Nutrition (Chapter 12) Dietary Supplements
What is the difference between the statements "calcium builds strong bones" and "calcium reduces the risk of osteoporosis"?
"Calcium builds strong bones" makes a claim that calcium affects the body's structure (bones). It is an acceptable structure/function claim. "Calcium reduces the risk of osteoporosis" is not an acceptable structure/function claim because it promises to prevent the disease of osteoporosis.
Structure/function claims are allowed on supplement labels but must be accompanied by what (which is not required on food labels?
"These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat or prevent any disease."
List foods rich in prebiotics:
-chicory -jerusalem artichokes -onion -garlic -leeks -wheat -barley -rye -oats -lentils -black beans kidney beans -soybeans -breastmilk
What are the most common reasons for taking supplements?
-promote or maintain health -improve energy -boost immune system
The 1994 FDA's Dietary Supplement and Education Act (DSHEA) requires that:
-supplements be safe -enadaltered -be properly labeled -be produced with good manufacturing practices -promoted with label information that is truthful
List foods rich in probiotics :
-yogurt with live cultures -buttermilk -kefir -cottage cheese -soy -tempeh -miso -sauerkraut -kimchi -breast milk (nonfermented)
Breastfed children and any child consuming less than ___qt/day of vitamin D fortified milk should receive a Vitamin D supplement.
1
What are the current FDA regulations on dietary substances?
1. Manufacturers must submit to the FDA info regarding the safety and efficacy of a dietary supplement containing a new dietary ingredient 2. The manufacturer needs only to demonstrate that the new dietary ingredient can "reasonably be expected to be safe" by providing some evidence of safety but not actually proving it 3. The FDA does not approve new dietary ingredients or supplements-- they are free to be marketed 75 days after submission to the FDA
What are the new proposed FDA regulations for dietary substances?
1. Safety must be established by a documented history of use at the same or higher dosage, frequency and duration of use 2. Lab or animal studies would be required for products marketed for consumption at higher than historical intakes 3. No human studies are required 4. The company is not obligated to report results showing adverse effects. They need only submit positive claims about the products safety.
What independent labs evaluate and set standards for dietary supplements and provide seals of quality that companies can display on their products?
1. United States Pharmacopeial Convention (USP) 2. NSF International 3. ConsumerLab.com (CL)
What are the benefits of probiotics?
1. improves the health of the mucosa in the gut 2. retrieves some energy from undigested carbohydrates 3. synthesizes Vitamin K, folate, and biotin 4. Displaces pathogenic (bad) bacteria 5. reduces carcinogen in the colon 6. enhances mineral absorption 7. promotes immune system health
Are dietary ingredients with or without daily values listed first?
1. name and amounts of dietary ingredients with daily values must be listed first 2. dietary ingredients without daily values next
The FDA requires that dietary supplement manufacturers list certain details about their products on product labels. he general information required on the package includes:
1. name of the product 2. the word "supplement" or a statement that the product is a supplement 3. the quantity of the package contents 4. name and location of the manufacturer, packer, or distributor 5. directions for use
In addition to the general information, a supplement must also have a supplement facts panel. What should it include?
1. serving size 2. amount of serving per serving size (weight) 3. percent of daily value (if known) 4. list of the products dietary ingredients 5. if it contains a botanical it must include the name of the plant or the common name from the Herbs of Commerce (2000 edition) 6. name of the plant or part that has been used 7. if it is a special blend- list all the ingredients in the blend in descending order by weight
Less than ______% take supplements on advice of or under supervision of a health care professional.
25%
What percentage of Americans use dietary supplements regularly?
64%
DSHEA requires that manufacturers notify the FDA ______ days before new dietary ingredients/products are introduced, and they must provide the agency with evidence that the supplement is "reasonably expected to be safe" at the labeled dosage. Unfortunately, it is common for supplement distributers and manufacturers to ignore this and other regulations.
75
More than ______% said it was important that they have access to supplements.
80%
What is the only source of Vitamin B 12?
Animal proteins and fortified foods
What are the two bacterial strains (probiotics) that are accepted as being health promoting?
Bifidobacterium sp Lactobacillus sp
...include any supplement that is derived from plants, and may include liquid extracts, oils, or herbs
Botanicals
What can high doses of some supplements cause?
Fatigue, diarrhea, hair loss, kidney stones, liver and nerve damage, and birth defects. They can lead to nutrient imbalances or interactions, reducing the absorption and utilization of other nutrients. And taking high doses of many minerals—as well as the fat-soluble vitamins A, D, and E—can be toxic. Even high doses of the water-soluble vitamin B6 are toxic, potentially causing permanent nerve damage.
What supplement should pregnant women or women who plan to become pregnant take to reduce the occurrence of neural tube defects?
Folic acid
What act expands some of FDA's authority with supplement manufacturers
Food Safety Modernization Act (FSMA)of 2011
What are examples of functional foods?
Functional foods include whole foods, like vegetables, berries, and fish; enriched grains; fortified juices and milks; and enhanced foods, such as sports bars and sports drinks designed to help you run longer or play sports harder.
What is a qualified health claim?
It is when the evidence linking a food, food component, or supplement to a reduced risk of a disease is emerging but not well enough established to meet the SSA standard for a true health claim. This is still allowed on products. Qualifying language is included to indicate that the evidence supporting the relationship is limited.
