Introduction
In this chapter we will explore the use of supplementary measures to support and achieve good health. We intend these to be used in conjunction with a health-promoting attitude, diet, and lifestyle. Examples of supplementary measures include pharmaceutical medications, surgeries, nutritional supplements, herbal medicines, physical therapies (chiropractic care, massage, and other bodywork), acupuncture, homeopathy, and any other treatment measure designed to support or improve health.
We divide supplementary measures into two categories: essential and adjunctive. An example of an essential supplementary measure is the use of insulin in the treatment of insulin-dependent diabetes. Without it, diabetics would either die or suffer greatly. There are numerous other examples where an appropriately used medication or surgery is absolutely essential to support good health.
Very few natural approaches are considered essential in the strict sense. Most would be classified as adjunctive. What this means is that they complement, complete, or support other therapies. For example, Saint-John’s-wort extract has shown very good results in the treatment of depression. However, it is not an essential medication. We view it as an important adjunctive tool to support psychological therapies, lifestyle modification, and dietary recommendations used in the treatment of depression. You can view these adjunctive therapies as temporary crutches to be discarded when and if function is restored.
There are two supplementary measures that, while not strictly essential, could be viewed as critical based upon their tremendous impact on health—nutritional supplementation and physical care.
Nutritional Supplementation
Nutritional supplementation encompasses the use of vitamins, minerals, other food factors, and botanicals to support good health as well as prevent or treat illness. The very term nutritional supplementationdenotes that these compounds are supplementary measures. A person cannot make up for poor dietary habits, a negative attitude, and a lack of exercise by taking pills, whether the pills are drugs or nutritional supplements. Although many nutritional supplements are effective in improving health, for the long term it is absolutely essential that attention be devoted to developing a positive mental attitude, a regular exercise program, and a healthful, whole-foods diet.
The functions of nutrients such as vitamins and minerals in the human body revolve around their role as essential components in enzymes and coenzymes. Enzymes are molecules involved in speeding up chemical reactions necessary for human bodily function. Coenzymes are molecules that help the enzymes in their chemical reactions.
Enzymes and coenzymes work to either join molecules together or split them apart by making or breaking the chemical bonds that join molecules together. One of the key concepts in nutritional medicine is to supply the necessary support or nutrients to allow all the enzymes of a particular tissue to work at optimal levels.
Most enzymes are composed of a protein along with a cofactor that is typically an essential mineral and/or vitamin. If the essential mineral or vitamin is lacking, the enzyme cannot function properly. When we provide the necessary mineral or vitamin through diet or a nutritional formula, the enzyme is then able to perform its vital function. For example, zinc is necessary for the enzyme that activates vitamin A in the visual process. Without zinc, vitamin A cannot be converted to its active form. This deficiency can result in what is known as night blindness. By supplying the body with zinc, we are performing enzyme therapy—allowing the enzyme to perform its vital function.
Many enzymes require additional support in order to perform their function. The support is in the form of a coenzyme, a molecule that functions along with the enzyme. Most coenzymes are composed of vitamins and/or minerals. Without the coenzyme, the enzyme is powerless. For example, vitamin C functions as a coenzyme to the enzyme proline hydroxylase, which is involved in collagen synthesis. Without vitamin C, collagen synthesis is impaired, resulting in failure of wounds to heal, bleeding gums, and easy bruising. There may be plenty of proline hydroxylase (the enzyme), but in order for it to function it needs vitamin C.
The Growing Popularity of Nutritional Supplementation
In the last few decades more Americans than ever are taking nutritional supplements. Research shows that over half of all Americans take some form of dietary supplement on a regular basis.1 Why are so many Americans taking supplements? They know they are not getting all that they need from their diets and realize that supplements make them feel healthier. Numerous studies have demonstrated that most Americans consume a diet that is nutritionally inadequate. Comprehensive studies sponsored by the U.S. government (NHANES I, II, III, and 2007–8; 10-State Nutrition Survey; USDA nationwide food consumption studies; etc.) have revealed that marginal nutrient deficiencies exist in a substantial portion of the U.S. population (approximately 50%) and that for some selected nutrients more than 80% of people in certain age groups consumed less than the Reference Daily Intake or Recommended Daily Intake (RDI).
These studies indicate that most Americans are extremely unlikely to consume a diet meeting the RDI for all nutrients. In other words, while it is theoretically possible that a healthy individual can get all the nutrition he or she needs from foods, the fact is that most Americans do not even come close to meeting all their nutritional needs through diet alone. In an effort to increase their intake of essential nutrients, many Americans look to vitamin and mineral supplements. Multivitamin products—defined as dietary supplements that contain at least three vitamins (some may also contain minerals)—were the most frequently reported supplement in all the NHANES surveys.1
While most Americans are deficient in a vitamin or mineral, the level of deficiency is usually not so great that obvious nutrient deficiencies are apparent. A severe deficiency disease such as scurvy (severe lack of vitamin C) is extremely rare, but marginal vitamin C deficiency is thought to be relatively common. The term subclinical deficiency is often used to describe marginal nutrient deficiencies. In many instances the only clue to a subclinical nutrient deficiency may be fatigue, lethargy, difficulty in concentration, a lack of well-being, or some other vague symptom. Worse, however, is that—as we extensively document in this book—chronic, long-term marginal deficiencies are an underlying cause of most of the disease we suffer in Western societies. Diagnosis of subclinical deficiencies is an extremely difficult process that involves detailed dietary or laboratory analysis. It’s not worth the cost to perform these tests because they are usually far more expensive than taking a year’s supply of the vitamin being tested for.
