Kris Clark, PhD, RD, sports nutrition director at Penn State University, says she very carefully uses select sports supplements with collegiate athletes: "I rely on the major nutrients in food, timing of meals and fluids to enhance athletic performance, and in general I discourage dietary supplements, other than the use of sport shakes, bars, and gels after practice or events for muscle cell recovery."
In addition to diet, exercise and other lifestyle factors can also play an important role in bone health. Smoking and drinking too much alcohol can increase your chances of developing osteoporosis, while weight-bearing exercise (such as walking, dancing, yoga, or lifting weights) can lower your risk. Strength or resistance training—using machines, free weights, elastic bands, or your own body weight—can be especially effective in helping to prevent loss of bone mass as you age.
Obviously, the best treatment plan for poor nutrition is to change your diet. Most Americans eat too little of what they need and too much of that they don't. For many women, decreasing fat and sugar consumption and increasing fruit, vegetables and grains in your diet can make a big difference. Many women also need to boost consumption of foods containing fiber, calcium and folic acid. Compare your diet to that suggested by the food pyramid and compare your nutrient intake to the suggested daily levels. Adjust accordingly, and you may be able to dramatically improve your health.
Protein should provide about 15% of a healthy person's daily calories. As a rule of thumb, people of both sexes and any size will do fine with about 60 grams of protein a day. Athletes who have large muscles and work out hard may need 20% more. But even that's not very much; 8 ounces of chicken or 6 ounces of canned tuna, for example, will fit the bill.
Those who want to use natural healing methods, such as the use of food and supplements of essential nutrients to prevent or reverse illness, should consult therapists who are qualified to give advice on how natural therapies can help. I recommend that anyone interested in supplements read the references for this article as well as the archives of the Journal of Orthomolecular Medicine http://orthomolecular.org/library/jom/ and the Orthomolecular Medicine News Service http://orthomolecular.org/resources/omns/index.shtml . Both are free access online.
Minerals are micronutrients and are essential for the proper functioning of the body. Cells in the body require minerals as part of their basic make-up and chemical balance, and minerals are present in all foods. Minerals can either be bulk minerals, used by the body in larger quantities, or trace minerals, used by the body in minute or trace amounts. Bulk minerals include sodium, potassium, calcium, magnesium, and phosphorus. Trace minerals include iron, zinc, selenium, iodine, chromium, copper, manganese, and others. Some studies have shown that the amount of minerals, particularly trace minerals, may be decreasing in foods due to mineral depletion of the soil caused by unsustainable farming practices and soil erosion. Supplemental minerals are available in chelated form, in which they are bonded to proteins in order to improve their absorption by the body.
Dairy. Women should get 3 cups of dairy each day, but most women get only half that amount.6 If you can’t drink milk, try to eat low-fat plain yogurt or low-fat cheese. Dairy products are among the best food sources of the mineral calcium, but some vegetables such as kale and broccoli also have calcium, as do some fortified foods such as fortified soymilk, fortified cereals, and many fruit juices. Most girls ages 9 to 18 and women older than 50 need more calcium for good bone health.
If the FDA receives reports of possible problems with a supplement, it will issue warnings about products that are clearly unsafe. The FDA may also take these supplements off the market. The Federal Trade Commission looks into reports of ads that might misrepresent what dietary supplements do. A few private groups, such as the U.S. Pharmacopeia, NSF International, ConsumerLab.com, and the Natural Products Association, have their own “seals of approval” for dietary supplements. To get such a seal, products must be made by following good manufacturing procedures, must contain what is listed on the label, and must not have harmful levels of ingredients that don’t belong there, like lead.
Good sources of iron include liver, kidneys, red meat, poultry, eggs, peas, legumes, dried fruits and dark, green leafy vegetables. Three ounces of cooked chicken liver contains 7.2 mg of iron; a cup of cooked spinach contains 6.4 mg. Your health care professional will probably recommend iron supplements during pregnancy (probably starting at 30 mg per day).
Salt, caffeine and alcohol intake may interfere with the balance of calcium in the body by affecting the absorption of calcium and increasing the amount lost in the urine. Moderate alcohol intake (one to two standard drinks per day) and moderate tea, coffee and caffeine-containing drinks (no more than six cups per day) are recommended. Avoid adding salt at the table and in cooking

