Trendy bytes: Anti-energy drinks

Are anti-energy drinks the new way to relax?

Could anti-energy be the new energy?  Numerous beverage companies seem to think so, and that's why we might be seeing more anti-energy drinks, or relaxation beverages, spilling onto the market.  From Slow Cow to Mary Jane's Relaxing Soda, these new beverages are intended to help you unwind, de-stress, and in the word of Frankie Goes to Hollywood, "Relax!"

What are anti-energy drinks?
Think of anti-energy drinks as sodas with active ingredients, such as melatonin, kava, valerian, and even THC, that are intended to help consumers mellow out.  Being the geeky RD that I am, I did test a few of these out, which is so daring given my dislike of liquid calories.  The ones I tried tasted similar to energy drinks.  They're lightly carbonated and are usually sweetened with added sugars, like "evaporated cane juice" or high fructose corn syrup.  The sugar-free or zero-calorie versions typically use alternative sweeteners, like sucralose (Splenda) and stevia.  To me, they only tasted okay.

Do they work and are they safe?
Because they're so new, there seems to be little to no scientific research on the safety or efficacy of anti-energy drinks.  So from a scientific standpoint, their proposed benefits do not appear to be supported by research nor are they refuted by research either. However, there is some evidence on the effectiveness of some of the active ingredients.  The effectiveness will depend on the type and amount of the active ingredient.  Here's a list of some of the most common active ingredients in relaxation beverages and a description of their potential effects.

• Melatonin:  Some research suggests that melatonin, a sleep-related hormone, may help people with insomnia fall asleep faster. However, it appears that the effect is small.       
• Valerian:  Research suggests that the herb valerian may slightly speed up the time that it takes to fall asleep as well as enhance the quality of sleep.  Unfortunately, the studies were not all well-designed.
• Kava:  Investigations into the herb kava propose that it may be helpful in the treatment of anxiety. However, more research is needed to confirm these results.  The safety of kava has been questioned given previous links to severe liver damage although typically from high doses and/or long-term use.
•  L-Theanine: Some research suggests that L-Theanine, an amino acid found in green tea, may have a relaxing effect on consumers. Again, more research is warranted for stronger and more conclusive evidence.

While some relaxation beverages may contain the recommended dosage of the active ingredient needed for the proposed benefits, many of them do not.  So whether or not these drinks will produce the desired effects is questionable.  My guinea pig husband and I both sampled a few of these drinks, and neither of us felt any more relaxed as a result.

In terms of safety, there are definitely some factors to consider. So far, short-term use of some "relaxing" ingredients seems to be well tolerated without harmful effects at prescribed doses.  However, prolonged use of these ingredients has not been well studied.  Also, combining these ingredients with other over-the-counter, prescription, or herbal sedatives or alcohol is not advised since their sedative effects may be intensified.  Due to safety concerns about excessive use, some relaxation beverages come with a recommended daily limit, which is usually no more than two drinks daily.  In addition, some of the drinks come with warnings advising against driving motor vehicles or operating machinery after consumption.  Concerns have also been raised about the use of these drinks by children, pregnant/nursing women, or those with health conditions, such as liver disease, anxiety, or depression.
 
What's the bottom line?
While the active ingredients in these drinks may have some legitimate effects on sleep and anxiety, there may not even be enough of them in the drinks to produce the desired effects.  On the other hand, there are also some reasonable safety concerns to consider.  If you really need to "slow your roll", I think that there are a lot of better ways to do it than by consuming an anti-energy drink.  Practice yoga.  Try deep-breathing.  Pray.  If a person really needs help relaxing or sleeping, then I'd suggest addressing the underlying causes of the problem first.  If the root cause of the problem is not being addressed, then the drink (given that it works) may only offer a band-aid solution, if anything at all.

Have you seen any of these drinks?  Do you think they'll catch on?

Photo credit: Francis Borgouin via Flickr

Guest Blog: Vitamin D - What you need to know

This blog post was written by Marina Vigil, a California State University, Long Beach Dietetic Intern.  She is one of my former students with whom I had the pleasure of working with during her self-select rotation.  Thank you for sharing your knowledge with us, Marina!

Photo credit:  pittaya (Flickr)

Vitamin D: What Do You Need To Know?

