Category Archives: Food Supplements

Introduction

See Consumer for easy-to-read facts about Zinc.

Zinc is an essential mineral that is naturally present in some foods, added to others, and available as a dietary supplement. Zinc is also found in many cold lozenges and some over-the-counter drugs sold as cold remedies.

Zinc is involved in numerous aspects of cellular metabolism. It is required for the catalytic activity of approximately 100 enzymes [1,2] and it plays a role in immune function [3,4], protein synthesis [4], wound healing [5], DNA synthesis [2,4], and cell division [4]. Zinc also supports normal growth and development during pregnancy, childhood, and adolescence [6-8] and is required for proper sense of taste and smell [9]. A daily intake of zinc is required to maintain a steady state because the body has no specialized zinc storage system [10].

Intake recommendations for zinc and other nutrients are provided in the Dietary Reference Intakes (DRIs) developed by the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies (formerly National Academy of Sciences) [2]. DRI is the general term for a set of reference values used for planning and assessing nutrient intakes of healthy people. These values, which vary by age and gender [2], include the following:

The current RDAs for zinc are listed in Table 1 [2]. For infants aged 0 to 6 months, the FNB established an AI for zinc that is equivalent to the mean intake of zinc in healthy, breastfed infants.

* Adequate Intake (AI)

Food A wide variety of foods contain zinc (Table 2) [2]. Oysters contain more zinc per serving than any other food, but red meat and poultry provide the majority of zinc in the American diet. Other good food sources include beans, nuts, certain types of seafood (such as crab and lobster), whole grains, fortified breakfast cereals, and dairy products [2,11].

Phytateswhich are present in whole-grain breads, cereals, legumes, and other foodsbind zinc and inhibit its absorption [2,12,13]. Thus, the bioavailability of zinc from grains and plant foods is lower than that from animal foods, although many grain- and plant-based foods are still good sources of zinc [2].

* DV = Daily Value. DVs were developed by the U.S. Food and Drug Administration to help consumers compare the nutrient contents of products within the context of a total diet. The DV for zinc is 15 mg for adults and children age 4 and older. Food labels, however, are not required to list zinc content unless a food has been fortified with this nutrient. Foods providing 20% or more of the DV are considered to be high sources of a nutrient.

The U.S. Department of Agriculture's (USDA's) Nutrient Database Web site [11] lists the nutrient content of many foods and provides a comprehensive list of foods containing zinc arranged by nutrient content and by food name.

Dietary supplements Supplements contain several forms of zinc, including zinc gluconate, zinc sulfate, and zinc acetate. The percentage of elemental zinc varies by form. For example, approximately 23% of zinc sulfate consists of elemental zinc; thus, 220 mg of zinc sulfate contains 50 mg of elemental zinc. The elemental zinc content appears in the Supplement Facts panel on the supplement container. Research has not determined whether differences exist among forms of zinc in absorption, bioavailability, or tolerability.

In addition to standard tablets and capsules, some zinc-containing cold lozenges are labeled as dietary supplements.

Other sources Zinc is present in several products, including some labeled as homeopathic medications, sold over the counter for the treatment and prevention of colds. Numerous case reports of anosmia (loss of the sense of smell), in some cases long-lasting or permanent, have been associated with the use of zinc-containing nasal gels or sprays [14,15]. In June 2009, the FDA warned consumers to stop using three zinc-containing intranasal products because they might cause anosmia [16]. The manufacturer recalled these products from the marketplace. Currently, these safety concerns have not been found to be associated with cold lozenges containing zinc.

Zinc is also present in some denture adhesive creams at levels ranging from 1734 mg/g [17]. While use of these products as directed (0.51.5 g/day) is not of concern, chronic, excessive use can lead to zinc toxicity, resulting in copper deficiency and neurologic disease. Such toxicity has been reported in individuals who used 2 or more standard 2.4 oz tubes of denture cream per week [17,18]. Many denture creams have now been reformulated to eliminate zinc.

Most infants (especially those who are formula fed), children, and adults in the United States consume recommended amounts of zinc according to two national surveys, the 19881991 National Health and Nutrition Examination Survey (NHANES III) [19] and the 1994 Continuing Survey of Food Intakes of Individuals (CSFII) [20].

However, some evidence suggests that zinc intakes among older adults might be marginal. An analysis of NHANES III data found that 35%45% of adults aged 60 years or older had zinc intakes below the estimated average requirement of 6.8 mg/day for elderly females and 9.4 mg/day for elderly males. When the investigators considered intakes from both food and dietary supplements, they found that 20%25% of older adults still had inadequate zinc intakes [21].

Zinc intakes might also be low in older adults from the 2%4% of U.S. households that are food insufficient (sometimes or often not having enough food) [22]. Data from NHANES III indicate that adults aged 60 years or older from food-insufficient families had lower intakes of zinc and several other nutrients and were more likely to have zinc intakes below 50% of the RDA on a given day than those from food-sufficient families [23].

Zinc deficiency is characterized by growth retardation, loss of appetite, and impaired immune function. In more severe cases, zinc deficiency causes hair loss, diarrhea, delayed sexual maturation, impotence, hypogonadism in males, and eye and skin lesions [2,8,24,25]. Weight loss, delayed healing of wounds, taste abnormalities, and mental lethargy can also occur [5,8,26-30]. Many of these symptoms are non-specific and often associated with other health conditions; therefore, a medical examination is necessary to ascertain whether a zinc deficiency is present.

Zinc nutritional status is difficult to measure adequately using laboratory tests [2,31,32] due to its distribution throughout the body as a component of various proteins and nucleic acids [33]. Plasma or serum zinc levels are the most commonly used indices for evaluating zinc deficiency, but these levels do not necessarily reflect cellular zinc status due to tight homeostatic control mechanisms [8]. Clinical effects of zinc deficiency can be present in the absence of abnormal laboratory indices [8]. Clinicians consider risk factors (such as inadequate caloric intake, alcoholism, and digestive diseases) and symptoms of zinc deficiency (such as impaired growth in infants and children) when determining the need for zinc supplementation [2].

In North America, overt zinc deficiency is uncommon [2]. When zinc deficiency does occur, it is usually due to inadequate zinc intake or absorption, increased losses of zinc from the body, or increased requirements for zinc [26,27,34]. People at risk of zinc deficiency or inadequacy need to include good sources of zinc in their daily diets. Supplemental zinc might also be appropriate in certain situations.

People with gastrointestinal and other diseases Gastrointestinal surgery and digestive disorders (such as ulcerative colitis, Crohn's disease, and short bowel syndrome) can decrease zinc absorption and increase endogenous zinc losses primarily from the gastrointestinal tract and, to a lesser extent, from the kidney [2,26,35,36]. Other diseases associated with zinc deficiency include malabsorption syndrome, chronic liver disease, chronic renal disease, sickle cell disease, diabetes, malignancy, and other chronic illnesses [37]. Chronic diarrhea also leads to excessive loss of zinc [24].

