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Nutrition 1 (Semester II) > 20. Supplements > Flashcards

20. Supplements Flashcards

1
Q

What is a supplement?

A

A concentrated source of a vitamin, mineral or other substance with a nutritional or physiological effect, sold in dose form

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2
Q

In which states should we use supplements?

A

Deficiency
Therapeutic uses
Prevent disease
Maintain health

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3
Q

Why are supplements needed?

A 
Reduced nutrient content due to soil depletion
Pesticides
High yielding crops
Long distance transportation
Processing/toxins
Weakened digestion
Stressful lifestyles
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4
Q

Which are the best forms to take as supplements?

A

Liquids

Powders

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5
Q

Pros and cons of liquids as supplements?

A

Excellent absorption

Expensive
Less stable

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6
Q

Pros and cons of powders as supplements?

A

Good for larger doses

Not good for ingredients that attract moisture

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7
Q

Pros and cons of capsules as supplements?

A

Fewer excipients than tablets

Not efficient in large doses

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8
Q

Pros and cons of tablets as supplements?

A

Cheap
Easy to produce in large quantities

More excipients
(try to avoid)
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9
Q

What are enteric formulations?

A

Used to ensure tablets survive stomach acid

Don’t release contents until SI

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10
Q

What sort of supplement is good in enteric form?

A

Garlic capsules

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11
Q

What are spore formulations good for?

A

Probiotics

survive stomach and release contents into SI

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12
Q

What do we need to be mindful of with chewable formulation?

A

Coated to make more palatable

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13
Q

What do we need to be mindful of with slow-release formulation?

A

Cheaper forms contain hydrogenated fats to hold tablets together longer

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14
Q

What are the benefits of liposomal supplements?

A

High bioavailability/absorption
Increased oral uptake in mouth
Increased uptake in target cells
Easier to take than large tablets

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15
Q

Examples of excipients in supplements

A 
Stabilising agents
Fillers
Binding agents
Emulsifiers
Flavours
Colours
Sweeteners
Preservatives
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16
Q

Vitamins/minerals absorbed in duodenum

A

Ca
Mg
Fe
Zn

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17
Q

Vitamins/minerals absorbed in jejunum

A

B vits
C vit
Ca
Mg

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18
Q

Vitamins/minerals absorbed in ileum

A

B12

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19
Q

How best to take water soluble vitamins?

A

With food

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20
Q

Why should you avoid taking B vits in the evening?

A

Used for energy so may trigger or exacerbate insomnia

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21
Q

How best to take fat soluble vitamins and CoQ10?

A

With food containing fat

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22
Q

How best to take EFAs?

A

With food

Avoid high levels of opposing fat though

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23
Q

How best to take amino acids?

A

With a carb food/drink

On an empty stomach

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24
Q

When best to have a protein shake

A

Any time of day

Post exercise/surgery

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25
Q

How best to take minerals

A

With food

adequate stomach acid is needed for digestion

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26
Q

When is it best to take Ca or Mg?

A

In evening to aid restful sleep

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27
Q

When is it best to take Zn?

A

On empty stomach before bed

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28
Q

What factors should be considered when working out dosage?

A 
Age of patient
Size of patient
State of health
Deficiency or insufficiency?
Digestive capability
Lab test results
Safe therapeutic range
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29
Q

What is the elemental amount of a mineral?

A

The amount available for absorption after it’s been freed from its carrier molecule

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30
Q

What are naturally sourced supplement ingredients?

A

Nutrients from vegetable, animal or mineral sources

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31
Q

What are synthetic supplement ingredients?

A

Manufactured with identical molecular structure to the same natural nutrients

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32
Q

What are food cultured supplement ingredients?

A

Nutrients (natural or synthetic) are added to yeast/algae suspensions where they concentrate within cells

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33
Q

What are the benefits of food cultured supplements?

A

Makes the nutrient more bioavailable

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34
Q

What are food based supplement ingredients?

A

Made by enzymatically reacting synthetic and natural vitamins with extracts containing vegetable proteins

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35
Q

Why aren’t food based supplements common?

