Multiple Vitamin-Mineral Supplements

What do they do?
Multiple vitamin-mineral (MVM) supplements, sometimes known as multivitamin-mineral supplements, contain a variable number of essential and/or non-essential nutrients. Their primary purpose is to provide a convenient way to take a variety of supplemental nutrients from a single product, in order to prevent vitamin or mineral deficiencies, as well as to achieve higher intakes of nutrients believed to be of benefit above typical dietary levels.
Many MVMs contain at least 100% of the Daily Value (DV) or the U.S. Recommended Dietary Allowance (USRDA) of all vitamins that have been assigned these recommended values. Mineral levels may be lower, or in the case of high potency MVMs, most or all mineral levels may also be at 100% of DV or USRDA. Micronutrients that should be included in a complete MVM are vitamin A (or beta-carotene), vitamin B-complex (thiamine, riboflavin, niacin and/or niacinamide, vitamin B6, folic acid (folate), vitamin B12, pantothenic acid, and biotin), vitamin C, vitamin D, and vitamin E, and the minerals calcium, magnesium, zinc, iodine, selenium, copper, manganese, chromium, molybdenum, and possibly iron. Some MVMs also contain vitamin K, but people taking the medication warfarin (Coumadin®) should consult their doctor before taking vitamin K supplements. Phosphorus is another essential dietary mineral, but is so abundant in the diet that it does not need to be included in an MVM formula. The only exception is for elderly people, whose diets tend to be lower in phosphorus. Calcium interferes with phosphorus absorption, so older people who are taking a calcium supplement might benefit from taking additional phosphorus.

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Potassium is an unusual case, as adequate amounts of potassium cannot, by law, be sold in non-prescription products. Thus potassium, when included in an MVM formula, represents only a trivial amount. MVMs may contain iron, but these should be taken only by people who have been diagnosed as having, or being at high risk of, iron deficiency, or who have a history of frequent iron deficiency.
Some nutrients may be beneficial at levels above what is possible to obtain from diet alone, and an MVM formula can provide these levels as well. Nutrients that may be useful to most people in larger amounts include vitamin C, folic acid, and calcium. Vitamin E has long been thought to protect against heart disease beginning at 100 IU per day, but more recent research has cast doubt on the value of vitamin E for heart-disease prevention.

2

Large amounts of vitamin B1, vitamin B2, vitamin B3, and pantothenic acid are often included in MVM formulas. Some people claim to experience improvements in mood, energy, and/or overall well-being when taking higher-than-RDA amounts of B vitamins. While there is not a great deal of scientific research to support those observations, one double-blind study of healthy volunteers found that an MVM supplement significantly reduced anxiety and perceived stress levels, and possibly improved energy and the ability to concentrate.

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The importance of including the nonessential nutrient beta-carotene in MVMs remains speculative. The synthetic beta-carotene found in most MVMs clearly does not prevent cancer and may increase the risk of lung cancer in smokers. Therefore, the inclusion of synthetic beta-carotene in MVM formulas is of questionable value, and it should be avoided by smokers. This concern was validated by the results of a large study in which male smokers who supplemented with synthetic beta-carotene had an 18% increase in incidence of lung cancer, compared with those given a placebo.

4 On the other hand, because beta-carotene can be converted to vitamin A without causing vitamin A toxicity, some manufacturers use beta-carotene as a source of vitamin A. In contrast to synthetic beta-carotene, however, natural beta-carotene and a few other carotenoids may be helpful in preventing certain diseases, including some cancers.

