While citrus fruits have long been known as a source of vitamin C, a new study suggests they may have an additional benefit – reducing the risk of stroke in women. The study, published in the American Heart Association’s Stroke journal, found that women with the highest concentration of citrus fruits in their diet had a 19% lower risk of ischemic stroke than those who are the lowest amounts. Study authors caution that more research needs to be done, but attribute citrus fruits’ reduction of stroke risk to flavanones, a subgroup of flavonoids that have anti-inflammatory benefits and may improve blood vessel health. Keep that in mind the next time life gives you lemons – or, for that matter, limes, oranges or grapefruits. In fact, type any of these fruits into the search field at cleaneating.com and choose form tons of recipes that incorporate nutrient-rich citrus!
Add a touch of warmth and sweetness to your black coffee with a dash of ground cinnamon. For maximum flavor, sprinkle cinnamon in the coffee mill with your whole beans and grind to thoroughly combine.
Essentially, vitamins and minerals are collective groups of nutrients that are necessary for the proper development, growth and functioning of the human body. Vitamins are organic substances are are required for the biochemical reactions in the body whereas minerals are inorganic substances the body needs to perform a variety of essential functions.
The human body is not normally able to synthesize vitamins in the amounts needed for optimal functioning. As a result, we must obtain those vitamins in adequate amounts by external means, either through the food we eat or by taking nutritional supplements. Vitamins are necessary for the body to utilize fats, proteins, minerals and carbohydrates, as well as to assist the body in functions such as fighting infection, keeping the mind alert, blood coagulation, and promoting good eyesight.
Although most medical experts will agree that the best way to obtain the vitamins our bodies need is through eating a balanced diet. However, the typical North American diet can often be lacking in vitamins and for that reason many people turn to supplements in order to bolster the levels of vitamins we take in.
The 13 known vitamins can be broken down into two categories: fat-soluble vitamins and water-soluble vitamins. Vitamins A, D, E and K fall into the category of fat-soluble vitamins or, put another way, vitamins that dissolve in fat but that do not dissolve in water. These vitamins are stored by the body, creating reserves that can tapped when the body needs them. Caution should be taken with ingesting fat-soluble vitamins, however. There is a fairly high risk of toxicity if taken in too-large amounts.
There are two kinds of Vitamin A. The first, retinol, is found in animal sources such as meat and dairy products. The second, beta-carotene, is a plant-based form of vitamin A. Good sources of beta-carotene include yellow and orange vegetables as well as green leafy vegetables. Those looking to boost their retinol should increase their intake milk, cheese, butter, liver, eggs and fish.
Vitamin D can, in fact, be synthesized in the body, with the help of ultraviolet light from sun exposure. Vitamin D helps th ebody to absorb calcium and phosphorus as well as assisting in the production of insulin and the fortification of the immune system against infection. Typically, good food sources of vitamin D are those that have been artificially fortified, such as bread and milk.
Part of a group of vitamins collectively known as antioxidants, vitamin E is charged with the task of protecting the body’s cells from damage caused by free radicals. By protecting the body against free radicals, vitamin E and the other antioxidants protect the body against a variety of diseases, including cataracts, heart disease and cancer. Vitamin E can be found in a variety of food sources, such as whole grains, green vegetables and vegetable oil.
Vitamin K is essential for the body’s ability to coagulate the blood as well as assisting in bone formation. Vitamin K is readily sourced from meat, dairy products and green leafy vegetables.
Water-soluble vitamins include vitamin C and the B-complex vitamins. As their collective name indicates, these vitamins dissolve easily in water and are only stored in small amounts in the body. Excess amounts of water-soluble vitamins are eliminated from the body via the urine. Although there is less of a risk of toxicity where water-soluble vitamins are concerned, it is also easier to develop a deficiency in these substances.
Probably one of the most well-known vitamins, vitamin C has a long history of being used as a remedy for the common cold. It works this this respect because of its ability to strengthen the immune system against infection. Vitamin C helps the body process carbohydrates and it also helps the body produce fats and proteins, it promotes healing and promotes the formation of connective tissues. Further, Vitamin C is instrumental in the production of various hormones and the release of certain kinds of brain chemicals. Vitamin C is easily obtained from a variety of food sources, including citrus fruits, melons, green vegetables, tomatoes, potatoes as well as meat, fish and dairy, although in smaller amounts. The concentration of vitamin C in raw vegetables is greater than that which can be found in cooked vegetables.
