3.Children who are picky eaters: Children who do not eat a varied diet may benefit from the regular use of a carefully designed supplement that contains a variety of powdered superfood extracts and micronutrients. Children’s developing brains also benefit from a DHA-EPA supplement, since reliance on seafood in today’s world can expose children to too much mercury and petrochemicals, both of which are found in fish.
Others who may benefit from taking multivitamins include people who have had weight-loss surgery, people who are on very low-calorie diets, people who have a poor appetite, and people who don’t get enough nutrients from food alone because of a medical or genetic reason.
Many people think that a healthy diet should supply all the nutrients we need for optimal health; this is pretty close to being true, but there are exceptions. The first exception is vitamin D, known as the “sunshine vitamin,” because the only way to obtain enough vitamin D naturally is from the rays of the sun. These days, however, most people work indoors, and many live in more northern climates with less daily sunshine. Also, with our mixed backgrounds, our skin has differing abilities to produce vitamin D from the sun—not only because of skin pigmentation but also because of genetic factors.
Sure, if we lived most of our lives outdoors, with not much clothing on—aging and wrinkling our skin in the process and in some cases creating a higher risk of developing skin cancer—then we wouldn’t need vitamin D supplements. The bottom line is that supplementing with vitamin D3 is important for many people to maintain an optimally healthy level in their bodies. Being severely deficient in any nutrient, even when arising from a desire to stay “natural,” is not healthful for anyone and gets many individuals into trouble, as I’ve frequently seen in my medical practice. A vitamin D deficiency does not just increase one’s risk of getting osteoporosis; it also can increase the risk of cancer.19
On the other hand, too high a dose of supplemental vitamin D can also have untoward effects.20 A 25-hydroxy vitamin D blood test can assure that people are not taking too much or too little, aiming for blood levels between 30 and 50 ng/dL. For most people who do not get enough sun exposure, a daily dose of 2,000 IU vitamin D3 (the preferred form) assures they will reach a favorable blood level without the risk of taking too much. Occasionally, people need more or less.
There is another important concept to grasp here: A growing segment of our health-seeking population restricts or omits animal products in order to protect against chronic diseases. As animal product consumption becomes more infrequent, the risk of vitamin B12 deficiency looms larger. So as we strive for more healthy produce and fewer animal products, we need to have a reliable source of B12. If you are elderly or completely vegan, your need for B12 can be significantly higher than the recommended daily intake because only a small percentage of a B12 supplement is absorbed at one time, and the supplements are generally taken only once a day.
Zinc, vitamin K2, and iodine are also nutrients that could be suboptimal depending on your choice of foods, and many very healthy eaters can still be low in one of these nutrients if they don’t consume animal products for zinc or seaweeds, seafood, or iodinated salt for iodine. Plant foods do contain adequate zinc, but because of the binding of zinc to plant phytates, the bioavailability is lower.21 This means that despite adequate zinc in the diet, many vegans may require a bit more for optimal immune function. Zinc needs can vary, and zinc absorption can decrease with aging.22
Just because some supplements are potentially dangerous doesn’t mean that all supplemental ingredients are harmful or not beneficial. In fact, when extensively studied, many have been shown to be life span favorable in general populations.
YOUR SUPPLEMENT SHOULD NOT CONTAIN YOUR SUPPLEMENT SHOULD CONTAIN
Folic acid Vitamin B12
Vitamin A Vitamin D
Beta-carotene Iodine
Vitamin E Zinc
Copper Vitamin K2
Vitamin K2 is another example of a supplement that may benefit the general population as well as those people eating an excellent diet. There are two natural forms of vitamin K: the K1 found in plants, especially green vegetables, and the lesser-known K2, which is more difficult to obtain from modern diets. Several studies have found that vitamin K2 reduces the risk of hip and spine fractures and reduces bone loss with aging.23 Vitamin K2 is found in some animal products, such as fish eggs and organ meats or natto, a fermented soy product, so supplemental K2 likely has significant benefits.
