-wheat flours or the further refined starches. Consequently, filling your diet with empty-calorie gluten-free foods can lead to nutritional insufficiency. Practice self-fortification by using as many gluten-free whole grain flours as you can in our recipes. Prepare nutritious whole grains, such as millet, quinoa and brown rice, as sides. For extra protection, consider taking a B-complex supplement or a multiple vitamin and mineral supplement that contains a complete B complex. Picking Eating Do you avoid vegetables because you never learned to like them? The biggest obstacle to a sufficient diet is fussiness about food – and it’s not just kids. Picky eating is a national epidemic affecting all ages. Studies find that fewer than 25 percent of Americans eat the modest 4 to 5 servings of fruits and vegetables recommended for good health. If you’re in the underachieving 75 percent, do all you can to expand your vegetable consumption. Talk to a nutritional professional about your individual quirks and needs. A generic supplement program might include a daily multiple vitamin and mineral, fish oil, vitamin C and organic ground-up leafy greens in a capsule or pressed into a pill. Purists argue against food in a pill but I gave up purism long ago with my picky-eating clients who are nutritionally deficient. Yes, eating vegetables the old-fashioned way is much preferable and people should keep trying to up their intake. In the meantime, swallowing a small quantity of vegetables in a pill is better than nothing. Dairy-Free Diet Eighty percent of cow’s milk protein is casein, the most allergenic protein in dairy. (The other is whey). Casein is a family of proteins found in all mammal milks. Goat’s milk casein has a structure closer to the casein found in human milk, which is why some dairy-intolerant folks may be able to digest goat’s milk. What about Chinese cuisine? It doesn’t contain dairy yet appears to be adequate for a third of the world’s population. The traditional Chinese diet is low in protein, which spares calcium. The average American diet is extremely high in protein, increasing excretion of calcium; thus, it requires increased calcium intake for balance. For those avoiding dairy, there are many modest sources of calcium, such as almonds, leafy greens and sesame seeds. Better sources, if tolerated, are canned salmon and sardines with bones. Nut, hemp and rice “milks” aren’t naturally rich sources of calcium. Their calcium enhancement is another form of supplementation. Count them as part of your supplementation but try not to drink more than a cup a day. Although some, like soy and hemp milks, have decent protein and others, like coconut milk, contain healthy fat, non-animal milk products are high in carbohydrates relative to other nutrients. Most people need between 800 and 1200 mg of calcium per day. The body can only absorb approximately 500 mg at a time, meaning your total intake needs to be split into at least two doses. The best utilized forms are citrate, gluconate and the chelates. I recommend products with a combination of forms that also contain some magnesium. Magnesium improves calcium utilization. Calcium carbonate is the poorest absorbed form but the most popular because it’s cheap and larger amounts can be put into smaller pills. It may increase constipation in those so inclined. Conversely, too much magnesium can cause diarrhea. Otherwise, both minerals are generally well tolerated. Vitamin D, which is chronically low in adults and children, works with calcium and is critical for proper immune functioning. Fortified dairy products and liver are the primary food sources of dietary vitamin D. The best source is sun exposure. You probably aren’t eating liver regularly and if you use sunscreen or work indoors, chances are you need vitamin D. Ask your doctor to test your blood vitamin D levels to know for sure. Many physicians already include vitamin D screening as part of the annual physical. The daily maintenance dose of vitamin D, preferably in the natural vitamin D-3 form, is usually between 1000-2000 IUs. However, I have clients who live in northern climates or don’t absorb vitamin D well who need 5000 IUs a day to maintain sufficient levels. So how do you help ensure your special diet is nutrient sufficient? Eat your vegetables. Consume as many whole, unprocessed foods as possible. And then fill in the gap between what you eat and what you need for optimal functioning with supplements. Consult with a savvy dietician or nutritionist to be sure you’re on the right track. Consult a qualified healthcare professional before taking supplements.