Getting the Nutrients You Need... Consistent use of multivitamins and other key supplements can promote good health and help prevent disease, according to a comprehensive new report released by the Council for Responsible Nutrition in 2002. The report found that ongoing use of multivitamins (preferably with minerals) and other single-nutrient supplements (like calcium or folic acid) demonstrated quantifiable positive impact in areas ranging from strengthening the immune system of highly-vulnerable elderly patients, and to drastically reducing the risk of neural tube birth defects such as spina bifida. While the addition of a multivitamin will benefit most people, different additional supplements should be chosen based on the specific lifestage, gender or lifestyle of the individual. For example, though calcium is generally important for all men and women, it is particularly critical for children building bone mass and elderly people seeking to preserve it. Dietary supplements are intended to supplement the diets of some people, but not to replace the balance of the variety of foods important to a healthy diet. While you need enough nutrients, too much of some nutrients can cause problems. In the natural health community, scientists and observers of human nature have concluded that the human body is not designed to consume isolated nutrients and use them effectively. It must take in a full spectrum of supporting complementary nutrients as they exist in nature. For example, lycopene is one phytonutrient found in tomatoes that is well known to help prevent prostate cancer. But, in fact, if you take lycopene by itself, it's not going to have nearly the positive effect of eating whole tomatoes or taking whole-food concentrates made from dried organic tomatoes. So getting these minerals as they are found in nature is very important.  Definitions of Dietary Supplements A dietary supplement is a product taken by mouth that contains a "dietary ingredient" intended to supplement the diet. The "dietary ingredients" in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites. Dietary supplements can also be extracts or concentrates, and may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or powders. They can also be in other forms, such as a bar, but if they are, information on their label must not represent the product as a conventional food or a sole item of a meal or diet. Whatever their form may be, DSHEA places dietary supplements in a special category under the general umbrella of "foods," not drugs, and requires that every supplement be labeled a dietary supplement. It is important to be well informed about products before purchasing them. Because it is often difficult to know what information is reliable and what is questionable, consumers may first want to contact the manufacturer about the product they intend to purchase The Dietary Supplement Health and Education Act (DSHEA) of 1994 defined both of the terms "dietary ingredient" and "new dietary ingredient" as components of dietary supplements. In order for an ingredient of a dietary supplement to be a "dietary ingredient," it must be one or any combination of the following substances: vitamin a mineral an herb or other botanical an amino acid  a dietary substance for use by man to supplement the diet by increasing the total dietary intake (e.g., enzymes or tissues from organs or glands), or a concentrate, metabolite, constituent or extract. A "new dietary ingredient" is one that meets the above definition for a "dietary ingredient" and was not sold in the U.S. in a dietary supplement before October 15, 1994. Dangers and Risks of Taking Supplements At least 40% of all Americans take some type of dietary supplement. Although people usually take supplements in an effort to improve their health, some people may actually endanger their health by using these products-especially if they also take medicines. Some dietary supplements may interact in dangerous ways with prescription or over-the-counter medicines, and some may cause side effects even when taken alone. Anyone who takes both dietary supplements and medicines may be at risk for drug-supplement interactions. However, the risks are greater for older people than for young adults. Physiological changes that accompany the aging process can increase the risk of side effects from both supplements and drugs. In addition, older people take more medications than younger people do ("polypharmacy"), and thus they are at increased risk of interactions. Although people over the age of 65 make up only about 13 percent of the total population, they use about 30 percent of all prescription drugs and at least 25 percent of all over-the-counter drugs. Two-thirds of adults over age 65 use one or more drugs each day, and one-fourth of the people in this age group take three or more drugs each day. National health surveys have shown that people in their fifties and older are more likely than younger people to be supplement users. For example, in a recent survey conducted by the American Dietetic Association, daily supplement use was reported by 65 percent of respondents age 55 and over, as compared to 47 percent of those age 35 to 54 and 35 percent of those age 25 to 34. Since older people are also the heaviest users of medications, their high rate of supplement use may be a cause for concern. In a survey commissioned by the American Council on Science and Health (ACSH), more than half of people over the age of 50 reported that they took prescription or over-the-counter medicines on a regular basis, and more than half of these people said that they also took dietary supplements. Thus, more than one-fourth of the 1825 older adults who participated in this survey were at risk for drug-supplement interactions.  