Vegetarians The bioavailability of zinc from vegetarian diets is lower than from non-vegetarian diets because vegetarians do not eat meat, which is high in bioavailable zinc and may enhance zinc absorption. In addition, vegetarians typically eat high levels of legumes and whole grains, which contain phytates that bind zinc and inhibit its absorption [31,38].

Vegetarians sometimes require as much as 50% more of the RDA for zinc than non-vegetarians [2]. In addition, they might benefit from using certain food preparation techniques that reduce the binding of zinc by phytates and increase its bioavailability. Techniques to increase zinc bioavailability include soaking beans, grains, and seeds in water for several hours before cooking them and allowing them to sit after soaking until sprouts form [38]. Vegetarians can also increase their zinc intake by consuming more leavened grain products (such as bread) than unleavened products (such as crackers) because leavening partially breaks down the phytate; thus, the body absorbs more zinc from leavened grains than unleavened grains.

Pregnant and lactating women Pregnant women, particularly those starting their pregnancy with marginal zinc status, are at increased risk of becoming zinc insufficient due, in part, to high fetal requirements for zinc [39]. Lactation can also deplete maternal zinc stores [40]. For these reasons, the RDA for zinc is higher for pregnant and lactating women than for other women (see Table 1) [2].

Older infants who are exclusively breastfed Breast milk provides sufficient zinc (2 mg/day) for the first 46 months of life but does not provide recommended amounts of zinc for infants aged 712 months, who need 3 mg/day [2,33]. In addition to breast milk, infants aged 712 months should consume age-appropriate foods or formula containing zinc [2]. Zinc supplementation has improved the growth rate in some children who demonstrate mild-to-moderate growth failure and who have a zinc deficiency [24,41].

People with sickle cell disease Results from a large cross-sectional survey suggest that 44% of children with sickle cell disease have a low plasma zinc concentration [42], possibly due to increased nutrient requirements and/or poor nutritional status [43]. Zinc deficiency also affects approximately 60%70% of adults with sickle cell disease [44]. Zinc supplementation has been shown to improve growth in children with sickle cell disease [43].

Alcoholics Approximately 30%50% of alcoholics have low zinc status because ethanol consumption decreases intestinal absorption of zinc and increases urinary zinc excretion [44]. In addition, the variety and amount of food consumed by many alcoholics is limited, leading to inadequate zinc intake [2,46,47].

Immune function Severe zinc deficiency depresses immune function [48], and even mild to moderate degrees of zinc deficiency can impair macrophage and neutrophil functions, natural killer cell activity, and complement activity [49]. The body requires zinc to develop and activate T-lymphocytes [2,50]. Individuals with low zinc levels have shown reduced lymphocyte proliferation response to mitogens and other adverse alterations in immunity that can be corrected by zinc supplementation [49,51]. These alterations in immune function might explain why low zinc status has been associated with increased susceptibility to pneumonia and other infections in children in developing countries and the elderly [52-55].

Wound healing Zinc helps maintain the integrity of skin and mucosal membranes [49]. Patients with chronic leg ulcers have abnormal zinc metabolism and low serum zinc levels [56], and clinicians frequently treat skin ulcers with zinc supplements [57]. The authors of a systematic review concluded that zinc sulfate might be effective for treating leg ulcers in some patients who have low serum zinc levels [58,59]. However, research has not shown that the general use of zinc sulfate in patients with chronic leg ulcers or arterial or venous ulcers is effective [58,59].

Diarrhea Acute diarrhea is associated with high rates of mortality among children in developing countries [60]. Zinc deficiency causes alterations in immune response that probably contribute to increased susceptibility to infections, such as those that cause diarrhea, especially in children [49].

Studies show that poor, malnourished children in India, Africa, South America, and Southeast Asia experience shorter courses of infectious diarrhea after taking zinc supplements [61]. The children in these studies received 440 mg of zinc a day in the form of zinc acetate, zinc gluconate, or zinc sulfate [61].

In addition, results from a pooled analysis of randomized controlled trials of zinc supplementation in developing countries suggest that zinc helps reduce the duration and severity of diarrhea in zinc-deficient or otherwise malnourished children [62]. Similar findings were reported in a meta-analysis published in 2008 and a 2007 review of zinc supplementation for preventing and treating diarrhea [63,64]. The effects of zinc supplementation on diarrhea in children with adequate zinc status, such as most children in the United States, are not clear.

The World Health Organization and UNICEF now recommend short-term zinc supplementation (20 mg of zinc per day, or 10 mg for infants under 6 months, for 1014 days) to treat acute childhood diarrhea [60].

The common cold Researchers have hypothesized that zinc could reduce the severity and duration of cold symptoms by directly inhibiting rhinovirus binding and replication in the nasal mucosa and suppressing inflammation [65,66]. Although studies examining the effect of zinc treatment on cold symptoms have had somewhat conflicting results, overall zinc appears to be beneficial under certain circumstances. Several studies are described below in which zinc is administered as a lozenge or zinc-containing syrup that temporarily "sticks" in the mouth and throat. This allows zinc to make contact with the rhinovirus in those areas.

In a randomized, double-blind, placebo-controlled clinical trial, 50 subjects (within 24 hours of developing the common cold) took a zinc acetate lozenge (13.3 mg zinc) or placebo every 23 wakeful hours. Compared with placebo, the zinc lozenges significantly reduced the duration of cold symptoms (cough, nasal discharge, and muscle aches) [67].

In another clinical trial involving 273 participants with experimentally induced colds, zinc gluconate lozenges (providing 13.3 mg zinc) significantly reduced the duration of illness compared with placebo but had no effect on symptom severity [68]. However, treatment with zinc acetate lozenges (providing 5 or 11.5 mg zinc) had no effect on either cold duration or severity. Neither zinc gluconate nor zinc acetate lozenges affected the duration or severity of cold symptoms in 281 subjects with natural (not experimentally induced) colds in another trial [68].

In 77 participants with natural colds, a combination of zinc gluconate nasal spray and zinc orotate lozenges (37 mg zinc every 23 wakeful hours) was also found to have no effect on the number of asymptomatic patients after 7 days of treatment [69].

In September of 2007, Caruso and colleagues published a structured review of the effects of zinc lozenges, nasal sprays, and nasal gels on the common cold [66]. Of the 14 randomized, placebo-controlled studies included, 7 (5 using zinc lozenges, 2 using a nasal gel) showed that the zinc treatment had a beneficial effect and 7 (5 using zinc lozenges, 1 using a nasal spray, and 1 using lozenges and a nasal spray) showed no effect.

More recently, a Cochrane review concluded that "zinc (lozenges or syrup) is beneficial in reducing the duration and severity of the common cold in healthy people, when taken within 24 hours of onset of symptoms" [70]. The author of another review completed in 2004 also concluded that zinc can reduce the duration and severity of cold symptoms [65]. However, more research is needed to determine the optimal dosage, zinc formulation and duration of treatment before a general recommendation for zinc in the treatment of the common cold can be made [70].

As previously noted, the safety of intranasal zinc has been called into question because of numerous reports of anosmia (loss of smell), in some cases long-lasting or permanent, from the use of zinc-containing nasal gels or sprays [14-16].

