Risk of Dying?

I don’t get it.

I just read a report from Reuters Health (October 1, 2015) titled “For seniors, hearing trouble linked to greater risk of death.”

It seems a study in the journal, JAMA Otolaryngology–Head and Neck Surgery, concluded that “Older adults with hearing impairment may have a higher risk of dying than people with normal hearing.”

They “looked at data on 1,666 adults from a nationally representative survey conducted in 2005-2006 and 2009-2010, as well as death records through the end of 2011.”

“The people included in the analysis were all over age 70 and had undergone hearing testing. Using World Health Organization criteria to define hearing impairment, and accounting for individuals’ age, the researchers found that people with moderate or severe hearing impairment had a 54 percent greater risk of dying than those with normal hearing. Mild hearing impairment was linked to a 27 percent increased risk.”

Even after adjusting for various health variables, “the study team found that people with moderately or severely impaired hearing had a 39 percent higher risk of death than those without hearing problems, and those with mild hearing impairment had a 21 percent greater risk.”

Sorry, but I don’t get it. I would have thought that all of these people, regardless of their hearing problems, would have a 100% risk of dying.

Don Goldberg

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Can Diet, and Dietary Supplements, Delay Onset of Dementia and Alzheimer’s Disease?

Can Diet, and Dietary Supplements, Delay Onset of Dementia and Alzheimer’s Disease? New Research says Yes!

Alzheimer’s disease is now the sixth leading cause of death in the United States. There are few things worse than watching a loved one suffer from this condition. In turn, Alzheimer’s disease accounts for 60% to 80% of all dementia cases. “Therefore,” according to Martha Clare Morris, Rush University Medical Center, Chicago, “prevention of cognitive decline, the defining feature of dementia, is now more important than ever. Delaying dementia’s onset by just 5 years can reduce the cost and prevalence by nearly half.”

Surprisingly, Dr. Morris and her colleagues found that modifying the diet may significantly slow cognitive decline among aging adults, even when the person is not at risk of developing Alzheimer’s disease. This finding, published online in the journal Alzheimer’s & Dementia, is in addition to a previous study by the same research team that found that this diet modification may reduce a person’s risk in developing Alzheimer’s disease.

In fact, the recent study shows that older adults who followed the “MIND” diet more rigorously showed an equivalent of being 7.5 years younger cognitively than those who followed the diet least.

This is pretty impressive. Researchers are spending millions and millions of dollars looking for drugs that will combat Alzheimer’s disease, and it turns out that modifications to our diet could be more effective than any drugs we have come up with so far?

So what is this miraculous diet? They call it the “MIND” diet. It’s a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. Both diets, by the way, have been found to also reduce the risk of cardiovascular conditions, like hypertension, myocardial infarctions, and stroke.

The MIND diet has 15 dietary components, including 10 “brain-healthy food groups” and 5 unhealthy groups: red meat, butter and stick margarine, cheese, pastries and sweets, and fried or fast food. Not that surprising so far, is it? I think most of us already know that saturated fat, hydrogenated oils, and sugar-laden foods are considered unhealthy. So these “5 unhealthy groups” does not seem unexpected.

What are the 10 “brain-healthy” food groups? To benefit from the MIND diet, a person would need to eat at least 3 servings of whole grains, a green leafy vegetable and one other vegetable every day — along with a glass of wine — snack most days on nuts, have beans every other day or so, eat poultry and berries at least twice a week and fish at least once a week.

In addition, the study found that to have a real shot at avoiding the devastating effects of cognitive decline, he or she must not only eat the good foods, but also limit intake of the designated unhealthy foods, especially butter, sweets and pastries, whole fat cheese, and fried or fast food.

The one thing I did find surprising is that berries are the only fruit specifically to be included in the MIND diet. They specified blueberries, saying that they are “one of the more potent foods in protecting the brain.” But they acknowledge, based on earlier research, that strawberries would be expected to work well also. I would think all highly colored berries would prove beneficial.

While this is encouraging, what is troubling is the fact that just a short time ago, another study was published showing that few adults in the U.S. eat enough fruit and vegetables to meet government recommendations. Overall, less than 15% of adults eat enough fruit dailty to meet the guidelines, and even fewer adults eat enough vegetables.

These results were reported in a study by the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention (July 10, 2015).

Could this lack of adequate intake of fruits and vegetables be related to the increased incidence of Alzheimer’s disease and dementia? More important, is this new research showing the connection between fruit and vegetable intake with Alzheimer’s prevention going to provide enough motivation for people to modify their diet? Sadly, I doubt it. So what are we to do?

The ideal solution, without question, is to eat more fruit and vegetables, while cutting back on saturated fats and sweets. For those who cannot, or will not, do this, there are a variety of nutritional supplements that provide a healthy alternate. Here are some examples.

Phyto-Antioxidant Extracts

These products contain isolated or concentrated extracts of plants, vegetables and fruits that can be taken in supplement form. They provide many of the active flavonoid antioxidants normally contained in those plant sources, but in high potency form.

Antiox Phyto Complex II
(Willner Chemists, No. 63745, 90 Veggie Caps)
Some of the most powerful, broad-spectrum antioxidants are those found in plants. This supplement contains a blend of several of the most potent plant-derived phyto-antioxidants available, in a high potency, professional strength veggi cap.
Phyto-Tech™ Antiox Phyto Complex II Capsules contains 375 mg of the following: Acai Berry Concentrate, Mangosteen Fruit Extract, Goji Berry, Pomegranate, Green Tea Leaf Extract, Grape Skin Extract, Grape Seed Extract.

