Herbs for Health: The Importance of Vitamin and Mineral Supplements

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You’re eating a balanced diet, taking note of the food groups
and the Recommended Dietary Allowances (RDAs). But you’re still
wondering: Do you need vitamin and mineral supplements? Yes, you do, says Louis Tobian, Ph.D., a University of Minnesota
scientist who has spent years studying diet and its relationship to
heart disease and blood pressure.

“If you’re living in the real world–with people eating out more
and so forth–it’s really hard to eat a perfect diet,” Tobian says.
“Take a multivitamin a day,” he says, and if you take a good one,
that might be all the supplementation you need.

Mary Ellen Camire, associate professor of food science at the
University of Maine, says that a lot of people use multivitamins as
a safety net, “in case they have a bad day and eat a lot of junk
food.”

“Americans like a quick fix,” she says. “The multivitamins
provide this.”

But, she says, “recommended intakes are for the whole
population,” and depending on age or health, “you may need more or
less.”

Which vitamins are for you?

Determining what nutrients to take “depends on the individual,”
Camire says. For example, some people staying out of the sun may
need supplemental vitamin D.

“Women have different needs; they lose iron with their periods.
And calcium is very important to young girls,” says Camire, the
mother of a teenage daughter who is going through a phase of eating
only instant mashed potatoes. Camire has to make sure her daughter
is getting what she needs. Tobian, a professor emeritus who reveals he is “kind of old” but
still “very active,” suggests a “One-A-Day” multivitamin and
mineral supplement. He says people should also consider taking
extra antioxidants, such as vitamins E and C. “No multivitamin pill
has enough E,” he says. “E is a genuine antioxidant–the evidence
shows that it’s advantageous.”

Camire and Tobian agree that, along with multivitamins,
minerals, and antioxidants, eating right and exercising are still
important.

“Supplements are good,” Tobian says, “but the big thing is to
eat a lot of fruits and vegetables. I really believe in a good diet
and exercise. . . . It’s highly abnormal and unhealthy for our
bodies to be sedentary.”

Who might benefit?

According to the American Dietetic Association, complete multivitamin and mineral supplements
are effective, safe, and may be helpful, especially when:

• The rush of everyday life prevents you from ­eating the U.S.
Food Guide Pyramid’s recommended number of servings from each food
category, especially grains, fruits and vegetables.

• You’re on a weight loss program that is very low in
calories.

• You’re elderly and not eating as much or as well as you
should.

• You’re a strict vegetarian.

• You don’t drink or eat calcium-rich foods such as milk,
cheese or yogurt.

• You’re a woman of child-bearing age who doesn’t eat enough
fruits, vegetables and beans.

For more information

The Council for Responsible Nutrition, a trade association
representing more than eighty dietary supplement companies, has
published two booklets on nutritional supplements. Optional
Nutrition for Good Health: The Benefits of Nutritional Supplements
(1998) compiles scientific evidence supporting the health benefits
of nutritional supplements. Vitamin and Mineral Safety (1997)
defines safe levels of intake for twenty-four nutrients, presenting
scientific evidence about intakes above the RDA.

To order a copy of either booklet, write to the Council for
Responsible Nutrition, 1300 19th St., N.W., Suite 310, Washington,
D.C. 20036; phone: (202) 872-1488. Cost is $10 for each
publication. (A summary review of Vitamin and Mineral Safety is
available for $5.)

Scientists say Americans need more folic acid

Adult men and women should increase their dietary intake of
folic acid, a member of the B vitamin family that is also called
folate, according to the latest report on Dietary Reference Intakes
(DRIs) from the Institute of Medicine. The report is the second in a series from U.S. and Canadian
scientists and provides Recommended Dietary Allowances (RDAs) and
additional dietary reference values for all the B vitamins. Adults need 400 micrograms daily, according to the report; a
survey taken at the end of 1997 shows that many U.S. adults aren’t
meeting this requirement.

The committee based its recommendation on values shown to guard
against anemia or other conditions that can develop when B vitamins
are lacking or missing. The DRI committee set its maximum amount of
synthetic folic acid for adults at 1,000 micrograms, or 1 mg,
noting that adults with vitamin B12 deficiency who take too much
folic acid have an increased risk of neurologic damage. Some studies have shown that folic acid and vitamin B6 may
reduce blood levels of homocysteine and thus may lower the risk of
vascular and heart disease. Given conflicting evidence, however,
the DRI committee found that the research wasn’t solid enough to
serve as the basis for nutrient intake.

