Mother Earth Living

Supplement Nutrients and What We Know About Them

Do Your Homework to Get the Most Out of What You're Eating
Monica Emerich and Elizabeth Bertani
January/February 1998
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The days of wine and peanuts?

Heart-conscious consumers may have a dietary option that doesn’t require a corkscrew.

Recent studies have shown that peanuts contain resveratrol, the same nutrient that makes red wine a potential ally in the war against heart disease.

At a September 1997 conference of the American Chemical Society in Las Vegas, Nevada, scientists from the U.S. Department of Agriculture (USDA) presented findings showing that peanuts contain significant amounts of resveratrol. Discovering the presence of resveratrol in peanuts is a step toward determining whether peanuts can help reduce cardiovascular disease and lower total cholesterol, according to the Peanut Institute, which funded the USDA studies.

The amount of resveratrol found in peanuts is relatively low. A typical one-ounce serving of peanuts contains 74 micrograms (mcg) of resveratrol; a typical five-ounce serving of red wine contains 800 mcg.

Another study involving peanuts concludes that a high-fiber, low-sugar diet that includes foods such as peanut butter, beans, yogurt, or broccoli can significantly reduce the risk of ­noninsulin-­dependent diabetes in women. Participants in the six-year study ­included 65,173 women ranging in age from forty to sixty-five. (1)

Healthy eating a goal, not a practice, for most Americans

The results from America’s nutrition report card are in: Nearly 80 percent of Americans surveyed say they are aware that their health is affected by what they eat, but putting their knowledge into practice is a challenge.

According to the 1997 American Dietetic Association (ADA) Nutrition Trends Survey, 40 percent of those surveyed say they fear that eating healthfully will mean giving up foods they enjoy. And despite understanding that good health and nutrition go hand in hand, only 39 percent of respondents say they are doing all they can to achieve a healthful eating plan.

About 20 percent of those surveyed say that eating well takes too much time, and 23 percent say they are confused or frustrated about what constitutes healthful eating.

Based on the survey, the ADA concluded that seven out of ten Americans believe that some foods are good while others are bad (a myth, according to the ADA). However, the number of Americans who think they should cut all fat from their diet—13 percent, down from 17 percent in 1991—is a positive trend because some fat is essential for good health.

“We want people to think moderation, not elimination,” says Bettye Nowlin, a Los Angeles-based nutrition education specialist and registered dietitian.

“As nutrition educators, we face an uphill battle to get people to look at the big picture of their total food intake.”

What’s clear is that Americans don’t want to sacrifice good taste for good nutrition. They want both, and that can be easily achieved, Nowlin says. Modifying recipes, eating some foods less often or in smaller portions, and including a variety of foods in the diet can help make not-so-healthy favorites part of a healthy diet. (2)

Nutrition Supplement - Vitamins, Minerals, and More

Youth in a capsule:
DHEA and melatonin are popular, but officials question claims

Many people wouldn’t mind diving into a fountain of youth. And some say they’ve found it in DHEA and melatonin, which, research says, can ­reverse age-­related conditions such as memory loss, osteoporosis, heart disease, and loss of sex drive, to name a few.

But some medical experts say look before you leap—the anti-aging claims made about the hormones don’t yet stand up to scrutiny.

Because of the enormous popularity of DHEA and melatonin, which have reputations as modern youth potions, officials at the National Institute on Aging issued a statement in 1997 advising consumers that “no one has shown that supplements of these hormones add years to people’s lives.”

In the past few years, DHEA (dehydroepian­drosterone) and melatonin have been available without prescription as die­tary supplements.

Clinical studies on the hormones number in the thousands and some have shown prom­ise, but others have offered conflicting conclusions and several have shown that the supplements cause significant side effects, including headaches, fitful sleep, gastrointestinal upset, and interference with the effects of prescribed drugs.

In addition, many commercial manufacturers of melatonin suggest daily doses of 3 mg—a dosage at least ten times higher than what the body produces normally, says Andrew Monjan, Ph.D., chief of the neurobiology branch of the National Institute on Aging in Bethesda, Maryland.

