Supplements in Practice Flashcards
Definition of a food supplement:
A concentrated source of a vitamin, mineral or other substance with a nutritional or physiological effect, alone or in combination, sold in dose form
Herbal products are classed as medicine
3 reasons for using supplements
- DEFICIENCY states - end stage symptoms associated with an extended lack of a particular vitamin
- THERAPEUTIC uses - insufficiency can be identifies when there is under functioning of certain biochemical pathways
- PREVENTATIVE health - to maintain optimal health and wellness
Factors for which supplements may be needed?
- Food processing reduce nutrient content
- Food additive deplete nutrients
- Weakened digestion
- Stressful lifestyle
- Nutrient depletion at birth
- Soil depletion
- High yield crops are deficient in certain nutrients
- Fertilisers
- Pesticides deplete soil
- Long distance transport
What are prohibited claims on supplements labels?
Health claims:
• No medicinal claims on labels are permitted; no presentation or labelling is allowed that infers that a supplement can prevent, treat or cure human disease.
Prohibited claims:
• Reference to the rate or amount of weight loss.
• Reference to recommendations of individual doctors or health professionals.
• Health claims on alcoholic beverages.
• Claims which suggest that health could be affected by not consuming the food.
What is a sign of good manufacturing of supplements?
GMP = good manufacturing practices
Many companies are GMP compliant (self-regulated) but not GMP approved
As supplements are unlicensed they do not have to meet the requirements of GMP
– Be of consistent high quality.
– Be appropriate to their intended use.
– Meet the requirements of the marketing authorisation (MA) or product specification
What manufacturing method may degrade a supplement quality?
- Fish oil and plant oil must be cold press
- Whey protein must be specially filtered to remote lactose and homes
- Cheaper extraction ad processing methods recuse the effectiveness and affect safety profile
- Ingredients may degrade over time so company add extra to meat label claim - OVERAGE
what is OVERAGE ?
Ingredients may degrade over a supplement’s shelf life. Reputable
supplement companies will add extra so that the amount left at the
end of its shelf life still meets the label claim. This is called overage.
What to check when looking for a good supplement?
- Are its products made in GMP facilities?
- Does it state the source of the product?
- Does its raw materials go through quality checks?
- What is the GMO status of its products?
- Are its products free from contaminants?
- What are the values of the company?
What is the pros and cons of the following supplement administration methods?
Tablets
Capsules
Powders
Liquids
Enteric Formulation
Spore form
Chewable formulations
Slow-release formulation
Tablets
+ Cheap and easy to produce in large quantities
- more excipients
Capsules
+ fewer excipients
- not efficient for large doses
Powders
+ good for bigger doses (glutamine)
- not suitable for sticky ingredients
Liquids
+ excellent absorption
- more expensive and less stable - need antioxidant like vit E to prevent oxidation
Enteric Formulation
+ good garlic capsule
- excipients so that they survive the stomach
Spore form
+ good for probiotics
Chewable formulations
- coated before they are compressed
Slow-release formulation
- contain hydrogenated fats to hold tablets together longer
What are liposomal supplements ? What are the advantages? What vitamins are good in this form?
Liposomal supplements have a protective phospholipid bilayer to protect the active ingredient
+ high bioavailability and absorption
+ Increased oral uptake in the mouth
+ Increased uptake into large cells
+ Easier to take than larger tablets
+ Suitable for water and fat soluble nutrients
B12 and VitC
The therapeutically-active component in a supplement
can be as low as how much of the total content?
How are called the additives used to in forming tablets and capsules to bind active ingredients together?
What other nom-active ingredients are added to supplements?
As low as 2%
Excipients
Capsule shell - gelatine or plant cellulose
Flow agents - Avoid magnesium stearate.
Binding agent - maltodextrin
Fillers
Natural fillers - Lithothamnion calcareum from fossilised seaweed
Emulsifiers - to mix oil and watery ingredients together
Flavours - avoid MSG
Calours
Sweeteners - Glycerine
Preservatives - Vit E, ascorbic acid
What vitamins are absorbed in the duodenum, Jejunum, Ileum?
Duodenum: Calcium, selenium magnesium, chromium, iron, manganese, zinc.
Jejunum: B vitamins, biotin, vitamin C, choline, inositol, calcium, magnesium.
Ileum: Vitamin B12.
How to take water soluble and fat soluble vitamins for better absorption?
Water soluble = B vitamins and C with food
Fat soluble = A D E K and CoQ10 with fat
Which water soluble vitamins are contraindicated to take in the evening?
What is the exception and why
B vitamins as they may trigger or exacerbate insomnia
B6 is the exception because it calm the NS
How to take amino acids supplements?
Ideally with carbohydrate food / drink or on an empty stomach.
Protein shakes: Take any time of day
Absorption of amino acids in liquid shakes depends on transit time through gut, stomach acid, proteolytic enzymes, etc
How to take mineral supplements? More specifically Calcium, magnesium and zinc
Minerals: Take with food. Adequate stomach acid is needed for digestion.
• Calcium and magnesium: Take in the evening to aid restful sleep.
