Vitamin D and Infectious Disease

Immunologic Effects of Vitamin D on Human Health and Disease

Nipith Charoenngam^{1 2}, Michael F Holick¹

Affiliations

PMID: 32679784
DOI: 10.3390/nu12072097

Free article

Abstract

Vitamin D is responsible for regulation of calcium and phosphate metabolism and maintaining a healthy mineralized skeleton. It is also known as an immunomodulatory hormone. Experimental studies have shown that 1,25-dihydroxyvitamin D, the active form of vitamin D, exerts immunologic activities on multiple components of the innate and adaptive immune system as well as endothelial membrane stability. Association between low levels of serum 25-hydroxyvitamin D and increased risk of developing several immune-related diseases and disorders, including psoriasis, type 1 diabetes, multiple sclerosis, rheumatoid arthritis, tuberculosis, sepsis, respiratory infection, and COVID-19, has been observed. Accordingly, a number of clinical trials aiming to determine the efficacy of administration of vitamin D and its metabolites for treatment of these diseases have been conducted with variable outcomes. Interestingly, recent evidence suggests that some individuals might benefit from vitamin D more or less than others as high inter-individual difference in broad gene expression in human peripheral blood mononuclear cells in response to vitamin D supplementation has been observed. Although it is still debatable what level of serum 25-hydroxyvitamin D is optimal, it is advisable to increase vitamin D intake and have sensible sunlight exposure to maintain serum 25-hydroxyvitamin D at least 30 ng/mL (75 nmol/L), and preferably at 40-60 ng/mL (100-150 nmol/L) to achieve the optimal overall health benefits of vitamin D.

This abstract and article was published in Nutrients, 2020: 12(7), 2097

In light of the current Covid-19 pandemic, questions are raised and answers sought about the role of nutrition in the prevention of infectious diseases. In this case, vitamin D (a fat soluble vitamin stored in the body) is examined.

Vitamin D Facts:

RDA Women: 600 IU; Men: 600 IU; UL: 4000 IU. Toxicity possible with long-term use of 10,000 IU daily. 1 microgram (mcg) vitamin D = 40 IU.

Primary Functions: Needed for absorption of calcium and phosphorus for bone formation nerve and muscle activity. Inhibits inflammation and is involved in insulin secretion and blood glucose level maintenance.

Consequences of Deficiency: Weak, deformed bones (children), loss of calcium from bones (adults), osteoporosis.

Concenquences of Overdose: Mental retardation in young children, abnormal bone growth and formation. Nausea, diarrhea, irritability, weight loss. Deposition of calcium in organs such as kidneys, liver and heart.

Primary Food Sources: Vitamin D – fortified milk, cereals, and other foods. Fish

Highlights: Vitamin D3, the most active form is manufactured from a form of cholesterol in skin cells upon exposure to ultraviolet rays from the sun. Inadequate vitamin D status is common. Breast-fed infants with little sun exposure benefit from vitamin D supplements. People with very dark skin, especially from Asian and Afro-Carribbean descent find it difficult to make vitamin D from limited sunlight.

NOTE: It’s important to know that megadoses of any vitamin or mineral are never recommended, unless there is a medical reason for doing so. In this case, a Canadian study reported that among 303 middle-aged and older adults (who were not vitamin D deficient), those who were randomly assigned to get 4,000 IU of vitamin D a day for 3 years lost more bone in their arms than those who got 400 IU a day. Those who got 10,000 IU a day lost more bone in their arms and shins than those who got 400 IU a day. See the consequences of overdose.

Chronic Disease: Can Your Lifestyle Make a Difference?

Lately in the literature, lifestyle medicine has been mentioned as an effective practice that influences our overall health and risk of diseases in general. Many of the leading causes of death in developed countries have been referred to as chronic diseases and ways to prevent these diseases is to practice a “healthy lifestyle”. But what does that exactly mean? Some research has suggested that our susceptibility to Covid-19 may even be altered by our lifestyles, obesity being named a risk factor.

