Ask the RD | March
Our registered dietitian, Jamie, offers answers to nutrition-related questions our community have submitted over the past month.
The information shared within this blog is meant for informational purposes only and should not be received as medical advice.
If you have a question to submit, please click the button and watch for a response the following month. Before submitting a question, we invite you to visit the main page for Ask the RD and enter a keyword into the search box — your question may already be answered!
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Creatine, a natural compound made of amino acids, is used to produce energy within the body. It works to replenish adenosine triphosphate (ATP) energy storage, which is used as the main fuel source for the body. The human body generates creatine in the liver, kidneys, and pancreas, primarily supporting muscles during physical activity. In addition to the creatine produced by the body, creatine comes from dietary sources including animal-based foods such as meats (beef and pork), seafood (fish and shellfish), and dairy (cow, sheep, and goat milk, yogurt, cheese).
Supplemental creatine in the form of creatine monohydrate is frequently used by athletes to enhance athletic performance given its known benefits for muscle function, building, and recovery. More recently, research is suggesting that creatine may also benefit brain health and slow age-related muscle loss. For those who choose to supplement, a dose of 3-5 grams per day of creatine monohydrate is considered safe and effective.
Who should be supplementing their diet with creatine? Supplemental creatine has been widely studied and is considered safe for most people. However, insufficient research has been done on children and teens, individuals that are pregnant or breastfeeding, those with kidney disease, liver disease, or bipolar disorder. Supplemental creatine may be most beneficial for athletes, especially those participating in strength training and/or short-duration explosive forms of exercise such as body building, football, hockey, wrestling, sprinting, and biking. For people over the age of 60, higher doses of supplemental creatine may support memory and reasoning, though more studies are needed to determine if creatine has a positive impact on dementia. As far as creatine’s role in reducing age-related muscle loss (sarcopenia), studies are showing some benefits for increasing both muscle mass and muscle strength for the aging population. Supplementation may enhance bone mineralization and even offer some anti-inflammatory benefits during times of metabolic stress, however, research is ongoing. While creatine supplementation is safe for most, I always recommend consulting with your physician before starting any supplements.
Previous Ask the RD Posts:
Are any supplements safe and healthy? Are there any that can’t be taken at the same time? (November 2023)
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The thyroid is a gland that produces hormones that function throughout our bodies. Thyroid hormones play a role in numerous body systems including circulatory, digestive, musculo-skeletal, nervous, reproductive, and respiratory systems. They influence body metabolism and play a critical role in keeping our bodies running smoothly. Both hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid) can have significant impacts on our health.
The diet can certainly influence thyroid health with a few key nutrients:
Iodine: The body needs adequate — but not excess — iodine to make thyroid hormones T4 and T3. Iodine can be found in dairy foods, seafood, seaweed, eggs, and iodized salt. People that follow a vegetarian or vegan diet may be at risk of not getting enough iodine. However, most people get plenty of iodine from the diet since the widespread fortification of table salt into iodized salt in the 1920s.
Certain foods, such as cruciferous vegetables (broccoli, cauliflower, cabbage, kale), soy, and millet can also affect how thyroid hormones are absorbed in the body. Though it is not necessary to avoid these foods all together, it is important to eat them in moderation and/or consider mediation timing if you are dealing with thyroid disease.
Selenium: The mineral selenium is essential in converting T4 into the active form T3. Brazil nuts pack the most selenium; so much in fact that you risk selenium toxicity if you regularly eat them. Other, more modest selenium-rich foods include tuna, halibut, shrimp, chicken, turkey, pork, eggs, sunflower seeds, and brown rice.
Zinc: The mineral zinc is involved in thyroid hormone production and regulation and also plays an important role in the conversion from inactive T4 into active T3. It can be found in oysters, beef, pork, poultry, lentils, and pumpkin seeds. Eggs, milk, and yogurt also contain small amounts of zinc.
Iron: Iron is needed for the synthesis of thyroid hormones. Many people fail to get enough iron in their diets, which can lead to impaired thyroid function. Rich sources include fortified grain products (such as breakfast cereals), organ meats, shellfish, red meat, dark poultry (chicken or turkey thighs and legs), beans, lentils, tofu, pumpkin seeds, sesame seeds, cashews, dried fruits (raisins, apricots, prunes), dark leafy greens, and potatoes. Pair plant-based iron foods (which contain non-heme iron) with vitamin C-rich foods (see below) for better absorption.
Vitamin A & D: Both are fat-soluble vitamins that play a role in thyroid hormone production. Vitamin A rich foods include beef liver, fish, dairy, egg yolks, sweet potatoes, carrots, pumpkin, red bell pepper, mango, papaya, and dark leafy greens. While vitamin D can be found in fatty fish and fortified foods such as dairy products and juices.
Vitamin C & E: These vitamins function as antioxidants, helping to protect your thyroid from oxidative stress. Choose citrus fruits, strawberries, bell peppers, and tomatoes for vitamin C and vegetable oils, nuts and seeds for vitamin E.
