What
exactly is meant by the term "nutrition supplements?"
The word "supplement" means exactly that: a nutrient or
group of nutrients (vitamins, minerals, protein, carbohydrates,
fats and oils) that are meant to supplement, but not substitute
for a healthy diet that you eat on a regular basis. Nutrition supplements
come in a variety of forms: pills, capsules, powders, liquids, and
even in gel form. The cost of nutrition supplements can range from
almost "at cost" to being outrageously expensive.
Should
I be taking supplements?
You probably don't need a general vitamin-mineral supplement if
you are eating a reasonably varied diet most of the time, aren't
restricting calories to lost weight, and generally don't skip meals.
This doesn't mean you have to be a "perfect eater" - no
one is! Taking extra supplements won't add extra energy. If you
are fatigued because of a poor diet, only better nutrition can correct
this problem. Being on a sleep-deprived schedule will require that
you find a way to get more rest. Downing some B vitamins won't do
the trick. Vitamins and minerals do not increase your appetite or
cause weight gain.
Some
students take a multiple vitamin-mineral supplement as sort of an
"insurance policy" if they can't be sure they are eating
well a lot of the time. But keep in mind that a supplement can never
make up for eating poorly. And a multiple vitamin mineral supplement
is just that; it can't provide your needed protein, energy, carbohydrates,
nor fiber. Only food can give you these needed nutrients.
Don't
some people need specific supplements?
Sure. Because of allergies, certain medical conditions, or simply
the inability to obtain needed nutrients on a regular basis, you
may know people who have to take specific supplements.
Calcium
Recommendations for daily calcium intake for young people from 19
to 24 years old are around 1200 mg. What does this mean in terms
of food? You need to get the equivalent of four 8-oz.servings of
dairy products or calcium-fortified equivalent foods per day. That
may be quite a challenge, so we encourage you to try for at least
3 servings, and then add a calcium supplement. Calcium supplements
are better absorbed from the intestine in the presence of lactose
(the sugar of milk) and protein. Taking the calcium supplement with
a glass of milk is ideal. Once the calcium gets absorbed into your
bloodstream, your bones will take up the calcium better in the presence
of vitamin D. That's why almost all dairy products and many calcium
supplements are fortified with vitamin D.
Other
foods high in calcium that are absorbed well are calcium-fortified
orange juice, tofu that is packaged in calcium brine, calcium-fortified
cereals, and almonds. Easy ways to work in that extra calcium is
to sprinkle cheese on your salad or baked potato, order lattes and
cappuccinos if you drink coffee, or whip up a smoothie with low
fat yogurt and fruit for a study break snack.
A great
buy for calcium as well as multiple vitamin and mineral supplements
can be found at the Health Services pharmacy. It should be noted
that most multiple vitamin-mineral supplements do not contain enough
calcium to be used as calcium supplements.
After
your mid-20's, your bones will have reached their "peak bone
mass." This means that if you are a woman, you will be carrying
to menopause the density that your bones have accrued when you were
much younger. Osteoporosis and bone fractures are becoming a very
large problem for older women (and some men). The most important
preventive measure you can do is to increase calcium intake now,
along with regular "weight bearing exercise." Examples
are walking, jogging, racket sports, Frisbee, and other activities
in which your body weight is supported by your own bones. Working
out with weight resistance exercise machines and free weights is
also very helpful for increasing bone density, no matter what your
age.
Iron
You may learn from having your blood tested by a medical provider
that your iron levels are low. It is often recommended that you
take iron supplements for awhile. Absorption of this iron will be
increased if you take the iron along with an acidic food or juice
(e.g., orange juice, tomato sauce, strawberries). Taking iron without
food may upset the stomach. Don't take a calcium supplement at the
same time, since calcium can interfere with the body's ability to
absorb iron.
It is
never advised to take iron supplements without medical advice just
because you "feel tired." Fatigue can be caused by many
things, including lack of adequate rest, depression, an imbalanced
diet, effects of some medications, and several medical conditions.
By taking iron supplements when you are not deficient in iron, you
could actually be doing more harm to your health. Hemochromatosis is a genetic disorder predisposing individuals to a toxic build-up of iron. Because supplementation may accelerate the effects of this condition, adult men should avoid taking supplements that include iron. You might be alerted
to possible iron deficiency when you try to donate blood and are
turned away because of a low iron level. Always consult with a medical
provider if you think you may be iron-deficient.
Vitamin
C
If you are a heavy smoker, you may need as much as an extra 100
mg. of vitamin C per day (easily met by drinking an extra glass
of orange juice, a large portion of broccoli, melon, or green pepper).
Research has not convincingly shown whether or not extra vitamin
C is helpful in warding off colds. It may help lessen the severity
of a cold, however. Extra vitamin C is usually recommended around
the time of surgery to aid in wound healing. Taking high amounts
of vitamin C over a very long period of time can actually lead to
"rebound scurvy," the deficiency disease of vitamin C.