In 1999, a Harvard-trained cardiologist, James E. Rippe published a textbook entitled Lifestyle Medicine in which he expressed his hope for a “new emphasis in medicine related to the links between daily behaviors and outcomes”. The idea slowly took root. In 2006, Loma Linda University School of Medicine, a Seventh Day Adventist institution in California, debuted the country’s first lifestyle medicine education program. A few years later the School of Medicine Greenville at the University of South Carolina went a step further, integrating lifestyle medicine into every facet of the curriculum and requiring prospective physicians in medical schools to spend 50 hours over two years covering the ways in which diet, nutrition and exercise impact the various organs and systems. Several other medical school programs have followed, that have been dedicated to the principals that healthy food, rich in nutrients, healthy fats, and lean protein, can be a potent weapon in the doctor’s bag.”

“How much a role does nutrition play in health? “It is the thing, says Jennifer Trilik , an associate professor at USC Greenville who directs the schools lifestyle medicine program. “if we’re talking about obesity, cardiovascular disease, cancer, there’s so much evidence that saturated fat and trans-fat cause chronic inflammation, damaged the DNA and create growths in an adult body that shouldn’t be there. On the other hand, apples and blueberries have so many healthy antioxidants. We were made to eat whole foods and plant based foods, not processed ones out of a bag.

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Vitamin C and Respiratory Infections

What Do We Know About Vitamin C?

Vitamin C is an essential nutrient in humans. Without it we die.

Most animals internally produce their own vitamin C; humans do not so we need to obtain it from the diet or other external sources (supplements). It is a water-soluble vitamin and cannot be stored in the body.

Severe deficiency may develop within three weeks of very low intake. This can result in a sub-clinical form of scurvy that can be manifested in increased susceptibility to infections. This is often shown initially by easy bruising.

Diets lacking in fruits and vegetables (such as a low-carbohydrate diet) often do not provide enough vitamin C.

Functions of vitamin C

Needed for manufacture of collagen
Helps the body fight infections, repair wounds
Act as antioxidant
Enhances iron absorption.

Primary food sources:

Fruits: guava, oranges, lemons, limes, strawberries, cantaloupe, grapefruit, kiwi fruit

Vegetables: broccoli, green and red peppers, collards, tomato, potatoes, ready to eat cereals (fortified)

FYI: The RDA for vitamin C is 15-75 mg/d for children, 75 mg/d for adult women, 90 mg/d for adult men, and 85 to 120 mg for pregnant and breastfeeding women.

The Tolerable Upper Limit is 2000 mg/d. Oral Intakes of 1 gram or more a day can cause nausea, cramps, and diarrhea and may increase the risk of kidney stones.

Impact on Infections

Some studies show that in common infectious diseases, supplemental vitamin C lessens the severity and duration of symptoms.

In severe respiratory diseases such as bronchitis or pneumonia, vitamin C has been shown to reduce symptoms and shorten hospital stays. Some studies report rapid clearance on chest x-rays of patients with lung infections, following intravenous vitamin C treatment.

From the Linus Pauling Institute (LPI) at Oregon State University comes this:

“March 13, 2020 – The Linus Pauling Institute is closely watching the clinical trials with intravenous (IV) vitamin C and COVID-19-related pneumonia with great interest. However, there currently are no available data to show vitamin C can prevent or successfully treat COVID-19 infections. Once the trial data are available for review, the LPI will comment on the efficacy of IV vitamin C in COVID-19.

In 1970, Dr. Linus Pauling, Nobel Prize winner, published Vitamin C and the Common Cold, a book that revolutionized the way the world viewed vitamin C and infectious disease. Dr. Pauling believed that increasing the daily dose of vitamin C could help the body mount a strong immune response when confronted with a respiratory infection.

Many people worldwide have reported better health after taking large amounts of vitamin C. To date, clinical trials have shown that vitamin C supplements can shorten the duration of the common cold. However, there are no data to suggest that vitamin C supplements can stop respiratory infections in the general population. Results from trials with participants undergoing heavy physical activity indicate a benefit of oral vitamin C on common cold incidence. There are no such trials on influenza or coronavirus.

The LPI continues to advocate for rigorous research on both oral and IV vitamin C for treating both inflammation and infection. Yet, the facts are that there have been few rigorous studies on vitamin C and respiratory infections. Clinical trials with IV vitamin C and coronavirus-related pneumonia are currently underway in China. These trials are of great interest to the LPI, and we will monitor them closely.

Meanwhile, the LPI recommends taking these steps to support a healthy immune system: Eat a healthy diet and ensure that you meet the recommended intakes of all micronutrients, especially vitamins A, C, D, E, as well as zinc

Oregon State University has established a COVID-19 website to provide detailed and updated information; links to OSU, local, state and federal resources; and some frequently asked questions. Please regularly check this website for important updates.”