Age-related macular degeneration Researchers have suggested that both zinc and antioxidants delay the progression of age-related macular degeneration (AMD) and vision loss, possibly by preventing cellular damage in the retina [71,72]. In a population-based cohort study in the Netherlands, high dietary intake of zinc as well as beta carotene, vitamin C, and vitamin E was associated with reduced risk of AMD in elderly subjects [73]. However, the authors of a systematic review and meta-analysis published in 2007 concluded that zinc is not effective for the primary prevention of early AMD [74], although zinc might reduce the risk of progression to advanced AMD.

The Age-Related Eye Disease Study (AREDS), a large, randomized, placebo-controlled, clinical trial (n = 3,597), evaluated the effect of high doses of selected antioxidants (500 mg vitamin C, 400 IU vitamin E, and 15 mg beta-carotene) with or without zinc (80 mg as zinc oxide) on the development of advanced AMD in older individuals with varying degrees of AMD [72]. Participants also received 2 mg copper to prevent the copper deficiency associated with high zinc intakes. After an average follow-up period of 6.3 years, supplementation with antioxidants plus zinc (but not antioxidants alone) significantly reduced the risk of developing advanced AMD and reduced visual acuity loss. Zinc supplementation alone significantly reduced the risk of developing advanced AMD in subjects at higher risk but not in the total study population. Visual acuity loss was not significantly affected by zinc supplementation alone. A follow-up AREDS2 study confirmed the value of this supplement in reducing the progression of AMD over a median follow-up period of 5 years [75]. Importantly, AREDS2 revealed that a formulation providing 25 mg zinc (about one-third the amount in the original AREDS formulation) provided the same protective effect against developing advanced AMD.

Two other small clinical trials evaluated the effects of supplementation with 200 mg zinc sulfate (providing 45 mg zinc) for 2 years in subjects with drusen or macular degeneration. Zinc supplementation significantly reduced visual acuity loss in one of the studies [76] but had no effect in the other [77].

A Cochrane review concluded that the evidence supporting the use of antioxidant vitamins and zinc for AMD comes primarily from the AREDS study [71]. Individuals who have or are developing AMD should talk to their health care provider about taking a zinc-containing AREDS supplement.

Interactions with iron and copper Iron-deficiency anemia is a serious world-wide public health problem. Iron fortification programs have been credited with improving the iron status of millions of women, infants, and children. Fortification of foods with iron does not significantly affect zinc absorption. However, large amounts of supplemental iron (greater than 25 mg) might decrease zinc absorption [2,78]. Taking iron supplements between meals helps decrease its effect on zinc absorption [78].

High zinc intakes can inhibit copper absorption, sometimes producing copper deficiency and associated anemia [79,80]. For this reason, dietary supplement formulations containing high levels of zinc, such as the one used in the AREDS study [72], sometimes contain copper.

Zinc toxicity can occur in both acute and chronic forms. Acute adverse effects of high zinc intake include nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, and headaches [2]. One case report cited severe nausea and vomiting within 30 minutes of ingesting 4 g of zinc gluconate (570 mg elemental zinc) [81]. Intakes of 150450 mg of zinc per day have been associated with such chronic effects as low copper status, altered iron function, reduced immune function, and reduced levels of high-density lipoproteins [82]. Reductions in a copper-containing enzyme, a marker of copper status, have been reported with even moderately high zinc intakes of approximately 60 mg/day for up to 10 weeks [2]. The doses of zinc used in the AREDS study (80 mg per day of zinc in the form of zinc oxide for 6.3 years, on average) have been associated with a significant increase in hospitalizations for genitourinary causes, raising the possibility that chronically high intakes of zinc adversely affect some aspects of urinary physiology [83].

The FNB has established ULs for zinc (Table 3). Long-term intakes above the UL increase the risk of adverse health effects [2]. The ULs do not apply to individuals receiving zinc for medical treatment, but such individuals should be under the care of a physician who monitors them for adverse health effects.

Zinc supplements have the potential to interact with several types of medications. A few examples are provided below. Individuals taking these medications on a regular basis should discuss their zinc intakes with their healthcare providers.

Antibiotics Both quinolone antibiotics (such as Cipro) and tetracycline antibiotics (such as Achromycin and Sumycin) interact with zinc in the gastrointestinal tract, inhibiting the absorption of both zinc and the antibiotic [84,85]. Taking the antibiotic at least 2 hours before or 46 hours after taking a zinc supplement minimizes this interaction [86].

Penicillamine Zinc can reduce the absorption and action of penicillamine, a drug used to treat rheumatoid arthritis [87]. To minimize this interaction, individuals should take zinc supplements at least 2 hours before or after taking penicillamine [85].

Diuretics Thiazide diuretics such as chlorthalidone (Hygroton) and hydrochlorothiazide (Esidrix and HydroDIURIL) increase urinary zinc excretion by as much as 60% [88]. Prolonged use of thiazide diuretics could deplete zinc tissue levels, so clinicians should monitor zinc status in patients taking these medications.

The federal government's 2015-2020 Dietary Guidelines for Americans notes that "Nutritional needs should be met primarily from foods. ... Foods in nutrient-dense forms contain essential vitamins and minerals and also dietary fiber and other naturally occurring substances that may have positive health effects. In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts."

For more information about building a healthy diet, refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate.

The Dietary Guidelines for Americans describes a healthy eating pattern as one that:

This fact sheet by the Office of Dietary Supplements provides information that should not take the place of medical advice. We encourage you to talk to your healthcare providers (doctor, registered dietitian, pharmacist, etc.) about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific brand name is not an endorsement of the product.

Updated: February 11, 2016

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Zinc Health Professional Fact Sheet

Dog food recipe that is designed to be simple to make and healthy for your dog.

NOTE:In an effort to simplify the dog food recipe I have incorporated the use of supplements. Without the supplements the dog food recipe would need an additional 10 to 20 ingredients. Unfortunately, our current agricultural practices yield foods with a fraction of the nutrient content of wild counterparts.

That said; this dog food recipe is deficient without the two supplements that are essential to the recipe:Dinovitesupplement andLickOchopsomega fatty acid supplement. Feeding this recipe without the supplements will result in multiple nutritional deficiency diseases.

Approximately 40 cups of dog food.

This dog food recipe can be halved or doubled to accommodate the size of your dog or for multi-dog households. Do not feed this dog food recipe without theDinoviteandLickOchopsdog supplements as it will cause this dog food recipe to be deficient.

Place 2-3 days worth of the dog food recipe in zip lock bags or plastic freezer containers. Store them in your freezer.

I personally prefer the freezer containers because they are easy to fill, thaw and serve. There is never any mess. I take one out and let it thaw on my counter. Feed my dogs and store the unused portion in my refrigerator. When its empty I wash it and it is ready for the next batch. Mix up some more of the easy cooked dog food recipe and Im ready to go. It works well.

NOTE:Remember you are handling raw meat so use common sense when making this dog food recipe. Use the same precautions you would use when handling raw meat for your family.

