Tag Archive for: supplements

Are Vitamin D and Calcium Still Worth Taking?

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Maybe you recently read a headline that went something like this: “Vitamin D and Calcium Do Not Prevent Fractures.” Many headlines were much worse. Over this past weekend I read the research paper published in JAMA. Is it real? Should you not bother taking your calcium and vitamin D to protect your bones? No—keep taking them. But it does give me an opportunity to talk about some of the issues surrounding these types of papers as well as the complexity of nutrition for our health. That’s our topic this week.

The study was a meta-analysis of studies that examined the relationship between the risk of fractures in elderly populations and supplementation with calcium, vitamin D, and both supplements together. After a rigorous database search, 33 randomized controlled trials were included in the meta-analysis. Some studies lasted several months, and some lasted several years. The amounts of calcium and vitamin D in the supplements varied in every study. After analysis, the researchers determined that neither calcium nor vitamin D nor the combination of both reduced the rate of fractures when compared to placebo. That led to their conclusions.

This was a mess as you probably guessed with differing quantities and lengths of the trials. What bothered me most was that if they really understood nutrition as well as the results of the studies they included, they could have done something special. I’ll cover that on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: JAMA. 2017;318(24):2466-2482. doi:10.1001/jama.2017.19344.

 

Interaction Between Food and Blood Thinners

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Blood thinners are the second most common medication that can interact with food and supplements. Blood thinners such as warfarin are used to prevent blood clots in people with atrial fibrillation, artificial heart valves, and deep vein thrombosis.

When a blood thinner is prescribed, people are given a list of foods and supplements to avoid. Top of the list is vitamin K and foods that contain vitamin K such as green leafy vegetables. Herbs such as garlic and ginkgo, supplements that contain vitamin E, coenzyme Q10, and omega-3 fatty acids are also discouraged because they may make the blood thinner. The goal is to optimize the international normalized ratio (INR), a measure of clotting ability. It isn’t that those types of patients have blood that coagulates more than normal; the theory is that keeping vitamin K from interfering with the blood thinner will reduce the probability of clots.

The problem: the recommendations are not supported by definitive research; it’s more a matter of playing it safe based on the theory of what the nutrients will do rather than actually based on science. In a recent review article, the authors concluded: “Restriction of dietary vitamin K intake does not seem to be a valid strategy to improve anticoagulation quality with vitamin K antagonists. It would be, perhaps, more relevant to maintain stable dietary habits, avoiding wide changes in the intake of vitamin K.” I absolutely agree.

What do you do? First, decide what diet you want to eat and supplements you want to take and stick to it. Second, work with your physician to adjust the blood thinner to get the dosage just right to keep your INR within range. Third, if you can’t get it normalized, there may be other factors as yet unknown that are affecting clotting. You’ll have to stick to the common recommendations, science-based or not.

Last chance to become an Insider and listen to tonight’s free conference call and get your health questions answered. You can learn more and join at this link.

What are you prepared to do today?

Dr. Chet

 

Reference: Medicine (Baltimore). 2016 Mar;95(10):e2895.

 

CO2 and Plant Nutrients: Proceed with Caution

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The Memos this week have examined a potential problem with the nutrient content of the plants we eat due to increasing CO2 levels. What does the research show? Part of the problem that Dr. Loladze had was that no one was doing much research on the issue of CO2 and nutrient content. That’s going to change based on some of the research that has been published.
 

Mineral Content Has Decreased

In a study published in 2004, researchers examined the nutrient content—13 nutrients and water—of 43 garden crops as reported by the U.S. Department of Agriculture in 1950 and 1999 (1). They reported declines in six nutrients: protein, calcium, iron, phosphorus, riboflavin, and vitamin C. The reductions ranged from 6% for protein to 38% for riboflavin. The researchers concluded that the decline could be explained by changes in the types of cultivated plants. Okay. If we’re now planting crops that have lower nutrient content, maybe they’ve been selected for size or appearance or the ability to be transported long distances. Do we think that’s okay?

In a study published in 2014, researchers used a creative approach to test the affect of increased CO2 on grains and legumes (2). They mimicked the predicted CO2 levels expected in the middle of this century in grains and legumes grown under field conditions. They set up an outdoor system that allowed more CO2 to be released on the plants. They found that grains and legumes had decreased levels of zinc and iron and grains had lower levels of protein.