Supplements of the omega-3 fatty acids EPA and DHA can also have important health benefits for those people who don’t eat seafood regularly. As discussed in Chapter 2, EPA and DHA are important for brain development and health, affecting intelligence and even emotional stability. Omega-3 fatty acids are also important nutrients for protection against depression, dementia, and neurological disorders.
The study results diagramed below tested fatty acid levels in 167 vegans of various ages who were eating a natural diet and avoided processed foods. Results showed that 64 percent had insufficiencies and that 27 percent had more severe deficiencies. These deficiencies were easily corrected with a low-dose vegan DHA/EPA supplement. There was no correlation with DHA insufficiency and ALA levels, the short-chain omega-3 fat found in leafy greens, walnuts, and flaxseeds from which the body can make EPA and DHA. There was also no correlation with the amount of omega-6 oil consumption. This means that the differences were largely due to a wide genetic variability in the conversion of ALA to DHA, since the problem was not solved by higher ALA intake and lower omega-6 intake. The important learning point here is that vegans and people who don’t eat fish may be placing themselves at needless risk of later life memory loss and dementia if they don’t take supplements. If a person is uncertain regarding their needs, thankfully, blood tests are easily available to check for adequacy.
Omega-3 Index in Vegans24
Omega-3 index measures levels of EPA and DHA in red blood cell membranes and represents long-term exposure to these beneficial fatty acids. Levels less than 3.5 percent are particularly alarming, because once your brain shrinks, no supplemental regimen can enlarge it again.
More than a dozen epidemiological studies have reported that reduced levels of omega-3 fatty acids were associated with an increased risk for age-related cognitive decline or dementia, such as Alzheimer’s disease. In the Women’s Health Initiative Memory Study of more than eleven hundred postmenopausal women, a higher omega-3 index was correlated with larger total normal brain volume and hippocampal volume measured eight years later.25 The hippocampus is critically important for memory and orientation.
4. WHAT ABOUT IRON SUPPLEMENTATION DURING PREGNANCY? ISN’T THAT UNIVERSALLY ACCEPTED AS IMPORTANT FOR OFFSPRING INTELLIGENCE?
Iron is essential for a baby’s developing brain and future intelligence, but excess iron promotes oxidative stress and is associated with elevated blood pressure in pregnancy and low birth weight.26 It’s important to understand that some additional nutrients from supplements may be useful during pregnancy and breastfeeding, but others (like vitamin A) can cause birth defects. Levels of DHA and vitamin D and iron status are important, but the amount needed may be different from person to person. Iron is particularly critical because both too much and too little can cause problems for the unborn child.
For a subset of women with adequate iron stores, taking supplemental iron can harm their child. It is wise for pregnant women to learn their iron status via a ferritin blood test, starting early in pregnancy, and then use this information to decide the appropriate level of supplementation (if any) to complement a health-promoting diet because absorption of iron varies so much among people.
During pregnancy, a woman’s iron needs increase, and it is estimated that 18 percent of pregnant women are iron deficient.27 Each woman needs to be evaluated to determine her own iron needs. Adequate iron stores are essential for early infant brain development and are needed to support the large increase in blood volume that occurs during pregnancy. Iron adequac
y is also important for the mother-child bonding during infancy.28 Most importantly, iron deficiency in the mother can lead to iron deficiency in her breast-fed infant, which may impair health and future intelligence.29
Iron is more readily absorbed from animal than from plant food sources. For this reason, it is important for pregnant women (and those planning to becoming pregnant), especially those eating a vegan, vegetarian, or flexitarian diet, to maintain adequate iron stores.30 In recent years, researchers have begun to support the idea of making individualized iron supplementation recommendations, rather than providing blanket guidelines for all pregnant women. Research scientists studying this issue have concluded that recommending a fixed dose of iron to avert deficiencies in all women does not result in optimal outcomes. It is safest to use the minimum effective dose. Substantial evidence shows that those women who have plenty of iron stores (documented by blood tests) to support a healthy pregnancy should not take any supplemental iron.
