Food vs. Supplements

Calcium food sources

Dairy products, fish (e.g., salmon and sardines), and dark, leafy greens.

Vitamin B food sources

Lean beef, turkey, tuna, sunflower seeds, spinach and otherleafy greens, eggs

Iron food sources

Liver, oysters, lean beef, chickpeas, beans, lentils, and sesame seeds

Vitamin D food sources

Salmon, tuna, lean beef, vitamin D-fortified milk and yogurt,fortified orange juice, egg yolk

Magnesium food sources

Spinach, kale, and other leafy green vegetables; unrefined grains;and legumes

supplements

•A product taken orally that contains one or more ingredients (e.g., vitamins or amino acids) intended to supplement one's diet and not considered food. •Come in a variety of forms -- tablets, capsules, gummies, and powders, as well as drinks and energy bars. •Examples: ⁃vitamins D and B12; ⁃minerals like calcium and iron; ⁃herbs such as echinacea and garlic; and ⁃products like glucosamine, probiotics, and fish oils.

Food?

•Any nutritious substance that people or animals eat or drink or that plants absorb in order to maintain life and growth. •Composition of food: ⁃Macronutrients - carbohydrates, protein, fats, and. `` water ⁃Micronutrients - vitamins and minerals ⁃Phytonutrients -- chemicals produced by plants that have antioxidant and anti-inflammatory benefits. •Dietary Guidelines for Americans state that nutritional needs should be met primarily through food. These guidelines further state, for some people supplements might be a useful way to get nutrients they might otherwise lack.

safety alerts

•Being sold does not mean a supplement is safe or effective. •Food and Drug Administration (FDA) maintains a list of dietary supplements that are under regulatory review or that have been reported to cause adverse effects. If taking a supplement, check the FDA website periodically for updates. •FDA does not regulate or oversee vitamin and supplement content or claims to the same degree as it does prescription medications. •Report serious reaction or illness through the Safety Reporting Portal website.

structure function claims (examples)

•Builds strong bones •Defends your health •Promotes relaxation •Slows aging •Improves memory •Guards against colds •Boosts the immune system •Lifts your spirits •Supports your health

supplement labels

•DSHEA and other federal regulations require the following information to appear on dietary supplement labels: ⁃a statement of identity that contains the words "dietary supplement." The word "dietary" may be replaced by the name of the dietary ingredient (e.g., "ginseng supplement") ⁃net quantity of contents (e.g., 60 capsules) ⁃nutrition information (i.e., Supplement Facts panel) including the product serving size, the amount, and percent daily value, if established, of each dietary ingredient ⁃If contains a proprietary blend, the net weight of the blend as well as a listing of each ingredient in descending order of weight must be identified. ⁃Part of the plant used, if an herb or botanical

Supplement Regulations

•Dietary Supplement Health and Education Act of 1994 (DSHEA) defines and regulates dietary supplements. •Supplements are regulated by the FDA for Good Manufacturing Practices under 21 CFR Part 111. •Must be labeled as a dietary supplement and be intended for ingestion and must not be represented for use as conventional food or as a sole item of a meal or of the diet.

who needs supplements contd...

•Dietary supplements may also be appropriate if: ⁃Do not eat well or consume fewer calories than needed. ⁃Are a vegan or a vegetarian who eats a limited variety of foods. ⁃Follow any other type of diet that restricts an entire category of foods ⁃Do not eat 2-3 servings/week seafood, which supplies omega-3 fatty acids for heart health. ⁃Have limited milk intake due to lactose intolerance or milk allergy, or do not consume enough dairy foods. ⁃Have heavy bleeding during menstrual cycle. ⁃Have a medical condition that affects how body absorbs or uses nutrients (e.g., chronic diarrhea, food allergies, food intolerance, or liver disease, gallbladder, intestines or pancreas). ⁃Have had surgery on digestive tract and are not able to properly digest and absorb nutrients.

evidence about supplements

•Evidence about the benefits of multivitamins is mixed. ⁃Multivitamins were associated with a small reduction in the risk of cancer and cataracts in men but did not reduce deaths from heart disease. ⁃A study published in The Journal of Nutrition (2015) reported a multivitamin with minerals lowered the risk of death from heart disease in women, but not in men. ⁃A review published in Annals of Internal Medicine (2013) found that multivitamins showed no benefit in preventing early death. •Because these and other findings conflict, the U.S. Preventive Services Task Force does not support vitamin and mineral supplements to ward off disease.

My Plate

•Four sections of plate: ⁃30% grains, ⁃40% vegetables, ⁃10% fruits, and ⁃20% protein, along with a glass of milk or a yogurt cup. •Additional My Plate recommendations: ⁃Make half your plate fruits and vegetables. ⁃Switch to 1% or skim milk. ⁃Make at least half your grains whole. ⁃Vary your protein food choices. ⁃The guidelines also recommend portion control while still enjoying food, as well as reductions in sodium and sugar intakes.

Why eat food?