*Special note: These are general guidelines, we are not trying to land a man on Mars. If your dog is losing a little weight and this is not desired, increase the amount you are feeding. If your dog is gaining weight on the serving size then cut back a little. In short, adjust the serving size depending on your dogs age, weight and activity level.

*Special Note: If you add the supplements to the whole batch when making the dog food recipe it is not necessary to add them with each serving. Use whichever method you find easier.

Click here to watch the video.

Please follow this introductory method, your dog will be fine. Your dog will not starve or hate you. Rapid diet changes can cause vomiting and diarrhea. A horrendous mess all over your house!

***Important Note:Do not mix kibble and the Easy Cooked Dog Food together! Doing so will GREATLY increase the chances of digestive upset for your dog!

Visit link:

Easy Cooked Dog Food Recipe - Homemade Dog Food

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Information regarding the effects of nutritional supplements on the body. Organized by major categories "Vitamins", "Minerals", "Amino Acids, Enzymes and Botanicals" with detailed listings and references for individual nutrients.

This site is provided as a public service and has no commercial affiliation or sponsorship.

vitamin, mineral, supplement, health, diet, nutrition, free, non-profit, foodsupplement, AMINO ACIDS, ENZYMES, BOTANICALS, BORON, CALCIUM CITRATE, CHROMIUM PICOLINATE, COPPER, GERMANIUM, IODINE, IRON, MAGNESIUM, MANGANESE, MOLYBDENUM, NICKEL, PHOSPHORUS, POTASSIUM, SELENIUM, SILICON, SODIUM, SULFUR, VANADIUM, ZINC PICOLINATE, ACETYLCYSTEINE, ACIDOPHILUS, ADAPTOGENS, ALANINE, ALKYGLYCEROLS, ALLIUM SATIVUM, L-ARGININE, ASTRAGALUS, L-ASPARTIC ACID, BHT, BLUEBERRIES, CAPSICUM ANNUM, L-CARNITINE, CHOLINE, CINNAMON, COENZYME Q-10, COFFEE, CRANBERRY JUICE, CRATAEGUS OXYACANTHA, CURCUMIN, L-CYSTEINE, DHEA, DMAE, DIMETHYLGLYCINE (DMG), ECHINACEA, EPA, eicosapentaenoic acid, EVENING PRIMROSE OIL, FATS, FLAXSEED OIL, GARLIC, GINKGO BILOBA, GINSENG, GLUCOSAMINE SULFATE, L-GLUTAMIC ACID, L-GLUTAMINE, GLUTATHIONE PEROXIDASE ENZYME, L-GLUTATHIONE, GLYCINE, GREEN TEA, GYMNEMA SYLVESTRE, LECITHIN, LYCOPENE, LYSINE, MELATONIN, L-METHIONINE, OMEGA-3 FATTY ACIDS, PHYCOTENE, PHYTOCHEMICALS, PREGNENOLONE, PROANTHOCYANIDINE, PROPOLIS, QUERCETIN, RU-486, SAMC, SAW PALMETTO, SHARK CARTILAGE, SUGAR, SULFHYDRYL GROUP, ST. JOHN'S WORT, SUPEROXIDE DISMUTASE, SOD, TAURINE, THYMUS EXTRACTS, TURMERIC, TYROSINE, WATER, A, ALPHA CAROTENE, BETA CAROTENE, ASCORBYL PALMITATE, Ester-C, B-1, THIAMIN, B-2, RIBOFLAVIN, B-3, NIACIN, NIACINAMIDE, B-5, PANTOTHENIC ACID, B-6, PYRIDOXINE, B-12, METHYLCOBALAMIN, B-13, OROTIC ACID, BIOTIN, C, D, E, FOLIC ACID, INOSITOL, K, P, BIOFLAVONOIDS, PABA, T, U

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Food Supplements: Their Effects on the Body

Supplements: Nutrition in a pill?

Supplements aren't for everyone, but older adults and others may benefit from specific supplements.

The Dietary Guidelines for Americans make it clear that your nutritional needs should be met primarily through your diet.

For some people, however, supplements may be a useful way to get nutrients they might otherwise be lacking. But before you go shopping for supplements, get the facts on what they will and won't do for you.

Supplements aren't intended to be a food substitute because they can't replicate all of the nutrients and benefits of whole foods, such as fruits and vegetables. So depending on your situation and your eating habits, dietary supplements may not be worth the expense.

Whole foods offer three main benefits over dietary supplements:

If you're generally healthy and eat a wide variety of foods, including fruits, vegetables, whole grains, legumes, low-fat dairy products, lean meats and fish, you likely don't need supplements.

However, the dietary guidelines recommend supplements or fortified foods in the following situations:

Dietary supplements also may be appropriate if you:

Talk to your doctor or a dietitian about which supplements and what doses might be appropriate for you. Be sure to ask about possible side effects and interactions with any medications you take.

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Supplements: Nutrition in a pill? - Mayo Clinic

"Food supplement" redirects here. For food additions that alter the flavor, color or longevity of food, see Food additive. Flight through a CT image stack of a multivitamin tablet "A-Z" by German company Abtei.

A dietary supplement is intended to provide nutrients that may otherwise not be consumed in sufficient quantities.

Supplements as generally understood include vitamins, minerals, fiber, fatty acids, or amino acids, among other substances. U.S. authorities define dietary supplements as foods, while elsewhere they may be classified as drugs or other products.

There are more than 50,000 dietary supplements available. More than half of the U.S. adult population (53% - 55%) consume dietary supplements with most common ones being multivitamins.[1][2]

These products are not intended to prevent or treat any disease and in some circumstances are dangerous, according to the U.S. National Institutes of Health. For those who fail to consume a balanced diet, the agency says that certain supplements "may have value."[3]

Most supplements should be avoided, and usually people should not eat micronutrients except people with clearly shown deficiency.[4] Those people should first consult a doctor.[5] An exception is vitamin D, which is recommended in Nordic countries[6] due to weak sunlight.

According to the United States Food and Drug Administration (FDA), dietary supplements are products which are not pharmaceutical drugs, food additives like spices or preservatives, or conventional food, and which also meet any of these criteria:[7]

In the United States, the FDA has different monitoring procedures for substances depending on whether they are presented as drugs, food additives, food, or dietary supplements.[7] Dietary supplements are eaten or taken by mouth, and are regulated in United States law as a type of food rather than a type of drug.[8] Like food and unlike drugs, no government approval is required to make or sell dietary supplements; the manufacturer checks the safety of dietary supplements but the government does not; and rather than requiring riskbenefit analysis to prove that the product can be sold like a drug, riskbenefit analysis is only used to petition that food or a dietary supplement is unsafe and should be removed from market.[7]

The intended use of dietary supplements is to ensure that a person gets enough essential nutrients.[9]

Dietary supplements should not be used to treat any disease or as preventive healthcare.[10] An exception to this recommendation is the appropriate use of vitamins.[10]

Dietary supplements are unnecessary if one eats a balanced diet.[11]

Supplements may create harm in several ways, including over-consumption, particularly of minerals and fat-soluble vitamins which can build up in the body.[12] The products may also cause harm related to their rapid absorption in a short period of time, quality issues such as contamination, or by adverse interactions with other foods and medications.[13]

There are many types of dietary supplements.

