Posted by Larry Hoover on December 2, 2002, at 12:40:42
In reply to Re: Supplement Plan; Larry---Comments? , posted by McPac on December 1, 2002, at 22:49:57
I'm going to comment on supplemental nutrition in general, as my philosophy is quite broad.
First, are we getting enough nutrients from food? I'll get to definitions of what "enough" is later, but first, dietary assessments across the Western world generally show that a substantial number of people do not meet RDAs of important nutrients. One of the most important assessment tools is NHANES (National Health and Nutrition Examination Survey), actually now in its third survey period. From the following study (link), you can see that a substantial proportion of Americans fall below the RDA in a number of key nutritional intake levels (see Tables).
http://www.nutrition.org/cgi/content/full/131/8/2177
Other studies from developed nations show similar characteristics with respect to dietary deficiencies.
Environ Res 2001 Dec;87(3):160-74
Dietary intakes of selected elements from longitudinal 6-day duplicate diets for pregnant and nonpregnant subjects and elemental concentrations of breast milk and infant formula.Gulson BL, Mizon KJ, Korsch MJ, Mahaffey KR, Taylor AJ.
Graduate School of the Environment, Macquarie University, Sydney, New South Wales, 2109, Australia. bgulson@gse.mq.edu.au
As part of a longitudinal investigation into mobilization of lead from the maternal skeleton during pregnancy and lactation, we have determined the daily intake of selected elements (hereafter called micronutrients) for various subjects and compared these intakes with recommended and/or published intakes, especially those of the United States, through the U.S. National Health and Nutrition Examination Survey (NHANES). We also sought to ascertain whether there was any seasonal effect in the diets. Six-day duplicate diets were collected from 15 pregnant and 16 nonpregnant migrants to Australia, 6 pregnant Australian control subjects, and 8 children of nonpregnant migrants (6 to 11 years). Samples of breast milk and infant formula were also analyzed. Blended samples were analyzed by inductively coupled plasma mass spectrometry for the elements Ca, Cu, Fe, Mg, P, K, Na, Zn, Ba, Sr, and Pb. Daily intakes of micronutrients were only about half of the daily intake estimated for non-Hispanic white females and infants in the U.S. NHANES III. Estimates of daily intakes from breast milk were also considerably lower for the migrant and Australian infants compared with the values extracted from tables of food composition and dietary recall for non-Hispanic white infants in the U.S. NHANES III. For example, Ca was a factor of approximately 3 times lower, Fe approximately 50, and Zn approximately 4. We consider our estimates a reliable indication of the daily intakes for several reasons, including the collection of up to nine quarterly collections of 6-day duplicate diets and retention of subjects in a longitudinal prospective study. The low intakes of the essential elements such as Ca, Fe, and Zn in all these population groups are of potential concern from a public health viewpoint.
Am J Clin Nutr 1989 Oct;50(4):718-27
Nutrient intake and vitamin status of healthy French vegetarians and nonvegetarians.
Millet P, Guilland JC, Fuchs F, Klepping J.
Department of Physiology, School of Medicine, University of Dijon, France.
The status of thiamin, riboflavin, folate, and vitamins B-6, B-12, C, A, D, and E was investigated in 37 middle-aged and healthy French vegetarians by means of a dietary survey and biochemical studies. Values were compared with those of a group of nonvegetarians. Unsatisfactory intakes of vitamin B-6 were observed: vitamin B-6 intake as a percentage of the French Recommended Dietary Allowances was approximately 66% for vegetarians and approximately 58% for nonvegetarians. Vegetarians had a higher mean intake of thiamin, riboflavin, and vitamins C, A, D, and E than did nonvegetarians. Vegetarians did not have a higher risk rate for a biochemical vitamin deficiency of thiamin, riboflavin, folates, and vitamins B-6, C, A, and E than the nonvegetarians. The percentage of subjects assessed as abnormal by blood vitamin concentrations was higher in vegetarians for vitamin B-12 (serum vitamin B-12) and vitamin D, which indicated a higher risk for a deficiency of vitamins B-12 and D in this group.
J Adolesc Health 1996 Jul;19(1):39-47
Marginal vitamin and mineral intakes of young adults: the Bogalusa Heart Study.Zive MM, Nicklas TA, Busch EC, Myers L, Berenson GS.
Department of Pediatrics, University of California at San Diego, La Jolla, USA.