The RDI Is Not Enough
Recommended Dietary Allowances (RDAs) for vitamins and minerals were first prepared by the Food and Nutrition Board of the National Research Council in 1941. These guidelines were originally developed to reduce the rates of severe nutritional deficiency diseases such as scurvy (deficiency of vitamin C), pellagra (deficiency of niacin), and beriberi (deficiency of vitamin B1). In the mid-1990s these guidelines were replaced with the RDIs. The RDIs show no more promise than the RDAs did in providing the public with useful information on the intake of nutrients needed for the prevention, mitigation, and treatment of a wide range of conditions and diseases.
A tremendous amount of scientific research indicates that the optimal level for many nutrients, especially the antioxidant nutrients vitamins C and E, beta-carotene, and selenium, may be much higher than the current RDIs. The RDIs focus only on the prevention of overt nutritional deficiencies in population groups; they do not define optimal intake for an individual.
The RDIs also do not adequately take into consideration environmental and lifestyle factors that can destroy vitamins and bind minerals in a way that makes them unavailable to the body. For example, even the Food and Nutrition Board acknowledges that smokers require at least twice as much vitamin C compared with nonsmokers. But what about other nutrients and smoking? And what about the effects of alcohol consumption, food additives, heavy metals, carbon monoxide, and other chemicals associated with our modern society that are known to interfere with nutrient function? The hazards of modern living may be another reason many people take supplements.
While the RDIs have done a good job of defining nutrient intake levels to prevent nutritional deficiencies, there is still much to be learned regarding the optimal intake of nutrients.
The Vitamin and Mineral Content of Conventionally Grown Foods Has Decreased Dramatically in the Past Century
Even if you are conscientiously working to eat more whole foods, it is very difficult if not impossible to get all the required nutrients from food alone. A sad fact is that conventionally grown foods do not contain as high a concentration of nutrients today as they did in the past. For example, one study showed that vitamin levels have decreased by as much as 37% from 1950 to 1999,2 and another found that trace minerals have dropped by as much as 77% from 1940 to 1991.3 While the researchers are arguing whether this is due to synthetic fertilizers or different types of seeds, the bottom line is that even supposedly “good” foods are depleted. Eating more organically grown foods will help, but we see no alternative to smart supplementation.
Conditionally Essential Nutrients
In addition to essential nutrients, there are a number of food components and natural physiological agents discussed in this book that have demonstrated impressive health-promoting effects. Examples include flavonoids, probiotics, carnitine, and coenzyme Q10. These compounds exert significant therapeutic effects with little, if any, toxicity. More and more research indicates that these accessory nutrients, although not considered “essential” in the classical sense, play a major role in preventing illness as well as exerting specific therapeutic effects and promoting healthy aging. We refer to these compounds as “conditionally essential” to indicate that there are certain conditions where their use becomes essential in order for the body to function properly.
Some Practical Recommendations
There are four primary recommendations we make to people to help them design a foundation nutritional supplement program:
1. Take a high-quality multiple vitamin and mineral supplement.
2. Take extra plant-based antioxidants such as flavonoid extracts or “green foods.”
3. Take a high-quality fish oil product to provide 1,000 mg EPA + DHA per day.
4. Take enough vitamin D (typically 2,000 to 4,000 IU per day) to elevate your blood levels to the optimal range.
Recommendation 1: Take a High-Quality Multiple Vitamin and Mineral Supplement
Taking a high-quality multiple vitamin and mineral supplement providing all of the known vitamins and minerals serves as a foundation upon which to build. Dr. Roger Williams, one of the premier biochemists of our time, states that healthy people should use multiple vitamin and mineral supplements as an “insurance formula” against possible deficiency. This does not mean that a deficiency will occur in the absence of the vitamin and mineral supplement, any more than not having fire insurance means that your house is going to burn down. But given the enormous potential for individual differences from person to person and the varied mechanisms of vitamin and mineral actions, supplementation with a multiple formula seems to make sense. The following recommendations provide an optimal intake range to guide you in selecting a high-quality multiple. (Note that vitamins and minerals are usually measured in one of three different units: IU = International Units, mg = milligrams, or mcg = micrograms.) For children up to two years of age, the dosage should be the low end of the range listed, multiplied by 20% (0.20). For example, the recommended low-end dosage for vitamin B1 (thiamine) is 10 mg, so the daily dosage for children up to two years would be 10 mg × 0.20 = 2 mg. For children two to four years old, the dosage is 40% of the low end of the range given; for children four to eight years old, the dosage is 60% of the low-end adult dosage; and for children nine years old or older the full adult dosage is sufficient.
