The Fundamental Pillars of a Nutritional Supplement Program

Linda J. Dobberstein, Chiropractor, Board Certified in Clinical Nutrition

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The Fundamental Pillars of a Nutritional Supplement Program
What do I take and where do I start with nutritional supplements? This is a common question for those choosing to add nutritional supplements to their health care regime. Today’s world offers a myriad of choices. It can be easily overwhelming. Knowing some very basic things can help you make good choices.

The nay-sayers against clinical nutritional speak out against the need for such support. Common sense and observation demonstrates that America is a country struggling with empty calorie abundance and malnutrition in children and adults. Researchers call this “high calorie malnutrition or energy dense, nutrient poor malnutrition”. Busy and modern lifestyles and/or affordability of quality foods, has led to high calorie intake, but the foods chosen lack the density of nutrients.

Dietary habits are slowly changing with smaller meals and healthier choices, but the general public has a long way to go to make up for the decades of dietary challenges and abuse. High calorie malnutrition diets certainly require changes in purchasing and preparing foods. When diets do not provide optimal nutritional status and coexist with numerous, ongoing stressors, gene defects like methylation defects, mitochondrial injury, chronic diseases, intestinal imbalances, and medications that strip the body of nutrients, then nutritional supplementation can be highly valuable and essential.

Diet Diary Challenge


To give you a track record of your daily food pattern, complete a diet diary for three to seven days. Write down everything that you eat, the time, and general quantity for each day. Keep a log of all the foods, beverages, snacks, treats that you consume for that time. Be truthful about it. Don’t wait for a “perfect time” to do this. There will always be dietary challenges, schedule changes, and indiscretions. The diet diary is a chance for you to be accountable to yourself and to truly see what you are doing. If you need help with interpretation, work with a practitioner who is skilled with this aspect. Perhaps share it with your spouse or best friend and use it to keep each other accountable.

Count the number of vegetables and fruits. Is it truly an optimal amount? Do the fruits and vegetables that you consume represent all of the colors of the rainbow on a daily basis? Or are you stuck in the rut of fruit cups or roll-ups, and a slice of lettuce and onion on the sandwich or burger? Are there a wide variety of foods or do you eat the same 10-20 foods each week? Is the diet high in carbs? Or is it a high protein or high fat diet? Is it a 40-30-30 diet (carb-protein-fat)? Are meals mostly prepackaged, restaurant made, or from a food truck? Is the salad lunch leaving you hungry and struggling mid-afternoon? Are you eating on the run and inhaling your food or skipping meals? All of these factors affect your nutritional intake and ultimately can influence your nutritional status.

The Five Pillars


The cornerstone of a good solid supplement program focuses on five basic, but major categories of nutrients: (1) a high quality multiple vitamin formula, (2) a multiple mineral formula, (3) fish oil, (4) vitamin D, and (5) probiotics. There are numerous other nutrients that can be added and the need depends on your particular concerns. A broader foundation of nutritional support may also include a broad spectrum antioxidant if your diet does not include 5-9 servings of brightly colored vegetables and fruits per day. It may also include nutritional support for the liver and detoxification. Don’t forget about sunshine exposure and exercise that help the assimilation of nutrients and help support gene signals.

1. High Quality Multiple Vitamin


A high quality multiple vitamin should be from natural sources, not synthetic or petroleum derived. Knowing what to look for in quality can help you from wasting your hard earned dollars on a low quality product that may even put more stress on your body. If you have a high fat, high calorie, nutrient poor diet or high calorie malnutrition, this alone puts very high stress on the body with metabolism. Researchers found that in animal studies, simply implementing a multiple vitamin/mineral complex decreased abdominal fat, reduced inflammation, improved triglycerides, and supported bone health.

The Journal of the American Dietetic Association evaluated 4,384 adults 51 years of age and older. They compared their nutritional status to those who took a multiple vitamin formula and those who did not. Less than 50 percent of all test subjects met the Estimated Average Requirement (EAR) for folate, vitamin E, and magnesium from food alone. In addition, those who did not take any multiple vitamin supplements had insufficient vitamins A, B6, C, folate, zinc, and magnesium to meet EAR.

