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Vitamins: Separating Fact From Fiction

There are enough myths around vitamins to make an ancient Greek blush, and it’s easy to see why. We all know that vitamins and minerals are essential to good health — it says so right there on the cereal box. And we live in the more-is-better era of Hummers, Big Gulps, and McMansions. Which raises the obvious question: if taking 100% of the Recommended Dietary Allowance (RDA) of, say, vitamin C is good enough to keep us going through the day, then why shouldn’t taking 1,000% be enough to melt our fat, cure our blues, and let us leap tall buildings in a single bound? Meanwhile, the $19 billion-a-year dietary supplement industry continually reminds us that we can get our vitamins from a pill. Which invites yet another question: Why should we bother choking down bushels of brussels sprouts when we could get the same effect by sprinkling supplement shavings over our Boston cream pie? If life were only that easy. The broad consensus from nutrition experts — or at least the ones who aren’t buying Hummers with the proceeds from supplement sales — is that while vitamins are indeed essential, big doses are usually pointless and can even be harmful. And no pill is likely to ever adequately substitute for a healthy diet.

Why They Matter

Vitamins and minerals are substances your body needs for normal growth and functioning. Some facilitate crucial chemical reactions, while others act as building blocks for the body. Nutritionists call vitamins and minerals “micronutrients” to distinguish them from the macronutrients such as proteins, carbohydrates, and fats that make up the bulk of our food. While micronutrients are vital for the proper processing of macronutrients, they’re needed in smaller quantities. Think of it this way: If macronutrients are the gas in your engine, then micronutrients are like the motor oil, coolant, and battery fluid. Micronutrient deficiency can lead to acute diseases with exotic names like scurvy, pellagra, and beriberi. Deficiency diseases were common in the U.S. until the 1940s, when the FDA-mandated fortification of common foods like bread and milk. These diseases are still common in many poorer countries.

Maintaining a Healthy Diet

It’s easy to get enough micronutrients from your food if you maintain a healthy diet, Audrey Cross, PhD, associate clinical professor of nutrition at Columbia’s School of Public Health, tells WebMD. But most people fail that test; they’ll eat two or three servings of fruits and veggies per day rather than the recommended five. That’s why Cross (and many other nutritionists) suggest a multivitamin as a sort of nutritional safety net for many of their patients. But it’s just a safety net. So-called “whole foods” like veggies and whole grains contain fiber and a host of other important nutrients that can’t be adequately delivered through pills. In fact, scientists are still finding new “trace elements” in whole foods that may someday be labeled essential to health — but aren’t found in any pill. “There are literally thousands of these compounds, and we’re just scratching the surface on knowing what their role is,” says David Grotto, a registered dietitian and spokesman for the American Dietetic Association. “We’re sending the wrong message if people believe they’ve got everything under control and if they’re taking vitamins while eating a horrible diet.”

Choosing a Supplement

It’s easy to become overwhelmed when looking at the dietary supplement shelves of a health food store or even your local supermarket. While many of the health claims are unproven or downright bogus, some supplements may be useful for some groups. Major multivitamin makers typically produce different varieties for men, women, children and older folks. Picking a pill that fits your group makes sense, says dietitian Grotto, as the optimal level of various nutrients varies by age and sex. For example, premenopausal women need more iron than children or the elderly, he says. But the elderly have a harder time obtaining adequate amounts of vitamin B-12 from natural sources, so the need for supplementation may increase with age, says Lynn Bailey, a University of Florida nutritionist who teaches courses on vitamins. Folate, or folic acid, is key to preventing birth defects (such as spina bifida), Bailey says. Bailey says all women of childbearing age should ensure they get 100% of the RDA of folic acid through fortified food or a multivitamin.

Calcium and Vitamin D

Calcium supplements are also important for certain age groups, Bailey says. The Institute of Medicine, part of the National Academy of Sciences, recommends that adolescents get 1,300 milligrams of calcium a day. One cup of milk or calcium-fortified orange juice contains about 300 milligrams of calcium. Other sources of calcium include cheese, tofu, yogurt, vegetables, and beans. A typical calcium supplement may contain 500 milligrams or 600 milligrams of calcium. Bailey gives her 15-year-old son a daily calcium supplement at dinnertime. People over 50 should get 1,200 milligrams a day of calcium to ward off osteoporosis (thinning of the bones), Bailey says. Federal dietary guidelines recommend that the elderly, the homebound, and people with dark skin boost their vitamin D intake with both fortified foods and supplements to reduce the risk of bone loss. Vitamin D helps with absorption of calcium; often calcium supplements will also contain vitamin D. (The full federal guidelines, updated in 2005, are available at www.health.gov/dietaryguidelines.) Special groups such as smokers, pregnant women, or people recovering from traumatic injury may need additional supplements, Cross says. Decisions to take supplements beyond a multivitamin are best made with your doctor or registered dietitian, she says. The evidence is strong that a healthy diet can ward off chronic diseases like cancer and heart disease. What’s less clear is if big intakes of particular micronutrients can boost that preventive effect further. There is promising evidence that the mineral selenium could prevent a variety of cancers, says Alan Kristal, DrPh, associate chief of cancer prevention at the Fred Hutchinson Cancer Research Center in Seattle. But beyond selenium, the data aren’t promising, Kristal says. For example, there’s no solid evidence that taking large doses of antioxidants like vitamins B or C have any beneficial effect. By Richard Sine

