supplement your dietary supplement iq
DESCRIPTION
by: Chris D’Adamo, Ph.D. - Assistant Professor and Director of Research; University of Maryland Center for Integrative Medicine Dietary supplementation is growing in popularity. While most Americans take at least one dietary supplement, many people are confused by the regulation, safety, and efficacy of the supplements that they consume. Dr. D’Adamo will clarify these issues and present the latest research on specific dietary supplements that are effective as well as those that may be best to avoid. Learn about popular dietary supplements that are being taken for a wide variety of health conditions — ranging from arthritis, to immune system enhancement, to depression — and become a more informed consumer when choosing supplements.TRANSCRIPT
Supplement Your Dietary Supplement IQ
Chris D’Adamo, Ph.D.Assistant Professor
Department of Family & Community MedicineDepartment of Epidemiology & Public Health
Director of ResearchCenter for Integrative Medicine
Presentation OutlineOverview of Dietary Supplements
DefinitionRegulation
Supplements to Generally ConsiderMultivitaminVitamin DOmega-3 Fatty AcidsProbiotics
Supplements to AvoidPotential for tainting with pharmaceuticals
Presentation OutlineSupplement & Drug Interactions
Supplements for Special SituationsPeople taking statins, beta-blockers, acid-blocking drugsVegetariansPregnant women
Evidence-Informed Supplements for Specific ConcernsJoint HealthDigestion
Checklist: Informed Supplement Consumer
Immune SystemHeart Health
Liver HealthDepression
Sleep
Dietary Supplements DefinedWhat is a dietary supplement?
1994 Dietary Supplement Health and Education Act (DSHEA)A product (other than tobacco) intended to supplement dietContains one or more dietary ingredients and taken orallyVitamins, minerals, herbs or other botanicals, amino acids
Vitamins Minerals Herbs Amino Acids
Immune System
Regulation of Dietary SupplementsFederal Regulation of Dietary Supplements
Food and Drug Administration (FDA)Supplements regulated as food
Pre-DSHEA assumed safe, post-DSHEA provide safety evidenceLabeling and claims requirements
Ingredient names & amounts, directions for use, no health claims, etc.2007 Good Manufacturing Practices (GMP)
Quality standards for manufacturing, preparation, storage, facilityFederal Trade Commission (FTC)
Regulate marketing of supplements
Regulation of Dietary SupplementsFederal Regulation of Dietary Supplements
No universal regulation of supplement content“Don’t know what you’re getting”… in many cases, true!
Many dietary supplement companies hire 3rd party laboratories for product purity certificationContains specified ingredientsNo contaminantsDissolves properly GMP compliantSome 3rd party labs better than others
NSF-certified gold standard
Supplements to Consider
Multivitamin: OverviewMost common dietary supplement
33% of Americans take multivitaminUsually contain at least 13 vitamins &
15 minerals most important to nutrition
How multivitamins are usedGenerally capsule or tablet orally once per day
Powders, liquids, multiple daily doses less commonBest taken with meal
Many of nutrients lipid-soluble, need fat for absorption
Multivitamin: TypesRDI-centric
RDI of most important vitamins/mineralsReference Daily Intake – replaced RDA in 1997Prevent micronutrient deficiency in most people "% Daily Value" on food & supplement labels
Widely available
Higher potencyExceeds RDI for many vitamins/minerals
Why? RDI prevent deficiency disease… not to promote optimal health!
Higher in vitamin D, B-vitamins, vitamin C, etc.Health stores, clinical practices, Amazon, etc.
Multivitamin: Favorable Research Improves nutritional status
2000 Journal of American College of Nutrition, 2009 European Journal Clinical Nutrition
Reduces risk of birth defects 2001 Epidemiology, 2002 Epidemiology, 2002 Pediatrics, 2003 Pediatrics
Associated with weight loss & decrease in body-fat % 2010 International Journal of Obesity Research
Reduced risk of macular degeneration & cataracts 2007 American Journal of Clinical Nutrition, 2008 Ophthalmology
Reduces risk of heart attack 2010 American Journal of Clinical Nutrition
Reduces risk of colon cancer 2002 Cancer Epidemiology, Biomarkers, & Prevention
Reduces risk of all-cause mortality and cancer mortality 2011 European Journal of Nutrition
Multivitamin: Unfavorable ResearchNo benefit in some studies
No reduction in risk of cancer or cardiovascular disease 2009 Archives of Internal Medicine
No reduction in risk of breast cancer 2010 Public Health Nutrition, 2010 American Journal of Clinical Nutrition
Slight increase in non-cancer, non-CVD mortalityLots of media coverage… but study flawed and over-interpreted
2011 Archives of Internal Medicine Direct conflict with 2011 European Journal of Nutrition Study!
Multivitamin: RecommendationsDoes brand make a difference? YES!
