The Scoop on Supplements
Kristin Kirkpatrick, MS, RD @kristinkirkpat Kristinkirkpatrick.com
KK’s Nutrition Rules
▪ Keep It Simple
▪ Stick with Whole Foods
▪ Eat Only 100% Whole Grains, with or without Gluten
▪ Keep added sugars and syrups to a minimum, preferably less than 100 calories per day
▪ Eat Until You’re NO LONGER HUNGRY, NOT until your full
▪ Use Your Grandma’s plates
▪ Cook More, order less
▪ Make your kitchen environment one which promotes a healthy weight
Over 100 million Americans spend a combined $28 billion on vitamins, herbs and supplements each year
-New England Journal of Medicine
FAQ’s
▪ What are the differences between water-soluble, fat-soluble, and herbal supplements?
▪ What are recent studies telling us about
supplements? ▪ What should I look for when choosing a supplement? ▪ Are all supplements equal? ▪ Should I be taking a supplement and if so, which
ones?
Water-Soluble VS. Fat-Soluble Vitamins
Water-Soluble Vitamins
▪ Include Vitamin C and all B Vitamins
▪ Dissolve in water once ingested ▪ Difficult to over-consume ▪ Need to be replenished daily ▪ Excess is excreted through waste ▪ Destroyed when exposed to bright
light
Fat-Soluble Vitamins
▪ Include Vitamin A, D, E, and K ▪ Should be taken with fat ▪ If regularly consumed, daily
replenishment is not necessary ▪ Excess is stored in the liver ▪ More shelf stable
Understanding Supplement Terms
▪ Dietary Reference Intake (DRI): The recommended level of daily consumption based on the most current research
▪ Adequate Intake (AI): Used when there is not enough info to calculate the DRI
▪ Upper Limit (UL): The highest daily level taken that will not have
adverse health risks for most people
▪ EAR: Estimated average requirement ▪ IU = international unit ▪ RE = retinol equivalent (used to quantify Vitamin A) ▪ Mg = milligram ▪ Mcg = microgram
Herbal Supplements ▪ Used for medicinal purposes for
thousands of years ▪ Classified by the FDA as a food
rather than a drug ▪ Anyone can produce an herbal
supplement ▪ They make many health claims such
as supporting health or are linked to body functions without substantiation
▪ Some supplements, including
products labeled as “natural” can have drug-like effects and may cause adverse health effects
Should I be taking Supplements?
▪ If your diet consists of a wide variety of foods such as fruits, vegetables, whole grains, dairy, and lean proteins, supplementation is probably not necessary
▪ Women who may become pregnant should get 400mcg of Folic Acid
(That means all women under the age of 45) ▪ Pregnant women should take a prenatal vitamin that includes iron or
take an additional iron supplement ▪ B-12 supplementation for adults over 50 is recommended ▪ Other candidates for supplementation include: individuals consuming
less than 1,600 calories a day, those who are vegan or vegetarian, have a medical condition that affects nutrient absorption (consult your doctor), or have recently undergone surgery that also interferes with absorption
Supplements for Women Ages 19-50
▪ 18mg Iron intake ▪ 1,000mg Calcium intake ▪ 1,000mg daily of Omega-3’s
Ages 50+
▪ Decrease Iron intake to 8mg ▪ Increase intake to 1200mg
Calcium ▪ 1,000mg daily of Omega-3’s
▪ Vitamin D3 dependent on levels
▪ 100-400mcg B-12 daily ▪ 400mcg Folic Acid daily
Supplements for Men
Ages 19-50
▪ 1,000mg of Calcium Daily
▪ 1,000mg Omega 3’s
▪ 400 IU Vitamin D3 daily
Ages 50+
▪ Increase to 1,200mg of Calcium daily
▪ Vitamin D3 dependent on
levels
Suggested Supplements
▪ Multivitamin ▪ Essential Fatty Acids ▪ Vitamin D ▪ Magnesium
Tips when Choosing a Supplement
▪ Check the Label ▪ Avoid Megadoses ▪ Check expiration dates ▪ Watch what you eat ▪ Keep up with supplement safety alerts
Mayo Clinic, 2013
Vitamin D3
▪ Necessary for: ▪ Regulation of calcium and phosphorus absorption in
the intestine ▪ Parathyroid-directed regulation of calcium balance ▪ Stimulation of bone cell mineralization ▪ Immune function
▪ New research: the prevention of cancers, type 1 diabetes, heart disease, osteoporosis and per- sistent, nonspecific musculoskeletal pain
Vitamin D Potency Variations in Supplements
▪ A 2013 study showed that Vitamin D in supplements ranged from 9%-146% of the amount listed on the label
▪ 55 bottles of over-the counter Vitamin D from 12
different manufacturers across 5 locations were tested
▪ This study found that variation did not only occur
among different brands, but in the individual pills in each bottle as well
JAMA Intern Med. 2013;173(7):585-586.