5 6 7

Increasingly, natural beta-carotene and a few other carotenoids are found in higher quality MVMs.
Another class of non-essential nutrients is the flavonoids, which have anti-oxidant and other properties and have been reported by some,8 though not all,9 researchers to be linked with a reduced risk of heart disease. MVM supplements also frequently include other nutrients of uncertain benefit in the small amounts supplied, such as choline, inositol, and various amino acids.
Preliminary and double-blind trials have shown that women who use an MVM containing folic acid, beginning three months before becoming pregnant and continuing through the first three months of pregnancy,10 11 have a significantly lower risk of having babies with neural tube defects (e.g., spina bifida) and other congenital defects.
In one double-blind trial, schoolchildren received, for three months, a daily low-potency vitamin-mineral tablet containing 50% of the USRDA for most essential vitamins and the minerals.12 The subjects were “working class,” primarily Hispanic, children, aged 6 to 12 years. Dramatic gains in certain measures of IQ were observed in about 20% of the supplemented children. These gains may have been due to the correction of specific nutrient deficiencies (for example, iron) found in these children. However, it was not possible in this study to identify which nutrients caused the increases in IQ.
What about “one-per-day” multiples?
One-per-day multiples are primarily B-complex vitamins, with both vitamin A and vitamin D included either at high or low potency, depending on the supplement. The rest of the formula tends to be low potency. It does not take much of some of the minerals—for example, copper, zinc, and iron—to offer 100% or more of what people normally require, so these minerals may appear at reasonable levels in a one-per-day MVM.
One-per-day MVMs usually do not provide sufficient amounts of many nutrient supplements shown to benefit people eating a Western diet, such as vitamin E, calcium, magnesium, and vitamin C. One-per-day MVMs should therefore not be viewed as a way to “cover all bases” in the way that high-potency MVMs, requiring three or more pills per day, are viewed.
How much is usually taken?
The following table shows the USRDA for nutrients as well as suggested optimum amounts of each vitamin and mineral that should be present in a daily MVM supplement for healthy people. Some people may want to take larger amounts because of specific health concerns. They should read the individual nutrient sections to learn about safe upper ranges of supplementation.

Which is better—capsule or tablet?
Multiples are available as a powder inside a hard-shell pull-apart capsule, as a liquid inside a soft-gelatine capsule, or as a tablet.
Most multiples have all the ingredients mixed together. Occasionally the B vitamins react with the rest of the ingredients in the capsule or tablet. This reaction, which is sped up in the presence of moisture or heat, can cause the B vitamins to “bleed” through the tablet or capsule, discoloring it and also making the multiple smell. While the multiple is still safe and effective, the smell is off-putting and usually not very well tolerated. Liquid multiples in a soft-gel capsule—or tablets or capsules that are kept dry and cool—do not have this problem.
Capsules are usually not as large as tablets, and thus some people find capsules easier to swallow.
Some people prefer vegetarian multiples. While some capsules are made from vegetarian sources, most come from animal gelatine. Vegetarians need to carefully read the label to ensure they are getting a vegetarian product.
One concern people have with tablets is whether they will break down sufficiently to allow the nutrients to be absorbed. Properly made tablets and capsules will dissolve readily in the stomach.
What about timed-release?
Some multiples are in timed-release form. The theory is that releasing vitamins and minerals slowly into the body over a period of time is better than releasing all of the nutrients at once. Except for work done on vitamin C—some of which showed timed-release C was better absorbed than non-timed-release—research on this question has been lacking. It is possible that some nutrients, especially minerals, will be poorly absorbed from timed-release multiples. Also, some doctors have concerns about the safety of ingesting the chemicals that are used in tablets or capsules to make them timed-release.
What about nutrient interactions?
Another area of controversy is whether all of the nutrients in a multiple would be better utilised if they were taken separately. While certain nutrients compete with each other for absorption, this is also the case when the nutrients are supplied in food. For example, magnesium, zinc, and calcium compete; copper and zinc also compete. However, the body is designed to cope with this competition, which should not be a problem if multiples are spread out over the day.
What about chewables?
Unfortunately, multiples do not taste very good. In order to make chewable multiples palatable, whether for children or adults, some compromises must be made. First, bad-tasting ingredients must be reduced or eliminated. Second, the rest of the ingredients must be masked with a sweetener.
Unless an artificial sweetener like aspartame (NutraSweet®) or saccharin is used, the only sweeteners available are sugars. Generally, consuming sugar is undesirable, and not having it in a chewable dietary supplement would be preferable. Xylitol, a natural sugar rarely used in chewables because it is relatively expensive, would be an ideal choice since it does not cause tooth decay or other known problems.
Some chewables, such as vitamin C, contain more sugar than any other ingredient. In such products, the sweetener should be listed as the first ingredient, but often is not. Care needs to be exercised when reading labels about chewable vitamins. If it tastes sweet, it contains sugar or a synthetic sweetener. In addition, chewable vitamin C products should contain buffered vitamin C, rather than the acidic form, ascorbic acid, in order to avoid damaging dental enamel.
When is the best time to take a multiple?
The best time to take vitamins or minerals is with meals. Multiples taken between meals sometimes cause stomach upset and are likely not to be as well absorbed.

(http://www.healthylife.net.au/HEALTHYLIFEHN.ASP?org=healthylife&ContentID=2887001)

Benefits Of Green Tea

Parts used and where grown
All teas (green, black, and oolong) are derived from the same plant, Camellia sinensis. The difference is in how the plucked leaves are prepared. Green tea, unlike black and oolong tea, is not fermented, so the active constituents remain unaltered in the herb. The leaves of the tea plant are used both as a social and a medicinal drink.