|
Recommendations for a Daily Multiple Vitamin and Mineral Supplement |
|
|
VITAMIN |
DAILY DOSE FOR ADULTS AND CHILDREN 9 YEARS AND OLDER |
|
Vitamin A (retinol)a |
2,500–5,000 IU |
|
Vitamin A (from beta-carotene) |
5,000–25,000 IU |
|
Vitamin B1 (thiamine) |
10–100 mg |
|
Vitamin B2 (riboflavin) |
10–50 mg |
|
Vitamin B3 (niacin) |
10–100 mg |
|
Vitamin B5 (pantothenic acid) |
25–100 mg |
|
Vitamin B6 (pyridoxine) |
25–100 mg |
|
Vitamin B12 (methylcobalamin) |
400 mcg |
|
Vitamin C (ascorbic acid)b |
250–1,000 mg |
|
Vitamin Dc |
1,000–2,000 IU |
|
Vitamin E (mixed tocopherols)d |
100–200 IU |
|
Vitamin K1 or K2 |
60–300 mcg |
|
Niacinamide |
10–30 mg |
|
Biotin |
100–300 mcg |
|
Folic acid |
400 mcg |
|
Choline |
10–100 mg |
|
Inositol |
10–100 mg |
|
MINERAL |
RANGE FOR ADULTS AND CHILDREN 4 YEARS AND OLDER |
|
Boron |
1–6 mg |
|
Calciume |
600–1,000 mg |
|
Chromiumf |
200–400 mcg |
|
Copper |
1–2 mg |
|
Iodine |
50–150 mcg |
|
Irong |
15–30 mg |
|
Magnesium |
250–500 mg |
|
Manganese |
3–5 mg |
|
Molybdenum |
10–25 mcg |
|
Potassium |
NAh |
|
Selenium |
100–200 mcg |
|
Silica |
1–25 mg |
|
Vanadium |
50–100 mcg |
|
Zinc |
15–30 mg |
a. Women of childbearing age who may become pregnant should not take more than 2,500 IU of retinol per day owing to the possible risk of birth defects.
b. It may be easier to take vitamin C separately.
c. Elderly people living in nursing homes or at northern latitudes should supplement at the high range.
d. It may be more cost-effective to take vitamin E separately rather than as a component of a multiple vitamin.
e. Women who have or who are at risk of developing osteoporosis may need to take a separate calcium supplement to achieve the recommended level of 1,000 mg per day.
f. For diabetes and weight loss, doses of 600 mcg of chromium can be used.
g. Most women who have gone through menopause and most men rarely need supplemental iron.
h. The FDA restricts the amount of potassium in supplements to no more than 99 mg. Potassium needs are best met through diet and the use of potassium salts used as salt substitutes.
Read labels carefully to find multiple vitamin/mineral formulas that contain doses in these ranges. Be aware that you will not find a formula that provides all of these nutrients at these levels in one single pill—it would be too big. Usually you’ll need to take at least three to six tablets per day to meet these levels. While many once-daily supplements provide good levels of vitamins, they tend to be insufficient in the amount of some of the minerals they provide. Your body needs the minerals as much as the vitamins—the two work hand in hand.
WHEN TO TAKE YOUR SUPPLEMENTS
• Multiple vitamin and mineral supplements are best taken with meals. Whether you take them at the beginning or end of a meal is up to you. If you are taking more than a couple of pills, you may find that taking them at the beginning of a meal is more comfortable. Taking a handful of pills on a full stomach may cause a little stomach upset.
• Flavonoid-rich herbal extracts can be taken with meals or at any other time desired.
• “Green food” drinks make great between-meal snacks (especially if you are trying to lose a little weight, as they can quell an overactive appetite).
• Fish oil supplements are best taken at or near the beginning of a meal to avoid any fishy aftertaste—some people burp up a little of the oil if they take it at the end of the meal on a full stomach.
• Vitamin D3 is best taken with meals.
Recommendation 2: Take Extra Plant-Based Antioxidants Such as Flavonoid Extracts or “Green Foods”
The terms free radical and antioxidant are becoming familiar to most health-minded individuals. Loosely defined, a free radical is a highly reactive molecule that can bind to and destroy cellular structures and blood components. Free radical (oxidative) damage is what makes us age. Free radicals have also been shown to be responsible for the initiation of many diseases, including the two biggest killers of Americans—heart disease and cancer.
Antioxidants, in contrast, are compounds that help protect against free radical damage. Antioxidant nutrients such as beta-carotene, selenium, vitamin E, and vitamin C have been shown to be very important in protecting against the development of heart disease, cancer, and other chronic degenerative diseases. In addition, antioxidants are also thought to slow down the aging process.