Source: Nutrition Now, Brown, Seventh Edition

Linus Pauling Institute, Oregon State University

Detox? A Lot of Pseudoscience

Before you dust off that juicer, you should take a long hard look at the latest fad – detoxing your body from alleged accumulated toxins from environmental chemicals that supposedly lead to illness. When searching Amazon, detox, natural, and hygiene is frequently mentioned in the titles of the latest diet books, not to mention the myriad of products from tablets, massages, tinctures and tea bags that promise to cleanse your body of these impurities and your hard earned money. You can go on two-day to seven-day detox diets which promise cleansing and weight loss. You may lose weight, but that is more than likely due to starvation rather than the diet itself. These toxins are never identified by the manufacturers of these products. When asked to provide some scientific evidence that support their claims, no one seems to be able to provide evidence that “detoxification” is not a bogus treatment. Despite this, the detox industry has become a huge business with a little help from some celebrities like Ann Hathaway and Gwyneth Paltrow. If toxins build up in the body with no way to excrete them, we would die or need serious medical intervention. However, we have kidneys, a liver, a colon, skin and lungs that physiologically are designed to rid our bodies of any unnecessary substances we don’t need.

Detox is actually not a new concept. Health reform began in earnest in the 19^th century in America. During that time, there had to be a great deal of food anxiety; food often was adulterated with chemicals in order to make it palatable. As Upton Sinclair in 1909 writes of the meatpacking industry in his famous book, The Jungle: “And then there was “potted game” and ‘potted grouse’ and ‘potted ham’ made out of the waste ends of smoked beef… and also tripe, dyed with chemicals so that it would not show white… and potatoes, skins and all, and finally the hard, cartilaginous gullets of beef… All this was ground up and flavored with spices to make it taste like something.” Ronald Deutsch, The New Nuts Among the Berries: How Nutrition Nonsense Captured America, Bull Publishing, 1977.

Food preservation was crude and foodborne illnesses were rampant. People had little resources to turn to in dealing with even the common diseases of society. Whom did they have to rely on for medical advice on how to remain healthy in an age of so much misinformation and confusion? People were vulnerable to just about any ideas from anyone medical or nonmedical that would help them to maintain health and avoid disease.

In the 1848 edition of Buchan’s Domestic Medicine was listed the general causes of illness: “diseased parents, night air, sedentary habits, anger, wet feet and abrupt changes of temperature.” “The causes of fever included injury, bad air, violent emotion, irregular bowels and extremes of heat and cold.” I’m going with the “diseased parent theory.
Cholera, shortly to be epidemic in many British cities, was caused by rancid or putrid food, by ‘cold fruits’ such as cucumbers and melons, and by passionate fear or rage.” William Buchan, Domestic Medicine, 1848: A Treatise on the Prevention and Cure of Diseases; Google eBook .

There are two major ideas that flourished and dominated the 19th century that led to the premise that toxins must be removed from the body by detoxification – auto-intoxication and the natural hygiene theory..

AUTO-INTOXICATION

During the 19^th century, people were told that constipation was at the root of most diseases and the term, autointoxication, became the mantra of the medical community. In 1852, a publication called The People’s Medical Lighthouse, a series of popular scientific essays on nature, uses and diseases of the lung, heart, liver, stomach, kidney, womb and blood had this to say about this common digestive problem: “daily evacuation of the bowels is of utmost importance to the maintenance of health”; without the daily movement, the entire system will become deranged and corrupted.” People’s Medicine Lighthouse, Lecture 71. Harmon Knox Root, A.M, M.D. 1852.

The term auto-intoxication was coined by Charles Bouchard, a French physician. Other physicians further defined the theory by describing the phenomenon as caused by the putrefaction or decay of proteins in the intestine generating offending toxins. This theory dominated a major part of the 19^th century and has survived to this day

The obsession with the auto-intoxication theory led to the marketing and sales of a myriad of bowel cleansing products along with laxatives, enema and colonic irrigation equipment. These gimmicks are still available today. Although doctors prescribe colon cleansing as preparation for medical procedures such as colonoscopy, most do not recommend colon cleansing for detoxification. Their reasoning is simple: Your digestive system and bowel naturally eliminate waste material and bacteria; your body does not need colon cleansing to do so.

