Focus on supplements

1 Focus on supplements

So many products claiming to have health benefits can be confusing. Some are recommended, though, to balance possible nutritional deficiencies linked to our modern lifestyle, or to compensate for changes due to medication. Not all brands are equivalent, so read content labels carefully to ensure you get the best product.

Co-ENZYME  Q10

This vitamin-like substance works as an anti-oxidant, combating free radical damage inside each cell. Because it is made in your body, true deficiency of Q10 is rare. It is claimed to be of benefit in many conditions, e.g.angina, high blood pressure, obesity, diabetes, atherosclerosis and other age-related diseases. However, there are no trials conclusively proving these claims.

What is known is that some cholesterol and blood pressure pills can deplete your levels of Q10, and that excess Q10 can change your reaction to blood thinners.

Bottom line: 
•    probably safe and of benefit if you are on high doses of statins or blood pressure medication
•    do not use if you are on Warfarin for any reason.

FISH OILS – Omega 3 and 6 oils

The active ingredients (PolyUnsaturated Fats or PUFA) in fish oils are called EPA and DHA: they are incorporated into the membrane of cells, especially in the heart and brain, and may be stored in fat tissue. Whether you have heart disease or not, the heart-healthy diet advises eating 2 portions of oily fish per week to obtain the PUFA’s you need. If you can’t do this, then a daily supplement is recommended. Brands differ in their content, so learn to check the labels and choose one which delivers a total EPA + DHA of about 1000mg (1gram) per DAILY dose, which is equal to eating oily fish twice weekly.

No matter how you get them, at these doses fish oils may prevent heart-beat irregularities.  To get the other benefits though, much higher doses are needed, and these may cause unpleasant side-effects, such as nausea, a “fishy” burp and diarrhoea. To lessen these problems, refrigerate the capsules, change brands or take them during your meals.

Used in high doses for a long time, some of the reported benefits of fish oils include
•    Slight lowering of BP
•    Slight rise in HDL ( “good cholesterol”)
•    Lowering of blood triglycerides (fats)
•    Lowering your chance of a fatal heat attack

There is no evidence that fish oil improves
•    Insulin sensitivity or diabetes
•    Inflammation as measured by C-rp blood tests

Your body stores of PUFA will be emptied within two months once you stop taking these supplements.  Fish oils do thin the blood, but not enough to cause problems such as bleeding ulcers or strokes.

Other PUFA’s are the Omega 6 group. Whilst these are also used in the body, they tend to promote inflammation. Though there is controversy about taking extra Omega 6 oils, most scientists agree that supplementing with Omega 3’s has benefit.

A small amount of plant omega 3’s, eg from flaxseed, can be converted into active forms, but is far less effective than fish oil.

Bottom line:
If you do not eat oily fish such as sardine, salmon, trout, anchovy, or mackerel twice weekly, you should use a daily supplement containing up to 1000mg of EPA and DHA combined. Many fish oils also contain added Vit.E.

The better brands have pure salmon-derived omega 3’s, preferably cold-water sourced, or krill oil.

PLANT STEROLS

These are available in “enriched margarines – e.g. Flora ProActive”. These plant substances are so chemically similar to cholesterol that they compete with cholesterol for absorption in the gut.  As a result, less cholesterol is absorbed from food. You will need to eat about 25g/day (5-6 teaspoons) of this margarine to reduce blood LDL-cholesterol by about 6%. Whilst no studies have shown that this has a direct effect on cardiovascular outcomes, it is expected to work. {Studies do show that their lowering of LDL with statins does correlate with better cardiovascular outcomes} Cost wise, using sterol-enhanced margarines to lower cholesterol is far more expensive than stopping smoking and consuming less of the harmful foods.

For the change in cholesterol achieved, statins are much cheaper, more powerful, and have a proven track record. But adding sterols to the use of statins may result in needing less of these drugs to achieve the target cholesterol.

Bottom line:
If you can afford it, and the rest of your daily fat intake is low, using sterol-enriched margarines may benefit you. Statins, however, will lower your cholesterol faster and cost less. Combining statins and sterol-enriched margarine may reduce the dose of statins you need.

VITAMINS

Vitamins are essential substances, needed in very small amounts; some which we cannot manufacture so must derive from food. Absolute deficiency of vitamins causes diseases such as scurvy or rickets.
•    Modern food production and storage techniques are thought to reduce the amount of vitamins available in our food.
•    Fast foods which replace a normal meal have almost zero vitamin value.

These two facts together mean that unless you are a dedicated organic food eater, whilst you may get enough to prevent a deficiency state, you may not be getting your daily requirement of vitamins for optimum health.

For best results, use a multivitamin with balanced doses of the different vitamins, which results in them all working together as in nature. Mega dosing with individual vitamins is no longer recommended, as there is a danger of overdosing with the fat-soluble ones A,D,E and K.

Bottom line:
Daily multivitamins are recommended, especially for those with a stressful lifestyle, or those taking drugs to inhibit absorption of fats (e.g. cholesterol): Vitamin D is made from cholesterol, so may need to be replenished as a multivitamin in these patients.