Based on extensive data, it appears that a combination of antioxidants will provide greater protection than a large dosage of any single antioxidant. Therefore, in addition to consuming a diet rich in plant foods (especially fruits and vegetables) and taking a high-potency multiple vitamin and mineral formula as detailed above in Recommendation 1, we recommend using some form of plant-based antioxidant to ensure broader antioxidant protection. Look to either flavonoid-rich extracts or green foods. Flavonoids are plant pigments that exert antioxidant activity and have effects that are more potent and more effective against a broader range of oxidants than the traditional antioxidant nutrients vitamins C and E, beta-carotene, selenium, and zinc. Besides lending color to fruits and flowers, flavonoids are responsible for many of the medicinal properties of foods, juices, herbs, and bee pollen. More than 8,000 flavonoid compounds have been characterized and classified according to their chemical structure. Flavonoids are sometimes called “nature’s biological response modifiers” because of their anti-inflammatory, antiallergenic, antiviral, and anticancer properties.4
Because certain flavonoids concentrate in specific tissues, it is possible to take flavonoids that target specific conditions. For example, one of the most beneficial groups of tissue-specific plant flavonoids are the proanthocyanidins (also referred to as procyanidins). These molecules are found in high concentrations (up to 95%) in grape seed and pine bark extracts. We recommend either grape seed or pine bark extract for most people under the age of 50 for general antioxidant support, as each appears to be especially useful in protecting against heart disease. For those over 50, ginkgo biloba extract is generally the best choice. If there is a strong family history of cancer, however, the best choice is clearly green tea extract (see below). Identify which flavonoid or flavonoid-rich extract is most appropriate for you and take it according to the recommended dosage. There is tremendous overlap among the mechanisms of action and benefits of flavonoid-rich extracts; the key point here is to take the one that is most specific to your personal needs.
|
Selecting a Flavonoid Supplement |
||
|
FLAVONOID-RICH EXTRACT |
DAILY DOSE FOR ANTIOXIDANT SUPPORT |
INDICATION |
|
Green tea extract (60–70% total polyphenols) |
150 to 300 mg |
Systemic antioxidant. May provide the best protection against cancer; best choice if there is a family history of cancer. Also protects against damage to cholesterol molecules. |
|
Grape seed extract or pine bark extract (95% procyanidolic oligomers) |
100 to 300 mg |
Systemic antioxidant; best choice for most people under age 50. Also specific for the lungs, diabetes, varicose veins, and protection against heart disease. |
|
Ginkgo biloba extract (24% ginkgo flavonglycosides) |
240 to 320 mg |
Best choice for most people over the age of 50. Protects brain and vascular lining. |
|
Milk thistle extract (70% silymarin) |
200 to 300 mg |
Best choice for additional antioxidant protection of liver or skin needs. |
|
Bilberry extract (25% anthocyanidins) |
160 to 320 mg |
Best choice to protect the eyes. |
|
Hawthorn extract (10% proanthocyanidins) |
300 to 600 mg |
Best choice in heart disease or high blood pressure |
The term green food refers to green tea and a number of commercially available products containing dehydrated barley grass, wheatgrass, or algae sources such as chlorella or spirulina. Mixing with water or juice rehydrates such formulas. These products—packed full of phytochemicals, especially carotenes and chlorophyll—are more convenient than trying to sprout and grow your own source of greens. An added advantage is that they tend to taste better than, for example, straight wheatgrass juice.
BENEFITS OF GRAPE SEED AND PINE BARK EXTRACT
The proanthocyanidins are one of the most beneficial groups of plant flavonoids. The most active proanthocyanidins are those bound to other proanthocyanidins in compounds referred to as procyanidolic oligomers (PCOs) or oligomeric proanthocyanidins (OPCs). Although PCOs exist in many foods, supplemental sources such as extracts from grape seeds (Vitis vinifera) and the bark of the French maritime (Landes) pine have shown significant benefits in clinical studies for the following health conditions:
Asthma
Atherosclerosis, hypertension, metabolic syndrome, and type 2 diabetes
Attention-deficit/hyperactivity disorder
Male infertility
Osteoarthritis
Periodontal disease
Varicose veins, venous insufficiency, and capillary fragility
Visual function, retinopathy, and macular degeneration
PCOs exert broad-spectrum antioxidant activity and are clinically useful in many other health conditions because of this action. A great deal of clinical research shows that supplementation with PCOs for six weeks at dosages of 150 to 300 mg considerably improves the serum (blood) total antioxidant capacity and ORAC score. Because of this effect (and others), throughout this book we recommend using grape seed extract or pine bark extract.
The green foods are particularly rich in natural fat-soluble chlorophyll—the green pigment that converts sunlight to chemical energy in plants, algae, and some microorganisms. Like the other plant pigments, chlorophyll also possesses significant antioxidant and anticancer effects. It has been suggested that chlorophyll be added to certain beverages, foods, chewing tobacco, and snuff to reduce cancer risk. A better recommendation would be to include green food products and fresh green vegetable juices regularly in the diet.
As far as product selection and dosage goes, we recommend looking at a product’s stated ORAC (oxygen radical absorbance capacity) value. Although there are many categories of antioxidants, researchers often measure antioxidant activity according to its ORAC value. In general, the higher the ORAC value of a food, the more capable that food is of exerting antioxidant protection against age-related conditions. The average North American diet provides less than 1,000 ORAC units per day. However, nutritional experts recommend an intake of 3,000 to 6,000 ORAC units per day, from a variety of sources. Many of the commercially available green food products are able to deliver this high ORAC value in one or two servings. Read labels carefully and choose respected brands. There are many excellent super green food products out there.