Cheap brands use cheap vitamin/mineral formsAffects absorption and effectiveness
Natural vitamin forms better absorbed than synthetic Natural vitamin E twice absorption of synthetic
Certain vitamin forms more effective than others Vitamin D3 superior to vitamin D2
Certain mineral binding salts better absorbed than others Magnesium citrate much better absorption than magnesium oxide
Multivitamin: RecommendationsHow to choose a good brand?
www.multivitaminguide.org Ranking based on: composition, bioavailability, synergistic effect, potency 101 of most common multivitamins in United States
Comparative Guide to Nutritional Supplements Lyle MacWilliam, biochemist, commissioned by Canadian Minister of Health Scientific analysis of 510 multivitamins available in United States & Canada
Multivitamin: Recommendations
Multivitamin: RecommendationsQuality is key! Consult rankings
Whole-food based multivitamins also good choice Synergy between hundreds of food components!
Always consume with mealImportant fat-soluble nutrientsPoor absorption in absence of fat
Be an informed consumer! Choose/avoid the following…Vit E: d-alpha tocopherol (natural) NOT dl-alpha tocopherol (synthetic)Vit E: look for "mixed tocopherols" and/or "gamma tocopherol"Vitamin D3 NOT vitamin D2
Methylcobalamin form of B12 NOT cynacobalamin form of B12
Avoid oxide binding salts (magnesium citrate NOT magnesium oxide)Avoid iron for men and postmenopausal women
Vitamin D: OverviewA uniquely important vitamin
Hormone-like activity (secosteroid)Controls expression of over 200 genes
Vitamin D active in most biological systemsMusculoskeletal system
Classically emphasized roleEndocrine systemNervous systemCardiovascular systemDigestive systemImmune system
Vitamin D: SourcesSun exposure
UVB light converted to vitamin D3 in skinD3 transported to liver, metabolized to 25(OH)D
Also called calcidiol… measured most vitamin D blood tests25(OH)D converted to calcitriol in kidneys
Calcium metabolism… remaining calcitriol & calcidiol → health benefits20,000 international units (IU) from 30 minutes sun exposure
Only spring and summer if north of Atlanta
Limited amount from foodsD3 from oily fish, eggs, butter, cheese, fortified milk/cereals
Vitamin D fat-soluble… needs fat for absorption 10-100 IU: depending upon source
Supplements deliver much higher doses… up to 5,000+ IU per pill
Vitamin D: Reference Daily IntakeCurrent RDI varies
Up to age 50: 200 IUAge 51-70: 400 IU70 and older: 600 IU
Amount to prevent vitamin D deficiencyRickets
Softening of bones → deformities, fractures, etc. Most common in children… rare in United States Also occurs in adults… called osteomalacia
Amount to prevent chronic disease… much higher!Call to substantially increase RDI to at least 1,000 IUExplosion in vitamin D research
Vitamin D: Favorable ResearchPrevents bone disorders (osteoporosis, fractures, etc.)
2009 Cochrane Systematic Database Review
Reduced risk of cancers (breast, colon, prostate, etc.) 2004 American Journal of Clinical Nutrition, 2009 Cancer Epidemiology
Improved survival among colorectal cancer patients 2012 Cancer Epidemiology, Biomarkers and Prevention
Reduced risk and better control of diabetes 2010 Diabetes, Obesity, & Metabolism, 2010 Diabetes Care
Reduced risk of obesity 2010 Obesity, 2010 Diabetes, 2009 Journal of American Dietetic Association
Help weight loss & improve cardiovascular risk factors 2012 British Journal of Nutrition
Reduced risk of cardiovascular disease 2009 Archives of Internal Medicine, 2010 American Journal of Cardiology
Vitamin D: Favorable ResearchImprove depression & Seasonal Affective Disorder
2008 Journal of Internal Medicine, 1999 Journal of Nutrition, Health, & Aging
Reduced risk of Crohn’s disease, rheumatoid arthritis, multiple sclerosis and other auto-immune disorders 2010 Journal of Rheumatology, 2007 American Journal of Clinical Nutrition
Stimulate immune system to prevent infection 2010 American Journal of Clinical Nutrition
Decreased risk of all-cause mortality 2008 Archives of Internal Medicine
Vitamin D: Unfavorable ResearchVitamin D supplementation not beneficial in some trials
Breast cancer – 2009 Breast Cancer Research and TreatmentHeart attack – 2007 Circulation
Between 200 – 400 IU vitamin D used… very low dose
No risks of high serum vitamin D in observational studiesUnless extremely high concentrations over 100 ng/mL
Increased risk of atrial fibrillation “excess” 25(OH) D > 100 ng/mL Vitamin D increases calcium absorption… too much calcium in blood?
