Tag Archive for: supplements

COVID-19: What We Don’t Know

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I’m sure you’ve heard the expression “What we don’t know could kill us” and that’s truer today than at any other time. While we may argue about masks and social distancing, there’s just still too much we don’t know about the novel coronavirus. The critical factor is that because of what we don’t know, we aren’t able to work on treatments that can be administered to more people sooner once they’ve been diagnosed.

The Microbiome

You’ve heard me repeatedly say that the immune system starts in the gut; I don’t think many healthcare professionals would debate that anymore. That’s why knowing how the microbiome deals with COVID-19 is critical to establishing prevention and treatment programs. I don’t mean preventing people from catching the virus—I mean preventing them from getting a very serious form of the infection that results in hospitalization and severe treatments such as intubation and respirators.

We know that the digestive system is full of ACE2 receptors as I’ve written about before. What we don’t know is how to specifically make the microbiome more robust. What specific foods should we eat? What specific strains of microbes should we ingest to help immune function?

If we should eat more vegetables, should they be raw or can they be cooked? There are 6,500 different microbes that we know of at this point with multiple strains; if we’re supposed to take specific microbes, which strains are the most effective? We just don’t know enough to make our personal immune system stronger. We should still do the things that we’re doing by eating more vegetables, taking fiber and probiotics, but we could do better if we had more specific information.

Genotype and Phenotype

We know that age is a risk factor for a serious case of COVID-19; we also know that conditions such as heart disease, hypertension, and type 2 diabetes are also associated with a serious COVID-19 infection. And that’s about it for right now. Let me give you three questions that may or may not be important but certainly have to be checked out.

Does race have an effect? In addition to the observations about co-morbidities and healthcare opportunities, there may be some impact related to race that hasn’t been examined yet. Or instead of race, maybe it’s ethnicity. Think about it; from an ethnic perspective, what was different between the people of Italy and Spain, where there were significant deaths, from those who lived in Norway and Denmark? What about male pattern baldness? What about familial hypercholesterolemia? Could either of those be a genetic risk factor?

What about phenotype? Are people who are ex-smokers at greater risk than those who never smoked? We would think so, but nobody’s studied it. What about people who’ve lost a significant amount of weight and maintained it? What about people who exercise regularly compared to those who never exercise? All those traits would be associated with a healthier lifestyle, but we haven’t tested their impact of the risk of COVID-19. Lifestyle can impact the expression of your genes. And in some ways, once genes are expressed or turned on, they may not be downregulated or turned off. That could be important.

Do supplements help? It’s easy to say massive amounts of vitamin C and vitamin D and turmeric will help, but do they help everyone? What if you already have adequate vitamin D levels? Could adding even more be counterproductive? The same is true for vitamin C. We know that vitamin C is an antioxidant, but in high quantities, it may act as a pro-oxidant and increase free radical damage. How much is the right amount? Think of all of the supplements that we all take. It would be nice to know which are the key supplements to help our immune function against this virus and which ones just help our bodies in our day-to-day activities. At this point, we don’t have enough information.

Better Treatments

The whole point of treatments for COVID-19 is to force the virus to back off long enough to allow the immune system to do its job. There are no medications that I’m aware of that can target the virus and kill it; that means it’s up to the body to do the killing, and even after a vaccine is available, that will still be the case. We need better treatments that can neutralize the impact the virus has on the body so that the immune system can, in effect, clean up the mess.

There have been a lot of debates about some medications such as hydroxychloroquine. There are hopeful additions that include steroids, although they have issues as well. We may even find out that specific types of diets including fasting may be beneficial. Or they may be disastrous. We need more research to find better treatments, and we need that research now.

As it relates to a vaccine, we really don’t know if there ever will be one or how effective it will be. Even if one is developed, the logistics are just incredible. How are we going to get 330 million doses of a vaccine ready for administration when we still don’t have enough tests available or enough gloves and masks for healthcare workers? Early testing means early treatment. But if you can’t test people to begin with, and you can’t get the results to them quickly, using better treatments could end up being too little too late for any given individual.

