Supplements - Big take away points:
Nothing is benign!! This JAMA article on “anti-oxidant” use is just ONE of MANY examples
https://jamanetwork.com/journals/jama/article-abstract/205797
68 trials, 230,000 participants.
Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.
High Potency (only if you know you have a deficiency)
In 2013 the US Preventative Task Force reported inadequate data to support
multivitamin use in people without deficiencies
Multivitamin-multimineral treatment has no effect on mortality risk.
No affect on CV disease, stroke
Maybe 9% reduce risk of cataracts
One poor study showed maybe decrease risk of some cancers in older men
Maybe people with breast cancer die less if taking multi
Who gets tested for deficiencies anyway??!!!
People on Diets / special populations
Pregnant women, pts s/p gastric bypass
Folic acid decreases the risk of neural tube defects so pregnant women should take
Especially if not eating fortified grains
THERE IS NO STANDARD FORMULA
Many dont have what they say they do
Consumer Lab tested some - these actually have what they say they have and best price
Flintstone gummies came out best for kids (had what they said they had)
Equate (Walmart) Brand for 50 +vita
Prenatal: most fail because guidelines change. Garden of Life did not
WE DON'T ENDORSE ANY BRAND
THE POINT IS YOU DON'T HAVE TO SPEND MONEY
YOU MAY OR MAY NOT NEED IT
EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are found in fish
They are Omega-3 fatty acids
The body can only manufacture limited amounts of EPA and DHA
You need to get it from your diet
Reduces triglycerides, raises HDL, reduces homocysteine, reduces Blood pressure
Homocysteine damages artery walls
So obvious it reduces risk of CV disease??!!!
Not so fast, multiple recent large randomized control studies did not see benefit
Maybe short term / secondary protection (after you have had your heart attack)
Increased intake of omega 3 in fish oil may reduce inflammation in pts with RA.
May help with pain in OA or RA but not function issues
Some studies say dec inflammation in UC
May decrease risk of dying from colon cancer if you already have it
May increase insulin resistance and oxidative stress in DM
May increase fasting blood sugar
High levels of oxidative products in fish oil products
**listen to our podcast on oils!
Top brands found to have 4 times the oxidative levels considered safe
https://www.ncbi.nlm.nih.gov/pubmed/28011269
Influences expression of more than 200 genes
Deficiency is linked to inc risk of heart disease, cancer, DM, asthma, autoimmune D
BUT low levels and HIGH levels are linked with negative outcomes
Get tested regularly - change dosage appropriately
Benefits of sunlight are more than vitamin D supp alone
Don't get burned but you need sun!!!
β-Endorphin: a natural opiate that induces relaxation and increases pain tolerance
Calcitonin Gene-Related Peptide: a vasodilator that protects against hypertension, vascular inflammation, and oxidative stress
Substance P: a neuropeptide that promotes blood flow and regulates the immune system in response to acute stressors
Adrenocorticotropic Hormone: a polypeptide hormone that controls cortisol release by the adrenal glands, thus regulating the immune system and inflammation
Melanocyte-Stimulating Hormone: a polypeptide hormone that reduces appetite, increases libido, and is also responsible for increased skin pigmentation
Might help in the short term
Only changing your diet will result in change in gut bacteria population
Take it if on antibiotics (if you must)
Take it when ill (maybe - no data)
Protein Powders/pre-workout shakes.
The reality is that there is some evidence (Peter Attia) that taking leucine just before and during a workout possibly slows muscle degradation. It is also important to note that any sort of deficiency in your diet is exceedingly rare and you can probably get all the Leucine you need from a normal healthy diet.
https://pubchem.ncbi.nlm.nih.gov/compound/L-leucine#section=Top
Over 300 enzymes need it to function especially those related to ATP / energy
Studies show most americans are deficient
In nuts - but watch the PUFAS (OMEGA 6s)
Take it if you have a reason
Anxiety, migraines, constipation
Hard to overdose (diarrhea)
Does no decrease endogenous melatonin (I was worried about this)
Good for shift workers / jet lag
Maybe for a fever if you feel terrible
Fevers help fight infections though
Acute inflammation is good - dont damper this
Find another way to treat chronic inflammation
See out podcast on Inflammation
https://www.ncbi.nlm.nih.gov/pubmed/23255568
https://www.ncbi.nlm.nih.gov/pubmed/29361684
http://annals.org/aim/fullarticle/1767855/vitamin-mineral-supplements-primary-prevention-cardiovascular-disease-cancer-updated-systematic
https://jamanetwork.com/journals/jama/fullarticle/1380451
https://www.ncbi.nlm.nih.gov/pubmed/22493407
https://www.ncbi.nlm.nih.gov/pubmed/23940215
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021439/
https://www.ncbi.nlm.nih.gov/pubmed/26161757
http://gut.bmj.com/content/58/12/1606.full.pdf
http://gut.bmj.com/content/early/2016/09/27/gutjnl-2016-311990
http://americancollegeofnutrition.org/content/the-journal/content/29/1/55.abstract
https://www.ncbi.nlm.nih.gov/pubmed/20694407
https://chriskresser.com/vitamin-d-more-is-not-better/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC128885/#B23