Historical or traditional use (may or may not be supported by scientific studies)
According to Chinese legend, tea was discovered accidentally by an emperor 4,000 years ago. Since then, Traditional Chinese Medicine has recommended green tea for headaches, body aches and pains, digestion, depression, immune enhancement, detoxification, as an energizer, and to prolong life.

Active constituents
Green tea contains volatile oils, vitamins, minerals, and caffeine, but the primary constituents of interest are the polyphenols, particularly the catechin called epigallocatechin gallate (EGCG). The polyphenols are believed to be responsible for most of green tea’s roles in promoting good health.1
Green tea has been shown to mildly lower total cholesterol levels and improve the cholesterol profile (decreasing LDL “bad” cholesterol and increasing HDL “good” cholesterol) in most,2 3 4 5 but not all,6 studies. Green tea may also promote cardiovascular health by making platelets in the blood less sticky.

Green tea has also been shown to protect against damage to LDL (“bad”) cholesterol caused by oxygen.7 Consumption of green tea increases anti-oxidant activity in the blood.8 Oxidative damage to LDL can promote atherosclerosis. While population studies have suggested that consumption of green tea is associated with protection against atherosclerosis,9 the evidence is still preliminary.

A few animal and test tube studies have demonstrated an anticancer effect of polyphenols from green tea.10 11 12 In one of these studies, a polyphenol called catechin from green tea effectively inhibited metastasis (uncontrolled spread) of melanoma (skin cancer) cells.13 The polyphenols in green tea have also been associated with reduced risk of a few types of cancer in humans.14 15 16 However, some human studies have found no association between green tea consumption and decreased cancer risk.17 18
In a double-blind trial, people with leukoplakia (a pre-cancerous oral condition) took 3 grams orally per day of a mixture of whole green tea, green tea polyphenols, and green tea pigments orally, and also painted a mixture of the tea on their lesions three times daily for six months.19 As compared to the placebo group, those in the green tea group had significant decreases in the pre-cancerous condition.
Compounds in green tea, as well as black tea, may reduce the risk of dental caries.20 Human volunteers rinsing with an alcohol extract of oolong tea leaves before bed each night for four days had significantly less plaque formation, but similar amounts of plaque-causing bacteria, compared to those with no treatment.21
Green tea polyphenols have been shown to stimulate the production of a few immune system cells, and have topical antibacterial properties—even against the bacteria that cause dental plaque.22 23 24
One study found that intake of 10 cups or more of green tea per day improved blood test results, indicating protection against liver damage.25 Further studies are needed to determine if taking green tea helps those with liver diseases.
Tea flavonoids given by capsule reduced faecalodour and favourably altered the gut bacteria in elderly Japanese with feeding tubes living in nursing homes.26 The study was repeated in bedridden elderly not on feeding tubes, and green tea was again shown to improve their gut bacteria.27 These studies raise the possibility of using green tea in other settings where gut bacteria are disturbed, such as after taking antibiotics. Further studies are needed to clarify the role of green tea in this respect, however.
High-tannin tea has been shown to reduce the need for blood removal from people with iron overload, or haemochromatosis, in an open study.28 The tea had to be taken with meals and without lemon or milk to be effective. Tea is believed to help in haemochromatosis by preventing iron absorption.
In a double-blind trial, men with precancerous changes in the prostate received a green tea extract providing 600 mg of catechins per day or a placebo for one year. After one year, prostate cancer had developed in 3.3% of the men receiving the green tea extract and in 30% of those given the placebo, a statistically significant difference.29 These results suggest that drinking green tea or taking green tea catechins may help prevent prostate cancer in men at high risk of developing the disease.
There are four case reports in which certain types of leukaemia or lymphoma (low grade B-cell malignancies) improved after the patients began taking green tea extracts.30

How much is usually taken?
Much of the research documenting the health benefits of green tea is based on the amount of green tea typically consumed in Asian countries—about 3 cups (750 ml) per day (providing 240–320 mg of polyphenols).31 However, other research suggests as much as 10 cups (2,500 ml) per day is necessary to obtain noticeable benefits from green tea ingestion.32 33 To brew green tea, 1 teaspoon (5 grams) of green tea leaves are combined with 1 cup (250 ml) of boiling water and steeped for three minutes. Decaffeinated tea is recommended to reduce the side effects associated with caffeine, including anxiety and insomnia. Tablets and capsules containing standardised extracts of polyphenols, particularly EGCG, are available. Some provide up to 97% polyphenol content—which is equivalent to drinking 4 cups (1,000 ml) of tea. Many of these standardised products are decaffeinated.