Vitamin D has been receiving a lot of attention lately. Why? Vitamin D is a fat soluble vitamin that has long been known to be an important part of the body’s bone growth and maintenance by helping to maintain proper levels of calcium and phosphorus. But now research suggests that Vitamin D may be involved in the treatment and/or prevention of many diseases including diabetes, multiple sclerosis, and some cancers. Even though some of this research is inconclusive, it is still important to get adequate Vitamin D.

Where can I get my Vitamin D?

Unlike most other nutrients, your body can make all the Vitamin D that you need with the help of sunlight.  This is why Vitamin D is sometimes called the sunshine vitamin. On a clear, sunny day, most people only need to expose their hands, face and arms (without sunscreen) for 5 to 30 minutes a few times a week. However, due to the risk of skin cancer, the American Academy of Dermatology does not recommend getting your Vitamin D from light, either naturally from the sun or artificially from indoor tanning. If you do get your Vitamin D from light, be aware of the risk of sun damage.  Wear sunscreen outdoors and limit use of tanning beds to decrease your risk of sun damage.

The best way to get your Vitamin D is through a healthy diet. Not many foods are naturally rich sources of Vitamin D, but the good news is that it is still easy to get the recommended amounts of Vitamin D! Because it is so important, many foods, such as dairy products, juices, and cereals, are fortified with Vitamin D. Tofu and other soy products are also often fortified. In addition, eggs and fatty fish, such as salmon, tuna, and mackerel, are natural sources of Vitamin D.   Try to include a variety of these foods to maintain an adequate amount of Vitamin D.

Who is at risk of deficiency?

Unfortunately, research shows that many people are not getting enough of this vital nutrient, even in areas with plenty of sun. With our busy lifestyles nowadays many people spend the sunniest part of the day inside and are missing out on Vitamin D production. The elderly are also at higher risk for deficiency because the body makes less Vitamin D with age. So, how do you know if you are deficient? The answer is you don’t unless you get tested. You should talk to your doctor about getting tested.  It’s important to know that your levels will be lower in the winter.

Can I have too much Vitamin D?

Now, some people say that you can never have too much of a good thing, but that is not always true. Although vitamin D is great for your health, too much vitamin D can have toxic effects. High levels of vitamin D can cause high levels of calcium known as hypercalcemia. But the good news is that you cannot get vitamin D toxicity from the sun. If you are in the sun too long, your body will stop making Vitamin D and will break it down instead to prevent toxic levels. Vitamin D toxicity is usually caused by taking supplements.  For this reason, I would not recommend taking supplements unless you know you are deficient. Then, you and your doctor or dietitian can determine whether a supplement is right for you.

For more info on the Institute of Medicine's dietary reference intakes for vitamin D, click here.

Do you know your Vitamin D level? What Vitamin D rich foods do you enjoy? 

8 Mistakes That You Could Be Making With Your Supplements

Photo courtesy of Michelle Loy. Copyright 2010. All rights reserved.

Are you currently taking dietary supplements? Could you be making some mistakes with your supplements?  I get asked a lot of questions regarding supplements, so today I thought I'd share my insight on some of the biggest mistakes I see people making with their supplement usage.

Are you relying on the advertisement or supplement label for information regarding the safety and effectiveness?  Many people rely on the supplement labels, advertisements, or sales people for information about a supplement, but keep in mind that the information may be inaccurate, misleading, or biased.  Advertisements also often rely on testimonials or anecdotal evidence; however, one person's experience does not necessarily make a supplement safe or effective.  It's best to do your own research of scientific, peer-reviewed, evidence-based resources so that you can make an informed decision about the supplements you choose to use.  Believe me, your time and effort will be worth it!  You may want to check out these resources for starters:  The National Institutes of Health Office of Dietary Supplements, The National Center for Complementary and Alternative Medicine, or ConsumerLab.com.

