Volume 13, Number 3: May 2005
Ask Dr. Nancy
With this issue, HealthLine offers readers a new column: expert health information from Nancy Van Vessem, M.D., Chief Medical Officer of Capital Health Plan. Dr. Van Vessem is pleased to answer members' questions about wellness care, healthy habits, and prevention. "More patients are asking me excellent questions," she explains, "and HealthLine is a way to share the answers." We start with two common questions that "Dr. Nancy" hears from members. If you have a wellness question for the column, please email it to and put "Dr. Nancy" in the subject line.
Q: Should I take a baby aspirin as a prevention?
A: Aspirin, a pain reliever in use for more than 100 years, also thins the blood (anti-clotting) and reduces swelling. Many doctors prescribe a daily aspirin for people who have had or are at risk for heart attacks, other cardiovascular disease (CVD), and strokes. Preliminary research indicates that aspirin may also help prevent certain cancers, but studies are not conclusive. The U.S. Preventive Services Task Force recommends a daily aspirin for heart health if you are:
- man over 40
- postmenopausal woman
- younger person with risk factors for CVD, such as smoking, high blood pressure, high cholesterol, or diabetes.
Preventive aspirin is not for people who have a bleeding disorder, gastrointestinal bleeding, or a history of peptic ulcer, liver, or kidney disease.
Now: baby vs. regular aspirin? The FDA-approved dose for heart and stroke is 81 mg. (a typical baby aspirin) to 325 mg. Many studies suggest that a baby aspirin is just as effective as a higher dose and probably safer, but more definitive research is needed.
Because of all these factorsfrom health status to risk to ageit's best to follow your doctor's advice about this preventive practice, including the dose amount.
Q: Should I take a daily multivitamin?
A: We can all agree that the best way to maintain proper nutrition is to eat a wide variety of natural foods, particularly fruits and vegetables. Healthy foods are the best source of vitamins and minerals. Also, foods contain nutrients not present in multivitamin/mineral tablets. Having said that . . .do you get your five fruits and vegetables a day?
In June 2002, an article in the Journal of the American Medical Association recommended that all Americans take a multivitamin daily to help prevent chronic diseases like heart disease and cancer. Why this broad advice? The average American has a diet deficient in nutrients, and a low-dose supplement poses very low risk. Just make sure the quantity of each vitamin does not exceed 100% of the Recommended Dosage Amount, and remember that vitamins added to foods (cereals, etc.) may decrease supplement need.
Some special circumstances that call for vitamin supplements include:
- Pregnant women need 400 mcg. daily of folate (or folic acid), which can reduce neural tube defects in unborn children by 50%.
- Calcium, 1,000-1,500 mg. a day, is important in reducing osteoporosis.
- People older than 50 may lose their ability to absorb vitamin B12 and can benefit from supplements.
- People on low-calorie diets (fewer than 1,200 kcal/day) should take a multivitamin.
There is evidence that large doses of vitamins can be harmful, especially fat-soluble vitamins such as A and D that accumulate in the body. Be sure to read the label to avoid an overdose. If you have questions or concerns, ask your primary care doctor. Final word: Multivitamins are a fall-back strategy. The best strategy is a healthy diet.
For healthy eating guidelines, classes, and appointments with our dieticians, call CHP's Health Education Department at 383-3511.