Dr. Loladze also published an article on mineral loss in plants. He examined every research paper that examined atmospheric CO2 on plants that we eat as well as trees and grasses. Remember that he is a mathematician; he used some very sophisticated techniques that are beyond me. However, to put it simply, the better the study was designed, the more the plants showed a decline in mineral content, averaging about 8% (3).
 

Far From Complete

The research in this area is really just beginning; scientists are just becoming aware of this nutrient decline. Perhaps that will attract research dollars. Dr. Loladze was never able to get significant funding for his work. Still, he persevered.

Here are two issues that I’d like explained or examined. First, why would an increase in carbohydrate content affect the mineral and protein content? If the minerals are in the soil, it would seem they would end up in the plant. That was never explained very well.

Another issue they raised was the protein content of goldenrod pollen. The researchers were able to examine it over the decades because samples are saved at the Smithsonian Institution. The protein content of goldenrod pollen has decreased by a third over the decades. They suggested that was important to bees; they need the pollen for the hive to survive. Is the lack of nutrients contributing to the collapse of bee colonies? Obviously, more specific research needs to be done before we really know the implications, if any. It’s going to be years until there’s enough research to make definitive statements about this.
 

Proceed with Caution

There is still every reason to eat your vegetables, fruits, and whole grains, even if the vitamin, mineral, and protein contents have declined somewhat—if anything, this a reason to eat even more to make sure you get your phytonutrients. Water and fiber are two more good reasons.

This also reinforces the need to do one more thing: take a multivitamin-multimineral that contains plant concentrates every day. If the nutrient content of plants is declining, that’s an excellent way to prevent nutrient deficits in your own body. It’s the simplest way to proceed with caution until the science catches up.

What are you prepared to do today?

Dr. Chet

 

References:
1. J Am Coll Nutr. 2004 Dec;23(6):669-82.
2. Nature 510, 139–142. doi:10.1038/nature13179.
3. Loladze. eLife 2014;3:e02245. DOI: 10.7554/eLife.02245

 

The Ignorant Vegan

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Before you write me an indignant email, remember this: the definition of ignorant is lacking awareness or uneducated. While being a vegan is a great way to eat, it can also be done poorly and thus can create health issues over time if vegans haven’t bothered to educate themselves. The issue is the foods people choose to include in their vegan diet.

Start with white: pasta, rice, bread, potatoes. Those are all vegan choices and can be prepared with some excellent recipes. The problem is the same as it would be for anyone, vegan or not: too many starches lead to an exaggerated insulin response. Calories still count: those extra calories can be converted to fat and actually increase cholesterol levels. You don’t get to overeat just because you’re vegan.

 

Nutrient Deficiencies

The problem doesn’t end there. Focusing on starches can limit the amino acids necessary to make complete proteins, at least in enough quantities to keep the body healthy. Isoleucine, leucine, and lysine are all deficient in those white starchy foods. The white foods have to be balanced with legumes which have high amounts of those amino acids.

Another potential issue can be iron. Because vegans do not eat seafood or meat, they can become iron deficient over time—and I’m talking six months or more. Yes, green vegetables such as spinach and kale do have iron, but a person has to be diligent in knowing the sources so they get those vegetables every day or at least several times per weak. In addition, soy products, sometimes a staple of a vegan diet, can interfere with iron absorption.

Last is vitamin B12. It’s sparse in plant-based products so unless you eat brewer’s yeast or the English staple marmite, vegans must take a B12 supplement.

 

Learning to Be a Vegan

Being a vegan is a healthy approach to improving your health but you have to be informed. It takes work for a while, until it becomes second nature. The one thing you can’t afford to be is an ignorant vegan. It can be dangerous to your health—the last thing you want.

Next week, I’m going to review the movie “What the Health” so make sure you see it this weekend. We’re going to answer the one question posed by the movie: does the science show that a vegan diet is the only path to optimal health?

What are you prepared to do today?

Dr. Chet

 

What Do Vegans Eat?