Are there any side effects or interactions?
Green tea is generally free of side effects. The most common adverse effects reported from consuming large amounts (several cups per day) of green tea are insomnia, anxiety, and other symptoms caused by the caffeine content in the herb.
An extract of green tea taken by healthy women with a meal inhibited the absorption of non-haem iron (e.g., the form of iron in plant foods) by 26%.34 Frequent use of green tea could, in theory, promote the development of iron deficiency in susceptible individuals.
There are a few case reports of people developing liver damage while consuming weight-loss products that contained concentrated extracts of green tea.35 A cause–effect relationship was not proven, and most of the products contained other ingredients in addition to green tea extract. Nevertheless, researchers have cautioned against the use of large amounts, or concentrated extracts, of green tea.
Are there any drug interactions?Certain medicines may interact with green tea. Refer to drug interactions for a list of those medicines.

(http://www.healthylife.net.au/HEALTHYLIFEHN.ASP?org=healthylife&ContentID=2102007)

Vegetarian Diet

The basics
Eating a vegetarian diet has been shown in many studies to be healthier than eating a meat-based diet. However, this is not the only reason people choose to go vegetarian: environmental, cultural, religious, and ethical factors all play into the decision to not eat meat.
Vegetarians do not eat meat, poultry, or fish (people who include small amounts of these foods in their diets sometimes call themselves semivegetarians, or flexitarians.) Vegetarians build their diets around a wide variety of plant foods, including grains (such as rice, barley, and oats), grain-based foods (such as bread, pasta, and cereals), pulses, vegetables, fruits, nuts and seeds.
Lacto-ovo vegetarians consume dairy foods and eggs, but no fish, poultry, or meat.
Vegans are strict vegetarians who do not eat any animal products, including dairy products, eggs, and honey.
Pesco-vegetarians include fish in their diet.
Health benefits can be reaped just by decreasing the amount of meat you eat, even if you don’t decide to follow a fully vegetarian diet.
Ready to veg out? Start by choosing whole grains, pulses, and soya products. Add in fruits and vegetables; remember you should get five to nine servings per day. Soya foods such as tofu, soya milk, and soya-based meat substitutes play an important role in many vegetarian diets. In addition, cheese and milk made from rice, almonds, and soybeans are prominent in some vegetarian diets.

Why do people follow this diet?
People choose vegetarian diets for a variety of reasons. Many choose them to improve their health or to decrease the risk of chronic diseases, such as heart disease, diabetes, or cancer. Others go vegetarian due to concerns about world hunger and the environment, because large-scale production of animal foods uses land that could otherwise be used to grow plant-based foods, and is a major cause of deforestation and soil erosion worldwide. Still others are concerned about the presence of antibiotics, hormones, pesticide residues or disease-causing agents (as with mad cow disease) that may be present in meat. Some vegetarians object to inhumane practices of modern-day animal farming, so their reasons for being vegetarian are largely ethical. Some vegetarians believe that humans are not physiologically suited to meat eating; humans have more in common with herbivorous animals than with carnivorous animals in terms of the structure and function of the digestive tract. Others follow a vegetarian diet according to their religious custom. Finally, some people choose vegetarianism in an attempt to live more simply and economically, and in closer harmony with the way most of the world’s population eats.

