ask the experts - health and nutrition questions - Brief Article

I have been smoking for almost 12 years and it is time to stop! But is there a way I can quit without using nicotine? -- CJ, Ill.

answer

Quitting smoking cold-turkey leads to nicotine withdrawal symptoms such as irritability, anger, anxiety, sleep disturbance and depressed moods. There is little evidence that hypnosis is helpful, and acupuncture rarely works. Quitting smoking is a learning process, not a complete matter of will power, so don't be discouraged if you don't succeed the first time. Most ex-smokers require several attempts before quitting.

Here are some helpful strategies: Set a date within the next four weeks to quit smoking. When you decide to quit, total abstinence is essential. Avoid or limit alcohol use. Enlist social support from friends and family. Make your environment tobacco-free. Each day collect the money you would have spent on cigarettes in a jar and take a loved one to dinner with the savings. If you have mild depression, you could consider taking St. John's wort or SAM-e to improve your mood. A pharmaceutical alternative is the medicine buproprion which helps with depression and smoking cessation. Nicotine patches and gum are sold without prescription and they do slightly help in quitting but they are expensive.

Q. Can you take too much calcium? What are the effects if you do? ER, Calif.

answer

Optimal calcium intake is estimated to be 1,000 to 1,500 mg a day for most adults, and a large percentage of them do not reach that. From supplements and the diet combined, calcium intake up to 2,000 mg a day is safe in most individuals.

High levels of calcium intake have several potential adverse effects. It is well known that calcium toxicity, with high blood calcium levels, severe renal damage, and calcium deposition (milk-alkali syndrome), can be produced by overuse of calcium carbonate, encountered clinically in the form of antacid abuse. It may make otherwise healthy persons more susceptible to developing high calcium levels in the urine, and might increase the risk of stone formation. It may also interfere with absorption of other nutrients like iron, which could be dangerous: for those with marginal iron status.

Gastrointestinal side effects of calcium supplements have been observed, such as constipation. Contamination with lead and other heavy metals is also a possible danger. However, most commercial calcium preparations are tested to ensure that they do not contain significant heavy metal contamination.

In conclusion, a modest increase in calcium intake should be safe for most people. Total calcium intake exceeding 2,000 mg a day seems more likely to produce adverse effects.

Q. What is the difference between complex carbohydrates and simple carbohydrates? Should I avoid one more than another? KM, R.I.

answer

Complex carbohydrates, primarily starches, are long chains of glucose molecules. The three types of complex carbohydrates of nutritional importance are fiber, starch, and glycogen.

Complex carbohydrates are important for several reasons. Starch and glycogen represent energy sources for the body while fiber has strong links to disease prevention. High fiber foods may be beneficial because they tend to be rich in antioxidants and low in fat and calories. A fiber rich diet is also beneficial in alleviating and preventing conditions including constipation, diverticulosis, perhaps colon and rectal cancer, heart disease, breast cancer, diabetes, and obesity. Grains and beans, such as barley, lentils, peas, beans, bulgur, whole wheat, etc., are great sources of complex carbohydrates.

I would certainly recommend reducing intake of simple carbohydrates such as glucose, fructose, sucrose and others since they are generally devoid of nutrients and tend to raise blood sugar levels. The rise in blood sugar levels induces an excessive release of insulin. Sugars also tend to convert into saturated fats and can cause hardening of the arteries.

Ray Sahelian is the author of the newly published Mind Boosters: A Guide to Natural Supplements That Enhance Your Mind, Memory, and Mood (St. Martin's Press, 2000). See www.raysahelian.com, pr write to him in care of Better Nutrition magazine, Sabot Publishing, 9 Riverbend Drive, South, Stamford CT 06907. He cannot answer questions by mail or telephone. "Ask Experts" is intended for educational purposes only. If you have a medical problem, consult your physician.

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