multivitamin

Toss My Vitamins? Not Me!

I was recently made aware of a NY Times article entitled,  “Should We Toss Our Vitamins?” and asked my opinion.  The article is filled with vague statements such as “taking vitamins does not extend life” and [there is] “limited evidence that vitamin and mineral supplementation could prevent cancer or cardiovascular disease”.  One physician, speaking on a study she was involved with, concluded, “I do think there’s room for more research.”  First, let’s consider the true clinical significance of these statements.  In the field of medical research, data should be completely objective, yet there are several points which definitely add subjectivity:

                – Types of and quality of products tested – cheaply made multivitamins contain forms of nutrients which are known to be poorly absorbed or utilized

                -Lack of uniformity in subjects being tested – variables such as diet, exercise and metabolic genetic tendencies are often not controlled

                -Broad goals being measured – longevity, cancer (often without attempt to narrow down aspecific form), and cardiovascular health either connote a variety of parameters which would need to be addressed, or may be unrealistic to expect from a supplement, especially when lifestyle parameters are not accounted for

 Given the unreliable and very difficult-to-translate data, it might help to look at a review published in November, 2013, by the Journal of the American College of Nutrition (CLICK HERE FOR FULL TEXT).  After taking into account all of the challenging variables , their end statement was: “ Based upon the available scientific evidence to date, supplementation with MVMs does not appear to increase all-cause mortality, cancer incidence or mortality, or CVD incidence or mortality and may provide a modest protective benefit.”

I did not used to feel multivitamins were necessary for the average person, but I’m beginning to change my mind a bit.  It is a true challenge to take in all the basic nutrients our bodies need, even if we are the most vigilant foodies.  Data reported in the Journal of American College of Nutrition states: “They studied U.S. Department of Agriculture nutritional data from both 1950 and 1999 for 43 different vegetables and fruits, finding “reliable declines” in the amount of protein, calcium, phosphorus, iron, riboflavin (vitamin B2) and vitamin C over the past half century.”  Reports of similar findings are easy to find, including a report by the Nutrition Security Council, which cites a decline from 400 mg to 55 mg in the sum of minerals (calcium, magnesium, and iron) found in cabbage, tomatoes, lettuce, and spinach.  That means our produce now is less than 15% as nutritious as it used to be!  We really need to eat a lot more spinach!!  But make sure it’s organic, or you may well offset all the extra minerals by taking on a large load of pesticides.

The high proportion of processed, grain-containing foods in the average person’s diet usually means that percentage of their diet is going to be low in nutrients, despite the fact that those foods are often “fortified”.  The nutrients which are used to fortify foods (folic acid, for example) are often not a high-quality form usable by the body.

And don’t forget about fats…the human body ideally wants a high ratio of omega 3:6, but again the high levels of omega 6’s found in processed foods make an adequate amount of omega 3 almost unattainable without taking in inordinate amounts of fish, which raises the risk of inadvertently taking in heavy metals or PCB’s.

In the end, although I feel nutrients from foods are the best form, getting enough from our diets has become increasingly difficult, even for the most disciplined eater.  The time involved in sourcing, purchasing, and preparing the most nutrient-dense foods can be overwhelming for many who already struggle to get all of their tasks taken care of.  Adding a multivitamin to help cover some of the bases can help ease the stress of trying to get the best nutrition.

From an economic standpoint, I believe the best  way to achieve optimal nutrition is to

                Eat whole, clean foods                               

Produce – organic is sometimes more expensive than conventional, so reserve it for the produce highest in pesticides – For a great guide, CLICK HERE.

Grains – use whole grains which are not commonly produced using GMO technology (spelt, quinoa, buckwheat, oats, etc.)

