Karen Collins, a nutritionist with the American Institute for Cancer Research in Washington, D.C., answers nutrition-related questions.
Q: Do people who are on long-term antacid medicines need extra vitamin B-12?
A: That depends on the type of antacid that is used. Vitamin B-12 occurs in food bound to protein. Stomach acid breaks the bond that ties them together, allowing the B-12 to be absorbed into the body.
Anything that greatly diminishes stomach acid for an extended period can cause low bio-availability of B-12. If the vitamin is not separated from food protein, it cannot be absorbed. Some mild antacids, such as Tums, that are used for occasional indigestion or as a calcium supplement reduce stomach acid but only for a short period. There is no evidence that these products interfere with B-12 status. However, some strong acid-blocking prescription medicines used long-term for treatment of reflux or ulcer disease keep stomach acid low for extended periods and can make it difficult for the body to absorb B-12. Adding more foods high in B-12 does not help, since the vitamin remains bound to protein. Some experts suggest patients on these medications should follow the recommendation for those over age 50. That is, either take a supplement containing B-12 or eat foods fortified with this vitamin. (The B-12 in fortified foods is not bound to protein and is easily absorbed.) Others suggest that people on these medicines should simply have their blood levels of vitamin B-12 monitored periodically.
Q: Does soy cheese provide calcium?
A: Soy cheese is not naturally a good source of calcium. Unless it is fortified with calcium, you'll need to include other sources in your diet to meet calcium needs. Soy cheese is, however, a good source of protein. For those who avoid dairy products, it is a very appropriate substitute as long as other steps are taken to meet calcium needs.
Q: What's the truth about granola: is it health food or bad news?
A: Granola has both nutritious and less-nutritious qualities. A mixture of oats and other whole grains, often including nuts and dried fruit, granola is generally a good source of dietary fiber and several nutrients. Sodium content is usually fairly low. On the other hand, granola often contains more fat than typical breakfast cereals. When this fat is in the form of partially hydrogenated vegetable oils, you should be concerned about the levels of trans fatty acids. (This is a type of fat that is not listed with the saturated fat on the label, but also raises blood cholesterol levels). Granola also tends to be concentrated in calories. The
added calories may be an advantage for people who are very active. For those watching their weight, however, the sizeable number of calories in a small portion of granola can be a disadvantage. One solution is to use a small amount of granola as a topping over a lower-calorie, lower-fat whole-grain cereal so the calorie and fat content is "diluted." Granola is also easy to make at home, where you can use a healthy oil that is not hydrogenated and include the nuts, seeds and fruits that are your favorites.