Vitamin is an organic compound required by an organism as a vital nutrient in limited amounts.[14] An organic chemical compound (or related set of compounds) is called a vitamin when it cannot be synthesized in sufficient quantities by an organism, and must be obtained from the diet. Thus, the term is conditional both on the circumstances and on the particular organism. For example, ascorbic acid (vitamin C) is a vitamin for humans, but not for most other animals. Supplementation is important for the treatment of certain health problems but there is little evidence of benefit when used by those who are otherwise healthy.[15]

Dietary elements, commonly called "dietary minerals" or "minerals", are the chemical elements required by living organisms, other than the four elements carbon, hydrogen, nitrogen, and oxygen present in common organic molecules. The term "dietary mineral" is archaic, as the substances it refers are chemical elements rather than actual minerals.

Herbal medicine is the use of plants for medicinal purposes. Plants have been the basis for medical treatments through much of human history, and such traditional medicine is still widely practiced today. Modern medicine recognizes herbalism as a form of alternative medicine, as the practice of herbalism is not strictly based on evidence gathered using the scientific method. Modern medicine, does, however, make use of many plant-derived compounds as the basis for evidence-tested pharmaceutical drugs, and phytotherapy works to apply modern standards of effectiveness testing to herbs and medicines that are derived from natural sources. The scope of herbal medicine is sometimes extended to include fungal and bee products, as well as minerals, shells and certain animal parts.

Amino acids are biologically important organic compounds composed of amine (-NH2) and carboxylic acid (-COOH) functional groups, along with a side-chain specific to each amino acid. The key elements of an amino acid are carbon, hydrogen, oxygen, and nitrogen, though other elements are found in the side-chains of certain amino acids.

Amino acids can be divided into three categories: essential amino acids, non-essential amino acids, and conditional amino acids. Essential amino acids cannot be made by the body, and must be supplied by food. Non-essential amino acids are made by the body from essential amino acids or in the normal breakdown of proteins. Conditional amino acids are usually not essential, except in times of illness, stress, or for someone challenged with a lifelong medical condition[citation needed].

Essential fatty acids, or EFAs, are fatty acids that humans and other animals must ingest because the body requires them for good health but cannot synthesize them.[16] The term "essential fatty acid" refers to fatty acids required for biological processes but does not include the fats that only act as fuel.

Bodybuilding supplements are dietary supplements commonly used by those involved in bodybuilding and athletics. Bodybuilding supplements may be used to replace meals, enhance weight gain, promote weight loss or improve athletic performance. Among the most widely used are vitamin supplements, protein drinks, branched-chain amino acids (BCAA), glutamine, essential fatty acids, meal replacement products, creatine, weight loss products and testosterone boosters. Supplements are sold either as single ingredient preparations or in the form of "stacks" - proprietary blends of various supplements marketed as offering synergistic advantages. While many bodybuilding supplements are also consumed by the general public their salience and frequency of use may differ when used specifically by bodybuilders.

According to University of Helsinki food safety professor Marina Heinonen, more than 90% of dietary supplement health claims are incorrect.[17] In addition, ingredients listed have been found to be different from the contents. For example, Consumer Reports reported unsafe levels of arsenic, cadmium, lead and mercury in several of the protein powders that were tested.[18] Also, the CBC found that protein spiking (the addition of amino acid filler to manipulate analysis) was not uncommon,[19] however many of the companies involved challenged their claim.[19]

The number of incidents of liver damage from dietary supplements has tripled in a decade. Most of the products causing that effect were bodybuilding supplements. Some of the victims required liver transplants and some died. A third of the supplements involved contained unlisted steroids.[20]

Mild to severe toxicity has occurred on many occasions due to dietary supplements, even when the active ingredients were essential nutrients such as vitamins, minerals or amino acids. This has been a result of adulteration of the product, excessive usage on the part of the consumer, or use by persons at risk for the development of adverse effects. In addition, a number of supplements contain psychoactive drugs, whether of natural or synthetic origin.[21][22]

BMC Medicine published a study on herbal supplements in 2013. Most of the supplements studied were of low quality, one third did not contain the active ingredient(s) claimed, and one third contained unlisted substances.[23][24]

An investigation by the New York Attorney Generals office analyzed 78 bottles of herbal supplements from Walmart, Target, Walgreens and GNC stores in New York State using DNA barcoding. a method used to detect labeling fraud in the seafood industry. Only about 20% contained the ingredient on the label.[25][26]

Some supplements were contamined by rodent feces and urine.[27]

Only 0.3% of the 55,000 U.S. market dietary supplements have been studied regarding their common side effects.[20]

In early 20th century there were great hopes for supplements, but later research has shown these hopes were unfounded.[28]

"Antioxidant paradox" means the fact that even though fruits and vegetables are related to decreases in mortality, cardiovascular diseases and cancers, antioxidant nutrients do not really seem to help. According to one theory, this is because some other nutrients would be the important ones.[29][30] Multivitamin pills have neither proved useful[4] but may even increase mortality.[31]

Omega-3 fatty acids and fish oils from food are very healthy, but fish oil supplements are recommended only for those suffering from coronary artery diseases and not eating fish. Latest research has made the benefits of the supplements questionable even for them. Contrary to claims, fish oils do not decrease cholesterol but may even raise the "bad" LDL cholesterol and cause other harms. Also the use of cod liver oil is criticized by scientists.[32]

Alice Lichtenstein, DSc, chairwoman of the American Heart Association (AHA) says that even though omega-3 fatty acids from foods are healthy, the same is not shown in studies on omega-3 supplements. Therefore, one should not eat fish oil supplements unless one suffers from heart diseases.[33]

The regulation of food and dietary supplements by the U.S. Food and Drug Administration is governed by various statutes enacted by the United States Congress and interpreted by the U.S. Food and Drug Administration ("FDA"). Pursuant to the Federal Food, Drug, and Cosmetic Act ("the Act") and accompanying legislation, the FDA has authority to oversee the quality of substances sold as food in the United States, and to monitor claims made in the labeling about both the composition and the health benefits of foods.

Substances which the FDA regulates as food are subdivided into various categories, including foods, food additives, added substances (man-made substances which are not intentionally introduced into food, but nevertheless end up in it), and dietary supplements. The specific standards which the FDA exercises differ from one category to the next. Furthermore, the FDA has been granted a variety of means by which it can address violations of the standards for a given category of substances.