Are you taking the correct dosage?  When talking with people about their supplements, I often find that many people aren't taking the dosage indicated on the container.  Some take more, some take less.  Most recently someone mentioned that she started taking a supplement upon the recommendation of her eye doctor.  She stated that she just takes the supplement "whenever her vision gets blurry", but the directions indicate that users should take "three capsules three times a day".  So keep in mind that if a supplement actually does what it claims, then taking it "whenever you feel like it" or "whenever you remember" may not benefit you as much as it would if you took the supplement as directed.  On the other hand, more isn't necessarily better when it comes to supplements either.  I know some people who pop extra vitamins to give them a boost of "energy" or to stave off a cold; however, there is a risk of toxicity associated with some supplements.  For example, taking too much iron can lead to iron toxicity, which has harmful effects, especially in children.  So be sure to follow the dosage directions carefully.

Are you timing it right?  Just as some medications indicate a specific time frame during which they should be taken (eg, morning, between meals), some supplements require the same.  For example, those who use zinc lozenges to recover from a cold quicker are usually advised to start taking the supplement at the first onset of symptoms and to continue for at least 48 hours after that. In addition, users are also directed to consume one tablet every two to three hours until symptoms subside.  However, I know  many people who do not follow the proper timing when taking zinc lozenges to treat the common cold.  These instructions are a little tough to follow, yet based on the evidence, they appear to be most effective when consumption is timed right.

Could your supplement be negatively interacting with a food, nutrient, drug, or other supplement?  While people may consider these things when taking medications, I often find that they do not give the same attention to supplements.  Many nutrients compete for the same sites of absorption in the gastrointestinal tract.  So consuming nutrients in supplement form can interfere with the absorption of nutrients from food.  For example, did you know that consuming calcium supplements with a type of iron in plant foods (non-heme iron) may reduce the bioavailability of the iron since they compete for absorption in the GI tract?  Also, some dietary supplements may increase or decrease the absorption, metabolism, or action of certain medications.  Did you know that many medications are derived from or modeled after herbal remedies?  It's true! For example, the chemical composition of aspirin is similar to that of willow bark.  For that reason, many herbal remedies can interfere with the metabolism or amplify the effects of medications.  For instance, consuming ginkgo biloba with blood-thinning drugs, such as coumadin or heparin, may prolong bleeding time and increase the risk for hemorrhage.  Or taking St. John's wort with antidepressant medications may intensify their effects.  Because of these potentially harmful interactions, you may want to have the supplements your taking evaluated by a Registered Dietitian, physician, or other health care provider.
  
Is there a reason you shouldn't be taking a supplement?  Some supplement labels will provide a list of contraindications or reasons that one should not take the supplement, and this list typically includes pregnant or lactating women and children.  Other than that, there aren't always comprehensive lists of contraindications.  However, we do need to be cautious about taking supplements given certain circumstances, conditions, or illnesses.  For instance, smokers are advised against long-term supplementation of beta carotene, a form of vitamin A, due to a possible increased risk for development of lung cancer.  Competitive athletes may need to avoid certain supplements because they contain a banned substance. For example, guarana is banned by the NCAA; however, this caffeine-loaded substance is found in many supplements designed to "improve athletic performance".  Taking such a supplement could result in suspension or disqualification from the sport.  Given the potential risks, it is wise to check with your physician, dietitian, or the athletic staff, in the case of athletes, to make sure that all substances contained in a supplement are considered safe, effective, and approved for use.

Are there other ingredients in the supplement that could be harmful to you?  I find that people often select a supplement based on the label claims or the major ingredients highlighted on the front of the label or on the supplement facts panel.  However, few people read through the entire ingredient list to see all that the supplement contains. Many supplements include other substances, such as binders and dyes, to which some people may be sensitive or allergic.  For example, some supplements contain soybean oil or soy lecithin, which may be harmful for someone with a soy allergy.  Someone with a wheat allergy may need to avoid products made with modified food starch as this may come from wheat.  If you do have food allergies or sensitivities, then it would be beneficial to thoroughly review the supplement ingredient list yourself for any potentially harmful substances or have your dietitian or health care provider do so with you.

Are you taking multiple supplements with the same ingredients?  When evaluating supplements, I often discover that a person is taking multiple supplements that contain the same nutrients.  For instance, they may be taking a multivitamin-mineral along with a B-complex supplement.  Each supplement contains some amount of all of the B vitamins, typically at least 100% of the Daily Value, so they're basically taking more than necessary.  In fact, since B vitamins are water-soluble and not stored to any great extent in the body, so the excess is basically excreted from the body in the urine. Pretty pricey urine, if you ask me!  So, examine your supplements carefully to make sure that you're not taking more than what's necessary.

