Dietary Supplements - What are They?
by Dr. Gary Farr on 22 February 2002

1

What are Dietary Supplements?

If you take a vitamin pill each day, you are taking a dietary supplement. That is, you are adding something to your diet of foods, most likely in an attempt to make up for a less than perfect diet, to promote good health, or to help speed healing when illness strikes. Dietary supplements are also prescribed for vitamin or mineral deficiencies such as iron for anemia or vitamin supplements for pregnant women and small children.

The Dietary Supplement Health and Education Act defines dietary supplements as a:

Despite drug companies efforts to hide the true facts regarding the effectiveness of dietary supplements, scientific studies support their role in the prevention and treatment of cancer and arthritis. (See the references on page 2 and 3 of this article).

The 13 vitamins and 19 minerals consumed by Americans are available in several forms. They are marketed by promoters and purchased by those who are looking for alternatives to the 4th leading cause of death in this country: medications. The Center for Disease Control, Johns Hopkins University and the New Jersey School of Medicine estimate that 80,000-120,000 Americans are killed by prescription drugs every year.

An estimated eight of ten Americans use vitamin supplements to the tune of an average household cost of $66 a year. The {rutgers} Rutger's Study confirms that because of the poor quality of processed foods, we don't get all of the nutrients necessary to provide us good health. Because of this it's not only the "special groups" of people that need dietary supplements in addition to a balanced diet. With the number of "junk foods," being consumed by the public, many busy people often forego nutritious meals in favor of fast foods. Our recommendation to these people is to take dietary supplements but to also receive the proper education to move them toward eating a more healthy diet. Supplements are just that; they should supplement the diet, not replace it.

Some supplements rise and fall in popularity. While these can be considered "fads", the fact remains that proper nutritional supplementation has its definite place in improving and maintaining the health of the individual.

HOW DOES IT WORK?

We have a clear understanding of what the body needs for good health. Vitamins and minerals in specified amounts are requirements to maintain a healthy body. Our government has widely publicized the "food pyramid," which indicates how many servings of various types of food are necessary for good health. Within the pyramid's six food groups (grains, fruits, vegetables, dairy, animal protein, and minimal amounts of fats and sweets) are foods that provide all necessary nutrients.

The government also publishes guidelines outlining a minimum daily requirement for each vitamin and mineral. These guidelines are continually reviewed and updated.

WILL IT HELP?

People who are nutritionally deficient certainly will benefit from dietary supplements or nutritional therapy. For example, the iron included in a daily multivitamin can make up for iron lost by menstruating women. The often poor diets of the frail elderly can be improved with the currently popular "complete nutrition in a can" products. Pregnant women require more calcium, iron and folic acid than non-pregnant women.

Many people still are convinced that megadoses of vitamin C can cure colds, although many good scientific studies disproved that idea. On the other hand, the use of zinc lozenges, taken no more than one day after the onset of a cold, may be helpful in reducing the time the cold lasts and lessening its symptoms.

Certain vitamins promote good eyesight, calcium helps build strong bones and teeth, and folic acid reduces the number of birth defects. The antioxidant vitamins, although still under study, seem to have real benefits in promoting good heart health. But there is no evidence that supplements cure or prevent cancer. Studies suggest that people who eat more fruit and vegetables containing these antioxidants, however, may have a lower risk for cancer.

One should be forewarned, however, that megadoses of nutrients to "treat" or prevent illness can be harmful; even toxic. Too much vitamin C, for example, can interfere with the body's ability to absorb copper, an essential metal required in our body chemistry. Too much phosphorous has a negative effect on how well calcium is absorbed. Megadoses of the fat soluble vitamins A, D, and K can easily reach toxic levels.

It is also important to remain skeptical of promises made on food supplement containers about their ability to promote health, reduce weight, or increase physical strength. Such claims are not regulated by the US government. In most cases the products do not live up to the claims. If you do choose to take a supplement, choose one that provides vitamins and minerals in amounts close to the RDA (100% RDA on the label). Avoid "organic", "natural" and time-release supplements. These are no better than standard supplements, but are more expensive. Local or store brands are just as good as national brands, but usually cost less.