Nutrient absorption, utilization, and excretion can be affected by prescription or recreational drug use, therefor a ________ supplement may be warranted
MVM
Supplement vs. non-supplement users:
More likely to report very good or excellent health* Have lower BMIs Have health insurance Have higher educational and socio-economic level Use alcohol moderately Refrain from cigarette smoking Exercise more frequently than nonusers Are of Asian and non-Hispanic, white descent Most common supplement taken by Americans is a multivitamin or multimineral
What supplement is recommended for pregnant women who have anemia, are carrying multiple fetuses or consuming little to no protein?
Multivitamin/mineral MVM
The FDA must pre-approve health claims based on what?
Significant Scientific Agreement (SSA)
What herbal supplement may reduce the effectiveness of prescription drugs for heart disease, depression, seizures, certain cancers and oral contraceptives?
St. JOhn's
What is the best nutrition-based strategy for health?
To eat a wide variety of food
What should vegans supplement with?
Vitamin B12, calcium, iron and zinc
What supplements are recommended to those with dark skin?
Vitamin D because the pigments block UV light and decrease the synthesis of Vitamin D
Labels containing structure/function claims need to have what else?
a disclaimer
Why are Vitamin B12 and Vitamin D supplements recommended for adults over the age of 50?
because B12 absorption tends to decrease with age and older individuals synthesize less vitamin D when exposed to UV light
Iron can interfere with ___________ absorption.
calcium
a qualified health claim must have a ________________.
disclaimer
Food manufacturers may opt to add additional nutrients to food products to boost nutritional value and potential health benefits. These products fall under a class of foods called
functional foods
Although dietary ingredients found in supplements are federally regulated, ingredients and additives that were already in the food supply prior to when DSHEA went into effect on October 15, 1994, were grandfathered in as GRAS. What does this stand for?
generally recognized as safe
French maritime pine bark (Pycnogenol) is an antioxidant that helps to decrease hypertension, improve cardiovascular function but may cause mild dizziness, nausea and...
headaches
What type of claim describes a relationship between a dietary supplement ingredient and a reduced risk of a disease or condition.
health claim
a subset of botanicals
herbal supplements
Licorice root is used to protect the liver against damage and for its anti-ulcer benefits. What are the adverse effects of licorice root?
hypertension
Women who have heavy menstrual bleeding may benefit from what supplement?
iron
What is hawthorn used for?
its cardiovascular benefits
Black Cohosh is used to relieve menopausal symptoms but can cause injury to what organ?
liver
Senna is a laxative that can cause what when taken at excessively high doses?
liver failure
Fenugreek lowers blood glucose and improves insulin sensitivity but can cause diarrhea and....
low blood glucose
Beta-carotene and vitamin A supplement was increasing participants' risk of ________ cancer.
lung
St. Johns wort is used to treat what?
mild to moderate depression but can cause hypertension
Do supplement manufacturers have to list known adverse effects on their label?
no
Do supplement manufacturers have to list known adverse effects on their labels?
no
Does the FDA approve dietary supplements based on their effectiveness and safety?
no
Supplements must also include another ingredients panel. This lists what?
non-dietary components found in the products such as fillers, water, artificial colors, sweeteners, flavors, and processing aids such as binders, gelatin, and stabilizers.
Holy basil is used for its anti-inflammatory and anticarcinogenic effects. What are its adverse effects?
none
What is another name for functional foods
nutraceuticals
No laws establish or cap potency for any supplements, except ____________
potassium
What is garlic used for?
reduction of hypertension and its cardiovascular benefits-- side effects = decreased clotting
The FDA must pre-approve health claims based on what?
significant scientific agreement (SSA)
these claims may state that consuming a nutrient or dietary ingredient may improve general well-being
structure/function claims
What problems arise due to the FDA not regulating dietary substances rigorously?
supplements are sometimes sold contaminated with banned substances or prescription drugs.
"Dietary Supplement" is defined by
the 1994 Dietary Supplement Health and Education Act (DSHEA).
How do we know if supplements on the market are pure and of high quality?
the FDA does track reports of illness, injury, or reactions that might occur in consumers after taking supplements
Dietary supplements do not undergo the rigorous testing for effectiveness, interaction, or safety requirements that prescription and over-the-counter drugs do. The DSHEA dictates who responsible for ensuring the product is safe unaltered, produced with good manufacturing and properly and truthfully marketed?
the manufacturer
What does the FDA regulate in terms of dietary supplements?
they regulate the products and the ingredients found within them but under a different set of regulations
Taking Coumadin, ginkgo biloba, aspirin and vitamin E can each do what to the blood?
thin the blood - taking any of these together can increase internal bleeding
What is ginger used for?
to reduce nausea and vomitting
The Dietary Supplement Health and Education Act of 1994 authorized the establishment of the Office of Dietary Supplements (ODS) at the NIH. What is the mission of ODS?
to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, stimulating and supporting research, disseminating research results, and educating the public to foster an enhanced quality of life and health for the U.S. population
Is it common for manufacturers to ignore the FDA requirements and regulations?
yes
copper can interfere with the absorption of _______________.
zinc
