- The Washington Times - Monday, February 2, 2004

Amey St. Clair of Arlington had migraines for months. The headaches were so severe they were affecting her quality of life. When her nutritionist suggested taking magnesium for the problem, she decided she would try anything.

After regularly taking the mineral by mouth and soaking in baths of Epsom salts, which also contain magnesium, her pain has disappeared.

Although Ms. St. Clair, 41, knows some people might question whether the magnesium actually eliminated the pain, she believes vitamins and minerals play a strong role in allowing the body to heal itself. When she had flu-like symptoms a few months ago, she took high doses of vitamin C, instead of an antibiotic, and felt better.

“My aunt influenced our family to start taking vitamins,” she says. “I have a great-aunt who is 85 who has outlived her siblings who passed away in their 60s. She swears it’s because of vitamins that she’s been taking for about 30 years. She takes a daily multivitamin, calcium, niacin, vitamin C, vitamin D and vitamin E. She says this has kept her well.”

Although most nutritionists and doctors rely upon the standards in the Dietary Reference Intakes created by the National Academy of Sciences in Northwest, which outlines the amounts of vitamins and minerals essential for a healthy lifestyle, they have a hard time agreeing upon the full effects of the substances on the body. Some medical professionals believe dietary supplements simply end up excreted with the urine, while others believe the substances might prevent major health problems.

There also is disagreement about organic versus synthetic vitamins, says Ted O’Brien, a licensed nutritionist for George Washington University’s Center for Integrative Medicine in Northwest. He suggests buying supplements labeled as organic or food-based, rather than synthetic ones.

Food-based supplements, which are usually more expensive than synthetic ones, have bioactive ingredients extracted from foods believed to have health-promoting benefits. They are condensed to fit into tablet or capsule form, while synthetic supplements are made in the laboratory.

Experts debate whether organic vitamins actually work better than synthetic ones. Mr. O’Brien says there are many possible factors that influence vitamin and mineral absorption in the body. For instance, he says, the combination of other essential nutrients is important. Calcium will absorb much better in the presence of magnesium. Also, he says, the quality of the nutritional supplement affects its outcome on the body. Further, the function of the digestive system of the individual who is taking the supplements can alter the absorption rate.

“Vitamins are very safe,” Mr. O’Brien says. “Generally, a person should have a multivitamin with mineral supplements. One pill a day.”

If people have food allergies or lifestyle restrictions that inhibit them from eating properly, vitamins could significantly improve their health, says Dr. Ann Marie Gordon, a private internist with an office at the Washington Hospital Center in Northwest. For instance, if an individual is on a low-calorie diet, fewer than 1,200 calories a day, taking a multivitamin would be important.

“If you don’t eat the recommended five vegetables and three fruit a day, taking a multivitamin supplement would be reasonable,” she says. “We know sometimes the demands of family and work can preclude eating a balanced diet. … There is evidence that multivitamins may improve immune function and decrease risk for some infection.”

Since vegetarians eliminate meat from their diets, they may need to take additional vitamin B12, Dr. Gordon says. Also, women who are pregnant or breast-feeding always need more nutrients, such as folic acid and iron. And the elderly also could benefit from taking B6 or B12 because their bodies tend to have problems absorbing those vitamins.

If a person doesn’t spend at least 15 minutes in the sun a day, they should take calcium and vitamin D, says Dr. Gordon. Also, the absorption of vitamins and minerals is decreased in the bodies of persons who smoke or use tobacco, therefore, they should take supplements of vitamin B6, vitamin C, folic acid and niacin, she says.

Impaired digestion and absorption usually are problems for heavy drinkers. They should take thiamin, folic acid, vitamin A, vitamin D and vitamin B12 daily. Alcohol, which alters the metabolism, affects minerals in the body, such as zinc, selenium, magnesium and phosphorus.

“If you drink excessively, you may also substitute alcohol for food,” Dr. Gordon says. “This results in a diet that lacks nutrients.”