There is no real substitute for a regular, well-balanced diet. But you also need to know that you really can't follow the general USDA guidelines found in the food pyramid. These recommendations fall short in providing you with a healthy diet. In addition, it is better to get the necessary vitamins and minerals from their natural whole food sources, rather than from food supplements.

No matter what promises or claims are made for vitamins and other dietary supplements, we do not suggest taking a supplement because a friend told you to, or because you read about it in a magazine or saw it on television. There are a lot of supplements on the market today that make some incredible claims as to their effectiveness in improving the functions of the body. Be very careful in what you take for "truth". Nutrition is a science and the art of knowing what to give each individual is just that, an art. Do your research and reading and choose a doctor or clinician who is {find_doctor} trained in clinical nutrition. Otherwise you may be getting a biased opinion to move you toward taking more drugs.

You can also View the PDF File for this supplement an article entitled "Understanding Food Supplements".

Dietary Supplements - What are They? | References - Part 1

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Why and how should we measure oxidative DNA damage in nutritional studies? How far have we come?
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David Heber
Colorful cancer prevention: -carotene, lycopene, and lung cancer
Am J Clin Nutr 2000 72: 901-902.

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Effects of supplemental beta-carotene, cigarette smoking, and alcohol consumption on serum carotenoids in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study [published erratum appears in Am J Clin Nutr 1997 Dec;66(6):1491]
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MC Ocke and RJ Kaaks
Biochemical markers as additional measurements in dietary validity studies: application of the method of triads with examples from the European Prospective Investigation into Cancer and Nutrition
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No effect of supplementation with vitamin E, ascorbic acid, or coenzyme Q10 on oxidative DNA damage estimated by 8-oxo-7,8-dihydro-2'- deoxyguanosine excretion in smokers
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RA Jacob and BJ Burri
Oxidative damage and defense
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FL Meyskens, Jr and A Manetta
Prevention of cervical intraepithelial neoplasia and cervical cancer
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JS Bertram and H Bortkiewicz
Dietary carotenoids inhibit neoplastic transformation and modulate gene expression in mouse and human cells
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CW Beecher
Cancer preventive properties of varieties of Brassica oleracea: a review
Am J Clin Nutr 1994 59: 1166S-1170S.

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Adjustment for bias due to errors in exposure assessments in multicenter cohort studies on diet and cancer: a calibration approach
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Diet, prolactin, and breast cancer
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M Lipkin
Application of intermediate biomarkers to studies of cancer prevention in the gastrointestinal tract: introduction and perspective
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FX Pi-Sunyer
Health implications of obesity
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T Westin, H Stein, G Niedobitek, K Lundholm, and S Edstrom
Tumor cytokinetic response to total parenteral nutrition in patients with head and neck cancers
Am J Clin Nutr 1991 53: 764-768.