PURPOSE: To determine reported vitamin and mineral intakes, vitamin supplement use, and food consumption patterns of young adults. METHODS: Twenty-four-hour dietary recalls were collected from 1988-1991 on a cross-sectional sample of 504 young adults in Bogalusa, Louisiana, between the ages of 19 and 28 years (58% female; 70% white). Reported vitamin and mineral intake data were analyzed for race and gender differences. Descriptive and inferential statistics were calculated where appropriate. Food sources of selected vitamins and minerals were also examined. RESULTS: Reported intakes of vitamins A, B6, E, D, and C, folacin, magnesium, iron, zinc, and calcium were most likely to be inadequate compared with the Recommended dietary Allowances (RDA); with more females than males reported nutrient intakes less than two thirds of the RDA. Approximately 10% of the population reported taking a vitamin/mineral supplement over the 24-h survey period. Food source data indicated that breads and grains, milk, vegetables and soups, fruits, and beef were the primary contributors of the selected vitamins and minerals. CONCLUSIONS: Public health organizations and dietitians need to educate young adults on practical strategies for making wise food choices rich in nutrient content relative to energy value to ensure intakes that approach the RDAs.
Ann Nutr Metab 1996;40(1):24-51
Vitamin status of healthy subjects in Burgundy (France).
de Carvalho MJ, Guilland JC, Moreau D, Boggio V, Fuchs F.
Department of Nutrition, University of Paraiba, Jaoa Pessoa, Brazil.
A nutrition survey was conducted in Burgundy (France) with a population sample of 337 middle-aged and healthy subjects (157 males and 180 females) recruited at a health examination center in 1985-1986. The status of beta-carotene, thiamin, riboflavin, folate, vitamin B6, B12, C, A, D, and E was assessed by means of 7-day food records and biochemical studies. Results were compared with two other recent nutritional surveys conducted in France: ESVITAF (control group only) and Val de Marne surveys. The dietary information collected for each subject was compared to the 1992 French Recommended Dietary Allowances (FRDA). Dietary vitamin intakes were higher in males than in females. Low vitamin intakes (< 1/2 FRDA) were found in 5% of males and 7% of females for thiamin, in 11% of males and 28% of females for vitamin B6, in 6% of males and 3% of females for vitamin C, in 87% of males and 91% of females for vitamin D, and in 8% of males and 13% of females for vitamin E. No subject had a vitamin intake < 1/2 FRDA for riboflavin, folate, vitamins A and B12. ESVITAF and Val de Marne studies also show low vitamin intakes for vitamin B6, thiamin, riboflavin, vitamins D and E. Biochemical status was examined using erythrocyte enzyme function and blood vitamin levels. The percent of subjects with deficient biochemical values was high for vitamin B6 (15% of all males and 20% of all females), and vitamin D (13% of all males, and 15% of all females). With regard to thiamin, riboflavin, vitamin C, folate, vitamin B12, vitamin A, and vitamin E, < 5% of subjects had values in the range of major vitamin deficiency. However, in both genders, except for vitamin C and vitamin A (only for females), low values corresponding to a moderate risk of vitamin deficiency was high for most vitamins. The incidence of a severe deficient vitamin status for thiamin and riboflavin was higher in Val de Marne than in Burgundy, or ESVITAF. In Val de Marne, the probability of a moderate risk of vitamin deficiency was high for thiamin, riboflavin, vitamin B6, vitamin A and vitamin E. Our results (as other studies performed in France and in other industrialized countries) raise the issue of the health significance of marginally deficient vitamin status.
Ann N Y Acad Sci 1993 Mar 15;678:244-54
Vitamin and mineral status of women of childbearing potential.
Block G, Abrams B.
Public Health Nutrition Program, School of Public Health, University of California, Berkeley 94720.
Increasing data suggest a role for micronutrients in pregnancy outcome, and in some cases nutritional status must be adequate in the first weeks of pregnancy. We examined nationally representative survey data on women of childbearing age: the NHANES II data for serum measures of iron status and the CSFII four-day data for dietary measures of intake of protein, iron, zinc, folic acid, and vitamins A, C, and B6. For those nutrients, women below or near poverty had consistently lower levels, with median intakes below the RDA for all but protein (e.g., folic acid, 150 micrograms in contrast with the RDA of 180 for nonpregnant and 400 for pregnant women; for B6, 0.96 mg instead of 1.6 or 2.2). Even among women with incomes as high as three times the poverty level or more, large segments of the population had very low intakes. For example, the 25th percentile in that group was only 142 micrograms/day of folic acid, 4.6 alpha-tocopherol equivalents of vitamin E, 6.7 mg zinc, and 433 mg of calcium. Approximately 15% of women had low transferrin saturation.