The Bottom Line

The novel coronavirus will be with us for a while longer. Maybe indefinitely. As I wrote a couple months ago, we don’t have to fear it; we have to respect it. Your job is simple: take care of your body the best that you can with diet, exercise, supplements, and reducing stress. If you’re going to venture out of your home, wear a mask, social distance, and wash your hands frequently. That’s our job. And know that there are people who will keep trying to find the answers we need and still more people who will help us if we get sick. We can give them time to work and lighten their load if we do our part.

What are you prepared to do today?

        Dr. Chet

Sorry, but Some Health Writers are Scammers

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The typical research paper may have findings that are controversial, but researchers are using the techniques of their profession. I may disagree with their conclusions for a variety of reasons, but at least it’s contained. Following the threads this author created was a challenge but fruitful, especially the first one.

The readers of her columns were told to hop on over to the FDA website to see how easy it is to get beneficial statements on the label. I read the entire set of guidelines, and here’s the bottom line: it’s most definitely not easy to get a label claim approved.

She asked the industry rep to give her the name of a scientist who is not in the supplement industry who believed the health claims on supplement labels were meaningful. The rep couldn’t think of anyone.

She made a big deal over that one: no independent scientist supports the claims on labels. “Just think about what that means,” she added. It means that the supplement industry rep isn’t acquainted with scientists outside of her area of expertise. Why would she be? It’s not her area. But if you’ve been a science writer for over 22 years, you would certainly know plenty of scientists. Why didn’t she contact them for their opinion?

The writer then talked about a conversation with an executive for a well-known nutrition watch-dog group. He talked about the gold standard for removing a product from the marketplace: ephedra was banned back in 2003 because people who took the weight loss product had died.

Actually, it took the death of a professional football player to get everyone interested in ephedra, which is more like medicine than a supplement. People died, but in most of those 55 cases, it was the abuse of the herb that caused the issue, not the recommended use. I wasn’t an ephedra fan because weight loss is calories in, calories out; you would expect that messing with metabolism to cause issues, especially when overusing an herb.

Then it was a wandering rehash of other studies on increased risks of cancer. It was her responsibility to do the reading before she wrote the article. Was she being one-sided in what she wrote? I think a better way to say it was that she didn’t complete her background research.

There was some talk, silly in my opinion, with a religion professor about the psychology of why people take supplements. And then she completed her comments by saying that people who take dietary supplements are wasting money on products that will never help them.

The Bottom Line

All in all, it was a poorly researched article about the benefit, or lack thereof, of dietary supplements. What was clearly apparent was that her lack of nutrition education meant she really didn’t know what questions to ask. Based on what she said, she never really read the FDA Guidelines for supplement manufacturers. If she had, she could have picked a product with a wild claim, and I can think of several, checked the background research, and then evaluated it according to the law to determine whether it complied or not, rather than simply saying it was easy.

Health writers, and in fact, any writer who writes about science, needs to be a critical thinker, not one that criticizes without thinking. In this case, she failed to do her job. The big problem with that is most people don’t have the science background to know whether what she said is trustworthy and many people will be misinformed, perhaps to the detriment of their health.

What about her claim that people are wasting money on supplements? We all know from our own experience, as well as from science, that supplements can make a difference in our health. As I’ve always said, no amount of supplements will make up for an unhealthy lifestyle, but using specific supplements are an important part of staying healthy.

What are you prepared to do today?

        Dr. Chet

Reference: FDA Link: https://bit.ly/2QLDRa2

Investigating Supplements

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Let’s turn to what the author I wrote about on Tuesday said and examine it in detail. She interviewed a variety of experts; I checked them out and they were most definitely legit, especially those who worked in the research arms of the NIH. She asked them a simple question that went something like “Which supplements have well-established benefits?” The scientist who works in the complementary and natural approaches research arm said the list was short: ginger for digestive issues, peppermint for the same, melatonin for sleep, and fish oil for cardiovascular disease all have established benefits. The clinical trials that weren’t as beneficial were for turmeric, St. John’s wort, ginkgo biloba, and echinacea. (That doesn’t mean they won’t work for you; we’re all different.)

Then she talked with an expert in vitamins and minerals who recommended folic acid for neural tube defects, vitamin B12 for vegans and the elderly, the combination of nutrients that seems to help with an eye condition and finally, that multivitamins have some benefit.

