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Supplements / Vitamins: why are they Important?By: Tim Wargo, M.D.
In this day and age, with high ( though not necessarily unusual) levels of stress, in an environment of packaged foods, and production which often depletes them of nutritional value, and an industry that leads to rapid depletion of our soil resources, it is important to be looking at a good program for supplementation of your diet. That being said, good sources of food are always important. Yes, organic is better in the long run, because the exposure to toxins is bound to be less. Yes, runoff from other farmers could be an issue. However, if someone is making an honest effort to reduce toxins in the food chain, it makes sense to eat better sources of food. The bottom line for me is always the realization that I can spend a ton of money on supplements and drugs, but if I do not eat well, then I am always behind the curve in staying healthy. Fresh fruits and vegetables are at the top of my list for obtaining vitamins and minerals, and trace elements. Unfortunately for various reasons fresh is often not available.
As a substitute, more people have become dependent on convenient rather than fresh or healthy sources. Foods in this category are more likely to be processed with higher amounts of simple sugars and preservatives. More people are going out to eat and therefore ingesting food which is often not healthy. All of these factors lead to problems in our health. At the end of the ingesting cycle are our tissues- cells, which function better when all of the building blocks are in place.
A healthy diet provides all of the essential building blocks- for repair and to prevent damage. Damage control is next to impossible when these pieces are missing, or if some of the pieces provided also cause damage. Interest in nutrition is showing us that diets high in simple sugars actually lead to more damage through inflammation- (a common denominator in all degenerative diseases). Although some inflammation can be helpful, too much is not healthy. All of these factors make nutrition a life long process- a challenge.
However, even in the best of circumstances, not all elements may be present in the foods found on your shelf. Taking selenium as an example, it has become more common to see this missing from our soils. Meat and fish are better for you when raised organically, and in a non-stress environment. It makes sense that if we are stressed in crowded quarters, that animals will also be stressed. In fact fish and chickens raised in open range/water environments have higher levels of omega-three essential fatty acids- a vital part of the healthy balance of essential oils. Omega-threes have been shown to be an important element in reducing inflammation and free radicals from our bodies. On the other hand, animals- fish- raised in crowded environments have higher omega-sixes. These have been shown to be pro-inflammatory, and therefore contribute to chronic disease states, and deterioration of our health, as well as faster aging. It is always difficult to decide in these cases which if any of these foods are better for us. The food chain to health is always very complex, considering the variety of foods we ingest, as well as our own genes which make us more or less prone to certain illnesses. Some products have gone to great lengths to determine the nature of this risk- using gene analysis, and other tools to sort them out. Information can also be gathered from family demographics and history of illness. At best these can only lead to generalizations, unless specific analysis is done of our genes. Ultimately genetic testing will be available to help sort this out, but current methods are still costly. In the interim I recommend five areas for optimization of nutrition:
- Water… water… water: ½ body weight in ounces/ day. That is free water- not soda or juices. Avoid high amounts of caffeine as it is a diuretic and robs body of calcium and water. Avoid high sugar drinks as well.
- A multivitamin- naturally made as much as possible…. Anything from a lab is suspect, unless it involves the processing of natural foods. Any process which burns, denatures, cooks, or otherwise alters these products is suspect. Some will optimize the product, or concentrate it. It is a complex process, and should help- not hinder the body. Lab manufactured products- or synthetic vitamins- go through the body with limited absorption and are a waste of money- even if “cheap”.
- Omega-three agents: wild fish and or flax preferred. Beware of toxins- in fish, or meat; for this reason smaller fish are better. Flax seed needs to be ground. Oil is available, but does not have the benefit of the fiber removed in the process. It is also more expensive, and has a shorter shelf life. Some people do not absorb the benefits of the seed as well as other sources of omega agents.
- Acidophilus is vital to function of the intestines. It facilitates the absorption of water, minerals, and trace elements. It helps the intestines to rid itself of pathologic organisms, including yeast, and bacteria which may frustrate the detoxification of substances. Probiotics and live organisms are preferable to dead forms. Many people cannot tolerate yogurt, and the culture often does not contain the necessary strains for optimal health.
- Calcium and Magnesium in an absorbable form is essential for bone, muscle, and brain health. Hydroxyapatite or citrate is preferable to carbonate. Lesser amounts can be used in these forms, and they are less likely to lead to reduction of vital stomach acid and formation of stones. A minimum of 500 mg/day of each is important for men and women. Optimal absorption of calcium is achieved with vitamin D. 500 IU. /day, especially in the Northeast.
- Other basics in form of zinc, copper and selenium can be found in multivitamins.
These are the basic requirements. In terms of product names- without naming them, I can say that not all are alike. I look at companies which have a large research arm for their products, and which are reliable with their sources- looking for evidence for toxins, and other agents which may lead to problems. There are a number of good references for minimum standards, and the key is bioavailability ( how well is it absorbed, and utilized). Unfortunately due to current technologies, it is not possible to get everything in one pill- some things just do not mix well- or cancel other elements affectivity.
7. Other agents may become more essential with certain conditions or deficiencies. Some examples of these for the pain and inflammation of arthritis are: glucosamine with joint pains- up to 1500 mg/day in divided doses for most people. This can be taken alone or in combination with chondroitin, as well as manganese ascorbate can be more efficacious. Additionally Niacinamide (vitamin B3) in doses of up to 3grams/day have been beneficial for arthritis, but runs the risk of causing flushing and or liver toxicity and should be monitored for these affects.
8. Lastly, another supplement is CO-q10- a coenzyme found in most meat and seafood products. It can also be manufactured from soy and beet products. It was first identified in 1957, and has extensive use in Russia, Europe, and Japan. Most of the products now used originate from Japan where it has been studied extensively for its cardiovascular benefits. It was approved there for use in congestive heart failure in 1974. It was originally suspected to be particularly important for those on statin drugs for cholesterol (lipitor-prevachol.), but the clinical significance of this problem is not yet clear. It also has use in the treatment of hypertension, possibly congestive heart failure, as well as breast cancer, and increasing exercise tolerance in chronic fatigue and other neurological disorders, such as Parkinson’s Disease, and Muscular Dystrophy. Research is also underway for its use in acute heart attack therapy, as well as angina, and prevention of recurrent heart attacks. Again, the form of this is important, especially since it is a very unstable compound, and very expensive in the better sources of this product. Doses up to 100 mg /day have been tolerated with minimal side affects. Be careful in the use of this with other agents for hypertension and diabetes as it may have an additive affect on these agents.
As always, I would advise of how important it is to be aware of any interactions with other agents – especially OTC (over the counter) drugs and medicines. I would advise consulting with your primary care physician, who all seem to be more and more open to a discussion of alternatives to health. There are also many reliable people in the nutrition field around who can help you as well. Be Well.
Dr. Tim Wargo’s practice is built around Integrative Medicine. He is a physician at Mad River Internal Medicine, Waitsfield, VT.
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