Exp Gerontol 1993 Jul-Oct;28(4-5):473-83Does diet provide adequate amounts of calcium, iron, magnesium, and zinc in a well-educated adult population?
Hallfrisch J, Muller DC.
Metabolism Section, National Institute of Aging, Baltimore, Maryland 21224.
Standard advice from dietitians, nutritionists, and physicians is that if one eats a well-balanced diet containing a variety of foods, supplements are not necessary. Little information is available, especially in those over 75, to determine whether actual diets do provide adequate amounts of these minerals. The participants of the Baltimore Longitudinal Study of Aging provide seven-day records which include vitamin and mineral supplement intakes. Median daily dietary intakes from diet in all 564 subjects and from diet plus supplements in those who use them were analyzed by age group and gender. More women than men took supplements. Median intakes of calcium from diet were below the recommended dietary allowance (RDA) for unsupplemented women and for supplemented women over 60. Approximately 25% of women under 50 and 10% of women over 50 consumed less than two thirds of the RDA for iron from diet. For both men and women, all groups had median diet intakes below the RDA for magnesium. Forty percent of men and about half of women consumed less than two thirds of the RDA. These results indicate that many people in this well-educated, presumably well-nourished population did not consume adequate amounts of calcium, iron, magnesium, and zinc from diet. More women than men are at risk. Even those taking supplements did not consume adequate levels of some minerals.
OK, so what is the RDA? How is it determined? I looked for hours, and I could never find a concise definition. Here is a composite: "The RDA is the amount of a nutrient which is required to prevent deficiency states in the majority of healthy people." Scientifically, the RDA is that amount of a nutrient which supplies the *known* requirement to avoid deficiency symptoms, set at 2 standard deviations above the median amount. That means that the RDA will prevent deficiency symptoms in 97.5% of healthy people. I emphasized the word "known" above, because the assessment is based on proven requirements.So, what about sick people? How much is required for optimal health? Those issues are not considered. Period.
The RDA evolved from the MDR (Minimum Daily Requirement), a concept arising from an awareness of the minimal nutritional needs of soldiers during the second world war. Now, ignoring the fact that soldiers were probably in the prime of their lives, and selected for health and vigour, and that they took substantial stores of nutrients with them (in their bodies), the MDR was, by definition, the minimum required to avoid overt deficiency symptoms. Somehow, that sense of the nutritional definition has been lost. The RDA was higher than the MDR, as it took the standard from one standard deviation (95% prevention) to two standard deviations (97.5% prevention).
In the 1970's (at the same time fat was demonized), a political decision was made that the typical diet would supply all the nutrition needed for the typical person. This decision was not based on any scientific principles. It simply became the doctrine of the FDA.
More recently, terms such as the TDI (Tolerable Daily Intake) have appeared. The TDI is the maximum amount recommended to protect *the most intolerant* subjects from toxicity symptoms. Please note the substantial difference in definition: "most...healthy" vs. "most intolerant". And, the RDA is currently morphing into RDI (Recommended Daily Intake), which is generally lower than the RDA, but still based on *proven need for healthy people*. It's no wonder people get confused.
What are the nutrient needs for sick people? That is as individual as we are. Please understand that I am NOT *NOT* advocating indiscriminate supplementation of any nutrients. However, the RDA may well be grossly inadequate for many people.
It has been estimated that a typical person is born with 100 genetic defects. It has further been estimated that a person acquires 100 more defects through interactions with the environment. Genes code for proteins, and many proteins are enzymes. Enzymes require co-factors to function at their maximum potential. Vitamins and essential minerals are all cofactors, or essential to the enzyme structure itself.
My personal experience has shown me that food does not meet my nutritional needs, no matter how well-selected that food is. But, I have taken care to test individual nutrient supplements, one at a time. It takes time. It takes attention. It takes a knowledge of what they're supposed to do. It takes a knowledge of what it seems my body isn't doing well. I'm very lucky to have the knowledge that I do.
I don't know how to help others with their needs, other than to make broad recommendations.
Just read the next three papers (two by Bruce Ames, a renowned geneticist), if you need further inspiration.
Med Hypotheses 1999 May;52(5):417-22
Toward a new definition of essential nutrients: is it now time for a third 'vitamin' paradigm?Challem JJ.
