Tag Archives: Centrum

My Ketogenic Mediterranean Diet: Day 59 + Updated Supplement Recommendations

888894Weight: 154 lb

Transgressions: none

Exercise: 90 minutes horse grooming and trail riding

Comments

I’ve finalized the latest supplements for dieters on the Ketogenic Mediterranean Diet, and tinkered with the original plan: Version 2.0 is published.

Daily supplements:

  • 1 or 2 plain Centrum multivitamin/multimineral supplements (two if over 250 lb or 114 kg)
  • Magnesium oxide 250 mg
  • Calcium carbonate 500 mg elemental calcium  (500 mg twice daily if over 250 lb or 114 kg)
  • Extra vitamin D to reach total of 1,000–1,2000 IU (each Centrum has 400 IU)
  • Potassium gluconate 2,750 mg (450 mg elemental potassium) or Morton Salt Substitute (potassium chloride) ¼ tsp (1.2 g)
  • If prone to constipation: sugar-free Metamucil powder 1–2 rounded tsp (5.8–11.6 g) in water
  • At least three quarts or liters of water 

Steve

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Centrum Multivitamin/Multimineral Supplement

1 or 2 Centrums daily

1 or 2 Centrums daily

I recommend Centrum for people on the Ketogenic Mediterranean Diet.  Since the composition of plain Centrum could change at any time (or be concocted differently in non-U.S. countries), I’m recording the contents of the current U.S. product.   Here are the component amounts with “% Daily Values” in parentheses. 

U.S. government authorities recommend Percent Daily Values for average non-pregnant healthy adults eating 2,000 calorie a day.

Vitamin A 3,5000 IU (70%), Vitamin C 60 mg (100%), Vitamin D 400 IU (100%), Vitamin E 30 IU (100%), Vitamin K 25 mcg (31%), Thiamin 1.5 mg (100%), Riboflavin 1.7 mg (100%), Niacin 20 mg (100%), Vitamin B5 2 mg (100%), Folic Acid 400 mcg (100%), Vitamin B12 6 mcg (100%), Biotin 30 mcg (10%), Pantothenic Acid 10 mg (100%), Calcium 200 mg (20%), Iron 18 mg (100%), Phosphorus 20 mg (2%), Iodine 150 mcg (100%), Magnesium 50 mg (13%), Zinc 11 mg (73%), Selenium 55 mcg (79%), Copper 0.5 mg (25%), Manganese 2.3 mg (115%), Chromium 35 mcg (29%), Molybdenum 45 mcg (60%), Chloride  72 mg (2%), Potassium 80 mg (2%), Boron 75 mcg, Nickel 5 mcg, Silicon 2 mg, Tin 10 mcg, Vanadium 10 mcg.

Why Centrum?

It’s been around for years and  has a good reputation.  It’s widely available at a reasonable price.  This is not a paid endorsement, in case you’re wondering.  Let me know if you think my faith is misplaced.  

Steve

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My Ketogenic Mediterranean Diet: Day 33 + Magnesium Review

CB022214Weight: 159 lb

Transgressions: 12 oz  of 7-Up carbonated beverage

Exercise: none

Comments

I accidentally drank a 7-Up at the hospital physician’s lounge: the diet 7-Ups were right next to the regular 7-Ups in the refrigerator.  It had 39 g of carbs, all sugar of course.  I didn’t realize what I’d done until too late; the texture finally gave it away.  I rarely drink 7-Up in any case.  My favorite diet soda is Fresca.  Nothing wrong with 1-2 daily for most folks.  If I were going to cheat on purpose, it wouldn’t be with soda pop.  Snickers bar is more like it!

My nutrient analysis of the un-supplemented Ketogenic Mediterranean Diet suggests that it may be deficient in magnesium.  Here’s a summary of magnesium physiology from UpToDate.com and Medscape:

Role of Magnesium

Influences properties of cell membranes.  Helps regulate other mineral levels: sodium, potassium, calcium.  Works with enzymes, particulary in energy production.  Helps with protein production.  Most of our magnesium is in our bones.

Sources

Leafy greens, nuts, legumes, animal proteins.  [All but legumes are on the Ketogenic Mediterranean Diet.]

Effects of Deficiency State

Abnormal EKG (an electrical tracing of heart activity).  Abnormal heart rhythms, especially ventricular arrhythmias.  Weakness, convulsions, loss of appetite, low blood levels of calcium and potassium, seizures, apathy, delirium coma.

Causes of Low Magnesium

Gastrointestinal or kidney losses: vomiting, diarrhea, diuretics, genetic disorders, several kidney-toxic drugs little used in the general population, small bowel bypass surgery, inability to absorb from intestinal tract.

Miscellaneous: marked dietary deprivation, diabetes, alcohol abuse, high blood calcium levels, ketogenic extremely high-fat diets used to suppress epilepsy (usually in children: up to 10% have low magnesium).

