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Jo-Anne M. Rizzotto, M.Ed, R.D., L.D.N., C.D.E.

Jo-Anne Rizzotto, MEd, RDN, LDN, CDCES, is Director of Educational Services at the Joslin Diabetes Center and Harvard Medical School in Boston, MA. She is a registered dietitian and a certified diabetes educator with over 25 years of clinical, research, management and industry experience and is a key member of the clinic leadership team. Jo-Anne is co-chair and an active member of the National Certification Board of Diabetes Educators Exam Board. Jo-Anne has a proven track record of managing many facets of quality assurance and improvement with documented outcomes including advancing the use of technologies in the clinic for the management of diabetes. Jo-Anne establishes, directs and manages all aspects of diabetes education programs including overall direction, content, design, delivery, budgeting and staff management. She ensures all programs and staff delivering education meet the highest quality standards and do so with the highest level of efficiency and effectiveness. Jo-Anne participates in and has been the co-principle investigator in numerous clinical research studies. Jo-Anne chairs and participates in a variety of high level selection committees, clinical guideline committees, publication review committees and academic promotion committees. She also chairs the quality committee with the General Counsel at the Joslin in addition to the Clinic policy and procedure committee.

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Q:

How much is too much of a vitamin or mineral to ingest before it becomes toxic? I eat at least six to seven servings of fruit and vegetables every day, including spinach almost daily. Am I at risk for vitamin A or iron toxicity?

A:

Kudos to you for eating six to seven servings of fruit and vegetables each day! Because food contains small amounts of vitamin A, it is unlikely that you are exceeding the Daily Value (DV) of 3,000 IU (International Units) in a day. The Tolerable Upper Level (TUL) of vitamin A—that is, the most you can take without worrying about any adverse effects—is 10,000 IU. Foods rich in vitamin A are orange, red and yellow fruits and vegetables, such as carrots, sweet potatoes, tomatoes and cantaloupe; and green leafy vegetables, such as spinach and broccoli.

Iron is more complicated because there is no amount that's right (or wrong) for everyone. Premenopausal women need 18 milligrams (mg) of iron each day, whereas postmenopausal women need only about 10 mg of iron daily. The TUL for iron is 45 mg in a day. Foods rich in iron are red meat, fish, poultry, eggs, legumes and fortified cereals.

Knowing the acceptable intake of each of these nutrients, along with reading labels and/or using some of the resources below, can help guide you further.

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