No evidence of harm from typical vitamin D supplementsFat-soluble, but safe at even at very high intake
Acute D3 toxicity intake ≈ 176,000,000 IU… 440,000 400 IU capsules Only toxic cases manufacturing mistakes (extremely rare)
Vitamin D: RecommendationsConvincing evidence: recommend 25(OH)D test to everyone!
Vitamin D inadequacy extremely common Between 36-100% depending on group, 2006 Mayo Clinic Proceedings
Supplementation most important for people who…Live north of Atlanta (in fall & winter)
Cannot synthesize from sunHave darker skin tone
Less efficient synthesis in skinOlder adults
Greater risk of osteoporosis & other chronic diseasesAvoid sun or wear sunscreen
Most vitamin D from sun exposureHave low serum 25(OH)D
Everyone should have vitamin D tested… inexpensive and major risk-factor!
Vitamin D: RecommendationsNot much difference by price or brand
Gel capsule preferable to tabletVitamin D fat-soluble… better absorption
Take with foodVitamin D fat-soluble
Vitamin D3 preferable to D2
D3 (cholecalciferol) more effective than D2 (ergocalficerol) 2004 Clinical Endocrinology & Metabolism
Serum 25(OH)D target range ≈ 40 ng/mL (100 nmol/L)More research needed for optimal threshold… most people low!
Omega-3 Fats: OverviewClass of polyunsaturated fatty acids (PUFA)
Common structure (C=C in n-3 position)
Three nutritionally important omega-3 fatsAlpha-linolenic acid (ALA)
One of two essential fatty acids “Short-chain”… converts to “long-chain”
Eicosapentaenoic acid (EPA) Long-chain omega-3
Docosahexaenoic acid (DHA) Long-chain omega-3
Health benefits of EPA and DHA most studiedPrecursor to eicosanoids… anti-inflammatory effects
Omega-3 Fats: SourcesVary by type of omega-3
ALA Nuts, seeds, vegetables
Flax seed, chia seed, walnuts, leafy greens
EPA/DHAOily fish
Salmon, sardines, mackerel, tuna, etc.Other animal products
Depends on animal's diet… grass-fed beef and pastured eggsSeaweed
Generally DHA onlyFortified foods
Milk, yogurt, cereals, etc.
Omega-3 Fats: RationaleStandard American Diet ("SAD") low in Omega-3
Evolved on diet with ≈ even omega-6:omega-3 (1:1)"Paleo-style diet" - Fish, grass-fed meat, vegetables, fruits, etc.Both omega-6 & omega-3 necessary
Linoleic acid (omega-6) an EFA Imbalance affects inflammatory cascade… especially if too much omega-6
Standard American Diet…20:1 omega-6:omega-3!
MUCH higher in many cases Recent changes… industrialization of food supply
Grain-fed beef, soybean oil, corn oil, etc.Thought to play role in auto-immune & inflammatory conditions
Omega-3 Fats: Favorable ResearchMore clinical research than any vitamins
All studies below RCT’s or reviews of RCT’s
Improved many auto-immune conditionsRheumatoid arthritis, Irritable Bowel Syndrome, asthma, etc.