This is because the body can adapt to these extremely high levels.
When one resumes a more normal intake, the body thinks it is then
in a deficiency state (babies born to mothers who consume these
very high levels during pregnancy sometimes develop this rebound
scurvy after birth).
Folate
There has been recent concern that all women of childbearing age
get adequate folate (a B vitamin) in their diets, in order to prevent
some types of birth defects. Folate is also linked to heart disease
prevention and may help prevent depression. Folate is easily found
in foods such as fortified cereals, dried beans and legumes, dark green leafy vegetables
(spinach, kale, broccoli), and orange juice.
Are
protein powder supplements necessary if I'm working out?
Unfortunately, a lot of money is spent on protein supplements (usually
in a powdered form), in the hopes that the protein consumed will
go straight to the protein of your muscle. If it were only that
easy, we could all save a lot of time in the gym!
The body
likes to take a more indirect route, however. Much of this high
level of protein is actually converted to carbohydrates and fats
in the body. Too much extra protein can put a burden on the kidneys,
be dehydrating, and can cause calcium loss from the body. Your protein
needs are usually met quite easily by a slight increase of protein
in the diet. Most Brown students, unless they are restricting calories,
get about 1-1/2 to 2 times the protein they need just with a regular
diet. This is true for both vegetarians and meat-eaters.
More
details about eating for working out and various sports supplements
can be found in the Nutrition
Resources section.
How
do I know if herbal supplements are safe?
This is a difficult question to answer, because there are no federal
regulations that standardize quality of ingredients contained in
these products. Additionally, no testing is done on the actual products
that you see on the shelves in stores. You therefore lack assurance
that what is stated to be true on a supplement label even resembles
what you are getting. The lobbying influence of the nutrition supplement
industry in Washington is very strong, and past efforts to get any
type of labeling legislation passed has failed. Additionally, few
long-term, reliable studies have been done on most herbal and "natural"
products. There is often very little information on food-herbal,
drug-herbal, and multiple herbal-herbal interactions. Of particular
importance for women is that if you are pregnant or breast-feeding,
you should not use any dietary supplement without the advice of
your physician.
Where
does all this leave you, as the consumer? Perhaps the most important
thing you can do is to try to stay informed about which products
are potentially harmful (the most important factor when deciding
to use supplements), which might be fairly neutral, and which
might actually do some good, if taken in sensible amounts.
Two excellent
and reliable books that you might want to explore in this area:
Sarubin,
Allison, MS, RD, The Health Professional's Guide to Popular Dietary
Supplements. The American Dietetic Assn., Chicago. 2000. (May
be checked out from the Health Education Library)
Foster,
Steven, and Varro E. Tyler, Ph.D., Tyler's Honest Herbal. A Sensible
Guide to the Use of Herbs and Related Remedies. 4th Ed. Haworth
Herbal Press, New York. 1999. (May be accessed in the Health Education
Office; not for loan)
You can
also use the links listed below for more information.
This web site provides independent test results and information
to help consumers and health care professionals evaluate health,
wellness, and nutrition products (by brand name). You can sign up
for newsletters. Health and nutrition products tested include: herbal
products, vitamins, minerals, other supplements, sports and energy
products, functional foods, foods and beverages, and personal care
products.
The US Government has an extensive web site on many aspects of nutrition.
You may explore questions about vitamins, minerals, herbal supplements,
and recent studies. The site provides many links to other nutrition-related
government web sites.
The FDA has a user-friendly web site that contains "Frequently
Asked Questions" about food supplements.
The National Institutes of Health Office of Dietary Supplements
has a web site that offers a comprehensive overview of nutrition
supplements as well as a listing of new studies and safety issues.
This site has articles by experts in exercise science, sports nutrition,
supplements and "ergogenic aids" for athletes. Other topics
include hydration and sports psychology.
This organization works to educate the public about beneficial herbs
and plants and to promote the safe and effective use of medicinal
plants.
NCCAM is part of the National Institutes of Health and is dedicated
to exploring complementary and alternative health practices in the
context of rigorous science. The A-Z index allows you to search
for a particular treatment or therapy. Topic areas include acupuncture,
vitamin supplements and ayurvedic medicine.
The alternative medicine center of Discover Health has information
on supplements, a Drug Interaction Center and articles on certain
herbal medicines.
Disclaimer: Health Education is part of Health Services at Brown University. Health Education maintains this site as a resource for Brown students. This site is not intended to replace consultation with your medical providers. No site can replace real conversation. Health Education offers no endorsement of and assumes no liability for the currency, accuracy, or availability of the information on the sites we link to or the care provided by the resources listed. Health Services staff are available to treat and give medical advice to Brown University students only. If you are not a Brown student, but are in need of medical assistance please call your own health care provider or in case of an emergency, dial 911. Please contact us if you have comments, questions or suggestions.
