Vexation Over Vitamins – Part II
By Dr. Mike Dostrow
Last week, I examined the recent controversial studies in the Annals of internal Medicine in which the authors emphatically conclude that we should” stop wasting money on vitamins” and “ enough is enough”. I presented an alternate point of view and promoted the use of a multi-vitamin, multi-mineral to “fill in the gaps” of our often insufficient nutrient intake. Yet with the vast quantities of supplement choices available it is difficult to make an informed decision. This weeks article will attempt to shed some light on this.
In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA), which categorizes supplements as foods, not drugs. Because they are not treated as drugs, the supplement manufacturers have little or no oversight regarding claims made about their products. So when a product claims to “cure cancer “ or “make your eyes greener” one should view this with a jaundiced eye.
The Food and Drug Administration (FDA) can, however, take action against any unsafe supplements after they are on the shelves. In 2007, the FDA started the Current Good Manufacturing Practices. This created oversight to ensure the ”consistency, identity, purity, strength and composition of dietary supplements.” Nevertheless, many supplements still contain little or none of what they claim and many contain substances which have undergone no real scientific scrutiny.
The amount of vitamins and minerals a person requires varies with age, sex, pregnancy and lactation. It is expressed as a Daily Value (DV), which is established by the Federal Government based on studies by nutritional scientists. Many of these values were derived from studies done in the late ‘60s and some nutritional experts cast doubt on their accuracy. They are, however, a good reference point and can be accessed through the National Institutes of Health, Office of Dietary Supplements website. As I mentioned last week, try to avoid mega doses of any supplement and choose products that at least approximate the daily values of the substances they contain.
Many authorities on supplements claim that synthetic vitamins are inferior because they are not well absorbed and can even be deleterious to health. So finding a supplement which claims to be” natural”, “organic” or “whole-food based” may be better than the alternative. Silena Mandich, owner of Sierra Sundance Whole Foods told me that” It is my belief that the quality and the bioavailability of vitamins and supplements is the most important factor when choosing a supplement product. Unnatural supplements (i.e. Centrum) can contain harmful additives and binders such as coal tars, artificial coloring, preservatives, sugars and starches.” She also recommends food-based supplements which “provide vitamins and nutrients which are naturally in a form that our bodies recognize and are able to absorb.”
Although manufacturers of supplements are not required to undergo thorough and often expensive scrutiny of their products, I believe the ones that do are often superior in quality. Organizations which offer this quality testing include: NSF International, ConsumerLab.com and U.S.Pharmacopeia. Look for these names on labels of products to make better decisions regarding supplement choices.
Deciding which supplement to choose is a complex and often confusing process. Perhaps some of the points raised can assist in negotiating the slurry of supplements available. It would be an arduous task to review all the factors which need to be considered in choosing the correct supplement and would result in an article of some length, certainly it is beyond the scope of this brief overview. Multiple websites exist to help make an informed decision. Here are a few of my favorites: www.acsm.org, nih.gov, www.drweil.com, consumerlab.com and www.hsph.harvard.edu. Silena Mandich at Sierra Sundance Whole Foods is also a valuable resource.
You can contact Mike Dostrow at docmpd@yahoo.com.