Are you taking a supplement to make up for what you lack in your diet?  Some people readily admit that they take supplements to make up for what their diet lacks.  Usually what's lacking are vegetables, fruits, legumes, and whole grains, which are also packed with vitamins, minerals, fiber, and phytochemicals.  I understand that it may be challenging to eat a healthful, well-balanced diet that includes a variety of foods from the various food groups everyday and that some people opt to take supplements as a safety net.  However, some people simply do not want to or do not like to include foods like vegetables and fruits into their diet, so they think that they're getting the next best thing with supplements.  It is important to keep in mind that they are called supplements for a reason.  They are meant to supplement the diet rather than serve as a substitute for food consumption.  Okay, so maybe it's better than nothing, but we need to consider what a person misses out on when s/he consumes supplements instead of food as a source of nutrients.  How is it possible to truly package the full nutritional value of a whole vegetable or fruit into one or even a few pills?  Also, research suggests that it is the combination of nutrients and phytochemicals of whole foods that work together synergistically to provide optimal nutrition to the body, and those processes would be lacking if we singled out nutrients or phytochemicals.  I also find that some people take supplements and still consume an unbalanced diet that provides less than optimal nutrition.  So far, it doesn't appear that taking a slew of supplements makes up for a diet loaded with less nutritious, processed foods.  Finally, when consuming supplements instead of whole foods, we are missing out on the FOOD!  While popping a pill or two might provide some of the essential nutrients one needs for basic physiological functioning, it will not necessarily help with satiety.  A person will still need to eat food to satisfy hunger.  Eat 5 cups of vegetables and fruits daily and most will find themselves very satiated and well-nourished!

If you're really ready to dig into some solid information regarding supplements, you may want to check out the titles below. Some of these can even be checked out at your local library!

• PDR for Nutritional Supplements 2nd Edition (PDR for Nutritional Supplements)
• PDR for Herbal Medicines, 4th Edition
• A-Z Guide to Drug-Herb-Vitamin Interactions Revised and Expanded 2nd Edition: Improve Your Health and Avoid Side Effects When Using Common Medications and Natural Supplements Together
• Understanding Dietary Supplements (Understanding Health and Sickness Series)

Zinc up?

So, have you survived or have you succumbed to the awful cold season that is upon us?  I thought I'd follow-up my post on Vitamin C and the Common Cold with a post on another popular homeopathic cold remedy...zinc.  Because of its role in assisting with immune function, it is no surprise that quite a few studies have evaluated the effectiveness of zinc for the treatment of colds.  While its mechanism of action is still not clear, some investigators hypothesize that zinc plays a role in preventing the attachment and  reproduction of rhinovirus, the most common cause of all colds, inside of the nose and suppressing the inflammation that is responsible for many of the awful symptoms.

When it comes to zinc and the common cold, it appears that the jury is still out.  In a thorough review of research spanning 40 years that examined zinc as a cold remedy, investigators evaluated 14 of the highest quality studies conducted in this area.  Of those, half of the studies found no effect of zinc lozenges or nasal sprays on the common cold while the other half found zinc lozenges and nasal gels beneficial for reducing the duration and/or severity of cold symptoms.  Two other major review studies  also concluded that the evidence is inconsistent but that further research is warranted (1,2).

Of the studies that have detected potential benefits from zinc for treatment of the common cold, I found a few interesting and possibly helpful pieces of information.  Zinc lozenges in the form of zinc gluconate (aka, zinc gluconium) or zinc acetate taken every 2 hours while awake within 24 hours of the onset of symptoms (at the very first sign of the symptoms is best) may help reduce the duration of the cold symptoms by an average of about 3 days!  It also appears that low doses (<9 mg of elemental zinc) are not as beneficial as higher doses (~9-24 mg).  As for the nasal sprays and gels, I wouldn't suggest touching those with a ten foot pole for now as the U.S. Food and Drug Administration recently warned consumers to stop using such products due to numerous reports of anosmia (loss of sense of smell) that may be long-lasting or permanent! (Something I've been telling my students and clients for a long time!)  Be forewarned, too, that anyone using zinc supplements should not consume greater than 40 mg/day as there are some negative side effects associated with excessive zinc consumption, which include:  nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, headaches, copper deficiency resulting in anemia, elevated cholesterol, and interestingly enough...impaired immune function.  (Note that an individual could possibly experience some of these side effects given the typical dosages and treatment protocols of these types of supplements.)

