A to zinc using dietary supplements wisely 3-5-2011

From A to Zinc From A to Zinc

Using Dietary Using Dietary Supplements Supplements

WiselyWisely

A Dietary Supplement is a A Dietary Supplement is a product that:product that:

is intended to supplement the dietis intended to supplement the diet

contains 1 or more dietary contains 1 or more dietary ingredients or their constituentsingredients or their constituents

is intended to be taken by mouthis intended to be taken by mouth

is labeled as being a dietary is labeled as being a dietary supplementsupplement

Dietary Supplement Use in Dietary Supplement Use in the U.S.the U.S.

Surveys reveal >50% of American Surveys reveal >50% of American adults have used some type of adults have used some type of dietary supplement in the last 30 dietary supplement in the last 30 daysdays

Total annual sales of 25.2 billion Total annual sales of 25.2 billion per yearper year

Dietary Supplement Use in Dietary Supplement Use in the U.S.the U.S.

The most popularThe most popular Multivitamins/multiminerals Multivitamins/multiminerals Vitamin E and C Vitamin E and C Calcium Calcium B-complex vitamins B-complex vitamins Fish oil/omega 3 fatty acidsFish oil/omega 3 fatty acids GlucosamineGlucosamine EchinaceaEchinacea Flaxseed oil or pillsFlaxseed oil or pills GinsengGinseng

Main Reasons for Taking Main Reasons for Taking SupplementsSupplements

Prevent a diseasePrevent a disease Help treat a disease or conditionHelp treat a disease or condition General healthGeneral health EnergyEnergy Weight lossWeight loss PregnancyPregnancy MoodMood Muscle-buildingMuscle-building

Federal Regulation of Federal Regulation of Dietary SupplementsDietary Supplements

Not the same as those for Not the same as those for prescription or over the counter prescription or over the counter drugs-in general they are less strictdrugs-in general they are less strict

A manufacturer A manufacturer DOES NOTDOES NOT have to have to prove a product’s safety and prove a product’s safety and effectiveness effectiveness before it is marketedbefore it is marketed


A manufacturer is permitted to say A manufacturer is permitted to say that a supplement addresses:that a supplement addresses:

supports healthsupports health a nutrient deficiencya nutrient deficiency is linked to a particular is linked to a particular body function (like immunitybody function (like immunity or heart health)or heart health)

ifif there is research to support the there is research to support the claim.claim.


Claim must be followed by the Claim must be followed by the words words

““This statement has not been This statement has not been evaluated by the US FDA. This evaluated by the US FDA. This product is not intended to product is not intended to diagnose, treat, cure, prevent any diagnose, treat, cure, prevent any disease”.disease”.


Manufacturers are expected to Manufacturers are expected to follow practices that ensure follow practices that ensure supplements are:supplements are:

processed consistentlyprocessed consistently meet quality standardsmeet quality standards


Monitors safety once a dietary supplement Monitors safety once a dietary supplement

is on the marketis on the market

If it finds a product to be unsafe, it can If it finds a product to be unsafe, it can take action against the manufacturer take action against the manufacturer and/or distributor.and/or distributor.

Monitors product information, such as Monitors product information, such as label claims and package insertslabel claims and package inserts


Polices product advertising and Polices product advertising and requires all information to be requires all information to be truthful and not misleadingtruthful and not misleading

Safety ConsiderationsSafety Considerations If you are thinking about or using a If you are thinking about or using a

dietary supplement:dietary supplement:

Tell your health care provider to help Tell your health care provider to help ensure coordinated and safe care.ensure coordinated and safe care.

Some supplements interact with Some supplements interact with medications, may increase the risk of medications, may increase the risk of bleeding or affect the response to bleeding or affect the response to anesthesia with surgery.anesthesia with surgery.

For example:For example:St. John’s wort can speed the breakdown of St. John’s wort can speed the breakdown of many drugs (including birth control pills) many drugs (including birth control pills) and thereby reduce their effectiveness)and thereby reduce their effectiveness)

Safety ConsiderationsSafety Considerations Read the label instructionsRead the label instructions

Talk to your health care provider if you Talk to your health care provider if you have questions, particularly about the have questions, particularly about the best dosage for you to takebest dosage for you to take

Take only one new supplement at a Take only one new supplement at a time to determine your body’s time to determine your body’s responseresponse

Safety ConsiderationsSafety Considerations

If you experience any side effects that If you experience any side effects that concern you, concern you, STOP STOP taking the dietary taking the dietary supplement and contact your health supplement and contact your health care provider.care provider.

Report your experience to the FDA’s Report your experience to the FDA’s MedWatch safety information line at MedWatch safety information line at http://www.fda.gov/medwatch/report/conshttp://www.fda.gov/medwatch/report/consumer/consumer.htmumer/consumer.htm or call 1-800-FDA-1088 or call 1-800-FDA-1088


Although many dietary Although many dietary supplements come from natural supplements come from natural sources, sources, “natural” does not “natural” does not always mean “safe”.always mean “safe”.

