Vitamin Boost
Whether walking down the aisles of a pharmacy, health food store or supermarket, consumers today are bombarded with options for dietary supplements.
From vitamins and minerals we may lack in our day-to-day diets to herbal extracts used for prevention, choosing the right combination of dietary aids is more complex than A, B and C.
With the wide variety of supplements available to the everyday consumer, opinions on nutritional needs and aids also vary.
As a registered dietitian, Gretchen Cararie has studied how the body uses nutrients, whether they come from diet or another form.Cararie shares her wealth of information through nutrition classes at Butler County Community College and La Roche College and through clients she sees through the Visiting Nurses Association.For many consumers, however, the assistance of a registered dietician is financially prohibitive."Dietitian services are usually not paid for by insurance," said Cararie, noting most people don't interact with a dietitian until warranted by a health condition such as diabetes.Consultations with a dietitian can cost $75 or more per hour."If you're just the average person who wants information about good eating, that makes it difficult," she said.Without readily available guidance, Cararie worries that consumers make decisions about diet and dietary supplements based on less reliable studies."I found this little study, done by the American Dietetic Association in 2002, asking people where they go for nutrition information. Seventy-two percent of the people said they go to the TV (for information)," Cararie said.Doctors were at the lowest end of the chart and dietitians were not cited as resources among those interviewed, she added.Though a one-on-one consultation may be out of reach, Cararie said reliable information is available in books, on the Internet or on television, provided people pay attention to the sources."As long as you're looking at the credentials of who's talking, then you can get some good information that way."Cararie's personal credentials include the title of registered dietitian, the credential of the American Dietetic Association, and licensed dietitian/nutritionist, the credential of the Pennsylvania Dietetic Association.She cautions consumers that the title "nutritionist" is not indicative of any certification, though the term is often used interchangeably with dietitian."That leads to a lot of confusion," said Cararie. "They need to look for an RD or an LDN."Before purchasing a variety of supplements to solve health problems, Cararie recommends requesting blood tests to look for any deficiencies."There's a basic statement in most nutrition books that says vitamins and minerals only cure diseases caused by deficiencies."You can't cure heart disease, for example, by taking a bunch of other supplements."Cararie also recommends researching the recommended daily allowance of nutrients based on age, sex and weight. Information is available through federal food and health agencies and at www.health.gov/dietaryguidelines.She added that the site www.MyPyramid.gov allows users to track their diets and exercise, helping consumers decipher where their deficiencies lie.
As a traditional naturopath, Lisa Kellerman has studied massage therapy, nutrition and herbology.The owner of Lisa's Natural Path herb and wellness shop in Butler Township, Kellerman advises her clients to take a variety of dietary supplements to enhance their well being, but not before consulting with a professional.For those who are able to pay, Kellerman offers health evaluations for a fee.The evaluations include a diet and lifestyle questionnaire, nutrition education and a health test kit, which clients use to report levels of metabolism, stress, blood sugar and Candida, a yeast that can lead to infections."If they can afford a whole health evaluation, that's the way to go."While the tests can help determine what products she will recommend to her clients, Kellerman said those who cannot afford the consultation should still take a few supplements that most people are in need of.The six products Kellerman recommends include a digestive enzyme, to eliminate any occasional digestive pain; a multivitamin, to ensure clients receive 100 percent of necessary vitamins and minerals they may be missing in their diet; a probiotic supplement, bacteria which promote the growth of microorganisms that assist in nutrient absorption; fiber, for cardiovascular health and good colon function; a fatty acid for energy and healthy skin; and antioxidant supplements, to boost the immune system and prevent cell damage to the body caused by strain or pollution.Though a healthy diet is still essential, Kellerman said lifestyles and the abundance of processed foods in our culture make it too difficult for even health-conscious individuals to get all the nutrients they need from food.Before adding any other supplements, Kellerman advises checking with a doctor about possible interactions with prescription drugs."Herbs are God's pharmacy,"she said. "They can interact with other medications."She also discourages her clients who seek to substitute an herbal nutritional supplement for a prescribed medication without consulting a doctor."If they're taking prescription medications, they shouldn't be pulling (supplements) off the shelf."
Despite all the options available to health-conscious consumers, Dr. Robert McNerney, a general internist in Butler, recommends his patients focus primarily on a well-rounded diet for their nutritional needs.On preliminary visits with patients, McNerney asks to see all supplements the person is taking. In return, he sends new patients home with information to help them track and analyze their daily diet.On return visits, doctor and patient can review what supplements might be excessive, those that might be helpful and what options are available through changes in diet to eliminate the need for supplements."You should definitely tell your doctor everything, particularly on a preliminary visit. Take in all medications and supplements," he said."Natural doesn't necessarily mean safe," he said.He said that the uses of many supplements are discovered by analyzing the diet of a cultural or geographic group and trying to pick out elements of its diet to figure out specific nutrients that result in a trend of good health.In some cases, he noted, a nutrient isolated from other aspects of that originating diet or lifestyle is not as effective.Though research has been done on the results of many supplements, McNerney said the supplement industry does not generally conduct studies that are as in-depth and lengthy as the more regulated drug industry."There is no effectiveness ratings for supplements," he said.Though he prefers a well-managed diet for his patients, McNerney considers some supplements a good option for those who may not wish to alter their diet drastically.One example of this is calcium, which he said many women do not get enough of."(Drinking milk), it's often a more rural and male thing to do."While he has come across many occasions of patients taking basic multivitamins, or a few other supplements targeting macular degeneration or heart disease, he has seen cases where a lack of education results in patients taking excessive doses.
As a dietitian who once considered herbal supplements "quackery," Mary Alice Gettings is now devoting effort to making sure she understands the benefits and drawbacks of dietary supplements."I wanted to know, not only for the community that I serve, but for myself," said Gettings, who supplements her own diet with several extra nutrients.Gettings now serves as the chair-elect of Nutrition in Complementary Care, a committee of the American Dietetic Association. She also works as a nutrition educator at the Penn State Cooperative Extention for Beaver and Butler counties.Her former skepticism combined with her recent study has led Gettings to a cautious acceptance of supplements."I can be tough on determining what's fact and what's fiction,"she said.While she agrees that in many cases there are no conclusive studies to prove the results of some herbal supplements, Gettings considers some time-honored treatments proof of efficacy."Something has to be said for 1,000 years of a supplement working,"she said, referring to herbal remedies used in Asia.Though she promotes the use of a multivitamin for most individuals, Gettings cautions supplement users about taking too much of a specific nutrient.One trend she notices is people adding a supplement to their daily routine that is already included in their multivitamin."If you get some calcium in your multivitamin, you might not need to take as much."Excesses of supplements are either flushed from the body, which Gettings considers a wasted investment, or stored in the body, which can prove toxic over time.Another concern Gettings shares with consumers is that there are several forms of some nutrients, some better absorbed by the body than others."If you are taking Vitamin D, you really should take D3, which is more available to your body,"she noted.Other supplements available are not as effective in pill form as they would be as a nutrient in other food, such as lycopene, which is better absorbed when digested with fats."If you need fat to absorb lycopene, you're not going to get that in the pill."Gettings suggests being an educated consumer and researching not only what supplements to take, but what brands' dosages are best.One Web site to assist consumers is Consumerlab.com, a subscription site that evaluates different brands of dietary supplements to assure the dosage matches that indicated on the label.No matter what supplements are chosen, Gettings said it is important to talk about any supplements with a doctor."People have to be empowered about their health. In the end, you're the only person who's going to take care of you."