In fact, colon cleansing can sometimes be harmful. Colon cleansing can cause side effects, such as cramping, bloating, nausea, and vomiting. More serious concerns with colon cleansing are that it can increase your risk of dehydration, lead to bowel perforations, increase the risk of infection, and cause changes in electrolytes. Civilisation and the colon: constipation as the “disease of diseases. James Whorton BMJ 2000; 321: 1586-9

According to Quackwatch In 2009, “Dr. Edzard Ernst tabulated the therapeutic claims he found on the Web sites of six “professional organizations of colonic irrigations.” The themes he found included detoxification, normalization of intestinal function, treatment of inflammatory bowel disease, and weight loss. He also found claims elated to asthma, menstrual irregularities, circulatory disorders, skin problems, and improvements in energy levels. Searching Medline and Embase, he was unable to find a single controlled clinical trial that substantiated any of these claims.Quackwatch, Gastrointestinal Quackery: Colonics, Laxatives, and More, Stephen Barrett, MD. August 4, 2010 www.quackwatch.com

My own investigations of the online “yellow pages” in searching for “Colon Cleansing” revealed that there were about twelve establishments advertising this service in my city of Asheville, North Carolina as of this writing.

NATURAL HYGIENE

Isaac Jennings, MD put forth the original ideas of natural hygiene in 1822 and became known as “The Father of Natural Hygiene.” He helped to developed a healing system called “Orthopathy” that claimed that Nature knows better than the most learned physicians of the time. That could be true – my opinion. Among earliest promoter of natural remedies was Samuel Thompson, a New Hampshire farmer who prepared “botanics”, as they were called, made from native herbs. In 1835, Dr. William Alcott, a graduate of Yale Medical school mixed part time farming with his medical practice. Other professors from Dartmouth and Amherst followed. A popular health cure came in the form of water cures. In 1849, the Water Cure Journal, Physiology, Hydropathy and the Laws of Life, edited by Dr. Russell Trall entered the health reform movement. By 1850, the Journal had 20,000 subscribers. Dr. Trall is quoted as saying: Typhoid and pneumonia are neither more nor less than a cleansing process – a struggle of the vital powers to relieve the system of its accumulated impurities”. http://www.whale.to/v/trall2.html.

A vulnerable public eagerly received their proclamations due to limited information and confusion on the causes of disease. Other proponents among many included Arnold Ehret, a German author of several books on diet, detoxification, fruitarianism, fasting, food combining, naturopathy, physical culture and vitalism. There was also Herbert M. Shelton who opened schools in Natural Hygiene and founded the American Society of Natural Hygienists Universal Healing, wwwuniversalhealingbelize.com/Brief- history- of –naturalhygiene.

In a previous post, the misguided principles of detoxification were supported and practiced by Dr. John Harvey Kellogg . Detoxification still is alive and thriving in the form of a pseudo-medical concept.. The bottom line: Detoxification is primarily designed to “sell you something”. If you want to “detox”, do not smoke, do exercise and eat a healthy balanced diet.

Ultra Processed Foods to Avoid

Ultra-processed foods are often thought as the nemesis of healthy eating. However, they are so ubiquitous in our food supply, it is so difficult to avoid them in the supermarket (they are displayed for our convenience and capture our cravings for sugar, salt, and fat as well.) The problem: If we tried to avoid all processed foods, there would be few choices in the supermarket. The best way for starters is to try to cut down on snack foods — they are highly processed and offer few nutrients.

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What Else is in Your Food?

Twenty five years ago, It was largely assumed that health benefits came from the vitamin and mineral content of fruits and vegetables. That conclusion turned out to be incorrect because supplementation with specific vitamins and minerals failed to yield the same health benefits as did diets rich in fruits and vegetables. In addition, use of individual vitamin and mineral supplements was found to increase health risks in some studies, but not all. So, what else is in our foods?

Now nutrition and other scientists are investigating the effects of thousands of other substances in food on health. The subjects of many current studies are plant chemicals known as phytochemicals or phytonutrients. Phytochemicals are not considered essential nutrients because deficiency diseases do not develop when we fail to consume them. They are considered to be nutrients however because they are biologically active and perform health promoting functions in the body. Most bioactive food constituents are derived from plants.