Also noted: Women who are of child-bearing age should take extra
folic acid beyond the recommended 400 micrograms–especially in the
month prior to conception and during the first month of pregnancy
–to reduce the risk of having a child with neural tube defects.

“They can best get folic acid from fortified cereal grains or
from a supplement,” said Roy M. Pitkin, DRI committee chair and
obstetrics and gynecology professor at the University of
California, Los Angeles, in an April 1998 release announcing the
report.

New form of DHEA may boost immunity without risky hormones

Worried about the possible side effects of DHEA? A new product
may alleviate that worry. Humanetics Corp. of Minneapolis recently received a U.S. patent
for the use of 7-Keto DHEA, a new dietary supplement and a natural
derivative of DHEA, or dehydroepiandrosterone. The patent is based
on the work of Henry A. Lardy, Ph.D., a biochemist and professor
emeritus of the Institute for Enzyme Research at the University of
Wisconsin. DHEA is a natural hormone that diminishes with age, says Ronald
Zenk, Humanetics president and CEO. DHEA supplements have been used
to strengthen the immune system, fight aging, and enhance
memory.

But some worries have been raised about the supplements. For
instance, the National Institute on Aging, part of the National
Institutes of Health, published safety concerns regarding DHEA’s
conversion to testosterone and estrogen and has warned about the
uninformed use of dietary supplements, singling out DHEA and
melatonin. An incorrect dosage may lead to prostate enlargement in
men; other concerns include liver damage, masculinization of women,
and an increased risk of heart disease. The 7-Keto DHEA, however, provides similar immunomodulatory
activity to DHEA but does not covert into the worrisome sex
steroids, according to Humanetics.

Lardy found dozens of derivatives of DHEA that he tested and
identified, and one of those was 7-Keto, which is far enough down
“the path of conversion” that it doesn’t convert into sex hormones,
Zenk says. Thus, 7-Keto provides the benefits of DHEA without the
worry of the hormones. Humanetics now plans to evaluate “the pharmaceutical path” with
its new product, Zenk says. 7-Keto is available through supplement
distributors.

Label terms stump teens

“Lite,” “low-fat,” and “calorie-free” are terms that tempt–and
may mislead–teens when they shop at grocery and convenience
stores.

According to results reported in Adolescence (Spring 1997),
teens have become more health conscious but rely too much on
front-of-the-label claims–ignoring the actual nutrition information
listed in the Nutrition Facts panel. Molly Gee, a registered dietitian and manager of the Institute
for Preventive Medicine at The Methodist Hospital in Houston,
suggests that the solution may be to take the intimidating
Nutrition Facts panel one step at a time.

“It can be your own personal road map,” Gee says. “Pick out the
part of the label that is of interest to you.” For instance, if
someone wants to lose weight or maintain heart health, that person
should look at the “fat” listing.

Confusing terms

Percent Daily Value: This replaces the RDA
(Recommended Dietary Allowance). “It’s a healthy eating goal,” Gee
says. “It specifies how much of a nutrient, vitamin, or mineral a
person should have.”

But what may be confusing, Gee says, is that the government
computes Percent Daily Value based on 2,000 calories. “If you eat a
little less than that, then keep in mind that it won’t take quite
as much of that nutrient to meet the daily requirement,” she
says.

Serving Size: How much you eat will affect the
Percent Daily Value. For example, if you eat two cups of cereal,
but the serving size is one cup, you double the Percent Daily Value
listed.

Fat: The most concentrated source of calories
is fat. If a product is high in fat–say 35 g–then “people can
decide if they want to blow their fat allotment for the day on this
one item,” Gee says.

Saturated fats are from animals, and polyunsaturated and
monounsaturated fats are from plant sources. “If someone has heart
disease, taking a look at saturated fats is important because
saturated fats elevate blood cholesterol,” she says.

Cow’s milk: the calcium debate

Many people drink cow’s milk for one reason:
the ­calcium it provides. Cal­cium, an essential nutrient, is
necessary for healthy bones. But research has shown that drinking
cow’s milk may not be the best way to “do a body good.”

“We certainly need calcium in the diet, but it doesn’t need to
come from milk,” says Neal Barnard, M.D., clinical researcher and
president of the Physicians Committee for Responsible Medicine and
author of five books.