2009 Cochrane Systematic Review, 2005 Nutrition, 2000 American Journal of Clinical Nutrition, 2000 European Respiratory Journal
Reduced blood pressure 2002 Journal of Hypertension
Lowers triglycerides 2009 Nutrition and Health
Decreased cardiovascular disease events and mortality 2006 American Journal of Clinical Nutrition, 2008 British Medical Journal,
2009 Clinical Cardiology, 2009 Annals of Internal Medicine
Omega-3 Fats: Favorable ResearchHelps treat depression
2009 & 2010 Journal of American College of Nutrition
Helps manage bipolar disorder 2009 European Journal of Clinical Nutrition
Prevention of psychotic disorder among high-risk 2010 Archives of General Psychiatry
Reduction in ADHD symptoms 2009 Journal of Attention Disorders
Decreased cognitive decline in older adults 2011 Journal of Nutrition, Aging, and Health
Omega-3 Fats: Unfavorable ResearchSome clinical trials found no benefit
ADHD 2001 Journal of Pediatrics
Cognitive performance2008 Neurology
Schizophrenia 2001 American Journal of Psychiatry
No clinical studies showing harmBut be aware of potential interaction with anticoagulants
Omega-3 Fats: RecommendationsConvincing evidence: recommend to most people
Not recommended for people on anticoagulant drugs Coumadin, etc. Omega-3 supplements can thin blood
Most important for people who…Don’t eat fatty, cold-water fish
Vegetarians/vegans… ALA poorly converted to EPA/DHA Flounder, catfish, etc. no omega-3
Have autoimmune or chronic inflammatory conditions Have high triglycerides or are at high risk for heart diseaseEat Standard American Diet
Omega-3 Fats: RecommendationsSupplement with ALA or DHA/EPA?
Flaxseed oil (ALA) vs. fish oil (EPA/DHA)
Fish oil superior to flaxseed oilALA conversion to EPA/DHA very poor!
Only 8 to 20% ALA converted to EPA/DHA 2008 Nutrition Reviews
Most omega-3 benefits from EPA/DHAKrill oil another good source of EPA/DHAIf vegetarian/vegan
Consider algae-based omega-3 supplement
Probiotics: OverviewProbiotics defined: World Health Organization
“Live micro-organisms… administered in adequate amounts, confer beneficial health effect on the host”
Probiotics can be bacteria or yeastsBacteria much more abundant… bigger role in healthPrimarily colonize or transiently act in gastrointestinal tract
Why are gut bacteria important?Over 100 trillion bacteria in gut
Ten times amount of cells in human body!500 different species of bacteria in gut
Critical role in metabolism and immune system
Probiotics: Important VarietiesThree classifications of probiotics
Genus – broadestSpecies – more specificStrain – most specific
Most probiotic supplements classified by genus & species only
LactobacillusOne of most common bacterial genera in gutConvert lactose & other sugars to lactic acid
Can help some with lactose intoleranceAcidic environment inhibits harmful bacteria
Over 100 speciesIndicated by L. _______Some of most important: L. acidophilus, L. casei, L. reuteri, L. brevis
Probiotics: Important VarietiesBifidobacterium
Another common bacterial genera in gutInhibit pathogenic bacteria
Competes for resources & produces lactic acid 29 species identified
Indicated by B. _______Some of most important: B. longum, B. breve, B. animalis
SaccharomycesCommon fungal genus in gut
Most yeast damage gut, e.g. Candida AlbicansSome species compete with pathogens
Indicated by S. _______S. Boulardii prevents/treats GI disorders
Probiotics: Dietary SourcesFermented foods
Component of most traditional diets
AsianMiso and natto
Fermented beans/grains… often soy L. acidophilus (miso) & B. natto (natto)
Kimchi Fermented cabbage, radishes, etc. L. kimchii
Kombucha Fermented tea S. cerevisiae
Probiotics: Dietary SourcesEuropean
Yogurt Fermented dairy
Cow, goat, sheep milk L. bulgaricus & Streptococcus thermophilus
Kefir Also fermented dairy More probiotic species than yogurt L. rhamnosus, B. longum, S. florentinus, etc.
Sauerkraut Fermented cabbage L. plantarum, L. mesenteroides, etc.
Probiotics: Dietary SourcesAfrican
Ogi Fermented grains… often corn L. brevis, L. acidophilus, etc.
Currently in United States…Primarily yogurtTraditional products available health food stores
Kefir, kimchi, kombucha, etc.
Probiotics: Supplement RationaleAmericans consume few fermented foods!