Recommendation 3: Take a High-Quality Fish Oil Product to Provide 1,000 mg EPA + DHA per Day
One of the major advances in nutritional medicine has been the ability to produce a fish oil supplement that is a highly concentrated source of long-chain omega-3 fatty acids and also free from damaged fats (lipid peroxides), heavy metals, environmental contaminants, and other harmful compounds. These pharmaceutical-grade fish oil concentrates are so superior to earlier fish oil products that they are revolutionizing nutritional medicine. Alternatively, vegetarian sources of long-chain omega-3 fatty acids produced from algae are now available.
While most Americans eat way too much of the omega-6 oils found in meats and most vegetable oils, they suffer a relative deficiency of the omega-3 oils—a situation that is associated with an increased risk for heart disease and about 60 other conditions including cancer, arthritis, stroke, high blood pressure, skin diseases, and diabetes. Particularly important to good health are the longer-chain omega-3 fatty acids such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found in fish, especially cold-water fish such as salmon, mackerel, herring, and halibut. Although the body can convert alpha-linolenic acid (a short-chain omega-3 fatty acid found in flaxseed oil, walnuts, chia, and many other nuts and seeds) to the longer-chain omega-3s, it is not a very efficient process.5
Some Conditions Benefited by Fish Oil Supplementation
Allergies
Alzheimer’s disease
Arthritis
Asthma
Attention-deficit/hyperactivity disorder
Autoimmune diseases (rheumatoid arthritis, lupus, MS, etc.)
Cancer (prevention and treatment adjunct)
Depression
Diabetes
Eczema
Elevated triglyceride levels
Heart disease (prevention and treatment)
High blood pressure
Inflammatory conditions (e.g., ulcerative colitis, Crohn’s disease)
Macular degeneration
Menopause
Osteoporosis
Pregnancy
Psoriasis
Why are the long-chain omega-3 fatty acids so important? The answer has to do with the function of these fatty substances in cellular membranes and inflammation. A diet that is deficient in omega-3 fatty acids, particularly EPA and DHA, results in altered cell membranes. Without a healthy membrane, cells lose their ability to hold water, vital nutrients, and electrolytes. They also lose their ability to communicate with other cells and be controlled by regulating hormones. They simply do not function properly. Cell membrane dysfunction is a critical factor in the development of virtually every chronic disease, especially cancer, diabetes, arthritis, and heart disease. Not surprisingly, long-chain omega-3 fatty acids have shown tremendous protective effects against all of these diseases.5
Long-chain omega-3 fatty acids are also transformed into regulatory compounds known as prostaglandins. These compounds carry out many important tasks in the body. They regulate inflammation, pain, and swelling; they play a role in maintaining blood pressure; and they regulate heart, digestive, and kidney function. Prostaglandins also participate in the response to allergies, help control transmission of signals along the nerves, and help regulate the production of steroids and other hormones. Through their effects on prostaglandins and related compounds, long-chain omega-3 fatty acids can mediate many physiological processes, so they are useful in virtually every disease state as well. Eating a diet rich in omega-6 and low in omega-3 fatty acids strongly promotes inflammation, which underlies many diseases and is associated with a significantly increased risk for many cancers—most notably breast and prostate cancer.
In selecting a fish oil supplement, it is essential to use a brand that you trust. Quality control is an absolute must to ensure that the product is free from heavy metals such as lead and mercury, pesticides, lipid peroxides, and other contaminants. For general health, the recommended dosage is 1,000 mg EPA + DHA per day. Read the label carefully, as it is not 1,000 mg fish oil, but 1,000 mg EPA + DHA. For therapeutic purposes such as reducing inflammation or lowering triglyceride levels, the dosage recommendation is usually 3,000 mg EPA + DHA per day.
In addition to taking a high-quality fish oil, we think it is also a good idea to take 1 tbsp flaxseed oil per day. Flaxseed oil is unique because it contains the essential fatty acids alpha-linolenic acid (an omega-3 fatty acid) and linoleic acid (an omega-6 fatty acid) in appreciable amounts. The best way to take flaxseed oil is by adding it to foods. Do not cook with flaxseed oil, because it is easily damaged by heat and light; add it to foods after they have been cooked, or use it as a salad dressing. You can also try dipping bread into it, adding it to hot or cold cereal, or spraying it over popcorn. Here is a sample salad dressing featuring flaxseed oil:
Flaxseed Oil Basic Salad Dressing
4 tbsp organic flaxseed oil
11/2 tbsp lemon juice
1 medium garlic clove, crushed
Pinch of seasoned salt or salt-free seasoning
Freshly ground pepper to taste
Place all ingredients in a salad bowl and whisk together until smooth and creamy. Jazz up this basic recipe to your own personal taste by using your favorite herbs and spices.