Eat clean meats and dairy products – again, somewhat more expensive, so reduce  serving sizes

Maintain good digestive health – make sure you are absorbing the nutrients from all the goodfood you are eating with proper stomach acidity, digestive enzymes, and a healthy intestinal lining

Take a quality multivitamin – this will set you back $20-$25/month, but provide very significant levels of minerals, trace minerals, and vitamins needed by the millions of different enzyme pathways in our bodies

Popping a multivitamin (especially a poorly formulated one) may not guarantee prevention of cancer, heart disease, or early death from any cause, particularly if it is not coupled with a healthy lifestyle.  However, I have experienced  overwhelming response from clients who have realized significant improvement in everything from digestive health to renewed energy and vitality when using a well-thought-out supplement regimen, especially when coupled with positive lifestyle changes.  Some of these improvements are purely subjective, as in “I feel so much better!” or “my abdominal pain is relieved”.  However, some are completely objective, as in homocysteine levels (a pro-inflammatory risk factor for heart disease and other issues, easily measured by blood test), which come down with a small combination of nutrients.

An optimal supplement regimen for you may or may not include a multivitamin, but it is far from accurate to proclaim quality nutrient products a “waste of money”.   A  large body of research on individual nutrients, which can be found by CLICKING HERE, supports the judicious use of supplements for optimal health.

Winter Wellness – Vitamin C

Ask just about anyone to name one vitamin that is helpful for colds and Vitamin C is bound to be the one named.  Dr. Linus Pauling is credited with sparking interest in Vitamin C, not only for immune function but beneficial effects on heart disease, diabetes, and cancer.  He personally used high doses of Vitamin C and felt it greatly reduced the number of colds he experienced.  His claims received much attention beginning in the 1970’s, so that numerous studies were conducted in the next 3 decades.  Analysis of these studies by Dr. Harri Hemila found an overall benefit in regards to prevention and duration.  Results were more favorable in groups of participants more prone to stress, whether through sports or jobs (e.g. soldiers).

These findings are well supported by work done by Dr. James Wilson, who has analyzed the role of Vitamin C in our stress response, including the proper production and use of cortisol, the stress hormone.  Perhaps the need for Vitamin C to prevent colds is even greater now than in the previous decades, owing to the fact that our lifestyles as a whole have become much more stressful?

Would taking Vitamin C be helpful for you?  To answer this you might look at benefit versus risk.  What are the risks of vitamin C supplementation?  It is a water-soluble vitamin and has shown remarkably low toxicity.  Because it enhances iron absorption, it is possible that it could lead to high levels of iron, so intake of iron should be assessed before taking mega-doses on a consistent basis.  The only other side effect which occurs regularly is diarrhea, which is actually used by many practitioners to serve as a guide to knowing what the correct dosage is for a patient.  It is commonly recommended that patients take 500 mg every hour until their stools are loose and watery, at which point they should stop and maintain a dosage 500 mg less than that which induced the effect.

Because it is water soluble and readily excreted, taking Vitamin C in smaller quantities throughout the day, and/or using a supplement which is sustained-release will increase its effects.

On a final note, Vitamin C absorption and usage has been shown to be enhanced in the presence of bioflavonoids, a large group of antioxidants from fruits and vegetables.  Using a Vitamin C supplement which contains a 2:1 ratio of Vitamin C: Bioflavonoids is the optimal  form for immune and stress-response support.  Since the basis for such a supplement is to mimic how Vitamin C is found in nature, it makes sense that incorporating plenty of raw vegetables and fruits which are high in Vitamin C would be the ideal form for overall health.  Produce with highest amounts of Vitamin C include oranges, grapefruits, sweet red pepper, broccoli, potatoes, and strawberries.  A daily diet including 2.5 cups of a variety of fruits and vegetables is estimated to contain roughly 200 mg of Vitamin C, which may be adequate for some, but may well create a need to supplement for individuals under various forms of stress.

Vitamin C may seem like an “old housewife” remedy, but its safety and usage are well documented and its availability is widespread and economical, making it a perfect tool in helping to fight the viruses to which we are continually exposed.

References
Linus Pauling Institute Newsletter, January 2006; Jane Higdon, Ph.D.Updated in November 2009 by: Victoria J. Drake, Ph.D.
Reviewed in November 2009 by: Balz Frei, Ph.D.
Director and Endowed Chair, Linus Pauling Institute
Distinguished Professor, Dept. of Biochemistry and Biophysics
Oregon State University; Copyright 2000-2010  Linus Pauling Institute

Winter Wellness – Zinc

This mineral is more important than you “zink”!

