Wednesday, April 20, 2005

We Stand to Lose Our Rights to Effective Supplements

First they banned l-tryptophan. Last year they banned ephedra. This year they banned all prohormones, despite the complete absence of health risks associated with their use. Now we stand to lose access to nearly all effective supplements. Read this article, forward it to friends, and write your representatives to support legislation refusing to adopt these insane policies.


Summer of '05 Critical Time for Dietary Supplements by Suzan Walter

The future of dietary supplements may be determined by what happens this summer. Not just one, but many different yet related matters are all coming to a head during the spring and summer months of 2005. Since everything is interrelated, you will want to track national, regional, and international events.

When you review articles and e-mails dealing with supplements (and there are a number making the rounds), it is important that you understand the impact of each of these events individually, as well as collectively. The following review is presented to assist you in understanding the nuances of each issue and in recognizing when some sources blur and confuse the distinctions.

Codex Guidelines for Vitamin and Mineral Food SupplementsThe Codex Guidelines for Vitamin and Mineral Food Supplements is an international document drafted to be guidelines for vitamin and mineral supplement products. It states that it is only for countries that designate these supplements as food, exempting countries that designate supplements as drugs. Last November, after over a decade of wrangling over numerous supplement regulation issues, a Codex committee completed an eight-step process that created the official Guidelines document. Finalization of the Guidelines document is on the agenda for the Rome July 4-9, 2005 session of the top Codex body, the Codex Alimentarius Commission. At this time, there does not appear to be anything that can be done to stop this final action. Under Codex authority, these Guidelines are optional suggestions, not a mandatory trade standard that must be followed in trade between countries.

However, there are agreements between Codex Alimentarius and the World Trade Organization that allow the WTO to use Codex documents (such as the Guidelines) as mandatory international trade standards to settle trade disputes. The WTO can enforce dispute decisions by pressuring the losing country through trade sanctions if they do not change their national laws or other regulations to conform to international trade standards. Therefore, the regulations in the Guidelines must be taken seriously.

The section of the Guidelines expected to have the most significant impact is the criteria by which the maximum amounts of vitamins and minerals that will be allowed in a supplement product are determined. The Guidelines state that "... upper safe levels of vitamins and mineral established by scientific risk assessment based on generally accepted scientific data...." As there is currently no generally accepted scientific risk assessment protocol available, what these limits will be is unknown. Some individuals are very concerned that the upper limits will be set too low. This could mean that instead of one convenient high-dosage capsule, the consumer might need to take a handful of low-dosage capsules.

FAO Risk Assessment ProtocolThe Food and Agriculture Organization (FAO) of the United Nations and the World Health Organization (WHO) announced in December, 2004, that they were accepting applications from individuals who wish to serve as the experts on a joint nutrient risk assessment project to define a scientifically-based nutrient risk assessment. Work is scheduled to begin in May, 2005. The balance of perspectives of the experts selected will be the first sign of how this project will progress. It is anticipated, but not guaranteed, that this nutrient risk assessment protocol will be used to define the upper safe limits of the Codex Guidelines.

European Union Food Supplements DirectiveThe collection of countries making up the European Union (EU) will be severely impacted by the activation of the EU Food Supplements Directive on August 1, 2005. The Directive is purported to provide reassurance for EU consumers that the ingredients used in food supplements have been thoroughly assessed for safety. There is a "positive list" that includes 28 vitamins and minerals that are deemed safe. After August 1, EU stores can legally only sell supplement products containing these ingredients. What is causing grave concerns, however, is the long list of 200 vitamins and minerals that did not make the "positive list." While a supplement would normally need to be proved dangerous to be removed from public consumption, the Directive works in just the opposite way. The supplement must be proved safe to get onto the "positive list" and be available to the EU consumer. The process of proving that a vitamin or mineral is safe is very costly.

A number of groups are so concerned about the negative impact of the Directive that this matter has been taken to the regional courts in Europe. At a January 25, 2005, hearing the Alliance for Natural Health and Nutri-Link Ltd presented their arguments that the EU is exceeding its powers. An opinion will be released April 5, 2005, with the final decision expected in June, 2005. The decision will set a major precedent for the world, particularly if the EU Directive side loses.

