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    Archive for the ‘supplements’ Category

    What’s The Deal With Supplements?

    Two alarmist bits of news captured the health world’s attention yesterday.  First, ‘supplements may cause early death in older women’.  Then, ‘vitamin E may be risky for prostate‘.  Let’s dissect.

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    You Ask, I Answer: How Many Grams of Fish Oils A Day?

    andrew-lessman-essential-omega-3-no-fishy-taste-mint-360-capsules~660045Saw this tweet from you the other day: “Ideal Omega 3 supplementation: 3 g total/day; DHA:EPA ratio of 2:3. Don’t bother with supplements that offer ALA.”

    My basic approach has been to consume at least 1,000mg (or 1 gram) per day; that seems to be the standard recommendation. I’m wondering if the 3 gram recommendation is meant for the greater population or just those with very high cholesterol or other conditions.

    — Guy Betterbid
    New York, NY

    One gram a day is not bad.  Here is what I base my “3 grams per day” recommendation on:

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    You Ask, I Answer: Protein Powder Terminology

    ion_exchange_protein_wpi_3kg_powder_shop_new_zealand_co_nz_smI was looking at different protein powders the other day, and saw a lot of terms that went over my head.  Can you help me out and at least tell me if I should even bother paying attention to some of these?

    Here are ones I wrote down:  “ion-exchanged”, “microfiltered”, “hydrolized”.

    Thank you.  Not only for answering this question, but for your blog.  I have learned a lot just by visiting your site!

    — Richard (last name withheld)
    San Jose, CA

    As if the cereal and bread aisles weren’t bad enough, protein powder shopping also involves sorting through a variety of fancy-sounding claims.  Let’s break them down:

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    You Ask, I Answer: Calcium & Magnesium

    500_T1_W275_HThere are supplements that contain both calcium and magnesium, and yet I have read articles which suggest that these two minerals do not combine well and “compete” in order to enter cells.

    Can you shed some light on this contradiction?

    — Beth Guy
    Portland, ME

    Gladly.

    Calcium and magnesium actually work in tandem in many ways.  That said, they also compete for absorption from receptors.  Consider them “frienemies”!

    Competition for absorption is only a problem, though, when calcium to magnesium ratios are disproprotioante.

    The ideal ratio for their consumption in one food or meal is 2:1 (calcium: magnesium).  Dairy products, for example, generally offer a 10:1 ratio.  Therefore, diets high in dairy can negatively impact magnesium absorption.

    This, by the way, helps to explain why despite having some of the highest dairy intakes of the world, the United States also has such high rates of osteoporosis (remember, magnesium is key to bone health!).

    If you’re buying a calcium supplement that also offers magnesium, make sure there’s a 2:1 ratio going on.  So, a 500 milligram calcium supplement should offer 250 milligrams of magnesium.  If it only offers 50 milligrams, put it back on the shelf.

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    You Ask, I Answer: Why Isn’t a Multivitamin Enough?

    Get_the_Right_MultivitaminsThis morning, my 13 year-old son asked me why I always want him to have a healthy breakfast.

    I explained that I wanted to make sure he got the vitamins and minerals his body needs.

    His response was: “Well, why can’t I just have two Pop Tarts and [a multivitamin]?”

    I didn’t really know what to say to that!  What would you have said?

    — Teresa Womell
    (Location withheld)

    “Because as long as you’re living under MY roof…”

    No, kidding.

    Truth is, your initial answer backed you into this corner.  You mentioned that eating healthy foods is important in order to get necessary vitamins and minerals.

    While that is certainly an important part of the equation, nutrition goes far beyond vitamins and minerals.

    Foods also offer phytonutrients, flavonoids, and antioxidants — chemical compounds that offer a variety of health benefits.

    Take an orange, for example.  It is a great source of vitamin C, folate, thiamin, and potassium.

    That’s fabulous in its own right — but there’s more!

    Oranges also offer approximately 150 phytochemicals and over 50 flavonoids that help lower our risk of heart disease, several cancers, and high blood pressure!  You simply can not get that from a supplement.

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    You Ask, I Answer: Vitamin Supplements (Redux)

    Natural-Vitamin-E-SoftgelIs a vitamin in [soft] gel form more easily absorbed in the body than in tablet form?