Phytochemicals play a variety of roles for plants as they provide protection for the plant against bacterial, viral, and fungal infections; ward off insects; and prevent tissue damage due to oxidation. Some operate as plant hormones or participate in the regulation of gene function, while others provide plants with flavor and color.

More than 2000 types of phytochemicals, that act as pigments, have been identified and give plants a wide variety of colors. Some of these phytochemicals have been identified: beta-carotene (orange), lycopene (red), anthocyanins (blue to purple), allicin (white), and lutein (yellow-green). Many of them function as antioxidants in the human body as well as help us to fight against many chronic diseases in other ways.

The following are examples of vegetables you can buy or plant in the garden (organic not necessary) that provide some specific human health benefits that are thought to be due to either established nutrients or phytochemicals. Keep in mind that some have more research behind their claims; however, many do not and simply rely on presumed health benefits.

Kale is a member of the cabbage family and is known to contain vitamins A, K, and C, as well as essential minerals like potassium, calcium, and magnesium. It is also rich in fiber and acts as a prebiotic that increases nutrient absorption in the gut. Kale also contains antioxidants that protect against oxidative damage and other aspects of chronic disease. Its nutrient density exceeds that of other vegetables like carrots, sweet potatoes, or those of the onion family.
Onions have been known for their healing properties for centuries. One study compared wound healing results after the daily application of onion gel and found that scars were significantly less noticeable after just four weeks of use. Recent research has suggested that onions also contain compounds useful for the treatment and prevention of cardiovascular disease, high blood pressure, diabetes and inflammatory diseases. Most of these benefits can be traced to onion’s high concentration of sulfur amino acids, phytochemicals such as flavonoids, phytosterols, and saponins – compounds that have anticancer, antibiotic, and antithrombotic activity.
Potatoes are a rich source of potassium, fiber, vitamin C. Little attention is paid to potatoes recently due to their high calorie density and their relationship with obesity and diabetes. If they are eaten in whole form and not as French fries or chips, they can be healthy due to their high potassium content. Often, they are the only source of potassium for many people including children. Adequate potassium can protect us from hypertension.
Tomatoes contain the phytochemical, lycopene, the carotenoid responsible for its red color and acts as an strong antioxidant. An increased intake has been associated with a decreased risk of prostate and breast cancers.
Cauliflower in both forms, white or purple are high in phenolic compounds (a phytochemical) and antioxidants. Purple cauliflower is especially high in anthocyanins that is a potent anti-inflammatory and antiviral compound.
Bell Peppers contain antioxidants that may protect against Alzheimer’s disease. Green, yellow, and red peppers are all high in phenolic compounds and vitamin C.

Bottom Line: As you can see, antioxidant activity can collectively have a powerful effect against free radical damage. This is enhanced by the many phytochemicals associated with a variety of vegetables and fruits, not just reliance on one or two of them in the diet.

The Best Advice on Eating Red Meat

The Red Meat Debate: Use Some Common Sense

For the past decade or so red and processed meats (beef in particular) has been associated with a higher risk of heart disease and certain cancers. Two NYT articles are presented here to that addresses this issue and helps to clarify how to deal with this ongoing issue.

The red meat debate continues as we wake up this morning to the news that consumption of red and processed meats are of little risk to our health.

CLICK HERE.

November 5, 2015

Back in 2015, an article appeared to agree with the current assessment about red and processed meat and in addition tells us how to deal with the disturbing reports about red and processed meat and heart disease and cancer.

So what can we really believe? The following article first appeared in 2015 and seems to me to take a common sense approach to the debate that never ceases. Hint: Life is a risk.

CLICK HERE.

Living Longer

The Blue Zones: A Book Review

By Sally J. Feltner, MS, Ph.D.

Ponce de Leon began his quest for the fountain of youth in 1531 and humans have been seeking magical solutions for keeping us younger and living our later years in relatively good health.

In 2009 with the backing of the University of Minnesota School of Public Health, AARP and the National Geographic, Dan Buettner established the Blue Zone Project and authored The Blue Zones: 9 Lessons for Living Longer from the people who lived the longest, He interviewed those who were either centenarians or those in their later years and began to investigate what factors may have contributed to five regions of longevity hotspots in the world that included:

Sardinia in Italy with the highest concentration of centenarian men.
Seventh Day Adventists in Loma Linda, California, where some residents live ten more healthy years than the average American.
The Nicoya Peninsula in Costa Rica that has the world’s lowest rates of middle-age mortality and the second highest concentration of male centenarians.
Ikaria, Greece that has one of the world’s lowest rates of middle age mortality and lowest rates of dementia. Only 20 percent of people over 80 showed any signs of dementia, whereas a similar study of long-lived people near Athens showed an almost 50 percent rate of dementia- a rate similar to that for older Americans.”
Okinawa, Japan home to the world’s longest living women.

