Nutritional Supplements: The Basics

1.  Supplements:  An Overview 

What is a dietary supplement?

Congress defined the term "dietary supplement" in the Dietary Supplement Health and Education Act (DSHEA) of 1994. A dietary supplement is a product taken by mouth that contains a "dietary ingredient" intended to supplement the diet. The "dietary ingredients" in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites. Dietary supplements can also be extracts or concentrates, and may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or powders. They can also be in other forms, such as a bar, but if they are, information on their label must not represent the product as a conventional food or a sole item of a meal or diet. Whatever their form may be, DSHEA places dietary supplements in a special category under the general umbrella of "foods," not drugs, and requires that every supplement be labeled a dietary supplement.

Source: http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ucm110417.htm  

Many people take dietary supplements. A product that contains vitamins, minerals, herbs or other botanicals, amino acids, enzymes, and/or other ingredients intended to supplement the diet. The U.S. Food and Drug Administration has special labeling requirements for dietary supplements and treats them as foods, not drugs. in an effort to be well and stay healthy. With so many dietary supplements available and so many claims made about their health benefits, how can a consumer decide what's safe and effective? This fact sheet provides a general overview of dietary supplements, discusses safety considerations, and suggests sources for additional information.

Key Points

• Federal regulations for dietary supplements are very different from those for prescription and over-the-counter drugs. For example, a dietary supplement manufacturer does not have to prove a product's safety and effectiveness before it is marketed.
• If you are thinking about using a dietary supplement, first get information on it from reliable sources. Keep in mind that dietary supplements may interact with medications or other dietary supplements and may contain ingredients not listed on the label.
• Tell your health care providers about any complementary and alternative practices you use, including dietary supplements. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

About Dietary Supplements

Dietary supplements were defined in a law passed by Congress in 1994 called the Dietary Supplement Health and Education ActA Federal law that defines dietary supplements and sets product-labeling standards and health claim limits. DSHEA defines supplements and outlines quality, safety, and efficacy regulations that are different from those for drugs. The U.S. Food and Drug Administration does not review dietary supplements for safety or effectiveness before they are sold. (DSHEA). According to DSHEA, a dietary supplement is a product that:

• Is intended to supplement the diet
• Contains one or more dietary ingredients (including vitamins, minerals, herbs or other botanicalsA plant or part of a plant used for its flavor, scent, or potential therapeutic properties. Includes flowers, leaves, bark, fruit, seeds, stems, and roots., amino acids, and certain other substances) or their constituents
• Is intended to be taken by mouth, in forms such as tablet, capsule, powder, softgel, gelcap, or liquid
• Is labeled as being a dietary supplement.

Herbal supplements are one type of dietary supplement. An herb is a plant or plant part (such as leaves, flowers, or seeds) that is used for its flavor, scent, and/or therapeutic properties. "Botanical" is often used as a synonym for "herb." An herbal supplementA type of dietary supplement that contains herbs, either alone or in mixtures. may contain a single herb or mixtures of herbs.

Research has shown that some uses of dietary supplements are effective in preventing or treating diseases. For example, scientists have found that folic acid (a vitamin) prevents certain birth defects, and a regimen of vitamins and zinc can slow the progression of the age- related eye disease macular degeneration. Also, calcium and vitamin D supplements can be helpful in preventing and treating bone loss and osteoporosis (thinning of bone tissue).

Research has also produced some promising results suggesting that other dietary supplements may be helpful for other health conditions (e.g., omega-3 fatty acidsEssential nutrients that the body cannot make on its own but can obtain from foods such as fish and flaxseed, or from dietary supplements. for coronary disease), but in most cases, additional research is needed before firm conclusions can be drawn.

Dietary Supplement Use in the United States

A national survey conducted in 2007 found that 17.7 percent of American adults had used "natural products" (i.e., dietary supplements other than vitamins and minerals) in the past 12 months. The most popular products used by adults for health reasons in the past 30 days were fish oil/omega 3/DHA (37.4 percent), glucosamineA substance found in the fluid around joints and used by the body to make and repair cartilage. Glucosamine in dietary supplements is made in the laboratory or from the shells of shrimp, lobster, and crabs. (19.9 percent), echinacea (19.8 percent), flaxseed oil or pills (15.9 percent), and ginseng (14.1 percent). In another, earlier national survey covering all types of dietary supplements, approximately 52 percent of adult respondents said they had used some type of supplement in the last 30 days; the most commonly reported were multivitamins/multiminerals (35 percent), vitamins E and C (12–13 percent), calcium (10 percent), and B-complex vitamins (5 percent).

Source: http://nccam.nih.gov/health/supplements/wiseuse.htm

What is a "new dietary ingredient" in a dietary supplement?