“Greens and beans–that’s all you need,” Barnard says. “Those are
­calcium-rich foods. . . . You can use supplements if you
want.”

He says there are several reasons to avoid milk and dairy
products as a source of calcium. Serious problems may occur from
the proteins, sugar, fat, and con­taminants in milk.

“For children, the greatest concern is juvenile growth-onset
diabetes,” Barnard says. A 1992 report in the New England Journal
of Medicine adds evidence to previous theories that cow’s milk
proteins encourage the production of antibodies that, in turn,
destroy the insulin-producing pancreatic cells. For babies under a year old, milk products may possibly cause
colic. “Cow’s milk is not mother’s milk,” Barnard says. “Human
babies are designed for human milk, not giraffe’s milk or rat’s
milk. It makes no sense.”

A 1991 study published in Pediatrics suggests that
breast-feeding moms may also have colicky babies if they drink
cow’s milk; the cows’ antibodies can pass through the mother’s
bloodstream into her breast milk. Most importantly, he says, milk doesn’t seem to reliably prevent
osteoporosis. According to studies, maintaining strong bones
depends more on ­preventing calcium loss than on boosting calcium
intake. As people get older, the body goes into “negative calcium
balance” and the bones start to lose more calcium than they take
in. This leads to osteoporosis, or soft bones.

According to the Physicians Com­mittee for Responsible Medicine,
almost all the calcium in the body is in the bones, but there is a
small amount– controlled by hormones–in the bloodstream that’s used
for muscle contractions, the maintenance of the heartbeat, and
other functions. The body loses calcium through urine, sweat, and
feces, and the calcium is renewed from the bones; the bone calcium
has to be restored from food. Diets high in protein, most notably animal protein, “cause
calcium to be lost through the kidneys,” or urine, Barnard says.
Dairy products are high in protein. “If you eliminate animal
protein from your diet, you cut your calcium losses in half,” he
says.

Eight hundred milligrams of calcium per day is the U.S.
Recom­mended Dietary Al­lowance; but, Barnard says that the needed
amount may vary, depending on age. Higher recommendations are for
people who are losing a lot of calcium, he says. Calcium is found in all kinds of plant foods, which are moderate
in protein and low in fat. For instance, one cup of broccoli has
178 mg of calcium; a half-cup of firm tofu has 258 mg.
Calcium-fortified orange juice has about 300 mg.

“There just isn’t a requirement for milk at all,” he says. “Want
something to splash on your cereal? Try soy or rice milk.”

For more information

Visit the Physicians for the Committee for Responsible Medicine
Web site at http://www. pcrm.org/ nutrition, or write to P.O. Box
6322, Washington, D.C. 20015; phone: (202) 686-2210.

If you do drink milk. . .

Why buy organic milk when regular milk costs less? Lots of
reasons.

Amy Barr, R.D, M.S., of Horizon Organic Dairy says that organic
milk is produced using no hormones, antibiotics, or pesticides.
Horizon, of Boulder, Colorado, is the leading producer of U.S.
organic dairy products–items that are certified organic by a
third-party certification organization. These “clean-living” cows eat only 100 percent organically grown
feed and never receive antibiotics, so chemicals and drugs don’t
end up in the milk. Hormones are not used for any purpose; organic
milk producers say that injecting hormones to mimic pregnancy and
force cows to produce more milk is unnatural and may harm the cows.
Most cows get pregnant the “regular” way–without the help of
artificial insemination.

“A cow can’t produce milk unless it’s had a baby,” Barr says.
“And bulls know what to do. The cows (give) milk, dry out, and
rest, then they get pregnant again.” Plus, a low-stress cow is a
happy cow, Barr says. “We milk them three times a day. Regular cows
get milked twice a day. They get plenty of fresh air and sunshine.
We don’t keep them inside.”

Focus on attention deficit: Can supplements help?

Vickie Parker’s grandson was diagnosed with
attention deficit hyperactivity disorder (ADHD) when he was seven
years old.

“My daughter had great pressure from the school system to put
him on Ritalin,” says Parker, of Friendship, Maryland. “She felt
she had no choice–and she knew of no alternatives.”

Parker’s grandson was given Ritalin. He became depressed; he was
put on antidepressants. He developed insomnia; sleeping pills were
suggested. Parker’s daughter, a nurse, shuddered; she didn’t want
her son to take more drugs. Parker’s daughter isn’t alone. Many parents whose children have
been diagnosed with ADHD or attention deficit disorder (ADD) have
the same concerns. Adults who have been diagnosed do too.