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Fecapentaene excretion: aspects of excretion in newborn infants, children, and adult normal subjects and in adults maintained on total parenteral nutrition
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JB Block, MF Dietrich, R Leake, SA Laidlaw, NE Vinton, and JD Kopple
Fecapentaene excretion: aspects of excretion in newborn infants, children, and adult normal subjects and in adults maintained on total parenteral nutrition
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J Conly, J Suttie, E Reid, J Loftson, K Ramotar, and T Louie
Dietary deficiency of phylloquinone and reduced serum levels in febrile neutropenic cancer patients
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J Conly, J Suttie, E Reid, J Loftson, K Ramotar, and T Louie
Dietary deficiency of phylloquinone and reduced serum levels in febrile neutropenic cancer patients
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H Adlercreutz, E Hamalainen, SL Gorbach, BR Goldin, MN Woods, and JT Dwyer
Diet and plasma androgens in postmenopausal vegetarian and omnivorous women and postmenopausal women with breast cancer
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H Adlercreutz, E Hamalainen, SL Gorbach, BR Goldin, MN Woods, and JT Dwyer
Diet and plasma androgens in postmenopausal vegetarian and omnivorous women and postmenopausal women with breast cancer
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AP Boyar, DP Rose, and EL Wynder
Recommendations for the prevention of chronic disease: the application for breast disease
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Meat, starch, and nonstarch polysaccharides and large bowel cancer
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DA Snowdon
Animal product consumption and mortality because of all causes combined, coronary heart disease, stroke, diabetes, and cancer in Seventh-day Adventists
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JH Shaw
Influence of stress, depletion, and/or malignant disease on the responsiveness of surgical patients to total parenteral nutrition
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Cancer cachexia: influence of systemic ketosis on substrate levels and nitrogen metabolism
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Lower lifetime occurrence of breast cancer and cancers of the reproductive system among former college athletes
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Immunologic evaluation in the nutritional assessment of children with cancer
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Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Introduction: correlates of diet, nutrient intake, and metabolism in relation to colon cancer
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Reproducibility of a diet history questionnaire in a case-control study of breast cancer
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Serum vitamin level maintenance in cancer patients on total parenteral nutrition
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Protein-energy nutritional status of pediatric cancer patients
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The relationship between bowel cancer and fiber content in the diet
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Diet, transit time, stool weight, and colon cancer in two Scandinavian populations
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Some current concepts in intestinal bacteriology
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Assessment of a short dietary method for prospective study on cancer
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Adherence to the Dietary Guidelines for Americans and risk of major chronic disease in women
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Catherine M Loria, Michael J Klag, Laura E Caulfield, and Paul K Whelton
Vitamin C status and mortality in US adults
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Anja Kroke, Kerstin Klipstein-Grobusch, Susanne Voss, Jutta Möseneder, Frank Thielecke, Rudolf Noack, and Heiner Boeing
Validation of a self-administered food-frequency questionnaire administered in the European Prospective Investigation into Cancer and Nutrition (EPIC) Study: comparison of energy, protein, and macronutrient intakes estimated with the doubly labeled water, urinary nitrogen, and repeated 24-h dietary recall methods
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Lawrence H Kushi, Katie A Meyer, and David R Jacobs, Jr
Cereals, legumes, and chronic disease risk reduction: evidence from epidemiologic studies
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Christine J Lewis and Elizabeth A Yetley
Health claims and observational human data: relation between dietary fat and cancer
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DR Jacobs, Jr, KA Meyer, LH Kushi, and AR Folsom
Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Women's Health Study
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S Hylla, A Gostner, G Dusel, H Anger, HP Bartram, SU Christl, H Kasper, and W Scheppach
Effects of resistant starch on the colon in healthy volunteers: possible implications for cancer prevention
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C Ip
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Biological effects of a diet of soy protein rich in isoflavones on the menstrual cycle of premenopausal women
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GA Colditz
Economic costs of obesity
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JK Ross, DJ Pusateri, and TD Shultz
Dietary and hormonal evaluation of men at different risks for prostate cancer: fiber intake, excretion, and composition, with in vitro evidence for an association between steroid hormones and specific fiber components
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JK Ross, DJ Pusateri, and TD Shultz
Dietary and hormonal evaluation of men at different risks for prostate cancer: fiber intake, excretion, and composition, with in vitro evidence for an association between steroid hormones and specific fiber components
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JT Dwyer
Health aspects of vegetarian diets
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Seasonal variation in intake of carotenoids and vegetables and fruits among white men in New Jersey
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AA Rider, RS Arthur, and BM Calkins
Diet, nutrition intake, and metabolism in populations at high and low risk for colon cancer. Laboratory analysis of 3-day composite of food samples
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GF Combs, ME Auld, L Gardner, and WD DeWys
Report on Clinical Nutrition Research Units
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Fatness and mortality in the West of Scotland
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Is taste related to anorexia in cancer patients?
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SH Cohn, KJ Ellis, D Vartsky, A Sawitsky, W Gartenhaus, S Yasumura, and AN Vaswani
Comparison of methods of estimating body fat in normal subjects and cancer patients
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A Palgi
Association between dietary changes and mortality rates: Israel 1949 to 1977; a trend-free regression model
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GM Sloan, M Maher, and MF Brennan
Nutritional effects of surgery, radiation therapy, and adjuvant chemotherapy for soft tissue sarcomas
Am J Clin Nutr 1981 34: 1094-1102.

