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TOPIC - Diet Supplements
Question
My wife's recent surgery has resulted in a loss of appetite and nausea. She likes one of the nutritional drinks that provides good nutrition and 360 calories per 8 ounces. She drinks 4 of these each day. How long can someone use these for a primary source of nutrition?
Answer
With drinking 4 cans, she is getting 1440 calories per day. Depending on her height, weight, activity level and medical condition, that may be enough or a little low. Use the Calorie Calculator to determine her daily caloric needs. If she is eating some foods as well, she would be getting some extra calories. She can take the nutritional supplement as her primary source of nutrition during this period when she does not feel like eating. Supplements such as Ensure Plus® or Boost Plus® provide 100% of the RDA for protein and most vitamins and minerals in about 4 to 4-1/2 cans. She can continue to use the drinks for weeks, and some have done it for months. Initially, check her weight once a week to ensure she is getting enough calories to maintain her weight. As her appetite improves, give her more nutrient-dense foods such as milk products or other high-protein foods and gradually cut back on the nutritional drinks.

Note, however, that the RDAs are for healthy adults, your wife may have additional nutrient needs due to her medical condition. I would suggest that you see a dietitian to further discuss your wife's specific nutritional needs.
Question
Are there any side effects to consuming too much sweeteners such as aspartame, which is commonly found in "diet" foods such as sugar-free sweets and diet coke? Also, other than causing calcium loss, are there any side effects of consuming 1-2 cans of diet coke a day?
Answer
Aspartame is generally well tolerated by most people with the exception of a small number of people--about 1 in 16,000--who have the hereditary disease phenylketonuria. Aspartame contains phenylalanine, which should be avoided by the these people. People with advanced liver disease and pregnant women with high levels of phenylalanine in the blood also may have trouble metabolizing the substance.

The FDA considers aspartame to be one of the most thoroughly tested and studied food additives the agency has ever approved. More than 100 toxicological and clinical studies the agency has reviewed confirm that aspartame is safe for the general population. The Acceptable Daily Intake (ADI) for aspartame set by FDA and reevaluated and reaffirmed several times is 50 milligrams per kilogram (mg/kg) of body weight per day. At this level, for example, a 150-pound (60-kilogram) person would need to consume 15-16 cans (12-ounce) of diet soda containing aspartame to reach this level of intake.

The calcium losses are due to the presence of phosphorus in carbonated beverages. Phosphorus (usually listed on soda as phosphoric acid) binds to calcium in the gut, thereby preventing the calcium from being absorbed and making its way to bone. Another theory is that calcium and phosphorus need to be eaten in a particular ratio to maintain bone health. Presumably, consuming a lot of phosphorus without taking additional calcium – like in soda pop – could throw off the delicate calcium/phosphorus balance. 1-2 cans of diet coke is a reasonable intake, taking too much of any one food is discouraged.
Question
Does Splenda have any calories in it per gram?
Answer
SPLENDA® is the brand name for sucralose; it is made from cane sugar and is converted to a no-calorie, non-carbohydrate sweetener. It has an insignificant calorie value per serving, although it contains a very small amount of dextrose and/or maltodextrin for volume. The amount of these ingredients is small, so SPLENDA® meets FDA's standards for "no calorie" sweeteners.
Question
I've started on a 1700 calorie per day diet. Do I require vitamin supplements as I intend to continue this diet for a while to come?
Answer
If you are eating a well-balanced diet (which is possible to do on 1700 calories), you do not need to take vitamin supplements. However, if you are omiting any food or food group from your diet, such as no fruit or dairy products, then you may need to supplement your diet with the missing vitamins or minerals to ensure that you are not creating a deficiency over the long term.
Question
Can I know about taking weight loss pills?
Answer
I am not in a position to comment on the safety or effectiveness of medication or drugs as it is not my area of specialty. I am aware, however, that many weight loss pills have side effects and may interact with other medication that you may be taking (including cough/cold medication, herbal supplements and vitamins). Some of the weight loss pills should not be used if you have a health condition such as hypertension, over-active thyroid or if you are allergic to certain medication.

A series of warnings have been issued by both the Food and Drug Administration (FDA) and leading medical researchers regarding the dangers of taking a popular diet drug, phentermine (brand name: Ionamine) particularly when used in combination with fenfluramine (another weight loss drug). This is just one example; there are many others.

IT IS VERY IMPORTANT THAT YOU CONSULT YOUR DOCTOR PRIOR TO TAKING THESE MEDICATION AS THEY HAVE SIDE EFFECTS AND MAY INTERACT WITH OTHER MEDICATION THAT YOU ARE TAKING. You should not start on ANY medication without first consulting your physician and you should let him/her know of all the medication you are currently taking, including herbs, health supplements and off-the-shelf medication.

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