Maintaining a healthy weight is important piece of the puzzle to achieve good health. A healthy weight can be determined using the body mass index charts (see web source below). If you find you are overweight or obese, weight loss may be beneficial for you. Before you begin any weight loss efforts, consult with your medical provider and/or consult a registered dietitian to create a weight loss plan. If you are underweight, consult a medical provider to assess your weight status.
Parents are advised to become familiar with the literature on essential nutrients, for instance by consulting the Orthomolecular News Service. Children should be given supplements in appropriate doses and in a suitable form. Pills should not be given before children can control the swallowing reflex. Multivitamin powder can be given dissolved in water or juice. Parents should not dose vitamin C so high that a child comes to school or kindergarten with loose bowels or diarrhea. In high doses, niacin may cause unpleasant side effects such as flushing and itching lasting up to several hours. [10] Although this is not dangerous, it may cause a child to feel unwell and anxious. Starting niacin supplementation with a low dose and gradually increasing it will allow the body to adapt and avoid the niacin flush. A multivitamin supplement containing moderate amounts of niacin is often adequate until a child is 8-10 years old. For younger children, the dosage should start with only a few tens of milligrams, and not increased to more than 50-100 mg/day. Adults may gradually get used to taking 1,000-1,500 mg/d divided into 3 doses per day.
In the United States, manufacturers of dietary supplements are required to demonstrate safety of their products before approval is granted for commerce.[83] Despite this caution, numerous adverse effects have been reported,[72] including muscle cramps, hair loss, joint pain, liver disease, and allergic reactions, with 29% of the adverse effects resulting in hospitalization, and 20% in serious injuries or illnesses.[72] By more than five-fold, the highest incidence of health problems derived from "combination products", whereas supplements for vitamins and minerals, lipid products, and herbal products were less likely to cause adverse effects.[72]
A person's caloric requirement depends on his body size and exercise level. Sedentary people of both genders will keep their weight stable by taking in about 13 calories per pound of body weight each day. Moderate physical activity boosts this requirement to 16 calories a pound, and vigorous exercise calls for about 18 calories a pound. On average, a moderately active 125-pound woman needs 2,000 calories a day; a 175-pound guy with a similar exercise pattern needs 2,800 calories. And like women, men will lose weight only if they burn more calories than they take in.
Some supplements may have side effects, especially if taken before surgery or with other medicines. Supplements can also cause problems if you have certain health conditions. And the effects of many supplements haven’t been tested in children, pregnant women and other groups. So talk with your health care provider if you’re thinking about taking dietary supplements.
Nutrition is particularly important when you are pregnant. Weight gain during pregnancy is normal—and it's not just because of the growing fetus; your body is storing fat for lactation. The National Academy of Sciences/Institute of Medicine (NAS/IOM) has determined that a gain of 25 to 35 pounds is desirable. However, underweight women should gain about 28 to 40 pounds, and overweight women should gain at least 15 pounds. The IOM has not given a recommendation for an upper limit for obese women, but some experts cap it as low as 13 pounds. If you fit into this category, discuss how much weight you should gain with your health care professional. Remember that pregnancy isn't the time to diet. Caloric restriction during pregnancy has been associated with reduced birth weight, which can be dangerous to the baby.
However, the Norwegian authorities do admit that vitamin D supplements are needed during part of the year. [1] Only part of the year? One third of Norway is within the Arctic Circle. Norway has far too little sunshine (especially during winter months) to get adequate levels of vitamin D from UVB radiation on the skin. The authorities also recommend that pregnant women take folic acid to prevent birth defects, and omega-3-fatty acids may be advisable for those who do not eat fish regularly. Norwegians have a long tradition of giving children cod liver oil, which in a daily tablespoon provides enough vitamin A and D and essential fatty acids to cover basic needs.

Other nutritional supplements include nutrient-dense food products. Examples of these are brewer's yeast, spirulina (sea algea), bee pollen and royal jelly, fish oil and essential fatty acid supplements, colostrum (a specialty dairy product), psyllium seed husks (a source of fiber), wheat germ, wheatgrass, and medicinal mushrooms such as the shiitake and reishi varieties.
A spokesperson for optimal nutritional intake is the well-known biochemist Bruce Ames, who proposed the "triage theory of nutrients," in which enzymes responsible for cell maintenance functions evolved to have lower affinity for the essential vitamin and mineral cofactors than the enzymes responsible for short-term survival, to preserve life during times of famine. [35]

Animal products, such as meat, fish and poultry are good and important sources of iron. Iron from plant sources are found in peas and beans, spinach and other green leafy vegetables, potatoes, and whole-grain and iron-fortified cereal products. The addition of even relatively small amounts of meat or foods containing vitamin C substantially increases the total amount of iron absorbed from the entire meal.


To make it easy to find reliable information, NIH has fact sheets on dietary supplements at ods.od.nih.gov/factsheets/list-all/. NIH also recently launched an online Dietary Supplement Label Database at www.dsld.nlm.nih.gov. This free database lets you look up the ingredients of thousands of dietary supplements. It includes information from the label on dosage, health claims and cautions.