If you're not so sure about taking the supplements and thinking, "Hey, maybe I can just boost my intake of zinc through food if I get a cold.", think again.  Increasing our intake of zinc through food at the onset of a cold will not have the same effect as that of the zinc lozenges given the proposed mechanism of action that I discussed before.  The rhinovirus is replicating in the nasal mucosa. Therefore, the zinc needs to be in close proximity to that area on a regular basis (every 2-3 hours) in order for it to possibly work, and food that's chewed and swallowed won't have the same effect.

So there you have it...the scoop on zinc-ing up when you come down with a cold, but you may still be asking yourself, "So, what should I do?"  We have to ask a few important questions.

1. Is this type of therapy more effective than mere suggestion or doing nothing?  Possibly.  
2. Is it as safe as doing nothing?  Maybe not.  
3. If there is a possibility of it being unsafe, does the potential for benefit exceed that of its potential harm?  Maybe not.    
4. WWMD? (or What Would Michelle Do -- lol)  Aw shoot, I admit it. I've taken zinc lozenges at the first hint of a cold.  Call me desperate!  In some cases, I believe it worked. In others, not so much. Maybe it's because I didn't follow the protocol 100%.  Or maybe it was good ol' placebo effect at it again. And maybe it just doesn't plain work!
   

Stay tuned for more along this same thread of some of the proposed cures for the common cold.

The 4-1-1 on Vitamin C and the Common Cold

It's definitely that time of year again...cold and flu season. It seems like people are succumbing to the seasonal plague left and right lately.  And maybe you, like many others, are ready to down some vitamin C to ward off that cold. Don't worry, I just went to Target the other day and their shelves are fully stocked with products, like Emergen-C, just for you.  But before you head on over to build up your own stash, let's take a look at the 4-1-1 on whether or not such products really work.

When researchers set out to see if our "cure" for the common cold really was a cure, their analysis of over 30 clinical trials conducted over a stretch of about 40 years uncovered some interesting results.  Overall, investigators found no significant effect of supplemental vitamin C on preventing the common cold for most healthy people.  I say most because the combined results of six studies detected a 50% reduction in risk of catching a cold for certain groups taking routine doses of 250-1000 mg/day of vitamin C  -- marathon runners, young skiers, and soldiers working in freezing temperatures to be exact. So, for the general population, loading up on vitamin C throughout the year or when cold season hits apparently doesn't really fend off those colds, but if you're exposed to extreme physical stress or cold temperatures, it might actually be helpful.

As far as vitamin C's use as a cold remedy goes, the evidence is mixed.  Thirty studies exhibited a slight reduction in the duration of colds for adults and children taking daily megadoses of vitamin C compared to those on placebo. What does this amount to?  If the average cold lasts about 7 days, this means that a routine vitamin C supplement may lessen the duration of a cold by 1/2 a day for adults and 1 day for children.  However, seven studies showed no difference between vitamin C megadoses and placebo for lessening the duration of a cold when supplementation started at the onset of symptoms.  In an analysis of 15 studies, regular megadoses or those taken after the onset of symptoms did not significantly affect the severity of cold symptoms.

One important note to make is that vitamin C is a water-soluble vitamin, which means that little of it is stored in the body.  A few studies suggest that the body's cells become saturated with daily doses of 200-400 mg and that digestive absorption decreases at doses >200 mg/day.  Given some of the hefty doses in available supplements, often around 1000-2000 mg, do you wonder what happens to the excess if our body cannot store it?  We eliminate it via the urine. And at intakes >2000 mg/d, one can potentially experience adverse effects, such as kidney stone formation, nausea, abdominal cramps, excessive gas, and diarrhea.