To be consistent with the current science, and to make the best decision to maximize the health of both mother and child, my iron recommendations for pregnant women are more intricate than standard recommendations. The goal of iron supplementation should be to achieve the “sweet spot” of adequacy for the baby’s development without excess.
I recommend that when a pregnant woman’s iron stores are low, with a ferritin level less than 30 ng/mL or hemoglobin less than 11 g/dL she should supplement with a low dose (such as 15–30 milligrams) of iron two to three times daily. When the ferritin level is in the middle range of 31–80 ng/mL and hemoglobin greater than 11 g/dL, supplementation with the standard dose of 9–27 milligrams iron (once daily) is reasonable, depending on the test results within that range. However, with ferritin levels greater than 80 ng/mL and hemoglobin greater than 12.5 g/dL, I do not recommend any iron supplements. Of course, women should discuss these recommendations with their personal physicians.
5. HOW BAD FOR YOU ARE ALCOHOLIC BEVERAGES?
Most people believe what they want to hear, and this is particularly true with how alcohol intake is related to health. We latch onto information which tells us that red wine is good for the heart or that drinking alcohol is okay in moderation. However, scientific evidence on this subject says otherwise. After declaring alcohol a carcinogen in 1988, the International Agency for Research on Cancer went further in 2014 and concluded that there is no safe amount of alcohol when it comes to cancer risk.31 In its “14th Report on Carcinogens,” the National Toxicology Program of the U.S. Department of Health and Human Services lists “alcoholic beverage consumption” as a known human carcinogen.32 The research evidence indicates that the more alcohol a person drinks—particularly the more alcohol a person drinks regularly over time—the higher his or her risk of developing an alcohol-associated cancer. Based on data from 2009, an estimated 3.5 percent of all cancer deaths in the United States each year can be attributed to alcohol intake.33
The risks of drinking a small amount of alcohol, such as a few drinks a week, is certainly minimal, but health authorities should not encourage it because even light drinking is somewhat risky. Most people are under the impression that “social drinking” is harmless. But in a meta-analysis of 222 studies comprising ninety-two thousand light drinkers and sixty thousand nondrinkers with cancer, it was estimated that light drinking could have contributed to five thousand deaths each from oropharyngeal cancer and breast cancer, and twenty-four thousand from esophageal squamous cell carcinoma yearly.34
Alcohol consumption also elevates your risk of developing other cancers. A 2016 review article noted strong evidence that alcohol causes cancer at seven sites: the mouth/pharynx, larynx, esophagus, colon, rectum, breast, and liver.35 Links have also been found between alcohol consumption and leukemia; multiple myeloma; and cancers of the head and neck, stomach, cervix, vulva, vagina, and skin.36 The evidence suggests that the relationship between alcohol consumption and cancer is dose-dependent; that is, light drinking increases cancer risk lightly, and heavy drinking escalates that risk into danger zones.
More than one hundred epidemiological studies have looked at the association between alcohol consumption and the risk of breast cancer in women. These studies have consistently found an increased risk of breast cancer associated with increasing alcohol intake. A meta-analysis of fifty-three of these studies (which included a total of fifty-eight thousand women with breast cancer) showed that women who drank more than 45 grams of alcohol per day (approximately three drinks) had 1.5 times the risk of developing breast cancer as nondrinkers. The risk of breast cancer was higher across all levels of alcohol intake: For every 10 grams of alcohol consumed per day (slightly less than one drink), researchers observed a small (7 percent) increase in the risk of breast cancer. The Million Women Study in the United Kingdom (which included more than twenty-eight thousand women with breast cancer) provided a more recent, and slightly higher, estimate of breast cancer risk at low to moderate levels of alcohol consumption: Every 10 grams of alcohol consumed per day was associated with a 12 percent increase in the risk of breast cancer.37 If you want to live as long as possible, the safest choice is to not drink alcohol at all.