Remarkably, all the regions had common characteristics that included family and purpose, community and spirituality, stress reduction and physical activity. Mr. Buettner later published The Blue Zones Solution and coauthored with Ed Diener, The Blue Zones of Happiness.

One major practice was that all their diets, though not vegan, were predominantly based on plants. Meat and other animal products are either the exception or used as a condiment. Additionally, Okinawans, practice a philosophy called hara-hachi bu regarding food; they only eat until they are 80% full.

In the Costa Rican Zone, everyone feels like they have a plan “de vida” or life plan. Even at ages above 60 and 70, inhabitants don’t stop living. They keep themselves busy; they love to work. It provides them a “reason to waking up in the morning” called ikigai. There is no word for “retirement” in Okinawa.

The book introduces some very interesting longevity “superstars.”

Marge Jones, at 100 years old from Loma Linda begins every day with a mile walk, a stationary bicycle ride, and some weight lifting. “I’m for anything that has to do with health”, she says
Kamada Nakazitam, 102 years old from Okinawa says “To be healthy enough to embrace my great – great grandchild is bliss.”
Ellsworh Wareham, age 91 from Loma Linda, assists during heart surgery procedures, something he does about two or three times a week
Abuela Panchita, 100 year old Costa Rican woman whose 80 year old son, Tommy bicycles to see her every day, spends every day cooking, splitting logs and using a machine to clear brush from her garden.
The notion of moai in Okinawa stands for “a social support network. Says 77 year old Klazuko Mann, “each member knows that her friends count on her as much as she counts on her friends.”
From the author: “I once pressed a 101-year-old woman in Ikaria, Greece to tell why she thought people there lived so long. ‘We just forget to die,’ she said with a shrug. None of them went on a diet, joined a gym, or took supplements. They didn’t pursue longevity – it simply ensued”

The final chapters in the first book boil it all down into nine lessons and a cultural distillation of the worlds’ best practices in longevity a and how they can be applied to the American food culture.

However, there is a downside that is currently happening. From the Author: “Sardinians today have already taken on the trappings of modern life. For example, junk foods are replacing whole-grain breads and fresh vegetables traditionally consumed here. Young people are fatter, less inclined to follow tradition, and more outwardly focused.”

I’ve enjoyed these books immensely and have often referred to them in various tweets and posts. The first book concludes with a chapter on Your Personal Blue Zone. Other books such as “the Blue]Zones Solution” give us more explicit ways to establish Blue Zones in other areas such as the U.S.

From the back cover of The Blue Zones Solution – “Propagating the Blue Zones would not only prevent a rise in the prevalence of diabetes (and other misfortunes) it would allow us to eliminate more than 80 percent of the burden we have now. That’s revolutionary.” David Katz, M.D., Director of the Yale-Griffin Prevention Research Center

The Blue Zones are lessons in how lifestyles can affect our health and longevity. Prevention of chronic disease as we age is the primary goal. More attention needs to be paid to improve the American diet in order to “add years to your life and life to your years.”

There’s A Supplement for That!!

By Sally J. Feltner, M.S.,Ph.D

In 1994, Congress passed the Dietary Supplement Health and Education Act that loosened the regulation requirements that ultimately favored the manufacturers and led to an explosion of the dietary supplement market.
As a result, the FDA now has minimal regulation over testing prior to marketing concerning the safety or effectiveness of any supplement. Any testing is the responsibility of the manufacturer so it becomes difficult to “prove” any safety issues that may be present.

Since 1994, the FDA has taken action against many products because they contain prescription drugs or contaminants. Most of the products under scrutiny were labeled for use as sexual enhancement, body building, and weight loss.

Dietary Supplement Labeling:

Fortunately, what goes on the label is regulated. Structure/function claims can advertise how the product affects normal body structures (such as “helps maintain strong bones”) or functions. Claims such as “improves circulation”, “prevents wrinkles” “supports the immune system”, and “helps maintain mental health” can be used, whereas “prevents heart disease”, “cures depression” cannot be.