Antiox Phyto Blend
(Willner Chemists, No. 57551, 1 fluid ounce)
Some of the most powerful, broad-spectrum antioxidants are those found in plants. This supplement contains a blend of several of the most potent plant-derived phyto-antioxidants available, in a convenient liquid extract.
Phyto-Tech™ Antiox Phyto Blend contains the following: Acai Berry 4:1, Mangosteen Extract, Goji Berry Extract, Pomegranate 40%, Glycerin Vegetable, Water Pure Deionized, Raspberry Flavor Natural.
This convenient liquid concentrate can be added to almost any beverage, even cocktails.

Food Based Multivitamin Supplements

Many companies provide “whole food” or “food based” multivitamin supplements. These products supply not only pure vitamins and minerals, but also associated food factors and food concentrates rich in phyto nutrients and phyto antioxidants. Here are some examples:

Whole Earth & Sea (Natural Factors)
Men’s Multivitamin & Mineral (No. 64965, 60 tablets)
Men’s 50+ Multivitamin & Mineral (No. 64967, 60 tablets)
Women’s Multivitamin & Mineral (No. 64964, 60 tablets
Women’s 50+ Multivitamin & Mineral (No. 64966, 60 tablets)
Bone Structure Multivitamin & Mineral (No. 65117, 60 tablets)

DaVinci Labs
Spectra Infinite (No. 56734)

Earth Source Multi (No. 13411, 180 tablets)

Garden of Life
Mens Multi Organic Kind (No. 64563, 120 tablets)
Womens Multi Organic Kind (No. 64567, 120 tablets)

Food Concentrate Powders

Lastly, there are supplements that consist of mixtures of dehydrated, concentrated vegetables and fruits. These products are perhaps the closest to a replacement for the lack of dietary fruits, vegetables and other healthy foods. They can serve as stand-alone meal replacements, perhaps along with a regular multivitamin supplements, or as a supplement to what may be a less than optimal diet.

DaVinci Labs
Spectra Reds (No. 45587, 11.4 ounces powder)
Spectra Purples (No. 51484, 11.6 ounces powder)
Spectra Oranges (No. 52730, 10.6 ounces powder)
Spectra Greens (No. 42432, 12.6 ounces powder)

The above products are only examples of the various categories of supplements. You are welcome to discuss your options with the pharmacists and nutritionists as Willner Chemists for additional recommendations.

Don Goldberg, R.Ph.

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What’s wrong with you people? Why aren’t you eating your fruits and vegetables?

What’s wrong with you people? Why aren’t you eating your fruits and vegetables?

We are told, over and over again, that there is no need for multivitamin supplements–it’s a waste of money, a scam, nothing but “expensive urine, a nefarious hoax foisted upon a gullible public by snake oil selling ne’er do wells! Why? Because all you need to do is eat a well balanced diet. What could be more simple, more easy?

This anti-supplement mantra surfaces every time there is talk about multivitamin supplements. Ignored is the fact that study after study, survey after survey, government or private, shows that people do not do it! They just don’t.

The most recent evidence of this is provided by the Centers for Disease Control and Prevention (CDC). “Fruit and vegetable intake has been persistently low for years but we just recently developed a way to look at how each state is doing” in terms of meeting recommendations, said lead author Latetia V. Moore of the National Center for Chronic Disease Prevention and Health Promotion at the CDC.

They report that less than 15 percent of adults in the U.S. eat enough fruit daily to meet federal recommendations. The number for vegetables is even lower. Please note that we are talking big time low, 15 percent and lower–that is heavy duty low!

On average, in 2013, half of the respondents actually consumed fruit less than once daily, and vegetables less than 1.7 times daily. Bear in mind that during this time, nutritionists have been emphasizing how important fruits and vegetables are to our overall health and well being. “Fruits and vegetables are major contributors of important nutrients that are typically lacking from Americans’ diets and they can protect against many leading causes of illness and death like heart disease, stroke and some cancers,” Moore said. “Eating fruits and vegetables in place of foods that are high in calories, added sugars, and solid fat can also help with weight management.”

Yes, we need to continue to encourage people to increase their intake of fruits and vegetables. But at the same time, we need to face up to certain realities. The fact is, for whatever reason, eating well is not easy. Recognizing this, we should be encouraging people to take a daily multivitamin multimineral supplement, not discouraging them. In fact, a phyto-nutrient rich antioxidant supplement, to further compensate for the lack of fruits and vegetables, should probably be a part of the daily regimen as well.

There is no need for dieticians to fear that people will interpret this to mean they can “substitute” a vitamin supplement in place of a healthy diet! People, obviously, are already not choosing a healthy diet. So what is there to fear. Focus, instead, on doing whatever is necessary to improve their nutrient levels–even if it means endorsing the use of vitamin supplements.

Don Goldberg, R.Ph.

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Did we loose our way while shopping for vitamins?

Sometimes, I wonder . . .