The European Union's Food Supplements Directive of 2002 requires that supplements be demonstrated to be safe, both in dosages and in purity.[34] Only those supplements that have been proven to be safe may be sold in the bloc without prescription. As a category of food, food supplements cannot be labeled with drug claims but can bear health claims and nutrition claims.[35]

The dietary supplements industry in the United Kingdom (UK), one of the 28 countries in the bloc, strongly opposed the Directive. In addition, a large number of consumers throughout Europe, including over one million in the UK, and various doctors and scientists, had signed petitions by 2005 against what are viewed by the petitioners as unjustified restrictions of consumer choice.[36]

In 2004, along with two British trade associations, the Alliance for Natural Health (ANH) had a legal challenge to the Food Supplements Directive[37] referred to the European Court of Justice by the High Court in London.[38]

Although the European Court of Justice's Advocate General subsequently said that the bloc's plan to tighten rules on the sale of vitamins and food supplements should be scrapped,[39] he was eventually overruled by the European Court, which decided that the measures in question were necessary and appropriate for the purpose of protecting public health. ANH, however, interpreted the ban as applying only to synthetically produced supplementsand not to vitamins and minerals normally found in or consumed as part of the diet.[40]

Nevertheless, the European judges acknowledged the Advocate General's concerns, stating that there must be clear procedures to allow substances to be added to the permitted list based on scientific evidence. They also said that any refusal to add the product to the list must be open to challenge in the courts.[41]

Effects of most dietary supplements have not been determined in randomized clinical trials and manufacturing is lightly regulated; randomized clinical trials of certain vitamins and antioxidants have found increased mortality rates.[42][43]

Excerpt from:

Dietary supplement - Wikipedia, the free encyclopedia

Food fortification or enrichment is the process of adding micronutrients (essential trace elements and vitamins) to food. It may be a purely commercial choice to provide extra nutrients in a food, while other times it is a public health policy which aims to reduce the number of people with dietary deficiencies within a population.

Diets that lack variety can be deficient in certain nutrients. Sometimes the staple foods of a region can lack particular nutrients, due to the soil of the region or because of the inherent inadequacy of the normal diet. Addition of micronutrients to staples and condiments can prevent large-scale deficiency diseases in these cases.[citation needed]

While it is true that both fortification and enrichment refer to the addition of nutrients to food, the true definitions do slightly vary. As defined by the World Health Organization (WHO) and the Food and Agricultural Organization of the United Nations (FAO), fortification refers to "the practice of deliberately increasing the content of an essential micronutrient, ie. vitamins and minerals (including trace elements) in a food irrespective of whether the nutrients were originally in the food before processing or not, so as to improve the nutritional quality of the food supply and to provide a public health benefit with minimal risk to health," whereas enrichment is defined as "synonymous with fortification and refers to the addition of micronutrients to a food which are lost during processing."[1]

Food fortification was identified as the second strategy of four by the WHO and FAO to begin decreasing the incidence of nutrient deficiencies at the global level.[1]

As outlined by the FAO, the most common fortified foods are:

The four main methods of food fortification (named as to indicate the procedure that is used in order to fortify the food):

The WHO and FAO, among many other nationally recognized organizations, have recognized that there are over 2 billion people worldwide who suffer from a variety of micronutrient deficiencies. In 1992, 159 countries pledged at the FAO/WHO International Conference on Nutrition to make efforts to help combat these issues of micronutrient deficiencies, highlighting the importance of decreasing the number of those with iodine, vitamin A, and iron deficiencies.[1] A significant statistic that led to these efforts was the discovery that approximately 1 in 3 people worldwide were at risk for either an iodine, vitamin A, or iron deficiency.[4] Although it is recognized that food fortification alone will not combat this deficiency, it is a step towards reducing the prevalence of these deficiencies and their associated health conditions.[5]

In Canada, The Food and Drug Regulations have outlined specific criterion which justifies food fortification:

There are also several advantages to approaching nutrient deficiencies among populations via food fortification as opposed to other methods. These may include, but are not limited to: treating a population without specific dietary interventions therefore not requiring a change in dietary patterns, continuous delivery of the nutrient, does not require individual compliance, and potential to maintain nutrient stores more efficiently if consumed on a regular basis.[3]

Several organizations such as the WHO, FAO, Health Canada, and the Nestl Research Center acknowledge that there are limitations to food fortification. Within the discussion of nutrient deficiencies the topic of nutrient toxicities can also be immediately questioned. Fortification of nutrients in foods may deliver toxic amounts of nutrients to an individual and also cause its associated side effects. As seen with the case of fluoride toxicity below, the result can be irreversible staining to the teeth. Although this may be a minor toxic effect to health, there are several that are more severe.[7]

The WHO states that limitations to food fortification may include: human rights issues indicating that consumers have the right to choose if they want fortified products or not, the potential for insufficient demand of the fortified product, increased production costs leading to increased retail costs, the potential that the fortified products will still not be a solution to nutrient deficiencies amongst low income populations who may not be able to afford the new product, and children who may not be able to consume adequate amounts thereof.[1]

Food safety worries led to legislation in Denmark in 2004 restricting foods fortified with extra vitamins or minerals. Products banned include: Rice Crispies, Shreddies, Horlicks, Ovaltine and Marmite.[8]

Danes said [Kelloggs] Corn Flakes, Rice Krispies and Special K wanted to include "toxic" doses which, if eaten regularly, could damage children's livers and kidneys and harm fetuses in pregnant women.[9]

One factor that limits the benefits of food fortification is that isolated nutrients added back into a processed food that has had many of its nutrients removed, does not always result in the added nutrients being as bioavailable as they would be in the original, whole food. An example is skim milk that has had the fat removed, and then had vitamin A and vitamin D added back. Vitamins A and D are both fat-soluble and non-water-soluble, so a person consuming skim milk in the absence of fats may not be able to absorb as much of these vitamins as one would be able to absorb from drinking whole milk.

Phytochemicals such as polyphenols can also impact nutrient absorption.

Ecological studies have shown that increased B vitamin fortification is correlated with the prevalence of obesity and diabetes.[10] Daily consumption of iron per capita in the United States has dramatically surged since World War II and nearly doubled over the past century due to increases in iron fortification and increased consumption of meat.[11] Existing evidence suggests that excess iron intake may play a role in the development of obesity, cardiovascular disease, diabetes and cancer.[12]

Fortification of foods with folic acid has been mandated in many countries solely to improve the folate status of pregnant women to prevent Neural Tube Defectsa relatively rare birth defect which affected 0.5% of US births before fortification began.[13][14] However, when fortification is introduced, several hundred thousand people are exposed to an increased intake of folic acid for each neural tube defect pregnancy that is prevented.[15] In humans, increased folic acid intake leads to elevated blood concentrations of naturally occurring folates and of unmetabolized folic acid. High blood concentrations of folic acid may decrease natural killer cell cytotoxicity, and high folate status may reduce the response to drugs used to treat malaria, rheumatoid arthritis, psoriasis, and cancer.[15] A combination of high folate levels and low vitamin B-12 status may be associated with an increased risk of cognitive impairment and anemia in the elderly and, in pregnant women, with an increased risk of insulin resistance and obesity in their children.[15] Folate has a dual effect on cancer, protecting against cancer initiation but facilitating progression and growth of preneoplastic cells and subclinical cancers.[15] Furthermore, intake of folic acid from fortification have turned out to be significantly greater than originally modeled in pre mandate predictions.[16] Therefore, a high folic acid intake due to fortification may be harmful for more people than the policy is designed to help.[14][15][17][18]

There is a concern that micronutrients are legally defined in such a way that does not distinguish between different forms, and that fortified foods often have nutrients in a balance that would not occur naturally. For example, in the U.S., food is fortified with folic acid, which is one of the many naturally-occurring forms of folate, and which only contributes a minor amount to the folates occurring in natural foods.[19] In many cases, such as with folate, it is an open question of whether or not there are any benefits or risks to consuming folic acid in this form.