If a function claim is made, the labeling has this warning: “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.” So who needs them?

Take the Case of Robert
Robert is 70 years old and has always been healthy. Recently, he experienced a few episodes of forgetfulness but thought nothing of it and attributed it to old age. Then he began feeling tired and having tingling in his hands and feet, difficulty walking, and diarrhea. He finally made a doctor’s appointment.

His blood test revealed he had a vitamin B12 deficiency and after a diet history, the doctor noticed he ate very little meat or dairy. Due to his age, the doctor explained the deficiency could be caused by a condition common in older adults that reduces the ability to absorb the vitamin and suggested he start to take a daily supplement containing the vitamin. He also gave him an injection of vitamin B12 in case the vitamin was not being adequately absorbed by Robert.

Who may benefit from vitamin and mineral supplements?

People with a diagnosed vitamin and/or mineral deficiencies
Newborns (vitamin K)
Vegans (vitamin B12 and D)
Pregnant women (folate and iron)
Elderly persons on limited diets (multivitamin/minerals)
People on restricted diets (multivitamins/minerals)
People at risk for osteoporosis (calcium, vitamin D)
People with alcoholism (multivitamin/minerals)
Elderly people diagnosed with vitamin B12, vitamin D and/or folate deficit

Guidelines for Using Vitamin and Mineral Supplements
Purchase products with USP (U.S. Pharmacopeia or the CL symbol (Consumer Laboratories) – tested for purity, ingredients, and dose.
Choose supplements containing 100% of the Daily Value or less.
Take supplements with meals.
Tell your health care provider about the supplements you take. Some may affect your prescription medications.

Nonvitamin NonMineral Supplements

Fatty Acids: Omega-3’s, fish oils, DHA and EPA, flaxseeds

Claims: To reduce heart disease and enhance brain function. This claim has recently been disputed and needs further research as to its effectiveness.

Omega-3s compete with omega-6s (vegetable oils like corn oil, soybean oil, safflower seed oil) for conversion to eicosanoids that help regulate blood clotting, inflammation, and blood pressure in the body.
Problem: We have far more 6’s in the food supply than we have 3’s. They work best at a ratio of 4:1 but instead we have 20:1 in favor of 6’s.

Flaxseeds contain alpha-linolenic fatty acid that can be be converted to EPA and DHA in the body; but this is not very efficient in humans and decreases as we age. EPA and DHA are the active forms which can lower inflammation and blood clotting factors. That is why we should eat EPA and DHA directly from fish instead of relying on their conversion in the body from alpha-linolenic acid.

Bottom Line:

Found to not be very effective in reducing heart attacks in supplement form.
Best to get them eating fatty fish 2-3 times a week. (salmon, trout, tuna)
Possible problems with mercury and contaminants in fish (farmed and wild-caught
Fish oil supplements not recommended for anyone taking blood thinner medications.

Enzyme Supplements

Enzymes are proteins that are broken down in the small intestine to amino acids; thus, the original enzyme and its functions are not intact – so little if any effect can be gained from taking them in their enzyme form.

One exception: Some are made to work in the digestive tract before they are broken down. For example, lactase breaks down lactose and is helpful to people who are lactose intolerant.

So, if these are not specially coated to protect them as they are in cystic fibrosis, most enzyme supplements are totally useless to the body. Healthy people make their own digestive enzymes in the pancreas and small intestine.

Hormone Supplements
Many marketed to athletes to replace the desirable steroid hormones that enhance muscle growth and strength and can be dangerous, like growth hormones. Again, without putting them to the test, there is no way to measure their safety or effectiveness.

Melatonin:
Not a protein, but a steroid hormone made in the pineal gland in the brain.
Marketed as a sleep aid and help with jet lag.
Claimed to improve sleep duration and quality
Somewhat effective
Dose is important – start low.

Coenzyme Supplements:
Coenzymes are enzyme helpers, such as coenzyme Q10.
Needed as an electron carrier in the final steps of energy (ATP) production
Are often claimed to be needed when statins are taken. .
This can cause side effects of statins of muscle pain and weakness.
Some studies show benefits of reduced pain – but not all

Herbal Remedies
As with all supplements, they are only as good if they are effective and safe (some are not). Human studies with herbal remedies have helped identify which herbals and supplements lack beneficial effects or have adverse effects. Some can pose a health risk. Results of most studies are mixed.