Do we sometimes loose site of what really matters? Do we let ourselves get so caught up in marketing hype that we forget to question, to apply basic common sense before falling in step with the crowd?
I wonder about this, for example, when I observe the effect of current marketing efforts on nutritional supplement trends.
For example. We all understand and appreciate the importance of essential vitamins and minerals. We know they cannot be made within our body–that they have to be obtained from foods.
We also understand that it is necessary for foods to be broken down so that these essential nutrients can be made available to the body. We call this digestion. It starts in the mouth, with chewing, and the action of numerous digestive enzymes and pH changes throughout our digestive tract. Different vitamins and minerals are absorbed in different ways. Some are passive and some are active (vitamin B12 and “intrinsic factor, for example). In each case, our body has developed it’s own complex mechanisms to free up the vitamins and minerals from food.
In fact, we have learned over time that there are other measures we can take to enhance the bioavailability of nutrients from food. Cooking, for example, can increase the digestibility of our food. Other techniques, such as fermentation, are effective as well.
In recognition of the importance of freeing up these essential nutrients from their food matrix, we attempt to enhance the digestive process by ingesting exogenous digestive enzymes in supplement form. These supplemental enzymes further assist in the breakdown of food, increasing the availability of proteins, fats and carbohydrate as well as freeing up the micronutrients for enhanced absorption.
Science has revealed the actual identity of many of these essential nutrients–the vitamins and minerals we need so badly. We know their molecular structure. And that’s not all–we can obtain these nutrients in pure form. Isn’t it wonderful? We can now prevent scurvy not only by eating oranges, but also by taking pure vitamin C tablets! We can prevent beriberi, pellagra, rickets, anemia etc by taking pure vitamins as an alternative to various foods.
In fact, studies on certain nutrients have shown that the pure nutrient is sometimes better absorbed than the same nutrient from food. Folic Acid is a well known example of this.
What I wonder about, then, is why we ignore this, and shun supplements that contain pure nutrients? Why do we embrace, instead, supplements that contain vitamins and minerals supposedly bound to food. Why do we take pure, isolated vitamins and minerals that are potent and ready to be used by the body and take a step backwards, mixing them with various food substances?
Perhaps it has something to do with the concept of “natural?’
Natural is good. Synthetic is bad. That is the mantra. The distinction between natural and synthetic, when it comes to vitamins, however, is very blurred. The processes involved in deriving “natural” vitamins, in meaningfully high potencies, seems to me to be little different from those employed in the “synthesis” of many of the same pure vitamins.
In fact, I suggest that perhaps the word “pure” is much more meaningful in this regard than the word “synthetic.” (. . . or “USP.”)
This is not to say that “food” complexed vitamin supplements are not of value. There are many additional co-factors that occur in nature alongside the vitamins and minerals. It makes sense that these co-factors may exert synergistic actions, and have biological activity of their own.
As is usually the case, however, there is a tradeoff. The more room taken up by the food, the less room there is for the actual vitamins and minerals.
So I have to wonder. Why take pure vitamins and minerals and make them less pure? Why take a high potency, highly bioavailable, economically priced vitamin mineral supplement and dilute it with food?
Food is good. And I recommend taking your vitamin/mineral supplements with meals. That way, you get your vitamins and your food.
Don Goldberg


“Folic acid absorption appears to be enhanced by gastric hydrochloric acid.1 However, achlorhydric individuals were found not to have low serum folate levels (even though folic acid absorption was reduced),2 apparently because achlorhydria leads to small-intestinal overgrowth of bacteria that synthesize folate.3
“The bioavailability of folic acid, when administered at usual doses, is close to 100%. At a dose of 5 mg, 93% was absorbed by healthy volunteers,4 and at a dose of 1,000 mg/day at least 10% was absorbed.5 The absorption of poly-glutamate forms of folate (the forms present in food) is less than that of synthetic folic acid,6 perhaps in the range of one-third to one-half.7,8 In developing recommendations for folate intake, the absorption of food-derived folate has been estimated to be half that of folic acid.”

Gaby, Alan R., MD. Nutritional Medicine. Alan R. Gaby, M.D., 01/2011. VitalBook file.
The citation provided is a guideline. Please check each citation for accuracy before use.

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Where have you been?

I’m still here. I’ve been busy trying to transition from the radio show, which we ended after over eighteen years, into web based “social media.” The problem is that I’ve never understood the appeal of “social media,” never been comfortable with it, and find it difficult to utilize. I thought the best approach would be to use an e-newsletter approach, as we have accumulated a large number of emails over the years, but that has not worked out. I set up a facebook page (willner.chemists.ny) and I started to “tweet.” Actually, I find Twitter to be the most promising, as it combines some of the benefits of the e-newsletter concept without many of the headaches. So I urge you to “follow” me on Twitter. The Twitter address is @willnerchemists.

Here are links to some of the articles I have recently written for Twitter:

Fructose and High Fructose Corn Syrup: Toxic or Tortured Logic?
I’ve always been somewhat uneasy about the recent demonization of fructose and high fructose corn syrup. Fructose occurs naturally in fruit, and is one-half of the sucrose (sugar) molecule. I certainly do not encourage or condone the over indulgence of refined sugar and/or high sugar foods. Calorie-dense and nutrient-poor foods, whether the empty calories are from unhealthy fats (saturated, hydrogenated, trans, etc) or refined carbohydrates, is what we should worry about . . . Read More!

Are you minding your PQQ’s? Maybe you should be!
PQQ (pyrroloquinoline quinone) is an exciting “new” micronutrient that you will be hearing a lot about in the future. Similar to CoQ10, PQQ affects mitochondrial function. The mitochondria are the parts of cell that generate energy. They are often called the “cellular power plants.” They are involved in other critical cellular functions as well, including cell growth. Recent interest has focused on energy, cardiac function, aging, longevity and mental health. . . Read More!

Restless Leg Syndrome and Nutritional Supplements
Restless legs syndrome is defined as “a neurological disorder characterized by a periodic need to move the legs in order to relieve an unpleasant or uncomfortable sensation in the legs. . . What causes this problem? . . . Read More.

Don Goldberg

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What would be the best multivitamin for me?

“I haven’t taken vitamins since my last pregnancy in 1994. I am a 53 year old woman in good health. The only medication I take Is synthroid for hypothyroidism. What would be the best multivitamin for me? And what other supplements do you recommend? I recently started listening to your radio show. I love it but I am not sure where to start? Thanks in advance for your help.”

I haven’t taken vitamins since my last pregnancy in 1994. I am a 53 year old woman in good health. The only medication I take Is synthroid for hypothyroidism. What would be the best multivitamin for me? And what other supplements do you recommend? I recently started listening to your radio show. I love it but I am not sure where to start? Thanks in advance for your help.

