The vitamins and minerals are in the news again, with all this being related to their addition to sports drinks, water and juices. Scientists suggests that consumers might be ingesting higher than necessary (and sometimes potentially harmful) amounts. When consumed in excess, water-soluble vitamins like B and C are in the urine, but fat soluble-vitamins including A, D, E and K, accumulate in tissues, posing potential risks. Some people (for example, pregnant or lactating women) will require additional vitamins and minerals, but for the majority of the population, these nutrients should be primarily acquired through daily diet. This discussion extends to antioxidants and the lack of information on the long-term supplementation effects. Scientists state that it is impossible to consume too much from foods but the exposure through supplementation may be too great. How do you counsel your patients about healthy diet and vitamin/mineral/antioxidant rich foods? For those who require supplementation, what are your typical recommendations?
In a recent national dietary survey published in the Journal of the Academy of Nutrition and Dietetics, researchers analyzed the diets of over 7,000 children and adolescents between 2 to 18 years old. Nutrient content of each food and supplement consumed in each child’s diet was calculated and compared to the Estimated Average Requirements (EAR). The results found that boys and girls between the ages 2 to 8 had the lowest levels of inadequate nutrient intake while girls between the ages 14 to 18 had the highest levels of inadequacy. Vitamin D, thiamin, and folate in fortified foods were the highest contributors of at least half of the nutrient intake. Other nutrients that contributed to at least 12 to 18 percent of the intake were vitamin A, vitamin C, riboflavin, niacin, B-6, B-12, iron, and zinc. Calcium was among the lowest at 4.5 to 6.6 percent. Despite the increased nutrients in fortified foods, a significant percentage of children did not meet the EAR for their age and sex. What are your recommendations to your patients for maintaining a healthy diet?
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In an 11 week trial recently published in The Journal of Physiology, researchers at the Norwegian School of Sport Sciences in Oslo assessed the effect vitamin C and E have on exercise endurance. 54 participants received either 1,000 mg of vitamin C plus 235 mg of vitamin E or placebo and they exercised up to four times a week. Researchers found no difference in performance between the two groups. However, those who took vitamin C and E seemed to produce less of a specific mitochondrial marker in their muscle cells, which suggests of a decrease endurance. What are your thoughts about this study? What are your typical recommendations to patients looking to enhance their exercise endurance?
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A recent randaomized, double-blinded, placebo-controlled trial published in JAMA evaluated the effect of long-term daily multivitamin supplmentation and the risk of cancer in 14,641 older men. During this 14-year study, researchers found that men who took a daily multivitamin had a small decrease in risk for cancer compared to those that had placebo. Do you have any experience using or recommending food-based multivitamins?
For more information, please read the article in JAMA.
A double-blinded, placebo-controlled trial recently published in the Journal of the National Cancer Institute evaluated the use of folic acid, vitamin B6, and vitamin B12 in 1,470 women, who were part of a larger study, and the risk of colorectal adenoma. Researchers concluded that women who took 2.5 mg of folic acid, 50 mg of vitamin B6, and 1 mg of vitamin B12 showed no decreased risk of colorectal adenoma compared to placebo. What counseling points do you generally provide to patients taking these supplements?
For more information, please read the abstract in the Journal of the National Cancer Institute.