Recommendation 4: Take Enough Vitamin D (Typically 2,000 to 4,000 IU per Day) to Elevate Your Blood Levels to the Optimal Range
A huge and growing amount of research has now shown that vitamin D deficiency is very common (at least 50% of the general population and 80% of infants are deficient) and plays a major role in the development of many of the chronic degenerative diseases.6–8 In fact, vitamin D deficiency may be the most common medical condition in the world, and vitamin D supplementation may be the most cost-effective strategy to improve health, reduce disease, and increase longevity. Those deficient in vitamin D have twice the rate of death and a doubling of risk for many diseases, such as cancer, cardiovascular disease, diabetes, asthma, and autoimmune diseases such as multiple sclerosis.8,9Vitamin D deficiency syndrome (VDDS) is a newly designated disorder linked to a myriad of health issues.
Vitamin D Deficiency Syndrome (VDDS)
• Low blood level of 25-hydroxyvitamin D (<25 ng/ml)
• Presence of at least two of the following conditions:
Osteoporosis
Heart disease
High blood pressure
Autoimmune disease
Chronic fatigue
Cancer
Allergies
Asthma
Psoriasis or eczema
Recurrent infections
Vitamin D is actually more of a prohormone than a vitamin. We produce vitamin D3 (cholecalciferol) in our body by the reaction of a chemical in our skin in response to sunlight. This vitamin D3 is converted by the liver and then the kidneys to its active hormonal form, 1,25-dihydroxyvitamin D [calcitriol, or 1,25-(OH)2D], which acts as a vital key to unlock binding sites on the human genome for the expression of the genetic code. The human genome contains more than 2,700 binding sites for calcitriol; those binding sites are near genes involved in virtually every known major disease.
There are two primary forms of supplemental vitamin D: D3 (cholecalciferol) and D2 (ergocalciferol). Supplemental vitamin D3 is derived from either lanolin or cod liver oil extract and is the form of vitamin D that most effectively treats vitamin D deficiency. Vitamin D2 is derived from fungal sources, so it is sometimes referred to as vegetarian vitamin D. Unfortunately, vitamin D2 is not naturally present in the human body and may have actions within the body different from those of vitamin D3. So most experts prefer D3.
RISK FACTORS FOR VITAMIN D DEFICIENCY
• Insufficient exposure to sunlight. Working and playing indoors, covering up with clothes or sunscreen when outside, or residing at a high latitude can make it likely that individual gets insufficient exposure to sunlight.
• Aging. Seniors are at greater risk due to lack of mobility (which means they may be less likely to be outside) and skin that is less responsive to ultraviolet light.
• Darker skin. A high incidence of vitamin D deficiency and its associated conditions in darker-skinned individuals is widely documented.
• Breastfeeding. Breastfeeding will result in vitamin D deficiency in the baby if the mother fails to ensure her own levels are high enough to provide for her baby’s needs. When the mother is deficient, the breast-fed child will be deficient due to the low vitamin D content of the mother’s breast milk.
• Obesity. Fat-soluble vitamin D gets trapped in fat tissue, preventing its utilization by the body.
WARNING: People with the following conditions should take vitamin D only with the guidance of a knowledgeable physician:
• Primary hyperparathyroidism
• Sarcoidosis
• Granulomatous tuberculosis
• Some cancers
The ideal method for determining the optimal dosage requires a readily available blood test for 25-hydroxyvitamin D [calcidiol, or 25-(OH)D]. While some people can achieve an optimal level with just 600 IU per day (or 20 minutes per day of sunlight exposure), others have a genetic requirement for as much 10,000 IU per day. The only way to determine where you fall is by testing. Many doctors are now routinely checking vitamin D status in their patients. You can also order a test from www.vitamindcouncil.org: you collect a small blood sample by skin prick and send it in to the lab. For optimal health, 25-(OH)D blood levels should be around 50–80 ng/ml (125–200 nmol/L).
Physical Care
A critical component of overall good health is the physical status of the body. The physical care of the human body involves addressing the following four areas:
Breathing
Posture
Bodywork
Aerobics and strength training
WHAT ABOUT PREGNANCY?
Pregnancy obviously results in an increased need for nutrients, including vitamins and minerals. Deficiency or excess of any of a number of nutrients can lead to birth defects in the baby and/or complications during pregnancy for the mother. What is a mother-to-be to do? In addition to eating a highly nutritious diet that focuses on whole, unprocessed foods, it is very important to take the following supplements:
1. A high-potency, full-spectrum prenatal multiple vitamin and mineral
2. Additional iron if needed
3. A fish oil supplement
4. Vitamin D3: 2,000 to 4,000 IU per day
5. A plant-based antioxidant formula
HIGH-POTENCY MULTIPLE VITAMIN AND MINERAL FORMULA
The discovery that folic acid supplementation in early pregnancy can reduce the incidence of neural tube defects in babies by as much as 80% has been referred to as one of the greatest discoveries of the last part of the 20th century. But folic acid is just one of many essential nutrients. What about the others? Are they less important than folic acid? Absolutely not! A deficiency of virtually any nutrient during pregnancy is going to have serious repercussions for mother and baby. Furthermore, adequate levels of key nutrients such as antioxidants, calcium, magnesium, and other B vitamins may help ensure a healthy pregnancy and delivery by preventing complications of pregnancy such as gestational diabetes and the potentially life-threatening condition preeclampsia (also known as toxemia of pregnancy).