Source: WebMD Feature Article by: Richard Sine

Reviewed by Louise Chang, MD

Are You Sleep Deprived?

More and more research is pointing to lack of sleep as one of the reasons for the onset of several diseases. That sleep is rejuvenating, is a well known fact. There is nothing like a perfect night’s sleep, to kick start another day’s work.

Symptoms for lack of sleep

• Tendency to commit mistakes
• Increased feeling of irritation
• Friction between husband and wife
• Ill-natured towards the children
• Feeling of drowsiness
• Decreased reaction times
• Increased risk for accidents while driving
• Poor decision making capacity
• Decreased performance levels
• Finding fault with others
• Picking unnecessary and unwanted quarrels
• Decreased immune function
• Impaired memory
• Weight increase and obesity
• Acquiring hypertension(2) and diabetes(3)

Reasons for lack of sleep

Insomnia is a term associated with the condition of disturbed sleep. While there are several causes for disturbances in sleep pattern, some of them are man-made. For example, some people have a tendency to stay up late at night. On top of that, you have to wake up early for the next day schedule. This means that you will be sleep deprived. Some other reasons for lack of sleep are:

• Restless legs syndrome
• Sleep apnea
• Depression
• Polyuria associated with diabetes
• Hormonal changes as in menopause
• Disturbances in circadian rhythm as in jet lag
• Eating just before going to bed
• Exercising just before bed time
• Intake of caffeine before bed time (Drinking coffee)
• Sleeping in the presence of bright light

It is generally agreed that people need to sleep between seven and eight hours every day. The maximum amount of time spent in deep sleep is called the core sleep. This is the time when you are not aware of your surroundings. The period of core sleep varies from individual to individual, but is essential for normal health. The sleepiness gradually wears off as the period of core sleep is crossed. Generally, it is good if you wake up at least thirty minutes after the core sleep. Studies have shown that too little sleep or too much sleep can be deleterious to health(2,4). Research has shown that either of these two habits can lead to increase in abdominal fat(4) . This can also increase the risk for acquiring cardiovascular disease and diabetes. Optimum sleep is invigorating. Too little sleep or too much sleep is debilitating.

Producing ideal conditions for sleep

A tired body produces good sleep. On the other hand, too tired a body can produce only disturbed sleep. If you eat just before going to bed, your level of sleep will not be satisfactory. Good bed room environment produces good sleep. But, we pay little attention to such matters. Even the height of the pillow can influence the way we sleep. Night lamps play an important role in sleep. Too bright a light can be disturbing. Recent research also shows that sleeping in the presence of light can lead to weight gain because of disturbances in melatonin secretion. Reading a book is the best sleeping pill one can come across. The most important thing is to have a clear mind. After all, the sleep center is located in the brain. Family feuds before bed time or carrying worries from the workplace to the bed, is not going to help the cause of good sleep. The best policy is to forget the past and to look forward to a rosier tomorrow. Sleep will automatically embrace you.

References:

1. Brain Basics: Understanding Sleep:National Institute of Neurological Disorders and Stroke.http://www.ninds.nih.gov/disorders/brain_basics/understanding_sleep.htm. Last updated:May 21, 2007 Accessed on: Feb 23, 2011

2.Gottlieb DJ, Redline S, Nieto FJ et al.Association of usual sleep duration with hypertension: the Sleep Heart Health Study.Sleep. 2006 Aug 1;29(8):1009-14.

3. Gottlieb DJ, Punjabi NM, Newman AB. et al.Association of sleep time with diabetes mellitus and impaired glucose tolerance.Arch Intern Med. 2005 Apr 25;165(8):863-7.

4.Chaput JP, Després JP, Bouchard C et al.The association between sleep duration and weight gain in adults: a 6-year prospective study from the Quebec Family Study.Sleep. 2008 Apr 1;31(4):517-23.

Last Updated: Feb 23, 2011
Written by Vangeepuram Satakopan
Partially Revised by Syed K.Haque, MD
Originally published at http://www.ihafs.org/2011/02/sleep-deprived/