She then asked the same question of a senior representative of a dietary supplement industry group. The person replied with much the same list of supplements and benefits.

In effect, the government agencies and the industry group agreed about benefits from some supplements. The next logical question in the writer’s mind was “What about all those supplements that neither group addressed? What about those supplements that fill the shelves of pharmacies, health food stores, and on the Internet? The type that say ‘good for energy,’ ‘may help your immune system,’ and so on.”

The author suggested that a curious person should just bop on over to the FDA website to see how easy it is for companies to get these statements on the product labels. So I did. I’ll let you know what I found out and finish this on Saturday.

What are you prepared to do today?

        Dr. Chet

Don’t Fall for a Bad Headline

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The headline of the Life and Culture section of my local newspaper was this: “Supplements Are a Scam.” You know that has to get my attention. Wouldn’t it get yours? Most of us take dietary supplements every day, so I read the article.

To paraphrase the opening, it went something like this “Wake up people! There are conspiracies about vaccinations and fluoridation floating around the internet. Why aren’t you pulling back the curtain to see the fraud right under your nose! They are selling you snake oil and you’re giving them a free pass. Who? The supplement industry, of course.”

The article contained some of the same-old, same-old arguments that we always see in these articles; more about that later. The question I always begin with is: “Who is doing the writing and how qualified are they?” This author has been writing about health for major newspapers and magazines for over 20 years. If she’s lasted that long, she must be a decent writer.

But does she have a solid background in science and nutrition? She got her undergraduate degree in English. That’s it. I’m not trying to be snooty, but that puts her into the category of someone who is self-taught. Whether it’s a person who was on death’s door but recovered when they discovered a supplement or diet that helped them or someone who’s a journalist as the author is, they need solid basic science and nutrition education and training. If not, they don’t know if they are asking the right questions, and that’s often a problem when it comes to nutrition research. As I’ve stated many times before, even those who do have health training often don’t ask the right questions but have no problems sharing opinions.

Are supplements a scam? Short answer: no. We’ll look at the claims the author made on Thursday.

What are you prepared to do today?

        Dr. Chet

You’re Invited to a Live Dr. Chet Seminar in Atlanta!

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The next stop on the Dr. Chet tour is going to be in Atlanta, GA, to talk about Nutrition for the 21st Century.

I’ll start with the most important question: what’s the best diet? The keto craze is in full swing, with Paleo right behind. The opposite side is going vegan, an all plant-based diet. What’s best for weight loss? For more energy? For weight maintenance? I’ll let you know the pros and cons of each approach so you can make the right choice for you.

Second, no matter which diet you choose to follow, will you get adequate nutrients? No matter how healthy the diet, there will always be gaps because of the way our food is grown and processed. This time around, it’s not just getting the right nutrients for your body but also your microbiome, the microbes in your digestive system that are critical to your immune system. They require healthier choices as well. I’ll cover the basic nutritional supplements for adults and children to lay a good foundation.

How do you decide on a quality manufacturer? There are new companies being started every day, and I’ll give you specific criteria you can use to evaluate supplement manufacturers. If you’re going to put supplements in your body, you want to be certain they’re safe and effective. I’ll let you know how to do that.

Next, there are some conditions that may be the result of a lack of adequate nutrients. Supplements don’t cure diseases, but the right nutrition may help your body help itself. I’ll cover some common conditions.

I’ll also have time to answer your questions. The goal is to provide you with enough information for you to make healthy choices every day. Please join me to get the latest information to do exactly that.

Who should attend? People who find themselves confused by the nutrition information available; one day something’s good, the next day it’s bad. I’ll clarify that for you. If you’re concerned about your personal health or that of your family, or you’re a business owner who wants to understand supplementation and diet better, you should be there. Everyone will walk away with something that will help them make healthier choices.

Nutrition for the 21st Century
March 22, 2020, 2 – 5 p.m.
Dunwoody Country Club
1600 Dunwoody Drive
Atlanta GA 30350

$29.95

Important note: Country club rules say you can’t buy tickets at the door, but you can buy them on your smartphone in the hallway or on your way there by going to drchet.com; please complete your purchase by 1:45. Your name will be added electronically to the list.

What are you prepared to do today?

