By Chaivat Phuvadakorn, M.D. Special to The Mirror
As children, we are taught in school about the “food pyramid” – to eat fewer servings of fats and meats and to consume more servings of fruits and vegetables (see www.choosemyplate.gov). I still remember my parents telling me to, “eat your fruits and vegetables!”
The recently released “2015-2020 Dietary Guidelines for Americans” reinforce the importance of fruits and vegetables as part of a healthy diet to promote overall health.
However, as we grow up, we don’t always practice what we are taught in school. Instead of three to five servings of vegetables and two to four servings of fruit, isn’t it just easier and more convenient to swallow a pill? Hence, the popularity of dietary supplements. In fact, I would say the majority of my new patients are taking vitamins and supplements. Some even come to their appointments with an entire bag of 20-plus bottles! Patients take supplements for a number of reasons – to “supplement” their diet, gain more energy or to improve their arthritis or memory.
Dietary supplements are a multi-billion-dollar industry; there are more than 50,000 different supplements currently on the market. However, most people do not realize that dietary supplements are not regulated in the same way as prescription drugs. Unlike prescription drugs, which are required to prove their safety and efficacy, dietary supplements are not reviewed by the FDA before they come on the market. In comparison to prescription drugs, there are far fewer randomized, placebo-controlled clinical studies of dietary supplements. Additionally, there have been frequent concerns about quality – what’s actually in the bottle? Previous issues include reports of contamination (such as with lead and anabolic steroids), accuracy of labeling (how much active ingredient is present in the product), and adverse effects (such as with “fen-phen,” in the 1990s). Another concern is potential interactions between dietary supplements and prescription medications such as warfarin.
But are dietary supplements “bad?” Not necessarily. There are some appropriate uses of supplements, as in conditions of iron or vitamin-B12 deficiency. However, I have seen the pendulum swing, where patients think taking more is better, but they may be doing more harm than good. Calcium is a good example. Calcium is important, especially for people being treated for osteoporosis. However, excess calcium can increase the risk of vascular calcification.
Before asking your doctor which dietary supplements to take, I encourage you to ask yourself these two questions: “Am I eating a well-balanced, healthy diet?” and “Why am I taking dietary supplements?” Most experts would agree that encouraging a well-rounded, healthy diet is the ideal way to obtain the recommended daily values of vitamins and nutrients.
There are additional benefits of a healthy diet, such as fiber, which has been shown to help with diseases such as diabetes and heart disease, as well as constipation. I recommend talking to your doctor or a dietitian about which supplements and what doses are appropriate for you.
Dr. Chaivat “Pop” Phuvadakorn is a board-certified geriatrician with the highly regarded UCLA Geriatrics Program in Westwood and Porter Ranch. For more information, visit uclahealth.org.