Vitamins, Minerals, & Other Dietary Supplements

Question 1

Dietary Supplement Health & Education Act (DSHEA)

Answer 1

-bars FDA from regulating dietary supplements unless the manufacturer makes an overt claim to treat disease
-manufacturers make claims based on “structure and function” of supplements that may cross this line (first admin right)
-dietary supplements: vitamins, minerals, herbs, or amino acids wo use of tx needed

Question 2

DSHEA

Answer 2

-manufacturer determines efficacy, safety, dose, formulation, purity
-FDA interferes if product found to be unsafe after market
-USP (United States Pharmacopeia) and NSF (national Sanitation Foundation) stamps indicate quality control in manufacturing

Question 3

Vitamins & combo supplements

Answer 3

-best obtained from balanced diet like Mediterranean, DASH, increase fruits & veggies
-no consensus that this confers any clear health benefit; may cause harm
-considered for those at risk of dietary deficiencies such as poor dietary absorption w chronic illnesses on certain meds or on restricted diets
-postmeno women should add vitamin D (600-800IUs) w calcium to reduce bone loss
-vitamin C supplementation has been suggested to reduce all-cause mortality in breast ca

Question 4

Calcium

Answer 4

-most women have insufficient dietary intake or absorption (avg 600 mg/d)
-taken w vitamin D may reduce bone loss & incidence of hip fx
-dietary reference intake 1,000 mg/d for women </=50yo and 1,200 mg/d for women >51

Question 5

Iron

Answer 5

-may be relevant for women who have heavy menses during perimeno or have other health issues

Question 6

Magnesium

Answer 6

-deficiency is common
-unclear clinical significance but may contribute to bone loss
-best obtained through food sources

Question 7

Zinc

Answer 7

-women who have a plant-based diet or who have conditions that cause chronic diarrhea may benefit from supplementation

Question 8

Chromium & other minerals

Answer 8

-role of supplementation for other minerals unclear
-may be beneficial for those with dietary restrictions or poor diets

Question 9

Coenzyme Q10

Answer 9

-studies show benefits in women w CVD or HF
-not really recommended by AHA or ACC

Question 10

Fish oil, omega-3, & omega-6 fatty acids

Answer 10

-helpful in a variety of diseases
-studies are inconsistent & inconclusive
-may incr bleeding risk

Question 11

Glucosamine & chondroitin

Answer 11

-decrease joint pain especially in those w moderate/severe pain
-dosing glucosamine 500mg TID or 1500mg/day; chondroitin 400mg/d

Question 12

SAM-e (S-adenosyl-L-methionine)

Answer 12

-effective for depression but not evidence is low quality

Question 13

Melatonin

Answer 13

-widely used for sleep support
-effects when studied are inconsistent