___Do you live or work in a smoky atmosphere?
___Do you buy foods exposed to exhaust fumes from busy roads?
___Do you generally eat nonorganic produce?
___Do you drink more than one unit of alcohol a day (one glass of wine, one pint or 600 ml of beer, or two shots)?
___Do you spend a considerable amount of time in front of a TV or computer screen?
___Do you usually drink unfiltered tap water?
Your score
Cardiovascular Check
___Is your blood pressure above 140/90?
___Is your pulse rate after fifteen minutes’ rest above 75?
___Are you more than 14 lb. (7 kg) over your ideal weight?
___Do you smoke more than five cigarettes a day?
___Do you do less than two hours of vigorous exercise (one hour if you are over fifty) a week?
___Do you eat more than one tablespoon of sugar each day?
___Do you eat meat more than five times a week?
___Do you usually add salt to your food?
___Do you have more than two alcoholic drinks (or units of alcohol) a day?
___Is there a history of heart disease or diabetes in your family?
Your score
Female Health Check
Are you pregnant or trying to get pregnant? Yes / No
Are you breast-feeding? Yes / No
Do you regularly suffer from premenstrual syndrome? Yes / No
Do you have menopausal symptoms or are you postmenopausal? Yes / No
Age Check
Are you under 14? Yes / No
Are you 14 to 16? Yes / No
Are you over 50? Yes / No
If any of your ‘lifestyle scores’ are 5 or more (eg if Energy is 6 and Immune Check is 6) highlight those columns on this page, if you are 14–16 or over 50 highlight the appropriate columns for these as well. Now add across for each nutrient BOTH your Symptom Score AND any scores in the highlighted columns (eg Energy Immune and over 50 columns) to arrive at your Total Score for each nutrient.
How to work out your optimum nutrient needs
From the Symptom Analysis section of the Optimum Nutrition Questionnaire, you will have arrived at your basic score for each nutrient, which then needs to be adjusted depending on your answers to the Lifestyle Analysis questions. To do this, add all the numbers you have circled to your symptom score. Do this for each row, entering each total in the first column on this page, headed Your Total Score. The higher your score for any given nutrient, the greater your need for that nutrient.
Once you have arrived at your score for each nutrient, you can work out your supplement needs by looking at the column that corresponds to your score in the chart on this page. For example, if your vitamin C score was 6, your estimated ideal supplementary intake of this vitamin is 1,600 mg per day. Now work out your own supplemental levels for each nutrient.
If you score 0 to 4 on any nutrient, I still recommend that you supplement it on a basic level, which can easily be achieved with a good daily multivitamin and mineral supplement. Remember: These levels are your supplementary needs, not your overall needs including what you should get from your diet. I have assumed that you have improved your diet—or will do so—so that it provides a basic intake of these nutrients. You will not get the same results from adding supplements to a poor diet.
For example, the ideal daily intake of calcium is 800 to 1,200 mg (if needs are high, as for pregnant women or elderly people). The average intake is around 900 mg. If you have a dairy-free diet but eat seeds, you should still be able to achieve at least 800 mg. So, if you have no symptoms or lifestyle factors that increase your need, you don’t need to supplement extra. If, on the other hand, you are pregnant, your supplemental requirement is 1,200 − 800 = 400 mg. This is why the range given for supplementation on this page goes from zero up to 400 mg.
Levels of minerals other than those in the chart are generally sufficient in most people’s diets and can be increased through dietary changes. Potassium, which balances sodium (salt), is best supplied by eating plenty of raw fruit and vegetables. Phosphorus deficiency is exceedingly rare, and the mineral is contained in almost all supplements as calcium phosphate. Iodine deficiency is also extremely rare. Copper is frequently oversupplied in our diets and can be toxic. A whole-food diet almost always contains enough copper.
Scores for children
For children under the age of fourteen, there is a simple method for adjusting the nutrient-need figures (which are based on adult requirements). Take the weight of the child in pounds and divide by 100. (Alternatively, take the weight of the child in kilograms and divide by 50.) Now multiply this number by the adult supplemental levels in the chart to give you the child’s actual supplemental levels. For example, if a child weighs 50 lb. and we divide that by 100, we get 0.5. If the child scored 6 for vitamin C, giving a supplemental level of 2,000 mg, we would multiply by 0.5 and get 1,000 mg. This is the child’s approximate optimal intake of vitamin C.
Alternatively, use the guide to optimal supplement intakes for children up to the age of eleven on this page. From fourteen onward, adult levels can be given.
Planning your ideal supplement program
In case you are wondering, it is not necessary to take thirty different supplements every day! Your needs can be compressed into four or five different supplements, each combining the nutrients above. The most common combinations are a multivitamin (containing vitamins A, B, C, D, and E) and a multimineral for all the minerals. Vitamin C is usually taken separately, since the basic optimum requirement of 1,000 mg (l g) makes quite a large tablet without the addition of any more nutrients.