What do the advocates say?
It is well documented that vegetarians are healthier than people who eat meat. In some cases, vegans have better health than lacto-ovo vegetarians. Although many vegetarians also exercise and avoid smoking, evidence indicates that their good health is largely due to diet. One study of 30,000 people in California compared vegetarians and meat eaters who, aside from their dietary differences, had very similar lifestyles and health practices. The vegetarians were less likely to be obese, or to have high blood pressure, diabetes, rheumatoid arthritis, or colon cancer. They were also less likely to die from heart disease. In fact, the vegetarians were healthier even than people who ate meat only occasionally. Even when vegetarians were fatter than meat eaters, the vegetarians had lower cholesterol levels.
Vegetarians have lower blood pressure even when they eat the same amount of salt as meat eaters and exercise less. Researchers have known since the beginning of the 1900s that feeding meat to vegetarians causes their blood pressure to rise.
Many studies show that vegetarians have less colon cancer than meat eaters. The composition of bacterial flora in the colon differs between vegetarians and people who eat meat in ways that could possibly affect cancer risk.
Many factors in vegetarian diets contribute to the better health of vegetarians. These factors include:
Vegetarians consume two to three times as much fibre as do meat-eaters. This may help to reduce cholesterol and blood glucose levels, and protect against colon cancer.
Vegetarians consume more anti-oxidants, which are found in a wide variety of plant foods. Anti-oxidants protect cells from oxygen-induced damage and reduce the risk for heart disease, arthritis, cancer, and other diseases.
Vegetarians consume more phytochemicals (special compounds found in plants) than do meat eaters. Phytochemicals have a wide range of protective effects in the human body. They help to detoxify carcinogens, stimulate the immune system, regulate cell growth (which helps to fight cancer), and reduce some of the harmful effects of excessive exposure to hormones.
Vegetarians eat more isoflavones than do meat eaters. These compounds, found mostly in soya foods, are another type of phytochemical. Research shows that isoflavones may reduce the risk for prostate cancer and may improve bone health.
Vegetarians consume much less saturated fat and cholesterol than do meat eaters. This helps to explain why they have significantly lower levels of blood cholesterol. One study showed that blood cholesterol levels were 14% lower in lacto-ovo vegetarians and 35% lower in vegans compared to meat-eaters. Lower intakes of saturated fat reduce the risk for heart disease and possibly for diabetes and cancer.
Vegetarians do not consume haem iron, a type of iron found in meat that may increase the risk of heart disease and cancer.
Vegetarians do not eat red meat, which has been linked to increased cancer risk in many studies. Red meat consumption stimulates the production of mutation-causing compounds in the colon and is linked to increased damage to DNA.

What do the critics say?
Critics of vegetarianism claim that people who choose this diet will have to “balance incomplete proteins” to synthesise complete protein in the body. Proteins that come from fruits, vegetables, pulses, and grain products are “incomplete” in the sense that they do not provide all nine essential amino acids (protein building blocks) in a single food; thus, according to critics, a vegetarian (and especially a vegan) must be careful to consume appropriate quantities of complementary proteins each day to ensure that he or she is getting enough dietary protein.
Contrary to this popular belief, inadequate protein intake is rarely a concern for vegetarians. Better understanding of protein nutrition shows that, for adults, it is not necessary to consume special combinations of foods to meet requirements for the right balance of amino acids. Many plant foods, such as grains and pulses, provide protein. Soya foods and dairy products are particularly rich in high-quality protein. Protein needs are easily met when vegetarians consume a variety of plant foods and eat enough food to meet calorie needs. In fact, most meat-eaters consume far more protein than they actually need.
Critics also point out that there is no way to get vitamin B12 via food except through animal products. Tempeh and other fermented soya products do not contain consistent enough quantities of B12 to meet the body’s requirements. Vegetarians must therefore eat B12-fortified foods or take vitamin supplements on a daily basis to prevent a deficiency.
Some critics fault vegetarian, and particularly vegan, diets for not providing sufficient calcium. In truth, most people, not just vegetarians, eat less than optimal amounts of calcium. Dairy products are a good source of dietary calcium, but they are not the only source. Green leafy vegetables and tofu are also good sources, and are usually eaten in large quantities by vegetarians. Vegans—who eat no animal products—are the most likely to suffer from calcium deficiency. Many Americans—vegetarians and meat eaters alike—could benefit from taking a calcium supplement.
Vegetarians eat less iron than non-vegetarians, and the iron they eat is somewhat less absorbable. As a result, vegetarians are more likely to have reduced iron stores. However, iron deficiency is not usually caused by a lack of iron in the diet alone; an underlying cause—such as iron loss in menstrual blood—often exists. Although iron is found in a variety of different foods, its availability to the body (bioavailability) varies significantly. This is determined by whether it is found in the form of haem and non-haem iron. Haem iron is found only in meat, fish, and poultry. It is absorbed much more readily than non-haem iron found primarily in fruits, vegetables, dried beans, nuts, and grain products, such as bread and iron-fortified breakfast cereals. Including a source of vitamin C at each meal improves absorption of vegetarian-source iron.
Strict vegans may become iodine deficient if they do not consume enough iodine, readily available in iodized salt.
Very few foods are good sources of vitamin D, which is why milk is fortified with it. Vegetarians who do not consume milk should be sure to get 20 to 30 minutes of sun exposure every day since this promotes the synthesis of vitamin D in the body. People who live in cloudy, smoggy, or northern areas, and people who do not leave their residences, need foods fortified with vitamin D. These fortified foods include breakfast cereals and some brands of soya milk and rice milk. Since people with dark skin make vitamin D less efficiently, they may also need supplemental sources of vitamin D or increased sun exposure.

(http://www.healthylife.net.au/HEALTHYLIFEHN.ASP?org=healthylife&ContentID=1301007)