Your Dietician: What you need to know about supplements

During January, the sales of nutritional supplements typically increase due to New Year's resolutions to adopt healthier habits. Do you take a multivitamin or other supplement? Then you're not alone. According to a survey by AARP, 83-percent of people aged 65 and older take supplements. The most popular supplements include multivitamins, vitamin D, calcium, omega-3 fatty acids or fish oil and vitamin B-12. Due to the winter being cold and flu season, sales of vitamin C, zinc and probiotics supplements also increase. Here's what you need to know before buying any supplement: Look for the USP symbol for safety Many people mistakenly believe that the Food and Drug Administration (FDA) tests supplements. They do not. The FDA only checks prescription medications and over-the-counter drugs such as cold and pain medicines. When shopping for supplements, look for products with the USP symbol on their label. USP, which stands for United States Pharmacopeia, is a nonprofit scientific organization that tests supplements. They test for ingredient accuracy (the supplements actually contain what is stated on the label), potency (the dosage stated on the label is accurate), purity (it contains no harmful ingredients), performance (the supplement breaks down and releases the nutrient for absorption in the body) and that the product was made under sanitary conditions. According to ConsumerLab, some supplements contain contaminants and/or contain significantly larger or smaller doses than listed on the label. Gummy supplements were found to have the most inaccurate dosages listed on their products. Possible interaction with prescribed medications Before buying any supplement, it is wise to check with your health care provider. Some supplements should not be taken if you have certain medical conditions. In addition, a supplement could make a prescribed medication weaker or stronger. For example, if you are taking medication to thin your blood (reduce blood clotting), you may not want to take omega-3 and fish oil supplements. Omega-3 fatty acids and fish oil also reduce blood clotting. Thus, taking a medication that reduces blood clotting and omega-3 fatty acids or fish oil supplements increases the risk of excessive bleeding, hemorrhage or bruising. More is not better More is not better when it comes to nutrients. Too much of anything can be harmful instead of healthful. The body works in a "Goldilocks" fashion — meaning it needs just the right amount of a nutrient to function properly: not too much and not too little. Choosing a multivitamin Therefore, when choosing a multivitamin, select one with 100 percent of the %DV (percent of the Daily Value) for all the nutrients listed on the multivitamin label. Try to avoid multivitamins or any supplement listing large amounts, such as 1,000 percent of any nutrient. Large amounts of vitamins A and E are especially harmful. These are fat soluble vitamins. Therefore, excess amounts are not excreted from the body and will build up in your body. According to Tufts University, "too much vitamin A or E may increase your stroke risk." Large doses of vitamin E (which acts as a blood thinner), when taken with a blood thinner medication, increase the risk of bleeding, including a hemorrhagic stroke (bleeding in the brain). Chronic intakes of large doses of vitamin A, which are stored in the liver, can build up over time and become toxic. Most people need Vitamin D supplements One supplement most Ohioans should be taking is vitamin D. Unless you fly south to catch some sunshine during the winter, you probably don't get enough vitamin D. (Sunlight on bare skin is the best source of vitamin D.) An adequate blood vitamin D level is vital for a strong immune system. With the flu going around, keeping your vitamin D level up is important. The amount or dose required to maintain a normal vitamin D level will vary, depending on a person's current blood level. Before starting a vitamin D supplement, always get a blood test to determine the vitamin D level in your body. This will determine the appropriate dose for you. People with extremely low blood levels are prescribed large loading doses of vitamin D. After achieving a normal blood level, the dose is reduced. Since vitamin D is a fat -soluble nutrient, it is stored in the liver. Continuing large doses of vitamin D after reaching a normal level damages the liver. Fat needed to absorb vitamin D Since vitamin D is fat soluble, fat is needed for its absorption. So, always take a vitamin D supplement with a meal containing fat. Most people take their vitamins with breakfast, which usually contains minimal fat. For the best absorption, try taking vitamin D with a meal containing more fat, such as dinner. Magnesium increases vitamin D absorption Nutrients always work together. Magnesium increases vitamin D absorption. Thus, taking vitamin D with foods rich in magnesium or a small dose of a magnesium supplement such as 250 milligrams will increase the absorption of vitamin D. Magnesium is required for over 300 functions in the body, including regulating blood pressure, blood sugar levels and heart rhythm. Since magnesium is in food, do not take a large dose of magnesium or you may be getting too much. (Large amounts of magnesium can cause diarrhea — such as the amount of magnesium in milk of magnesia.) Foods highest in magnesium include bran/bran cereals, almonds, spinach and Swiss chard, cashews, pumpkin and sunflower seeds. Won't prevent heart disease or cancer While it would be great if just popping a multivitamin pill would prevent heart disease or cancer, numerous studies on thousands of people have not shown that any supplements prevent these or any disease. In fact, all supplements are required to have this statement (usually in very tiny print), "This product is not intended to diagnosis, treat or prevent any diseases." Supplements are meant to supplement your diet — i.e. to fill in any shortfalls of certain nutrients you may not be getting in the recommended amount. They are not a replacement for eating nutrient-rich foods. Foods superior to supplements Getting nutrients from food is always superior to getting them from supplements Foods contain thousands of nutrients not found in multivitamins or other supplements. For example, in addition to vitamin C, an orange contains over 170 different polyphenols (antioxidants/anti-inflammatory agents) not found in multivitamins/supplements. These nutrients work together in our body. Thus, just taking a multivitamin with vitamin C will not provide the same health benefits. Unlike multivitamins, the Mediterranean diet way of eating has been proven to reduce the risk of heart disease, cancer and many other ailments. It includes daily eating plenty of whole fruits and vegetables containing hundreds of polyphenol compounds with antioxidant/anti-inflammatory properties. Aim to eat at three servings of fruit and four servings of vegetables each day. Studies have found that eating 30 different fruits and vegetables each week results in the healthiest microbiome in the GI tract—where 70-percent of our immune system lies. The Mediterranean diet is more than a diet. It's a lifestyle that includes daily physical activity/walking and social interaction. So, if your goal is to prevent heart disease and/or cancer, load up on a variety of colorful fruits and veggies and take a brisk walk each day. Phyllis J. Molnar is a registered and licensed dietitian who writes about food and health for The Chronicle-Telegram and The Gazette. Email her at pjmolnar56@gmail.com.