Tuesday, March 10, 2009

Food vs. Supplements and Real Advice vs. Fake Advice


Note: This post is participating in an "RD Blogfest" in honor of National Registered Dietitian Day (March 11)

I read many online articles, forums, message boards, Q & A, and the like. Too often, I am frustrated by what I read by bloggers, parents, and journalists about nutrition. I have seen blanket advice to supplement kids' diets with unnecessary vitamins and supplements; advice for pregnant moms to take 2 regular vitamins instead of one prenatal vitamin; and advice to breastfeeding moms to take unsafe amounts of herbs to increase their breast milk. I could go on and on. The running theme is that the advice usually doesn't hold water. Much of the advice on the internet is not grounded in research, but rather folklore, feeding nonsensical nutrition advice that will forever be ingrained on the world wide web.

I am bothered when people advise others to take vitamin supplements or herbs without taking into account their diet or health status. It's important to see the whole picture. And I am really bothered when the reason that poor advice is given is that someone is trying to sell you something or increase their Google search hits.

Food vs. Supplements:
Here is a Registered Dietitian's review of some good journalistic articles from February and March 2009 explaining in simple language the results of of some recent research about vitamin supplements. I hope I can convince you to focus on food rather than supplements, and to seek out advice from qualified health professionals.
  • A research study showing that kids who don't need vitamins are usually the one who take them anyway. The article states that the AAP does not recommend supplements for most kids over the age of 1.
  • Dr. Sanjay Gupta's view on vitamins supplements emphasizing that there is no research proving supplements help make you healthier.
  • Postmenopausal women saw no health effect from multivitamin in a recent study.

  • This article questions the safety of nanoparticles in vitamins and the lack of oversight by the FDA.

  • Multivitamins don't help prevent cancer or heart disease in this study.

  • Prenatal vitamins don't contain the amount of iodine they claim to contain according to this report .

  • Too much supplemental vitamin E might cause heart defects according to a recent study .

  • A good review explaining how some anti-oxidants can act as pro-oxidants if taken in supplemental form.

The RD recommendation:

Get your vitamins, minerals, and phytochemicals in their natural form from food, not pills, unless you can't (eg: health reason or food restrictions). If you think you might need to supplement your diet, ask a Registered Dietitian to help you.

Here are links to other bloggers participating in RD Blogfest:

Annette Colby- No More Diets! A Registered Dietitian Shares 9 Secrets to Real and Lasting Weight Loss

Ashley Colpaart - Dietitians working in food policy, a new frontier

Diana Dyer - There and Back Again: Celebration of National Dietitian Day 2009

Marjorie Geiser - RD Showcase for National Registered Dietitian Day - What we do

Cheryl Harris - Me, a Gluten Free RD!

Marilyn Jess - National Registered Dietitian Day--RD Blogfest

Julie Lanford - Antioxidants for Cancer Prevention

Renata Mangrum - What I'm doing as I grow up...

Liz Marr - Fruits and Veggies for Registered Dietian Day: Two Poems

Meal Makeover Moms' Kitchen - Family Nutrition ... It's our "Beat"

Jill Nussinow - The Registered Dietitian Lens I Look Through

Wendy Jo Petersen - March 11 is our day to shine!

Diane Preves - Registered Dietitians and the White House Forum on Health Reform

Andy Sarjahani - Dr. Seuss Tribute continued: Green Eggs and Ham and a Sustainable Food System

Rebecca Scritchfield - Big Tips from a "Big Loser"

Anthony Sepe - RD Showcase: Registered Dietitian Day, March 11, 2009

Kathy Shattler - RD Showcase for Nutri-Care Consultation

UNL-Extension, Douglas/Sarpy County - Nutrition Know How - Making Your Life Easier

Monika Woolsey - Dietitians--Can't Do PCOS Without Them!

Monika Woolsey - In Honor of National Registered Dietitian Day

Jen Zingaro - My life as a Registered Dietitian

34 comments:

  1. Happy RD Day, fellow blogfest blogger--
    Anthony Sepe
    http://fromadietitiansperspective.blogspot.com

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  2. Hi. I came here from the link on Renata's blog Nurturing Notes. What about non-vitamin supplements like probiotics, or digestive enzymes?

    -Alan

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  3. Hi Alan,

    There is certainly a place for vitamins and non-vitamin supplements in the world. However, one should always consult with someone before taking them. Some reasons why someone might consider taking these non-vitamin supplements: you are lacking digestive enzymes and you have had a GI workup confirming this, you cannot get probiotics from food (i.e. yogurt, kefir, vegetables pickled with probiotics), or you have a medical condition that requires taking a lot of probiotics (i.e. antibiotic use, diarrhea, some types of reflux, etc...).

    I am more concerned about digestive enzymes than I am about probiotic use. If someone wants to take a probiotic supplement once in a while, it is usually okay. However, taking digestive enzymes for too long may suppress your natural digestive enzymes. I would instead recommend foods that have digestive enzymes such as pineapple or papaya.

    Lastly, the people who prescribe them (i.e. chiropractors, nutritionists, etc..) usually have a large stake in your purchase so take the recommendation with a 'grain of salt'. These are not FDA-regulated products!

    Hope that helps to clarify things!

