Conscious Choice Seattle: Supplements to Watch in 2004

February 2004 | Feature Story

Supplements to Watch in 2004

By Susan M. Kleiner

Vitamin D

You may have been in high school health class the last time you heard about vitamin D deficiency. Rickets, the failure of bones to mineralize, had all but disappeared in developed nations. But to the dismay of physicians and public health officials rickets is reappearing, especially here in the Northwest. There are three main reasons why rickets is making a notorious comeback:

Long-term breast-feeding without vitamin D supplements,

Decreased exposure to the sun,

High prevalence of rickets in groups immigrating from less developed nations.

Most of the vitamin D that your body requires comes from exposure to sunlight. Ultraviolet energy from the sun is absorbed by the skin and converted into vitamin D. Vitamin D is also available from a handful of foods that we eat. It is found naturally in oily fish like salmon and mackerel and fish oils, and in vitamin D-fortified milk and cereals. Because vitamin D is limited to only this small number of foods, we greatly depend on sunlight to cover our needs.

Recommended Intakes

The recommended dietary intake for vitamin D is 200 IU per day for men and women from birth to age 50, 400 IU from 51 to 69 years of age, 600 IU for those 70 and older, and 1000 IU for pregnant women. A number of factors influence how much vitamin D is found in our blood. Levels are highest during the summer and lowest in the winter. As we age blood levels of vitamin D decrease, and women at any age tend to have lower levels than men. People living in northern latitudes have less sun exposure, leading to lower levels of vitamin D in blood. Anyone who stays inside and gets little sun exposure has lower blood levels of vitamin D, particularly during the winter months. Higher levels are found in people who take vitamin D supplements.

Body fat content has also been shown to influence blood levels of vitamin D. The evidence is showing that even with adequate exposure to sunshine, fat-soluble vitamin D is trapped in the excess subcutaneous fat of obese women and doesn’t escape into the bloodstream as seen in more normal weight women. This implies that body fat levels should be considered in the development of dietary recommendations for vitamin D, and that supplementation may be necessary to achieve healthy blood levels in overfat women. Further research is necessary before recommended intake levels can be prescribed.

The 15-minute Sunshine Fix

Studies have shown that young adults in northern climates end the winter at a deficit for vitamin D. There is even a significant group of people, like medical students and hospital residents that rarely see the light of day, who are vitamin D deficient at the end of the summer.

Make it a priority to get out into the sunshine. Sun exposure on the hands, arms, and face for five to fifteen minutes per day is thought to be adequate to supply your body with sufficient vitamin D. Another strategy is to estimate how long you can be in the sun without burning. Divide this time by 4. Use this number as the minutes of your sun exposure time. Stay alert. This is not a license to tan, and extra sun exposure will not help your body make more vitamin D. After your time is up, put on your sunscreen and your hat to prevent burning and the negative effects of chronic overexposure to sunlight.

Take advantage of the summer months for storing up vitamin D. Because vitamin D is fat-soluble it can be stored in our fat cells. These stores get us through the dark months of winter until the sun comes back out in the spring.

Consume vitamin D in the recommended amounts from fish, milk, and fortified cereals. Add a margin of safety by using a multivitamin supplement that contains 200-400 IU of vitamin D. Active women who train or exercise primarily indoors and/or who live in northern climates should supplement with 400-800 IU of vitamin D. Massive doses of vitamin D are not recommended and can lead to vitamin toxicity.

Let the sun shine in!

Omega-3 Fatty Acids and Alpha linoleic acid (ALA)

If you think of the sea as an unlocked treasure trove, it isn’t a stretch to think that marine life could produce food with the potential to rival man-made pharmaceuticals—even ones as potent, effective and wildly popular as Prozac, prescribed by doctors to millions for the treatment of depression. Lo and behold, a while back scientists began noticing that countries with the highest fish consumption per capita also had the lowest levels of depression. Curious, researchers at the National Institutes of Health conducted a series of studies—using piglets as subjects, no less—to observe in a systematic way the effect of fish consumption on mood.

Suddenly they had pens of happy pigs. Based on this study and others that followed, fish oils containing omega-3 fatty acids—polyunsaturated fats, which the body can’t produce itself and therefore must get from your diet—are now believed to produce effects similar to Prozac and other antidepressant drugs. How do the fats work? Like those drugs, they raise levels of the mood-elevating neurotransmitter serotonin in the frontal cortex of your brain, where depression and impulsivity are modulated (one hopes). Suddenly, those little piglets who were given fish oils had doubled their serotonin levels after 18 days. Who needs slop when you’ve got omega 3’s?