Yes, the number of choices can be overwhelming. But let’s see if we can simplify it for you and others who may share your concern. We will start by pointing out that you are in “good health” except for the hypothyroidism.

I will also point out that when it comes to the choice of your basic multivitamin, multi mineral and possible other “base” supplements, the choices are often the same, regardless of whether or not you have other health problems. The reason for this is that my approach is to establish a “nucleus” or base supplement regimen, and then add to it, as necessary, to address any specific health problems you may have. No health problems? No additional supplements necessary.

In your case, due to your age, you do not need a high level of iron in your supplement. So I would look for a product that contains no more than the recommended daily value (18 mg) at most.

I will also make the assumption that your reason for taking a multi is along the lines of “insure adequate or optimal intake of all the essential nutrients.” You want to grow old, and you want to remain relatively healthy while doing so.

And, finally, I have to assume that your diet is “average.” Good but not great. If you are a vegetarian, don’t eat dairy, eat a lot of dairy and red meat, never eat vegetables and fruit, etc, your needs will be different.

So we arrive at the following conclusion. You need a basic, balanced multivitamin supplement. You need supplemental calcium and magnesium and, perhaps, extra vitamin D. You will probably benefit from two additional supplements: an omega-3 fish oil supplement, and a phyto antioxidant blend.

The most difficult choice is the first one, the multivitamin. The reason for this is that there are many options: form, dose, green, all-in-one. Let’s look at each option.

Form. You can get multivitamins in capsule, tablets, powder and liquids. If you cannot swallow tablet and capsules, you might prefer the convenience of powders and liquids. With powders and liquids, however, you have greater stability concerns, flavor (taste) considerations, and liquids are usually lower potency. Some people find it easier to swallow a capsule than a tablet, but tablets are usually less expensive and contain the highest dose. The same daily dose, for example, that you get in six capsules will fit into four tablets. You will see a variety of other marketing claims touting one form over another, but a properly formulated, properly manufactured tablet will work just fine.

Dose. You can get a one-a-day multi. You can get two-a-day, three-a-day, four-a-day, and even six-a-day multivitamin supplements. What is the difference? One obvious difference is that the more you take, the greater the amount (and perhaps variety) of nutrients you will get. It is easy to fit all of the vitamins and trace minerals into one or two tablets or capsules. But calcium and magnesium are required in higher quantities, and these will not fit into a one or two per day multi. I will discuss this further in a moment, under the “all-in-one” heading. The one thing I strongly urge you not to do is choose a one-per-day multi. Here is the reason. Most of the vitamins and trace minerals in a one-per-day multi are water soluble. They will be absorbed relatively easily and quickly and reach peak blood levels within an hour or so. Then, they begin to be excreted, and whatever does not get absorbed into the tissues during that time finds its way into the toilet bowl. In other words, after half the day, you no longer are getting any benefit from the multi. If you divide your daily dose into at least a twice per day dosages, you are now getting roughly double the benefit! I suggest a minimum of two-per-day, one with breakfast and one with dinner.

Green. Many multivitamin supplements are now being marketed as “food grown,” “food based,” and similar terms. This is nice. Nothing beats food as a source of your essential vitamins and minerals, and including as much food concentrate in the multi as possible is no doubt a good thing. Just we warned that the more food concentrates you include, the less room you have left for the actual vitamins and minerals themselves. So the good news is that this type of multi contains a lot of healthy food-derived cofactors, etc but the bad news is that they are usually lower in potency. To get potencies similar to the “non-green” multi preparations, you many need to take a larger number of tablets or capsules. This is fine if you are willing to do so.

All-In-One. As I said earlier, you cannot obtain the full daily dose of calcium and/or magnesium in a one or two per day multivitamin supplement. There is just not enough room. And it makes no sense to me to take several hundred percent of the U.S. Daily Value of the B-vitamins, while only taking 20% of the Daily Value of calcium and magnesium. So you have two choices. You can take a separate calcium-magnesium supplement, with a dose of two or more per day depending on the type and quality, or you can take a multivitamin supplement that includes the full dose of calcium and magnesium all in the one product. Of course, the daily dose of this “all-in-one” multi has to be higher, to accommodate these added ingredients–usually four tablets daily or six capsules daily.

The total number of tablets, whether you take a separate multi and a separate calcium-magnesium may end up being the same, but many people prefer the convenience of the all-in-one type of product.

So you can narrow down your choice by making four choices as defined above: What form do you prefer? How many are you willing to take each day? Do you want a straight multivitamin multi mineral supplement, or one that includes food concentrates? And do you want everything in one product, or a separate multivitamin and a separate calcium-magnesium?

If you call Willner Chemists (800 633 1106) pre-armed with this information, or stop by one of the Willner Chemists stores in Manhattan or Atlanta, one of the pharmacists or nutritionists will easily and quickly provide you with appropriate options. I am not going to mention specific products here, as we carry numerous quality brands at Willner Chemists. The recommendations might vary from one time to another depending on several factors including which brands might be on sale at the time.

I will provide an example of the “all-in-one” multivitamin multi mineral that is under the Willner Chemists brand. It is called “Willvite,” and the four per day dose provides everything, including calcium and magnesium, in the proper balance and potency.

There are, of course, other supplements that relatively healthy adults might want to take in addition to a multivitamin, calcium and magnesium. I would suggest the following three supplements should be part of most general regimens:

(1) An omega-3 fish oil supplement. The type chosen depends on your diet and health. If you have heart disease, inflammatory conditions, etc, I suggest a high potency EPA/DHA concentrate. If you are healthy, or if you do not eat fish, a “whole” fish oil concentrate might be appropriate.