        Dr. Chet

Maintaining Bone Health

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In trying to live every day we’re alive, I’ve spent a lot of time talking about the ability to move, but it’s not just about muscle. Those muscles connect to bones for the most part, and the bones must be healthy as well. One of the basic tenets of healthy bones is Wolfe’s law, which can be summarized as “function determines structure.” In everyday terms, to have healthy bones you must stress them regularly. Exercise is critical to that effort. But it’s not as simple as that.

Hormones and nutrients are also critical to bone health. Our ability to make hormones and absorb and utilize nutrients diminishes as we get older. Hormone replacement therapy has been controversial, and that’s a discussion a woman should have with her physician. In terms of nutrients, the ones critical to healthy bones are calcium, magnesium, vitamin D, and vitamin K2.

Before increasing any nutrients via supplements, have a bone-density test as well as a vitamin D test. If either test has low results, then taking a combination of the nutrients mentioned earlier would help the bones when combined with exercise. Any exercise that’s weight bearing is beneficial such as walking, but not swimming, with added benefits for weight training.

Maybe the best we can do is to stop the loss of bone mass, but that will help you live better for longer. We’ll move from bones to joints on Thursday.

What are you prepared to do today?

        Dr. Chet

Food Is Better Than Supplements, But …

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Getting your nutrients from food by eating a healthy diet is the most desirable way of getting vitamins, minerals, and phytonutrients. Period. If we could all do it, no question that’s the best way. But you and I don’t live in some fantasy world. We’re busy. We don’t always have enough time to shop and cook healthy meals. Dietary supplements have helped fill the nutrition gap.

What should we think about this latest research? Should we stop taking supplements, especially calcium? Before I give you my opinion, I want to tell you that I emailed the corresponding author of the paper, a brilliant woman and a talented researcher. I had two questions about the study. She answered me the same evening—Saturday night before Easter. That I got such quick reply was remarkable; I’m still waiting for answers from other researchers I contacted months ago.

The first question I asked was a basic one: what was the mortality rate of the subjects in the study compared with the national cancer mortality rate? The national mortality rate is 156 deaths per 100,000 people per year. That works out to 1.6 people per 1,000. The rate in the study was about 3 people per 1,000. She replied that the study results are not directly comparable for complicated reasons.

But here’s something that can be directly compared. A 62% increase in cancer mortality would be transferable to national statistics because that’s the idea: to generalize to the entire population. A 62% increase means that 2.5 people per 1,000 would die from cancer in a given year instead of 1.6. When applied to the entire population that could be a lot of people, but it applies only to those who took over 1,000 mg of calcium per day.

The other question I asked was whether they had data on how long the people were taking the supplements; NHANES asked about the 30 days prior and recorded the prior 24 hours. How long were they taking the supplements? Weeks? Months? Years? Decades? That might have made some difference. The data were collected in the questionnaires used for two of the cycles that I examined, but that data was not used in the analysis.


The Bottom Line

I think we should eat the best diet we can. I also think we should use quality dietary supplements to complement our diet. This study was an exercise in statistics more than nutrition. It can tell us the statistical outcomes of the people in the study, but it can’t really be used to tell us anything about what we should do as individuals.

Not every person who took a higher amount of calcium died from cancer. On top of that, if supplementation did have a significant negative impact on our health, it stands to reason there would have been more negative results than just for calcium. Because the research questions were fitted to the available data, there’s just too much we don’t know about factors that can influence the results.

Another good question the study didn’t ask is why people were taking calcium. For instance, a woman with osteoporosis may take calcium for better bone health. Did those women have fewer broken bones with supplementation? If so, that might be worth any higher risk that exists. As with any nutritional intervention, it’s important to weigh the pros and cons. If you’re concerned, talk to your healthcare professional about what you should do; they know you and your health status and can help you make the right choices.

Supplement confusion is a good reason to get a copy of my new CD Supplementing Your Diet. Check out why at drchet.com.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Intern Med. doi:10.7326/M18-2478.

Food vs. Supplements: A Closer Look

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There’s no question National Health and Nutrition Examination Survey (NHANES) has done the best job of collecting data on nutritional intake in large-scale studies. I’ve applauded it in the past, and I’m not going to change now just because there’s an NHANES-based paper that critiques the use of supplements. NHANES data were used by one of the co-authors of the current research paper we’re examining; in that study, they demonstrated regular use of a multivitamin-multimineral can compensate for deficiencies in our diet.