ER Eichner, CR McDonald, and VL Dickson
Elevated serum levels of unsaturated folate binding protein: clinical correlates in a general hospital population
Am J Clin Nutr 1978 31: 1988-1992.

JG Bieri and RP Evarts
Tocopherols and polyunsaturated fatty acids in human tissues
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Albert van der Vliet
Cigarettes, cancer, and carotenoids: a continuing, unresolved antioxidant paradox
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F Xavier Pi-Sunyer
Overnutrition and undernutrition as modifiers of metabolic processes in disease states
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Helen Wiseman, James D O'Reilly, Herman Adlercreutz, Anthony I Mallet, Elizabeth A Bowey, Ian R Rowland, and Thomas AB Sanders
Isoflavone phytoestrogens consumed in soy decrease F2-isoprostane concentrations and increase resistance of low-density lipoprotein to oxidation in humans
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Heiner Boeing, Ute M Weisgerber, Andro Jeckel, Hans-Joachim Rose, and Anja Kroke
Association between glycated hemoglobin and diet and other lifestyle factors in a nondiabetic population: cross-sectional evaluation of data from the Potsdam cohort of the European Prospective Investigation into Cancer and Nutrition Study
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William B Grant
Fish consumption, cancer, and Alzheimer disease
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Robert M Russell and Xiang-Dong Wang
IARC Handbooks of Cancer Prevention, Volume 3: Vitamin A,
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Mark Messina
Soy, soy phytoestrogens (isoflavones), and breast cancer
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Joanne L Slavin, Margaret C Martini, David R Jacobs, Jr, and Len Marquart
Plausible mechanisms for the protectiveness of whole grains
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Brenda Cartmel, Thomas E Moon, and Norman Levine
Effects of long-term intake of retinol on selected clinical and laboratory indexes
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Dietary Supplements - What are They? | References - Part 2

References Regarding Arthritis:

Joel M Kremer
n-3 Fatty acid supplements in rheumatoid arthritis
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R Roubenoff, RA Roubenoff, LM Ward, and MB Stevens
Catabolic effects of high-dose corticosteroids persist despite therapeutic benefit in rheumatoid arthritis
Am J Clin Nutr 1990 52: 1113-1117.

HR Schumacher, FW Bernhart, and P Gyorgy
Vitamin B6 levels in rheumatoid arthritis: effect of treatment
Am J Clin Nutr 1975 28: 1200-1203.

Jens Kjeldsen-Kragh
Rheumatoid arthritis treated with vegetarian diets
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VE Honkanen, CH Lamberg-Allardt, MK Vesterinen, JH Lehto, TW Westermarck, TK Metsa-Ketela, MH Mussalo-Rauhamaa, and YT Konttinen
Plasma zinc and copper concentrations in rheumatoid arthritis: influence of dietary factors and disease activity
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F Xavier Pi-Sunyer
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DT Felson
Weight and osteoarthritis
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Measurement issues in preventive strategies: past, present, and future
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ER Stadtman
Ascorbic acid and oxidative inactivation of proteins
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Protective role of vitamin E in biological systems
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L Wallentin and L Skoldstam
Lipoproteins and cholesterol esterification rate in plasma during a 10- day modified fast in man
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Symposium on surgical treatment of morbid obesity. Proceedings of a consensus conference sponsored by the National Institute of Arthritis, Metabolism, and Digestive Diseases of the National Institutes of Health; held in December 1978 at Bethesda, Maryland
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Biochemical effects of a diet containing foods enriched with n-3 fatty acids
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n-3 Polyunsaturated fatty acids inhibit the antigen-presenting function of human monocytes
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Essential fatty acids in health and chronic disease
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Gary E Fraser
Associations between diet and cancer, ischemic heart disease, and all-cause mortality in non-Hispanic white California Seventh-day Adventists
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C van Weel
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AP Simopoulos
Omega-3 fatty acids in health and disease and in growth and development
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CD Thomson and MF Robinson
Selenium in human health and disease with emphasis on those aspects peculiar to New Zealand
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