No, that’s not my German Opa talking… science has proven that ZINC truly is a crucial nutrient for several body systems.  It’s role in the immune response became clear in the 1960’s when studies revealed that those suffering from widespread infections in endemic areas of the world were overwhelmingly found to be zinc deficient.    More common in the Western world are mild deficiencies, which are still linked with increased susceptibility to various infections.

Although we know zinc is so important in keeping our resistance to infections high, it is not yet clear whether taking lozenges at the first sign of a cold is helpful.  Some studies say yes, some show no difference.  The nasal spray, Zicam, was removed from the market because of a predisposition to cause a loss of sense of smell.

While the issue of whether benefits are produced acutely is still under question, how can you take advantage of zinc’s protection during the winter months?  By making sure you are topped off as a preventative measure.  A listing of the foods highest in zinc content is listed below.  It is also available in supplement form, in a variety of salt forms.  Zinc picolinate is well absorbed, as are the sulfate and chelates.  It is best to take zinc separated from foods as they may hinder absorption.  A maintenance dose of 15 mg is usually sufficient, although using 30 mg daily for a short period of time may help to bring up levels which are low.

Is there a way to know whether your zinc levels are low?  Yes, in the form of a taste test called the Zinc Challenge.  We can give you a small amount of liquid to hold in your mouth for 30 seconds.  If you get a strong taste of something like hydrogen peroxide right away, it is a good sign and means your body has adequate stores of zinc.  Tasting nothing, or deriving only a mild flavor indicates additional amounts are needed to keep your immune system ready for exposures.  Stop by the pharmacy at any time to take the challenge!

Below are food sources as mentioned…..

Shellfish, beef, and other red meats are rich sources of zinc. Nuts and legumes are relatively good plant sources of zinc. Zinc bioavailability (the fraction of zinc retained and used by the body) is relatively high in meat, eggs, and seafood because of the relative absence of compounds that inhibit zinc absorption and the presence of certain amino acids (cysteine and methionine) that improve zinc absorption. The zinc in whole grain products and plant proteins is less bioavailable due to their relatively high content of phytic acid, a compound that inhibits zinc absorption (5). The enzymatic action of yeast reduces the level of phytic acid in foods. Therefore, leavened whole grain breads have more bioavailable zinc than unleavened whole grain breads. Recently, national dietary surveys in the U.S. estimated that the average dietary zinc intake was 9 mg/day for adult women and 13 mg/day for adult men (4). The zinc content of some relatively zinc-rich foods is listed in milligrams (mg) in the table below. For more information on the nutrient content of specific foods, search the USDA food composition database.

Food Serving

Zinc (mg)

Oysters 6 medium (cooked)

76.3

Crab, Dungeness 3 ounces (cooked)

4.7

Beef 3 ounces* (cooked)

6.0

Pork 3 ounces (cooked)

2.2

Chicken (dark meat) 3 ounces (cooked)

1.8

Turkey (dark meat) 3 ounces (cooked)

3.8

Yogurt, fruit 1 cup (8 ounces)

1.8

Cheese, cheddar 1 ounce

0.9

Milk 1 cup (8 ounces)

1.8

Cashews 1 ounce

1.6

Almonds 1 ounce

1.0

Peanuts 1 ounce

0.9

Beans, baked 1/2 cup

1.8

Chickpeas (garbanzo beans) 1/2 cup

1.3

*A three-ounce serving of meat is about the size of a deck of cards.

References
Mol Med. 2008 May-Jun;14(5-6):353-7.  Zinc in human health: effect of zinc on immune cells.  Prasad AS.

Shankar, A.H. & Prasad, A.S. Zinc and immune function: the biological basis of altered resistance to infection. American Journal of Clinical Nutrition. 1998; volume 68: pages 447S-463S.  (PubMed)