(2) Vitamin D. At this time, the consensus of opinion is that most of us do not get enough vitamin D. And vitamin D is being increasingly targets as important in the prevention of many serious health problems. Most multivitamins do not contain more than 400 IU of vitamin D, so additional vitamin D is indicated. Many experts consider 800 to 1,000 IU per day as the new “minimum” dose. You can get vitamin D as a stand alone supplement, or you can get omega-3 fish oil supplements with added vitamin D. Natural Factors and Nordic Naturals are two brands that have that combination.

(3) Phyto Antioxidants. Increased antioxidants appear to be beneficial in numerous health conditions, from macular degeneration to aging. Most multivitamin supplements provide the standard vitamin and mineral antioxidants such as vitamin C, vitamin E, zinc and selenium. But many of the powerful antioxidants are those found in plants–the flavonoids and polyphenols found in grape skin, green tea, berries, fruits and vegetables. “Phyto” refers to plants, and a “phyto-antioxidant” supplement is a perfect complement to the regular multivitamin supplement. I recommend the Willner Chemists Phyto-Tech “Antiox Phyto Complex” (liquid filled capsule) or “Antiox Phyto Blend” (dropper bottle liquid).

On the one hand, I have provided a recommendation of what you might call a basic, or “nucleus” nutritional supplement regimen, suitable for almost everyone. A multivitamin, calcium-magnesium (either separate or included in the multivitamin), omega-3 oils, extra vitamin D, and extra “phyto” antioxidants. On the other hand, everyone is different, and everyone has unique needs. The challenge of decided on a multivitamin pales when compared to getting qualified and factual guidance on the remainder of your supplement requirements tailored to your unique health, diet and medical needs. You will not find this guidance in health food stores. You will not find it from your multilevel marketing salesman. You will find it at Willner Chemists.

Don Goldberg, R.Ph.

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Safety of Calcium Supplements Confirmed

Expert Panel Confirms Safety of Calcium Supplements in Relation to Cardiovascular Disease

Calcium Supplements Remain a Valuable Tool For Maintaining Bone Health

Last year, a report was published that surprised most people, patients and doctors alike. It seemed to indicate that calcium supplements increased the risk of cardiovascular disease. Why was this so surprising? For one thing, the benefits of calcium supplementation were widely accepted, with its effect on bone health at the top of the list. For another, it just doesn’t make sense. The report concluded, for example, that only calcium from supplements seemed to be the problem, not calcium from food. The study was far from conclusive, being observational in nature, and had many short comings. Many experts urged caution, and suggested we should not over react. But that did not stop the popular press.

While studies such as this should not be taken as the final word, they certainly should be looked at. There may be lessons to be learned. It may be that it is inadvisable to take a high dose of calcium, via supplements, all at one time, for example. Some people do that. The report may merely highlight the importance of not taking calcium alone, i.e. without magnesium, vitamin D, vitamin K, etc. It may be that some people make the mistake in thinking “if 1,000 mg a day of calcium is good, 2,000 mg a day is better.” We don’t know. At the least, it suggests that more investigation and research might be appropriate.

Such research has been ongoing, and the following findings published in Advances in Nutrition indicated that calcium supplements can indeed be used, safely and effectively, to achieve and maintain bone health by people who do not get optimal calcium from their diet. The following summary of results was posted on the website of the Council for Responsible Nutrition (www.crnusa.org):

Individuals who do not obtain recommended intake levels of calcium through dietary sources can safely utilize calcium supplements to achieve optimal bone health, an expert panel concludes. These findings appear in the November online edition of Advances in Nutrition, a journal that highlights the significance of recent research in nutrition and illustrates the central role of nutrition in the promotion of health and prevention of disease.

Responding to questions raised last year about a possible link between calcium supplements and a potential increased risk of cardiovascular disease, an expert panel composed of academic and industry experts in the fields of nutrition, cardiology, epidemiology, bone health, and integrative medicine convened on Nov. 10 and 11, 2011 in Washington, D.C.

The panel collected and examined the available body of scientific literature, including randomized controlled trials (RCTs) and observational data, assessing whether long-term use of calcium supplements could promote the occurrence of strokes, coronary heart disease, heart attacks and other forms of cardiovascular disease, and cross-referenced these findings with four of the Bradford-Hill criteria for causal interference: strength, consistency, dose-response and biological plausibility. The panel concluded that the available science does not suggest an increased risk for cardiovascular disease from calcium supplement use.

“There is a strong body of evidence from a variety of rigorous scientific studies reinforcing the benefits of calcium in promoting bone growth and maintenance. After reviewing the entire scope of scientific literature for calcium, we are now more confident than ever in both its health benefits and safety,” said panelist Robert P. Heaney, M.D., Osteoporosis Research Center, Creighton University Medical Center. “Consumers can feel confident about the safety of their calcium supplements and should continue taking them with confidence. They should, however, be aware of how much calcium their diets provide, and then supplement accordingly.”

In addition to Dr. Heaney, panel experts included: Stephen Kopecky, M.D., Division of Cardiovascular Diseases, Mayo Clinic; Kevin Maki, Ph.D., Provident-Biofortis; John Hathcock, Ph.D., former senior vice president, scientific and international affairs, Council for Responsible Nutrition (CRN); Douglas MacKay, N.D., vice president, scientific and regulatory affairs, CRN; and Taylor Wallace, Ph.D., senior director, scientific and regulatory affairs, CRN.
The CRN Foundation, the educational non-profit affiliate for CRN, the dietary supplement industry’s leading trade association, commissioned the panel after results from a meta-analysis of RCTs, and reanalysis of the Women’s Health Initiative by researchers at a New Zealand laboratory, prompted concern about a potential association between calcium supplement use and a small increase in risk for adverse cardiovascular events. However, a number of issues with the meta-analysis and accompanying studies—such as exclusion of the majority of RCTs which indicate calcium has no effect on the cardiovascular system; large reliance on unpublished data; failure to appropriately ascertain cardiovascular events; and a lack of information on known cardiovascular risk determinants—warranted a complete examination of the scientific literature.
The CRN Foundation assembled the expert panel to study the findings of this analysis in context with the larger body of scientific research on calcium.