Other research suggests that it is indeed the omega-3 fatty acids in fish oils, and not something else in the fish, that is making people feel better. Alpha linoleic acid, another omega-3 fatty acid found mostly in flaxseed and hempseed oil, was also found to have antidepressive effects in many subjects. So watch for the supplement companies to tell you what your mother already told you many years ago: fish really is brain food.

Coenzyme Q10

Known commonly as CoQ10, it is integral to the pathway of energy production, and is an important antioxidant. CoQ10 is manufactured by the body, but manufacturing peaks at around age 20 and declines thereafter. Numerous studies are investigating the influence of CoQ10 on the aging process. It has already been shown to help support heart function in cardiac patients compromised by heart failure and prior to cardiac surgery, as well as individuals taking cholesterol-lowering medications.

Another major area of research is whether CoQ10 can enhance athletic performance by supporting cellular energy production. The results of studies are conflicting at this point, with some showing a benefit and some showing no effect.

When combined with vitamins E and C, CoQ10 appears to be a powerful antioxidant. Supplement companies will certainly be touting this important benefit and promoting its protective effects for cardiac patients, while hoping to score with new research results on aging and performance enhancement.

White Navy Bean Extract

A new twist on an old theme is the newly formulated starch blocker, white navy bean extract marketed under the name Phase 2. In the 1980’s these products were pulled from the market for safety concerns. New treatments have purportedly produced a safe product that blocks starch absorption by inactivating amylase, the enzyme required for starch digestion and absorption. Several studies have been conducted by the manufacturer, some of which have been published in scientific journals. Others are listed on the website. The product has received a 2002 Product Merit Award from the Nutrition Business Journal. This is definitely one to watch for as its own product, and as an ingredient in other diet and weight loss products.

A few words about ephedra

You likely know ephedra is the first supplement banned by the FDA under a landmark 1994 act. While the scientific community debates the move, expect to see ephedra substitutes marketed on the Internet and appearing on your store shelves, including citrus aurantium or green tea extract combined with caffeine. There is little scientific evidence to date showing these products actually lead to a thermogenic effect of weight loss. Boost your metabolism, yes. Drop pounds? No one has proven it.

Where to Buy Your Local Supplements

When it comes to buying supplements, even many professionals are in the dark. So here are the questions that I ask when I go shopping for supplements.

Where to shop? I like to go somewhere with a salesperson that seems to know more than just where to find the price on the bottle. That means either a pharmacy where the pharmacist can tell me about the product, an individually owned natural food/supplement store where the owner can tell me about the different brands carried in the store or a chain that takes pride in the education of their employees and the quality of their products.

Here in the Puget Sound area I have found that I go to my local pharmacy for common products like vitamin C. I have shopped at Nature’s Pantry and found the owner to be well informed on the quality of the ingredients and manufacturing processes used by the different brands carried in the store. He was forthright regarding the efficacy of the supplement. He didn’t want to sell me something that I might be dissatisfied with because he was building a relationship with me as a customer, and the long-term relationship mattered more than just one sale.

I have shopped at both franchise and corporate GNCs over the years, and I have been a consultant to the General Nutrition Corporation. Again, it’s the sales person that wins me or loses me. A hard sell and I’m out the door. But a considerate discussion of what might work and what might not, with some insight about the supplement and manufacturer will win me over.

Whole Foods is a good example of a chain store that takes pride in the products put on the shelf and the knowledge of salespeople. The Whole Foods staff, like the individually owned stores, saves you some work by only carrying high-quality brands. Its staff can often assist with choosing a product that has the greatest potential of working for you.

What product to buy? In the end, you still have to do your own homework. You wouldn’t dream of buying a car without reading the safety ratings, checking out the maintenance and reliability statistics, looking at the resale value and talking with people about their personal experiences with the same car.

When you buy a supplement, it is something going into your body. It should be safe, effective and reliable. It should meet its marketing claims. Just like with the car, you can’t depend on the salesperson to educate you entirely.

Can the Internet help? Two of my favorite websites for honest supplement reviews are Supplementwatch.com, and Consumerlabs.com. You can also go into the scientific literature yourself by logging onto the National Library of Medicine’s scientific medical database called Pub Med (http://www.ncbi.nlm.nih.gov). – Susan Kleiner

Susan M. Kleiner is a Ph.D. nutritionist and author of “Power Eating” and “The Be Healthier, Feel Stronger Vegetarian Cookbook.” Her High Performance Online Cookbook is at www.allrecipes.com or check out www.powereating.com. She liveson Mercer Island.

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