In many cases, the micronutrients added to foods in fortification are synthetic.

In some cases, certain forms of micronutrients can be actively toxic in a sufficiently high dose, even if other forms are safe at the same or much higher doses. There are examples of such toxicity in both synthetic and naturally-occurring forms of vitamins. Retinol, the active form of Vitamin A, is toxic in a much lower dose than other forms, such as beta carotene. Menadione, a phased-out synthetic form of Vitamin K, is also known to be toxic.[20]

There are several main groups of food supplements like:

Many foods and beverages worldwide have been fortified, whether a voluntary action by the product developers or by law. Although some may view these additions as strategic marketing schemes to sell their product, there is a lot of work that must go into a product before simply fortifying it. In order to fortify a product, it must first be proven that the addition of this vitamin or mineral is beneficial to health, safe, and an effective method of delivery. The addition must also abide by all food and labeling regulations and support nutritional rationale. From a food developer's point of view, they also need to consider the costs associated with this new product and whether or not there will be a market to support the change.[21]

Examples of foods and beverages that have been fortified and shown to have positive health effects:

"Iodine deficiency disorder (IDD) is the single greatest cause of preventable mental retardation. Severe deficiencies cause cretinism, stillbirth and miscarriage. But even mild deficiency can significantly affect the learning ability of populations........ Today over 1 billion people in the world suffer from iodine deficiency, and 38 million babies born every year are not protected from brain damage due to IDD."Kul Gautam, Deputy Executive Director, UNICEF, October 2007[22]

Iodised salt has been used in the United States since before World War II. It was discovered in 1821 that goiters could be treated by the use of iodized salts. However, it was not until 1916 that the use of iodized salts could be tested in a research trial as a preventative measure against goiters. By 1924, it became readily available in the US.[23]

Currently in Canada and the US, the RDA for iodine is as low as 90g/day for children (48 years) and as high as 290g/day for breast-feeding mothers.[24]

Diseases that are associated with an iodine deficiency include: mental retardation, hypothyroidism, and goiter. There is also a risk of various other growth and developmental abnormalities.[24]

Folic acid (also known as folate) functions in reducing blood homocysteine levels, forming red blood cells, proper growth and division of cells, and preventing neural tube defects (NTDs).[25]

In many industrialized countries, the addition of folic acid to flour has prevented a significant number of NTDs in infants. Two common types of NTDs, spina bifida and anencephaly, affect approximately 2500-3000 infants born in the US annually. Research trials have shown the ability to reduce the incidence of NTDs by supplementing pregnant mothers with folic acid by 72%.[26]

The RDA for folic acid ranges from as low as 150g/day for children aged 13 years old, to 400g/day for males and females over the age of 19, and 600g/day during pregnancy.[27]

Diseases associated with folic acid deficiency include: megaloblastic or macrocytic anemia, cardiovascular disease, certain types of cancer, and NTDs in infants.[28]

Niacin has been added to bread in the USA since 1938 (when voluntary addition started), a programme which substantially reduced the incidence of pellagra.[29] As early as 1755, pellagra was recognized by doctors as being a niacin deficiency disease. Although not officially receiving its name of pellagra until 1771.[30]Pellagra was seen amongst poor families who used corn as their main dietary staple. Although corn itself does contain niacin, it is not a bioavailable form unless it undergoes Nixtamalization (treatment with alkali, traditional in Native American cultures) and therefore was not contributing to the overall intake of niacin.[31] Although pellagra can still be seen in developing countries, fortification of food with niacin played a huge role in eliminating the prevalence of the disease.[30]

The RDA for niacin is 2mg NE(niacin equivalents)/day (AI) for infants aged 06 months, 16mg NE/day for males, and 14mg NE/day for females who are over the age of 19.[31]

Diseases associated with niacin deficiency include: Pellagra which consisted of signs and symptoms called the 3D's-"Dermatitis, dementia, and diarrhea. Others may include vascular or gastrointestinal diseases.[30]

Common diseases which present a high frequency of niacin deficiency: alcoholism, anorexia nervosa, HIV infection, gastrectomy, malabsorptive disorders, certain cancers and their associated treatments.[30]

Since Vitamin D is a fat-soluble vitamin, it cannot be added to a wide variety of foods. Foods that it is commonly added to are margarine, vegetable oils and dairy products.[32] During the late 1800s, after the discovery of curing conditions of scurvy and beriberi had occurred, researchers were aiming to see if the disease, later known as rickets, could also be cured by food. Their results showed that sunlight exposure and cod liver oil were the cure. It was not until the 1930s that vitamin D was actually linked to curing rickets.[33] This discovery led to the fortification of common foods such as milk, margarine, and breakfast cereals. This took the astonishing statistics of approximately 8090% of children showing varying degrees of bone deformations due to vitamin D deficiency to being a very rare condition.[34]

Risk factors for vitamin D deficiencies include:

The current RDA for infants aged 06 months is 10g (400 International Units (IU))/day and for adults over 19 years of age it is 15g (600 IU)/day.[35]

Diseases associated with a vitamin D deficiency include rickets, osteoporosis, and certain types of cancer (breast, prostate, colon and ovaries). It has also been associated with increased risks for fractures, heart disease, type 2 diabetes, autoimmune and infectious diseases, asthma and other wheezing disorders, myocardial infarction, hypertension, congestive heart failure, and peripheral vascular disease.[34]

Although fluoride is not considered an essential mineral, it is seen as crucial in prevention of tooth decay and maintaining adequate dental health.[36] In the mid-1900s it was discovered that towns with a high level of fluoride in their water supply was causing the residents' teeth to have both brown spotting and a strange resistance to dental caries. This led to the fortification of water supplies with fluoride with safe amounts to retain the properties of resistance to dental caries but avoid the staining cause by fluorosis (a condition caused by a fluoride toxicity).[37] The tolerable upper intake level (UL) set for fluoride ranges from 0.7mg/day for infants aged 06 months and 10mg/day for adults over the age of 19.

Conditions commonly associated with fluoride deficiency are dental caries and osteoporosis.[36]

Some other examples of fortified foods:

Despite having some scientific basis, but with controversial ethics, is the science of using foods and food supplements to achieve a defined health goal. A common example of this use of food supplements is the extent to which body builders will use amino acid mixtures, vitamins and phytochemicals to enhance natural hormone production, increase muscle and reduce fat. The literature is not concrete on an appropriate method for use of fortification for body builders and therefore may not be recommended due to safety concerns.[42]

There is interest in the use of food supplements in established medical conditions. This nutritional supplementation using foods as medicine (nutraceuticals) has been effectively used in treating disorders affecting the immune system up to and including cancers.[43] This goes beyond the definition of "food supplement", but should be included for the sake of completeness.

