Supplement questions


  • Health
  • Sunday, 09 Feb 2003

With the shift in nutrition pattern towards one of unhealthy excess, the role of supplements in maintaining health is becoming more prominent

ACCORDING to a World Health Organisation (WHO) report on globalisation and its impact on nutrition patterns and diet-related diseases, the changes in the world food economy have resulted in increased consumption of high-energy food sources that are rich in saturated fats and low in complex carbohydrates.  

People who regularly eat more than they need for energy, growth and tissue repair are predisposed to becoming overweight and obese. The lack of physical activity due to modern amenities such as motorised transport and labour-saving appliances that have replaced the need to expend energy is also a contributing factor. 

Obesity is on the rise and WHO proclaims it is an epidemic with a prevalence of 10% to 40% in the most affluent segments of society. Less than 40 years ago, most populations in developing countries were facing starvation, deplorable conditions and poor economic conditions. Today, there has been a shift from severe dietary deficiencies towards diet-related chronic conditions associated with dietary excess and sedentary lifestyles. Coronary heart disease, stroke, hypertension and some forms of cancers, diabetes mellitus and obesity are diet-related conditions. 

Overeating is really a choice to eat what one likes and not what one should. Excessive calorie intake and poor food choices also increase the risks of micronutrient deficiencies and lead to obesity.  

Obesity is the major factor in diabetes, especially Type II diabetes. It is difficult to treat, it has serious complications, and it reduces life expectancy by eight to 10 years.  

Surprisingly, it is a common condition that many people may be unaware of. Type II diabetes accounts for 80% to 90% of the existing 110 million diabetics worldwide. In Malaysia, it is estimated that 8.7 of every 100 people above the age of 35 suffer from diabetes. 

In view of this shift from malnutrition to dietary excessiveness, is there a role for dietary supplements? 

Reversing a long-standing anti-vitamin policy, The Journal of the American Medical Association (JAMA) is advising all adults to take at least one multivitamin supplement daily. About 20 years ago, the conclusion of JAMA was that normal healthy people do not need to take multivitamins because all the nutrients needed could be obtained from the diet. The change in tune is due to a greater understanding of the benefits of vitamins in maintaining health and preventing common chronic and age-related diseases. 

The process of ageing also affects nutritional requirements. Elderly people are especially vulnerable to malnutrition, resulting in an array of diet-related conditions including cardiovascular problems, poor immunity, impaired cognitive function, diabetes, osteoporosis and cancer.  

Current clinical studies and research have added weight to the benefit of supplementing antioxidant vitamins such as betacarotene, C, E and the mineral selenium in reducing the development of many degenerative diseases and to increase healthy life expectancy. Oxidative stress is believed to be a contributing factor of cardiovascular disease, certain cancers, cataracts and dementia that afflict the elderly population.  

Skeletal health is another area of concern and nutritional factors play a key role in building and maintaining bone mass. Osteoporosis is excessive loss of bone mass resulting in fractures, pain, deformity, and loss of movement and independence. Osteoporosis is entirely preventable and all it takes is 1.5g of calcium daily. This is usually combined with magnesium and vitamin D as they abet the body to absorb calcium.  

Nutrient deficiencies are also associated with a poor immune system and increased susceptibility to infectious diseases. In turn, infection affects the nutritional status that compromises the immune function further, thus setting up a vicious circle of nutrient paucity.  

Conditions such as allergies, rheumatoid arthritis and Crohn’s disease are believed to be due to a compromised immune system. Certain nutrients, such as beta glucan from the cell wall of Baker’s yeast, eicosapentanoic acid from fish oils, vitamin A, zinc, iron and copper, have the ability to modulate immune function and influence beneficial clinical outcomes. 

Although not all research on the antioxidant vitamin E and ginkgo biloba agree that these nutrients slow the progressive decline of cognitive functions in the elderly, nutritional experts believe that combinations of vitamins, minerals and herbal antioxidants are likely to offer great potential for elderly people with mental impairments such as Alzheimer’s disease. 

Our current lifestyle demands more nutrients than ever. Pollution, stress, alcohol, processed food, cigarette smoking, prescription drugs and medications all make demands on our liver, which is working constantly to detoxify our system. The liver draws on vitamins and minerals that are vital in helping it do its job. A deficiency in these helpers results in an overloaded and under-performing liver that compromises our health. 

Opinion is still divided over the best way to solve a nutritional deficiency. Some nutritionists maintain that a well-balanced diet should do the trick – that is, to eat foods from the six major food groups comprising carbohydrate, fruits, vegetables, dairy products, fats, and protein.  

However, there are individuals who are highly allergic or sensitive to dairy foods, gluten or fish. And let us admit it: very few of us eat the five servings of fruits and vegetables a day that is the minimum amount considered to provide sufficient essential nutrients. But even if we do, nutritional experts say that for most people, healthy levels of certain vitamins such as folate and vitamin E are not achievable from recommended diets.  

The use of dietary supplements has without doubt achieved great success by virtually eliminating vitamin A deficiency, the major cause of blindness in children of third world countries. Although dietary or nutritional supplements are effective in improving health, they are not designed to replace a well balanced diet. Nor are they meant to provide a false sense of security for consumers that their nutritional needs are complete.  

Plant food is rich in natural phytochemicals that have not been all identified as well as dietary fibre and enzymes that are wholesome and beneficial for our health. These substances cannot be replicated in tablets or capsules. For the long term, by encouraging and educating changes in diet, a food-based approach is the more natural approach and more likely to be sustained. Even so, the reality of this is that it is often difficult to change dietary practices, as “old habits die hard”. 

 

  • References: 

    1. Nutrition In Transition: Globalization and Its Impact On Nutrition Patterns and Diet-Related Disease. www.who.int/nut/trans.htm 2. Richardson David P., Nutrition in Transition: The Role of Micronutrients. IADSA, September 2002. 

    3. Vitamins for Chronic Disease Prevention in Adults, Journal of American Medical Association (JAMA 2002; 287:3127-3129). 

    4. Murray M.T., Encyclopaedia of Nutritional Supplements. Prima Health, USA, 1996. 

    This article is contributed by a panel of herbal medicine and natural healthcare practitioners. For more information, e-mail starhealth@thestar.com.my B>  

    Who and when 

    PEOPLE who may benefit from dietary or nutritional supplements include: 

  • Women with excessive menstrual bleeding may need iron supplementation. 

  • Pregnant or breast-feeding women need more of certain nutrients such as folic acid, calcium and long chain polyunsaturated fatty acids like DHA for brain development in the baby. 

  • People on weight loss or crash diets that do not meet their nutritional needs.  

  • Some vegetarians may not receive adequate calcium, iron, zinc and vitamin B12. 

  • Certain disorders or diseases and some medications interfere with nutrient intake, ingestion, absorption, metabolism or excretion.  

  • Cigarette smokers have increased need of anti-free radical nutrients such as betacarotene, vitamin C, E and selenium.  

  • Alcohol drinkers require zinc as alcohol depletes zinc. 

  • Habitual drug abusers. 

  • The elderly, especially those who are disabled or chronically ill. 

  • People who live sedentary lifestyles. 

  • Those who are allergic or sensitive to particular foods. 

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