The Dietary Supplement Health and Education Act (DSHEA) of 1994 defined both of the terms "dietary ingredient" and "new dietary ingredient" as components of dietary supplements. In order for an ingredient of a dietary supplement to be a "dietary ingredient," it must be one or any combination of the following substances:

• a vitamin,
• a mineral,
• an herb or other botanical,
• an amino acid,
• a dietary substance for use by man to supplement the diet by increasing the total dietary intake (e.g., enzymes or tissues from organs or glands), or
• a concentrate, metabolite, constituent or extract.

A "new dietary ingredient" is one that meets the above definition for a "dietary ingredient" and was not sold in the U.S. in a dietary supplement before October 15, 1994.

Source: http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ucm110417.htm  

2. The importance of Supplements

When we speak about nutritional supplements, the first things that usually come to mind are calcium, glucosamine or iron. While these certainly are the most commonly used forms today, the vitamin and mineral world has evolved into a big business and more and more people are realizing the benefits and the importance of supplementing our bodies.

Fifty years ago, it was virtually impossible to walk into a grocery store and have a selection of herbs and supplements at our fingertips. But today there is a vast supply of just about anything you could think of.

 But why is supplementation so important to us, especially once we reach certain ages?  Through time, our bodies go through some major physical changes and if we have lived normal lives, then we probably have been introduced to such things as processed foods, fast foods, sugars and all the things we love but know are not good for us. Essentially, what it comes down to is making sure that the immune system is functioning properly. If our immunity is suppressed for whatever reason, the body is not going to be able to fight off even the simplest attack on our system.

The body is composed of six nutrient groups:

-Fats

-Proteins

-Carbohydrates

-Water

-Vitamins

-Minerals

In order for the immune system and for cell function to be at its optimal levels, all these groups are necessary in our regular diets.

For people who are watching their diets, getting the proper amounts of fats, proteins and carbohydrates may be an achievable goal and if you are hydrating your system consistently with water then you are almost there. But the problem arises in the foods and drinks that we regularly consume that don’t give us the adequate supply of vitamins & minerals in our diets. So right away, our immune and cell functions are affected. We need to replace what the body is lacking in our diets to have optimal health. If there is a chronic illness or degenerative process occurring within the body, this must be considered in a workup.

Taking nutritional supplements to make up for the deficiencies in our regular diets should be an integral part of our health. But we are providing a lot more in the ways of organ and cell function.

It is very important to distinguish between nutritional supplements and Western medicine and how a disease process is treated. Medications are primarily for more acute situations where the objective is to block a certain process the body is going through, usually in a rapid manner. While the results may vary, this may be causing further problems because the body itself is not being allowed to do what it was intended to do in the first place-to heal itself. Conversely, nutrients are completely safe in the fact that they are already present in the body although their effects may take a little longer.

In today’s world of chemicals, pesticides, inorganic fertilizers, heating processes and a diet that consists of at least 90% processed foods, it is essential for our bodies to make up for this depleted type of diet.

 Most vitamins cannot be made by the body, they must be taken in as food. Our best sources for this are whole foods that are heavy in vitamins.

3. Types of Supplements

The optimum vitamins that we should look for are whole food vitamins. Whole food vitamins are obtained by taking a vitamin-rich plant, removing any water or fiber and then packaging it for stability. In this form, the vitamins retain its full nutritional integrity. When taken by an individual, the person does not have to utilize any of its own reserves to get the full effect of the supplement.

The major problem today is the increasing number of synthetic products that are available to us. Vitamins and minerals must work synergistically together in order for them to be a whole food supplement. If there is a vitamin deficiency, this can cause a mineral deficiency and the same is true the other way around. With a whole food vitamin, it should contain trace amounts of important minerals in order for them to function properly. When there are no traces of minerals in a vitamin supplement, the body must rely on its own body’s mineral stores causing possible depletion.

Vitamins serve several different functions, including hormone production, antioxidants (cell protection from free radicals), growth regulators for the body and enzyme metabolism.

Here is a list of the most common vitamins and their primary functions:

-Vitamin A: for immune strength; used for healthy skin and for blood sugar stabilization; antioxidant

-Vitamin B complex: depleted as we age, used for energy stores.

            B1 (thiamine): for cognitive health

            B2 (riboflavin): strong antioxidant

            B3 (niacin): taken for cholesterol and triglycerides regulation

            B5 (pantothenic acid): used as an anti-inflammatory

            B6 (pyridoxine): also an anti-inflammatory, also promotes prostaglandins that aid in artery dilation.

            Folic Acid: critical for human fetal development, important for women of childbearing age. Also, important for atherosclerosis risk.

            B12: good for food metabolization, nervous system stimulation and the prevention of pernicious anemia.

-Vitamin C: another powerful antioxidant, reduces free radical production, protects against cancers, heart disease and infection.

-Vitamin D: actually a hormone; strong antioxidant; essential for bone health and also facilitates the absorption of calcium. It is best taken in by natural sunlight but also found in raw dairy and fatty fish.

Vitamin E: Very strong antioxidant

Vitamin K: Essential for clotting, important for women prone to osteoporosis

Minerals originate from the earth and most of the minerals that come from our diet, come directly from plants or indirectly from animal sources. In reference to minerals, there are four types of supplements that are available.