“Studies have not documented under what con­ditions melatonin is useful and what the contra­dictions might be,” Monjan says, adding that more research is needed to answer these questions.

Checking the claims

Despite scientific caution, however, melatonin and DHEA are intensely popular and represented as risk-free.

“What is happening is a selective reading of the literature,” Monjan says.

For example, marketers often claim that there are no adverse side effects from DHEA and melatonin supplements. In a sense, the marketers are correct, providing they refer to the right study. But other studies have indicated significant problems, including liver damage and growth of facial hair on women associated with high levels of DHEA. Additionally, officials at the National Institute on Aging are concerned that, because DHEA breaks down into estrogen and testosterone, taking DHEA supplements may cause increased levels of these two hormones. This, in turn, could increase the risk of breast cancer and prostate cancer in some people. However, study results of this problem are inconclusive. 8

Food for thought: New dietary guidelines focus on improving health

Label-readers get ready—official nutrition content tallies will soon reflect not only how nutrition can prevent disease, but also how it can improve health.

Since 1941, the Recommended Dietary Allow­ances (RDAs) have provided guidelines on the minimum nutrients needed to maintain health. Now, in a shift of perspective, the National Academy of Sciences—a private, nonprofit society that advises the fed­eral government on scientific and technical matters—has decided it’s time to update and expand the RDAs.

The new guidelines, called Dietary Reference Intakes (DRIs), will provide recommended daily levels of nutrients that, taken in sufficient amounts, can prevent chronic diseases, including cancer, osteoporosis, and heart disease. Due in the year 2000, the DRIs will be the result of a seven-phase report conducted by the Institute of Medicine, a branch of the sciences academy.

Beginning with bones

In August of last year, the Institute of Medicine released the first part of the report, which covered the roles that cal­cium, vitamin D, phosphorus, magnesium, and fluoride play in optimal bone health and other body operations.

One highlight of the report was its focus on calcium because of the great disparity between recommended daily intake and the amount of calcium the average American actually consumes. According to the recommendations, adults ages thirty-one to fifty should ingest 1,000 mg of calcium a day, while those over fifty-one should take 1,200 mg daily. For children ages one to three, the acad­emy recommends 500 mg daily; ages four to eight, 800 mg; and ages nine to eighteen, 1,300 mg.

Calcium is plentiful in dairy products, salmon, turnip greens and other dark leafy vegetables, dried figs, and broccoli.

More to come

The institute’s complete report also will establish guidelines for maximum recommended amounts. This could help reduce health risks associated with taking too much of a particular nutrient. An excess of vitamin A, for example, can cause birth defects, bone abnormalities, double ­vision, and other health problems.

Additional sections of the report will address B ­vitamins; vitamin C and other antioxidants; protein, fat, and other macronutrients; iron, zinc, and other trace elements; electrolytes and water; and food components such as fiber and ­phytoestrogens.

To obtain the full text of the first study, contact the Food and Nutrition Board, Institute of Medicine, 2101 Consti­tution Ave. NW, Wash­ington, D.C. 20418. Email: fnb@nas. edu.

Arthritis remedies ­debated National group questions supplements’ effectiveness

Forty million Americans endure the agony of arthritis, so it’s no wonder that two supplements said to ease pain and protect cartilage are in headlines and shopping carts nationwide.

Yet the Arthritis Foundation has issued strong warnings against taking the products—glucosa-mine (glu-COS-a-meen) and chondroitin (con-DROY-tin) sulfate—because of a lack of well- controlled, long-term clinical studies. And although the two supplements are often marketed together, many health-care practitioners question chondroitin’s efficacy.

On the other hand, some question why products that have been around for years should create a controversy. In Europe, clinical studies on the two supplements date back to the 1940s.

