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Liquid, Chewable or Tablet Vitamins: Does the Form Really Matter?

by on Wednesday, March 2nd, 2011

Walk down the vitamin aisle and you will see tablets, capsules, gummies, chewables, powders and liquids. About 57.6 percent of U.S. adults aged 20 and older used a dietary supplement in the past 30 days, according to a 2017 to 2018 survey by the National Center for Health Statistics, so this is a question many people have. Some sellers claim that liquid vitamins are far better absorbed. Let us see what holds up.

Do liquids work better than pills?

You may have read that about 90 percent of the nutrients in pills are not absorbed, and that liquids are far more effective. I could not find a reliable source for this. The NIH Office of Dietary Supplements lists tablets, capsules, gummies, powders and drinks as supplement forms, and does not rank one as better than the others. How much of a nutrient you absorb depends on the nutrient itself, the dose, how well the product is made, what you eat with it and your own body. A good tablet that breaks down properly is absorbed well, and a poorly made liquid may not be.

What are the real differences?

Liquids are useful if you cannot swallow pills. They need accurate measuring, and it is worth checking the label for added sugar and sweeteners. Chewables and gummies are easy to take, but many contain added sugar, and nutrient amounts vary from brand to brand, so compare the Supplement Facts panel. Because they can taste like candy, keep them out of the reach of children. Tablets and capsules are the most common form and are easy to store and dose, although some people find them hard to swallow.

Which form should you choose?

Choose one that you will take every day. A supplement in a drawer does nothing, so a form that is easy for you to swallow, chew or measure is a better choice than the “best” one that you skip. If you take a vitamin with fat in it, such as vitamin D, take it with a meal. Calcium and iron are better kept apart, as the Office of Dietary Supplements advises; our guide to calcium supplements has more. Check the Supplement Facts label for the amounts of each nutrient, and compare them to what you need.

How do you know that a product is good?

Several independent organizations test supplements and let products that pass display a seal. According to the Office of Dietary Supplements, the seal indicates that the product was properly manufactured, contains the ingredients listed on the label and does not contain harmful levels of contaminants, although it does not guarantee that the product is safe or effective. Use is common and rises with age, reaching 74.3 percent among adults 60 and older, so it is worth reading labels carefully if you take several products.

Do you need a supplement at all?

Most healthy people can get what they need from food. A supplement can help if you have a medical need, a restricted diet, or a deficiency that a doctor has found. For example, vegans need a source of vitamin B12. Ask your doctor or a dietitian before you buy, and read vitamins and your health and getting the right amount of vitamins. If you take medicine, check with your pharmacist first, because some supplements interact with drugs.

In short, form is a matter of convenience, taste and price. The quality of the product, the dose and the habit of taking it matter far more.

Muscle Myths: What the Evidence Says About Reps, Sets and Squatting Past Your Toes

by on Tuesday, March 1st, 2011

Gym advice travels fast, and much of it is repeated without ever being checked. A few of the most popular training rules, such as “always do 12 reps,” “three sets is the magic number” and “never let your knees go past your toes,” are worth a closer look. The research is clearer on some of these than you might expect.

Do you need 12 reps to build muscle?

No. A 2017 systematic review and meta-analysis of 21 studies compared low-load training (60 percent of your one-repetition maximum or less) with high-load training. It found that gains in maximal strength were greater with heavier loads, while muscle growth was similar across a wide range of loads. The authors concluded that maximal strength benefits come from heavy loads, while muscle hypertrophy can be achieved equally across a spectrum of loading ranges. Note that in these studies the sets were carried to momentary failure. In practice, it means that a mix of heavier sets of lower reps and lighter sets of more reps is fine, and you can vary them. See the full abstract if you are curious.

Is three sets the rule?

Three sets is a reasonable number, but there is nothing special about it. The 2026 position stand of the American College of Sports Medicine, which summarized 137 systematic reviews with more than 30,000 participants, found that strength was enhanced by 2 to 3 sets, lifting heavier loads (80 percent of one-repetition maximum or more), and training at least twice a week. Muscle growth was enhanced by higher weekly volumes of 10 or more sets. It also found that training to momentary muscle fatigue, equipment type, exercise complexity and set structure did not consistently change results. The simple conclusion is that healthy adults should do progressive resistance training, adding load or volume over time, and keep it up. How you split the work matters less than doing it regularly.

How many exercises per muscle group?

You may have read that three or four exercises per muscle group is too many and that you should do 30 to 50 reps in total. I could not find a source for those specific numbers, and the position stand points the other way: weekly sets matter for growth. If you are a beginner, one or two exercises per muscle group, done well, are plenty. Add sets later as you progress.

Should your knees stay behind your toes?

