Supplements blamed for 23,000 ER visits in US each year

MIAMI -- Over the counter supplements, including vitamins, sexual enhancements and weight loss aids, are being blamed for 23,000 visits to US emergency rooms each year, according to a decade-long study this week.

The findings published in the New England Journal of Medicine are based on reports from a nationally representative sample of 63 emergency departments from 2004 through 2013.

The study raised new concerns among experts over the safety of an industry that critics say is largely unregulated and yet highly popular among consumers -- bringing in $14.8 billion in 2007, or one third of the out-of-pocket expenditures for prescription drugs, according to background information in the article.

More than one quarter (28 percent) of visits were by adults aged 20 to 34.

Weight loss aids were a leading culprit in this age group, causing more than half of emergency room visits, commonly for heart related symptoms including palpitations, chest pain, or irregular heartbeat.

More than one fifth (21 percent) of emergency visits were due to children swallowing supplements.

"Child-resistant packaging is not required for dietary supplements other than those containing iron, and despite such packaging, iron supplements were the second most commonly implicated type of supplement in unsupervised ingestion by children," said the study.

When it came to people, swallowing problems caused nearly 40 percent of emergency department visits for supplement-related adverse events.

Just 2,000 people are hospitalized annually after taking supplements.

The research did not track any deaths that might have been linked to supplement use.

The study pointed out that although the US Food and Drug Administration is tasked with overseeing supplements, "neither safety testing nor FDA approval is required before the marketing of dietary supplements."

The researchers also said their estimates are likely lower than the actual number because patients do not always report using supplements.

The Council for Responsible Nutrition, an industry group, said the findings should be viewed in context, and defended the safety of supplements.

"The results of this study reinforce that dietary supplements are safe products, particularly when put into context with the number of people -- over 150 million Americans -- who take dietary supplements every year," said Duffy MacKay, senior vice president of scientific and regulatory affairs.

"To put this projected number of 23,000 annual emergency room (ER) visits into context, we estimate that far less than one tenth of one percent of dietary supplement users experience an emergency room visit annually."

source: interaksyon.com

Panel questions value of calcium, vitamin D pills

WASHINGTON (AP) — Popping calcium and vitamin D pills in hopes of strong bones? Healthy older women should not bother with relatively low-dose dietary supplements, say new recommendations from a U.S. government advisory group.

Both nutrients are crucial for healthy bones and specialists advise getting as much as possible from a good diet. The body also makes vitamin D from sunshine. If an older person has a vitamin deficiency or bone-thinning osteoporosis, doctors often prescribe higher-than-normal doses.

But for otherwise healthy postmenopausal women, adding modest supplements to their diet — about 400 international units of D and 1,000 milligrams of calcium — do not prevent broken bones but can increase the risk of kidney stones, the U.S. Preventive Services Task Force said Monday.

It is not clear if those doses offer bone protection if taken before menopause, or if they help men's bones, the guidelines said.

What about higher-dose supplements that have become more common recently? There's not enough evidence to tell if they would prevent fractures, either, in an otherwise healthy person, the panel concluded. It urged more research to settle the issue.

It's a confusing message considering that for years, calcium and vitamin D supplements have been widely considered an insurance policy against osteoporosis, with little down side to taking them.




"Regrettably, we don't have as much information as we would like to have about a substance that has been around a long time and we used to think we understood," said Dr. Virginia Moyer of the Baylor College of Medicine, who heads the task force. "Turns out, there's a lot more to learn."

The main caution: These recommendations aren't for people at high risk of weak bones, including older adults who have previously broken a bone and are at risk for doing so again, said Dr. Sundeep Khosla of the American Society for Bone and Mineral Research. Those people should consult a doctor, said Khosla, a bone specialist at the Mayo Clinic who wasn't part of the panel's deliberations.

Calcium and vitamin D work together, and you need a lifetime of both to build and maintain strong bones. Vitamin D also is being studied for possibly preventing cancer and certain other diseases, something that Monday's guidelines don't address and that other health groups have cautioned isn't yet proven.