“In light of our safety findings combined with the well-documented benefits of calcium, we urge physicians to continue recommending calcium supplements to their patients as appropriate, as our review of the scientific literature further reinforces the valuable role of calcium in helping consumers maintain bone health,” said the Mayo Clinic’s Dr. Kopecky. “Building and maintaining calcium is vital for all age groups—young children to adolescents to adults and the elderly must obtain adequate amounts of calcium, either through diet or supplementation. For those who are unsure if they need to supplement their diets with additional calcium, make sure to discuss your current nutritional picture with your physician.”

Supporting the expert panel’s conclusion is the recent “Framingham Study,” published online in the Nov. 7 American Journal of Clinical Nutrition by Elizabeth Samelson, Ph.D., et al., which also looked at the association of calcium and coronary artery calcification and found that “…calcium intake from diet and supplements appeared to neither increase nor decrease vascular calcification, which is a measure of cardiovascular risk…The use of calcium supplements is important for many older adults to ensure adequate intake for bone health.”1

The Institute of Medicine currently suggests women ages 19 through 50 and men up to 71 obtain a Recommended Dietary Allowance (RDA) of 1,000 milligrams calcium daily; women over 50 and men 71 and older should obtain 1,200 milligrams daily to ensure they are meeting their daily needs for strong, healthy bones. Calcium is popular among U.S. consumers, and according to CRN’s most recent survey of U.S. adults, 17 percent indicate they take a calcium supplement.

(The Council for Responsible Nutrition (CRN), founded in 1973, is a Washington, D.C.-based trade association representing dietary supplement manufacturers and ingredient suppliers. In addition to complying with a host of federal and state regulations governing dietary supplements in the areas of manufacturing, marketing, quality control and safety, our 75+ manufacturer and supplier members also agree to adhere to additional voluntary guidelines as well as CRN’s Code of Ethics. Visit http://www.crnusa.org. The CRN Foundation was established in 2009 as a non-profit 501(c)(3) organization for the purpose of educating people about the beneficial, safe and responsible use of dietary supplements and their ingredients as part of a culture of wellness.)

1 Samelson, E.J., Booth, S.L., Fox, C.S., et al. (2012). Calcium intake is not associated with increased coronary artery calcification: the Framingham Study1–3. Am J Clin Nutr, 96(5), 1-7.

Don Goldberg

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Sorry, But There Is Good News About Multivitamins

The Good News About Multivitamins

There was good news about nutritional supplements recently. Very good news. A good study–a very good study–showed remarkable benefit associated with the use of multivitamin supplements. In short, this new study indicates that men who took a modest potency multivitamin multimineral supplement reduced their risk of cancer, overall, by eight percent.

An overall eight percent reduction in cancer is not something to take lightly. Especially when it merely involves taking a basic multivitamin supplement. What a large benefit from so small an effort. Why wouldn’t everybody support the idea of taking, at least, a basic multivitamin multimineral supplement every day?

You would think that common sense alone would support the idea. We know how important vitamins and minerals are to our health. We know that a deficiency of one or more of these vital nutrients can lead to life-threatening illness. We know that, for many reasons, many of us do not eat as nutritious a diet as we should. So why would anybody argue against a daily multivitamin multimineral supplement? Why would we even need to “prove” the value of daily supplementation?

That’s a good question. But it seems that “proof” is necessary, but elusive. There is something about ascribing significant health benefits to nutritional supplements that irritates certain people to no end. Health problems, according to these folks, should only be treatable and preventable by a balanced diet, exercise, and medications. Any implication that nutritional supplements belong in that list is met with consistent resistance and scepticism.

A good example of this was the way this recent study was reported in The New York Times. When a negative study comes out pertaining to nutritional supplements, it is given headline status. When a positive study, such as this one, is published, however, it does not receive similar treatment. Instead, it’s importance is minimized. In this case, the positive study about multivitamins reducing the risk of cancer by 8% was covered in an article by Roni Caryn Rabin, titled “Curbing the Enthusiasm on Daily Multivitamins.” The first sentence of the article poses the question “can you reduce your risk of cancer by taking a multivitamin every day?

The article continues “Last week, Boston researchers announced that one of the largest long term clinical trials of multivitamins in the United States–encompassing 14,000 male physicians 50 and older, and lasting over a decade–found that taking a common combination of essential vitamins and minerals every day decreased the incidence of cancer by 8 percent, compared with a placebo pill.”

The article continues with more positive news: “. . . The researchers also looked for side effects and found that daily vitamins caused only minor problems, like occasional skin rashes.

“Even though an 8 percent reduction in the overall cancer rate is fairly modest, Dr. Demetrius Albanes, senior investigator at the National Cancer Institute, said the potential public health implications were vast. “If you think of the hundreds of thousands of new cases of cancer every year, 8 percent can add up quite a bit,” he said.”

Then, however, the author launches a detailed explanation as to why we should not let this positive study lead us to make the mistake of thinking this justifies taking multivitamin supplements. She points out that “previous studies have yielded decidedly mixed results.” She points out that “Current federal dietary guidelines and American Cancer Society recommendations encourage people to eat a balanced diet rich in fruits and vegetables.”

“Until now,” she states, “the consensus has been that there is insufficient scientific evidence to justify taking a multivitamin to prevent cancer or other chronic diseases.” Note that she used the term “until now.” Interesting choice of words.

