Beauty Health for Life

The National Institutes of Health (NIH) National Center for Complimentary and Alternative Medicine (NCCAM) reviewed the safety and effectiveness of 6 dietary supplements commonly used by people with diabetes.

You can view their report here:
Research Report: Treating Type 2 Diabetes with Dietary Supplements

Its publication date is June 2005, so it may not lect the most recent findings for these supplements. Nonetheless, it provides a good overview of each supplement along with a summary of research findings.

The 6 supplements reviewed were:

Alpha-Lipoic Acid
Chromium
Coenzyme Q10
Garlic
Magnesium
Omega-3 Fatty Acids

The agencys recommendations, in short:

"The evidence that is available is not sufficiently strong to prove that any of the six supplements discussed in this report have benefits for type 2 diabetes or its complications."

"The six dietary supplements appear to be generally safe at low-to-moderate doses. However, each can interact with various prescription medications, affecting the action of the medications."

"Consult your health care provider before starting a supplement, especially if you are pregnant or nursing, or considering giving a supplement to a child."

Dietary supplements accounted for more than half the Class 1 drugs recalled by the U.S. Food and Drug Administration from 2004-12, meaning they contained substances that could cause serious health problems or even death, a new study from St. Michaels Hospital has found.

The majority of those recalled supplements were bodybuilding, weight loss or sexual enhancement products that contain unapproved medicinal ingredients, including steroids, said the studys lead author, Dr. Ziv Harel.

Almost one-quarter of the substances are manufactured outside of the United States, he said in the study published online in the journal JAMA Internal Medicine.

Unlike pharmaceutical products, dietary supplements do not require FDA approval before they can be sold. The FDA defines a dietary supplement as a product taken by mouth that contains a "dietary ingredient" such as vitamins, minerals, herbs, other botanicals, amino acids or substances such as metabolites. There are about 65,000 dietary supplements on the market consumed by more than 150 million Americans.

Of the 465 drugs subject to a Class 1 recall in the U.S. between Jan. 1, 2004, and Dec. 19, 2012, 237 or 51 per cent were dietary supplements. The majority of recalls occurred after 2008 for reasons unknown, the researchers said.

Supplements marketed as sexual enhancement products were the most commonly recalled dietary supplements (95, or 40 per cent).

Dr. Harel, a nephrologist whose research focus is patient safety, said that when the FDA learns of an adulterated dietary supplement, it is required to contact the manufacturer to trace the source of the product and initiate a recall. However, a recent investigation by the Office of the Inspector general determined that the FDA does not possess accurate contact information for 20 per cent of supplement manufacturers.

The FDA has recently introduced a number of initiatives aimed at mitigating the impact of the most common adulterated supplements, including the creation of multinational enforcement groups and widespread media campaigns focusing on improving awareness.

"Despite these initiatives, products subject to Class I recalls continue to be readily available for sale, which may be due to an increasingly complex distribution network associated with these products, as well as ineffective communication by the FDA to consumers," Dr. Harel said.

"We also found a number of recalled products to be manufactured outside of the U.S. where manufacturing practices may not be subject to the same oversight and regulation required of domestic companies."

Dr. Harel said increased efforts are needed to regulate this industry. "Keeping the status quo may taint the dietary supplement industry as a whole."

Low levels of vitamin D have been implicated as a potential cause of diseases ranging from cancer to diabetes. Now an extensive review suggests its really the other way around: Low levels of the "sunshine vitamin" are more likely a consequence -- not a cause -- of illness.

In their review of almost 500 studies, the researchers found conflicting results. Observational studies, which looked back at what people ate or the kinds of supplements they took, showed a link between higher vitamin D levels in the body and better health.

But, in studies where vitamin D was given as an intervention (treatment) to help prevent a particular ailment, it had no effect. The one exception was a decreased death risk in older adults, particularly older women, who were given vitamin D supplements.

"The discrepancy between observational and intervention studies suggests that low [vitamin D] is a marker of ill health," wrote review authors led by Philippe Autier, at the International Prevention Research Institute, in Lyon, France.

Vitamin D is known to play a key role in bone health. Low levels of vitamin D have been found in a number of conditions, including heart disease, autoimmune diseases, diabetes, cancer and Parkinsons disease. These findings may explain why so many Americans are currently taking vitamin D supplements.

Its nicknamed the sunshine vitamin because the body produces vitamin D when exposed to the sun (if someone isnt wearing sunscreen). Its also found in some foods, such as egg yolks and fatty fish, and in foods that have been fortified with vitamin D, such as milk.

The current review, published online Dec. 6 in The Lancet Diabetes & Endocrinology, looked at 290 observational studies. In these studies, blood samples to measure vitamin D levels were taken many years before the outcome of the study occurred. The review also included results of 172 randomized clinical trials of vitamin D. In randomized trials, some people receive a therapy while others do not.

