Porterville Recorder

Get nutrients from food, not supplement­s

- Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.

Hello again, dear readers, and welcome to the continuati­on of this month’s letters column. Our volume of mail keeps growing, so we’ll be adding extra letters columns as needed.

— A reader asked about dietary supplement­s. “My doctor recently told me to stop taking probiotics and fish oil,” he wrote. “But my wife and I have been taking them for many years. What say you?” Probiotics and fish oil are among the most popular supplement­s. Our own preference is that these nutrients be obtained through food-based sources. Fermented foods like sauerkraut, kefir, yogurt, kombucha and miso all contain beneficial strains of bacteria. They’re also less costly than supplement­s. The same goes for fish oil. It’s better -- and more delicious -- to get your omega-3s by eating fatty fish like salmon, mackerel, sardines, herring and black cod. If you’re buying a probiotic, please choose those with as many diverse strains as possible. But our firm belief is that a pill cannot replace a balanced, healthy diet.

— Along those same lines, a reader asked about vitamin D. “I take 1,000 internatio­nal units of vitamin D3 daily in two forms -- a tablet and a gel cap,” he wrote. “Is there any advantage of one form or the other?” Vitamin D3 is better absorbed than D2. When it comes to tablets versus gel caps, there’s no difference. It’s important to note the upper limit is 5,000 IU daily. We advise getting vitamin D through dietary sources, including fortified dairy, mushrooms and fish. And, if there’s no skin cancer risk, a bit of daily sunshine.

— We’ve been getting an important coronaviru­s vaccine question from a number of readers who are in treatment for cancer, or who are otherwise dealing with a weakened or compromise­d immune system. A reader in Naples, Florida, said that soon after her husband became fully vaccinated, a cancer diagnosis meant he began immunother­apy and chemothera­py, which suppress the immune system. “Do you have any informatio­n on how much protection cancer patients have?” she asked. “Interestin­gly, the CDC didn’t mention this group in their latest publicized guidance. I think it would be an important issue for your column to address, as there are many cancer patients, unfortunat­ely.” Due to the need to first confirm that the vaccines work in people with healthy immune systems, the initial COVID-19 vaccines studies did not include those who were immunosupp­ressed. And because we are still in the early stages of the vaccine rollout, it’s not yet clear how effective the vaccines might be in these groups of people. Thank you, as ever, for taking the time to write to us.

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