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The simplest way to describe a vegan diet is that it includes everything—except any food that comes from animals. If it comes from a plant, you can eat it. That includes all vegetables, all fruits, all grains, all legumes, and all nuts.

Peanut butter and jelly? Yes, if the bread is vegan. Baked sweet potato with brown sugar? Yep. A glass of wine or beer? Absolutely. Vegan pasta with marinara sauce? Ditto, but don’t add the Parmesan. I could go on and on, but you can see that it’s more than just salads and raw vegetables. And yes, you should eat plenty of those as well.

What should you eliminate? Meat from any animal; fish is also off limits. Fat from any animal. Anything cooked in or containing animal fats. Those biscuits you love? They’re made with lard, which comes from beef. The butter that goes on those biscuits? Nope, it comes from milk. Your favorite cake? No, it’s made with eggs. How about Jell-O; certainly Jell-O has to be okay! Not that either. It contains gelatin which comes from an animal. You can still eat those deep-fried foods as long as the oil is all vegetable.

The animal sourcing can extend to supplements as well. Gelcaps and capsules are made from animal or fish gelatin, although there are good vegan choices today. But don’t skip the supplements; they’re important because one nutrient that’s not easily accessible from plants is vitamin B12.

Just as there are vegan supplements, there are vegan versions of almost any food you can think of: eggs, milk, cheese, bread, burgers, even steak. I don’t know how good they taste, but they exist.

Seems pretty straightforward, doesn’t it? I’ll tell you how people can get it wrong on Saturday. Don’t forget to catch the documentary “What the Health” so you can follow along my review of the movie next week.

What are you prepared to do today?

Dr. Chet

 

Power Up with Vitamin B12

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The final supplement I’ll cover this week is vitamin B12, sometimes called the energy vitamin. Many vitamins are involved with energy production, but a lack of B12 can certainly cause problems with energy and other issues.

Vitamin B12 is also known as cobalamin and if you’re wondering, yes, this vitamin does include the mineral cobalt. There are two primary functions of B12 in the body. The first is to help reduce the chemical homocysteine to methionine while helping folate be converted into a usable form in the same reaction. Without enough B12, homocysteine increases inflammation in the body . . .

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Do You Make Enough Coenzyme Q10?

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There’s one major difference between coQ10 and other vitamins, minerals, and nutrients such as omega-3s: we can produce coQ10 ourselves. The problem is that we may not produce all the coQ10 we need, especially as we get older.

CoQ10 is used in the production of energy from both carbohydrates and fat in the mitochondria of the cells. You remember mitochondria from science class; they’re often called the powerhouse of the cells. And coQ10 is the substance that’s used to produce that power. It’s critical in the steps where oxygen is used to produce ATP, the . . .

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What You Need to Know About Omega-3s

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This week I’m covering basic information about three supplements.  One of my favorites and one I don’t ever leave home without is omega-3 fatty acids.

There are three basic forms of omega-3 fatty acids: eicosapentanoic acid or EPA, docosahexaenoic acid or DHA, and alpha-linolenic acid or ALA. The body cannot make omega-3 fatty acids, so they have to come from food and supplements. ALA is an essential fatty acid—the body can make EPA and DHA from it but not very well—so getting EPA and DHA from diet and supplements is critical.

EPA . . .

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Why You Need to Supplement

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The author of the opinion article in JAMA recommended that physicians make their patients aware of the research that questions the effectiveness of supplementation, hence his title “Negligible Benefits, Robust Consumption” (1). In making that recommendation, he gives the precise reason why that’s a bad idea. As I said Thursday, the answer can be found in the data used in the original article in JAMA about supplementation use in the U.S. (2).

While the JAMA article focused on supplementation, it also included data on food . . .

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Supplements: No Benefits?

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The opinion piece in the journal article was titled “The Supplement Paradox: Negligible Benefits, Robust Consumption” (1). The author is a well-respected physician who has written often about what he feels are the problems in the dietary supplement industry. He used the article I talked about Tuesday as a basis for his latest thoughts. Why would supplement use stay the same when research demonstrates that there are little to no benefits?

He raised three points. First, he suggests that people haven’t heard about the negative studies. I would debate that based on the questions I get about science . . .

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