“European doctors have recognized the benefits of these natural substances for decades, and both are available as nonprescription treatments for arthritis in Europe,” says Morton Walker, a podiatrist and a widely published author on orthomolecular nutrition and holistic medicine. In Europe, the two supplements are most often used separately, he adds, but many alternative and conventional doctors, including Jason Theodosakis, M.D., author of The Arthritis Cure, have recommended both compounds to arthritis patients for years and with good results.

The Arthritis Cure (St. Martin’s Press, 1997) has been at the heart of the controversy surrounding glucosamine and chondroitin. The book sold out within five days of its first printing, and many manufacturers of the glucosamine and chondroitin products flooding the market cite the book in their promotional ­materials. In response, the Arthritis Foundation has accused Theodosakis of using the word “cure” inappropriately and misleading the public.

“Good, controlled, long-term studies are needed to see if these products are indeed helpful and safe,” says Doyt L. Conn, the foundation’s senior vice president for medical affairs. The Arthritis Foundation also has expressed concern that no studies have used the two supplements in combination.

Successful studies

Glucosamine—a compound made from glucose that occurs naturally in the joints—is used by the body to create cartilage. Glucosamine, glucosa-mine sulfate, glucosamine hydrochloride, and N-ace-tyl-glucosamine (NAG) all appear in arthritis formulas. In repeated short-term studies, glucosamine sulfate, the form of supplemental glucosamine usually used in controlled and double-blind clinical trials, has reduced the pain of osteoarthritis caused by the degeneration of cartilage between bones, which makes joints stiff, tender, and eventually enlarged. Without cartilage to cushion them, bones rub against each other and cause pain. Studies indicate that glucosamine provides relief by rebuilding cartilage in joints and pro­tecting existing cartilage from enzyme damage.

Chondroitin sulfates are produced in very small quantities in our bodies. They help attract and maintain fluids in joint cartilage—fluids that carry important nutrients and protect the joints from enzymes that destroy cartilage. In some clinical studies, chondroitin, given through injection and oral supplements, has been shown to provide effective pain relief in osteoarthritis sufferers.

Questioning chondroitin

The Arthritis Foundation, however, is concerned that the studies have yet to use a combination of glucosamine and chondroitin. And not all researchers and clinicians are convinced that chondroitin is even necessary in a formula for arthritis relief.

“Because of the size of the chondroitin molecule, it is too large to be delivered to cartilage cells,” says Michael Murray, a naturopathic doctor (N.D.), author, and founder of Enzymatic Therapy, a company that distributes a glucosamine sulfate product. “Taking a combination of glucosamine sulfate and chondroitin sulfate provides little, if any, benefit compared to glucosamine sulfate alone,” he says.

At a clinic in Portland, Oregon, called A Woman’s Time, Tori Hudson, N.D., has administered glucosamine sulfate and chondroitin sulfate for more than two years to her patients with arthritis. Recently, however, she has stopped recommending chondroi­tin sulfate.

“I don’t believe that chondroitin sulfate is absorbed well in the oral form,” she says. “And when we are already getting such excellent results with gluco­samine sulfate in 90 percent of patients who use it, why add chondroitin?”

Experimental use

George Young, M.D., a rheumatologist at Boulder Medical Center in Boulder, Colorado, says he believes both supplements are useful and does not object to his patients taking them, especially because the products have produced few side effects, unlike the often-prescribed nonsteroidal anti-inflammatory drugs (NSAIDs). Common NSAID side effects include nausea, nervousness, cramps, diarrhea, drows­iness and, in some cases, stomach bleeding or ulcers. Studies have also shown that NSAIDs may even ­inhibit cartilage formation and accelerate cartilage destruction.

Yet Young agrees with the Arthritis Foundation that long-term studies are needed to verify the effi­cacy and safety of glucosamine and chondroitin. He is doubtful, though, that such studies will occur in the United States. The U.S. Food and Drug Administration (FDA) verifies that no U.S. drug company has yet submitted an application for the mixing of a glucosamine or chondroitin product for FDA review. Because the FDA has not approved the substances, it cannot confirm or refute efficacy or safety claims.

