Are Vitamins Just a Placebo?

Do we all really need to take multi-vitamin/ mineral supplements as the supplement sellers suggest? This has been a debatable topic with nutritionists for the past few years. Some studies suggest that they are really not necessary unless you are diagnosed with a particular vitamin/mineral deficiency or underlying health issue. Others say that vitamins are only placebos and are marketed to the “walking well” population. In other words, they show no benefits when taken by healthy people.

Supplements can be very expensive and some studies say they only add to the profits of the vast supplement industry. Every supplement consumer should be aware of these realities and make their own educated health care decisions.

Dietary Supplement Realities: What Consumers Need to Know

  • FDA does not approve, test, or regulate the manufacture or sale of dietary supplements.
  • The FDA has limited power to keep potentially harmful diet supplements off the market.
  • Dietary supplements may not have been tested for safety or effectiveness before they are sold.
  • Dietary supplements often do not list side effects, warnings, or drug or food interactions on product labels.
  • Ingredients listed on supplement labels may not include all active ingredients.
  •  Dietary supplements may not relieve problems or promote health and performance as advertised. Claims on labels are often vague and unsubstantiated by clinical trials.
  • Studies have shown that the multivitamin/mineral pills that most people take provide plenty of B vitamins and vitamin C, but little calcium. The intake of both calcium and Vitamin D may be less than optimum and should be discussed with your doctor.

One of the most serious consequences of supplements results when they are used as a remedy for health problems that can be treated, but not by vitamins or minerals. Vitamin and mineral supplements have NOT been found to prevent or treat heart disease, cancer, diabetes, hypertension, premature death, behavioral problems, sexual dysfunction, hair loss, autism, chronic fatigue syndrome, obesity, cataracts or stress. Some such as vitamin E, vitamin C and beta-carotene may be harmful to certain groups of people. If taken, dosages should not be excessive.

Who may benefit from vitamin and mineral supplements? 

People with diagnosed vitamin and/or mineral deficiencies

Vegans (vitamin B12 and D)

Pregnant women (folate and iron)

Elderly persons on limited diets (multivitamin/minerals)

People on a restricted diet (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 deficiency

  • 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. Megadoses are not recommended.
    Take supplements with meals.
    Tell your health care provider about the supplements you take.

Source: Judith Brown, Nutrition Now, 2013.

Lori A. Smolin and Mary B. Grosvenor, Nutrition: Science and Applications, Third Edition.

Nutrition News!!

Nutrition News: What You Need to Know

A Rise in Metabolic Syndrome

Half of U.S. adults age 60 or older now have what is called metabolic syndrome – a cluster of symptoms that raise the risks of heart disease, diabetes, and stroke. Talk to your doctor if you have three or more of the following:

  • A large waist circumference
  • Low HDL (the “good” cholesterol)
  • High triglycerides
  • High blood pressure
  • A high fasting blood sugar leveL

A HEALTHY LIFESTYLE CAN CUT the  RISK!!

DO YOU NEED VITAMIN D? 

The Facts:

Vitamin D is a fat-soluble vitamin found in two forms, Vitamin D2 (ergocalciferol) and D3 (cholecalciferol). The RDA for women and men is 15 mcg or 600 UL and the UL is 100 mcg (4,000 IU  The primary functions are: needed for absorption of calcium and phosphorus and their utilization in bone formation, and nerve and muscle activity. It also inhibits inflammation and is involved in insulin secretion and blood glucose level maintenance. You may have seen lately the claim that it is needed especially in older adults for the prevention and/or treatment for COVID-19; however, so far there is no solid evidence to support that.

There is some preliminary evidence that it may offer some antiviral responses against the risk of respiratory infections in general and boost the ability of lung cells to fight bacteria and viruses. A large meta analysis)  published in 2017 in BMJ (British Medical Journal) concluded that taking a D supplement with anywhere from less than 800 IU to more than 2000 IU reduced the risk of having at least one respiratory tract infection. Those most deficient saw the most benefits, and there is “no trial that has shown any benefit for giving vitamin D in any population that is getting enough vitamin D,” says F. Michael Gloth, III, M.D., an associate professor of geriatric medicine at Johns Hopkins University Medical School.

About 50 percent of people aged 60 and older take a D supplement and for some, it may useful. About 80% of older adults don’t get enough D in their diet as well as there are few food sources of vitamin D, since we make our own D in the skin.  Because of this, The National Academy of Medicine recommends 600 IU of vitamin D a day up to age 70; 800 IU daily after that. Ultimately, whether to get tested or take a supplement comes down having this discussion with your doctor.