    Also, does that list of 10 USP-approved companies you shared with us by definition invalidate all other companies such as Solgar, which also produces vitamins?  In fact, there are a whole lot of very big companies not on the list.  Is there a reason?

    Lastly, my doctor says all vitamins are regulated by the DEA; it that correct?

    — Barlow (Last name withheld)
    Westchester, NY

    Vitamins consumed in softgel form are absorbed more quickly than those in tablet form.

    That said — “so what?”.

    Supplements are not medication.  When you have the flu, you want to take something that will alleviate symptoms as soon as possible.  If you’re looking to boost your omega-3 intake, quick absorption is not a priority.

    Keep in mind that even vitamins in tablet form have undergone a significant amount of testing to ensure they dissolve as quickly as possible.

    As for the list of supplements tested and verified by third-party public heath organization U.S. Pharmacopeia (USP) I shared recently — a company’s absence does not mean their supplements are not high quality.

    USP testing is completely voluntary.  Some companies — especially well-known ones — are confident of their popularity, and may therefore not see any added benefit to being USP approved.  It is quite a shame that the average consumer is not aware of what USP testing is or what a USP logo on a supplement bottle means.

    Remember, too, that there is a fee to be USP-tested.

    Lastly, I think your doctor is confused.  The Drug Enforment Agency (DEA) has nothing to do with vitamin supplements.

    Perhaps he is thinking of DSHEA — the Dietary Supplement Health and Education Act of 1994.  That is the infamous ruling that allows supplements to bypass testing by — and regulation from — the Food & Drug Administration, since they are not considered “conventional food products.”

    The only way in which supplements are regulated (and I use that term very loosely) is that, as of June 2010, manufacturers will be “required” to formulate products that abide by “good manufacturing practices”, are accurately labeled (good luck enforcing that!), and free of contaminants.

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    You Ask, I Answer: Chlorella

    chlorellaWhat are your thoughts on chlorella?

    My housemate and other raw foodists I’ve met swear it’s the most amazing and beneficial stuff ever.  I’ve also heard that it’s dangerous and toxic.

    The way I’ve heard it spoken about makes it seem like it’s a trendy nutrient that’s not very well understood by most people.

    What’s true and what’s hype?

    — Leah (Last name withheld)
    (Location Unknown)

    Chlorella is, very simply, a species of freshwater algae.

    Despite very limited research, chlorella is accompanied by lofty claims from its manufacturers, including:

    • helps achieve weight loss
    • “eliminates cancer risk”
    • contains the highest amount of protein per ounce than any other food
    • provides nutrients easily absorbed by the human body
    • offers very high levels of chlorophyll

    Each of these claims, by the way, is either completely misguided or inaccurate.  Here is why:

    1. Helps achieve weight loss

    No single food helps speed up weight loss.  You can make the argument that a food, depending on its composition, can make weight loss easier.  For example, a food like almonds that provides a fair share of fiber, protein, and fats (the three pillars of satiety) is a great addition to a weight loss plan since it takes fewer calories to feel full, in comparison to other foods.

    Ultimately, though, weight loss is about caloric balance, not about one single food’s magical properties.  Adding chlorella to a diet too high in calories will not result in weight loss.

    2. “Eliminates cancer risk”

    This is one of those claims that send my blood pressure through the roof.  While many foods contain phytonutrients and antioxidants that can help reduce one’s risk of developing certain diseases, it is preposterous to ever claim something downright eliminates cancer risk.  After all, diet is not the only cause of cancer.

    3. Contains the highest amount of protein per ounce than any other food

    A “so what?” statement.  The average adult in the United States already consumes 200 to 300 percent of their daily protein requirement.  What this factoid leaves out of the equation is that chlorella contains a very high amount of protein as percentage by weight.  You would need to eat a very high amount of chlorella to get a decent amount of protein from it.

    4. Provides nutrients easily absorbed by the human body

    A cliché vague statement that is meant to sound a lot more important than it really is.  The same can be said for thousands of foods.  It is worth pointing out, though, that the B12 in chlorella appears to be absorbable (unlike that of many other sea plants, which is in an analogue form).

    5. Offers very high levels of chlorophyll

    Too bad we aren’t plants.  Chlorophyll is completely irrelevant within the framework of human nutrition.

    In regards to chlorella’s toxicity, one concern is that if the water system in which this plant grows is contaminated, these toxins are directly absorbed.