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Food fortification - Wikipedia, the free encyclopedia

Bills retired and lives alone. Often hes just not hungry or is too tired to fix a whole meal. Does he need a multivitamin, or should he take one of those dietary supplements he sees in ads everywhere? Bill wonders if they workwill one help keep his joints healthy or another give him more energy? And, are they safe?

Dietary supplements are substances you might use to add nutrients to your diet or to lower your risk of health problems, like osteoporosis or arthritis. Dietary supplements come in the form of pills, capsules, powders, gel tabs, extracts, or liquids. They might contain vitamins, minerals, fiber, amino acids, herbs or other plants, or enzymes. Sometimes, the ingredients in dietary supplements are added to foods, including drinks. A doctors prescription is not needed to buy dietary supplements.

Do you need one? Maybe you do, but usually not. Ask yourself why you think you might want to take a dietary supplement. Are you concerned about getting enough nutrients? Is a friend, a neighbor, or someone on a commercial suggesting you take one? Some ads for dietary supplements in magazines or on TV seem to promise that these supplements will make you feel better, keep you from getting sick, or even help you live longer. Sometimes, there is little, if any, good scientific research supporting these claims. Dietary supplements may give you nutrients that might be missing from your daily diet. But eating a variety of healthy foods is the best way to get the nutrients you need. Supplements may cost a lot, could be harmful, or simply might not be helpful. Some supplements can change how medicines you may already be taking will work. You should talk to your doctor or a registered dietitian for advice.

People over 50 may need more of some vitamins and minerals than younger adults do. Your doctor or a dietitian can tell you whether you need to change your diet or take vitamins or minerals to get enough of these:

The National Academy of Sciences recommends how much of each vitamin and mineral men and women of different ages need. Sometimes, the Academy also tells us how much of a vitamin or mineral is too much.

Vitamin B122.4 mcg (micrograms) each day (if you are taking medicine for acid reflux, you might need a different form, which your healthcare provider can give you) CalciumWomen over 50 need 1,200 mg (milligrams) each day, and men need 1,000 mg between age 51 and 70 and 1,200 mg after 70, but not more than 2,000 mg a day. Vitamin D600 IU (International Units) for people age 51 to 70 and 800 IU for those over 70, but not more than 4,000 IU each day Vitamin B61.7 mg for men and 1.5 mg for women each day

When thinking about whether you need more of a vitamin or mineral, think about how much of each nutrient you get from food and drinks, as well as from any supplements you take. Check with a doctor or dietitian to learn whether you need to supplement your diet.

You might hear about antioxidants in the news. These are natural substances found in food that might help protect you from some diseases. Here are some common sources of antioxidants that you should be sure to include in your diet:

Right now, research results suggest that large doses of supplements with antioxidants will not prevent chronic diseases such as heart disease or diabetes. In fact, some studies have shown that taking large doses of some antioxidants could be harmful. Again, it is best to check with your doctor before taking a dietary supplement.

Herbal supplements are dietary supplements that come from plants. A few that you may have heard of are gingko biloba, ginseng, echinacea, and black cohosh. Researchers are looking at using herbal supplements to prevent or treat some health problems. Its too soon to know if herbal supplements are both safe and useful. But, studies of some have not shown benefits.

Scientists are still working to answer this question. The U.S. Food and Drug Administration (FDA) checks prescription medicines, such as antibiotics or blood pressure medicines, to make sure they are safe and do what they promise. The same is true for over-the-counter drugs like pain and cold medicines.

But the FDA does not consider dietary supplements to be medicines. The FDA does not watch over dietary supplements in the same way it does prescription medicines. The Federal Government does not regularly test what is in dietary supplements. So, just because you see a dietary supplement on a store shelf does not mean it is safe, that it does what the label says it will, or that it contains what the label says it contains.

If the FDA receives reports of possible problems with a supplement, it will issue warnings about products that are clearly unsafe. The FDA may also take these supplements off the market. The Federal Trade Commission looks into reports of ads that might misrepresent what dietary supplements do.

A few private groups, such as the U.S. Pharmacopeia (USP), NSF International, ConsumerLab.com, and the Natural Products Association (NPA), have their own seals of approval for dietary supplements. To get such a seal, products must be made by following good manufacturing procedures, must contain what is listed on the label, and must not have harmful levels of things that dont belong there, like lead.

If you are thinking about using dietary supplements:

Heres what one active older person does:

When she turned 60, Pearl decided she wanted to stay healthy and active as long as possible. She was careful about what she ate. She became more physically active. Now she takes a long, brisk walk 3 or 4 times a week. In bad weather, she joins the mall walkers at the local shopping mall. On nice days, Pearl works in her garden. When she was younger, Pearl stopped smoking and started using a seatbelt. Shes even learning how to use a computer to find healthy recipes. Last month, she turned 84 and danced at her granddaughters wedding!

Try following Pearls examplestick to a healthy diet, be physically active, keep your mind active, dont smoke, see your doctor regularly, and, in most cases, only use dietary supplements suggested by your doctor or pharmacist.

Here are some helpful resources:

Department of Agriculture Food and Nutrition Information Center National Agricultural Library 10301 Baltimore Avenue, Room 108 Beltsville, MD 20705 1-301-504-5414 http://fnic.nal.usda.gov

Federal Trade Commission 600 Pennsylvania Avenue, NW Washington, DC 20580 1-877-382-4357 (toll-free) 1-866-653-4261 (TTY/toll-free) http://www.consumer.ftc.gov/topics/healthy-living

Food and Drug Administration Center for Food Safety and Applied Nutrition 5100 Paint Branch Parkway College Park, MD 20740 1-888-723-3366 (toll-free) http://www.fda.gov/AboutFDA/CentersOffices/OfficeofFoods/CFSAN

National Center for Complementary and Alternative Medicine NCCAM Clearinghouse P.O. Box 7923 Gaithersburg, MD 20898 1-888-644-6226 (toll-free) 1-866-464-3615 (TTY/toll-free) http://www.nccam.nih.gov

National Library of Medicine MedlinePlus http://www.medlineplus.gov

Office of Dietary Supplements National Institutes of Health 6100 Executive Boulevard Room 3B01, MSC 7517 Bethesda, MD 20892-7517 1-301-435-2920 http://www.ods.od.nih.gov

The Federal Government has several other websites with information on nutrition, including:

http://www.nutrition.govlearn more about healthy eating, food shopping, assistance programs, and nutrition-related health subjects.

http://www.choosemyplate.govinformation about the Dietary Guidelines for Americans

For information on exercise, nutrition, and health scams and other resources on health and aging, contact:

National Institute on Aging Information Center P.O. Box 8057 Gaithersburg, MD 20898-8057 1-800-222-2225 (toll-free) 1-800-222-4225 (TTY/toll-free) http://www.nia.nih.gov http://www.nia.nih.gov/espanol

Sign up for regular email alerts about new publications and find other information from the NIA.

Visit http://www.nihseniorhealth.gov, a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health and wellness information for older adults. Special features make it simple to use. For example, you can click on a button to make the type larger.

National Institute on Aging National Institutes of Health U. S. Department of Health and Human Services

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Dietary Supplements | National Institute on Aging