The observational studies showed a potential benefit from vitamin D. For example, vitamin D was associated with a 58 percent reduced risk of cardiovascular events, a 38 percent decreased risk of diabetes and a 34 percent decreased risk of colon cancer in these studies.

But, when the researchers looked to the randomized clinical trials that used vitamin D as a treatment, they failed to find any effect on disease occurrence or severity from raising vitamin D levels.

However, vitamin D did reduce the risk of dying from any cause in older people taking 800 international units a day, according to the review.

Dr. Shaun Jayakar, an internal medicine and geriatric specialist from St. John Hospital and Medical Center in Detroit, said the findings in elderly people "are likely due to a reduction in falls and fractures. Supplementing with vitamin D would lead to stronger bones, which would reduce falls and factures."

Because the majority of interventional trials failed to find any benefit from vitamin D, the reviews authors conclude that low vitamin D levels dont lead to ill health, rather theyre caused by ill health.

They theorize that inflammation that occurs in many illnesses may be what depletes vitamin D levels.

Dr. Robert Graham, an internist from Lenox Hill Hospital in New York City, said, "This comprehensive review did a really good job at trying to tease out the effects of different study designs, and the findings will be controversial."

He said there are currently five, large ongoing interventional trials that will help to better define vitamin Ds role in disease. However, the results of those studies wont be available for a number of years. Until then, he recommended, "Try to achieve homeostasis [equilibrium]. You dont want to get to a low level of vitamin D."

The Institute of Medicine recommends 600 international units of vitamin D for adults, and 800 international units for people over 70.

Both Graham and Jayakar agreed that those are reasonable supplement levels. Jayakar said that for most people, vitamin D supplements are harmless, but added that "its a pocketbook issue. Almost 50 percent of the population is taking vitamin D supplements. Thats a lot of money for something that likely has no benefit," he said.

Jayakar added that this reviews findings suggest that low vitamin D levels could be used as a marker -- a sign -- of disease in younger people. "If someone isnt feeling well and they have low vitamin D, maybe we should use that to start searching to see if something else is going wrong," he said.

Consuming omega-3 fish oils can help to prevent skin cancer, according to the first clinical trial exploring the influence of fish oils on the skin immunity of humans.

The study was conducted by a team of researchers from the University of Manchester and funded by the Association for International Cancer Research, and examined the effect of taking omega-3 on 79 healthy participants.

Findings of the study, published in The American Journal of Clinical Nutrition, revealed that consuming regular doses of fish oils increases immunity to sunlight.

It directly decreases sunlight-induced immunity suppression - called immunosuppression - which affects the bodys power to combat skin cancer and infection.

Professor Lesley Rhodes, Professor of Experimental Dermatology from the Photobiology Unit Dermatology Centre at the Universitys School of Medicine and Salford Royal NHS Foundation Trust, said their study was the first of its kind conducted using humans:

"There has been research in this area carried out on mice in the past but this is the first time that there has been a clinical trial directly in people. It has taken a number of years to get to this stage and the findings are very exciting. This study adds to the evidence that omega-3 is a potential nutrient to protect against skin cancer. Although the changes we found when someone took the oil were small, they suggest that a continuous low level of chemoprevention from taking omega-3 could reduce the risk of skin cancer over an individuals lifetime."

The volunteers consumed a 4g dose of omega-3 - approximately one and a half portions of oily fish each day. Then they were exposed to either 8, 15, or 30 minutes of summer midday sun in Manchester using a specific light machine.

A number of other participants took a placebo before being exposed to the sunlight machine.

Immunosuppression was shown to be 50 percent lower in the subjects that took the omega-3 and were exposed to 8 and 15 minutes of sunshine compared with the volunteers who did not take the supplement. Little to no impact on those in the 30 minute group was shown.

The conclusions from this study are significant in the battle against skin cancer, because earlier studies have always shown that sunscreens are frequently applied incorrectly and only worn on vacation.

However, Professor Rhodes points out omega-3 is not a substitute for suntan lotion or physical protection, and that it should be seen as additional protection factor to help keep the skin from burning.

Historically, fish oil has already been associated with health benefits like protecting against cardiovascular disease, helping prevent age-related vision loss, and even slowing the growth of prostate cancer cells.

Fish oil supplements may protect the heart in stressful situations, according to a recent study. Jason Carter, a researcher at Michigan Technological University, conducted the study with 67 healthy volunteer test participants in their 20s. Over a 2-month period, they were either given nine grams of fish oil pills or nine grams of olive oil as a placebo.

The test subjects were screened for heart rate, blood pressure and other related metrics. At the end of the test period, both groups took a mental arithmetic test that involved adding and subtracting numbers in their head. Their stress response was measured at that time.

