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Ask Dr Emma
Dr Emma answers your health questions.
ShutterstockQ. Do I need to take vitamin supplements?
A: As a general rule, most people do not need to take generic vitamin supplements. As long as you have a healthy, varied diet, you should get the vitamins and minerals you need from your food. The NHS does recommend that the following groups of people take these particular supplements:
Everyone should take vitamin D supplements in the Autumn and Winter months. The recommended dose is a daily supplement containing 10 micrograms of vitamin D.
Women who are pregnant or trying to conceive should take 400 micrograms of folic acid daily until the 12thweek of pregnancy to prevent the risk of neural tube defects in the unborn child.
Children aged 6 months to 5 years should take vitamin supplements containing vitamins A, C and D daily.
Alongside this, some people have vitamin deficiencies which should be replaced. For example, many young women are iron deficient and need to take iron supplements, and older adults who are at risk of brittle bones need calcium supplements. There are also certain medical conditions that mean vitamins like B12 need replacing. Your doctor will recommend specific vitamin replacements if you need them, usually after a blood test.
When you’ve already got the necessary amount of a vitamin in your body (through food), your body just gets rid of any excess in the urine or stores it in the fat in your body. So, taking additional vitamins that you already get enough of in your diet can be considered a waste of money. Also, too much of some vitamins can rarely be harmful.
Q. Is coffee bad for me?
A: This question has multiple answers, because coffee comes in multiple forms. Before we go into specifics, it’s important to mention that many coffee drinks from your favourite cafes are flavoured with sugary syrups or topped with cream etc. So, one issue with coffee is that in some forms, it can add a lot of calories to your daily intake.
Now to talk about the main active ingredient in coffee – caffeine. Caffeine increases the body’s adrenaline levels. Adrenaline is our ‘fight or flight’ hormone – it gets our bodies ready for action by increasing our heart rate, opening our airways and other things. Caffeine also stimulates our nervous system so that we’re more alert. People who have high blood pressure or problems with heart palpitations should avoid lots of caffeine, as it can make these things worse. It’s also been recommended that pregnant women, or women who are trying to get pregnant should watch their caffeine intake.
Other ingredients in coffee are compounds called polyphenols. These actually decrease blood pressure and increase blood flow to the brain, which is beneficial. There’s actually evidence that shows that coffee-drinkers are at lower risk of stroke and type 2 diabetes. Coffee also has antioxidants, which can be helpful in preventing cancer – there’s some evidence that shows lower risk of liver cancer in those who drink coffee.
So overall, coffee is safe. Like most things, it should be enjoyed in moderation.
Q. Will eating late in the day make me gain weight?
A: There’s good evidence both for and against this statement and to be honest, I’m not sure exactly where I stand, personally.
It’s generally thought that your body doesn’t metabolise food differently at different times of the day; weight gain/loss can simply be explained by the number of calories you take in minus the number of calories you burn up. There have been scientific studies that show no difference in weight gain between animals that are fed late and those who are fed earlier in the day. However, other research shows that it’s not that straightforward.
Some researchers have reported that those who eat later have higher average blood sugars and burn less fat overnight than those who eat earlier. It seems that this effect varies greatly amongst individuals due to several factors, including genetics and the person’s usual sleeping pattern. Another area of science that is worth thinking about is how fat is used in the body. Fat is the form in which the body stores energy, like a power bank that can be used when there are no other forms of energy available. So, the body won’t start to burn fat unless it believes no other energy source is coming. Therefore, if you eat late at night, the window of opportunity for your body to actively burn fat is smaller.
I think the simplest fact to hold on to is that if you eat late and then go to bed, you have less opportunity to actively burn the calories you’ve eaten. Of course, your body will passively burn calories by carrying out the essentials – breathing, keeping your heart beating etc, but this will be less than the calories you would burn whilst at work or running errands. It’s also been suggested that people who eat late at night are more likely to snack on calorific foods or make unhealthy food decisions because they’re tired after a long day.
Q. Does stress cause hair loss?
A: Stress is implicated in so many medical issues, and hair loss is definitely one of them. There are many reports of acute, reversible hair loss following periods of emotional stress. The relationship is hard to characterise accurately however, since hair loss in itself is stressful. Everyday emotional stress causing long term hair loss is not so well supported scientifically.
There is a common medical condition known as telogen effluvium, which is where hair gets “stuck” in the telogen, or shedding phase of the hair cycle, and sufferers complain of marked hair loss. It’s normal for 10% of a person’s hair to be in the telogen phase, but in telogen effluvium, 30% or more of hair is in this phase. We commonly see telogen effluvium triggered by childbirth, a severe illness or a major life event. It’s also seen in people who lose a lot of weight in a short period of time. In most cases, telogen effluvium spontaneously resolves after a few months, but in some cases, it can become a chronic problem.