A

Low nutrient potency
Fluctuating nutrient levels
Limited shelf life

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36
Q

Why is a natural form of vit C better for building collagen?

A

Stays in the body longer

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37
Q

Why is a synthetic form of vit C better for detoxification?

A

Rapidly excreted from body and will take a large amount of free radicals with it

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38
Q

When may food based supplements not be enough to supply optimal dosage?

A

Poor dietary habits
Environmental factors
Chronic health conditions
Food sensitivities

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39
Q

What do naturopaths try to avoid in supplements?

A 
Preservatives
Colours
Fillers
Binding agents
GMO
Irradiated products
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40
Q

Common organic mineral carriers

A 
Citrate
Fumarate
Malate
Ascorbate
Glycinate
Picolinate
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41
Q

Common inorganic mineral carriers

A 
Oxide
Sulphate
Chloride
Nitrate
Carbonate
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42
Q

Why are citrates good?

A

More bioavailable

Requires less stomach acid to break bonds and free the mineral for absorption

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43
Q

Why are picolinates good?

A

High absorption

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44
Q

What is a chelator?

A

Substance that binds tightly to mineral atoms

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45
Q

What are the advantages of chelators?

A

Bypasses competitive absorption with other minerals
Body treats it as an AA and is efficient at absorbing these
Extends length of absorption sites

46
Q

What are the disadvantages of AA chelates?

A

AA complexes may be too tightly bonded
Dosage can end up too low
May be expensive for clients

47
Q

Which vitamins and mineral should Ca be taken with if supplementing?

A

D3/K2

Mg

48
Q

When can supplementary Ca be ineffective at preserving bone density?

A

If dietary intake is sufficient

49
Q

What can too much Ca lead to?

A

Kidney stones

Soft tissue calcification

50
Q

Which Ca is easier to absorb - citrate or carbonate?

A

Citrate

51
Q

Good forms of Ca

A

Citrate
Glycinate
Gluconate

52
Q

Poor forms of Ca

A

Carbonate
Ascorbate
Oxalate

53
Q

Why should Ca oxalate never be used as a supplement?

A

Can lead to kidney stones

54
Q

Should Mg and Ca be taken together?

A

No, keep 2 hours apart to achieve highest serum levels

55
Q

How does Ca interact with Zn and Fe?

A

May reduce absorption of these minerals

56
Q

Why should excess intake of phosphorus in soft drinks, caffeine and dietary fat be avoided with Ca supplements?

A

These things will increase Ca excretion

57
Q

How do corticosteroids and Ca interact?

A

Long term use of the drug can lead to reduced Ca absorption and inhibition of osteoblasts

58
Q

How does levothyroxine and Ca interact?

A

Compete for absorption

take 4 hrs apart

59
Q

How does oestrogen therapy and Ca interact?

A

Increases absorption of Ca

beneficial

60
Q

How do antibiotics quinolones and tetracyclines interact with Ca supplements?

A

Ca hinders bioavailability of the antibiotics

61
Q

Which vitamins and mineral does Mg need for absorption?

A

B6
D
Se

62
Q

What is Mg absorption hindered by?

A

Phytates
Fibre
Alcohol
Excess saturated fat

63
Q

Which form of Mg is good for insomnia?

A

Mg glycinate

64
Q

What are the transdermal forms of Mg?

A

Mg chloride

Mg sulphate

65
Q

Which form of Mg is good for energy production?

A

Mg malate

66
Q

What is Mg sulphate also known as?

A

Epsom salts

67
Q

What is the cheapest form of Mg available?

A

Mg oxide

68
Q

How do antibiotics and Mg interact?

A

Mg may reduce absorption of the antibiotics

take 2 hrs apart

69
Q

How do blood pressure meds and Ca channel blockers interact with Mg?

A

Mg may increase the risk of negative adverse effects

70
Q

How does HRT, OCP and diuretics interact with Mg?