DSHEA & Legislation in U.S.The key legislative protection that gives consumers in the United States access to dietary supplements is the Dietary Supplement Health and Education Act of 1994 (DSHEA). A number of senators and and members of congress in Washington are working to reverse some or all of these protections. Last year, in the 108th session of Congress, a number of bills were introduced that caused concern among those who use supplements. It is expected that these bills will be reintroduced in the current (109th) session in April-May time frame, with serious committee hearings in the following months. While the bill numbers will be different, the content is expected to be very similar. A few of the bills to watch for are:

Dietary Supplement Safety Act (was S. 722)This bill would amend the Federal Food, Drug, and Cosmetic Act to require that manufacturers of dietary supplements submit to the FDA reports on adverse experiences with dietary supplements. Opponents question whether dietary supplements need to be held to a higher standard than drugs. Would it be fair to have a supplement taken off the market based on one negative reaction while a drug can remain available even as it harms many?

Dietary Supplement Access and Awareness Act (was H.R. 3377)This bill would grant the FDA authority to regulate supplements in the same way that it regulates over-the-counter drugs. Opponents are concerned that this is working toward the day when you would need a doctor's prescription to get vitamin and mineral supplements.

Safe Food Act of 2004 (was S. 2910)This bill would create a new federal food safety agency. Ten separate federal agencies handling various food matters would be combined into one. This sounds like an efficient administrative approach. However, the bill stated that the term "food" would not include dietary supplements. If not food, what's left? Drugs?

How these events are connectedSome of the connections between the events described above are obvious. However, there are some subtle relationships that are not as well known. Here are a few examples:

The EU has a very strong influence on decisions made in Codex committee sessions. In fact, the Guidelines document does not include a number of items because the EU delegate was vehemently against them. In one prominent example the delegate from South Africa tried on a number of occasions to get wording into the Preamble of the Guidelines to acknowledge that vitamins and minerals had preventive benefits. The EU delegate successfully objected every time. At this same Codex session the FAO/WHO publication, "Diet, Nutrition and the Prevention of Chronic Diseases" was being promoted on the literature table. Based on this demonstration of EU influence, many people believe that the EU Food Supplements Directive indicates what Codex documents might end up including in the future.

The United States Federal Register, October 11, 1995, FDA Policy on Standards, states that "where a relevant international standard exists, or completion is imminent, it will generally be used in preference to a domestic standard...." If this is still the FDA policy, once the Codex Guidelines are finalized this summer, will we find the FDA working to use this against the DSHEA?

Have you noticed the growing number of situations where dietary supplement companies are being required to submit costly documentation to prove that a vitamin or mineral is safe, even when there is extensive research already demonstrating its safety and effectiveness? This is what is currently happening in Europe and Canada. The negative economic impact is changing the landscape of the entire industry. Are we seeing a scenario where small companies will either have to sell out to larger supplement companies or fold? Where many of the larger companies are being bought out by pharmaceutical companies? Do current events support the strength of the supplement companies or the pharmaceutical companies?

As you consider the difference between what is on the six o'clock news and what the health freedom advocacy web sites proclaim, evaluate for yourself what this difference might mean for you and those you love. Get involved with groups that support what you believe will be most beneficial.


Suzan Walter, president of the
American Holistic Health Association, researched how the Codex Alimentarius and the World Trade Organization function and applied this information to track the potential impact of the document Codex Guidelines for Vitamin and Mineral Food Supplements. She attended the Codex Committee on Nutrition and Foods for Special Dietary Uses sessions as an observer in 2002, 2003, and 2004 and continues working to try to validate true facts in the face of conflicting information being presented by opposing groups. Suzan created an educational website codexinfo.org to explain these matters to the U.S. public and offer a variety of points of view. If you would like to be alerted when new information is posted at codexinfo.org, e-mail your name and e-mail address to codex@ahha.org.

