The “U.S. market for nutritional supplements is poised for healthy growth, with sales forecast to climb 39 percent from 2007 to 2012 – to reach $8.5 billion,” according to www.packagedfacts.com.With so many supplements and claims of good health, how does one decide what, when and how to use them?In Falcon, Colo., Dr. Kent Herbert takes the minimalist approach. “A good Centrum-type multi-vitamin is good for most people,” Herbert said. “I stick to the recommended daily allowances and shy away from mega doses of vitamins.”Although Herbert doesn’t take vitamins, he said he appreciates the value of the B complex and the omega-3 fatty acids for some people. However, if their diet is sufficient, most healthy adults don’t need a vitamin, Herbert said.”If people are interested in improving their health, it’s far better to get vitamins through a good balanced diet,” he said.”I try to be scientific about it. Certain vitamins can be checked in the blood, such as B12.”The two most deficient vitamins in people are B and D, Herbert said. Exposure to the sun causes the body to make its own vitamin D, and getting enough sun shouldn’t be a problem in Colorado, Herbert said. But, “We’ve overdone sun protection, and that’s caused a resurgence of vitamin D deficiency,” he added. “The American Academy of Physicians has said people should get 10 to 15 minutes of sun exposure a day and you can’t get that from a tanning booth,” he said.According to the National Institutes of Health Web site, vitamin D is naturally present in few foods and is essential for absorbing calcium and enabling normal mineralization of bone.NIH also states that “laboratory and animal evidence as well as epidemiologic data suggest that vitamin D … could affect cancer risk. Strong biological and mechanistic bases indicate that vitamin D plays a role in the prevention of colon, prostate and breast cancers. Emerging epidemiologic data suggest that vitamin D has a protective effect against colon cancer.”Laura Tonsits, dietitian at Penrose Community Hospital, said she takes a conservative approach to supplementation, but she suggests a vitamin D supplement for everyone because the required amount has increased.”The recommendation used to be 200 to 600 international units and maybe at the most 800 for those in nursing homes, but now the recommendation is 1,000 to 2,000 IUs a day,” Tonsits said.Some research indicates that a combination of genetic predisposition, vitamin D deficiency and stress can compound the chance of developing an autoimmune disease like multiple sclerosis, she said, adding that the Colorado Springs area has a high rate of multiple sclerosis, fibromyalgia and lupus.”You can’t get enough vitamin D in your diet. One cup of milk has 100 IUs. Unless someone is really making a concerted effort, it would be tough to get enough vitamin D through your diet alone,” Tonsits said.For bone health, especially for women, she said she recommends taking additional calcium, which is often combined with vitamin D in one pill.Tonsits said the pills should be labeled as Vitamin D 3 for adequate absorption in the body.”It’s not a bad idea for many people to take a general multi-vitamin. I also put a lot of people on fish oil supplements,” she said, because of “elevated triglycerides, which go hand in hand with stress, sugar and alcohol consumption and lack of exercise.”Colorado Pediatrician Dr. Ken Richeaux said he thinks the next scientific breakthrough in nutrition will be based on the work of Louis Ignarro, pharmacologist at the University of California, Los Angeles School of Medicine.According to www.wikipedia.org, Ignarro shared the 1998 Nobel Prize in Physiology or Medicine with Robert Furchgott and Ferid Murad for work on understanding the way nitric oxide works in the blood stream to prevent and treat heart disease and pulmonary hypertension.In his book, “No More Heart Disease,” published in 2005, Ignarro wrote that the endothelial cells, which line the interior surface of the blood vessels, produce nitric oxide; which works in the cardiovascular system to prevent the build-up of plaque.Over time, as people eat foods that undermine the ability of the endothelial cells to produce nitric oxide, they develop problems with plaque, cholesterol and high blood pressure that lead to strokes and heart attacks, Ignarro wrote.He recommended in his book a diet of foods containing L-arginine and L-citrulline, two amino acids that boost the endothelial cells’ ability to make nitric oxide, which has the effect of reducing cholesterol and lowering blood pressure.Such foods include almonds, garbanzo beans, melons, peanuts, salmon, soy and walnuts.Ignarro also recommended foods high in antioxidants, such as avocados, black beans, blueberries and broccoli, as well as supplements containing the two amino acids.Richeaux supports Ignarro’s recommendation, but said patients should also let their doctors know if they are taking supplements to lower their blood pressure.Patients should have their blood pressure closely monitored, especially if they take blood pressure medication because the combination can force blood pressure down too low, he said.Richeaux attended medical school 25 years ago. He said doctors do not get enough training in medical school about nutrition. “We are taught to diagnose disease and treat it with surgery and pharmaceuticals,” he said.The pharmaceutical industry can afford to send sales representatives to doctors’ offices, Richeaux said. But doctors don’t see sales representatives for nutritional supplements.