Choosing the right formula is an art in itself. Chapter 46 helps you through the maze by showing you how to decipher the small print and read between the lines, while chapter 47 explains how to devise a simple daily routine of vitamin supplements. Alternatively, you can walk into your local health food store, show the product adviser your calculations of your personal requirements and ask for help designing a supplement program that meets your needs.
46
Everything You Need to Know about Supplements
Not all supplements are the same. Analysis of a wide variety of multivitamin tablets to find out how much it would cost to get the basic optimum vitamin requirements produced a range between twenty cents and over eight dollars a day! And with so many supplements available, all promising perfect health, it is easy to get confused. For instance, if you are looking for a simple multivitamin preparation to meet the basic optimum requirements, you have at least twenty products to choose from. This chapter explains what to look for in a good supplement.
Reading the label
Labeling laws vary from country to country, but many of the principles are the same. However, since the laws keep changing, many manufacturers are as confused as the public. Below is a typical label with advice on how to interpret the small print.
On this label, the dosages are easy to understand, the chemical names for the different vitamins are given, and the fillers (for example, calcium phosphate) are listed. Directions for when and how to take the tablets are given. These are the things to go for when you are buying supplements: do not be misled by an attractive-looking label or a very cheap price, but do not pay too much either!
Unfortunately, however, not all supplements are true to their labels, so it is not always best to buy the cheapest. Reputable vitamin companies should give you a list of all the ingredients on the label.
This multivitamin combines optimal levels of antioxidants, vitamins, minerals, and enzymes in one daily multi-nutrient supplement. The levels of nutrients provided help fortify your immune system and minimize free radical damage that Leads to age-related concerns.*
Supplement Facts: Different title than on food. Food labels say, “Nutrition Facts”.
Serving Size: Serving size will be amount per serving, not necessarily “daily” recommendation.
Servings
Per Container: Servings per container will tell you how many total servings you have. The daily serving will vary according to the “suggested use” recommendations.
Amount Per Serving: Nutrients are listed on a per-serving basis, not necessarily a complete daily recommended amount.
% DV: Daily values (DV), formerly RDA’s, have been established for some items.
Vitamin C: Different forms of the same nutrient are combined and only listed once on the label.
Magnesium: Weight listed is elemental weight of mineral, not weight of source.
Choline: The source of the nutrient may be listed in parentheses next to or under the name.
Inositol % DV: Nutrients without a %DV are set apart from those for which a %DV has been set.
Other ingredients: Other ingredients used during the manufacturing process are listed.
*This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
The box above, and the way it appears, is required by new FDA regulations. Anytime there is a statement of benefits, this FDA statement must appear.
Vitamin names and their amounts
For most supplements, the ingredients have to be listed in order of weight, starting with the ingredient present in the greatest quantity. This is often confusing, since included in this list are the nonnutrient additives needed to make the tablet. Often the chemical name of the nutrient is used instead of the common vitamin code (for example, ergocalciferol for vitamin D).
VITAMIN CHEMICAL NAME(S)
A retinol, retinyl palmitate, beta-carotene
B1 thiamine, thiamine hydrochloride, thiamine mononitrate
B2 riboflavin
B3 niacin, niacinamide
B5 pantothenic acid, calcium pantothenate
B6 pyridoxine, pyridoxal-5-phosphate, pyridoxine hydrochloride
B12 cyanocobalamine, methylcobalamine
C ascorbic add, calcium ascorbate, magnesium ascorbate, sodium ascorbate
D ergocalciferol, cholecalciferol
E dl-alpha-tocopherol, tocopheryl acetate, tocopheryl succinate
Biotin biotin
Folic acid folate
When you have identified which nutrient is which, look at the amount provided by each daily dose. Some supplements state this in terms of two tablets (“Each two tablets provide …,” since the supplement is designed to be taken twice a day. The amount supplied will be given in milligrams (mg) or micrograms (mcg or µg). Most countries have now switched to “µg” as the symbol for micrograms, which are thousandths of a milligram.
Vitamin A measurements are a little tricky. This is because beta-carotene is not actually vitamin A but can be turned into vitamin A by the body. So, to indicate the equivalent effect of a certain amount of beta-carotene compared with vitamin A (retinol). So, to indicate the equivalent effect of a certain amount of beta carotene compared with vitamin A (retinol) beta-carotene is reported in IUs. This means that 10 IU of beta-carotene has more or less the same antioxidant effect of 10 IU of vitamin A. Not everybody converts beta-carotene to vitamin A with the same efficiency. Also, beta-carotene does not have the associated toxicity in excess. Therefore, it’s best to both eat and supplement both. To work out your total equivalent vitamin A from supplements add up both the IU for vitamin A and beta-carotene in your supplements.
Elemental minerals
Minerals in multivitamin and mineral tablets often omit the “elemental” value of the compound, stating only the amount of the mineral compound. For instance, 100 mg of zinc amino acid chelate will provide only 10 mg of zinc and 90 mg of the amino acid to which it is chelated (attached). What you want to know is the amount of the actual mineral, in this example 10 mg. This is called the “elemental value.” Most reputable manufacturers make your life easy by stating something like “zinc amino acid chelate (providing 5 mg zinc) 50 mg” or “zinc (as amino acid chelate) 5 mg,” both of which mean you are getting 5 mg of elemental or actual zinc. Otherwise, you may have to contact the manufacturer for more detailed information. Most good companies declare this information either on the label or in literature that comes with the product.