    Chlorella gets nothing but a shrug and a feeble “meh” from me, especially since it is mostly consumed in powder or pill form (highly processed forms that deteriorate its initial nutritional profile).

    I would much rather someone spend the money they were planning on plunking down for a chlorella supplement on real food instead.

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    You Ask, I Answer: Buying Vitamins

    uspSince vitamins are not regulated by the Food & Drug Administration, how does one know if  they are getting what they pay for?

    My local store says that you have to go on faith, however, my faith in companies is at an all time low ebb.

    Do you have any guidelines for the purchase of vitamins other than “faith?”

    — Barlow (Last name withheld)
    Westchester, NY

    Yes, there are two steps you can take to ensure you are getting higher-quality vitamin supplements.

    Number one: look for the “USP Verified” logo on packaging.

    USP — U.S. Pharmacopeia — is “a voluntary testing and auditing program that helps dietary supplement manufactures ensure the production of quality products for consumers” through laboratory testing, quality control, and manufacturing audits.

    You can see a list of USP-verified supplements on their website.

    Number two: for thirty dollars a year (less than three dollars a month!), you can subscribe to ConsumerLab.com, a private company that provides third-party assessment of thousands of supplements.

    Unless you purchase a large amount of niche supplements — which I don’t believe most people need to do — looking for USP certification should suffice.

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    You Ask, I Answer: L-Carnitine

    reflex_l_carnitine_120capsI have a dental practice, and one of my patients is a competitive bodybuilder.

    The other day he and I were talking about weight loss and he told me to buy L-Carnitine.  He said that if I took some an hour before working out, I would lose more fat more quickly.

    Have you heard this before?

    — Laura (last name withheld)
    Annapolis, MD

    I have heard indeed heard this myth before.  More times than I’d like to admit, to be frank.

    L-Carnitine is an amino acid  involved in fat metabolism (meaning it helps break down fats so they can later be used for energy by the body).

    It is not essential (we do not need to get it from food) since we  make carnitine from other amino acids in our diets that are essential.

    Manufacturers of ergogenic aids are quick to point out that L-carnitine helps speed up fat loss while providing more energy and helping increase lean muscle mass.  In other words, it’s yet another “miracle pill.”

    Alas, studies relating to sports nutrition have found no benefit from L-carnitine supplementation. 

    What many people forget is that they already consume a fair share of this amino acid from food if they eat  meat and dairy products.

    Remember, since carnitine is not essential, you do not need to get it from the diet.  A diet that does not include meat and dairy does not make one “carnitine deficient.”

    As with many other supplements, I say:  keep your money safe in your wallet.

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    You Ask, I Answer: Dong Quai

    200
    I recently purchased Yogi Woman’s Energy tea. It says that it helps balance hormones.  

    It uses Dong Quai, which, to my knowledge is supposed to be a natural way to balance hormones.  Since having a baby a year ago, my menstrual cycle has been ranging from 29-35 days each month, where before it was 31 days like clockwork.

    Is all this hype?
    — Sandy (last name withheld)
    (Location Unknown)

    Dong quai is a toughie because, while it does have some estrogen-mimicking compounds, very little is known about effective dosage amounts for humans. 

    I view this the same way I view soy, meaning you would need to consume quite a significant amount to really experience any tangible effects.  

    PS: I am always weary of vague claims like “helps balance hormones”, especially since we have absolutely no data on the necessary amounts to have an effect on hormone levels.

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    You Ask, I Answer: Lysine Supplements

    41TQEQ7ZRSLWhat is your take on lysine supplementation?

    One of my friends swears by it.  She says she feels more energetic and focused since she started taking one lysine pill every day for the past two months.

    What are the benefits of taking extra lysine?

    — Damira Baswani
    Evanston, IL

    My verdict?   “Placebo effect”!

    Lysine is one of nine essential amino acids.

    Remember, any time you see the word essential in the context of nutrition, it refers to a component we must obtain from food, since our bodies are unable to produce it.  All vitamins and minerals are essential.  Cholesterol is not.

    Lysine is found in high amounts in baker’s yeast, beans, beef, cheese, eggs, lentils, nuts, pork, poultry, and tofu.  Turkey, canned tuna, and milk are also good sources.

    People whose diets include the foods listed above do not need to supplement any additional lysine.