Omega 3 Fats
▪ Necessary for: ▪ Lower inflammation ▪ Decreased risk of cardiovascular disease
Magnesium ▪ Participates in >300 intermediary enzymatic
reactions ▪ Necessary for: ▪ Neuromuscular contractions ▪ Muscle relaxation ▪ Cardiac function ▪ Regulation of acid-alkaline balance ▪ Protein synthesis ▪ Fatty acid synthesis and oxidation ▪ Utilizing calcium, phosphorus, sodium & potassium
Magnesium
▪ Absorbed in the lower SI & colon ▪ Regulated by the kidneys ▪ Deficiency is common ▪ Increases in CKD, Crohn’s Disease, Bowel
Resections, Alcoholics, Elderly and Pregnant Women
▪ Signs: Weakness, muscle cramps or twitches, insomnia, heart irregularities
Proceed with Caution ▪ Though natural, some herbal supplements have been shown to
have poisonous effects ▪ Supplements, such as Ginseng and St. John’s Wort may interact
with blood-thinning medications ▪ Supplements are required by the FDA to be labeled with certain
information, but botanicals obtained out of the country or that are personally mixed are not subject to the same requirements
▪ Energy Drinks
▪ Ginkgo (G. biloba) ▪ Not all herbal supplements are the same!
Carbonate Vs. Citrate
▪ Calcium carbonate is more commonly available
▪ Dependence on stomach acid for absorption, so is absorbed most efficiently when taken with food
▪ calcium carbonate is 40% calcium by weight
▪ Does not need to be taken with food
▪ calcium citrate is 21%
calcium
NIH Office of Dietary Supplements, 2013
Evaluation of Garcinia Cambogia Extract
▪ Garcinia originates as a plant whose fruit rind is used to make medicine
▪ A recent study showed that Garcinia Cambogia “plays an
important role in the regulation of endogenous lipid biosynthesis”
▪ The use of extracts have been associated with weight loss
and fat loss in humans ▪ Most studies have used small sample populations and further
research should be conducted on long-term effects ▪ Currently there have been no reported increases of mortality
or significant toxicity from Garcinia Cambogia usage
Raspberry Ketone: What You Should Know
▪ “Raspberry Ketone is the natural phenolic compound found in red raspberries (Rubus idaeus)”
▪ There have been no studies
conducted on the effects of Raspberry Ketone on humans, only rats
▪ Rat studies showed that Raspberry
Ketone helped with the breakdown of fat cells
▪ Before Raspberry Ketone became
known as a trendy “fat-burner” it was used in fragrances, cosmetics, and as an insect attractant
Consumer Reports, 2013
Overarching Goals
▪ Get to the root cause of symptoms ▪ Identify deficiencies and imbalances ▪ Short-term: use supplementation to create
balance and optimal nutrient status ▪ Long-term: Use food as medicine
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