• Zinc: Take on an empty stomach before bed. Caution: Some people may suffer stomach discomfort after taking zinc.
What consideration to take when working out dosage?
• Age of the client: May need higher dose with increasing age.
• Digestive capability: Ability to absorb and excrete? Constipated?
• State of health: Dosing for optimum health or for disease state?
• Therapeutic doses: Evidence of dosages that are shown in clinical trials to be effective for certain disease states.
• Dietary deficiency or insufficiency: What symptoms are there?
• Lab test results: What do these indicate?
• Safe therapeutic range: Age group of client?
How to compare supplement dosage for Mineral, protein and fish oils?
Elemental amount of minerals: This is the amount of mineral available for absorption when it has been freed from its carrier molecule => the ‘elemental mineral’ is the amount of the mineral that is actually used by the body.
Protein supplements: Compare the amount of protein (in grams) per 100 g of powder.
Fish oils: Compare the active ingredients, EPA and DHA.
How do I find a good, efficient supplement?
• What are the companies’ quality control procedures?
• Are they GMP-approved / compliant?
• Are their products ISO accredited?
• What is the traceability of raw materials?
• Who formulates their products?
• What is their background / qualifications?
• What is their experience?
• What other companies have they formulated products for?
• What is the philosophy of the company?
When can the term natural can be used for a supplement?
The term ‘natural’ can be used even if only 10% of the product is natural. The other 90% could be synthetic.
What are the pros and cons of various supplement sources?
Natural source
Synthetic
Food cultured
Food based
Natural source = Nutrients from vegetable, animal or mineral sources.
+ Natural may have better efficacy than synthetic forms
- Generally not available in higher doses.
Synthetic = Manufactured with identical molecular structure to the same natural nutrients
+ When wanting to use higher doses
- The ascorbic acid in food is found within the vitamin C complex along with other compounds, including bioflavonoids, which offer additional health benefits and are not in synthetic supplements but in whole food
Food cultured - It is thought culturing makes nutrients that are more bioavailable’. Nutrient supplements are often grown in yeast or algae.
Food based = physical mix of isolated nutrients within a food base but there may not always be bonding at a cellular level.
+ metabolic outcome may be the same as food-cultured as the body recognises these two forms as food.
- low nutrient potency, fluctuating nutrient levels and limited shelf life. Nutrients are easily degraded by heat, pH changes, light, and oxygen.
What vitamins to chose and which to avoid
Vitamin A: Retinol palmitate
AVOID retinyl palmitate.
Vitamin B1 (thiamine): Benfotiamine*, thiamine hydrochloride
AVOID thiamine mononitrate.
Vitamin B2 (riboflavin): Riboflavin, riboflavin 5 phosphate.
Vitamin B3 (niacin): Niacinamide (nicotinamide), nicotinic acid may cause flushing.
Vitamin B5 (pantothenic acid): Pantothenic acid, calcium D-pantothenate.
Vitamin B6 (pyridoxine): Pyridoxal 5 phosphate
AVOID pyridoxine hydrochloride.
Vitamin B12: Methylcobalamin, adenosylcobalamin, hydroxycobalamin,
AVOID cyanocobalamin.
Folic acid: Methylfolate
AVOID pteroylglutamic acid.
Choline: Choline bitartrate, lecithin
AVOID choline chloride.
Vitamin C (ascorbic acid): Vitamin C complex with bioflavonoids (listed as food), ascorbic acid (good for detoxification protocols).
Vitamin D: Vitamin D3 ( cholecalciferol)
AVOID irradiated ergosteral, calciferol.
Vitamin E: D-alpha tocopherol, d-alpha tocotrienol
AVOID dl-alpha tocopherol, dl-alpha tocopherol acetate or succinate.
Consideration when opting for natural vs synthetic supplements:
- Natural supplements usually have better bowel tolerance than synthetic ones so they are retained longer in the body
- Food-state supplements may not be enough to supply the optimal dosage when someone has a high nutritional requirement
- Sensitivities to foods or fillers in food-based products, such as gluten or nightshades, can cause mild to severe reactions; isolated, synthetic nutrient products may work better for some sensitive people.
- What is the desired outcome? As naturopaths, it is preferable to opt for naturally-sourced nutrients. However, synthetic forms can have a useful role depending on the reason for supplementing.
example: If you use ascorbic acid, the most common synthetic form of vitamin C, it will be rapidly excreted from the body but will take a significant amount of free radicals with it. This is ideal if detoxification is the desired outcome.
example: methylfolate, although the most bio-effective form of folate, cannot be natural or from food sources.
Try to avoid: preservatives, colourants, fillers or binding agents to allow the activity of, and synergy between, vitamins, minerals, plant enzymes, phytonutrients without physiological or biochemical interference. Avoid GMO and irradiated products.
What is the issue with irrigation in supplements?
Irradiated supplements:
• High-doses of radiant energy used to destroy pathogens.
• Destroys delicate nutrients and disrupts their natural frequencies.
• Less damaging technologies include dry steam sterilisation.
