Older Americans are hooked on vitamins

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When she was a young physician, Dr. Martha Gulati noticed that many of her mentors were prescribing vitamin E and folic acid to patients. Preliminary studies in the early 1990s had linked both supplements to a lower risk of heart disease.

She urged her father to pop the pills as well. But a few years later, Gulati, now chief of cardiology for the University of Arizona College of Medicine-Phoenix, found herself reversing course after rigorous clinical trials found neither supplement did anything to protect the heart. Even worse, studies linked high-dose vitamin E to a higher risk of heart failure, prostate cancer and death from any cause. “‘You might want to stop taking [these],’ ” she told her father.

More than half of Americans take vitamin supplements, including 68 percent of those 65 and older, a 2013 Gallup poll said. Among older adults, 29 percent take four or more supplements, according to a Journal of Nutrition study.

Often, preliminary studies fuel exuberance about a dietary supplement, leading millions of people to buy in to the trend. Many never stop. They continue even though more rigorous studies — which can take many years to complete -— hardly ever find that vitamins prevent disease, and in some cases cause harm. “The enthusiasm does tend to outpace the evidence,” said Dr. JoAnn Manson, chief of preventive medicine at Boston’s Brigham and Women’s Hospital.

There’s no conclusive evidence that dietary supplements prevent chronic disease in the average American, Manson said. And while a handful of vitamin and mineral studies have had positive results, those findings haven’t been strong enough to generally recommend supplements, she said.

The National Institutes of Health has spent more than $2.4 billion since 1999 studying vitamins and minerals. Yet for “all the research we’ve done, we don’t have much to show for it,” said Dr. Barnett Kramer, director of cancer prevention at the National Cancer Institute.

Part of the problem, Kramer said, could be that much nutrition research has been based on faulty assumptions, including the notion that people need more vitamins and minerals than a typical diet provides; that megadoses are safe; and that the benefits of vegetables can be boiled down into a pill.

Vitamin-rich foods can cure diseases related to vitamin deficiency. Oranges and limes prevent scurvy. And research has long shown that populations that eat a lot of fruits and vegetables tend to be healthier than others.

But when researchers tried to deliver the key ingredients of a healthy diet in a capsule, Kramer said, those efforts nearly always failed. It’s possible that the chemicals in the fruits and vegetables on your plate work together in ways that scientists don’t fully understand, said Marjorie McCullough, strategic director of nutritional epidemiology for the American Cancer Society.

More important, perhaps, is that most Americans get plenty of the essentials. Although the Western diet has a lot of problems — too much sodium, sugar, saturated fat and calories, in general — it’s not short on vitamins. Read more…

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The Truth About Skin, Hair, And Nail Supplements

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Spoiler alert: Some work while others are a total waste of money.

 

 

 

Can a powder or pill really give you a glowing complexion, strong, shiny strands, or nails that grow quickly and never crack?

Sure, there are plenty of products out there promising to do these very things. And we’ve all seen a celebrity or beauty blogger who swears by her daily collagen smoothie or biotin supplement. But despite the hype, there’s actually not much science backing up the validity of beauty supplement claims.

“Most of us dermatologists just don’t recommend oral supplements to healthy people,” says Sheryl Hoyer, MD, a dermatologist with Northwestern Medicine.

But does that mean all supplements are a waste of your money? Or are there any that might actually be beneficial? Here’s what you need to know about things like biotin, keratin, collagen, and other popular pills, straight from the experts.

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Biotin

Also known as vitamin B7, biotin plays an important role in helping the body metabolize proteins—which are needed to produce healthy skin, hair, and nail cells. People who are severely deficient often end up with hair loss, eczema, and brittle nails, and supplementing can help correct those problems, explains Melanie Palm, MD assistant clinical professor of dermatology at the University of California-San Diego and founder of The Art of Skin.

But if you already get the recommended 30 mcg of biotin daily, loading up on extra won’t give you a beauty boost, according to a reent review of 18 studies.c And as long as you eat a balanced diet, you’re almost certainly getting your fill. The nutrient is found in eggs, salmon, pork chops, hamburgers, sunflower seeds, sweet potatoes, almonds, broccoli, and spinach.

 

​ Do Hair, Skin, And Nails Vitamins Actually Work?
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Prenatal vitamins

Pregnant women are known for having thick, lustrous hair that grows really fast. But contrary to popular belief, it’s not because they’re taking prenatal vitamins. “It’s more likely the hormones of pregnancy, not the vitamins, that are enhancing hair growth,” says Hoyer.

In fact, there’s zero evidence that prenatals do anything for hair growth—whether you’re pregnant or not, she adds. So unless you’re having a baby (or trying for one) don’t bother buying these.

​ Do Hair, Skin, And Nails Vitamins Actually Work?
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Keratin

Keratin is the structural protein that makes up the outermost layer of hair, skin, and nails. Our bodies make plenty of it on their own, but beauty buffs often claim that supplementing can make hair stronger and shinier.

Again though, there’s no evidence to back this up. In fact, keratin is highly resistant to the digestive acids in your stomach—so taking a supplement could cause more harm than good. “Cats who regularly groom themselves with their tongues often form hairballs in their intestines that they eventually vomit, because they can’t ingest the keratin in their fur,” Hoyer says. You don’t want to end up like that, do you?

​ Do Hair, Skin, And Nails Vitamins Actually Work?
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Collagen

Like keratin, collagen is a naturally occurring structural protein that gives skin its smooth, plump appearance. And when production dips with age, wrinkles start to form.

So is supplementing the fountain of youth? One industry-funded study did show that women who took about three tablespoons of a collagen-based product for 60 days experienced less skin dryness and fewer wrinkles. (Independent studies are far and few between.)