Tuesday, April 19, 2005

Supplement News You Can Use

Here is some recent research information on supplements. Use your own judgment and experience to learn what works for you.

1) Whey protein before workouts boosts antioxidant levels. Antioxidants bond with free radicals (which can damage various cells in the body, especially DNA) to remove them from the body. Intense exercise, like other forms of stress, can increase free radical levels in the body by decreasing the body's production of glutathione, a powerful antioxidant. French researchers found that giving alpha-lactalbumin-enriched milk protein to rats before two hours of intense exercise resulted in higher levels of glutathione. Other studies have shown that standard whey protein, similar to what was used in the study (but cheaper), can also raise glutathione levels in the bodies of athletes. Before your next weight training session or endurance training session, have 20-40 grams of whey protein about 1-2 hours before training. There is additional research that indicates whey protein before weight training can speed the healing and growth process (see next item).
(J Nutr, 134: 128-131, 2004)

2) Protein and carbs before or after weight training speeds muscle growth. The evidence continues to mount that pre- and post-training meals are the most important of the day for those trying to build new muscle. In a recent study, soldiers in basic training were given a protein-carbs-amino acid drink either before or after training. Those given the drinks (77.4 grams of carbs, 17.5 grams of whey protein, and 4.9 grams of branched-chain amino acids) recovered faster and had fewer injuries than those who did not have the drinks. This is an improvement over the usual carbs and amino acids given as an alternative to simple carbs alone. However, John Berardi (go here) has shown in his research that the ideal ratio of carbs to protein is 2:1 and that benefits are greatest when the drink is consumed before, during, and after workouts. Biotest formulated a supplement (Surge) based on his research (go here).
(Int J Sport Nutr Exerc Metab, 14: 255-271, 2004)

3) Fish oil supplementation increases fat use during exercise. Fish oil has many benefits besides lowering cholesterol and making your sore joints feel better. Researchers from the University of Missouri, Columbia, gave men four grams of fish oil a day for three weeks. They found that those on the fish oil supplements showed increased use of fat for energy during endurance exercise (60 minutes of jogging at 60 percent effort). This replicates findings from other studies. Higher doses of fish oil (up to 24 grams a day, for 6 grams total DHA and EPA) have been shown to increase insulin sensitivity, which would also lead to greater fat loss from exercise. Start with the smaller dose and see if it works for you.
(J Ex Phys on-line, Feb., 2004)

Friday, April 15, 2005

Update on Plastic Water Bottles

Yesterday's USA Today [click header to read the story] ran an article about the risks of plastic water bottles. I posted on this a while back, but there is now better information available.

According to Frederick vom Saal, a developmental biologist at the University of Missouri who reported his findings in Environmental Health Perspectives, published by the National Institute of Environmental Health Sciences, there have been 115 studies published looking at the health risks of bisphenol A, which mimics the sex hormone estradiol. Of those studies, 94 reported significant effects in rats and mice, while 21 did not. Eleven of the studies were funded by chemical companies -- none of these studies reported negative effects.

"Bisphenol A mimics the sex hormone estradiol in the body, acting "like birth control pills," says vom Saal. The body is exquisitely sensitive to sex hormones, needing only tiny amounts to trigger major changes. That's why scientists are concerned about the impact of even the extremely low levels of bisphenol A found in people." ... "The Centers for Disease Control and Prevention says it is detected in 95% of all people tested."

With all we know about estrogen-induced cancers in both men and women, there is ample reason to avoid using these bottles as much as possible. The industry argues that the bottles are safe, but do we really want to trust people who stand to lose a lot of money if they have to use alternate bottling techniques?

Please read Some Plastic Water Bottles Are Unsafe to review which plastics are safe and which are dangerous.

Thursday, April 14, 2005

FDA Ban on Ephedra Struck Down

The FDA ban on ephedra has been struck down by a federal judge in case brought by Utah firm, Nutraceutical. Judge Tena Campbell's ruling returns the issue to the FDA "for further rulemaking consistent with the court's opinion" and keeps the agency from enforcement action against companies selling ephedra products.