She continues with a listing of additional cautionary references. She reminds us of the review by the National Institutes of Health in 2006 which “concluded that evidence was ‘insufficient to prove the presence or absence of benefits from use of multivitamin and mineral supplements.’ Again, note the actual terminology: “presence or absence.” Then she reminds of the recent studies that cast doubt on vitamin D and Calcium supplements. She neglects to mention, of course, that these studies have been met with strong criticism and are considered very controversial. She also, it seems, has found it necessary to support her argument by departing from what was initially a critique of daily multivitamin supplements to studies dealing with individual nutrients, at higher dosages.

Thank goodness we have people like Ms. Rabin, and publications like The New York Times out there to protect us from making mistakes such as this.

One of the interesting comments in her article was “Generally speaking, people who take vitamins are a relatively healthy bunch to begin with, experts say. They tend to eat a varied and healthful diet, watch their weight and be physically active. It’s not always clear that the benefits they attribute to vitamins actually result from the pills.” This is very true. But why doesn’t it work both ways. It may not always be clear that the benefits attributed to vitamins actually result from the “pills,” but it is also true that it may not always be clear that negative findings are directly related to the “pills” as well.

The next paragraph in her article confirms this. “There’s a mystique about vitamins, that vitamins are some type of magical ingredient,” said David G. Schardt, senior nutritionist for the Center for Science in the Public Interest, an advocacy group in Washington. “There is a kernel of truth in that, because vitamins are essential to life. But that people will live longer or healthier lives if they take vitamins or eat foods fortified with vitamins–that’s difficult to prove.”

Yes, it’s difficult to prove, and difficult to disprove.

This is not to say we should ignore negative studies. We can learn from negative studies as well as from positive studies. The finding that smokers given high dosages of synthetic beta carotene seemed to experience greater incidence of lung cancer rather than lower incidence, as expected, is not something to be dismissed. There are lessons to be learned from negative findings like this. But we need to look at the full picture. And we need to factor in a large dose of common sense.

Yes, there is the danger that some people might make the “if a little is good, a lot has to be better” mistake. And yes, the benefit of certain nutrients in multivitamin supplements may be more significant, even therapeutic, for those deficient in that nutrient. But we don’t know if we are deficient in one nutrient or another. We don’t know if we are subclinically deficient, i.e. not sufficiently deficient to cause disease, but at levels less than optimal. As they say in the study, a daily multivitamin appears to be safe. The upside is great, and the downside is minimal. Why is taking a multivitamin supplement such a threat?

Those who are so concerned that we might rely on nutritional supplements, rather than a healthy diet rich in fruits and vegetables, act as if the role of diet is somehow “proven” and the role of supplements is not. Is this true? Perhaps not. Here is an excerpt from the actual study, Multivitamins in the Prevention of Cancer in Men: The Physicians’ Health Study II Randomized Controlled Trial, JAMA. 2012;():1-10. doi:10.1001/jama.2012.14641.

“Multivitamins are the most common dietary supplement, regularly taken by at least one-third of US adults. The traditional role of a daily multivitamin is to prevent nutritional deficiency. The combination of essential vitamins and minerals contained in multivitamins may mirror healthier dietary patterns such as fruit and vegetable intake, which have been modestly and inversely associated with cancer risk in some,3 but not all, 4,5 epidemiologic studies.” [emphasis is mine]

Clearly, it seems, the evidence for fruit and vegetable intake is not “proven” either. There are those two references: 4. Löf M, Sandin S, Lagiou P, Trichopoulos D, Adami HO, Weiderpass E. Fruit and vegetable intake and risk of cancer in the Swedish women’s lifestyle and health cohort. Cancer Causes Control. 2011;22(2):283-289. 5. Hung HC, Joshipura KJ, Jiang R, et al. Fruit and vegetable intake and risk of major chronic disease. J Natl Cancer Inst. 2004;96(21):1577-1584

Getting back to the study, “The Physicians’ Health Study II is the first clinical trial to test the affects of multivitamins on a major disease such as cancer,” said lead author J. Michael Gaziano, MD, chief of the Division of Aging at Brigham and Women’s Hospital and an investigator at VA Boston. “Despite the fact that more than one-third of Americans take multivitamins, their long-term effects were unknown until now.”

“Researchers had nearly 15,000 men over the age of 50 take either a multivitamin or a placebo every day for more than 10 years. The men self-reported a cancer diagnosis, and researchers confirmed the diagnosis through medical records. Researchers found the group taking a daily multivitamin had an 8 percent reduction in total cancer compared with the group taking the placebo. They also found a multivitamin was associated with an apparent reduction in cancer deaths.

“Study co-author Howard D. Sesso, ScD, an associate epidemiologist in the Division of Preventive Medicine at Brigham and Women’s Hospital said, “Many studies have suggested that eating a nutritious diet may reduce a man’s risk of developing cancer. Now we know that taking a daily multivitamin, in addition to addressing vitamin and mineral deficiencies, may also be considered in the prevention of cancer in middle-aged and older men.”

“Researchers point out that it is not clear which specific vitamins or minerals in a multivitamin may be responsible for the reduction in cancer risk. Also, it is not known if the results can extend to women or to men younger than the age of 50. Researchers plan to follow up with study participants to determine the affect of a daily multivitamin on cancer over an even longer period of time.

“A similar study is examining the affect of daily multivitamin use on cardiovascular disease risk. Results of that study will be announced at the American Heart Association Scientific Sessions in early November.” (As reported in ScienceDaily, Oct. 17, 2012)

Don Goldberg

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New Line of Supplements for Cancer Patients

Cancer patients often face a difficult choice. They may feel that they would benefit from nutritional and herbal support during and after treatment, but their physicians may be against it. One authority may suggest that nutritional and/or herbal support will work synergistically with conventional treatments, and other experts caution against it. Wouldn’t it be great if complementary cancer specialists developed a line of supplements and skin care products that met the needs of cancer patients and the requirements of your oncologist? Well, such a line is now available, and the name of the line is OncoQOL. Your Oncologist may already know about it.

