Simply Healthy E22 - Supplements

Simply Health ME

Supplements - Big take away points:

Get nutrients from Food Be selective in your supplementation Focus on your lifestyle first Food synergy concept Supplements are an over-simplificiation

Nothing is benign!! This JAMA article on “anti-oxidant” use is just ONE of MANY examples

https://jamanetwork.com/journals/jama/article-abstract/205797

68 trials, 230,000 participants.

Take home:

Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.

Multivitamin

General

High Potency (only if you know you have a deficiency)

In 2013 the US Preventative Task Force reported inadequate data to support

multivitamin use in people without deficiencies

Multivitamin-multimineral treatment has no effect on mortality risk.

No affect on CV disease, stroke

Maybe 9% reduce risk of cataracts

One poor study showed maybe decrease risk of some cancers in older men

Maybe people with breast cancer die less if taking multi

So why supplement?

Who gets tested for deficiencies anyway??!!!

People on Diets / special populations

Pregnant women, pts s/p gastric bypass

Folic acid decreases the risk of neural tube defects so pregnant women should take

Especially if not eating fortified grains

THERE IS NO STANDARD FORMULA

WHO THE HELL KNOWS

Many dont have what they say they do

Consumer Lab tested some - these actually have what they say they have and best price

Flintstone gummies came out best for kids (had what they said they had)

Equate (Walmart) Brand for 50 +vita

Prenatal: most fail because guidelines change. Garden of Life did not

WE DON'T ENDORSE ANY BRAND

THE POINT IS YOU DON'T HAVE TO SPEND MONEY

YOU MAY OR MAY NOT NEED IT

We are no help

Fish Oil

EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are found in fish

They are Omega-3 fatty acids

The body can only manufacture limited amounts of EPA and DHA

You need to get it from your diet

Reduces triglycerides, raises HDL, reduces homocysteine, reduces Blood pressure

Homocysteine damages artery walls

So obvious it reduces risk of CV disease??!!!

Not so fast, multiple recent large randomized control studies did not see benefit

Maybe short term / secondary protection (after you have had your heart attack)

Arthritis

Increased intake of omega 3 in fish oil may reduce inflammation in pts with RA.

May help with pain in OA or RA but not function issues

Some studies say dec inflammation in UC

May decrease risk of dying from colon cancer if you already have it

Maybe breast cancer too

Helps with depression

BAD THINGS

May increase insulin resistance and oxidative stress in DM

May increase fasting blood sugar

High levels of oxidative products in fish oil products

**listen to our podcast on oils!

Top brands found to have 4 times the oxidative levels considered safe

https://www.ncbi.nlm.nih.gov/pubmed/28011269

Vitamin D

Influences expression of more than 200 genes

YAY epigenetics

Deficiency is linked to inc risk of heart disease, cancer, DM, asthma, autoimmune D

BUT low levels and HIGH levels are linked with negative outcomes

More is not better

Get tested regularly - change dosage appropriately

Get outside

Benefits of sunlight are more than vitamin D supp alone

Don't get burned but you need sun!!!

Benefits of Sunlight

?-Endorphin: a natural opiate that induces relaxation and increases pain tolerance

Calcitonin Gene-Related Peptide: a vasodilator that protects against hypertension, vascular inflammation, and oxidative stress

Substance P: a neuropeptide that promotes blood flow and regulates the immune system in response to acute stressors

Adrenocorticotropic Hormone: a polypeptide hormone that controls cortisol release by the adrenal glands, thus regulating the immune system and inflammation

Melanocyte-Stimulating Hormone: a polypeptide hormone that reduces appetite, increases libido, and is also responsible for increased skin pigmentation

Probiotics

Might help in the short term

Only changing your diet will result in change in gut bacteria population

Take it if on antibiotics (if you must)

Take it when ill (maybe - no data)

Just change your diet

Protein Powders/pre-workout shakes.

Don't do it

The reality is that there is some evidence (Peter Attia) that taking leucine just before and during a workout possibly slows muscle degradation. It is also important to note that any sort of deficiency in your diet is exceedingly rare and you can probably get all the Leucine you need from a normal healthy diet.

https://pubchem.ncbi.nlm.nih.gov/compound/L-leucine#section=Top

Magnesium

Over 300 enzymes need it to function especially those related to ATP / energy

Studies show most americans are deficient

Harder to get from food

In nuts - but watch the PUFAS (OMEGA 6s)

Take it if you have a reason

Anxiety, migraines, constipation

Hard to overdose (diarrhea)

Melatonin

Helps with sleep latency

I take it.

Try it

Does no decrease endogenous melatonin (I was worried about this)

Good for shift workers / jet lag

Tylenol

Maybe for a fever if you feel terrible

Fevers help fight infections though

Liver toxicity,

Ibuprofen

Acute inflammation is good - dont damper this

Find another way to treat chronic inflammation

See out podcast on Inflammation

https://www.ncbi.nlm.nih.gov/pubmed/23255568

https://www.ncbi.nlm.nih.gov/pubmed/29361684

http://annals.org/aim/fullarticle/1767855/vitamin-mineral-supplements-primary-prevention-cardiovascular-disease-cancer-updated-systematic

https://jamanetwork.com/journals/jama/fullarticle/1380451

https://www.ncbi.nlm.nih.gov/pubmed/22493407

https://www.ncbi.nlm.nih.gov/pubmed/23940215

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021439/

https://www.ncbi.nlm.nih.gov/pubmed/26161757

http://gut.bmj.com/content/58/12/1606.full.pdf

http://gut.bmj.com/content/early/2016/09/27/gutjnl-2016-311990

http://americancollegeofnutrition.org/content/the-journal/content/29/1/55.abstract

https://www.ncbi.nlm.nih.gov/pubmed/20694407

https://chriskresser.com/vitamin-d-more-is-not-better/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC128885/#B23