Sunday, January 5, 2020

NEW YEAR'S RESOLUTION - SHOULD I TAKE MORE SUPPLEMENTS?


The Federal Food, Drug and Cosmetic Act defines a supplement as a vitamin, mineral, herb or other botanical, amino acid, or dietary substance for use by man to supplement the diet by increasing the dietary intake, concentrate, metabolite, constituent extract, or combination of preceding substances. With the astronomical variety of supplements being marketed it comes as a surprise to many that these products are not fully regulated by the Food and Drug Administration (FDA). Supplements fall under the Dietary Supplement Health and Education Act (DHSEA) of 1994 that prohibits manufacturers and distributors from marketing false or unsafe products. Prior to distribution, companies selling supplements must establish a safety plan and proper labeling to meet the DHSEA regulations. Although meeting these regulations are required, the FDA does not test these supplements to verify that what is on the ingredient list is actually being sold.

While the FDA does not regulate such products, there are independent organizations that test these products to determine if the ingredients on the label are in fact what the supplement contains without the addition of ingredients not listed. Unfortunately, these independent companies do not test to see if the supplement has a particular health effect or if it is safe. Organizations such as Consumer Labs, NSF Internationals and US Pharmacopeia all have their own seal of approval that can be found on the front of the supplement bottle indicating that the specific supplement has been tested.

Under federal law dietary supplements cannot be promoted for the treatment of disease because they are not proven to be safe and effective. Label claims such as “address nutrient deficiency,” “supports health,” “shrinks tumors,” “this product does it all” and scientific words being used like “scientific breakthrough” and “secret Ingredient” must be followed by this disclaimer “This supplement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease”. These label claims can be tip-offs of a company looking to take advantage of the limited knowledge of the general public and that supplements are simply not fully regulated by the FDA.

Before purchasing a supplement, it is important to speak with a doctor, registered dietitian or a pharmacist to determine a person’s nutrition needs. Factors to consider may include age, diet, current medical conditions or medical conditions a person may be at risk for such as osteoporosis, heart disease, kidney disease, cancer, pregnancy and more. It is also important to do your homework before purchasing any type of over the counter supplement. Questions a person should ask include: What does this supplement do? What are the risks and the benefits? How much do I take? How long do I take it? When do I take it?

When researching supplements, it is important to consider the risks. Speaking with a doctor, registered dietitian or pharmacist before taking a supplement will be helpful in determining which are safe for specific medical conditions. Many supplements can have interactions with current medications a person may be taking. Examples include vitamin C and E with cancer treatments; antidepressants and birth control with St. John’s Wort; vitamin K with Coumadin; ginseng with Heparin; anticoagulants and NSAIDS; gingko biloba with high blood pressure medications. Health conditions to be aware of when taking supplements include surgery, pregnancy, breastfeeding, heart disease, high blood pressure, and gastrointestinal issues. For example, during pregnancy a prenatal vitamin is recommended as consuming the recommended dosage of specific vitamins like folate can prevent long term birth defects such as spina bifida.

If a potential problem is suspected with a supplement it can be reported to the Federal Trade Commission, State Attorney’s General Office, State Department of Health, or your Local Consumer Protection Agency. If an illness is suspected to be a result from taking a supplement, report to your doctor immediately and a compliant can be filed with the FDA online.




Office of Food Additive Safety, Guidance for industry: Distinguishing liquid dietary supplements from beverages. U.S. Department of Health and Human Services. January 2014. Accessed March 26th, 2019.

Dietary Supplement Products and Ingredients, FDA website. https://www.fda.gov/Food/DietarySupplements/ProductsIngredients/default.htm. Accessed March 26, 2019

Dietary Supplements. FDA Website. https://www.fda.gov/Food/DietarySupplements/default.htm. Accessed March 26, 2019
Dietary Supplements, What you need to know. National Institutes of Health website. https://ods.od.nih.gov/HealthInformation/DS_WhatYouNeedToKnow.aspx. Accessed March 26, 2019

FDA 101: Dietary Supplements. FDA website. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm050803.htm. Accessed March 26, 2019

Medication Interactions: Food, Supplements and Other Drugs. American Heart Association Website. https://www.heart.org/en/health-topics/consumer-healthcare/medication-information/medication-interactions-food-supplements-and-other-drugs. Accessed March 26, 2019

Medication and Supplements that can raise your blood pressure. Mayo Clinic Website. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/blood-pressure/art-20045245 Accessed March 26, 2019

15 Supplement Ingredients to Always Avoid. Consumer Reports Website. https://www.consumerreports.org/vitamins-supplements/15-supplement-ingredients-to-always-avoid/ Accessed March 26, 2019

Mixed Medications and Dietary Supplements Can Endanger Your Health. FDA website. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm420349.htm. Accessed March 26, 2019

Guidance for Industry. Distinguishing Liquid Dietary Supplements from Beverages. FDA website. https://www.fda.gov/downloads/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/DietarySupplements/UCM381220.pdf . Accessed March 26, 2019.

WHICH DIET IS RIGHT FOR YOU?

We all know that as the new year approaches and we are leaving our holiday baggage behind, "diets" are on every one's minds. Diets come and go and are very trendy. A "live-it" instead of a diet is a more reasonable philosophy. After all, we do have to live with it. What is out there right now?.... the paleo, the zone, the low carb, the detox, the keto. Well, most importantly, eating habits should be chosen according to the nutrients a body needs for growth, maintenance and disease prevention, but that doesn't always happen. Americans want weight loss and they want it quick. What if you can't stick with it?

US News and World Report rated 35 diets and found that the well studied, Mediterranean diet ranked #1 for the third year in a row. Next was the long standing DASH (Dietary Approach to Stop Hypertension), Flexitarian (vegan with occasional meat added), WW (the re branded name known as Weight Watchers) and MIND (stands for Mediterranean-DASH Intervention for Neurodegenerative Delay.) In the MIND diet, parts of the Mediterranean and DASH diets have been combined with a new goal: reduce dementia and a decline in brain health that usually occurs as we age.

Although the above choice all seem like decent choices, let's talk about the #1 choice. Why the Mediterranean diet? Well, as mentioned earlier, people can stick to it, it is well researched and it is a "whole" diet that tastes good, The Mediterranean diet includes plenty of fruits and vegetables, beans, whole grains, healthy fats, such as olive oil, avocado, nuts and fish, especially omega 3 fish, such as salmon, tuna and trout. The diet discourages processed foods, thus limiting saturated fat, sodium and sugar, but doesn't eliminate any food groups. Meals from the sunny Mediterranean areas have been linked to stronger bones, a healthier heart, a lower risk of dementia and breast cancer, and longer life, along with reduced risk of diabetes and high blood pressure.

Out of the 35 diets ranked in US New and World Report, the keto diet came in last. The keto diet limits carbohydrates to 20 grams a day which is the equivalent to one piece of fresh fruit. People do seem to lose weight, initially, on the keto diet, but, generally find it difficult to maintain. People complain of headaches and dizziness and there is a concern that the amount of saturated fat long term can cause heart disease and even, gallbladder issues.

So, you decide....which diets work for you?

For more information on the Mediterranean diet, try https://oldwayspt.org/traditional-diets/mediterranean-diet  or https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801. For the information on diet reviews, visit https://www.cnn.com/2020/01/02/health/best-diet-worst-diet-2020-wellness/index.html.