The ban was initiated following the death of Baltimore Orioles pitching prospect Steve Bechler, who was overweight and had a liver ailment. He consumed more than the recommended dosage of an ephedra-based weight-loss product on an empty stomach and then pitched on a hot afternoon in Florida. He died of heat stroke.

An additional 155 deaths (the high-end estimate) have been linked to ephedra during the past several years, most of which have been overdoses. As a way of putting this in perspective, nearly 500 people die each year from acetaminophen poisoning (that's Tylenol, by the way). Last time I checked, 300,000 people were expected to die this year from issues associated with being overweight.

The combination of ephedra and caffeine has been proven more effective (in double-blind, placebo-controlled studies) than any of the prescription weight-loss drugs available. In hundreds of studies, the combination has been proven safe for those who do not have health risks (high blood pressure, heart disease, thyroid disease, and a few other conditions). If you do not think the pharmaceutical industry lobbied hard for the ban, then you must not be paying attention.

This is one the courts have gotten right. Conservative, knee-jerk Republicans will no doubt see this as another example of the "radical judiciary" running over the law. Bad laws need to be thrown out.

[Click header to read the news story.]

Wednesday, April 13, 2005

Supplements to Improve Joint Function

With all the recent media scares about the health risks of the COX-2 pain drugs, I am frequently asked questions by my personal training clients about how to treat joint pain, especially arthritis. I've assembled this list of supplements that have proven to be effective in relieving joint pain. I've cited studies that support the claims for those who want to do extra research. Not every person will respond to every supplement, so give them a try and see which ones work for you.

General:

GLUCOSAMINE is an amino-sugar that is a key component of mucopolysaccharides (a complex polysaccharide group [sugar] with an amino acid group attached, occurring primarily in joints) that diminishes as we age. Some studies show new connective tissue in as little as 30 days after taking the supplement. Only the sulfate form of glucosamine has been shown to increase the rate of cartilage repair and the reduction of tissue loss in joint diseases. Glucosamine hydrochloride, by itself, has not produced sustained benefits in multiple studies. Until more is known, the sulfate variation is the best choice.

There has been some concern that glucosamine impairs blood sugar metabolism, but according to a review of two three-year studies, glucosamine does not reduce insulin sensitivity or produce any other abnormalities in glucose metabolism. There is also no evidence that glucosamine increases cholesterol levels. However, acetaminophen use seems to inhibit the benefits of glucoasmine sulfate.
1. Current Opinion in Rheumatology. 2003 Sep; 15(5): 651-5.
2. Journal of Family Practice. 2003 Aug: 52(8); 645-7.
3. Archives of Internal Medicine. 2003 Jul 14; 163(13): 1514-22.
4. Journal of Arthroplasty. 2003 Apr; 18(3 Suppl 1): 5-9.
5. Metabolism. 2001 Jul; 50(7): 767-70.

CHONDROITIN SULFATE is a component of cartilage. The supplement is recommended in the bestseller The Arthritis Cure. It may make joint fluids more slippery and help protect cartilage from breaking down. Recent studies verify beneficial effects, seeming to indicate that CS is actually used by the body to build new cartilage. Research indicates that CS acts as a powerful antioxidant and may be of benefit to those suffering from rheumatoid arthritis.
1. Archives of Internal Medicine. 2003 Jul 14; 163(13): 1514-22.
2. Osteoarthritis Cartilage. 2003 May; 11(5): 335-42.
3. Free Radical Research. 2003 Mar; 37(3): 257-68.
4. Journal of Arthroplasty. 2003 Apr; 18(3 Suppl 1): 5-9.
5. Osteoarthritis Cartilage. 1998 May; 6 Suppl A: 31-6.


MSM powder (methyl sulfonyl methane) is bio-available sulfur in a dietary derivative of DMSO (with no odor). Research suggests anti-inflammatory properties, pain relief, allergy relief, immune system improvement, and much more. Many think MSM is an essential nutrient, and that sulfur, the primary component of MSM, is a neglected element in human health. As has been noted above, it is the sulfur component of glucosamine and chondroitin that seems to impart at least some of the therapeutic benefit.