B complex vitamins help keep the body’s metabolism working as it should, in many cases with several of these vitamins working together. B vitamins are non-toxic as they are water soluble and, therefore, it is not common to have too much of these vitamins in the body. B vitamins serve several functions in the body, including keeping the nervous system healthy and helping the body to produce disease-fighting white blood cells. Vitamin B1 (also known as thiamin) removes excess lactic acid from the body, and folic acid helps in healthy fetal and infant development. Niacin (also known as vitamin B3) has been shown to be very helpful in controlling the levels of bad cholesterol in the blood.
There are many good food sources of B-complex vitamins. These include organ meats such as liver, poultry, fish, yeast, wheat germ, spinach, dairy and certain legumes include soybeans and peas.
The body requires higher concentrations of minerals than of vitamins. Of the seven minerals – calcium, phosphorous, magnesium, sodium, potassium, chloride and sulfur – the body needs at least 100 mg daily. Trace elements such as zinc and iodine are only required in small amounts but are still necessary for the healthy development and functioning of the body.
Iron plays an important role in carrying oxygen to the tissues in the body. Deficiency in iron can lead to a condition known as anemia and, for this reason, iron-fortified multivitamins are very popular, especially among women who are at a higher risk of anemia due to menstruation. Food sources of iron include red meat, liver, dark green vegetables and legumes.
Necessary for healthy bones and teeth, calcium is the most abundant mineral in the body. It also is necessary for blood clotting and the healthy release of neurotransmitters in the brain. Good sources include: green leafy vegetables, beans, nuts and dairy products.
Zinc is found in all of the body’s cells. It promotes healing and helps the body fight infection. Pregnant women should take care not to become deficient in zinc because that can lead to abnormal fetal development. Animal products are the best source of zinc.
Leave the USANA Home Office headed east toward the towering Wasatch Mountains and any one of three routes will put you at The Orthopedic Specialty Hospital (TOSH) in less than 20 minutes. There are 12 measly miles of road between the corporate headquarters and the medical campus—road that represents a connection deepened by, but not built upon, proximity.
Collaboration is the vocabulary word Tyler Barker, Ph.D., a physiologist and clinical researcher at TOSH, would use to describe the research relationship with his neighbors to the west. It’s a collaboration manifested in shared interest, workload, and desire to be better through a two-heads-are-better-than-one philosophy.
“USANA isn’t just supporting the research, they’re doing it,” Barker said. “It would not be possible without USANA. Sometimes I feel bad because I’m always bugging Brian.”
He’s talking about Brian Dixon, Ph.D., USANA’s director of product innovation, and one of the members of USANA’s Research and Development team Barker works with most closely. Dixon and Barker should be familiar with each other. Both logged time at the Linus Pauling Institute (LPI). They kept in touch after their time in Corvallis, Oregon, and have fostered the collaborative spirit both point to as a strength of the partnership, which officially started in 2009.
But Barker’s relationship with USANA actually goes back further. As part of a research partnership with LPI, USANA funded Barker’s dissertation.
“USANA has brought TOSH to a whole new level. TOSH is world renowned for its surgery and physical therapy, and the research, but I feel like the collaboration with USANA on research has taken that research to a whole new level.” — Tyler Barker, Ph.D., physiologist and clinical researcher at TOSH
A Recipe for the Perfect Collaboration
Although the research partnership between USANA and TOSH is fairly new, the collaborative nature of the relationship is already bearing fruit.
“USANA has brought TOSH to a whole new level,” Barker said. “TOSH is world renowned for its surgery and physical therapy, and the research, but I feel like the collaboration with USANA has taken that research to a whole new level.”
None of it would be possible without the unique expertise and resources Barker and TOSH bring to the table. And since TOSH is a world-class facility on the forefront of orthopedics, their contribution is by no means paltry. There’s the medical-campus setting with physicians, surgery, physical therapy, athletic training, and research under one roof. Then there’s the constant stream of patients that make up a large, varied population—everything from kids getting ready for their first football practice to osteoarthritis sufferers in need of a total knee replacement. Everything adds up to the perfect setting for human clinical research about nutrition and orthopedics, and the perfect partner for collaboration.
“Tyler and his team bring a specific skill set and expertise to a problem, and our team at USANA brings another skill set. It works well,” Dixon said. “You have a physiologist working with a molecular biologist, and Tyler can do things that we can’t do. We can do things that they can’t do. Those are the perfect collaborations.”
