Last week chocolate was good for you and red wine was not so good. This week red wine is good for you and chocolate is only good in moderation. There is a lot of conflicting information out there about what foods, vitamins, and dietary supplements are good for us.
More and more, it is up to consumers of every age to self-educate on these matters, which is no easy task.
“It’s best to get nutrients from diet first before determining if you need dietary supplements,” said Carol Haggans, Scientific and Health Communications Consultant in the Office of Dietary Supplements at the National Institutes of Health (www.nih.gov).
Which Vitamin is for You?
The doctor of the futureThat said, Ms. Haggans cautions that there are a few nutrients that our bodies need but that don’t get absorbed—especially as we age-- and therefore we may need to take supplements:
- Vitamin B12. “Vitamin B12 is only available in animal products so any vegetarians at any age and vegans need to supplement,” she said. “People over fifty have trouble absorbing B12 from food, even if they are eating enough.” Ms. Haggans said that vitamin B12 might be available in fortified cereals as well as animal products. There is no risk in getting too much vitamin B12, Ms. Haggans said, but there is a recommended amount depending on the individual. “It is not considered toxic at any dose,” she said.
- Vitamin D and calcium. “The need for vitamin D and calcium increases with age,” said Ms. Haggans, noting that fortified milk and fatty fish are sources for these. The exact amount of calcium needed depends on age and gender, however it is possible to get too much and develop kidney stones, she said. “While we can make vitamin D from sun exposure, a lot of older people don’t get out in the sun very much or they wear protective clothing,” explained Ms. Haggans.
- Iron. “Pre-menopausal women need more iron,” said Ms. Haggans. “Post-menopausal women can risk taking too much iron.” To avoid possible toxicity with taking iron, Ms. Haggans recommends that people check the label of any multivitamins to verify the amount of iron, if any, that is included.
The Office of Dietary Supplements at the National Institutes of Health provides an online alphabetical list of dietary supplement fact sheets at http://ods.od.nih.gov/factsheets/list-all/, and additional information can be found at http://ods.od.nih.gov/HealthInformation/DS_WhatYouNeedToKnow.aspx.
See our article this month on new research that shows a positive effect of vitamin E in people with Alzheimer’s disease.
Duff MacKay, N.D., Vice President of Scientific & Regulatory Affairs at The Council for Responsible Nutrition, a trade association for dietary supplements (www.crnusa.org), recommends that elderly people concerned about taking vitamins and dietary supplements consult their doctors as well as primary caregivers. “The elderly tend to be on more medications and have more potential for interactions,” he said. “It’s important they talk and are open with their clinician and pharmacist about what they are taking.”
Mr. MacKay noted that not all interactions between vitamins and dietary supplements with medications were negative. “Calcium is a large molecule that can compete with others for absorption into the blood,” he said.
Before taking dietary supplements, the U.S. Food & Drug Administration offers some food for thought on their website, http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ucm110493.htm:
- “Dietary supplements are intended to supplement the diet, not to cure, prevent, or treat diseases or replace the variety of foods important to a healthful diet.
- Supplements can help you meet daily requirements for certain nutrients, but when you combine drugs and foods, too much of some nutrients can also cause problems.
- Many factors play a role in deciding if a supplement is right for you, including possible drug interactions and side effects.
- Do not self-diagnose any health condition. Together, you and your healthcare team can make the best decision for optimal health.”
There are a lot of dietary supplements marketed to senior citizens, Ms. Haggans conceded, and it is up to them to be wary and make informed decisions about what they should take.
“There are a lot of products marketed to elderly people that falsely claim to reduce disease risk, like cancer, heart disease,” she said. “These are red flags because dietary supplements are not cures or treatments. Seniors sometimes fall prey to that more so than others when they have concern over chronic disease.”
In short, she said, “If it sounds too good to be true, it probably is.”
The bottom line is that vitamins and dietary supplements are not meant to be substitutes for medications. “With a doctor’s advice, people should take supplements to fill in a nutrient gap,” said Ms. Haggans.