This is one of the oldest gym rules, and a 2003 study tested it. Researchers had seven weight-trained men do parallel barbell squats with and without a barrier that stopped the knees moving past the toes. When the knees were restricted, knee torque fell from about 150 to 117 newton-meters, but hip torque rose from about 28 to 303 newton-meters, and the trunk leaned further forward. The authors concluded that restricting the knees may reduce stress on the knees, but forces are probably transferred to the hips and low back, and that proper joint loading during the squat may require the knees to move slightly past the toes. This was a small study of seven men, so treat it as a reminder that technique is about balance, not a single rule. Read the study abstract.

What should you do instead?

Use a weight you can control, keep a full range of motion, increase the load gradually and stop a set if your form falls apart. If you have a joint problem or an old injury, ask a doctor or a qualified trainer to check your squat. For a plan to follow, see full-body workouts in two or three sessions a week, and fitness for men: cardio, strength and safer training for more on safe training. Our guide to preventing sports injuries has twelve habits worth building.

Fiction of Muscle

Fiction of Muscle

How to Choose a Yoga Video for Beginners (and What a Good One Teaches)

by on Monday, February 28th, 2011

Finding a well-made yoga video that is truly suited to beginners can be a challenge. Most exercise videos are aimed at people who already know what they are doing. They may include a few easier moves, but the instruction assumes that you already know your way around. The few that are labeled “for beginners” can be repetitive and slow, and they sometimes give you no way to progress, as if beginners were going to stay beginners forever.

What should a good beginner video teach?

Clear instruction. A beginner needs more than a demonstration. A good teacher explains how to place your feet, where your weight should be and what the pose should feel like. When a teacher describes how the muscles of the feet should turn toward the big toe, you can feel it as well as see it. Calm, steady speech is a plus, since yoga depends on concentration.

A manageable number of poses. A class that introduces too many new poses at once is hard to follow. Look for one that repeats a small number of basic poses and builds up slowly.

Familiar basics. Many beginner classes include the cat pose on hands and knees, downward-facing dog, which looks like an upside-down V, and the corpse pose, which is lying on your back, completely relaxed. Our guide to basic yoga postures and their variations explains these and other essential poses.

Modifications and props. A beginner video should offer options for people who are stiff or new to yoga. For example, a folded blanket can go under the knees or the hips to make seated poses more comfortable, and a folded towel can help with some other poses. A teacher who tells you about these in advance is thinking about you.

A good ending. Most classes end with stretching and relaxation. Many use soft music, which may help you drift off. Choose a class with a final rest if you want to unwind.

Which video is an example?

One title that often comes up for beginners is Yoga Zone: Flexibility and Tone, taught by Alan Finger. It runs for about 50 minutes, and it is known for detailed instruction on alignment and for a relaxed teaching style. We cannot say that it is the right fit for everyone, and a DVD from some years ago may be hard to find, so treat it as an example of the style to look for, not a recommendation. Whatever you choose, preview a sample if you can, to hear the teacher’s voice and see how the class is paced.

Where can you try a class first?

Free classes are a low-risk way to find out what style you like. The video at the end of this post is a beginners’ class titled “Yoga for Beginners Part 1” from YogaEasy, which you can try before buying anything.

How can you stay safe?

Yoga is generally safe for healthy people when it is done properly, but sprains and strains can happen. The NCCIH advises learning with a qualified instructor if you can, and moving slowly and carefully. Never force a pose, and stop if you feel pain. If you are pregnant, are over 65 or have a health condition, check with your doctor first. A video is not a substitute for a live teacher, but it is a good starting point, and many people go on to take a class after a few weeks at home.

If you would like to learn what yoga is all about, read our posts on what yoga is and how to choose a yoga video, or try the 12-step sun salutation.

Women’s Health Habits That Matter: Checkups, Screening, Sun Protection, Bones and Sleep

by on Tuesday, February 22nd, 2011

Staying healthy does not need a complicated plan. For most women, a handful of habits and the right checkups do most of the work. Here are the ones with the best backing, with the numbers checked against current guidelines, in place of the long list of tips you may have seen elsewhere.

What should you eat and drink?

Build your meals around vegetables, fruit, beans, whole grains and lean protein, and cut back on foods that are high in saturated fat and added sugar. If you are trying to lose weight, you do not need to follow a strict plan to start: smaller portions and fewer sugary drinks are a good beginning, and our guide to eight habits for losing weight the healthy way shows how. As for water, the often-quoted “eight glasses a day” is not an official target. The National Academies report that women who appear adequately hydrated take in about 2.7 liters (91 ounces) of total water a day from all beverages and foods, and that normal drinking, with thirst as a guide, is enough for most healthy people. Needs are higher in hot weather and during long workouts.

How active should you be?

At least 150 minutes of moderate activity a week plus two days of muscle strengthening is the target for adults. Walking, taking the stairs, playing with your children, yoga and home workouts all count. If you want an easy start, try a gentle morning yoga routine for beginners.

Do you get enough sleep and rest?

