Dietary Supplements including botanicals

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Amber Burgess, Registered Dietitian
Wilson County Health Department
Dietary Supplements
 FDA Definition
 A dietary supplement is a product taken by mouth that contains a
"dietary ingredient" intended to supplement the diet. The "dietary
ingredients" in these products may include: vitamins, minerals, herbs
or other botanicals, amino acids, and substances such as enzymes,
organ tissues, glandulars, and metabolites. Dietary supplements can
also be extracts or concentrates, and may be found in many forms such
as tablets, capsules, softgels, gelcaps, liquids, or powders. They can also
be in other forms, such as a bar, but if they are, information on their
label must not represent the product as a conventional food or a sole
item of a meal or diet. Whatever their form may be, DSHEA places
dietary supplements in a special category under the general umbrella of
"foods," not drugs, and requires that every supplement be labeled a
dietary supplement.
 Definition of a Nutraceutical:"Food, or parts of food, that provide medical or health
benefits, including the prevention and treatment of disease."
(Dr. Stephen DeFelice, Foundation for Innovation in Medicine)
 Nutraceutical Categories:
 Dietary Supplements including botanicals:
 Vitamins, minerals, co-enzyme Q, carnitine
 Gingsing, Gingko Biloba, Saint John's Wort, Saw Palmetto
 Functional Foods:
 Oats, bran, psyllium and lignin's for heart disease and colon cancer
 Prebiotics - oligofructose for control of intestinal flora
 Omega-3 milk in prevention of heart disease
 Canola oil with lowered triglycerides for cholesterol reduction
 Stanols (Benecol) in reduction of cholesterol adsorption
 Medicinal Foods:
 Transgenic cows and lactoferrin for immune enhancement
 Transgenic plants for oral vaccination against infectious diseases
 Health bars with added medications
Dietary Supplements
 Problems that can occur with supplements
• Interactions with other medications
• Overdoses/Toxicity
• Your current state of health (treatments for cancer and
other health issues)
• Can exacerbate some conditions
• Again interfere with other medications for treatment
Drug Interactions
• Herbal and nutritional supplements may interact
unfavorably with prescription drugs.
• Nutritional supplements recommended for nervous system and
brain function such as 5-HTP or St. John's Wort, should not be
recommended for those taking prescription antidepressants.
• “Vitamin C should not be taken with aspirin, as it can irritate the
stomach and limit absorption. Minerals should be taken in
proper proportions to prevent unfavorable interactions; large
amounts of zinc may deplete the body of the mineral copper,
while too much calcium adversely affects the magnesium levels
in the body. Balanced mineral supplements are recommended to
alleviate these interactions.”
 More is better?
• Not necessarily…some supplements contain several
times over the maximum absorbable dose per pill.
• Wastes money – What your body doesn’t absorb gets
excreted in the urine.
• Can build up toxicity – mostly with fat soluble
 Calcium Supplementation
• Most provide anywhere from 500-1500mg per tablet
• Human body can only absorb about 500mg of calcium
at a time
• Type of calcium makes a difference also
• Calcium citrate vs. Calcium carbonate
• For adults, the recommended dietary reference intake for
Vitamin C is 65 to 90 milligrams (mg) a day, and the upper
limit is 2,000 mg a day.
• Megadoses of Vitamin C supplements may cause:
• Diarrhea
• Nausea
• Vomiting
• Heartburn
• Abdominal bloating and cramps
• Headache
• Insomnia
• Kidney stones
Diabetes and Supplements
 There are supplements that have been researched as
complimentary therapy to the standard drug
treatments for diabetes.
 Some of those supplements include:
 Vitamin D & Calcium
 Garlic
 Coenzyme Q10
 Chromium
 Omega 3 fatty acids
 Magnesium
Dietary Supplements
 Don't substitute dietary supplements for any
 If you’re considering using a dietary supplement in
place of drugs, consult your health care provider first.
And remember, just because it is “natural” doesn’t
mean it’s gentler or more beneficial to your body.
 Many supplements contain active ingredients that
have strong biological effects and their safety is not
assured. (See article from cancer society.)
Dietary Supplements
• There are many different supplementary products
Focus on key health issues and why it may be
beneficial to take supplements
Research the supplements you are interested in taking
Weigh the pros and cons
Discuss with your Medical Doctor before taking
any supplements!
Nutritional Supplements/Meal
• Non Diabetic
• Boost
• Ensure
• Carnation Instant Breakfast
• Store Brands
• “Diabetic Friendly”
• Glucerna
• Boost Glucose Control
Diabetic Friendly Meal
• Meal Bars
• Snack Bars
• Meal Replacement Shakes
• Snack Shakes
Diabetic Friendly Meal
• Uses of Diabetic Meal Replacements:
• To provide a source of calories and nutrition during
times where you would tend to skip meals for various
• These products provide better glucose control over the
regular versions and prevent sharp spikes in blood sugar.

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