Guidance on food supplements

… antioxidants have no effect in extending life span, and too much of certain antioxidants can actually be harmful.

By: Connie M. Pfeiffer, PharmD.
   Vitamins and supplements have become a multibillion dollar industry in recent years. Many consumers are aging baby boomers who, in their quest to find the fountain of youth, are looking for that magic pill or combination of pills that will keep them strong and healthy and help them live a longer and more active life.
   According to a study in last month’s Journal of the American Medical Association (JAMA), an estimated 80 to 160 million people in North America and Europe take antioxidant vitamins. That represents about 10 to 20 percent of all adults who live in those areas of the world. Americans alone spent more than $2 billion dollars on nutritional supplements and vitamins last year.
   But just how effective are these vitamins and supplements? How much does anyone really need, and how much is too much? In the zeal to stay healthy, might some people actually be doing themselves more harm than good? These are valid questions, especially in light of the recent study published in JAMA, led by a highly respected international network of experts based at Copenhagen University Hospital in Denmark.
   The group, which specializes in performing systematic reviews of scientific evidence on health interventions, questioned the value of such popular supplements as vitamins A, E, C and beta carotene. Their analysis, based on studies of thousands of people, found that these antioxidants have no effect in extending life span. In addition, the study found that too much of certain antioxidants can actually be harmful. These include beta carotene supplements, which have been found to increase the risk of lung cancer in smokers.
   What the Danish study does support is something that we have known for a very long time: that the best way to get the nutrients your body needs is through your diet. An antioxidant-rich diet is based on lots of colorful fruits and vegetables. They include cruciferous vegetables such as broccoli and cauliflower, as well as red and green vegetables such as bell peppers, and fruits such as blueberries, raspberries and strawberries, all eaten in variety and as part of a balanced diet.
   These days, however, with so many people eating on the run and little time to sit down to a well-balanced meal, it is reasonable to supplement the diet with a multivitamin to ensure the recommended daily allowance (RDA) of certain nutrients. A multivitamin for a child makes sense, too, especially if the child is a fussy eater.
   Certain supplements have proven benefits, especially calcium. However, most people do not get enough calcium in their diets. Adding 1,000 to 1,500 mg of calcium to the diet per day is reasonable and can help prevent the appearance of colon polyps and decrease the risk of hypertension. Calcium can also help ward off osteoporosis, which should be treated more as a pediatric disease. Many children do not get enough calcium in their diet. Children should be building strong bones throughout their teenage years and beyond by consuming more calcium and engaging in weight-bearing exercises.
   Many people firmly believe in the powers of Vitamin C to ward off the common cold and there is indeed some benefit. Studies show that taking 1,000 to 2,000 mg of vitamin C when you feel the onset of a cold will lower the severity of the symptoms and shorten them by about a day but will not keep the illness entirely at bay. As for zinc products, if you take a 50 mg lozenge every two hours while you have a cold, they can help lower the duration of the cold from seven days to five to six days.
   Vitamin B has been associated with benefit in maintaining the nerves and tissues. Many people mistakenly believe it helps relieve mental stress, but it is really the general stress of wear and tear on the body, that it can most help combat. It is reasonable to take a B complex vitamin, but if you are taking a good multivitamin, you really do not need to do so.
   Vitamins B and C are water soluble and will be flushed out of the body. They generally do not accumulate, but in very high doses, can have toxic side effects. Vitamins A and D don’t get flushed out of the body very well and in extremely high doses, can also cause side effects, including problems with the liver.
   A popular supplement that has been touted as a healthy way to get protein in the diet is soy, which has also been recognized for lowering cholesterol and increasing bone mineral density. Soy is a food, but when you ingest it through a powder or tablet it is considered a supplement. A daily dose of 12.5 to 25 grams of soy protein is reasonable for most people. But a healthier way to ingest it is as a food, taken, for example, in tofu, soy milk or in soy beans where you are getting the complete active components.
   Omega-3 fatty acids found in fish oil has been proven to lower cholesterol, blood pressure and the risk of heart attack and atherosclerosis. While these fatty acids are found in oily fish like salmon, it is reasonable to take a fish oil supplement, particularly if you have a history of heart disease in your family. If you are a vegan or don’t like the oily taste of the fish, flax seed is another good source of Omega-3 fatty acids.
   When it comes to vitamins and supplements, there is no magic pill that is going to do everything for everyone. For most people, a good multivitamin, a calcium supplement and a well-balanced diet rich in antioxidant-laden fruits and vegetables are going to provide all the nutrients you need to stay healthy.
To find a physician with Princeton HealthCare System, call (888) 742-7496 or visit www.princetonhcs.org.