A

These may decrease Mg levels

71
Q

Which are the best absorbed Fe supplements?

A

Ferrous citrate
Ferrous fumarate
Ferrous sulphate

72
Q

What consideration should be given to ferrous fumarate and sulphate?

A

May inhibit absorption of vit E

73
Q

Why is overdosing Fe in children bad?

A

Toxic

Can be fatal

74
Q

Why should Fe supplementation be avoided in GI bacterial overgrowth?

A

Fe feeds the bacteria

75
Q

Why can Fe supplements cause free radical damage?

A

Fe has pro-oxidant effects

76
Q

What should always be checked before commencing Fe supplementation?

A

Serum ferritin

Transferrin

77
Q

Drug interactions with Fe

A

Antibiotics
Thyroxine
Levodopa

78
Q

Adverse reactions with Fe

A

Diarrhoea
Constipation
Nausea

79
Q

In which conditions is Fe toxicity more common?

A

Haemosiderosis
Haemochromatosis
Thalassaemia

80
Q

Which form of chromium is best for treating T2D?

A

Chr malate

81
Q

Why should we be careful in supplementing chromium in diabetics?

A

It may increase the effects of some diabetes drugs

82
Q

Which form of Zn may cause stomach irritation?

A

Zn sulphate

83
Q

Which meds should be taken away from Zn?

A

Antibiotics

84
Q

Which meds reduce Zn absorption?

A

Aspirin

PPIs

85
Q

Which forms of vit C are best for health maintenance?

A

Low dose food forms (rosehip, acerola)

86
Q

Which forms of vit C are best for detoxification?

A

High dose ascorbic acid

AO, quickly excreted

87
Q

Why aren’t tablets, chewables, fizzy tablets the best forms of vit C?

A

Sweeteners
Artificial colourings
Additives

88
Q

Which forms of vit C are best to take?

A

Bioflavonoids (quercetin, rutin)

Liposomal

89
Q

What are the advantages of time-released vit C?

A

Maximise total absorption over the day

90
Q

What are mineral ascorbates?

A

Buffered vitamin C

91
Q

What are the benefits of buffered vit C?

A

Cause less GI upset

92
Q

What needs to be considered when taking a buffered vit C?

A

The accompanying dose of mineral

93
Q

What is Ester-C?

A

A patented form of buffered vit C

Well absorbed and GI tolerated

94
Q

Why should high dose vit C be avoided in those with haemochromatosis?

A

Vit C may increase Fe absorption

95
Q

How do statins and vit C interact?

A

Vit C may affect lipid levels in those taking statins

96
Q

In which circumstances may there be an increased need to supplement vit A?

A

Pancreatic disease
Eye disease
Measles

97
Q

Pre-formed variants of vit A in supplements

A

Retinol acetate

Retinyl palmitate

98
Q

Provitamin A version in supplements

A

Beta carotene

99
Q

Why is vit A supplementation not recommended for current or previous smokers?

A

Shown to accelerate lung cancer growth

100
Q

What form of vit D3 do we find in supplements?

A

Cholecalciferol

101
Q

What form of vit D2 do we find in supplements?

A

Ergocalciferol

102
Q

Which is the most effective form of vit D in supplements?

A

Cholecalciferol

103
Q

Which is the natural form of vit E?

A

D-alpha-tocopherol

104
Q

When are Se supplements most commonly used?

A

Immune system health

Supporting T3 production in hypothyroidism

105
Q

Optimal forms of Se

A

Selenomethionine

Selenodiglutathione

106
Q

Active forms of B12

A

Methylcobalamin

Adenosylcobalamin

107
Q

What inactive form are most B12 supplements in?

A

Cyanocobalamin

108
Q

Do B12 supplements still need IF?

A

Yes

109
Q

What should be added to fish oils to prevent oxidisation?

A

AO

110
Q

Why should we be wary of fish oils from liver?

A

Could contain pollutants

111
Q

From what substance can vegan forms of EFAs be obtained?

A

Algae

Nutrition 1 (Semester II) (16 decks)

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