Simply stated, taking a multiple vitamin and mineral supplement designed specifically for pregnant and lactating women makes perfectly good sense. The only caveat is to make sure that the vitamin A content is provided by beta-carotene rather than retinol. Do not take more than 3,000 IU of vitamin A per day if you are pregnant unless it is provided in the form of beta-carotene rather than as retinol. Unlike retinol, beta-carotene carries with it no toxic effects on the fetus.
ADDITIONAL IRON IF NEEDED
The dramatic increase in the need for iron during pregnancy usually cannot be met through diet alone. Supplementation is often warranted. Usually the amount of iron contained in a prenatal multiple is sufficient, but if a mother-to-be develops anemia or has evidence of low iron stores (serum ferritin is the best determination), then additional supplementation is required. Ferrous sulfate is the most popular iron supplement, but it is certainly less than ideal, as it often causes constipation or other gastrointestinal disturbance. The best forms of iron supplements are ferrous succinate, ferrous glycinate, ferrous fumarate, and ferrous pyrophosphate. Of these, we prefer ferrous pyrophosphate that is micronized (very small particle size) and then microencapsulated. The advantages of this form are that it is extremely stable, has no taste or flavor, is free from gastrointestinal side effects, and provides a sustained-release form of iron (up to 12 hours) with a high relative bioavailability, especially if it is taken on an empty stomach.
For iron deficiency during pregnancy, a woman will need to take an additional 30 mg iron twice per day between meals for best absorption. If this recommendation results in abdominal discomfort, then try the pyrophosphate form, or the supplement can be taken with meals three times per day.
FISH OIL SUPPLEMENT
Take a high-quality fish oil supplement to increase the level of omega-3 fatty acids available to the growing fetus. One of the more important omega-3 fatty acids for fetal development is DHA. In fact, DHA is essential for proper brain and eye development, as it is the primary structural fatty acid in the gray matter of the brain and retina of the eye. Take 1,000 mg EPA+DHA per day.
VITAMIN D: 2,000 TO 4,000 IU PER DAY
Maternal vitamin D deficiency is associated with a higher risk of a number of complications of pregnancy, including preeclampsia, gestational diabetes, preterm birth, fetal growth restriction, low birth weight, and maternal muscle weakness. In a double-blind trial, pregnant women in Canada were randomly assigned during their first trimester to receive 400 IU, 2,000 IU, or 4,000 IU of vitamin D3 per day until delivery.10 The percentage of women who achieved sufficient blood levels of vitamin D was significantly higher in the group that received 4,000 IU per day, and these women and their babies were less likely to have deficient or insufficient vitamin D serum levels. There were no adverse events related to the dose of vitamin D. Women with adequate levels of vitamin D have children with a significantly reduced risk of autism, allergies, asthma, and diabetes type 1.
PLANT-BASED ANTIOXIDANT FORMULA
Grape seed extract, pine bark extract, bilberry extract, green tea extract, and/or super green foods can be consumed safely at recommended dosages and offer significant health benefits for the mother and developing child.
Since the importance of regular aerobic exercise and strength training was discussed in the chapter “The Healing Power Within,” the other three components are discussed here.
Breathing
Have you ever noticed how a sleeping baby breathes? With each breath the baby’s abdomen rises and falls because the baby is breathing with its diaphragm. If you are like most adults, you tend to fill only your upper chest because you do not utilize the diaphragm. Shallow breathing tends to produce tension and fatigue. One of the most important methods of maintaining health as well as producing more energy and less stress in the body is breathing with the diaphragm. Try it. Take a deep, natural breath in by using your diaphragm and let it out slowly. Learn what it feels like to breathe easily and naturally using your diaphragm; you will definitely notice improved energy levels, reduced tension, and improved mental alertness.
Posture
Posture, the manner in which the body is held, is extremely important to good health. First of all, when the body is slouched, with shoulders slumped and head down, diaphragmatic breathing is more difficult. As a result, poor posture promotes shallow breathing and low energy levels, not to mention possible physical repercussions due to misalignment of vertebrae and/or muscle spasms. Have you noticed that when you breathe with the diaphragm, the spine becomes more erect, the shoulders are pushed back, and the head is pulled up? Energetic posture and good diaphragmatic breathing usually go hand in hand.
One of the keys to gaining more energy in your body is to assume a more energetic posture. It sends a message to the subconscious that you are energized and ready to go. Become aware of how you are holding your body as well as how you are breathing. You will probably notice that when you have low energy levels, you tend to hold your body in a tight posture with your head slightly down and shoulders slouched. When you find yourself in this position, just start breathing with your diaphragm and pull your head up by imagining a cord affixed to the top of your head gently pulling your spine and neck straight and into alignment.
