Revisiting Supplementation

23 09 2013

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Earlier this year I started up a short series on vitamin supplementation. Since this time I’ve read numerous additional articles and studies and thought it would be a good idea to post my latest thoughts on vitamin supplementation.

As I said in my first post, vitamin supplementation is not absolutely necessary for everyone and most vitamins and minerals should be achieved through eating a well-balanced diet of whole foods. Take the term supplementation literally; you should really only supplement with something if you cannot get adequate amounts from your diet. With this in mind, let’s start with the most commonly used supplement out there: multivitamins.

Multivitamins

Earlier this year, my general stance on multivitamins was that they were a good way to ensure intake of all vitamins and the benefits surely outweighed the risks. Even the Harvard School of Public Health agreed: “Looking at all the evidence, the potential health benefits of taking a standard daily multivitamin seem to outweigh the potential risks for most people.” However, the more I read, the more I become skeptical of effectiveness of multivitamin products. The major issues?:

  • Most multivitamins provide levels around the recommended daily allowance (RDA), which accounts for a minimum level of health, not an optimal level.
  • Most multivitamins contain a majority of micronutrients that are readily met through even the poorest of diets. You end up getting very little of what you actually need, and too much of what is unnecessary.
  • Multivitamins lack the other compounds of real food which are necessary for absorption and that contribute to optimal health.
  • Too much focus on including a plethora of vitamins and minerals, not enough focus on the necessary vitamins and minerals, nor optimal dosing.

I have multivitamins in the house, but I stopped taking them earlier this summer. When I stopped, there was no noticeable change in my energy levels, general well-being, or overall health. Instead, I began to concentrate on individual vitamins and minerals that are difficult to get through a balanced diet, which is now the recommendation that I would make for others. Multivitamins are great in concept, but their effectiveness has not been proven. Due to this, most people will be much better off spending their money on only the vitamins and minerals that are the most difficult to get, which include…

Vitamin D

The RDA for vitamin D is roughly 400-800 IU, but the optimal level is, at minimum, 2000 IU; as I mentioned in my post on Vitamin D earlier in the year, daily intake of closer to 4000 IU is recommended. The only people who do not need to concern themselves with vitamin D are those that live within the tropics and have frequent sun exposure with bare skin (wearing a t-shirt and shorts is not enough). For the majority of my readers, those of us in the northern hemisphere, vitamin D supplementation is absolutely necessary for optimal health, especially in the winter. Don’t overlook this important vitamin!!!

vitamin-d3-stupid-doctors_o_1222705

Vitamin K

The RDA for vitamin K is roughly 60-120 mcg, and the optimal level is roughly 1000 mcg. The problem with getting enough vitamin K is that most foods containing the vitamin have very poor bioavailability, or in other words, the human body is simply unable to extract the full amount from the food. Due to this, supplementing with vitamin K might be necessary.However, if you eat a diet that contains a lot of leafy greens (kale, spinach, collards, broccoli, brussels sprouts, etc.) and lean animal protein (especially whole eggs), you likely needn’t worry about additional supplementation.

Iron

A friend of mine recently told me that she was thinking about getting an iron supplement. My reaction: Why? Her answer: Because a friend of mine said it helped with her premenstrual cramps. Okie dokie. Here’s the thing about iron: yes, it is a common deficiency (especially among women) in our society, but you shouldn’t start taking an iron supplement on a whim. I suffered from an iron deficiency for years, supplemented with over-the-counter pills and liquids for a few years, and since my levels returned to normal I have been able to maintain healthy levels of iron through my diet. The cause of my deficiency remains a mystery, but those typically at risk include children and pre-menopausal women, most notably those with diets restrictive of animal sources (vegans and vegetarians). If you suffer from the symptoms below, please consult your physician to see if iron supplementation is right for you:

  • fatigue
  • dizziness
  • pallor
  • hair loss
  • twitches
  • weakness

Calcium

Deficiency is common in older people and those with low dairy intake. If you do not consume dairy and do not eat a lot of kale, collard greens, broccoli, or other greens, you will almost surely be calcium-deficient. These whole foods contain far more bioavailable calcium than their supplemental counterparts, so increasing these foods in the diet should be option #1, but supplementing with a high quality calcium supplement could be a secondary option. My first suggestion would be to start with a whey protein supplement, as whey contains 20% of the RDA for calcium and also provides additional protein- something that will only benefit the body. If you are considering a calcium supplement, please first consult your physician; multiple studies have linked calcium supplementation with an increased risk of cardiovascular disease and several forms of cancer, so proceed with caution. Again, whole foods are the best choice.

Magnesium

I covered this in-depth in its own piece a few months ago, but long story short:magnesium supplementation can be quite beneficial for athletes. For the general population, if you don’t consume a diet that contains ample amounts of nuts, seeds, beans and/or leafy greens, you may very well be magnesium-deficient.