Like with anything, the research collaborations between USANA and TOSH start with a good idea. Conversations between Barker and USANA’s team produce ideas that could work for both parties. USANA and TOSH then work to turn those ideas into mutually beneficial research. That means designing a study, manufacturing the supplements, working on blinding and randomization—important steps to assure scientifically valid results—recruiting subjects, and collecting and analyzing the data. So the collaboration runs from conception to publication or presentation of the findings.
“I feel like it’s more on an academic level, as opposed to something marketing-driven,” Barker said of the relationship between the two groups.
Teamwork in Action
The relationship between USANA and TOSH materializes in the four human clinical studies currently underway—all of which explore the convergence of orthopedics and nutrition.
The first study examines whether low vitamin D status impairs recovery from muscle damage, and whether supplementing increases vitamin D levels and improves recovery. Data is only collected in the four winter months, but TOSH has finished subject recruitment and enrollment. Barker is ready to start data analysis, and he’s excited about what he’s seen so far. There have already been presentations at international scientific conferences, and the first manuscript from the study is in print now.
Barker was also able to leverage USANA’s resources to secure $40,000 in additional grant money for the study, getting even more research out of the company’s investment.
Knees are the focus of two other USANA-TOSH collaborations. One study builds on Barker’s dissertation, investigating the role vitamins E and C play in strength recovery following ACL injury and surgery, and whether multivitamin/multi-mineral supplements have an influence on strength recovery, as well. The ACL, or anterior cruciate ligament, is one of the four major ligaments of the knee. The study is approaching 50-percent subject recruitment, and Barker expects to do an interim analysis soon.
The other knee study explores whether multivitamin/multi-mineral supplements influence strength recovery, inflammation, and wound healing following a total knee replacement—a procedure that is increasing in frequency, especially in women. Barker said they are halfway to their goal of 30 subjects.
Data collection is continuing on both knee studies, but is just underway in the final USANA-TOSH collaboration—a vitamin D-osteoarthritis study. There are already 20 subjects, and five have finished their 12 weeks of supplementation—either a custom pack of vitamin D, fish oil, and joint-health supplements, or placebos. It’s a big study that involves several end points and outcome measures. But it’s important because, according to the Centers for Disease Control and Prevention, osteoarthritis affects an estimated 26.9 million adults in the United States, and is currently the leading cause of disability. This study is so important USANA has committed $250,000, plus the cost of supplements and other sample analysis.
There are other things Barker has going on as well, like a case study exploring vitamin D status in the first subject to enroll in the total knee study. “We’re funding four studies and we expect four conclusions to come out of it,” Dixon said. “But Tyler goes above and beyond. He is consistently reanalyzing the samples he and his team have already collected as new research comes out to verify findings or even make new ones. So we get a lot of bang for our buck.”
And the fact that these studies are happening in humans, in a medical setting, makes the research even more valuable.
“Subjects are coming here to get better—they have a bum knee or a bum hip or something—we want to make their lives better,” Barker said. “But at the same time, let’s do a little research to find out what’s going on and see if we can improve that.”
A Bright, Busy Future
When USANA evaluates which research to support, the phrase “cutting edge” is always part of the conversation. Working with researchers pushing the frontier of science is paramount, and the research with TOSH definitely fits USANA’s cutting-edge mantra. Crossover between orthopedics and nutritional science has been infrequent, but it’s quickly becoming an emerging area of interest—one where TOSH and USANA are already making advances.
“You can probably count all the studies that have examined vitamin D and inflammation in orthopedics on one hand,” Barker said.
Most of the research in orthopedics involves surgery, physical therapy, and biomechanics. There have been a few studies with vitamin C, iron, and folate, but most have been observational, not experimental, in nature. USANA and TOSH are trying to do both and, in the process, produce truly groundbreaking work.
And by no means is that work done. In fact, Barker and Dixon think the future looks bright. USANA funding has already allowed Barker to hire two research assistants to help shoulder the burden of running numerous clinical studies at the same time. Barker usually has about five studies on the backburner, too, and there are indications that some of those might be of interest to USANA.
“We’ve talked about a couple of possible studies, and there’s some additional funding that’s going to be coming TOSH’s way,” Dixon said. “Who knows where nutritional science and patient care is going to go in the future? But we’ll obviously be on that cutting edge.”
Barker would like to get to a point where USANA and TOSH are doing larger phase two and three clinical studies. The specifics aren’t clear, but what is—judging by the glowing way he talks about the collaboration he’s had with USANA—is Barker’s excitement about what the future holds for the partnership.
“USANA has quality supplements and quality people,” Barker said. “And then, with all the subjects and patients that walk through the doors here, basically, what we can do is endless. There are always questions and hypotheses.”