    Lysine deficiencies — and even low consumption of lysine-rich foods, for that matter — are very rarely seen in developed countries.  You usually only see them in very poor areas of developing countries, where diets are mainly composed of one or two different foods (both of which offer very little lysine).

    While a lysine deficiency can cause anemia and fatigue, extra amounts of the amino acid do not result in increased energy.

    For the average person eating a varied diet, lysine — and other amino acid — supplements are unnecessary.

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    You Ask, I Answer: Calcium Supplements

    1779509845.JpegI just noticed that there are different kinds of calcium supplements!

    Today at the store I saw some that had calcium carbonate and some that were made from calcium citrate.  Which one is better?

    Thank you so much for this blog.  I read it every day and have learned so much!

    — Elizabeth Tackan
    Woodbury, NJ

    Thank you for your support, Elizabeth.  And thank you for your question!

    Both calcium citrate and calcium carbonate supplements are adequate.

    For optimal absorption, though, take calcium citrate on an empty stomach and calcium carbonate with meals.

    Remember, too, that our bodies can only absorb 500 milligrams at a time.

    If you are looking to supplement 800 milligrams, take one 400 milligram pill in the morning and another at night.

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    You Ask, I Answer: Health Benefits of Garlic

    garlic_bulbWhat health benefits do we get from eating garlic?

    Is it better to eat it raw (like in the pesto recipe you shared) or cook it?

    Do you need a certain amount of cloves to get the health benefits?

    — Whitney Bennett
    New York, NY

    The most solid evidence on daily and consistent garlic consumption is that it can:

    • Help reduce levels of LDL (“bad”) and total cholesterol
    • Slow down atherosclerosis (hardening of the arteries)
    • Discourage platelet aggregation (the grouping of platelets in the blood which ultimately forms clots)

    There doesn’t appear to be a difference whether garlic is consumed in a raw or cooked state.  For optimal results in terms of active compounds, though, fresh garlic should always be used (as opposed to pre-minced, jarred varieties).

    One garlic clove a day, once a day, provides the above-mentioned health benefits. An additional clove or two won’t pose any harm.

    I am not a fan of garlic supplements.  Firstly, since supplements are unregulated, you never know what you are truly getting.

    Number two — in the event that these supplements pack in high amounts of concentrated garlic, they may overly thin the blood.

    PS: If you take garlic supplements, you must stop taking them at least three weeks prior to any kind of surgery to prevent excessive bleeding.

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    In The News: Herb At Your Own Risk

    kava_16054_6_(big)_CNN.com’s homepage currently features this excellent article on the dangers of unsupervised herbal supplementation, especially when it’s recommended by the likes of “intuitive healers” (that’s code word for “will gladly take your money in exchange for potentially dangerous advice.”)

    Herbs are often touted as perfectly safe botanicals, especially by those who sell them.  Far from it!

    While certain herbs — in specific quantities — can provide some health benefits, high intakes can lead to a variety of health conditions as well as very dangerous effects when combined with other herbs or medication.

    Additionally, a good amount of the purported benefits from herbal supplementation are anecdotal or only obtained from excessive amounts.

    CNN went to a most appropriate source for this article — Dr. Brent Bauer, director of the Complementary and Integrative Medicine Program at the Mayo Clinic.

    Given the horrendous caliber of self-proclaimed experts who have gotten plenty of air time lately, it’s great to see members of the press turn to a credible source!

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    The (Non-Existent) Battle of the Sexes

    300054755506The makers of Centrum are heavily advertising their newest multivitamin — Centrum Ultra Women’s — on television.

    This product — “specially formulated with key nutrients to help meet a woman’s nutritional needs” — contains additional amounts of Vitamin D (which the commercial points out “has been shown to promote breast health”) and calcium.

    Sounds lovely, but this is marketing hype in its purest form.

    First of all, the link between vitamin D intake and breast cancer is only suggestive at this point.  More research is certainly needed.

    Additionally, there is a growing body of research which suggests that adequate levels of vitamin D may help lower men’s risk of developing prostate cancer.

    As for the extra calcium (the Ultra Women’s formula provides 500 milligrams, while the Ultra Men’s offers 210 milligrams) — why?  Men and women have the exact same calcium recommendations (these fluctuate according to age, not sex).

    Main takeaway: both sexes equally benefit from adequate nutrition.

    His and hers multivitamins are simply a result of Madison Avenue looking to maximize profit.  Don’t fall for it.

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