But it’s not a surefire solution. “In your gut, collagen [that you consume through food or a supplement] is broken down into amino acids. And it’s at your body’s discretion how those amino acids are used,” Palm says. “It could become proteins to help your blood vessels, repair your liver, or stimulate your brain—not necessarily amino acids to produce collagen.” In other words, collagen might be a beneficial anti-ager, but there’s no guarantee.

​ Do Hair, Skin, And Nails Vitamins Actually Work?
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Vitamin C

It’s an antioxidant—and a potentially potent one at that. Vitamin C has been shown to protect against aging and skin cancers by boosting the production of collagen, preventing collagen from degrading, and fighting the formation of melanin (skin pigmentation), Hoyer says.

The problem? Even at high doses, only a fraction of that vitamin C supplement actually makes its way into your skin. Topical products that contain vitamin C are more effective—but even then, there’s not a ton of evidence to support their use, says Hoyer. “Because of all this, I’m not a big proponent of vitamin C yet. But I don’t think there’s much harm in it.”

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Omega-3s

Here’s the one supplement that might actually do you some legit good. These essential fatty acids provide must-have nutrition for healthy hair and skin cells. “Our skin cell membranes are composed of a cholesterol-derived layer, and omega-3s are needed to help maintain that. In the same way, they help with the integrity of the hair,” Palm says.

In other words, getting your fill just might contribute to a glowier complexion and shinier strands. If you don’t regularly eat fish like salmon and tuna, aim for 500 mg of DHA and EPA (the most potent types of omega-3s, which are found in fatty fish) daily, Palm recommends. Nature Made Fish Oil Pearls will help you hit the daily mark.

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Vitamins and micronutrients is an essential part of a healthy lifestyle.

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For the most part, all of these dietary requirements can be obtained from a balanced diet, but recently dietary supplements have become a popular resource for balancing dietary nutrition. Dietary supplements are especially recommended to elderly people as nutritional insufficiency is commonly seen in this age group. Supplements can go a long way towards building longer, healthier lifespans by protecting against health decline and disease caused by insufficient nutritional intake.Despite the added health benefits, use of dietary supplements increases the risk of exceeding the recommended doses for vitamins and nutrients. Previous studies reported contradicting evidence on the benefits of vitamin use; some showed evidence of improved health while others have observed a higher risk of mortality for multivitamin users compared with non-users.These reports raised safety concerns for long term multivitamin use. A study published in the British Journal of Nutrition looked at dietary supplement use in an Icelandic elderly population to identify how supplement intake contributes to the risks of exceeding recommended nutritional values, and to investigate whether supplement use is associated with mortality.

This study included5764 Reykjvik residents;58% female and 42% male with an average age of 77 at the beginning of the study. Prior to the study, scientists assessed the general health of all individuals in order to account for other factors that could influence mortality. Researchers recorded the educational status, smoking patterns, alcohol consumption, degree of physical activity, and other lifestyle characteristics that have an impact on human health. Participants filled out questionnaires explaining their dietary patterns and frequency of supplement use and submitted their supplements to a registry. To calculate the nutritional content obtained for each individual, scientists looked up the nutritional contents of each specified supplement in a database and multiplied nutritional content by the frequency of weekly use.

Results indicate that 77% of study participants used at least 1 dietary supplement.The most popular vitamin was fish-liver oil, used by 55% of the participants, followed by multivitamins, used by 31% of the participants. There were very few instances where vitamin and mineral consumption exceeded the recommended daily dose; the only notable exceptions were that 22% of the participants who used B6 supplements exceeded the recommended intake, as did 14% of participants who took Zn. Overall, patterns showed that vitamin users were less likely to smoke, were more educated, consumed less alcohol, and had a lower prevalence of diabetes than non-smokers. However, no correlation was found between dietary use and hypertension. Within a 7 year period, there was a total of 1221 deaths among the registered participants, but no significant correlation was identified between the use of vitamins and mortality rates. read more…

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A Primer on Vitamin B12

Health and pillsVitamin B12 (cobalamin) is a workhorse vitamin. It helps keep nerve and blood cells healthy, make DNA, and prevent megaloblastic anemia. Cobalamin is different from other vitamins because it is not plant-sourced, but is found naturally in a wide variety of animal products such as meat, fish, eggs, and dairy.

The July 2017 issue of Nature Reviews includes a disease primer that discusses the epidemiology, mechanism/pathophysiology, diagnosis/screening, prevention, and management of vitamin B12 deficiency.

B12 status varies through the lifetime, creating a need to consider patient factors when interpreting diagnostic biomarkers of B12 status. Inadequate intake, impaired absorption, chemical inactivation, or inherited B12 transport or metabolism impairment may lead to deficiency. Diagnosis is critical because B12 deficiency can be life-threatening.

Clinical B12 deficiency with hematological and neurological manifestations is relatively uncommon. On the other hand, 2.5-26% of the general population has subclinical deficiency and it’s unclear if these people will progress to deficiency or continue to have low but stable B12 levels.

B12 deficiency’s signs and symptoms are weakness, constipation, numbness and tingling in the hands and feet, confusion, poor memory, and mouth or tongue soreness. Vitamin B12 deficiency can affect individuals at any age, but vegans and elders are at increased risk. It is often difficult to diagnose elderly patients because its typical clinical manifestations are absent or are confused with dementia.

Increased consumption of animal products and fortified foods may prevent B12 deficiency, as will  oral or parenteral B12 supplementation. Initially, higher doses are required to replete B12 stores in the body.

Hematologic abnormalities respond to B12 treatment in about 5 days and completely recover in 4 to 6 weeks. Neurological abnormalities are slower to correct. B12 deficiency not due to nutritional deficiency may require lifelong treatment. read more…

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