Guidelines for Herbal Use

Don’t use for serious, self-diagnosed conditions.
Let your doctor know what herbals you take.
Clear the use of herbal remedies with your doctor if you take prescription meds.
Do not use if attempting or are pregnant.
Don’t mix herbal remedies.
If you are allergic to certain plants, make sure the same is not true of the chosen herbal supplement.
Buy herbs with the USP label or have the CL label.

Functional Foods
Generally taken to mean food or food ingredients that may provide a health benefit beyond the effects of traditional nutrients it contains

Examples of functional foods with proposed health benefits include:

Stanol and sterol fortified margarines, psyllium fiber, whole oat products – reduced blood levels of LDL cholesterol
Omega-3 acids – reduce blood triglycerides – must be in high doses
Cranberry juice extracts – decreased urinary tract infections
Folic-Acid fortified breads and cereals – decreased neural tube defects
Probiotics – decreased risk of infections, lactose intolerance, diarrhea

DISCUSSION:

According to Marion Nestle, author of Unsavory Truths, and Food Politics – Paulette Goddard Professor of Nutrition, Food Studies, and Public Health, emerita, at New York University, Visiting Professor of Nutritional Sciences at Cornell:

“I wrote extensively about the paucity of evidence for the value of dietary supplements for anyone who eats enough of a reasonably varied diet. The supplement industry funds many studies that demonstrate health benefits from taking one supplement or another, but studies funded independently usually do not – and sometimes suggest that taking nutrients in pill form can be harmful.”

Don’t be fooled by the claims made by the purveyors of dietary supplements – In my opinion, most are more than likely no better than the remedies peddled by our ancestors, i.e., the snake oil salesmen. Lately some supplements have become very expensive (my opinion) and the consumer has the right to know whether to spend hard earned money on these products or not. To put it simply – Buyer Beware,

The Pros and Cons of the Paleolithic Diet

The Paleolithic diet has been around for a few years and in my opinion is a pretty good diet, but alas as with every restrictive diet, there are caveats.

The following article comprehensively covers the pros and cons of this eating pattern. It is based on the facts (as we know them) that our ancestors only had access to certain foods and that our genetic development is presumed to have evolved from inclusion and exclusion of these foods into our current dietary pattern. Evidence for this is presumed to be accurate – however, we truly do not know what our Paleo ancestors really ate. Our ancestors lived in diverse environments; therefore, their diets were dependent on the foods found there. There is a great deal of controversy about the possibility that some ate a diverse plant-based diet, e.g. hunting was not so reliable.

Most evidence is based on our contemporary hunter-gatherer societies which exhibit less chronic disease than those populations that follow the current American diet. For example, there are no Hadza adults diagnosed with diabetes in Tanzania, while the Tsimané people in Bolivia have an 80 percent lower rate of atherosclerosis compared to people in the U.S. The Maasai community in Kenya that relies on red meat, blood and milk is also known for little to none cardiovascular diseases.

The Pros and Cons

Our ancestors and modern-day hunter-gatherers ate more animal-based foods, which contain good amounts of high-quality protein, calcium, iron, omega-3 fatty acids and vitamins B12 and K2. Such nutrients are commonly found in seafood, red meat, pastured eggs and liver.

An ancestral diet removes refined sugar, grains and seed oils from one’s daily meals. Avoiding these modern products helps reduce markers of inflammation, leading to improvements in blood pressure, waist circumference and lipid profiles, components of the metabolic syndrome.

One study showed that people who consumed less added sugar, refined grains and processed foods could significantly reduce weight in 12 months. The ancestral diets provide foods that are more satiating, which help people consume fewer calories.

The Paleo diet excludes extremely calorie dense foods (starchy foods) as well as many processed and snack foods.

However the diet eliminates two major food groups (dairy and grains (enriched or whole). This puts at risk adequate vitamin D and calcium levels as well as the other nutrients found within these foods.

The Paleo diet provides some essential nutrients and may appeal to some people that are not interested in a total plant based eating pattern, i.e., dedicated carnivores.

CLICK HERE.

Immunologic Effects of Vitamin D on Human Health and Disease

Abstract

AUTO-INTOXICATION

NATURAL HYGIENE

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