•Fresh food has nutrients necessary for good health (e.g., magnesium, calcium, and vitamins A and C). •The typical American diet is heavy in nutrient-poor processed foods, refined grains, and added sugars—all linked to inflammation and chronic disease. •Even if eat a healthy, well-balanced diet, one might still fall short of needed nutrients.

Who needs supplements?

•If healthy and eat foods from all five food groups, do not need supplements. •Supplements (or fortified foods) might be appropriate for some: ⁃Women who may become pregnant -- 400 µg/day folic acid from fortified foods or supplements; also eat foods that naturally contain folate. ⁃Pregnant women -- take a prenatal vitamin that includes iron or a separate iron supplement. ⁃Adults >50 -- eat foods fortified with vitamin B-12, such as fortified cereals, or take a multivitamin that contains B-12 or a separate B-12 supplement. -Adults>65 -- take 800 international units of vitamin D daily to reduce fall risk.

first step is to improve ones diet!

•Improve diet before use supplements because nutrients are most potent when they come from food. •Food also has many nonessential but beneficial nutrients (e.g., hundreds of carotenoids, flavonoids, and antioxidants) not available in supplements.•Food is often less expensive than supplements.

Common deficiencies

•Minerals ⁃Iron -- large component of red blood cells; binds with hemoglobin and transports oxygen to cells. ⁃Iodine - essential for normal thyroid function and production of thyroid hormones ⁃Calcium -- mineralizes bones and teeth, especially during times of rapid growth and important for bone maintenance. ⁃Magnesium - essential for bone and teeth structure; also involved in more than 300 enzyme reactions. •Vitamins ⁃Vitamin D -- functions like a steroid hormone in your body. ⁃Vitamin B12 (or cobalamin) -- essential for blood formation, as well as brain and nerve function. ⁃Vitamin A -- helps form and maintain healthy skin, teeth, bones, and cell membranes. Furthermore, it produces eye pigments, which are necessary for vision.

why eat food contd

•Supplements do not substitute for food. They cannot replicate all the nutrients and benefits of whole foods, such as fruits and vegetables. Whole foods offer three main benefits over dietary supplements: ⁃Greater nutrition. Whole foods are complex, containing a variety of nutrients the body needs. ⁃Essential fiber. Whole foods, such as whole grains, fruits, vegetables and legumes, provide dietary fiber. As part of a healthy diet, fiber can help prevent certain diseases, such as type 2 diabetes and heart disease, and it can also help manage constipation. ⁃Protective substances. Many whole foods are also good sources of antioxidants — substances that slow down a natural process leading to cell and tissue damage. It isn't clear that antioxidant supplements offer the same benefits as antioxidants in food.

choosing and using supplements

•Talk to your doctor. Supplements can be harmful if taken in certain combinations with certain prescription medications or before surgery or other medical procedures. •Check the label. Product labels can tell you what the active ingredient or ingredients are, which nutrients are included, the serving size, and the amount of nutrients in each serving. •Watch what you eat. Vitamins and minerals are added to many foods, including breakfast cereals and beverages. •Avoid megadoses. Taking more than the recommended daily values (DVs) can increase risk for side effects. Children are especially vulnerable to overdoses of vitamins and minerals. •Most water soluble. Excess of what body needs will generally be passed in the urine so will not cause a dangerous buildup in the urine. However, Vitamins A, D, E are fat soluble so can build up in the system.

claims

•Three categories of claims defined by statute and/or FDA regulations: ⁃health claims -- describe a relationship between a food substance (a food, food component, or dietary supplement ingredient) and reduced risk of a disease or health-related condition. ⁃nutrient content claims -- permits the use of label claims that characterize the level of a nutrient in a food if authorized by FDA and are made in accordance with FDA's authorizing regulations. ⁃structure/function claims -- describe the role of a nutrient or dietary ingredient intended to affect the normal structure or function of the human body, for example, "calcium builds strong bones."

downsides of supplements

•Water-soluble vitamins readily excreted from the body, while fat-soluble vitamins be stored in tissues. Fat-soluble vitamins are more likely to cause toxicity. ⁃An excess of vitamin A is harmful to everyone but particularly for pregnant women. Symptoms include hair loss, dizziness, nausea, headaches, coma, and even death. ⁃Excessive iron can be damaging to the gastrointestinal system. Symptoms include nausea, vomiting, diarrhea and stomach pain. Over time, iron can accumulate in the organs, and cause fatal damage to the liver or brain. •Can interfere with some medicines and even make you ill.

supplement labeling contd...

⁃the name and place of business of the manufacturer, packer, or distributor ⁃complete list of ingredients by their common or usual names, either in descending order of prominence or with the source of the dietary ingredient in the "Supplement Facts" panel following the name of the dietary ingredient (for example, calcium (from calcium carbonate) ⁃safety information that is considered "material" to the consequences that may result from the use of the supplement ⁃the disclaimer "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease" if the supplement bears a claim to affect the structure or function of the body (structure/function claim), a claim of general well-being, or a claim of a benefit related to a classical nutrient deficiency disease. •Manufacturers may add additional information on labels (e.g., claims and statements of quality assurance) and may decide on the placement of that information.