Evidence-Based Complementary Medicine Flashcards
(16 cards)
Define dietary supplements
Refers to vitamins and mineral supplements, nutritional products (e.g. fish oils and glucosamine), herbal and homeopathic products and aromatherapy oils
In Australia dietary supplements are referred to complementary medicines. True or False
True
Inadequate fruit and vegetable intake can lead to nutrient deficiencies. True or False
True
Reduced fruit and vegetable intake is linked to poor health and increased risk of non-communicable disease (NCD’s). **An estimated 3.9 billion deaths worldwide were attributed to inadequate fruit and vegetable consumption in 2017. **. The WHO suggests that consuming more than 400mg of fruits and vegetables per day can improve health and reduce the risk of certain NCDS. Overall diet should be low in fat, sugars and sodium
Understand this
Outline the 3 ways vitamins and supplements are used.
-
-
Treats a gross deficiency or prevents deficiency
- Primary: inadequate intake
- Secondary: reduced bioavaliability of nutrient, malabsorption, increased metabolism or excretion, metabolic disorders, pharmaceutical solutions -
Prevent adverse outcomes in specific population
- pregnant woman - Treat symptoms not associated with a deficiency (e.g. common cold and flu)
At a global level micronutrients with the lowest levels of adequate intake was calcium, iron, Vitamin A and zinc. True or False
- Treating or Preventing deficiency
True
In high income countries folate was the micro-nutrient that had the highest prevalence of inadequate intake. True or False
- Treating or preventing deficiency
True
List the populations that are at risk of calcium deficiency.
- these risk populations should be considered for screening such as blood tests to see if there are adequate levels in blood. If not then supplementation or an improved dietary plan to prevent development of deficiency
Treating or preventing deficiency
- Postmenopausal women (associated with declining
estrogen)
– Amenorrheic women (decreased circulating
estrogen)
– Dairy free diets used for the management of
lactose intolerance or cow’s milk allergy
– Vegetarians (due to veganism or high dietary
phytic and oxalic acids).
List the populations that are at risk of Vitamin A deficiency
Treating or preventing deficiency
- Premature infants
– Infants and young children in developing
countries’
– Pregnant and lactating women in developing
countries
– People with cystic fibrosis
List the populations that are at risk of zinc deficiency
Treating or preventing deficiency
- Vegetarians
– Pregnant and lactating women
– Older infants who are exclusively breastfed
– People living with sickle cell disease
– Alcoholics
List the populations that are at risk of folate deficiency
Treating or preventing deficiency
- Women of childbearing age
– Pregnant women
– People with malabsorptive disorders
– People with the MTHFR polymorphism
– Alcoholism
List the populations that are at risk of iron deficiency
Treating or preventing deficiency
- Pregnant women
– Infants and young children
– Women with heavy menstrual bleeding
– Frequent blood donors
– People living with cancer
– People who have gastrointestinal disorders
or have had gastrointestinal surgery
– People living with coeliac disease, and
some inflammatory bowel diseases.
– People living with heart failure
List the populations that are at risk of Vitamin D deficiency
Treating or preventing deficiency
- Breastfed infants
– Older adults
– People with limited sun exposure - Homebound individuals; people who
wear long robes, dresses, or head
coverings for religious reasons
– People with dark skin - People who are obese or have undergone
gastric bypass surgery
How can we prevent adverse outcomes in pregnant woman (a specific population). Adverse outcomes are often associated with low micronutrient intake .
Preventing adverse reactions in specific populations
- Inadeqate folate intake during pregnancy is associated with an increased risk of neural tube defect. To increase folate levels daily recommended folic acid dose of 0.4mg either alone or in a multi-vitamin supplement should be consumed - women who are planning to become pregnant and for the first 3 months of pregnancy
- Iron deficiency anaemia is associated with pre-term birth and low birth weight.
- 30 to 60 mg of Iron should be consumed
-** Pregnant woman who have a low dietary intake of iron and an impaired biochemical status,** all the guidelines recommend therepeutic doses of iron to prevent adverse outcomes of iron deficiency - Calcium deficiency increases the risk of gestational hypertension, neonatal mortality and pre-term birth and this is counteracted with calciuim supplementation
- larger effects of this adverse reactions when women consume less than 600mg per day
- WHO recommends: 1.5 to 2.0 grams of oral elemental calcium for reducing the risk of pre-eclampsia (specific hypertension of pregnancy)
Provide an example where a vitamin or mineral is used to treat symptoms not associated with a deficiency. Discuss dose, adverse reactions, precautions and drug-nutrient interactions
Vitamin and supplement used to treat Sx not associated with a defic.
- Zinc which treats upper respiratory tract infection
Dose: >75mg/day in divided doses commenced within 2-3 days of symptom onset of common cold - reduced Sx at day 7 - Adverse: bad taste, nausea when zinc lozenges are consumed but not syrup
- Caution:
- intranasal zinc is not recommended due to the risk for loss of smell
- overdoses of zinc are associated with zinc-induced copper deficiency resulting in blood dyscrasias and neurological symptoms
- Drug-nutrient interactions:
- anti-virals, tetracyclines, quinolone and penicillamine should be taken at least 2 hours before, or 4-6 hours after, zinc supplements to minimize the effects of any interactions.
- zinc should be taken 3 hours after cephalexin to minimize an interaction