Fish oil/Omega-3

Yep, fish oil is important. Do it.

Yep, fish oil is important. Do it.

Essential fatty acids (EFAs) omega-6 and omega-3 are essential to human health and must be consumed in the diet. The North American diet contains a plethora of omega-6 foods, but very few omega-3s. An optimal ratio of the two EFAs is 1:1, so everyone should make an effort to eat fatty fish a few times a week or to supplement with a fish oil supplement. I covered this supplement here.

Creatine

Often thought of as a supplement for bodybuilders and gym junkies, creatine has gotten a weird reputation. Creatine is naturally produced in the human body and is a major component in supplying energy to cells, namely muscle. Yes, creatine has demonstrated reliability when it comes to things like overall power output and strength, but it is also very beneficial for people who do not frequent the gym. Non-meat eaters are a population that should surely be supplementing with creatine. As roughly half the creatine stored in the human body comes from the diet (which can only be derived from animal sources), vegetarians and vegans have significantly lower levels in their bodies. This can result in poor energy levels and decreased cognition. Creatine supplementation studies have shown a significant increase in cognition/intelligence, as well as the ability to ward off the symptoms of depression, most notably in vegetarian/female populations. If you are a meat-eater, you may not need creatine supplementation (unless you have personal strength goals at the gym, in which case you should definitely be supplementing), but for non-meat eaters, creatine supplementation should be seriously considered.

Aside from these supplements listed above, there really aren’t many other that I would advise looking into. One of my favourite online images will serve to give you a very good idea of which supplements can be trusted for what:

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The graphic isn’t perfect- for example there have been reliable studies conducted on magnesium demonstrating an increase in serum magnesium in the body, a decrease in blood pressure and an increase in aerobic capacity and muscle oxygenation- but it’s a nice overview with fairly accurate indication of what you should and should not spend your money on. In the end there are tons of supplements on the market claiming to do many things, but the reality of the matter is that most are good in theory, but poor in practice. Eat whole foods, do your homework, and if you are taking a supplement, be honest with yourself and listen to your body- are you actually getting any benefit from the supplement? If not, save your money and improve your diet!

For more information on nutritional supplementation, or for questions related to specific supplements, please feel free to post a comment below!

Happy Monday!

DW

 





Supplements 101: Magnesium (Athletes Take Note!)

22 03 2013

magnesium-sources

What is magnesium?

Magnesium is an essential mineral required by the body for maintaining normal muscle and nerve function, keeping a healthy immune system, maintaining heart rhythm, and building strong muscles and bones. Magnesium is also involved in at least 300 biochemical reactions in the body, including ATP production (energy!) and protein synthesis. (Athletes, are you listening?) Although magnesium deficiency is relatively rare, only about 1/3 of North Americans meet the Recommended Daily Amount (RDA). These low levels can lead to muscle spasms, cardiovascular disease, diabetes, high blood pressure, anxiety disorders, osteoporosis, and cerebral infarction, and can worsen symptoms for problems like migraines and premenstrual syndrome (seriously, ladies, get your magnesium). Conversely, consuming too much magnesium typically causes diarrhea as the body attempts to excrete the excess. The current RDA for magnesium is about 400 mg, which does not seem hard to meet with a healthy diet, but the human digestive system only absorbs 20-50% of the magnesium we ingest. It is an incredibly important mineral for healthy human functioning.

What are the benefits of supplementing magnesium?

Aside from preventing the diseases and issues mentioned above, adequate magnesium levels are beneficial for the following reasons:

  • Increased energy and endurance
  • Increased, healthy metabolism
  • Improved quality of sleep
  • Improved immune function

Who should be supplementing with magnesium?

Well, anyone deficient in magnesium (roughly 2 of 3 people in the general population) can certainly benefit from magnesium supplementation, and it can greatly improve your quality of life. How to tell if you are deficient? Do you suffer from these symptoms?:

  • Magnesium can help.

    Magnesium can help.

    Constipation/irregular hard bowl movements (This is a dead giveaway; healthy people have 2 soft bowel movements daily.)

  • Fatigue/general lethargy
  • Hard time falling asleep/Poor quality of sleep
  • Cramps and muscle twitches
  • High stress levels
  • Obesity/Diabetes/Hypertension/Osteoporosis
  • For women, having severe premenstrual syndrome symptoms (extreme bloatedness, wild mood-swings, extreme irritability, etc.)

I am also willing to wager that you have low magnesium levels if you eat a lot of processed white flour and high-sugar products, have a low intake of green leafy vegetables, don’t eat many nuts, seeds or beans, drink alcohol on a regular basis,and/or have a low-protein diet. If you fall into this category, you are at a high risk for magnesium deficiency and almost certainly suffer from some of the symptoms listed above.