Commercial yogurt not optimal sourceOften high in sugar… feeds yeast & pathogensRelatively low bacterial count
100 million lactic acid bacteria per serving… 100 trillion bacteria in gut
Probiotics: Favorable ResearchMost clinical research of all dietary supplements
All clinical trials or reviews of clinical trialsMajor species listed for each outcome
Regulates bowel functionEffective against diarrhea… especially antibiotic-associated
L. rhamnosus GG, S. Boulardii, L. Bulgaricus and many others 2012 Journal of American Medical Association
Effective against constipation B. lactis, L. casei 2010 World Journal of Gastroenterology
Probiotics: Favorable ResearchEffective treatment for some Inflammatory Bowel Disease
Ulcerative Colitis B. Animalis, B. Breve, L. Acidophilus and combinations 2010 Proceedings of the Nutrition Society, 2010 Annals of Pharmacotherapy
Crohn’s Disease Evidence not as convincing… some success with L. Rhamnosus 2009 Current Pharmaceutical Design
Effective treatment for Irritable Bowel Syndrome L. Acidophilus, B. Breve, B. Bifidum, S. Boulardii and combinations 2010 Journal of Nutrition
Probiotics: Favorable ResearchEffective treatment for other autoimmune conditions
Eczema and allergic rhinitis L. Acidophilus, B. Lactis, L. Sakei 2010 American Journal of Clinical Dermatology, 2010 Pediatric Pulmonology
Improve immunity in healthy individuals Reduces risk of common cold
L. paracasei, L. plantarum, L. BulgaricusYounger adults
2010 European Journal of Nutrition Older adults
2010 British Journal of Nutrition
Probiotics: Unfavorable ResearchIneffective in some trials for certain conditions
Crohn’s Disease2008 Digestive Disease and Sciences
Pancreatitis (feeding tube)2008 Lancet
No evidence of harm from oral probiotic supplementationNot necessarily harmless… more research needed
Probiotics: RecommendationsRecommend to people eating Standard American Diet
Usually not necessary if consume variety of fermented foodsDon’t typically need to take on an ongoing basis
Cycle on and off occasionally... few times a year or specific situations
Most important for people who…HAVE BEEN ON ANTIBIOTICS!
Critical to replenish flora & prevent side-effects Have digestive problems and/or food intolerancesWill be travelling out of the country
Prevent diarrheal disordersHave an autoimmune conditionAre at high risk for infections
Especially useful during flu season
Probiotics: RecommendationsCore product: contains genus & species variety
Especially Lactobacillus & BifidobacteriumOccasionally rotate products for increased variety
Specific conditions: single-species okay S. boulardii, L. GG, etc. for diarrhea
Choose high potency productsAt least 5 billion colony forming units (CFU)≥ 10 billion preferable… especially after antibiotics
Many products contain over 100 billion CFURemember… 100 trillion bacteria in gut!
Probiotics: RecommendationsChoose refrigerated product during summer
Probiotics die if exposed to high temperaturesRefrigerating extends life & assures potency
Choose products that specify strainMost specify genus and species
Best products also specify strain!
Choose products supported by researchProbiotic supplements vary tremendously
Trust those supported by researchCompany can point to studies
Supplements to Avoid
Supplements to AvoidMost supplements safe… but some may pose risk
Especially products tainted with pharmaceuticalsThree classes of supplements most likely to be tainted
Weight-loss supplementsNot likely to be effective long-term
Cannot replace healthy diet & exercise habitsOften stimulant-based… contraindications?
Especially among overweightSome products tainted with sibutramine
Active ingredient in Reductil (withdrawn by FDA)Increases blood pressure, pulse, potential risk for CVD eventshttp://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsi
ngMedicineSafely/MedicationHealthFraud/ucm234592.htm
Supplements to AvoidSexual-enhancement supplements
Some products tainted with tadalafil or sildenafilActive ingredients in Cialis and ViagraCan interact with nitrates to cause low blood pressure http://www.fda.gov/Drugs/ResourcesForYou/Consumers/Buying
UsingMedicineSafely/MedicationHealthFraud/ucm234539.htm
Bodybuilding supplementsSome products tainted with anabolic steroids
Often marketed as containing “steroid-like” components Have caused liver or kidney problems http://www.fda.gov/Drugs/ResourcesForYou/Consumers/Buying
UsingMedicineSafely/MedicationHealthFraud/ucm234539.htm
Tainted products rare… but can pose health risk!