What could explain the same data showing potential benefits and hazards of supplements? Two reasons in my opinion. First, the research questions were not part of the original study; that’s supported by the fact that the lead author would have been six or seven years old when data collection began.

Imagine you apply for a loan. You’d give the bank all kinds of financial data: your total earnings, where you work, what you owe, and so on. Then imagine that researchers take all that very accurate data and estimate your hourly wage. They could be right on the money or way off, because they don’t know how many hours you worked; that wasn’t one of the questions. It’s the same with the data in this study; the researchers can make a great guess from the data they have, but the question they’re trying to answer wasn’t one of the original questions asked so their guess may be very far from correct. That happens often in these retrospective studies.

Second, the bulk of the researchers were experts in statistics and epidemiology. The statistical analysis accounted for 11 factors to numerically make the data comparable. We can’t really know what that does to modify the data instead of collecting data on actual variables.

Still worried? I’ll finish this up on Saturday.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Intern Med. doi:10.7326/M18-2478.

Food vs. Supplements

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Last week, the health headlines blared that nutrients from foods were better than nutrients from supplements—specifically that excess calcium from supplements was associated with an increased risk of dying from cancer. That will get your attention if you take supplemental calcium, especially if you’re taking calcium because your physician told you to take it because you have osteopenia or osteoporosis. Let’s take a closer look at this study published in the Annals of Internal Medicine.

Researchers examined data collected for the National Health and Nutrition Examination Survey (NHANES) on food intake and supplement use. NHANES data are now collected every two years, so they selected six consecutive cycles and tracked the all-cause mortality from subjects in those data. They found that in over 30,000 adults over 20 years of age tracked for six years, there were 3,613 deaths with 805 from cancer.

The researchers then examined the food intake and supplement use of the subjects from the prior 30 days of data collection with mortality data. That’s where they discovered that in the subjects who died from cancer, there was a 62% greater risk if they took more than 1,000 mg of supplemental calcium per day. The overall conclusion was that nutrients from foods are better than nutrients from supplements; in addition, some supplements may be hazardous.

Should you start chucking out your calcium supplements? We’ll take a closer look at this study the rest of this week.

What are you prepared to do today?

        Dr. Chet

Reference: Ann Intern Med. doi:10.7326/M18-2478.

Supplementing Your Diet

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Last week, a study was published that concluded that nutrients from food are better than nutrients from supplements. Does that mean you can throw out the supplements and just eat more? Short answer: no.

Did you ever notice that one week some vitamin is good for you and the next it’s supposed to be bad for you? Why is that? One reason is the way nutrition research is done.

One of the most popular audios I’ve ever made was Supplements Made Simple, so now I’ve updated all the tracks and included a section about the problems with nutrition research.

Introducing Supplementing Your Diet—Why, What, and Who. This CD examines the issues related to dietary supplements in the 21st century. The first question is simply why do we need them? Can’t we get enough nutrients from the food we eat? I’ll address that question from a variety of perspectives, including those based on your physiology and biochemistry.

What about the research that says supplements aren’t necessary and are a waste of money? As I said, I’ll tackle that issue head on with three specific reasons too much research on supplements is flawed and yields misleading conclusions.

If you do need to supplement your diet, where do you begin? I’ll explain the four supplements everyone should take and the reasons why.

Finally, how do you decide which company to buy supplements from? I’ll give you five characteristics that distinguish a high-quality manufacturer. That will help you choose the company whose supplements are best for you. This audio cuts through the forest of obstacles to help you see things clearly so you can make an informed decision on how to supplement your diet.

All this information is just $9.95 plus shipping and handling.

And if you’re in the supplement business, this audio will answer your potential clients’ questions about the basics. If you want to grow your supplement business, I’ve included special pricing on five copies of this CD so you can loan them to clients to help them make their decisions. You can point them to my online bio to show them why they can rely on my explanations.

Enjoy this holiday weekend, and I’ll be back Tuesday.

What are you prepared to do today?

        Dr. Chet