Supplementation and Medications

Americans spend 30 Billion dollars a year on supplements, but do we really know what we are buying or if we really need it? Unlike medications, supplements are not regulated by the government. The label is regulated by the FTC, so if a company makes false claims on the label, the FTC can step in. But what about the actual product? The manufacturer is responsible for the legitimacy/quality of the actual product. They are not tested for safety or efficacy by the FDA. When in doubt, look for a product that has been tested by either the independent, nonprofit US Pharmacopoeial (USP) Convention Dietary Supplement Verification Program or ConsumerLab.com. Food is always the best place to start if you want to add nutients to your diet, not an oral supplement. It is always important to tell your physician about supplements that you take, as many can have serious interactions with medications. There are common medications that can reduce nutrient absorption and potentially cause deficiencies. Start with food, but if you feel you cannot meet your needs with food, consider supplementation. Below are just a few of the common medications that can cause deficiencies, I will list the most basic repletion and some, not all interactions and then food sources:

• Acid suppresing medications and antiacids: H2 deplete calcium, folic acid, iron, B12, and D3. PPI deplete magnesium and B12. The recommended supplements: B12 25-1000 mcg/day, Magnesium 250-400 mg/day and Calcium 500-1000 mg/day divided doses. Potential interactions: Goldenseal, ginger and green tea (tagament only).
• Antibiotics: May deplete calcium, magnesium, potassium, B vitamins and Vitamin K. Calcium 500-1000 mg/day divided doses, Magnesium 250-400 mg. Some interactions include green tea catechins, St. Johns wort, iron and zinc. inetractions: St. johns Wort, Green tea catechins, zinc.
• Anxiety medications: This class only is regarding benzodiazepines. Calcium 500-1000 mg in divided doses. Interacts with Kava.
• Birth control: Folic acid 240 mcg, magnesium 250-400 mg and Vitamin B62-5 mg. Interactions include copper, iron, garlic, St. johns Wort, and green tea.Blood pressure medications: Calcium 500-1000 mg divided doses, folic acid 120-240 mcg, magnesium 250-500 mg, CoQ10 100-200 mg. Interactions garlic, ginko biloba, St. Johns Wort, green tea, goldenseal, melatonin.
• Cholesterol lowering medications: CoQ10 100-200 mg, Vitamin D3 1000-2000 IU. May interact with garlic, St. Johns Wort, Red rice yeast, Vitamin A.
• Diabetes medication (oral): Folic acid 120-240 mcg, Vitamin B12 25-1000 mcg, Calcium 500-1000 mg, Vitamin D3 1000-2000 IU. May interfere with: Alfalfa, aloe vera, ALA, bilberry, CoQ10, chromium, garlic, ginko biloba, ginseng, green tea, melatonin, milk thistle, niacin, St. johns Wort, Vitamin K.
• Hormone Replacement Therapy: Folic acid 240 mcg, Magnesium 250-400 mg, B6, 2-5 mg and B12 25-1000 mcg. May interact wieth caffeine, red clover extract, soy isoflavones, St. Johns Wort and zinc.

It is always best to start with food. Good sources of some of the most common nutrients include:

• Calcium: Dairy, dark leafy greens, tofu, sardines, canned salmon, unsweetened fortified plant milks.
• Folate (folic acid): Asparagus, avocado, broccoli, spinach, lentils, eggs, banana, beans, peas, citrus.
• Vitamin B12: Eggs, dairy, nutritional yeast, beef, fish, chicken, spinach.
• Vitamin B6 Eggs, banana, salmon, chickpeas, dairy, sweet potato, carrots, spinach.
• Vitamin C: Citrus, peppers, strawberries, broccoli, kiwi, potatoes.
• Vitamin D3: Cold water fatty fish, milk, mushrooms (raw), unsweetened fortified plant milk.
• Magnesium: Avocado, almonds, beans, quinoa, brown rice, seeds, beans, spinach.
• CoQ10: fatty fish, spinach, cauliflower, broccoli, strawberries, oranges, soy, lentils, nuts and seeds.
• Iron: spinach, tofu, lentils, animal proteins, beans, dried fruit. It is important to boost iron absorption of plant based foods with Vitamin C rich foods such as citrus.

Always talk to your physician or dietitian before taking any supplements. Start with food first and remember, if a little is good, a lot is NOT better when you are taking a supplement. Many supplements can reach toxic levels and can be dangerous. The best way to go is always with a balanced, well rounded diet with vegetables, fruits, whole grains, low fat dairy and lean proteins.

How The Quality Of Your Diet Affects Heart Health

One in every four Americans will be afflicted with heart disease and have at least one risk factor. According to CDC statistics, one person dies every 36 seconds in the United States from cardiovascular disease. There are many factors that put you at risk of heart disease. Some are not within our control, such as age, gender and race, but there are things we can do with some modifiable risk factors, such as: smoking, a sedentary lifestyle, hypertension,elevated cholesterol, an unhealthy weight, poor diet, and diabetes. A new study published in the Journal of the American College of Cardiology has shed new light on the best diet for heart health.  Previous studies on heart disease have focused on higher income populations, but further research into more diverse populations has shown that what we consume plays a large role in risks for heart disease. Diets high in refined carbohydrates, saturated fat, refined oils, red meat and sugar sweetened beverages put people at much higher risk for hreart disease. This study highlighted the Mediterranean Diet as a heart healthy, well-tested diet to reduce cardiovascular disease. The Mediterranean type diet emphasizes whole grains, fruits and vegetables, legumes, nuts, fish, poultry, and moderate low fat dairy and heart-healthy olive oil intake; The study shows that this pattern will likely reduce cardiovascular disease risk by about one-third. This healthy dietary pattern needs also to be low in refined grains, added sugars, trans fats, SSBs, and red and processed meats. What else should you do to reduce your risk for cardiovascular disease:

• Stop smoking: Ask your physician for cessation tools to assist with breaking the habit.
• Exercise: The Physical Activity Guidelines for Americans recommends adults move at least 150 minutes per week moderatly and 75 minutes per week vigerously. Start slow-remember, some movement is better than no movement. kit is also important to add 2-3x/week of dtrength training, stretching, and neuromotor activity.  Make sure to get clearance from a medical provider prior to starting a new exercise program. 
• Reduce alcohol consumption: Men should have no more than 2 alcoholic beverages in a day and women should have no more than 1 a day.
• Reduce sodium intake and increase potassium rich foods: Consume no more than 2300 mg a day. Read labels , especuially on pre packaged foods, bread, canned and snack foods. Pottasium rich foods include: fruits, vegetables, beans and low fat dairy.
• Maintain a healthy weight: Waist circumference is a determinant of heart health. Men sould have a waist circumference under 40″ and women 35″. If your BMI is elevated,  enlist the help of an RD to help create a healthy meal plan and assist you in reaching your goals.
• Reduce stress: Meditation, call a friend, take a walk. We might not be able to eliminate stress, but we can reduce it.
• Sleep: adults need between 7-9 hours of sleep. We all need that rest, renewal and repair.
• Make sure you have annual screenings for blood pressure, BMI, and lab work to check lipid profiles.

Your physician and RD can help you put together a program to help reduce your risk of developing heart disease or help control cradiovascular disease if you are already afflicted.  There is always room for imporvemnt!