Supplementation 101

Written by Dr. L. Lee Coyne

Responsible supplementation is no longer an option, it is a necessity if your objective is optimal health.

A joint committee of US and Canadian scientists through the U.S. National Academies, an independent, non-governmental body, publishes on a regular basis, a table of Dietary Reference Intakes (DRIs) values. These tables help guide us to appropriate levels for fat and protein intake along with many of the known or recognized vitamins and minerals. (Notice - there is no DRI for carbohydrates).

Many health advisers try to tell their clients that they only need a “well balanced” diet to meet these recommendations.

However if you do some careful arithmetic you will find the task very difficult. Then if you read Dr. Shari Leiberman’s book “The Real Vitamin and Mineral Book” in which she uses a term “Optimal Daily Intake” (ODI), you will find the task even more difficult. The ODI is based on the latest research and reflects what our industrialized world has done to the air, water and food; in terms of quality and pollutants. This column will be in defense of the dogmatic opening statement “supplementation is no longer an option, it is a necessity”.

Nutritional supplementation is one of the fastest growing industries in North America. Estimates of size range from $15 to $18 billion annually, compared to just $3 billion in 1990. Globally, the market for sports nutrition products (excluding sport beverages) is estimated at US$4.7 billion (Euromonitor, April 2010). Weekend sports enthusiasts and lifestyle users are using sports nutrition products.

Like all rapidly growing industries, the market place can become a consumer’s night mare with a myriad of choices, a range of quality and some over zealous misleading marketing claims.

Herbal products were relatively unregulated, but that changed in Canada when the Natural Health Products (NHP) Regulations came into effect in 2004. Most herbal products are now classified as natural health products and need to be licensed with a Natural Product Number (NPN) on the label (not a DIN), just like vitamin and mineral supplements.

Vitamin and mineral supplements were transferred from the Therapeutic Products Directorate (TPD) to the Natural Health Products Directorate (NHPD) for management when the new NHP Regulations were approved and the NHPD was created. The NHPD is now the Natural and Nonprescription Health Products Directorate (NNHPD) as they have taken on the registration of low-risk drug products like sunscreens, medicated skin creams, etc.

Under the NNHPD Regulations, higher therapeutic dosages of vitamins and minerals are now allowed, unlike in the days when vitamins and minerals were considered to be non-prescription drugs and had fairly low upper daily dosages. The NNHPD recognizes that higher levels of some vitamins and minerals are safe and effective.

Food products do not require registration provided they meet the Canadian Food and Drug Regulations and are properly labelled. Products that meet the definition of a natural health product but are in food-like formats (such as bars and shakes) are handled by the Food Directorate now.
 
Finally, most of the harmful natural products have dropped off the Canadian market because the manufacturers could not supply Health Canada with adequate safety and efficacy data to get them licensed as NNHPDs or consumers complained enough about them to get them taken off the shelf by compliance officers from the Health Products and Food Branch Inspectorate (HPFBI).

But the market place is still a “consumer beware” environment.

Why Supplement?

1. In the early 1900’s, all produce (100%) was organic. Rutgers University has published several papers comparing the nutrient density of organic produce and commercially grown produce. Organic always wins.
2. According to a US Department of Agriculture paper the average Calories intake in the early 1900’s was 3800 Calories but today the average intake is only 1800 Calories. Less than half -  and most is not organic. So we tend to eat less than half the nutrients each and every day.
3. Risk of “free radical” damage is much higher today as the industrial world contaminates our food, water and air. We also produce free radicals during physical and psychological stress. Free radicals are biochemical units that, in excess, will destroy healthy cells unless we protect ourselves with adequate nutrition.
4. With average fat intake falling to 32% of Calories (compared to 48% in 1900), it becomes more difficult to get the essential fatty acids (EFA’s) from our diet. EFA’s are responsible for encouraging fat metabolism and the creation of some “super hormones” that lead to the production of anti-inflammatory hormones. Processed food tends to alter or eliminate the EFA’s.
5. Wide use of antibiotics has lead to the destruction of “friendly bacteria” in the intestine. Friendly bacteria, like acidophilus and bifidus play a big role in digestion and in maintaining the health of the colon.
6. A low Calorie intake is associated with a reduced fiber intake. The American Cancer Society recommends a daily fiber intake of 30 grams but average North American eats only 12 – 15 grams per day. Such a low intake increases the risk of colon cancer and other toxic side effects.
7. Most people do not consume enough complete, high quality protein, particularly at breakfast and lunch. (There is a tendency to eat more protein than can be absorbed during the evening meal). Therefore I have become a big fan of Soy Protein Isolate supplementation at breakfast, lunch, during snacks and just before exercise. A modern solution to a modern problem.

What to Use

In my nutritional coaching practice, I divide supplementation into the following categories:

1. Nutritional Supplements – basic nutrients found in the DRI tables.
2. Herbal Supplements - which are really nature’s medicine, designed to prevent and/or solve certain health problems. Few are designed for long term consumption.
3. Fiber Supplements – fibre is indigestible but necessary for detoxification and regularity. It is not really a nutrient.
4. Protein Supplements – self-explanatory.
5. Friendly Bacteria – some now refer to these tiny organisms as “probiotics”.

Considering the Why Supplement list and the above categories, the following is a responsible supplement program that would benefit the heath of all people. This is basic, minimal and designed primarily for prevention of ailments and maintenance of good health.

1. High Quality Multiple Vitamin/Mineral. Should include all 8 recognized B vitamins including biotin. Balanced in proportion to the RNI. This multi-vitamin should also contain high levels of Calcium and Magnesium.
2. Anti-Oxidants – Vitamin in the form of mixed carotenoids like alpha, beta and gamma carotene; Vitamin C, at least 1,000 mg in a sustained release format; Vitamin E in the mixed tocopherol format supported with selenium and grape seed extract.
3. Fiber Supplement containing a mixture of soluble and insoluble fibres.
4. Protein Supplement – preferably a Soy Protein isolate - not only to obtain extra protein but to also take advantage of the phytonutrients known as isoflavones.
5. Friendly bacteria – acidophilus and bifidus .

Other Considerations

Responsible nutrition consultants may recommend other supplements for therapeutic reasons. The key word is “responsible”. Their recommendations will include the use of products from reputable companies. The best products are from companies that conduct true, publishable clinical research. They would be proud of such research and be prepared to share it with you upon request.

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