“OncoQOL’s nutritional supplement products are exclusive, specially formulated products containing nutrients and botanicals that address nutritional needs that can arise during cancer treatment.” I am excited about this, as I think it is very important that Oncologists become comfortable with products that can be recommended to their patients.

To read more about the OncoQOL line, click here.

The products will be available directly from physicians and, I am pleased to announce, from Willner Chemists.

There will be an interview with Sreenivas Rao, MD (an Internal Medicine doctor who has been working in the Oncology field for the past 10 + years) who developed this innovative product line, on The Willner Window Radio Program on Sunday, November 18th, 2012, starting at 2 pm. You can listen live in the greater New York area, on WOR (710 AM). You can also listen live over the internet (www.wor710.com). And, if you miss the live broadcast, an mp3 recording of the show can be found on the Willner Chemists web site, in the Radio section.

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Immune Enhancing Supplements Gain Validation

Immune Enhancing Supplements Gain Validation

There will always be a certain amount of controversy when it comes to recognizing the value of herbal and nutritional supplements as immune system modulators. Historically, conventional medicine has demanded double-blind, placebo controlled human studies. Such studies, however, on these types of products are difficult to set up and impractical to fund. In spite of that, significant progress is being made.

Two new studies provide good examples of this. One study, published in Evidence-Based Complementary and Alternative Medicine – investigated an Echinacea purpurea extract for the prevention and treatment of the common cold. The results were positive. Those taking the echinacea had a slightly reduced chance of coming down with a cold, but those who did get sick had a “highly significant” reduction of days spent with the illness–672 days compared to 850 days in the placebo group. In addition, the echinacea group experienced a 59% reduction in recurring infections.

One interesting thing about this study is that it is one more contradiction to the once fashionable advice against taking echinacea continuously, over a long period of time. This often repeated caution was the result of a misinterpretation of a German publication.

This is only one of many positive studies on echinacea, by the way. A meta-analysis published in 2007 in The Lancet Infectious Diseases (Vol. 7, Pages 473-480) concluded that echinacea may cut the risk of catching the common cold by almost 60%. And researchers from the University of Connecticut combined the results of 14 different studies with positive results. In one of the studies they found in that echinacea taken in combination with vitamin C reduced cold incidence by 86%, and when the herbal was used alone the incidence was reduced by 65%.

The other study I want to call your attention to is related to my recent article on the importance of mushroom extracts as immune system modulators. (You can read that article here.) I am not alone when it comes to having a very high regard for the efficacy of beta-glucan rich mushroom extracts for immune support. It seems the European Union is backing a 240-person trial to investigate the ability of a range of beta-glucans to boost immune systems.

The data will be analyzed using, “many biomarkers including those indicative for the innate immune system, the adaptive immune system, the effect on gut microbiota and metabolites generated by the gut microbiota as a response to the intervention.”

The trial involves several sources of beta-glucans in addition to one of the mushroom extracts I wrote about–a yeast beta-glucan, an oat beta-glucan, a wheat arabinoxylan, and beta-glucan from Shiitake mushroom.

There may be a difference between using echinacea, or similar herbs and beta-glucan rich mushroom extracts. As I pointed out in the above referenced article, “If your immune system is already overactive, as is the case with autoimmune diseases, you should avoid echinacea. It’s also not recommended for progressive diseases such as multiple sclerosis. Finally, the jury is still out on whether echinacea should be used by persons with HIV infections.”

“This is why many experts in the field believe that these conditions are the domain of the adaptogenic herbs. Adaptogens such as astragalus, ashwagandha and eleuthero “tend to enhance the immune system by way of a balancing approach, as opposed to the more nonspecific approach taken by echinacea. This means adaptogens can be used to treat conditions in which the immune system is either depressed or overactive.”

Getting back to the echinacea study, the actual product used was Echinaforce by Bioforce. It was a randomised, double-blind, parallel, placebo-controlled clinical trial with 717 participants. The group assessed safety and efficacy variables over a collective total of 11,472 weeks, or 2,868 months of prophylaxis. The patients mixed 25 drops of Echinaforce or a placebo with water and held it in their mouths for 10 seconds before swallowing it, three times per day over a four month period.

The conclusion, again, was as follows: “the new data reports that three daily doses of the common remedy for four months reduced the likelihood of developing cold and also slashed the duration of the illness by an average of 26%. The herbal supplementation was also reported cut the number of recurrent colds, suffered by those with weakened immune systems, by 60%.
“Prophylactic treatment with Echinaforce over 4 months appeared to be beneficial for many reasons,” explain the researchers, led by senior author Professor Ronald Eccles, from Cardiff University, UK.”

Echinaforce is a mixture of both the herb and root from Echinacea purpurea. As this study shows, along with other studies, this type of extract works. There are other forms, such as root only, as well as other sources, such as Echinacea angustifolia. It should be noted that this study did not compare the efficacy of one type against the other.

The mushroom extract product referenced in my previous article was PhytoTech Mushroom Extract Complex, available from Willner Chemists.

Reference: (1) Evidence-Based Complementary and Alternative Medicine
Published online ahead of print, doi: 10.1155/2012/841315
“Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes: A Randomized, Double-Blind, Placebo-Controlled Trial”
Authors: M. Jawad, R. Schoop, A. Suter, P. Klein, R. Eccles
(2) Immunomodulation: Enhancing Immune Function With Herbal Supplements – Doing It The Right Way. By Don Goldberg. Willner Chemists Catalog/Newsletter Autumn 2012. (Digital version online at http://www.willner.com.
(3) http://www.nutraingredients-usa.com/Product-Categories/Minerals/Top-Immune-Health-Ingredients/(page)/7

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