Nutrient Supplementation: Who needs it? Flashcards
Nutraceuticals
Nutrition science term for foods that naturally contain chemicals that are beneficial to health.
Prevent or treat disease.
Improve physiologic function.
Ie. tomatoes (lycopene), soy (isoflavones), carrots and peppers (carotenoids), and fish oils, flax seeds, leafy greens (omega 3 fatty acids)
Phytochemical’s
Plant (biological activity)
Polyphenols are a large group of flavonoid subgroup.
No established DRIs.
Carotenoids in red, orange, yellow, and green plants.
Flavonoids in berries, apples, citrus, onions, soybeans, and coffee.
Anthocyanins in berries and red wine.
Resveratrol in red win, grapes, dark chocolate, and peanuts.
Proanthocyanidins and flavanols in grapes, apples, cocoa, and red wine.
Sulfides and thiols in onions, garlic, leeks, olives, and scallions.
Functional Foods
Natural or formulated food that enhances physiologic function or prevents/treats disease beyond the traditional nutrient benefit.
Natural include green tea, dark chocolate, garlic and onions, broccoli and cabbage, soybeans and nuts, strawberries, blueberries, and olive oil.
Formulated include benecol, take control, fortified cereal, fortified orange juice, sports drinks.
Fortified Foods
Formulated food that enhances physiologic function or prevents/treats disease beyond the traditional nutrient benefit.
Supplements
A product taken by mouth that contains a dietary ingredient intended to supplement the diet.
FDA supplements.
Most popular supplements include multivitamins, vitamin D, vitamin C.
Dietary Supplements Health and Education Act 1994
Categorized supplements as food, not drugs.
Lead to reduced regulation…
-no FDA approval before marketing
-companies are responsible for safety
-companies do not have to provide safety info for FDA
-No guidelines on practices for purity, quality, safety, or composition.
-No limits to serving sizes or amount of nutrient in supplement
-once marketed, FDA must provide its unsafe before removing
Natural Health Products (Health Canada)
A plant or plant material, an alga, a bacterium, a fungus, or non-human animal material.
As extract or isolate of the above.
Any of the following: biotin, niacin, pantothenic acid, riboflavin, thiamin, vitamin A, vitamin B6, vitamin B12, vitamin C, D, and E.
An amino acid.
An essential FA (omega 3 and 6).
A synthetic duplicate of an amino acid or essential fatty acid.
A mineral.
A probiotic.
Definition of Natural Health Products
Includes herbal remedies, homeopathic medicine, traditional medicines.
Usually sold in capsule, pill, liquid, or bulk without prescription.
One degree for medicinal reasons vs thirst, nourishments, or hunger.
Natural Health Products Regulation
Regulated under Canada’s food and drug act which means products with a natural product number have the quality and safety standards that are the same as drugs.
Standards for…
-product and site licensing
-reporting of adverse reactions
-manufacturing practices
-clinical trials involving humans
-labeling and packaging
-ensures that we can readily obtain NHPs that are known to be safe, effective, and high quality
Not enough oversight and significant industry influence.
Big Supp
Continues to reject providing information for consumers.
Evidence mounts against supplement.
Consumer report investigations.
Tainted Drugs
Most of the nearly 800 dietary supplements flagged by the FDA as tainted with potentially harmful drugs from 2007-2016 were marketed to improved sex drive, help with weight loss or build muscle.
Idea of buy or beware.
But some people do need to take supplements.
Supplement Ingredients Associated with Illness and Injury
Must be aware of excessive amounts of certain supplements can be harmful.
Ie. vitamin A in excess consumption associated with birth defects
Also need to understand that some populations need them still so we must educated ourselves before prescribing them.
What about advertising?
Federal advertising regulations requires that label claims must be truthful and not misleading, and claims must be substantiated.
Hallmarks of Quackery
Foreign or exotic origin.
Fast (short-term), unrealistic results.
No need for healthy behaviours or effort.
Unsubstantial claims.
Suspicious titles/schools.
How to protect yourself from fraudulent or dangerous supplements…
1) Find a drug, naturpathic information number of establish that standards for purity, strength, quality, packaging, labeling, and storage have been followed.
2) By recognized brands.
3) Natural doe snot mean safe.
4) Don’t be afraid to contact company and ask questions.
5) Find out for yourself through health and nutrition websites.
8 Questions from a Critical Consumer
1) How many studies?
2) What were the study designs?
3) Who was studied? How many participants?
4) What measures were used?
5) How was the treatment administered?
6) What was the study duration? Was there a follow-up?
7) How does this compare to previous research?
8) Who funded this study?
What about the web?
1) What is the purpose of the site? Commercial or educational
2) Does it contain accurate information? Testimonials vs science
3) Does it provide reputable references? Peer-reviewed, recognized
4) Who owns or sponsors the site? Full disclosure, conflict of interest
5) Who wrote the info? RD, PhD, MD or MSc
6) Is the information current and updated? Contact information
Supplements as Ergogenic Aids
Ergo = work
Genic = producing
Products used with the intent of improving exercise performance by improving the production of energy.
Some ergogenic aids are legal, other banned by athletic organization and/or legal systems.
Counselling Clients on Use of Ergogenic Aids
Identify what products are used, when, and why.
Identify client’s knowledge of the product(s).
Evaluate client’s diet (can goals be met by lifestyle change).
Accept benign practices and educate if product is potentially harmful.
Research before speaking
-many client’s will have up to date information before you do.
SOAP Checklist
Helps professionals make evidence-based recommendations and consider the client’s needs.
Supports effective communication with the client.
Subjective, Objective, Assessment, and Plan.
SOAP is a cyclical process.
Subjective Data on Supplements
What claims are made, who is making them?
Motivation behind the claim?
Where is it marketed?
Who is marketed to?
Where did client get information?
Objective Data on Supplement
Is the supplement viewed as safe?
What is known of the efficacy of the supplement?
What is the mechanism by which the active compound works?
What is the recommended dose for the product?
Is there harm at any intake level?
Does the company follow safety/purity manufacturing guidelines?
Assessment of Supplement
Summarize validity of product claims.
Assess risk/benefit ratio for current client.
Review specific product brand, formulation, etc.
Plan for action with Client
Define timeline for use.
Monitor client’s response to supplement.
-side effects
-positive outcomes
Document pros and cons of supplement use.
Remember that the client is the gatekeeper.