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  4. Wishing you a Happy National Registered Dietitian's Day!

    I loved your post supporting natural food and natural digestive enzymes. I too am a believer in working with our bodies to support health and energy, instead of doing things to them.

    Thanks for providing the science and research links!

    With joy,
    Annette Colby, PhD, RD
    www.AnnetteColby.com

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  5. Hi fellow National RD Day blogger! I am wondering what you think of omega-3 supplementation? If you don't eat seafood -- and a lot of people certainly don't, I see this particular nutrient as a challenge. Thoughts?

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  6. Great question Liz!
    The two supplements that I am actually most likely to recommend are omega-3 fatty acids and vitamin D.

    Omega 3 fatty acids would be for someone who does not eat 12 ounces/week, and most pregnant women.

    I also recommend having your 25(OH)D levels tested and supplementing with vitamin D if the result is below 50 ng/ml. This is especially true for pregnant and nursing women. However, since vitamin D is a fat soluble vitamin, one should never take it without getting their blood levels tested and under guidance.

    There are many other examples of possibly necessary supplements: iodine for people with thyroid problems, B12 for vegans, Calcium/Magnesium for people who do not foods high in calcium. I could go on and on. But the underlying point is that without guidance, people may end up taking all of the above based on information they read online and in magazines and that could be potentially dangerous.

    To summarize from both of my comments: There is certainly a time and place for different types of dietary supplements but supplements should only be taken after a thorough assessment of diet, health, and possibly lab values.

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  7. Continued:
    I would like to point out that in both of these questions, the comments indicated that a supplement was better than food version or that it could be a required supplement. The first step that a registered dietitian would take would be to a) figure out if it was needed in their diet and b) Figure out how the patient can incorporate the foods into his/her diet. If the latter cannot be done, a supplement may be recommended.

    However, with vitamin D (which is not really a vitamin but a hormone the body makes from the sun) it is difficult to obtain from foods and almost impossible to get from the sun during winter months in northern latitudes. Therefore, if vitamin D levels are truly low the only way to bring them up would be to supplement, buy a UV light, or go on vacation to Florida!

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  8. Thanks for your vision with this blogfest, Renata! I am inspired by the fact that you organized it all AND had time to write great posts for your own blog!

    Monika

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  9. Wishing you all a good day and a good month.

    I have to weigh in on the "use supplements" side, since I often work with clients with malabsorption issues like IBS, crohn's, diarrhea. These people often, based on MRT testing, need to restrict their diets due to food sensitivities. So, then supplements are a good thing.

    I've also spent many years working with elderly persons that aren't eating adequate foods and/or calories with increased needs so for them, vitamins/minerals may make the difference between living independently and ending up in a nursing home. So, as Renata says, it is an INDIVIDUAL issue. Some people will be harmed by to much/many supplements!

    Jan Patenaude
    JanP at nowleap.com

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  10. This isn't my blog, but I wish it were :-)
    That's why we had the blogfest!

    Debra,

    This is a great article and some great feedback for us all. Thanks for sharing your expertise with all of us.

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  11. Thank you Jan! Yes, as stated, certainly people with specific health conditions may need supplements. That is why a thorough assessment is required for people with Crohn's and other diseases.

    However, since MRT testing measure delayed immune reponse, some people may cut out food that they can actually eat without any problems. After cutting out the food for a certain period, a food challenge test can help you figure out if it a true allergy. It would be so sad for someone to cut out a food and try to replace certain components of it with supplements if they don't need to. As we know, whole foods contain more than just vitamins and minerals. There are allergists and alternative practitioners that can help people de-sensitize themselves to foods if that is a true issue.

    Also, as Renata just said, this is not Renata's blog. My name is Debra but I chose not state my full name on the blog just yet. you can read more about me on the upper right-hand side of the main blog page.

    Renata's blog can be found at www.nuturingnotes.blogspot.com

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  12. Great post Debra! I have so many friends who are pregnant, planning, or just had a baby! I'll definitely share!! Happy RD Day!

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  13. Great blog post and follow-up comments! Happy RD Day. :-)

    Diana Dyer, MS, RD
    www.CancerRD.com
    www.dianadyer.blogspot.com
    www.365DaysofKale.blogspot.com

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  15. This proves only one thing- be careful who you listen to when taking multivitamins, food supplements or other nutritional substances.

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  18. I swear there are some people out there that thing we're at that age where you can just take a little pill and it's a three course meal. Maybe supplements can help if you're not getting a full diet, but it's not substitute long term. The biggest joke of all is probably Vitamin C supplementation. Vitamin C is in everything! Yet some people still feel like they need a pill to get 800% of their daily recommended dose.

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  20. Now you can find fake food in hypermarkets.

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  21. In My opinion on the topic, natural supplements can be much helpful than other synthetic ones who are claiming to be natural, I suggest before taking any supplements, please read the labels first. Good Luck for the RD BlogFest

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  22. Hi, Great Site, Vitamin supplements are a large part of having good health. We need water, sleep, exercise, a healthy diet love and prayer are some of the essentials of good health and well-being.

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  23. Nice Post...thanks for sharing this informative blog...

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  24. A friend told me that he does take supplements instead of eating food so that he gets the nutrients and not the calories.

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