Your multiple vitamin should provide you with all of the B vitamins ideally in the coenzyme or active form. For example, a quick way to tell if your multiple has coenzyme forms is to look at vitamin B12. Methylcobalamin, adenosylcobalamin or hydroxycobalamin are excellent forms of vitamin B12. Cyanocobalamin brings trouble especially if you have methylation defects, detoxification problems, fatigue, or other health concerns. A methylation defect is a genetic polymorphism that affects approximately 40-60 percent of the population.

Methylation is an extraordinary process in the body happening more than a billion times per second. It is directly involved with DNA and neurotransmitter synthesis, detoxification, keeping the insulation around nerves intact, and more. Methylation problems have been linked with over 800 disorders ranging from depression, anxiety, thyroid problems, cancer, developmental disorders, Alzheimer’s disease, fibromyalgia, reproductive problems, multiple sclerosis, and hundreds more. If you have the genetic polymorphisms, your need for higher daily intake of folate, vitamin B6, B12, choline, and sulfur rich foods is generally higher than average. A diet high in processed foods, vegetarian diets, malabsorption, stress, etc. all change this equation and do not support these defects to the extent that is needed. In the rapid paced world we face and the preponderance of methylation risk, for this reason alone a quality multiple vitamin is essential.

2. Multiple Mineral


Quality mineral supplementation is just as important as a multiple vitamin in today’s challenged world. We saw in the American Dietetic Association article listed above, that magnesium was deficient in nearly all of the survey participants even in those who supplemented. The National Institutes of Health recognizes the lack of adequate magnesium in the diet and leaves no doubt that this is a major issue for the majority of the population.

Magnesium works with the B vitamins, specifically thiamin as a team player. If B vitamins are deficient, magnesium and other minerals will fail to provide their best functionality in the body. Magnesium is vital for the prevention of osteoporosis, heart disease, blood pressure, brain health, stress tolerance, inflammation management, insulin resistance, PMS, migraine headaches, restless leg syndrome, etc. with several hundred enzyme systems affected. Every organ in the body needs magnesium, especially the heart, muscles, and kidneys. In addition to poor diet, stress, sweating, malabsorption, there are numerous medications (blood pressure, diuretics, laxatives, methotrexate, antibiotics) that block or rob the body of magnesium. It is estimated that four out of five adults fail to meet the daily RDA (400-420 mg/day for men, 310-320 mg/day for women) of magnesium.

A study in the Journal of Nutrition noted that individuals 60 years of age and older who participated in the National Health and Nutrition Examination Survey found inadequate mineral intakes in adults. In this study, men had 70-75 percent insufficient intake when measuring calcium intake, women had 87 percent insufficient intake relative to the basic RDA. For zinc measurements, it was found that men had 35-41 percent inadequate intake and women had 36-45 percent inadequate intake for the basic RDA. Without zinc, hearing impairments, immune system aging, poor digestion, increased inflammation, impaired methylation, macular degeneration, poor wound healing, thyroid and adrenal stress, prostate health, and blood sugar function are impaired. Athletic activities, saunas or other activities that promote sweating, alcoholism, vegetarian diets and digestive disorders increase the need for zinc.

3. Fish Oil


Fish oil provides the essential fatty acids EPA and DHA. The omega-3 oils are essential in that they must be supplied on a regular basis, i.e. they are essential or mandatory to get in the diet. Today’s Standard American Diet is woefully lacking in omega-3 oils with far too much omega-6 oils that promote inflammation and upset the balance of omega-6 to omega-3. Prior to modern agriculture, wild game and domesticated animals used for meat grazed on grasses or alfalfa. These plants contained plant-based omega-3 oils which would become part of that animal’s cellular structure. If humans did not have access to fish, the omega-3 oil needs would be found in natural, free-range, grass-fed animals. Conventional-raised animals are now fed corn or other grains to fatten them up quickly, which then gets the animal off to the market sooner with a higher weight. The end result is that the animal consumes much higher omega-6 oils in the diet and has markedly less omega-3 oils in their diet. The meat now becomes more proinflammatory because the food the animal ate contains higher amounts of omega-6.