Some people don’t take any vitamins because they are concerned about overdosing on them, says Stephanie Dacko, a clinical dietitian at Georgetown University Hospital in Northwest. Although the total ramifications of supplements on the body are unknown, she believes unneeded water-soluble vitamins or minerals simply pass through the body in urine once the body has obtained the necessary nutrients.

However, she says fat-soluble vitamins, such as vitamin A, vitamin D, vitamin E and vitamin K, have the potential to be toxic, since they are stored in the body and can’t be excreted through urine. In general, she says persons should avoid megadoses and not exceed the Dietary Reference Intakes.

She says she is unsure whether vitamin E can prevent Alzheimer’s disease, as some medical professionals hope.

“Some people think it can help protect the cells from the damage that results from the aging process and maintain brain function,” she says. “Others think there’s no benefit at all.”

The debate about the influences of supplements isn’t a black or white issue, says Rebecca Costello, deputy director of the office of dietary supplements at the National Institutes of Health in Bethesda.

In fact, the way in which supplements are regulated through the Food and Drug Administration is different than prescription medicines. Whereas prescription medicines have pre-market evaluation, supplements are monitored after they come on the market.

“It’s a very young science,” she says. “We’re learning. It’s one thing to study vitamins in an isolated system. When we put them in the human body, and they interact with multiple targets, then, the picture becomes a little bit more confusing.”

When researchers started to study nutrients about 100 years ago, Mrs. Costello says they focused on deficiency diseases. People were becoming ill because of a lack of a certain vitamin or mineral. For instance, in the early 1900s, medical professionals discovered rickets, a disease of the skeletal system, is caused by a lack of vitamin D.

“We’re more focused now on preventing disease,” she says. “We’re spending a lot of money evaluating how the nutrients work … and how they play a role in chronic disease prevention.”

Where to find them:

Vitamins

Vitamin A: Fish liver oils, carrots, parsley, spinach, collards, cantaloupe

Vitamin B1: Brewer’s yeast, rye and whole-wheat flour, beans, seeds, brown rice

Vitamin B2: Almonds, brewer’s yeast, cheese, chicken, organ meats, wheat germ

Vitamin B3: Beef liver, brewer’s yeast, white-meat chicken, sunflower seeds, meats

Vitamin B9: Whole grains, lentils, oranges, whole wheat, green leafy vegetables

Vitamin B12: Beef, dairy products, seafood, not found in vegetables

Vitamin C: Many fruits and vegetables

Vitamin D: Fortified milk, some seafoods

Vitamin E: Vegetable oils, nuts, green leafy vegetables

Vitamin H: Whole grains, nuts, meats, lentils, brewer’s yeast, tuna, chocolate

Vitamin K: Spinach, green tea, cabbage, turnip greens, brussels sprouts, alfalfa, soybeans, cheddar cheese, oats, cauliflower

Minerals

Calcium: Dairy products, green vegetables, dried legumes

Chromium: Brewer’s yeast, chicken, dairy products, seafood, fresh fruit, potatoes with skin, whole grains

Cobalt: Organ and muscle meats, milk

Copper: Lentils, wheat germ, blackstrap molasses, some nuts, mushrooms, honey

Iodine: Seafood, iodized salt

Iron: Liver, meat, eggs, legumes, whole grains, green leafy vegetables

Magnesium: Beans, nuts, whole grains, leafy green vegetables

Manganese: Avocados, beans, oatmeal, nuts, buckwheat

Phosphorus: Meat, dairy products, beans, peas, cereals, poultry, grains

Potassium: Avocados, bananas, apricots, potatoes, and many other foods

Selenium: Seafood, meat, grains

Zinc: Widely distributed in food, especially pumpkin and sunflower seeds

More information:

For the Dietary Reference Intakes log onto:

www.iom.edu/file.

Source: Ted O’Brien, licensed nutritionist for George Washington University’s Center for Integrative Medicine

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