Athletes should take special notice, especially if they have any of the above symptoms. Due to the fact that magnesium is critical in protein synthesis and ATP production, athletes (especially those who train with weights or train for endurance sports) have a much higher magnesium requirement. Additionally, high-protein diets inhibit magnesium absorption, further compounding the problem and making magnesium requirements even higher for athletes. Magnesium is also essential for the detoxification of cortisol and increases insulin sensitivity, glucose homeostasis, insulin action and insulin secretion. It is arguably the most important mineral for athletic performance.

How much magnesium should we take?

As I mentioned above, the RDA is roughly 400 mg per day. I am not an expert on magnesium, nor have I ever taken a magnesium-specific supplement (I’ve made efforts to increase dietary magnesium and a few of my other supplements contain additional magnesium as well), but 400 mg seems low to me. As we all have unique bodies and diets, ingested magnesium will be handled differently by everyone. I would make two separate recommendations (after first increasing your whole food magnesium intake by making better food choices, of course):

General population: Up to an additional 400 mg daily. Start with 100 daily, then 200, etc. Slowly add it to your diet and see how it improves your symptoms. If you start having diarrhea, you’ve taken too much.

Athletes: Up to an additional 400-1000 mg daily. Nowhere on the internet could I find concrete evidence on how much magnesium should be supplemented for athletes. This is a topic that is currently being heavily investigated, but not enough research has been done on the topic. The bottom line is that we know athletes have a higher need and that athletic performance is compromised when magnesium levels are low. Competitive athletes should absolutely be supplementing with magnesium, and should take as much as their bodies can handle.

Additionally, it is essentially impossible to overdose on magnesium as the body is very good at getting rid of the excess quickly; worst case scenario is that you have to make a few extra trips to the bathroom.

I'm guessing that they're referring to transdermal...

I’m guessing that they’re referring to transdermal…

When should we take magnesium?

Here a some general guidelines for supplementing with magnesium:

  • Magnesium is best absorbed on an empty stomach
  • Vitamin C and calcium can increase magnesium absorption
  • Carbonated drinks, especially soft drinks, prevents magnesium absorption
  • Alcohol can cause you to excrete magnesium
  • High-fiber, protein and/or fat meals can inhibit magnesium absorption; again, magnesium is best to take on an empty stomach.
  • Magnesium is best absorbed in small, frequent doses; it is therefore advisable 100 mg doses a few times daily.

I recommend taking small doses between meals. Take your first dose first thing in the morning and your last dose right before going to bed. The smaller, more frequent the doses, the better your body will absorb the mineral.

How do I find a high-quality magnesium supplement?

There are two main ways to supplement magnesium: orally and transdermally (through the skin).

With oral supplements, magnesium chloride is the most absorbable (~50%) and magnesium oxide is the least (~4%). Magnesium oxide is the most commonly found ingredient in supplements, so you’ll probably have to do some searching before finding the best supplement. I will always recommend liquid or enteric-coated capsules over tablet form. Magnesium complexes and amino acid chelates can be as good or better than magnesium chloride, especially if you can find a supplement that contains multiple forms (faster results can be obtained when multiple forms are supplied). Acceptable forms include:

  • astronutrition_com-Nutricology-Magnesium-Chloride-Liquid---8-fl_oz-31Magnesium Ascorbate
  • Magnesium Citrate
  • Magnesium Fumarate
  • Magnesium Gluconate
  • Magnesium Lactate
  • Magnesium Malate
  • Magnesium Pidolate
  • Magnesium Glycinate
  • Magnesium Lysinate
  • Magnesium Orotate
  • Magnesium Taurate

** Avoid magnesium glutamate and magnesium aspartate, as they break down into glutamic acid and aspartic acid respectively, which without being bound to other amino acids become neurotoxic. Both glutamic acid  and aspartic acid are also components of aspartame, and you know how I feel about that…)

Transdermal magnesium should be delivered using magnesium chloride due to its stability, bio-availability and naturally occurring abundance. Magnesium chloride is the most soluble and absorbable magnesium and is derived in a natural state from seawater sources. Available in spray, lotion and bath salts (just don’t eat the bath salts). Transdermal supplementation does not have any adverse gastrointestinal side effects, and is therefore a preferable choice for many people.

For the best combination of convenience and bioavailability, I recommend a combination of whole foods containing magnesium, a transdermal magnesium chloride product for convenience and a dosage of oral magnesium chloride that does not produce side effects.

As always, look for well-reputed brands that haven’t had major product recalls.

BONUS: Vitamin D3 can help increase magnesium absorption, so take your oral magnesium supplement with your liquid vitamin D supplement, or spray on some magnesium oil and go play in the sun!

Other considerations

As always, consult your physician before supplementing with a new substance Magnesium supplementation is extremely safe, so there isn’t much else to consider!

For additional questions on nutritional supplementation, you know how to find me!

DW