For example, the herbs comfrey and For example, the herbs comfrey and kava can cause serious harm to the kava can cause serious harm to the liverliver

Safety ConsiderationsSafety ConsiderationsBe AwareBe Aware

An herbal supplement may contain An herbal supplement may contain dozens of compoundsdozens of compounds and that its and that its active ingredients may not be knownactive ingredients may not be known

Researchers are studying many of Researchers are studying many of these products in an effort to these products in an effort to identify active ingredients and identify active ingredients and understand their effects in the bodyunderstand their effects in the body


What’s on the label may not be What’s on the label may not be what’s in the bottlewhat’s in the bottle

Analyses sometimes find Analyses sometimes find differences between labeled and differences between labeled and actual ingredients. For example:actual ingredients. For example:

An herbal supplement may not An herbal supplement may not contain the correct plant speciescontain the correct plant species


The amount of the active ingredient The amount of the active ingredient may be lower or higher than the may be lower or higher than the label states.label states.

May be contaminated with other May be contaminated with other

herbs, pesticides, or metals, or herbs, pesticides, or metals, or

even adulterated with unlabeled even adulterated with unlabeled

ingredients such as prescriptioningredients such as prescription

drugs.drugs.

Safety ConsiderationsSafety Considerations Skip the lure of this myth: Skip the lure of this myth:

“Even if a supplement won’t “Even if a supplement won’t help me, at least it won’t hurt help me, at least it won’t hurt me”me”

High doses, taken long enough High doses, taken long enough or combined with other or combined with other supplements, can be harmful.supplements, can be harmful.


Look for products labeled with the Look for products labeled with the voluntary USP (U.S. Pharmacopeia) voluntary USP (U.S. Pharmacopeia) or NF (National Formulary) lettersor NF (National Formulary) letters

Indicates the manufacturer self-Indicates the manufacturer self-reports voluntary standards of quality.reports voluntary standards of quality.

Reliable Sources of Reliable Sources of InformationInformation

Office of Dietary Supplements, Office of Dietary Supplements,

National Institutes of HealthNational Institutes of Health

http://ods.od.nih.govhttp://ods.od.nih.gov

Accurate, science-based facts on Accurate, science-based facts on dietary supplements dietary supplements

CalciumCalcium What is it and what does it do?What is it and what does it do? How much do I need?How much do I need? What foods provide calcium?What foods provide calcium? What kinds of calcium dietary What kinds of calcium dietary

supplement are available?supplement are available? Am I getting enough?Am I getting enough? What happens if I don’t get enough?What happens if I don’t get enough? What are some effects of calcium on What are some effects of calcium on

health?health? Can calcium be harmful?Can calcium be harmful? Are there any interactions with Are there any interactions with

calcium that I should know about?calcium that I should know about?


National Center for Complementary National Center for Complementary and Alternative Medicineand Alternative Medicine

http://nccam.nih.gov/health/http://nccam.nih.gov/health/herbsataglance.htmherbsataglance.htm

Fact sheets that provide an overview Fact sheets that provide an overview of herbs of herbs

EchinaceaEchinacea

Common namesCommon names What it is used forWhat it is used for How it is used How it is used What the Science Says What the Science Says Side Effects and CautionsSide Effects and Cautions SourcesSources For More InformationFor More Information


MedlinePlus: Supplements & Herbal MedlinePlus: Supplements & Herbal InformationInformation

http://nlm.nih.gov/medlineplus/druginformation./htmlhttp://nlm.nih.gov/medlineplus/druginformation./html

Browse to learn about their effectiveness, usual dosage Browse to learn about their effectiveness, usual dosage and drug interactionsand drug interactions

Acai BerryAcai Berry What is it?What is it? How effective is it?How effective is it? How does it work?How does it work? Are there safety concerns?Are there safety concerns? Are there interactions with Are there interactions with

medications?medications? Are there interactions with herbs and Are there interactions with herbs and

supplements?supplements? Are there interactions with foods?Are there interactions with foods? What is the dosage used?What is the dosage used? Other namesOther names ReferencesReferences


Memorial Sloan-Kettering Cancer Memorial Sloan-Kettering Cancer CenterCenter

http://www.mskcc.org/mskcc/html/11570.cfmhttp://www.mskcc.org/mskcc/html/11570.cfm

Evidence-based information about herbs, Evidence-based information about herbs, vitamins and other supplementsvitamins and other supplements


http://www.fda.gov/Food/DietarySupplements/default.http://www.fda.gov/Food/DietarySupplements/default.htmhtm

Q and AQ and A OverviewOverview Tips for the Dietary Supplement User: Making Tips for the Dietary Supplement User: Making

Informed Decisions and Evaluating Web InformationInformed Decisions and Evaluating Web Information

Final ThoughtsFinal Thoughts

Do your best to ensure good Do your best to ensure good health by following a healthy diet health by following a healthy diet

http://www.MyPyramid.govhttp://www.MyPyramid.gov

Don’t expect a pill to make up for Don’t expect a pill to make up for unhealthy unhealthy

food choicesfood choices

Be informed about any Be informed about any supplement you choose to take!supplement you choose to take!

Karen Palmer, RD,LD,CDEKaren Palmer, RD,LD,CDE 763-520-5489763-520-5489

[email protected]@northmemorial.com

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A to zinc using dietary supplements wisely 3-5-2011

Education