For now, national standards advise the average adult to get about 1,000 mg of calcium, 1,300 for postmenopausal women, every day. For vitamin D, the goal is 600 IUs of vitamin D every day, moving to 800 after age 70, according to the Institute of Medicine, which set those levels in 2010. The nutrients can come from various foods, including orange juice fortified with calcium and D; dairy foods such as milk, yogurt and cheese; certain fish including salmon; and fortified breakfast cereals. Harder to measure is how much vitamin D the body also produces from sunshine.

Most people should get enough calcium from food, said Mayo's Khosla. But while he cautions against too high doses, he frequently tells his patients to take a multivitamin because it's harder to get vitamin D from food and during the winter.

While supplement science gets sorted out, the task force's Moyer advises healthy seniors to exercise — proven to shore up bones and good for the rest of the body, too.

source: philstar.com

Bridging the nutritional gap

MANILA, Philippines - Diabetes, hypertension, obesity — more and more people are getting afflicted with these so-called “lifestyle diseases.”

As a result, their performance at work or at play is impaired. What is causing the increasing number of cases of lifestyle diseases? According to the Food and Nutrition Research Institute (FNRI), an unhealthy diet is a key factor in the prevalence of these conditions.

Vitamins and minerals are necessary for proper food metabolism. When people do not get the right amount of vitamins and minerals into their body, they are unable to efficiently turn the proteins and carbohydrates that they eat into energy. This is why even though they eat so much, they still feel weak and get tired quickly.

Vitamins and minerals are also needed to strengthen the immune system. When people have a shortage of important vitamins and minerals in our body, their immune system is less than optimal and they become vulnerable to illness.

This unhealthy diet creates a vicious cycle: when people feel sick or weak or tired, they lose their drive to engage in healthy physical activities such as sports or exercise. Even simple things such as walking or climbing stairs become tiresome. This leads to a sedentary lifestyle, where they feel that changing their diet and physical routine is too great an effort, so, it’s not surprising that their health and our quality of life suffer.

Lack of nutrients

 Based on the 2008 FNRI National Nutrition Survey, more than 70 percent of Filipinos across populations groups lack vitamins A and C, calcium, and iron in their daily diet.

For example, the FNRI’s Recommended Nutrient Intake (RENI) on a daily basis for vitamin A is 550 micrograms for male adults (aged 19 to 65 and above), and 500 micrograms for female adults (aged 19 to 65 and above).

However, the 2008 survey shows that actual average vitamin A intake among Filipino adults is just 499.6 micrograms, while the elderly only take in 379.9 micrograms daily.

In the case of vitamin C, the RENI for male adults (aged 19 to 65+) is 75 milligrams while the RENI for female adults (aged 19 to 65+) is 70 milligrams.

The 2008 survey, however, shows that on the average, Filipino adults only consume 44.7 milligrams of vitamin C daily, while the elderly consume 44.5 milligrams daily.

As for calcium, the RENI for male adults is 750 milligrams for those aged 19 to 64, and 800 milligrams for those aged 65 and above. The RENI for female adults is 750 grams for those aged 19 to 49, and 800 grams for those aged 50 and above.

According to the 2008 FNRI survey, the actual average daily calcium consumption among adults is only 370 milligrams, while the elderly only consume 330 milligrams of calcium every day.

Iron consumption among Filipino adults is also below the RENI. The RENI for iron among male adults aged 19 to 65 and above is 12 milligrams. The RENI for iron among non-pregnant female adults aged 19 to 64 is 27 milligrams, and for those aged 65 and above, 10 milligrams.

Actual average iron consumption among Filipino adults, however, was found to be only at 9.4 milligrams daily, while the average consumption among the elderly was even lower at 7.5 milligrams a day.

The 2008 FNRI survey also found that 65 percent of Filipinos across population groups are not taking enough calories to meet their daily energy requirement.

The RENI pegs the energy requirements for Filipino male adults as follows: 19 to 29 years old, 2,490 kilocalories (kcal); 30 to 49 years old, 2,420 kcal; 50 to 64 years old, 2,170 kcal; and 65 years old and above, 1,890 kcal.