I know...you swear that you take (or have taken) vitamin C and it's truly helped prevent a cold, right?  Well, there may be good reason -- placebo effect.  In a surprising twist, investigators in one study found that individuals who took placebo but thought they were taking vitamin C recounted fewer colds than those who actually consumed vitamin C but believed they were receiving a placebo. 

So, where does this leave us -- the real, live persons surrounded by this onslaught of sneezes and sniffles?  If you don't mind sparing the expense and feel that saving yourself from 1/2 a day's worth of a cold (when you catch one) is worth it, then daily supplementation with up to 200 mg of vitamin C may be worthwhile to you. (The recommended intake is 75 mg/d for women, 90 mg/d for men, and an additional 35 mg/d for smokers.)  Will you be harmed by taking doses of up to 2000 mg/d? It's unlikely as the risk of potential adverse effects at that level is low.  However, one can easily obtain the recommended intake (and more) through food alone by aiming for at least 5 cups of vegetables and fruits daily.  Let's see how this is done.

• Breakfast: 1 large orange = 91 mg
• Snack:  2 kiwis = 128 mg
  
• Lunch:  1/2 c cherry tomatoes = 9.5 mg, 1 c romaine lettuce = 11 mg
  
• Snack:   1/2 c red bell pepper = 95 mg
• Dinner:  1 large baked sweet potato = 35 mg, 1/2 c broccoli = 40 mg
• Total =  409.5 mg of Vitamin C from the equivalent of 5 c of vegetables and fruits!

Stay tuned for future posts related to this timely topic.

Jump on the bandwagon with jojoba?

I received a request to blog about my take on jojoba beans (active ingredient: simmondsin). You may have heard the term jojoba in relation to cosmetics as the oil of its seeds is often used as a moisturizer. What you may not know is that a recently published book on all things health-related touted the use of jojoba beans to help raise HDL (or good) cholesterol levels and curb hunger. So my challenge is to weigh the evidence on these claims and provide my best advice about this potential wonder supplement.

Because I was not that familiar with this particular supplement to start, I started collecting data in two ways. One was through my colleagues in various professional nutrition networking groups to which I belong, and the second was through my own review of research conducted and published in peer-reviewed professional journals on this topic within the last ten years. Ultimately, none of my professional colleagues responded to my request for additional information on this supplement after multiple requests, and I believe it's because this is not a widely used supplement nor is there much known about its potential benefits.

In my review of the literature, I stumbled upon a handful of intervention studies (~10), and ALL of these studies were conducted on animals (primarily rats, but also dogs and chickens). There were no studies conducted on humans that were published in peer-reviewed journals within my search of the last ten years of data. None. So, how can we generalize the results of these studies to humans? Should we? Of the studies reviewed, most were conducted on fewer than 50 subjects (all animal subjects). For stronger data, researchers typically want >50 subjects included in the study. Most of the studies were very short-term studies lasting way less than one year, which also serves as another limitation. Apparently, earlier studies conducted on the long-term use of higher doses of jojoba meal in rats resulted in the death of said rats. So, if this happened in rats, how do we know what a safe dose is in humans, if any? Also, one study had supplements provided by and was funded by a manufacturer and supplier of simmondsin supplements. Hmmmm...do you think the results could have the potential to be biased in any way?

While very limited evidence suggests possible effects of simmondsin on appetite reduction, there is currently not enough strong evidence, especially in humans, on the safety or effectiveness available for me to recommend the use of this supplement to anyone at this time. So much for that bandwagon...

Supplements - Did you know...

Did you know that...

• while the Food and Drug Administration (FDA) regulates the dietary supplement industry, supplements are not held to the same regulatory standards as food or drugs? Essentially, dietary supplement manufacturers do not have to guarantee their dietary supplement safe and effective before placing it in the marketplace. In contrast, pharmaceuticals undergo several phases of study from animals to humans before they can be approved for use in the general population. In addition, the FDA provides oversight for supplements only after they are on the store shelves, if safety is called into question. More recently, some additional regulations were set in place to improve safety by establishing improved manufacturing practices and to ensure that the product contains what it claims to contain and nothing that could be harmful (i.e., lead). Unfortunately, even recent reports evaluating the content of certain supplements revealed that many of them either do not contain the ingredient(s) or contain less than what's claimed on the label. Even though the new guidelines were set in place to enhance supplement safety, I question how tight the monitoring will be. Plus, there is still no guarantee that the supplements are safe and effective.
• dietary supplements are also not standardized as prescription drugs are? What does this mean? Well, standardization involves following practices that ensure batch-to-batch consistency of a product or a high quality product. So, the contents of the supplement you bought six months ago will be consistent with the contents of the same product on the shelf today.
  