Weight Loss Supplements Possible reasons that some people use dietary supplements for weight loss are listed below. In a great many cases, these supplements appeal to the desire for a "magic bullet" that is less demanding than special diets and increased physical activity. Other reasons may be that they are available without a prescription and often advertise remarkable benefits. People also may be attracted to them because they are marketed as "natural," which may be misinterpreted by some as an assurance of safety and efficacy. Social stigma of obesity Health benefits of weight loss Desire for a "magic bullet" for weight loss Less demanding than accepted lifestyle changes, such as exercise and diet Frustration with previous attempts at dieting and/or exercise Easily available without a prescription More easily accessed than a professional consultation with a physician, nurse, or nutritionist Inflated advertising claims Appeal of a "natural" remedy Perception that natural equals safe Burning Calories We've all read about special pills or formulas that help your body "burn" excess calories. If only it were that simple. But the reality is this: you need to burn off 3,500 calories more than you take in to lose 1 pound, according to the American Dietetic Association (ADA). One way to do this is to reduce the amount of calories you take in. But ADA says diet alone isn't as effective as diet and exercise. According to the National Institutes of Health (NIH), most of the energy we burn every day goes towards basic functions such as: * sleeping * breathing * digesting food * sitting But beyond this, any physical activity in addition to what we normally do burns up extra calories. Just how many calories are we talking about? Just to give you an idea, here is the amount of calories used during an hours worth of specific activities, according to NIH. These figures are based on a 150-pound person. Heavier people burn more calories, lighter people burn less. For example, a 100-pound person burns 1/3 fewer calories, so you would multiply the number of calories by 0.7. For a 200-pound person, multiply by 1.3. In upcoming issues we will explore more of the exercise and diet choices available for Living Healthy! Drug and Supplement Interactions Many of the drug-supplement interactions that have been reported in the medical literature have involved herbal supplements, such as kava, ginkgo biloba, licorice, and St. John's wort. However, the problem of drug-supplement interactions is not limited to herbs. Some vitamins and minerals-such as vitamin E, folic acid, calcium, and zinc, can interact with certain types of drugs. For example, vitamin E may interact with anticoagulants. Other types of non-herbal supplements, such as melatonin and S-adenosylmethionine, can also be involved in interactions. Drugs and supplements may interact in a variety of ways. In some instances, a drug and a supplement may have similar actions in the body. Taking both at the same time can cause an excessively strong effect. For example, combining an anticoagulant drug such as warfarin with a supplement that also inhibits blood coagulation, such as high-dose vitamin E, feverfew, fish oil, garlic, or ginkgo biloba, could increase the risk of abnormal bleeding. In other instances, a supplement may counteract the effect of a drug. For example, supplements that tend to stimulate the immune system, such as vitamin E, zinc, or the herb echinacea, could interfere with the actions of drugs that are designed to suppress the immune system, such as corticosteroids or cyclosporine. Some dietary supplements may affect the absorption of a drug from the digestive tract into the bloodstream. For example, if calcium supplements are taken at the same time as levothyroxine (a drug used to treat thyroid problems) or tetracyclines (antibiotics used to treat infections), less of the drug may be absorbed. As a result, the drug won't be as effective as it should be. Other supplements may affect the way that the body breaks down a drug. For example, the herb St. John's wort increases the activity of an enzyme that breaks down a variety of drugs-including some drugs used in the treatment of heart disease, cancer, or AIDS as well as drugs used to prevent the rejection of organ transplants. If a patient who is taking one of these drugs also takes St. John's wort, the drug may be broken down more quickly than usual, and it won't be fully effective. Dietary supplements may also interact with medicines that you can buy without a prescription, such as aspirin and cold remedies. In addition, some supplements may interact with alcohol. A few dietary supplements may also interfere with diagnostic tests. For example, the use of high-dose vitamine C supplements can interfere with tests for occult blood in the stool. Benefits of Vitamin and Minerals Multivitamin and multimineral supplements are specifically designed to provide a variety of both essential and/or non-essential nutrients for the body. The primary purpose of these supplements is to allow individuals the option of taking only one or a few dietary supplements that provides many nutrients to the body. Multivitamin supplements can help to prevent both vitamin and mineral deficiencies, and are used by many to increase essential nutrients in the body to achieve additional health benefits. Multivitamins usually contain at least 100, if not more, of the recommended dietary allowance of essential vitamins. While not all multivitamins contain minerals, in the case of high potency multivitamins, mineral content may also exceed 100 of Daily Value or U.S. Recommended Allowance (USRDA). Nutrients that should be included in what we consider a complete multivitamin include: Vitamin A Vitamin B-complex -including thiamine, riboflavin, niacin and/or niacinamide, vitamin B6, folate, vitamin B12, pantothenic acid, and biotin. Vitamin C Vitamin D Vitamin E Vitamin K Calcium Magnesium Zinc Iodine Selenium Copper Manganese Chromium Molybdenum  Whole Health and You! Nutritional supplements are a way of life. They include dietary supplements for weight loss and herbal supplements that can improve your health. To ensure that you are following a balanced and common sense approach to whole health it is important to look at many sources of information and advise. These include registered dietitions and your physician. It is our objective in Living Healthy to keep you informed about a wide range of nutrition, exercise and lifestyle choices that will help you ask the right questions in order to find the best approach for you.