Supplement and Drug Interactions
Supplements and Drug InteractionsSt. John’s Wort and Antidepressants
Synergy: increased risk of serotonin syndrome
Red Yeast Rice and StatinsSynergy: increased risk of muscle & liver problems
Calcium/magnesium/zinc and AntibioticsReduced absorption: antibiotic may not work as well
Ginkgo Biloba and AnticoagulantsIncreased bleeding risk
Fish Oil and AnticoagulantsIncreased bleeding risk
Supplements for Special Situations
Supplements for Special SituationsCoenzyme Q10 for people on statins or beta-blockers
aka “CoQ10”
These medications deplete CoQ10Coenzyme Q10 supplementation recommended
2006 Annals of PharmacotherapyAlso good idea to take with Red Yeast Rice
Why is supplementing with CoQ10 important?Critical in muscle function… particularly heartReduces cardiovascular disease risk and blood pressure
2007 Nutrition Review & 2006 Journal of Cardiac FailureReduces statin-induced muscle myopathy
2007 American Journal of Cardiology
Supplements for Special SituationsVitamin B12 for people on stomach acid-blockers
Prilosec, Zantac, antacids, etc.
These medications deplete vitamin B12
Reduced stomach acid to absorb B12
Why is vitamin B12 important?Help metabolize protein, fat, and carbohydratesLow levels → fatigue, depression, neurological damageLow concentrations associated with Alzheimer’s disease
2010 NeurologySupplementation lowers homocysteine
2008 Proceedings of Nutrition SocietySupplementation reduces cognitive decline
2012 American Journal of Clinical Nutrition
Supplements for Special SituationsB-vitamins and zinc for vegetarians
Especially B12 for vegansVegetarian diets typically low in these nutrients
2002 American Journal of Clinical Nutrition
Folic acid for pregnant womenDeficiency can cause neural tube defectsSupplementation prevents neural tube defects
2009 Annals of Internal MedicineCan often be obtained in quality multivitamin
Evidence-Informed Supplementation for Specific Health Concerns
Popular Supplements: Joint HealthGlucosamine & Chondroitin
2006 New England Journal of Medicine
Methylsulfuromethane (MSM)2006 Osteoarthritis and Cartilage
Hyaluronic Acid2008 Nutrition Journal
Turmeric2006 Arthritis and Rheumatism
Ginger2001 Arthritis and Rheumatism
Popular Supplements: DigestionGeneral Digestive Support
Digestive EnzymesBroad-spectrum plant-based (preferable)Animal-based
Pancreatin2009 Alimentary Pharmacology & Therapeutics
Acid-reflux… tapering off acid-blocking medications
Deglycyrrhizinated Licorice (DGL)2001 Hospital Practice
Aloe VeraTypically juice
Popular Supplements: Immune SystemEchinacea
2006 Cochrane Database Systematic Review
Vitamin C 2010 Journal of International Medical Research
Vitamin D 2010 Nutrition
Zinc 2011 Cochrane Database Systematic Review
Probiotics 2006 Journal of Clinical Gastroenterology
Mushroom extracts 2012 Medicine and Sports Science
Popular Supplements: Heart HealthRed Yeast Rice
2010 American Journal of Cardiology
Fish Oil2009 Annals of Internal Medicine
Coenzyme Q102007 European Heart Journal
Vitamin D2009 Archives of Internal Medicine
Popular Supplements: Liver HealthMilk Thistle
2008 Annals of Hepatology
N-Acetyl Cysteine (NAC)2005 Clinical Therapeutics
S-Adenosyl Methionine (SAM-e)2007 Hepatology
Turmeric2009 Liver International
Popular Supplements: DepressionSt. John’s Wort
2008 Cochrane Database Systematic Review
Fish Oil2010 Journal of Clinical Psychiatry
S-Adenosyl methionine (SAM-e)2002 International Journal of Psychopharmacology
Popular Supplements: SleepMelatonin
2004 Journal of Clinical Endocrinology & Metabolism
Valerian Root2006 American Journal of Medicine
5-Hydroxytryptophan (5-HTP)2000 Alternative Medicine Review
Checklist: Informed Supplement Consumer□ No interactions with other drugs/supplement - Talk to healthcare professional and consult literature
□ No outrageous label claims - Especially weight loss, sexual, bodybuilding products
□ Carefully read all ingredients on label - Consider content, quality, source of ingredients
- Some forms of vitamins, minerals, etc. better than others - Look for strains on probiotics
Checklist: Informed Supplement Consumer□ Seek 3rd party verification certificate - Sign of commitment to product quality - NSF “Gold Standard” of product quality
□ Choose brands supported by peer-reviewed research - Ultimate sign of commitment to product quality! - Companies not required to conduct research…
provides consumers & healthcare professionals with evidence the supplement works
Thank You! Questions?
Contact information: [email protected]