A visit to the health food store
can be an overwhelming experience. It's tough to figure out what to choose from
among the dizzying assortment of dietary and nutritional supplements on the
shelf. From vitamins to minerals to weight loss pills, there are thousands of
options to choose from. But do you really need any of them? Do they really
work, and if so, which ones are best?
The Dietary Supplement Health and
Education Act, approved by Congress in 1994, defines dietary supplements as
products that: Are intended to supplement the diet; Contain one or more
ingredients (like vitamins, herbs, amino acids or their constituents); Are
intended to be taken by mouth; Are labeled as dietary supplements.
It's important to remember that dietary
supplements are designed to supplement your diet, not to replace nutritious
foods.Still, the ADA recognizes that some people may require supplements
because the vitamins and/or minerals they need are hard to get in adequate
amounts in the diet. These groups include: Pregnant women; Nursing mothers;
strict vegetarians; People with food allergies or intolerances; Senior
citizens.
Whether
they really need them or not, sales figures show that plenty of people are
purchasing supplements. Here are some of the most popular supplement categories:
Multivitamins
Taking a daily multivitamin with
minerals has long been considered nutritional "insurance" to cover
dietary shortfalls.
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There is no harm in taking a
once-daily multivitamin, as long as you select one based on your age and sex.
Take one daily or just on days when your diet is inadequate. But better than a
multivitamin is to fill in the gaps with food that offers so much more than
supplements.
Meal Replacements
Powdered and liquid products like
Slim Fast and Ensure might not be what most of us think of as dietary
supplements. But they're included in the list because they are designed to
supplement the diet.
For people who can't eat regular
food because of illnesses, these products are good alternatives. Still, eating
a wide variety of nutrient-rich foods is better, if tolerated.
And what about weight management?
Using a meal replacement can help control calories and be beneficial, experts
say -- as long as it's part of a lifestyle that includes exercise and a
calorie-controlled diet.
Sports Nutrition Supplements
This is a broad category that
includes both sports performance and weight loss supplements. It includes
pills, powders, formulas and drinks formulated not just to hydrate but to
enhance physical activity. Among them are creatine, amino acids, protein
formulas, and fat burners.
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”These products provide a subtle,
incremental effect. You can't use a sports supplement for a week and expect to
gain pounds of muscle, but if used properly, research shows they can provide a
slight, not overwhelming, edge," says Andrew Shoa, PhD, vice president for
regulatory affairs for the Council for Responsible Nutrition, a trade
association for the dietary supplement industry.
Calcium
Calcium is one of the minerals most
often lacking in Americans' diets. But experts say that whenever you can, you
should choose calcium from foods such as dairy products, fortified foods, dark
leafy greens, soybeans, beans, fish, and raisins.
The U.S. Dietary Guidelines
recommends three servings of low-fat or non-fat dairy each day to help bridge
this gap. But there are plenty of people who shun dairy, the best source of
calcium in our diets.
If you do choose a calcium
supplement, look for calcium citrate or lactate. These forms are best absorbed
by the body, says Grotto.
B vitamins
B vitamins include thiamin, niacin,
riboflavin, pantothenic acid, vitamin B-6, and vitamin B-12.
Many of us don't need these
supplements, experts say.
Romance surrounds the B vitamins
because people misuse them to reduce stress and think a supplement will make
them a nice person in traffic. But there is not much research to support this
theory. And besides, our diets are plentiful in B vitamins.
One exception is seniors, who may
need additional B-12 because as we get older, we absorb less of it. Most of us
should skip the supplements and get our Bs from grains, dark green vegetables,
orange juice, and enriched foods. People with certain medical conditions or who
take drugs that interfere with vitamin absorption may also require
supplementation.
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Vitamin C
Vitamin C is often taken in an
effort to ward off colds, though there's little proof this works.
There is scant evidence it may
decrease the intensity or duration of colds, but it won't do any harm up to
about 1,000 milligrams a day. Because it is a water-soluble vitamin, excess
amounts are excreted.
Your health-care provider may tell
you to take vitamin C if you have a wound that's healing. But wound otherwise,
go for food sources. Rich sources
include oranges, peppers, grapefruits, peaches, papayas, pineapples, broccoli,
strawberries, tomatoes, and melons.
Glucosamine and Chondroitin
These supplements are often taken
by people with joint pain.
In a study published in the The New
England Journal of Medicine, these supplements, taken alone or in combination,
were not found to provide significant relief from osteoarthritis knee pain
among all participants. However, results in a subgroup of study participants
with moderate to severe pain showed the combination may be effective.
While the evidence is not
conclusive, some rheumatologists say many of their patients find relief from
the combination.
About 40% of my osteoarthritis
patients benefit from taking 1,500 mg of glucosamine and 1,200 mg chondroitin
sulphate a day (for) four to eight weeks," says Kaiser Permanente
rheumatologist Eduardo Baetti. But
"most patients are also taking pain relievers, such as Tylenol."
Homeopathic Medicines
These are not technically dietary
supplements, but are nonetheless a popular category.
Homeopathy, or homeopathic
medicine, is a medical philosophy dating back to the late 1700s. It's based on
the idea that our bodies have a self-healing response. So, the theory goes, if
certain a substance causes a symptom in a healthy person, giving that person a
very small amount of the same substance may cure the symptoms.
The National Institute of Health's
National Center for Complementary and Alternative Medicine web site notes that
studies on homeopathy have been contradictory. Some have suggested the results
are similar to a placebo effect, while others have found positive effects that
are not readily explained in scientific terms.
Vitamins D
Chances are, you are not getting
enough vitamin D for good health.
"The current recommendations
are not adequate to protect against chronic diseases or prevent
osteoporosis," vitamin D expert Michael Holick, MD, tells WebMD. "All
evidence suggests that infants and adults can tolerate 1,000 IUs a day as safe,
without risk of toxicity.
Holick suggests taking a daily vitamin
D supplement or getting safe sun exposure to maintain proper blood levels of
vitamin D.
And be sure to eat a variety of
foods rich in vitamin D such as fortified milk and cereals, salmon, and tuna.
Check with your dermatologist about guidelines for safe sun exposure.
Ninety-five percent of the sales in
this category come from fish and not animal oils.
Unless a doctor is treating you for
heart disease or high triglyceride levels, you should not take fish oil
supplements, says Alice Lichtenstein, DSc, Tufts University researcher and
chairwoman of the American Heart Association (AHA) nutrition committee.
Studies show that omega-3 fatty
acids are cardio-protective and the basis for the AHA recommendation to consume
fatty fish twice weekly. But the studies do not show that popping a supplement
can have the same benefit in healthy individuals.There is also a misperception
that fish oils can lower cholesterol, but this is not true.
If you don't like fatty fish such
as salmon, Lichtenstein recommends eating other kinds of fish such as canned
tuna. (Just be sure to avoid any fish that is breaded and fried.)
Foods such as canola oil, soybeans,
flax, walnuts and algae are all sources of omega-3s, but they are not a
substitute for fatty fish.
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Experts agree there are some rules
of thumb for choosing dietary and nutritional supplements. First, look for
trusted brands that have been around for some time.
Another tip: read the
claims carefully. If they look too good to be true, they probably are.Products
promising to pack on 20 pounds of muscle in a week are not going to deliver
because nothing can yield those kind of results.
Last
but not least, be sure to check with your doctor before taking any dietary
supplements.