Scientists think that acetaldehyde, a compound formed during the digestion of alcohol, may be responsible for the development of these types of cancers. In addition, alcoholic beverages also contain other carcinogenic substances, such as arsenic, benzene, cadmium, formaldehyde, lead, ethyl carbamate, acrylamide, and aflatoxins.38
Some people say that red wine is good for the heart. The link between alcohol and a reduced risk for coronary heart disease is thought to primarily be due to the fact that alcohol interferes with blood clotting. But this effect is valuable only in a person who consumes a dangerous, heart-disease–promoting diet, which increases the propensity of clot formation to abnormal levels. For someone who eats a healthful diet rich in unrefined plant foods, a high level of protection against heart disease will already exist, and then one would not want to abnormally thin the blood with alcohol because it could cause bleeding, increasing the risk of hemorrhagic stroke.39
An added risk of light drinking is that it can lead to occasional binge drinking or heavy drinking—consuming three or more drinks a day—which is dangerous and associated with cardiomyopathy, hypertension, and potentially life-threatening arrhythmias.40 Younger people who have higher rates of excessive or binge drinking more frequently suffer the adverse consequences of acute intoxication (accidents, violence, and social problems). In fact, among males 15–59 years of age in the United States, alcohol abuse is the leading risk factor for premature death.41
Red wine contains a widely studied beneficial compound from grape skins called resveratrol. This compound has been shown to have several anti-inflammatory and antioxidant effects that may contribute to cardiovascular protection.42 However, at this point, we don’t know whether resveratrol in red wine contributes additional protection beyond the blood-thinning effects of alcohol, and it is unlikely that the resveratrol benefit would outweigh the carcinogenic risk of the alcohol.
Regardless of those possible benefits, it doesn’t make sense to consume a carcinogenic substance just to get resveratrol, because resveratrol can also be found in grapes, raisins, blueberries, cranberries, peanuts, and other plant foods.
6. HOW DO YOU GET YOUR KIDS TO EAT HEALTHFULLY, ONCE THEY HAVE BECOME PICKY EATERS AND WON’T EAT FRUITS AND VEGETABLES AND ONLY WANT JUNK FOOD?
There are two important approaches to the secret of getting children to eat healthfully. The first one is relatively simple: Only keep healthy food in the house. Children’s environments should not expose them to dangerous choices, such as drug use, alcohol, cigarettes, and junk food, and they should understand the reasons why. The second approach is to model the behavior and eating you want your children to follow. Children will frequently copy their parents’ behavior, especially when that behavior makes logical sense and can be explained to them.
Once children have been exposed t
o highly sweetened, artificial foods, it becomes more difficult to change their behavior because they frequently no longer desire healthy fruits and vegetables. Family meetings can be important—to discuss the problem of unhealthy food consumption and changes that the family agrees are important. In a family meeting, every person has input and can make suggestions. Children can help motivate parents to eat better, and parents can help motivate children to eat better.
One great way to start this conversation with your children is to enlist their help in your efforts to eat better. Explain why you are no longer eating sweets and white flour and processed foods, and how they can help you stick to a healthy diet. Kids love their parents and want them to live a long life. Focusing on you gets the focus off the children so they don’t feel criticized for their eating choices. They will also want to learn this information. When they learn how much food can affect life span and health, they will easily grasp why it is important not to be tempted with unhealthy foods around the house. Then, as a consequence, they will understand that family members can all help and support each other in retraining the taste buds, learning to cook healthier, and removing unhealthful temptations from the home.
My mission is to help people recognize that learning about optimal nutrition for a better life is essential, basic knowledge—like reading and writing. It should be a part of our education from early in life.
In today’s unhealthy world with fast food and junk food all over the place, we need regularly scheduled family meetings to plan the week’s shopping and menus, enlist everybody in helping out, and discuss and share why it is so important for everyone to eat healthfully. And in family meetings, you can “show them the evidence.” This doesn’t have to be all or nothing, especially at the beginning. By working as a family unit, and properly supporting each other, you all can improve your health habits. Use this as an opportunity to bring your family together with a common goal. Your children can understand the concept of Frankenfoods being designed by the fake food industry to make people like them better than real food made by nature.
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