“Those in the fish oil group showed blunted heart rate reactivity while they were stressed compared to those who took olive oil," said Carter. "Similarly, the total [muscle sympathetic nerve activity] reactivity to mental stress was also blunted in the fish oil group.” There was not much difference between the two groups at rest, however.
Results of the study were published in the May edition of the American Journal of Physiology – Regulatory, Integrative, and Comparative Physiology, published by the American Physiological Society. It is available online at http://bit.ly/10j0CSS

Vitamin D supplement potency varies widely, and the amount of vitamin D in over-the-counter and compounded supplements does not necessarily match the amount listed on the label, according to a research letter published in the journal JAMA Internal Medicine.

The analysis showed that the amount of vitamin D in these supplements ranged from 9 percent to 146 percent of the amount listed on the label. Not only was there variation among different brands and manufacturers, but also among different pills from the same bottle.

"We were surprised by the variation in potency among these vitamin D pills," says Erin S. LeBlanc, MD, MPH, lead author and investigator with the Kaiser Permanente Center for Health Research in Portland, Ore. "The biggest worry is for someone who has low levels of vitamin D in their blood. If they are consistently taking a supplement with little vitamin D in it, they could face health risks."

According to a recent editorial in the New England Journal of Medicine, more than 100 million Americans spend a combined $28 billion on vitamins, herbs and supplements each year. The U.S. Food and Drug Administration is considering new safety guidelines for some supplements but, for the most part, the industry remains unregulated.

Some manufacturers participate in a voluntary quality verification program operated by the U.S. Pharmacopeial Convention -- an independent, nonprofit organization that sets public standards for the quality of dietary supplements. In order to receive the USP verification mark, manufacturers facilities undergo annual good manufacturing-practice audits, and their products are tested for quality, potency and purity. Dr. LeBlanc and her colleagues included one supplement from a USP Verified manufacturer in their sample. They found the amount of vitamin D in pills from that bottle was generally more accurate than the other bottles tested.

"The USP verification mark may give consumers some reassurance that the amount of vitamin D in those pills is close to the amount listed on the label," said Dr. LeBlanc. "There are not many manufacturers that have the USP mark, but it may be worth the extra effort to look for it."

Vitamin D-deficient older individuals are more likely to struggle with everyday tasks such as dressing or climbing stairs, according to a recent study accepted for publication in The Endocrine Societys Journal of Clinical Endocrinology & Metabolism (JCEM).

Scientists estimate many as 90 percent of older individuals are vitamin D deficient. The vitamin – typically absorbed from sunlight or on a supplementary basis through diet – plays a key role in bone and muscle health. Vitamin D deficiency can lead to a decline in bone density, muscle weakness, osteoporosis or broken bones.

"Seniors who have low levels of vitamin D are more likely to have mobility limitations and to see their physical functioning decline over time," said the studys lead author, Evelien Sohl, MSc, of VU University Medical Center in Amsterdam, the Netherlands. "Older individuals with these limitations are more likely to be admitted to nursing homes and face a higher risk of mortality."

Using data from an ongoing Dutch cohort study (The Longitudinal Aging Study Amsterdam), the researchers examined among two groups – 762 people between the ages of 65 and 88, and 597 people between the ages of 55 and 65 – over the course of six years. Using blood test results, the subjects were split into groups with the highest, moderate and lowest vitamin D levels. To assess mobility limitations, participants were asked about their ability to perform routine tasks, including sitting down and standing up from a chair or walking outside for 5 minutes without resting.

Among the older group of participants, people with the lowest vitamin D levels were 1.7 times more likely to have at least one functional limitation compared to those with the highest vitamin D levels. In the younger cohort, individuals with low vitamin D levels were twice as likely to have at least one physical limitation.

While the majority of the people in the older cohorts top two vitamin D groups did not report any physical limitations, 70 percent of the people with the lowest vitamin D levels had at least one limitation.

In addition, the study found vitamin D-deficient individuals were more likely to develop additional limitations over time. The older cohort reported more mobility issues after three years, while the younger cohort developed additional limitations over the course of six years.

"The findings indicate low vitamin D levels in older individuals may contribute to the declining ability to perform daily activities and live independently," Sohl said. "Vitamin D supplementation could provide a way to prevent physical decline, but the idea needs to be explored further with additional studies."

(Women of course should keep on consuming fish or fish oil supplements. In addition to all the benefits listed below:

Regular use of fish oil supplements, which contain high levels of the omega-3 fatty acids, EPA and DHA, was linked with a 32 percent reduced risk of breast cancer.