“It’s not uncommon that supplements are sold ­before all the evidence is in,” says David Schardt, an associate nutritionist with the Center for Science in the Public Interest in Washington, D.C., a nonprofit education and advocacy organization that promotes health through educating the public about nutrition and alcohol. “People don’t realize that sometimes these are experimental products.”

For more information

Newman, N. M., and R. S. M. Ling. “Acetabular bone destruction related to non-steroidal anti-inflammatory drugs.” Lancet 1985, 2:11–13.

Vaz, A. L. “Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulfate in the management of osteoarthrosis of the knee in out-­patients.” Current Medical Research Opinion 1982, 8: 145–49.

The Arthritis Foundation, 1330 West Peachtree St., Atlanta, GA 30309. (404) 872-7100.

Center for Science in the Public Interest, 1875 Connecticut Avenue NW, Suite 300, Washington, D.C. 20009. (202) 332-9110; fax: (202) 265-4954.

Thorne Research at http://www.Thorne.com/. Although a private manufacturer, Thorne Research offers abstracts of some of the foreign studies on glucosamine on its Web site.

Label lingo

More information will soon be included on labels of ­vitamins, minerals, herbs, and amino acids, according to a recent ruling by the U.S. Food and Drug ­Administration.

All dietary supplements will be required to include a “supplement facts” panel, which follows the same basic format as that used on food labels. Manufacturers have until March 1999 to comply. News Capsules

Additionally, manufacturers must follow certain rules if they use the terms “high potency” and “antioxidant” on labels. Products labeled “high potency” must meet 100 percent or more of established Reference Daily Intakes (RDIs); the term may be used on multi-ingredient products if two-thirds of the ingredients are at 100 percent or more. “Anti­oxidant” may be used if scientific research shows that it will inactivate free radicals or prevent free-­radical damage in the body.

Cancer fighter ­abundant in broccoli sprouts

Good news for broccoli haters: The plant’s young sprouts contain as much as fifty times the cancer prevention power as the mature vegetable, according to a recent study.

Researchers at Johns Hopkins University have found that three-day-old broccoli sprouts are brimming with a potent cancer fighter called ­sulforaphane. This compound—identified as a chemo­preventive in 1992 and found in broccoli, cauliflower, and other vegetables—helps prevent ­tumors from forming, according to earlier studies.

The young broccoli sprouts consistently contain from twenty to fifty times the amount of sulforaphane that mature heads do, says Paul Talalay, M.D., professor of pharmacology and head of the research team. Broccoli sprouts look and taste similar to alfalfa sprouts, he says.

Talalay’s research team fed extracts of the sprouts to groups of twenty female rats for five days and exposed these rats and the control group to a carcinogen. Results showed that the rats receiving the extract developed fewer, smaller, and slower-growing tumors.

Clinical trials are currently under way to determine whether less than a quarter-cup of sprouts a day can provide the same protection as one to two pounds of mature broccoli a week, according to a Johns Hopkins press release. (3)

References

(1) Salmeron, Jorge, et al. “Dietary fiber, glycemic load and risk of non-insulin-dependent diabetes mellitus in women.” The Journal of the American Medical Association 1997, 6:472–477.

(2) American Dietetic Association, press release, 1997. The ADA’s 1997 Nutrition Trends Survey.

(3) Fahey, J., Y. Zhang, and P. Talalay. “Broccoli sprouts: An exceptionally rich source of inducers of enzymes that protect against chemical carcinogens.” Proceedings of the National Academy of Sciences USA, 1997. 94: 10367–10372.

“Nutrition Supplement: Vitamins, minerals, and more” is offered as a bimonthly supplement to Herbs for Health and is written by Monica Emerich and Elizabeth Bertani of Natural Information, 2888 Bluff Street, Suite 301, Boulder, Colorado, 80301. Design: Bren Frisch. “Nutrition Supplement” is intended as an educational service, not a source of medical advice or guide for self-medication. Please consult a qualified health-care professional for treatment of any serious health problems.


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