Dr Dulcy gives health advice

FACTS: WHAT TO THINK ABOUT BEFORE YOU START AUGMENTING YOUR NUTRIENT INTAKE

It’s a good idea to speak to your healthcare provider before taking anything.

Most dietary supplements are safe, and some of them offer actual health benefits, but there can be some risk with their use.

Dietary supplements are products designed to augment your daily intake of nutrients, usually the vitamins and minerals. Other substances also fall into this category: botanical (herbal) products, amino acids, essential fatty acids and oils, enzymes, probiotics and animal organ and glandular extracts are all sold as dietary supplements.

Dietary supplements are regulated to some extent but not as strictly as medications. In South Africa, for example, the Food and Drug Administration (FDA) doesn’t require proof that dietary supplements are safe or effective before they are sold. Some products are advertised to have health benefits but have no clinical trials demonstrating safety or effectiveness.

While dietary supplement use is considered to be generally safe, there are some things to think about if you're taking dietary supplements. Always speak with your health care provider if you are:

Taking any medications, as some dietary supplements may have unwanted interactions.

Planning surgery, because some supplements can affect bleeding or response to anaesthesia.

Pregnant or nursing, since some supplements can affect the baby.

Thinking about taking a dietary supplement in place of medical treatment.

BENEFITS

Normally, you should be able to get all the nutrients you need from a balanced diet.

However, taking supplements can provide additional nutrients when your diet is lacking or when certain health conditions cause you to develop an insufficiency or deficiency. In most cases, multivitamin supplements provide all the basic micronutrients – vitamins and minerals – your body needs. These multiple vitamins are generally safe because they contain only small amounts of the each nutrient. Individual nutrients can also be sold as dietary supplements, but usually in larger amounts than what's found in a typical multiple vitamin. They may be used to treat a deficiency, such as iron, but sometimes they’re used therapeutically to treat specific health conditions or risk factors. For example, large doses of niacin may be used to raise good cholesterol and folic acid has been used to reduce the risk of a birth defect called spina bifida. Scientific research supports some of the benefits of using many dietary supplements for certain health conditions but in many more cases, the effectiveness has not been backed up by the research evidence.

The National Institute of Health Office of Dietary Supplements has dietary supplement fact sheets that assess the evidence for and against the therapeutic use of a large number of dietary supplements.

Dietary supplements can be useful for some kids in some circumstances, but it’s always best to speak to your paediatrician before starting your child on any new dietary supplements. Kids who eat balanced diets shouldn’t need to take supplements, but children who are extremely picky eaters have certain health conditions or have to follow restricted diets might be at risk of some deficiencies. In these cases, dietary supplements can be beneficial.

RISKS

In South Africa, dietary supplements are not regulated as strictly as drugs; manufacturers do not have to prove that their use is either safe or effective.

Standardisation of supplements is optional, although they are prohibited from selling unsafe products. The Food and Drug Administration maintains a list of tainted products that are marketed as dietary supplements.

The worst offenders are usually weight loss aids, “natural” sexual enhancement pills and supplements targeted at bodybuilders. Dietary supplement manufacturers do have to follow some rules regarding labelling and the claims that can be made about the supplements. The claim can be made that a dietary supplement addresses a nutritional deficiency, supports health, or reduces the risk for a particular health problem when there is enough evidence to support that claim.

Most dietary supplements are safe as long as you follow the label instructions, but large doses of certain nutrients can have strong biological effects on the body. While that may be beneficial in some cases, there are times when taking large doses of individual supplements can be dangerous. For example, the fat-soluble vitamins A and D can build up to toxic levels in your body when taken in large doses over extended periods of time. Vitamin B-6 is a water-soluble vitamin, so your body doesn’t store it as efficiently as a fat-soluble vitamin, but prolonged use of vitamin B-6 in large amounts can cause nerve damage. Large doses of vitamin C may cause diarrhoea.

Mineral supplements can also be dangerous. For example, both selenium and iron supplements can be toxic in large amounts. Some dietary supplements can interact with over-the-counter or prescription medications, or even with each other, and some supplements should be avoided before undergoing surgery.

Ask your health care provider about supplements before taking anything.

SOME COMMON SUPPLEMENTS VITAMINS AND MINERALS

Vitamins, minerals and other micronutrients are needed in small amounts for good health. Without them, diseases such as scurvy will develop (vitamin C). Some of the effects of vitamin and mineral deficiency have been known for hundreds of years and the amounts needed to prevent deficiency are given as the recommended daily allowance (RDA), formerly the minimum daily requirement. The current consensus is that a proper diet provides all the micronutrients that most people need. In recent times, supplementing the diet with vitamins and minerals has shifted from trying to prevent deficiencies to taking higher amounts of them in an effort to supposedly enhance health. Overdoses of vitamin A and D can occur and lead to health problems. Both are fat-soluble vitamins – as is vitamin – and can build up in the body over time. For vitamin E and selenium, a recent trial found a 17% increase in the risk of developing prostate cancer in men who took 400 units of vitamin E daily, and no protection against developing prostate cancer from selenium. Taking calcium and vitamin D can help prevent osteoporosis and broken bones in older women. However, this benefit may be cancelled out by an increased risk of heart attack and stroke. OMEGA 3

To get adequate omega 3 from diet, it is recommended that everyone eats fish – particularly fatty, cold water fish – at least twice a week. Salmon, mackerel, herring, sardines, lake trout and tuna are especially high in omega-3 fatty acids. Omega 3 fatty acids are essential nutrients that are important in preventing and managing heart disease. Omega 3 fatty acids play important roles in brain function, normal growth and development and inflammation. Deficiencies have been linked to a variety of health problems, including cardiovascular disease, some cancers, mood disorders, arthritis, and more.

But that doesn’t mean taking high doses translates to better health and disease prevention. Findings show omega 3 fatty acids may help to: Lower blood pressure. Reduce triglycerides. Slow the development of plaque in the arteries.

Reduce the chance of abnormal heart rhythm.

Reduce the likelihood of heart attack and stroke.

Lessen the chance of sudden cardiac death in people with heart disease.

But we cannot ignore that for the second time in two years, researchers have found a link between high levels of omega 3 fats in the blood and prostate cancer. PROTEIN These are very popular for gym goers. Everyone has their preferred protein for before training or after training.

Whey is the most commonly used, because it's a water-soluble milk protein. It is a complete protein and contains all nine of the amino acids necessary for human dietary needs. In very specific circumstances, protein powders can be useful. They’re an easy and convenient source of complete, high-quality protein. The problem is it doesn't take that much protein to achieve the muscle and body goals most trainers want. Most people already get about 15% of their daily calories in protein.

To build a 0.45kg of muscle the body needs between 10 and 14 additional grams of protein per day and some of these powders have 80 grams of protein per serving. You don’t need that. All your body is going to do is break it down for energy. And too much protein can be hard on your kidneys and your liver. It also can contribute to dehydration. To avoid those risks make sure you get your protein from high protein foods in your daily diet FOLIC ACID Folate (vitamin B9) is an essential nutrient found green, leafy vegetables, broccoli, peas, corn, oranges, grains, cereals, and meats. Folate has important roles in the synthesis of DNA and, consequently, cell division. Significant folate deficiency can lead to macrocytic anaemia.

Folic acid, a synthetic form of folate, is used in multivitamin supplements because it is better absorbed. Folic acid’s benefits in pregnancy are well documented. Supplementation before conception, and in the first few weeks of pregnancy, significantly and substantially lowers the risk of several different birth defects.