Overall, it is important to eat a balanced and varied diet consisting of colorful fruits and vegetables, whole grains, plant-based proteins, lean animal proteins, dairy, and healthy oils to ensure nutrient adequacy. Additionally, choosing mostly whole/minimally processed foods, increasing fiber intake, reducing sugar intake, and staying adequately hydrated can support optimal thyroid function.
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Unfortunately, hair thinning and hair loss are common during menopause. Hormonal changes, namely declining levels of estrogen and progesterone, negatively impact hair growth. Some nutritional strategies to support hair and scalp health include:
Eat adequate calories. Diets that are too low in calories can worsen thinning hair. Consuming adequate calories help to meet your body’s basic needs, maintain a healthy body weight, and to support healthy hair growth.
Protein: Protein is essential for hair growth. Ensure you are getting enough by including a palm-sized portion of protein at each meal.
High protein foods include meat, poultry, fish, eggs, dairy, beans (including soy), and lentils.
Carbohydrates: Carbohydrates fuel our bodies with energy and provide valuable vitamins and minerals that can support healthy hair growth.
Choose a variety of complex carbohydrate foods such as whole grains, starchy vegetables, fruits, and beans and lentils.
Fat: Dietary fat is needed to help your body utilize fat soluble vitamins like A, D, E, and K.
Choose healthy fats from non-tropical plant oils, nuts, seeds, avocados, and fish.
Increase your intake of omega-3 fats by including more salmon, tuna, walnuts, flax and chia seeds.
Consume your vitamins and minerals through whole foods.
Vitamin A: Choose yellow and orange fruits and vegetables, including sweet potatoes, winter squashes, papaya, mango, and cantaloupe, as well as dark leafy greens.
Vitamin D rich foods include egg yolks, fortified dairy products, and fish though supplementation may be beneficial if living at latitudes with insufficient sun exposure.
Vitamin E can be found in nuts, seeds, nut butters, salmon, and trout.
Iron-rich foods include red meats, shellfish, dark meat poultry, fortified grain products, leafy greens, beans, lentils, tofu, pumpkin seeds, sesame seeds, cashews, and dried fruits.
Good sources of zinc include oysters, beef, pork, poultry, lentils, and pumpkin seeds.
Consider supplementation if deficient: A balanced diet consisting of a variety of whole grains, fruits, veggies, lean proteins, and healthy fats should be providing your body with everything it needs. However, dietary supplements can be helpful when dealing with chronic inadequacies and deficiencies. If you are going to supplement, I’d recommend choosing a multivitamin + mineral that provides 100% of the essential nutrients.
In addition to hormonal causes, hair loss can also occur due to high stress, rapid weight loss, harsh hair treatments, medical conditions, medications, medical treatments such as chemo or radiation, or even genetics. As such, be sure to discuss significant hair loss concerns with your physician or dermatologist.
Previous Ask the RD posts:
Can you recommend dietary adjustments to help reduce hot flashes? (December 2024)
How can I maintain a healthy post-menopausal weight? (May 2024)
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Mushrooms have long been used in cooking, offering their savory umami flavor and chewy consistency. Though frequently used in Eastern medicine for thousands of years, it hasn’t been until recently that mushroom teas and coffees entered the main-stream health and wellness scene.
Mushroom tea/coffee has become a popular caffeine alternative, boasting a beverage full of vitamins, minerals, and antioxidants. Mushroom coffee is said to help improve sleep, increase energy, heighten focus, enhance immunity, reduce inflammation, regulate metabolism, support weight loss, and even slow the aging process. It is typically made from a blend of medicinal mushroom varieties including chaga, lion’s mane, reishi, king trumpet and others which are harvested, dried, processed, and ground into a powder before being sold as mushroom tea/coffee.
Unfortunately, well-designed human studies using mushroom coffee are lacking. Though we could reasonably extrapolate the health benefits from studies looking at consuming whole, unprocessed mushrooms, but it is difficult to guarantee that mushrooms’ beneficial properties are preserved when consumed in the processed form of mushroom coffee. For now, I would say mushroom coffee is likely safe to consume for most, that is if you enjoy the taste and don’t mind paying a bit more money as compared to your standard cup of coffee. But be aware, medicinal mushroom extracts, such as those found in these teas and coffees, can interfere with some medications; please check with your pharmacist or physician before consuming.
As far as culinary mushrooms go, feel free to eat and enjoy them knowing they are not only delicious but also a good source of fiber, B vitamins, vitamin D, selenium, potassium, copper, and antioxidants.
For additional information, see Providence’s health blog on the topic.
Jamie Libera, RD, LD, CCTD, is a clinical dietitian within the Providence health system. She works closely with the heart programs in offering consultations for heart failure patients, cardiac rehab patients, and serves as the nutrition consultant for Basecamp Prevention + Wellness. Jamie offers monthly nutrition-based classes and a monthly heart-healthy recipe as part of Basecamp’s free community programming.