The makers of Lignisul MSM claim the following for their product:
MSM maintains the structure of proteins in the body, helps in the formation of keratin (essential for hair and nail growth), aids in the production of immunoglobulin (which maintains the immune system), and catalyzes the chemical reactions which change food into energy.
They feel these functions often lead to
* Inhibition of pain impulses along nerve fibers (analgesia)
* Lessening of inflammation
* Increase in blood supply
* Reduction of muscle spasm
* Softening of scar tissue
1. Alternative Medicine Review. 2002 Feb; 7(1): 22-44.
2. The Miracle of MSM: The Natural Solution for Pain. Jacob, S.W., Lawrence, R.M., Zucker;
1999. New York: Penguin.
3. Annals of Internal Medicine. 1993 Nov 1; 119(9): 867-73.
4. International Journal of Anti-Aging Medicine. Summer 1998; I (I): 50.
5. Federation of American Societies for Experimental Biology. 69th Annual Meeting. April 1985, p.692.


SAMe is a combination of L-methionine and ATP and is most often used to enhance mood and brain function, but also seems to relieve osteoarthritis pain, most likely due to the sulfur component.
1. British Journal of Rheumatology. 1997 Jan; 36(1): 27-31.
2. Revista Clinica Espanola. 1990 Jun; 187(2): 74-8.
3. American Journal of Medicine. 1987 Nov 20; 83(5A): 72-7.
4. International Journal of Clinical Pharmacology Research. 1985; 5(1): 39.

CETYL MYRISTOLEATE has been studied for its effect on inflammation and pain due to osteoarthritis and various auto-immune diseases such as rheumatoid arthritis and psoriasis. CM provides lubrication to the joints and bones. The waxy substance seems to have the ability to relieve inflammation while lubricating joints by acting like an essential fatty-acid, only many times more effectively. It does not need to be taken for long periods (usually only a month) or at high doses. In clinical research, injections were superior to oral doses, but oral doses still provided relief.
1. Pharmacological Research. 2003 Jan; 47(1): 43-7.
2. Journal of Rheumatology. 2002 Aug; 29(8): 1708-12.
3. Journal of Pharmacological Science. 1994 Mar; 83(3): 296-9.


GREEN-LIPPED MUSSEL. Studies show extract of Perna canaliculus from New Zealand supports healthy, limber joint function. (Patented as Lyprinol.) Contains active anti-inflammatory proteins and chondroitin sulfate. Anti-inflammatory action of this supplement also seems to benefit those with atopic asthma. Works well with glucosamine, MSM, etc., at 1-4 grams per day in divided doses with food.
1. Allergy and Immunology (Paris). 2003 Jun; 35(6): 212-6.
2. European Respiratory Journal. 2002 Sep; 20(3): 596-600.
3. Journal of Nutrition. June 2002; 132: 1634S-1636S.

SEA CUCUMBER extract. Mucopolysaccharides and chondroitins from this starfish relative are similar to natural substances present in healthy joints. It appears that anti-inflammatory relief from pain in many arthritic conditions and joint problems might occur from this variation of CS. Other research indicates powerful anti-tumor effects (apoptosis) in hormone-related cancers of the prostate and breast.
1. Journal of Biological Chemistry. 1991 Jul 25; 266(21): 13530-6.
2. Prostate. 2003 Jun 1; 55(4): 281-91.
3. Biochemical and Biophysical Research Communications. 2002 Aug 30; 296(4): 942-8.


Lipids:

OMEGA-3 FATTY ACIDS (particularly fish oil). The essential fatty acids EPA and DHA are found pre-formed in fish oil. They lower blood cholesterol and triglycerides, normalize blood pressure, and have anti-inflammatory properties. Most American adults have low DHA and EPA. Evidence is overwhelming that the omega-3 fats are as potent as pharmaceuticals in relieving inflammation and joint pain. When consuming higher doses of fish oil (up to 6 grams of combined DHA/EPA a day equals 20 or more 1000 milligram capsules) to combat arthritis pain, it is crucial to increase vitamin E intake (400-800 I.U. per day). It is also important to eliminate trans-fatty acids, minimize saturated fat, and reduce omega-6 fatty acids (other than GLA from evening primrose, borage, or black currant oils).