Next week, don’t miss the final Scientific Method story, which looks at research going on inside the USANA Home Office.
There was not even one death caused by an dietary supplement in either 2008 or 209, according to the most recent information collected by the U.S. National Poison Data System (NPDS). The annual report of the American Association of Poison Control Centers shows zero death from multiple vitamins; zero deaths from any of the B vitamins; zero deaths from vitamins A, C, D, or E; and zero deaths from any other vitamin. Sixty poison centers provide coast-to-coast data for the NPDS, which is then reviewed by twenty-nine medical and clinical toxicologists.
Over half of the U.S. population takes daily nutritional supplements. Even if each of those people took only a single tablet daily, that makes 154,000,000 individual doses per day, for a total of over 56 billion doses annually. Since many persons take more than just one vitamin or mineral tablet, actual consumption is considerably higher, and the safety of nutritional supplements is all the more remarkable.
If nutritional supplements are allegedly so “dangerous”, as the U.S. Food and Drug Administration and news media so often claim, then where are the bodies? Those who wonder if the media are biased against vitamins may consider this: how many television stations, newspapers, magazines, and medical journals have reported that no one dies from nutritional supplements? Consumers are not getting a fair picture of vitamin safety and efficacy from government-sponsored sources, particularly the National Institutes of Health. However, when they do have all the information, consumers see that vitamin supplements are far safer than drugs.
Vitamin supplementation is not the problem. It is under-nutrition and over-medication that are the problems. Vitamins are the solution.
“Vitamin-bashing” news media articles are typically based on studies with faulty design whose conclusions were preordained. One example is the meta-analysis, which is not new research but instead a review of existing research. It is not a clinical study, but rather a statistical look at a collection of studies. If you analyze enough failed studies, you will get a negative meta-analysis. If you exclude enough successful studies, you preordain the conclusion.
Low-dose vitamin studies are the ones that get negative results. Most vitamin research is low dose. You cannot test the effectiveness of high doses by giving low doses. Any time nutritional research employs inadequately low doses of vitamins – doses that hundreds of orthomolecular physicians have already reported as too small to work – vitamin therapy will be touted as “ineffective”. You can set up any study to fail. One way to ensure failure is to make a meaningless test, which is assured if you make the choice to use insufficient quantities of the substance to be investigated.
One reason commonly offered to justify conducting low-dose studies is that high doses of vitamins are somehow dangerous. They are not. There are those who may not believe this next statement, but it is not a matter of belief – it is a matter of fact: there is not even one death per year from vitamin supplements. However, there are at least 106,000 deaths from drugs each year in the U.S., even when taken as prescribed. This may be a low estimate.
It is ironic that critics of vitamins preferentially cite low-dose studies in an attempt to show lack of vitamin effectiveness, yet they cannot cite any double-blind, placebo-controlled studies of high doses that show vitamin dangers this is because vitamins are effective, and safe, at high doses. Health professionals and other interested persons are invited to personally search the literature for evidence of deaths caused by vitamin supplement s- you will not find any.
Decades ago, the mantra of the nutrition “experts” was “eat a balanced diet”. What foods were being balanced were inadequately described, but they were deemed sufficient. Extra vitamins were said to “just make expensive urine”. Vitamins can do so much more than preventing deficiency disease, which requires very low amounts. “Megadoses”, used properly, can accomplish wonders. We have defined a healthy diet, which forms a base for health, but factors such as availability and cost may prohibit achieving it. While working toward that ideal, we also must fill in the gaps with supplementation of vitamins and other nutrients. The further away one is from eating a good diet, the greater the need for supplementation, not to substitute for but to augment. Nutritional supplements are safe and effective for children.
Change your family’s dietary lifestyle and you dramatically improve your health. “That’s so simplistic!” rails our inner critic. We doubt natural therapy because it’s too simple to work and we doubt self-care because we doubt ourselves. We’ve been educated to be good consumers, and that includes becoming consumers of health-care services. We have not been educated to be self-reliant.
The good news is that therapeutic nutrition is cheap, simple, effective, and safe. Of course, we have been taught that anything cheap, simple, and safe cannot possibly be effective against “real” diseases. And when, by our own verified experiences, we find that megavitamin therapy is cheap and effective, we have pharmaphilic fear-mongerers trying to tell us that it can’t be safe.