Supplement labels are also required to show the percentage of the recommended daily allowance (RDA) that is met by the product. But for the purposes of achieving optimum nutrition, this is largely irrelevant, since the amounts needed are often many times higher than the RDA.
Fillers, binders, lubricants, and coatings
Supplements often contain other ingredients that are necessary in their manufacture. While capsules do not really need to have anything added, tablets usually do to enable the ingredients to stick together to form a tablet. Tablets start off as powders, and to get the bulk right “fillers” are added. “Binders” are added to give the mixture the right consistency, and lubricants are also used. Only when this is done can the mixture be turned into small, uneven granules, which are then pressed into tablets under considerable force. Granulating allows the mixture to lock together, forming a solid mass. The tablet may then be covered with a “protein coating” to protect it from deterioration and make it easier to swallow.
Unfortunately, many tablets also have artificial coloring and flavoring added, as well as a sugar coating. For instance, many vitamin C tablets are colored orange and made to taste sweet, since we associate vitamin C with oranges! Vitamin C is naturally almost white and certainly is not sweet—nor should your supplement be. As a rule of thumb, buy only supplements that declare their fillers and binders (sometimes also called “excipients”). Companies with integrity are usually only too happy to display this information. The following fillers and binders are perfectly acceptable, and some even add further nutritious properties to the tablet:
Dicalcium phosphate. A natural filler providing calcium and phosphate.
Cellulose. A natural binder consisting of plant fiber.
Alginic acid/sodium alginate. A natural binder from seaweed.
Gum acacia/gum arabic. A natural vegetable gum.
Calcium stearate or magnesium stearate. A natural lubricant (usually from animal source).
Silica. A natural lubricant.
Zein. A corn protein for coating the tablet.
Brazil wax. A natural coating derived from palm trees.
Stearate, which is the chemical name for saturated fat, is used as a lubricant. The cheapest comes from animal sources, although nonanimal stearates are available. If you are a strict vegan or vegetarian, you may want to check this with the supplement company. If a product is labeled “suitable for vegans,” it cannot legally contain any ingredients sourced from animals.
Most large tablets are coated. This makes them shiny, smooth, and easier to swallow. It is not so necessary with small tablets. If a tablet is chalky or rough on the outside, it is not coated. Coating, depending on the substance used, can also protect the ingredients, increasing their shelf life. Avoid sugar-coated, artificially colored supplements. Natural colors, for example, from berry extracts, are fine.
Very occasionally a manufacturer overcoats a batch of tablets and, particularly in people with a shortage of stomach acid, this can inhibit the tablet’s disintegration. Most reliable companies check the disintegration time of each batch to rule out this possibility, so it is a rare problem.
Free from sugar, gluten, animal products, and so on
Many of the better supplements will declare that the product is free from sugar and gluten. If you are allergic to milk or yeast, do check that the tablets are also free from lactose (milk sugar) and yeast. B vitamins can be derived from yeast, so you need to be careful. If in doubt, contact the company and ask for an independent “assay” of the ingredients: good companies will supply this information.
Sometimes glucose, fructose, or dextrose is used to sweeten a tablet and yet the packaging still declares “no sugar.” These products are best avoided. A small amount of fructose is the least evil if you are having difficult
y enticing a child to take vitamins. Any other preservatives or flavoring agents should be avoided unless they are natural. Pineapple essence, for instance, is a natural additive.
If you are vegan or vegetarian, choose supplements that state they are suitable for vegans or vegetarians. Retinol (vitamin A) can be derived from an animal source, synthesized, or derived from a vegetable source such as retinyl palmitate. Vitamin D can be synthesized, or derived from sheep’s wool or from a vegetable source. Companies do not have to state the source of the nutrients, just their chemical form.
Advisory statements
Some supplements are required by law to carry “advisory notices.” In my view, these cautions are, in most cases, exceedingly overcautious. For example, vitamin B6 supplements containing above 10 mg have to say that “long-term intakes may lead to mild tingling and numbness.” I know of not one single case where this has actually happened, although it will happen at higher doses, above 500 mg. If you are particularly concerned by such warnings on labels, read chapter 49, which gives you a realistic upper limit for nutrients, based on the latest science.
47
Building Your Own Supplement Program
So now you know how to read the labels and find out if a particular supplement contains what you need. Here’s how to turn your nutrient needs into a supplement program.
Theoretically at one extreme you could take just one mega-mega-multivitamin and mineral that has everything you could possibly need in it. The trouble is that it would be enormous, be impossible to swallow, and no doubt give you a lot more than you need of some nutrients. The other extreme is to take one supplement for each nutrient, exactly matching your requirements—but you’d end up with handfuls of pills.
The New Optimum Nutrition Bible Page 42