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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
Federal Regulation of Federal Regulation of Dietary SupplementsDietary Supplements
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.
Federal Regulation of Federal Regulation of Dietary SupplementsDietary Supplements
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”.
Federal Regulation of Federal Regulation of Dietary SupplementsDietary Supplements
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
Federal Regulation of Federal Regulation of Dietary SupplementsDietary Supplements
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
Federal Regulation of Federal Regulation of Dietary SupplementsDietary Supplements
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
Safety ConsiderationsSafety Considerations
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
Safety ConsiderationsSafety ConsiderationsBe AwareBe Aware
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
Safety ConsiderationsSafety ConsiderationsBe AwareBe Aware
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.
Safety ConsiderationsSafety Considerations
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?
Reliable Sources of Reliable Sources of InformationInformation
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
Reliable Sources of Reliable Sources of InformationInformation
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
Reliable Sources of Reliable Sources of InformationInformation
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
Reliable Sources of Reliable Sources of InformationInformation
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