Lifestyle habits can make a difference:

  • Don’t smoke – smoking depletes many vitamins and limit your ability to make vitamin D.
  • People carrying extra weight often have low D levels. Losing that extra weight may boost D levels.
  • Physical activity may increase vitamin D levels.
  • Getting enough sun – just 15 to 20 minutes a day on face, arms, legs, back without sunscreen can give a healthy dose. This can be harder in the winter or if you have darker skin.
  • Diet can help a little – cow’s milk and plant milks are usually fortified as well as some juices and cereals. Fatty fish and egg yolks help.
  • People with bowel disease or metabolic problems can affect D absorption. A simple blood test is often recommended by your doctor. Consult with your doctor who can help you with testing your individual levels, no matter what your age or health status.

Source: CRConsumer Reports On Health, October, 2020

What is the difference betwwen ALA, EPA, and DHA  Omega 3 fatty acids?

Both nuts and fish contain healthy omega-3 fatty acids. They help fight inflammation, boost brain and heart health and ensure healthy fetal development.   However there are three omega-3 fats (ALA, EPA and DHA) that differ in how we acquire them in our diets. The omega-3 from nuts is primarily ALA, while EPA and DHA are found preformed in fish. and algae. Here are the facts:

  • Omega-3 ALA cannot be created in our bodies and must, therefore be acquired from diet or supplements.
  • ALA is good but EPA and DHA are better (EPA for inflammation and DHA for brain/heart health. Your brain is made up of 58% DHA by dry weight.
  • Although we are technically able to synthesize our own EPA and DHA from ALA, we don’t do so very efficiently (in fact, the rates of conversion are quite low at 3% and 19%, respectively).
  • So if you’re vegetarian or simply don’t like fish, you may need to supplement your diet with EPA/DHA from fish or look for vegetarian omega-3 supplements that derive EPA and DHA from algae. Simply, that is where the fish get it.

Source: Tufts Health & Nutrition Letter

Diet Supplements: Beliefs and Reality

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Consumers tend to believe that dietary supplements:

  • Have fewer side effects than prescription drugs.
  • Are approved by the FDA.
  • Will improve and maintain health.
  • Are safe, high quality, and effective.
  • May replace conventional medicines.

DIETARY SUPPLEMENT REALITIES

  • FDA does not approve, test, or regulate the manufacture or sale of dietary supplements.
  • The FDA has limited power to keep potentially harmful diet supplements off the market.
  • Dietary supplements may not have been tested for safety or effectiveness before they are sold.
  • Dietary supplements often do not list side effects, warnings, or drug or food interactions on product labels.
  • Ingredients listed on supplement labels may not include all active ingredients.
  •  Dietary supplements may not relieve problems or promote health and performance as advertised.
  • One of the most serious consequences of supplements results when they are used as a remedy for health problems that can be treated, but not by vitamins or minerals. Vitamin and mineral supplements have NOT been found as yet to prevent or treat heart disease, cancer, diabetes, hypertension, premature death, behavioral problems, sexual dysfunction, hair loss, autism, chronic fatigue syndrome, obesity, cataracts or stress. Some such as vitamin E, vitamin C and beta-carotene may be harmful to certain groups of people. If taken, dosages should not be excessive.

Judith Brown, Nutrition Now, 2013.

The recent pandemic brings with it its schemes, misinformation, and claims for combating the virus. The supermarket tabloid covers feature various foods to eat to avoid viral infections.  Always consult with your doctor about these claims. And thanks to Quackwatch,  you can find  a very comprehensive guide about COVID-19 claims HERE.

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,

 

Is Vitamin C a Valid Treatment for COVID19?

Just read an extensive article concerning the claims that intravenous vitamin C  therapy could be a valid treatment for COVID19. This therapy has been around for decades or at least since the 1970’s when the Nobel Prize winner, Linus Pauling promoted its oral use for curing or preventing the common cold and even as a cancer treatment. Proponents have once again emerged with the same claims concerning COVID19 virus treatment and/or cure with Intravenous vitamin C.

Bottom Line: There is no evidence that this occurs. According to one physician of Orthomolecular Medicine: “if you test people with pneumonia, Influenza or COVID19, you can measure and see that their vitamin C levels are low”; this tells us little if nothing.

Orthomolecular medicine promotes the premise that extremely high doses of natural substances help the body to address illness. For example, the Daily Value for vitamin C is only 90 mg/day (more than enough to prevent scurvy).  In orthomolecular medicine, at least 1500 mg/day would be required and more is better. Fortunately, vitamin C is a water-soluble vitamin and is commonly excreted from the body in urine. However, there are side effects at high doses that include diarrhea and other gastrointestinal issues.

A clinical trial in China is investigating the claim of intravenous vitamin C therapy and COVID19;  and it will be interesting if we hear any positive results when the study concludes next year.

Here are the facts as we know them.

CLICK HERE.