• just because a supplement contains naturally occurring ingredients does not mean it's safe? Natural does not = safe. Mushrooms are natural, but some contain natural toxins that are harmful. Arsenic, lead, mercury...these are all naturally occurring elements, but it doesn't mean that they're necessarily safe either.
• more isn't necessarily better? For one, when some nutrients, such as water-soluble vitamins like vitamin C or B vitamins, are consumed in excess of the body's needs, most excesses are excreted in the urine rather than stored in the body. Plus, higher levels may contribute to harmful toxicity disorders.
  
• depending on the ingredients and dosage, they may have negative interactions with other nutrients, foods, medications, or processes in the body? Symptoms of toxicity for nutrients most often occur from consumption of dietary supplements rather than foods. For example, high doses of iron can result in reduced absorption of copper and zinc and vice versa. Some dietary supplements can result in increased or decreased absorption or increased or decreased function of medications and vice versa.
• so far the only diseases or conditions that supplements, such as vitamins or minerals, cure are the ones caused by a deficiency of that nutrient? For instance, vitamin C does not cure the common cold, but it can cure scurvy, the vitamin C deficiency disorder. Even though we often see media clips about how a new research study shows that nutrients, such as vitamins of minerals, can help prevent or treat some condition, it doesn't necessarily mean that a supplement will do the same. In fact, several recent studies have shown that consumption of nutrients in supplement form may actually do more harm than good. For example, a study conducted some years ago found that beta-carotene (a form of vitamin A and weak antioxidant) in supplement form can actually increase lung cancer risk in smokers! More recent studies show that the antioxidant supplements of vitamin A, E, and beta carotene may actually slightly increase the risk of death.
• just because the person in the ad or a family member or friend says s/he took a supplement that helped with X, Y, or Z doesn't mean that it is actually a safe and effective treatment? Testimonials or anecdotal evidence are a great way to sell products, but they prove nothing.
• just because the product label or ad says the supplement does X, Y, and Z does not mean that the product is safe and works? Of course the company is going to tell you their product works, but don't you think they might have a biased opinion?
  

So, am I against supplements? No. I believe that there definitely are certain situations in which a dietary supplement can be helpful, and I believe that it's important for people to make informed decisions when deciding whether or not to take a supplement.

So, what do you do? Here are my quick tips:

• Consider buying recognized brands from well-established companies. These companies generally have more at stake because they want to be around for a long time, so they work harder to ensure a higher quality product.
  
• Scan the shelves for standardized products. How will you know? Look for the USP symbol. USP stands for the United States Pharmacopeia. This agency provides standards for the quality, purity, strength, and consistency of dietary supplements and conducts tests verifying the product ingredients, integrity, purity, and potency. Some other organizations or programs that provide similar standards or testing include: the Dietary Supplement Verification Program (DSVP), ConsumerLab.com and NSF International.
  
• Read the Supplement Facts Panel. It's best to stick with supplements that provide no more than 100% of the Daily Value (DV), especially those that are considered more potentially harmful such as vitamin A, D, or iron.
• If the claims sound too good to be true, then they probably are. I always tell students and clients that if I knew of a product out there that really was the MIRACLE pill for weight loss or enhanced performance, etc. I certainly wouldn't want to keep that a secret.
• Run the dietary supplements by your healthcare provider before using them. In fact, I always ask my clients to bring their supplement containers with them to our visits so that I can help them evaluate these products.
• Remain skeptical of the latest headlines. They make good stories, but the sound nutrition or health advice is typically based on a broad body of research and not a single study. Who were they studying? How many people were in the study? How long was the study? There are many factors to consider, and one study alone does not mean the results are generalizable to the population at large or to you specifically.
• Finally, lots of research powerfully indicates that foods, not supplements, are the best source of nutrients.
  

Have a healthy one!