In addition to diet, exercise and other lifestyle factors can also play an important role in bone health. Smoking and drinking too much alcohol can increase your chances of developing osteoporosis, while weight-bearing exercise (such as walking, dancing, yoga, or lifting weights) can lower your risk. Strength or resistance training—using machines, free weights, elastic bands, or your own body weight—can be especially effective in helping to prevent loss of bone mass as you age.
If you lose weight suddenly or for unknown reasons, talk to your health care professional immediately. Unexplained weight loss may indicate a serious health condition. And even if it doesn't, simply being underweight is linked to menstrual irregularity, menstrual cessation (and sometimes, as a result, dental problems, such as erosion of the enamel and osteoporosis) and a higher risk of early death.
Try not to think of certain foods as “off-limits.” When you ban certain foods, it’s natural to want those foods more, and then feel like a failure if you give in to temptation. Start by reducing portion sizes of unhealthy foods and not eating them as often. As you reduce your intake of unhealthy foods, you may find yourself craving them less or thinking of them as only occasional indulgences.
Trans fatty acids, also known as trans fats, are solid fats produced artificially by heating liquid vegetable oils in the presence of metal catalysts and hydrogen. They also pose a health risk, increasing LDL or "bad" cholesterol and increasing your risk of coronary heart disease. They are often found in cookies, crackers, icing and stick margarine, and in small amounts in meats and dairy products. Beginning in January 2006, all food manufacturers had to list the amount of trans fatty acids in foods, resulting in a significant reduction in the amount of these fats used in prepared foods. In its guidelines, the American Heart Association notes that trans fats increase risk of heart disease by raising "bad" LDL cholesterol and should be avoided as much as possible. In addition, research has shown that trans fats can also decrease "good" HDL cholesterol, increase inflammation, disrupt normal endothelial cell function and possibly interfere with the metabolism of other important fats—even more evidence that they are very bad for overall health.
Whether you're visiting the drug store, grocery or natural food shop you'll likely find an aisle where there are jars and bottles of things for you to put in your body that are neither foods nor medicines. Ranging from vitamins and minerals to fiber and herbal remedies, these supplements are not regulated in the same way as either food or medicine. Some of them are backed by solid research, others are folk remedies or proprietary cures. If your diet does not include enough of certain vitamins or minerals, a supplement may be a good idea. Natural treatment for conditions like constipation may be effective. But because these substances are unregulated, it is always a good idea to educate yourself about the products and to use common sense when taking them. This is even more true if you are pregnant or taking a medicine that may be affected by supplements.
The dietary supplements industry in the United Kingdom (UK), one of the 28 countries in the bloc, strongly opposed the Directive. In addition, a large number of consumers throughout Europe, including over one million in the UK, and various doctors and scientists, had signed petitions by 2005 against what are viewed by the petitioners as unjustified restrictions of consumer choice.[95] In 2004, along with two British trade associations, the Alliance for Natural Health (ANH) had a legal challenge to the Food Supplements Directive[96] referred to the European Court of Justice by the High Court in London.[97]
The U.S. Food and Drug Administration does not regulate herbs and other dietary supplements in the same way it does prescription and non-prescription drugs. Unlike pharmaceutical manufacturers, who must prove a drug's safety and effectiveness prior to putting it on the market, supplement manufacturers are not required to prove the safety and effectiveness of a supplement before it is made available to consumers. (The Dietary Supplement Health and Education Act has exempted supplement manufacturers from these regulations). 

Compared to pharmaceutical drugs, supplements of most essential nutrients are quite harmless. However, some supplements may have poor quality, or contain toxic metals such as lead or cadmium. Therefore, it is the duty of our authorities to ensure that potentially hazardous products or supplements of poor quality are not sold, and that consumers are offered fair prices in a free market. An example where the Norwegian authorities do not follow up such basic duties is that pharmacies demand more than 1,600 Norwegian Kroner (about $190) per kg of vitamin C in powder form, which would cost less than $20 with free competition and no restrictions in permitted doses or outlets.


The dietary supplements industry in the United Kingdom (UK), one of the 28 countries in the bloc, strongly opposed the Directive. In addition, a large number of consumers throughout Europe, including over one million in the UK, and various doctors and scientists, had signed petitions by 2005 against what are viewed by the petitioners as unjustified restrictions of consumer choice.[95] In 2004, along with two British trade associations, the Alliance for Natural Health (ANH) had a legal challenge to the Food Supplements Directive[96] referred to the European Court of Justice by the High Court in London.[97]
A 2013 study on herbal supplements found that many products were of low quality, one third did not contain the active ingredient(s) claimed, and one third contained unlisted substances.[77] In a genetic analysis of herbal supplements, 78% of samples contained animal DNA that was not identified as an ingredient on the product labels.[55] In some botanical products, undeclared ingredients were used to increase the bulk of the product and reduce its cost of manufacturing, while potentially violating certain religious and/or cultural limitations on consuming animal ingredients, such as cow, buffalo or deer.[55] In 2015, the New York Attorney General identified four major retailers with dietary supplement products that contained fraudulent and potentially dangerous ingredients, requiring the companies to remove the products from retail stores.[78]
Specialty products may offer particular health benefits or are targeted for specific conditions. These products may consist of whole foods or may be isolated compounds from natural or synthetic sources. Examples include antioxidants, probiotics (supplements containing friendly bacteria for the digestive tract), digestive enzymes, shark cartilage, or other animal products, or chemical extracts such as the hormone DHEA (dehydroepiandrosterone) and coenzyme Q10, an antioxidant.
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