1)    Elemental: these are the least expensive made and have an absorption rate between one and eight percent.

2)    Ionic: This means in the form of ions. Ions are unstable molecules and thus, incomplete molecules. Not the ideal form of mineral intake.

3)    Colloidal: Barely gets absorbed by the body.

4)    Chelated: Superior to all others; Best absorbed at the cellular level; most readily absorbed into the bloodstream.

Here are some common minerals and their functions:

 -     Calcium: the two primary functions are for muscle contraction and bone building

 -     Magnesium: important for heart and immune function, as well as muscle and bone;

            Linked to hypertension, osteoporosis, headaches, diabetes and much more

-       Sodium: cell life, waste removal

-       Phosphorus: bone formation, cell energy, nerve transmission

-       Chromium: insulin function, immune function

-       Iron: hemoglobin formation,

-       Zinc: antioxidant production, fat metabolism, wound healing, skin health

-       Boron: reproductive health

Other important supplements:

-       Amino Acids: Important to supplement if diet is low on animal protein.

-       Coenzyme Q10: essential for heart and immune function; naturally present in most human cells

-       Fiber: decreases inflammation, lowers cholesterol and blood sugar levels; intestinal health

-       Probiotics:  “friendly bacteria” for the intestinal flora to help reestablish a healthy intestinal tract.

-       Fish Oils: commonly referred to as omega-3 fats ; numerous benefits including heart function and the prevention of cancers; body fat reduction

 4. Nutritional Deficiencies

Most Americans (99%) are vitamin or mineral deficient, causing an array of chronic conditions or illnesses to appear that their doctor may never look at their diet as the culprit.

But vitamins and minerals play an extremely vital role in our health and we are usually surprised to learn that nearly all of us have some type of a deficiency.

A common question may be how being deficient in our diets can lead to illness. Let’s use the example of chromium, the most common mineral that Americans are deficient in (at least 90%). One of the primary functions of chromium is the regulation of insulin and it’s relation to the pancreas. Eating foods that cannot be digested properly (processed foods, refined sugars, etc.) will ultimately deprive our bodies of the needed chromium that regulates this insulin function. If there is any disruption of the insulin-pancreas relationship, we then can see how being insulin deprived can be a precursor to adult onset diabetes (type 2).

The primary reasons for mineral deficiency are

1)    soil depletion: lowered mineral content in plants due to topsoil issues

2)    diet: processed and refined foods inhibit absorption of minerals

3)    Mucoid plaque of the colon: excess will cause dehydration and the loss of water and minerals that should have been reabsorbed.

4)    Competition: an excess of one mineral may cause a deficiency in another because minerals compete for absorption.

5)    prescription medications: have an inhibitive effect on mineral absorption

It is very important to note that supplementing on vitamins and minerals does not necessarily mean that absorption is taking place at the cellular level or in the bloodstream. There are many synthetic (man-made) products that are available to us and that may be causing a whole different issue. If the supplements being taken are not bioavailable, which means being utilized by the cell, then this is a waste of time and money and may be causing a toxicity issue.

5. Toxicity and Side Effects of Supplementation

The question may present that vitamin and mineral supplementation in excess may cause side effects or even toxicity. As mentioned earlier, if the supplements are not being properly absorbed at the cellular levels and taken in excess then toxicity may occur. That is why it is essential to only take whole food supplements, because the chance of absorption is a lot higher opposed to synthetic supplements. Upon doing research, looking for chelated products should be our top priority in making a decision. The cost may have an influence on some people but cheaply made supplements will obviously be the lower end product (elemental form).

In regards to side effects, there may be an issue where either a prescription medication or an over the counter product (motrin, advil, etc.) is said to have an adverse reaction to a specific supplement. While the chance of this occurring is extremely rare, there is always the recommendation that this be discussed with your physician before beginning a regimen of supplements and medications concurrently.

As of this date, there has never been a recorded death due to the use of nutritional supplements while prescription medications are the 4^th leading cause of death in the U.S. today.  Unless it is a life saving drug, the answer seems obviously clear that supplementation is much safer than its western counterpart. If a diet is not at least 80% raw foods, the need for supplementation becomes increasingly important to make up for the lost nutrients the body eventually goes through.

:

Course under development

Other Baratta Institute Courses under development

B105 Managing low back pain with exercise

B110 Nutritional considerations for the arthritic or osteoporotic patient

B115 Living with chronic pain

TEST

Welcome to this 3-contact-hour Continuing Education  course (RN-CEP 11430, MFT- PCE 39) with instant online processing and certification 24/7.  Study the course below, take the 12-question multiple-choice TEST, register and pay online. If you score 75%, you can then print out your certificate on your printer.

Study this web-site for 3 hours for an approved (RN-CEP 11430, MFT- PCE 39) 3-hours Continuing Education Certificate (0.3 CEUs).  Click here for the  TEST.