Implications

Hmm…, causes of magnesium deficiency include …ketogenic extremely high-fat diets used to suppress epilepsy…  The ketogenic anti-epilepsy diet may be even lower in carbohydrates than is the Ketogenic Mediterranean Diet, so fewer leafy greens (and nut-free?).  Since I don’t treat children with epilepsy, I haven’t done much research into the anti-epilepsy ketogenic diet yet. 

One Centrum multivitamin/multimineral supplement contains only 13% of the recommended “% Daily Value” of magnesium.  Might be a good idea for KMD dieters to take an additional magnesium supplement, probably available over-the-counter at pharmacies, supermarkets, or health food stores.  Or get a blood level of magnesium drawn periodically.

-Steve

 

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My Ketogenic Mediterranean Diet: Day 15 and Week 2 Recap

Just a few supplements

Just a few supplements

Weight: 162 lb (73.6 kg)

Waist circumference: 35 inches (89 cm)

Transgressions: none

Exercise: none

Comments

Down 3 lb (1.36 kg) for the second week of the diet, for a total of 8 (3.64 kg) since the start two weeks ago.  Waist size down 1.5 inches in two weeks.  I still doubt the majority of  that loss weight is fat.  More likely to be water, glycogen, and intestinal contents.  But some of it’s fat.  Rate of weight loss likely to slow soon, which is fine with me.

My daily caloric intake for the last week has averaged 1,850 calories.  Total daily digestible carbohydrate is about 25 g.

Nutrient analysis at NutritionData suggests that my food consumption is deficient in vitamins D, E, thiamine, B6, folate, pantothenic acid.  Less commonly are suggested deficiencies in vitamins A, C, K, niacin, and B12.  It also suggests inadequate intake of minerals: calcium, iron, magnesium, potassium, sodium (!), copper, manganese, and occasionally zinc.

In any case, I’ve been taking a Centrum multivitamin and multimineral supplement and extra vitamin D (400 IU) daily.  A single  Centrum tablet has the following “percent daily values” for vitamins and minerals: 100% for C, D, E, thiamine,B6, folate, niacin, pantothenic acid, B12, and iron.  It also has the following percent daily values: vitamin A 70%, vitamin K 31%, calcium 20%, magnesium 13%, potassium 2%, copper 25%, zinc 73%, and manganese 115%.  [Note that the manufacturer could change the composition at any time.]

Summary of Vitamin and Mineral Content

This very low-carbohydrate ketogenic diet may be deficient in multiple vitamins and minerals, unless supplemented.  A single Centrum ensures good levels, for most adults, except for possibly calcium, magnesium, potassium, sodium, copper, zinc, and vitamin K. 

Supplementing with elemental calcium (e.g., calcium carbonate) 500-1,000 mg daily might be a good idea.  Magnesium and potassium supplements might be a good idea.  Adding some salt (NaCl) to food should supply enough sodium.  [The standard American diet has far more salt than necessary.]     

 I’m just not convinced yet that this diet could actually be deficient in potassium.

Clinically significant deficiencies of copper and magnesium based on diet are probably rare.  I’ll have to do more research.  Nearly all the low blood levels of magnesium I see are in heavy alcohol drinkers or people using diuretics.

If you try a very low-carb ketogenic diet, you might ask your physician to draw blood levels of magesium and potassium two weeks after you start.

After two weeks on the Ketogenic Mediterranean Diet I feel as fine as usual.  I don’t see or feel any signs of vitamin or mineral deficiency.  But an experiment of one isn’t worth much.

Easy bruising is a relatively common occurrence in people on very low-carb ketogenic diets.  I wonder if it’s related to vitamin K deficiency.  Such bruising is seen also in children on the seizure-control ketogenic diet (not for weight loss); the diet seems to unmask a preexisting genetic predisposition to bleeding.

Vitamin K intake is a serious concern for people taking certain blood thinners (anticoagulants): coumadin, warfarin, coumarin.  Too much vitamin K counteracts the blood thinner; too little enhances the blood thinning.  Both situations are dangerous.  [I’m not talking about aspirin and Plavix.]  

I’m doing my nutritional analysis at NutritionData.  You can analyze your own diet via My Tracking.  They have a footnote accompanying the nutrient analysis for all of my vitamins and minerals: “missing or incomplete value.”  I assume that means the reported micronutrient amounts could be higher than reported. 

Potential Supplement Recommendation for the Ketogenic Mediterranean Diet

[This is a work in progress.  Stay tuned.]

Taking two Centrums daily could neatly solve the potential deficits of vitamins A and K, and minerals magnesium, copper, and zinc.  On the other hand, it could be overkill.  Add calcium as above, and maybe extra vitamin D 400 IU.  [There’s good evidence that the current U.S. Daily Value for vitamin D is too low.]  To summarize this daily supplementation regimen:

  • Two Centrums 
  • Additional calcium (elemental) 500-1,000 mg
  • Additional vitamin D 400 IU   

-Steve

Disclaimer:  Information herein is meant to complement, not replace, any advice or information from your personal health professional.  All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status.  Always consult your personal physician before making any dietary changes, such as vitamin and mineral supplementation.

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