In the first population-based study in women of childbearing age, those who rarely or never ate fish had 50 percent more cardiovascular problems over eight years than those who ate fish regularly. Compared to women who ate fish high in omega-3 weekly, the risk was 90 percent higher for those who rarely or never ate fish.)

The report about the Omega-3 very strong connection to prostate cancer is very disturbing, although personally, that risk is in the past. Nevertheless, for almost all males, a risk-reward calculation should be made of the risk vs.the benefits of Omega-3 consumption. Because, while the risks are great, so are the rewards.

Heres what I wrote in 2008:

Jons Health Tips: Eating Fish

I eat a lot of fish – mostly salmon, but lots of other fish as well. However, I avoid swordfish and tuna, especially tuna steaks and albacore because of high levels of mercury, and tilapia because of high levels of omega-6. I eat fish because its healthy and I like it, and when I’m eating fish I’m not eating meat. I supplement my fish consumption with fish oil or flaxseed oil on days that I do eat meat.

My daughter, who is a pediatrician and vegetarian, also uses flaxseed oil and gives her 3 children fish oil supplements.

Here’s why: (see link above for details on each of these)

Fish reduces asthma and allergies

Eating fish may explain very low levels of heart disease in Japan

Eating Fish May Prevent Memory Loss and Stroke

A diet rich in fish and omega-3 oils, may lower your risk of dementia and Alzheimer’s disease, according to a study published in the November 13, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology. People who ate fish at least once a week had a 35-percent lower risk of Alzheimer’s disease and 40-percent lower risk of dementia.

Oily fish can protect against rheumatoid arthritis

Eating fish and foods with omega-3 fatty acids linked to lower risk of age-related eye disease

The evidence of health benefits has grown even stronger since then. Here is a small sampling:


1. There is mounting evidence that omega-3 fatty acids from fish or fish oil supplements not only help prevent cardiovascular diseases in healthy individuals, but also reduce the incidence of cardiac events and mortality in patients with existing heart disease. A new study, published in the August 11, 2009, issue of the Journal of the American College of Cardiology, extensively reviews data from a broad range of studies in tens of thousands of patients and sets forth suggested daily targets for omega-3 consumption.

2. Omega-3 Fatty Acids=Reduced Risk of Colon Cancer

3. Omega-3 fatty acid kills neuroblastoma cancer cells

4. New research has shown for the first time that omega-3 in fish oil could "substantially and significantly" reduce the signs and symptoms of osteoarthritis.

5. Eating at least two servings of oily fish a week is moderately but significantly associated with a reduced risk of stroke, finds a study published on bmj.com today. But taking fish oil supplements doesnt seem to have the same effect, say the researchers.

And most important:

6. Older adults who have higher levels of blood omega-3 levels—fatty acids found almost exclusively in fatty fish and seafood—may be able to lower their overall mortality risk by as much as 27% and their mortality risk from heart disease by about 35%, according to a new study from Harvard School of Public Health (HSPH) and the University of Washington. Researchers found that older adults who had the highest blood levels of the fatty acids found in fish lived, on average, 2.2 years longer than those with lower levels.

Calcium-rich diet and supplements provide similar benefits

Taking a calcium supplement of up to 1,000 mg per day can help women live longer, according to a study whose lead author was Lisa Langsetmo, a Ph.D. Research Associate at McGill University, and whose senior author was Prof. David Goltzman, Division of Endocrinology and Metabolism in the Department of Medicine of the Faculty of Medicine and researcher in the Musculoskeletal Disorders axis at the Research Institute of the McGill University Health Centre (RI-MUHC).Their findings are published in the Journal of Clinical Endocrinology & Metabolism (JCEM).

Calcium, an essential nutrient for bone health, is commonly found in dairy products as well as vitamins. Although calcium is an essential nutrient for bone health, past studies have linked calcium supplements to heart disease risk. The researchers, located at universities across the country, analyzed data from the large-scale Canadian Multicentre Osteoporosis Study (CaMos) seeking to determine whether calcium and vitamin D intake were associated with overall increased risk of death.

"We found that daily use of calcium supplements in women was associated with a lower risk of death, irrespective of cause," said the studys lead author, Prof. Goltzman, Director, Calcium Research Laboratory at McGill. "The benefit was seen for women who took doses of up to 1,000 mg per day, regardless of whether the supplement contained vitamin D."

The longitudinal study of participants living in or near 9 cities across Canada monitored the health of 9,033 Canadians between 1995 and 2007. During that period, 1,160 participants died. Although the data showed women who took calcium supplements had a lower mortality risk, there was no statistical benefit for men. The study found no conclusive evidence that vitamin D had an impact on mortality.

"Higher amounts of calcium were potentially linked to longer lifespans in women, regardless of the source of the calcium," says Goltzman. "In other words, the same benefits were seen when the calcium came from dairy foods, non-dairy foods or supplements."