Aloha, Oregon 97006, USA. 74543.2122@compuserve.com
The concepts of vitamin 'deficiency' diseases and the recommended dietary allowances (RDAs) have not kept pace with the growing understanding of the cellular and molecular functions of vitamins and other micronutrients. As a consequence, many researchers and clinicians rely on outdated signs and symptoms in assessing nutritional deficiencies. A new paradigm, presented here, proposes that: (1) deficiencies can be identified on biochemical and molecular levels long before they become clinically visible; (2) the definition of essential micronutrients be broadened to include some carotenoids and flavonoids, as well as various human metabolites, such as coenzyme Q10, carnitine, and alpha-lipoic acid, which are also dietary constituents; (4) individual nutritional requirements are partly fixed by genetics but also dynamically influenced by variations in the body's biochemical milieu and external stresses; and (5) the distinction between nutritional and pharmacological doses of vitamins is meaningless, since high doses of micronutrients may be required to achieve normal metabolic processes in some people.
Am J Clin Nutr 2002 Apr;75(4):616-58
High-dose vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity (increased K(m)): relevance to genetic disease and polymorphisms.Ames BN, Elson-Schwab I, Silver EA.
Department of Molecular and Cellular Biology, University of California, Berkeley, USA. bames@chori.org
As many as one-third of mutations in a gene result in the corresponding enzyme having an increased Michaelis constant, or K(m), (decreased binding affinity) for a coenzyme, resulting in a lower rate of reaction. About 50 human genetic dis-eases due to defective enzymes can be remedied or ameliorated by the administration of high doses of the vitamin component of the corresponding coenzyme, which at least partially restores enzymatic activity. Several single-nucleotide polymorphisms, in which the variant amino acid reduces coenzyme binding and thus enzymatic activity, are likely to be remediable by raising cellular concentrations of the cofactor through high-dose vitamin therapy. Some examples include the alanine-to-valine substitution at codon 222 (Ala222-->Val) [DNA: C-to-T substitution at nucleo-tide 677 (677C-->T)] in methylenetetrahydrofolate reductase (NADPH) and the cofactor FAD (in relation to cardiovascular disease, migraines, and rages), the Pro187-->Ser (DNA: 609C-->T) mutation in NAD(P):quinone oxidoreductase 1 [NAD(P)H dehy-drogenase (quinone)] and FAD (in relation to cancer), the Ala44-->Gly (DNA: 131C-->G) mutation in glucose-6-phosphate 1-dehydrogenase and NADP (in relation to favism and hemolytic anemia), and the Glu487-->Lys mutation (present in one-half of Asians) in aldehyde dehydrogenase (NAD + ) and NAD (in relation to alcohol intolerance, Alzheimer disease, and cancer).
Mutat Res 2001 Apr 18;475(1-2):7-20
DNA damage from micronutrient deficiencies is likely to be a major cause of cancer.Ames BN.
University of California, 94720-3202, Berkeley, CA, USA. bnames@uclink4.berkeley.edu
A deficiency of any of the micronutrients: folic acid, Vitamin B12, Vitamin B6, niacin, Vitamin C, Vitamin E, iron, or zinc, mimics radiation in damaging DNA by causing single- and double-strand breaks, oxidative lesions, or both. For example, the percentage of the US population that has a low intake (<50% of the RDA) for each of these eight micronutrients ranges from 2 to >20%. A level of folate deficiency causing chromosome breaks was present in approximately 10% of the US population, and in a much higher percentage of the poor. Folate deficiency causes extensive incorporation of uracil into human DNA (4 million/cell), leading to chromosomal breaks. This mechanism is the likely cause of the increased colon cancer risk associated with low folate intake. Some evidence, and mechanistic considerations, suggest that Vitamin B12 (14% US elderly) and B6 (10% of US) deficiencies also cause high uracil and chromosome breaks. Micronutrient deficiency may explain, in good part, why the quarter of the population that eats the fewest fruits and vegetables (five portions a day is advised) has about double the cancer rate for most types of cancer when compared to the quarter with the highest intake. For example, 80% of American children and adolescents and 68% of adults do not eat five portions a day. Common micronutrient deficiencies are likely to damage DNA by the same mechanism as radiation and many chemicals, appear to be orders of magnitude more important, and should be compared for perspective. Remedying micronutrient deficiencies should lead to a major improvement in health and an increase in longevity at low cost.
poster:Larry Hoover
thread:129993
URL: http://www.dr-bob.org/babble/20021127/msgs/130258.html