The CDC says that adults aged 18 to 60 need 7 or more hours of sleep a night, and that enough sleep helps with stress, mood, weight and heart health. Going to bed and getting up at the same time, keeping the bedroom cool and quiet, and avoiding caffeine late in the day all help. Time with friends, a good book or a walk are fine ways to wind down. If you regularly cannot sleep, speak to your doctor.

How do you protect your skin from the sun?

The American Academy of Dermatology recommends a sunscreen that is broad-spectrum, SPF 30 or higher and water resistant. Most adults need about 1 ounce, roughly a shot glass, to cover the skin that is not covered by clothing, and it should be reapplied about every two hours and after swimming or sweating. Shade, long sleeves and a wide-brimmed hat help too. For a skin routine, see the importance of skin care.

Which bone and calcium habits count?

Women aged 19 to 50 need 1,000 mg of calcium a day and women over 50 need 1,200 mg, according to the NIH Office of Dietary Supplements. Food is the best place to get it. If you take a supplement, it is better to split a large dose into two smaller ones. Vitamin D and weight-bearing exercise such as walking also protect bones. Be wary of claims that calcium or vitamin E prevent menstrual cramps or menopausal hot flashes; I could not find reliable support for those, so ask your doctor instead. For more on calcium, read calcium supplements and how to take them safely.

Which screening tests do you need?

These are worth discussing at your yearly visit. The U.S. Preventive Services Task Force recommends screening for cervical cancer every 3 years with cervical cytology in women aged 21 to 29, and, for women aged 30 to 65, every 3 years with cytology, every 5 years with high-risk HPV testing, or every 5 years with both. It also recommends a mammogram every 2 years for women aged 40 to 74. Both recommendations may be updated, so ask your doctor what applies to you, especially if you have a family history or other risk factors. The USPSTF breast cancer recommendation and cervical cancer recommendation explain the details.

What about smoking and alcohol?

If you smoke, quitting is one of the best things you can do for your health, and it is also good for your bones. Alcohol is best kept low. Your doctor or pharmacist can help you find a plan that works.

How a Good Diet Can Lower Cholesterol: One Example Day

by on Saturday, February 12th, 2011

A good diet can lower cholesterol

Take James, a father of two, who went for a routine medical check-up. He exercised moderately and loved to eat, but everything was about to change when his results came back.

What did the results show?

His LDL cholesterol, the type often called “bad” cholesterol, was well above the recommended level. The doctor said that if nothing changed, James could soon suffer from high blood pressure, a heart attack or a stroke. As a father of two, he took the warning very seriously, because he wanted to keep providing for his family.

What did the doctor change?

James had been exercising twice a week, and the doctor advised him to do more. He started exercising four times a week and added other activities to help lower his cholesterol. Health authorities recommend at least 150 minutes of moderate activity a week for adults.

The doctor also pointed out that there is no use in exercising more if what you eat does not change, because the food you burn off is just replaced by the next meal. James was referred to a dietitian, who went through his usual foods with him. The ones that were high in saturated fat were set aside and replaced with healthier choices.

What did a day of eating look like?

The plan looked simple. James would eat food that was low in saturated fat and no longer rich in refined carbohydrates.

Breakfast: Because his LDL was high, the dietitian suggested egg whites instead of whole eggs, unsweetened tea in place of his morning coffee, and cereal with fat-free milk when he ate with the kids.

Lunch: Skinless chicken or a small portion of lean meat with plenty of vegetables and side dishes. Vegetarians can swap in beans, lentils or tofu.

Snack: It takes time to adjust, and anyone new to this will feel hungry in the late afternoon. Carrot sticks or an apple are a much better choice than a donut that is full of sugar. Instead of cola, he drank water or an unsweetened drink.

Dinner: Fish, or pasta with vegetables on the side. There was no need to fill up, since he would be sleeping for the next six to eight hours.

Alcohol: James gave up beer. A small glass of wine with dinner may be acceptable for people who already drink and whose doctor agrees, but if you do not drink, do not start.

James also learned to make good choices when eating out or at gatherings. For someone at risk of heart disease or high blood pressure, there is no room for slipping, and the whole family benefited from the change.

What was the result?

At the follow-up check-up, James’s cholesterol had improved, with his LDL much lower than before. The plan he chose is only one of many. It can take some time to find the right one, but lowering your cholesterol is well worth the effort.

What can you learn from his story?

The American Heart Association recommends that people with high LDL cholesterol limit saturated fat to less than 6% of their calories, which means about 13 grams a day on a 2,000-calorie diet. Swap butter, full-fat cheese and fatty meat for olive oil, nuts, beans and oats, and have your cholesterol checked again to see the effect. Read more in our posts on how to lower cholesterol through diet, a diet to lower cholesterol, eating to lower cholesterol with oats, fruit, beans and healthy fats, and exercise and cholesterol.