For female adults, the energy requirements are: 19 to 29 years old, 1,860 kcal; 30 to 49 years old, 1,810 kcal; 50 to 64 years old, 1,820 kcal; and 65 years old and above, 1,410 kcal.

On the average, however, Filipino adults only consume 1,915 kcal daily while the elderly consume even less, with only 1,436 kcal daily.

According to FNRI’s computation, these figures mean that 65 percent of Filipinos are not getting enough energy for their everyday activities.

So how do people change to a healthy lifestyle and be at their best? Obviously, they need to commit themselves first to a healthy diet. The FNRI website (www.fnri.dost.gov.ph) provides an illustrated, dietary guide called the Filipino Food Pyramid to help people make the right food choices for optimum health and nutrition.

 Besides switching to a healthy diet, Filipinos also need to take health supplements to fill in the nutrition gaps on days when, for one reason or another, one’s food choices are less than ideal.

There are encouraging signs that more and more Filipinos are becoming educated about the value of nutritional supplements and they are taking more of these. FNRI surveys show in 2003, only 22.9 percent of Filipinos said they took health supplements. In 2008, that figure had risen to 46.8 percent.

The top two reasons these people gave for taking supplements were health and extra energy. Other reasons were “doctor-recommended,” “perform better in school/work,” and “not getting enough vitamins from the diet.”

To get the maximum benefits from a vitamin and mineral supplement, make sure to choose one that has complete nutritional content.  Centrum is complete and specially balanced with 30 vitamins and minerals the body needs, from vitamin A to zinc. For adults aged 50 and above, on the other hand, Centrum Silver’s age-adjusted formula is perfect for the changing needs in their golden years.

source: philstar.com

Harley Pasternak Blogs: The Truth About Fruit

An apple a day keeps the doctor away.

But does a melon a day do the same? The truth is, fruit is healthy. But some fruits are healthier than other fruits.

Fruits are convenient, versatile and delicious! They're great as snacks, in salads, for baking and as desserts.

But, let's examine what a fruit is made up of. For the most part, fruits are water, fiber, minerals, vitamins and sugar.



Almost all of the fruit's fiber – the stuff that makes you feel full, reduces your chance of getting many cancers and keeps your blood sugar in check – is in its skin or seeds. In fact, one may say that without fiber, fruits really aren't that healthful of a snack. Moreover, most of the minerals and vitamins also lie in the skin and/or seeds of a fruit.

That's why my golden rule with fruits is to choose the ones that have either edible skin or edible seeds. Fruits like apples, peaches, plums, apricots, cherries and pears are just a few great examples of fruits with edible skin. Raspberries, strawberries, blackberries and kiwis are example of fruits with edible seeds.






The one exception to the rule is citrus fruit. While you may not eat the skin or seeds of an orange, clementine or grapefruit, these fruits are still on my list of favorites. These fruits have good fiber to calorie ratios, are loaded with vitamin C (among other nutrients), and have a low glycemic index (i.e. They don't make your blood sugar surge too high).

The fruits that I prefer to minimize (not eliminate – there are no "bad fruits"), are primarily tropical fruits like bananas, mango, papaya and pineapple. These fruits, not surprisingly, are higher in calories and sugar, and are lower in fiber than ones with edible skin and/or seeds or citrus fruits.

Perhaps it's not a coincidence that the 6 fattest countries in the world are all tropical islands that base a large part of their diets on fruits that don't fit into our skin/seed/citrus rule.

So, that being said, one of my favorite smoothies to make in the morning is a peach lassi smoothie. Super-creamy, it is a lightly spiced morning mixture based on the classic Indian treat. It has two of my favorite fruits, is high in fiber, protein, calcium, vitamin D, and is delicious! Garnish with crushed pistachios for extra fiber and a satisfying crunch.

Peach Lassi Smoothie
Peaches (frozen slices or chunks)
Nonfat Greek yogurt
Fresh lime juice
Dash of ground cinnamon
Fresh raspberries


Directions: Pulse first four ingredients in a blender. Stir in berries and enjoy.

source: people.com