By becoming aware of your breathing and your posture, you may notice a great deal of muscular tension or stress in certain areas of your body. That is where the next phase of physical care of the body comes into play—bodywork.
Bodywork
The need to touch and be touched is universal. In other countries around the world, bodywork practitioners are relied upon much more than in the United States. However, there is a growing trend among Americans toward increased popularity of bodywork treatments.
There are many different types of bodywork to choose from, including various massage techniques, chiropractic spinal adjustment and manipulation, Rolfing, reflexology, shiatsu, and many more. Fortunately, all of these techniques can provide benefits, so it is really a matter of personal preference. Find a technique or practitioner that you really like and incorporate bodywork into your routine.
Both of this book’s authors are fortunate to have experienced a broad range of bodywork, from Rolfing and deep tissue massage (often referred to as sports massage) to more gentle techniques such as Trager massage, Feldenkrais, and craniosacral therapy. Our experience has led us to the conclusion that the therapist is more critical to the outcome than the technique. The technique is only a tool. The result is largely dependent upon the person using the tool. If your physical body (as well as your attitude) is in need of a tune-up, begin looking for a good chiropractor or body worker. How do you find such a person? Word of mouth is probably the best method. Ask around.
Our own personal belief is that the most effective techniques are those that teach body awareness and address underlying structural problems. We have divided these techniques into two major classifications: deep tissue work and light touch therapies. The techniques we discuss below require a practitioner to undertake extensive education and training before calling himself or herself a certified therapist.
Deep tissue work such as Rolfing and Hellerwork are probably the most powerful bodywork techniques, able to quickly create change in body posture and energy levels. Unlike massage and spinal adjustment, Rolfing and Hellerwork are focused not on the muscles and spine but rather on the fascia, the network of elastic sheathing that helps support the body, keeping bones, muscles, and organs in place. According to Rolfers and Hellerwork practitioners, the fascia can be damaged by physical injury, emotional trauma, and bad postural habits, throwing the body out of alignment. Rolfing, Hellerwork, and other deep tissue treatments attempt to bring the body back into balance, restore efficiency of movement, and increase mobility by stretching and lengthening the fascia to bring it back it to its natural form and pliability.
Rolfing or Hellerwork treatments consist of 10 or 11 sessions, each lasting between 60 and 90 minutes. Treatments are sequential, beginning with more superficial treatments and ending with deeper massage. Deep tissue treatment can be quite painful, but the rewards are worth it. Deep tissue therapies can be quite remarkable in their ability to improve breathing, posture, tolerance of stress, and energy levels. In addition, many people going through deep tissue therapy report resolution of emotional conflicts. It seems that many painful or traumatic experiences are stored in the fascia and muscles as tension. Releasing the tension and restoring freedom in the fascia can produce remarkable increases in energy levels.
If Rolfing or Hellerwork is too painful for you, there are three light touch therapies that can produce similar but more gradual results and feel incredibly pleasurable. The first technique is called Tragerwork or Trager massage. Tragerwork was the innovation of Milton Trager, M.D. According to Trager, we all develop mental and physical patterns that may limit our movements or contribute to fatigue as well as pain and tension. During a typical session, the practitioner gently and rhythmically rocks, cradles, and moves the client’s body so as to encourage the client to see that freedom of movement and relaxation are entirely possible. The aim of the treatment is not so much to massage or manipulate, but rather to promote feelings of lightness, freedom, and well-being. Clients are also taught a series of exercises to do at home. Called Mentastics, these simple, dance-like movements are designed to help clients maintain and enhance the feelings of flexibility and freedom they may have experienced during the sessions.
The other “light touch” therapies that we recommend are two similar techniques: Alexander and Feldenkrais. In these methods the practitioner guides the patient to become aware of habitual and limited movement patterns and replace them with more optimal movements. Like many bodywork techniques, these techniques are difficult to describe. Basically, what these techniques teach is body awareness. The participant learns the difference between muscular tension and relaxation, and how different postures feel—restricted or free.
Final Comments
Supplementary measures can make a dramatic impact on a person’s quality of health and quality of life. In some cases a supplementary measure is a primary therapy; in other situations it may be simply supporting or promoting good health. We highly recommend incorporating nutritional supplementation and physical care as essential supplementary measures to support or attain good health.
QUICK REVIEW
• Supplementary measures are either essential or adjunctive to good health.
• Two supplementary measures that could be viewed as essential, based upon their tremendous impact on health, are nutritional supplementation and physical care.
• The components of a foundational nutritional supplement program are:
1. Take a high-quality multiple vitamin and mineral supplement.
2. Take extra plant-based antioxidants such as flavonoid extracts or “green foods.”
3. Take a high-quality fish oil product to provide 1,000 mg EPA + DHA per day.
4. Take enough vitamin D3 (typically 2,000 to 4,000 IU per day) to elevate your blood levels to the optimal range.
• The physical care of the human body involves the following four areas:
• Breathing with the diaphragm promotes good health, higher energy levels, and feelings of less stress.
• Posture is extremely important to the physical care of the body.
• Bodywork can provide enormous benefits.
• Exercise should include both aerobic and strength training.