Fish oil is essential because our body can’t make these oils. Here are just some of the benefits seen with fish oil. We need these oils for brain function, growth and development, cell membrane health, and managing inflammation. Low levels of DHA/EPA has been consistently found in major depression, bipolar disorder, schizophrenia, and ADHD. Research continues to show other benefits in that it protects the liver from inflammation, fatty liver build-up (NAFLD) improving lipid metabolism, and metabolic syndrome due to the Western diet (high calorie malnutrition). A recent breast cancer study demonstrated omega-3 oils induced autophagy (cell clean-up) and apoptosis (cell death) in breast cancer cells. Include heart health, thyroid, eye health and numerous other concerns. The bottom line -- if you eat don’t eat fish or other similar omega-3 rich foods in your diet, then supplementation is essential.

4. Vitamin D


Vitamin D is a vitamin and also a hormone. It is required by every single cell in your body, just like thyroid hormone. It affects blood sugar, heart, brain, thyroid, bone, immune, digestive tract, inflammation regulation, gene expression, cancer risk, blood pressure, multiple sclerosis, and more.

New research studying the effects of higher doses of vitamin D3 demonstrated improved executive function in the brain in healthy adults. Executive function is like the CEO of the brain. It is the part of the brain that is in charge of planning, scheduling and then ultimately completion of the tasks. In this study, it showed that vitamin D status was a significant independent predictor of verbal fluency. It was noted that commonly used cutoff levels and reference ranges have been based on bone health and that actual optimal levels of brain health and mental function are actually unknown. Gene studies show that individuals who had genetic variants with low vitamin D levels in the blood had a significantly higher risk of diabetes and obesity.

If you spend the majority of your time indoors, expect the sunshine through the car window to supply your daily vitamin D need, live in climates that are vitamin D challenged, or have the VDR Taq or VDR Bsm gene polymorphism as seen on your commercial genetic test, then your ability to manage vitamin D is compromised. Vitamin D3 supplementation is essential and recommended. The study mentioned above suggested that levels exceeding 100 nmol L may be optimal for at least some aspects of executive functioning or optimal brain function. General optimal recommendations for lab values to be between 50 ng/ml and 80 ng/ml.

5. Probiotics


The intensive gut microbiome research going on for the last several years has been changing our understanding of just how important having healthy gut flora actually is. Gut flora is involved not only with the immediate digestion process and keeping the gut lining intact, but numerous other things. It is directly involved with bone health, neurotransmitter production, depression/mood disorders, autoimmune risk, cancer, and obesity. Breaking new research has identified a link between the gut flora and how the brainstem and hypothalamus regulate energy and metabolism. The mechanisms are not understood yet, but the door is open to explore how gut bacteria affect key command posts in the brain with life and survival.

There are numerous reasons for chronic problems with gut health and microbiota. These include the love affair with antibiotics for medical treatment and feedlot farming and the use of Roundup and how it disrupts the gut microbiome. It also includes the changes in how expecting mothers treat pregnancy and delivery with C-section and insufficient breastfeeding which prevents the normal inoculation in beneficial bacteria that occurs in infants. This alone can set the child up for lifelong challenges simply because of insufficient beneficial bacteria colonization and engagement of the immune system. The bottom line, if we don’t take care of the trillions of microorganisms in the gut with quality unprocessed foods rich in nutrients and fermented foods or probiotics, core health is compromised. It causes the body and immune system to lose tolerance to self, triggering inflammation, neurotransmitter problems, autoimmune disorders, weight gain and a host of problems.

The next time that you get the advice that nutritional support is not needed and today’s modern diet can meet all nutritional requirements, consider the context of you and the world. The world is not flat.

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