Ultimately, we have to decide who we are going to listen to. Read the research for yourself and see for yourself. Everything changes the day you decide to no longer let your health-care providers treat you like a child. At first, it may not be easy to face down a domineering doctor or even to negotiate compromises with a family member. It is not easy to bring yourself to read the research, and it takes some gumption to try high-dose vitamin therapy for the first time. Until you see how well it works, that is. And then, with experience, it becomes easier. We do not need to fear illness – we need to learn what to do to avoid it and to fly out of it in one piece when it is suddenly upon us.
You cannot expect a small child to swallow a tablet or a chunk of a tablet. You can crush the tablet (or tablet fraction) and give the resulting powder in juice or mixed in a bit of food. Hot food is not an appropriate choice for heat-sensitive vitamins. Applesauce or other pureed fruit works well; pineapple or other sweet juice is fine, as well. Pick a food or drink that hides a vitamin taste nicely. Remember, you get to swallow these things whole. Vitamins are not put into tablets for nothing! I still remember the time my father first gave me a vitamin pill when I was a kid. I innocently asked him if it was chewable or not and his answer was, “Try it”. Crunch. Yuk.
Giving “doctored” portions early in the meal helps ensure children get down. Use as small an amount of juice or fruit as possible rather than “taint” an entire portion. The moment the dose is swallowed, immediately follow it with a favorite “chaser”: sweet juice or fruit will take away any aftertaste. We would go so far as to have two cups of juice on the table in front of the child: one contained an eighth cup or less of juice with the powder mixed in; the other cup was comfortably full of juice only. The moment the old-tasting juice disappeared, we had the yummy juice right at the kid’s lips. Speed is important here. Hit the taste buds with a nice flavor before they even get a chance to figure out the first one.
Chewable supplements are tasty and convenient. Once a child is old enough to handle chewable tablets, he or she will usually take them without complaint. Beware of artificial colors, flavors, and especially sweeteners. These potentially harmful chemicals are money savers for the manufacturer and do no good for your child. Try a health food store, and always read labels.
Here is one way to tell if a child is old enough to swallow a vitamin tablet: offer a small cash reward if the kid can do it. Since chewable tablets tend to be more expensive than regular tablets containing the same amounts of nutrients, you will still be money ahead if this works. Start first with a small capsule. Tell the child that it is okay if they can’t swallow this like a big boy or girl can. Pride and spending money seem to be an irresistible combination for kids. For the child of an age that should be able to handle a tablet or pill but says, “I can’t swallow that monster”, try this: have him or her put it under the tongue and not worry about it, when concentrate on swallowing a big gulp of water. The pill finds its way into the slipstream.
When in public places, keep supplements low-key. Likewise, when visiting relatives, there is no need to make a show or an issue over children’s vitamins. You can give your child their vitamins before you leave home or when you get back. Chewable supplements that look and taste like candy are convenient in more ways than one. Health food stores and pharmacies have a variety of popular vitamin products that do not even resemble “pills”. Technically, most schools require a letter from a doctor giving permission for a child to take supplements at school. If you can get such a letter from your doctor, it is handy to have. There is no reason for any kid to be singled out at school just because supplements have always been a part of their good diet. Most principals are sensitive to children’s feelings and will respond well to your friendly parent note or phone call.
Your children don’t like tablets? Many vitamins (notably vitamin C) are available in powdered form; some multiple vitamins are, too. If you cannot find powdered supplements, you can make your own: gelatin capsules may easily be pulled apart, and tablets can be crushed between two spoons or in a mortar and pestle. The result is utterly unflavored, so mix with juice or applesauce. Remember that the shelf life of liquid and powdered vitamins is much shorter than vitamins in capsules or tightly pressed tablets. We often put our vitamin C powder in small, easily closed bottles and work from them. Read expiration dates whenever you buy vitamins.
If too big to swallow, fat-soluble vitamins or fish oil that come in capsules should not be a problem. With a needle, poke a hole in each end and squeeze the contents into something tasty.
If a certain vitamin supplement does not agree with your child, you might want to simply try a different brand. Like ice cream, some products are artificially colored or flavored. Natural brands tend to be better in this regard. Always read the label, looking for what is not in the tablet as well as what is. It is worth remembering that many times a person is having a problem only with the tableting ingredients (excipients).
For brand suggestions, you might ask friends what ones they like and why. Health food stores are very willing to help you select an appropriate supplement. Health professionals may have an opinion as well. Remember to consider the source of your nutritional information. Let the buyer beware and do some research on the Internet. You need to know that you are doing, and why. You can also write directly to manufacturers for a full disclosure of all ingredients and excipients in every nutritional product the company sells.