One problem is that there’s no clear-cut test for ADD/ADHD.
Diagnosis is based on a combination of chronic behavior problems
listed in the 1994 edition of the American Psychiatric
Association’s Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV). Not all practitioners agree with these diagnostic criteria,
which include symptoms ranging from “often fidgets with hands or
feet or squirms in seat” to “often does not seem to listen when
spoken to directly” and “often talks excessively.”

The DSM lists behaviors that correspond with the everyday,
typical behavior of children, says Peter R. Breggin, psychiatrist
and author of Talking Back to Ritalin (Common Courage Press:
Monroe, Maine, 1998).

Breggin–an advocate of counseling whose motto is “educate, not
medicate”–says “these children do not have a disorder. . . . Within
the past few years, instead of figuring out what our kids need, we
have begun a massive drugging of our children to make them fit our
needs.”

Ritalin: An imperfect treatment

Ritalin (methylphenidate hydrochloride) is a nervous system
stimulant used to treat ADD and ADHD, as well as narcolepsy and
other ailments. According to IMS America, a health-care information
company, the number of prescriptions for Ritalin in the United
States has gone from 4.5 million to 11.4 million in the past five
years. Critics believe that Ritalin is overprescribed.

“It’s being used in the 1990s because of extensive marketing,”
Breggin says.

Questions also remain about the side effects of Ritalin and
other stimulants. According to the Drug Enforcement Administration,
Ritalin may cause nervousness, insomnia, addiction, and weight
loss. Some parents and diagnosed adults are seeking a variety of
alternatives to Ritalin and other drugs. Approaches include
counseling, the use of natural supplements, and changes in
diet.

Supplemental approaches

“When I found my grandson was having such good results from
supplements,” Parker says, “I wanted to let others know that there
are other alternatives.” So in 1997 she founded Grandparents and
Parents Against Ritalin to spread the word. (The group can be
reached at 800-995-2010.)

Nutrition researcher Jacqueline Stordy, another advocate of
supplements, found that people with learning disorders such as ADHD
may be deficient in essential fatty acids. Other research from
Purdue University (1995) hypothesizes this is because of “altered
fatty acid metabolism.”

Stordy, Ph.D., a retired professor of nutrition at the
University of Surrey in England, is now a nutrition consultant and
adviser for Efamol Nutraceuticals, which developed a patented
supplement based on her research. The supplement combines DHA-rich
fish oil and evening primrose oil, a source of gamma linolenic
acid. Stordy says, however, that the supplement isn’t a cure; it’s
“natural help” for people who are deficient in long-chain fatty
acids. It may be weeks or months before results are noticeable.

Other research has focused on the relationship of certain
minerals to the metabolism of fatty acids. A 1996 study in Turkey
looked at the effects of serum-free fatty acids (FFAs) on
forty-eight ADHD children. The research concluded that blood serum
levels of FFA and zinc are correlated and that a zinc deficiency
may be a cause of ADHD. Low FFA levels may be secondary to the zinc
deficiency. In 1997, a study by Polish scientists linked the development of
ADHD to low blood serum magnesium levels. Another study by the same
team gave children diagnosed with ADHD about 200 mg of magnesium a
day for six months; the researchers noted decreased hyperactivity
in the children. More research is needed, however, on the possible benefits of
the relationship between fatty acids and mineral supplements.

–Herbs for Health technical editor Anne Sundermann contributed to
this report.

“Nutrition supplement: vitamins, minerals, and more” is offered
as a bimonthly supplement to Herbs for Health and is written by Lee
Peck, an independent journalist from Fort Collins, Colorado. Design
by Bren Frisch. “Nutrition supplement” is intended as an
educational service, not a source of medical advice or a guide for
self-medication. Please consult a qualified health-care
professional for treatment of any serious health problems.

Additional reading

“The New Food Label” (Backgrounder:BG95-14) can be found on the
Food and Drug Administration’s Web page at http://www.fda.gov. To
order it by mail, free of charge, write to FDA, HFE-88, Fishers
Lane, Rockville, MD 20857; include the title and backgrounder
number. Also available: “On the Teen Scene: Food Label Makes Good
Eating Easier” (Reprint 98-2294).

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