The anti-inflammatory effects of DHA and EPA also produce relief in rheumatoid arthritis sufferers, especially when reducing omega-6 fatty acids (arachidonic acid in particular). The benefits have been confirmed through a variety of studies over the years, yet NSAIDs are still the preferred first treatment by most physicians. If moderate- to high-dose fish oil treatment was initiated at first diagnosis, the patient’s quality of life would be greatly improved over the long term.
[DHA is also available in a vegan form.]
1. American Journal of Clinical Nutrition. 2000 Jan; 71(1 Suppl): 349S-51S.
2. Lipids. 1999; 34 Suppl: S191-4.
3. Seminars in Arthritis and Rheumatism. 1997; 27: 85-97.
4. Advances in Experimental Medicine and Biology. 1997; 400B: 589-97.
5. Rheumatic Diseases Clinics of North America. 1991 May; 17(2): 391-402.
6. Arthritis and Rheumatology. 1995 Aug; 38(8): 1107-14.
7. British Journal of Rheumatology. 1993 Nov; 32(11): 982-9.


FLAX OIL is the best vegetarian source of essential omega-3 fatty acids. Alpha linolenic acid in flax is the primary omega-3 lipid that converts to DHA and EPA in the body (the conversion rate is only 15 to 25 percent, which is why fish oil is a better source for DHA and EPA). However, flax oil also contains omega-9 fatty acids, which are known to inhibit one of the pro-inflammatory leukotrienes implicated in joint deterioration. As with fish oil, one should increase the intake of vitamin E when using high dose flax oil treatments (2 to 4 tablespoons a day).
1. American Journal of Clinical Nutrition. 2000 Jan; 71(1 Suppl): 343S-8S.
2. American Journal of Clinical Nutrition. 2000 Jan; 71(1 Suppl): 349S-51S.
3. American Journal of Clinical Nutrition. 1996; 63: 116-22.


GLA-Gamma linoleic acid from borage oil, evening primrose oil, or black currant seed oil. Noted for its anti-inflammatory properties, it is also a thermogenic brown-fat stimulator for fat loss. Research indicates that GLA can increase levels of the anti-inflammatory prostaglandin PGE1. Studies with its use in treating rheumatoid arthritis have been very successful. A combination approach of using GLA with fish oils, taken in alternate doses throughout the day, might prove highly beneficial.
1. Journal of Investigative Medicine. 1999 May; 47(5): 246-50.
2. Prostaglandins, Leukotriones, and Essential Fatty Acids. 1998 Oct; 59(4): 273-7.
3. Journal of Nutrition. 1997 Sep; 127(9): 1765-71.
4. Annals of Internal Medicine. 1993 Nov 1;1 19(9): 867-73.
5. British Journal of Rheumatology. 1994 Sep; 33(9): 847-52.


Herbs:

CURCUMIN extract from turmeric is a powerful antioxidant (actually prevents formation of free radicals as well), anti-viral, anti-inflammatory, and anti-carcinogenic supplement. The primary action seems to be the ability of turmeric to inhibit the metabolism of arachidonic acid, a pro-inflammatory omega-6 lipid, when blood levels are too high (this is common in the typical American diet).
1. Lipids. 1997 Nov;32(11):1173-80.

CAPSAICIN is often used as a topical analgesic for those suffering from muscle pain or arthritis. Its effectiveness seems to be enhanced by the addition of glyceryl trinitrate. Capsaicin offers no known healing properties -- only a reduction in pain through the reduction of local neurotransmitters responsible for the pain signal. There may also be mild anti-inflammatory action.
1. European Journal of Pain. 2000; 4(4): 355-60.
2. Lipids. 1997 Nov; 32(11): 1173-80.
3. Drugs Aging. 1995 Oct; 7(4): 317-28.
4. Journal of Rheumatology. 1992 Apr; 19(4): 604-7.