Overview Ten years ago your doctor, under the advice of the Government Medical Advisors, would have told you that taking supplements succeeds only in giving you expensive urine.
Government health agencies in the US, Britain, Canada, Australia and many European countries are now suggesting supplements. As these Governments are billed through various medicare programs for fractured hips from osteoporosis, or other diseases which have a diet-related component, they pay more attention to such an easy fix, especially as the patient pays for these personally.
Calcium As we age calcium supplementaion becomes necessary. The Canadian recommendation is for 500 mg. three times a day for women and twice a day for men over 45 years of age. Calcium citrate is absorbed even in people who lack stomach acid. Calcium carbonate needs acid to be absorbed.
Vitamin D To ensure that the Calcium is properly absorbed and used supplementation with Vitamin D seems reasonable. Some studies show as little as 400 iu a day is helpful. Most studies state that over 2000 units may do harm. We suggest 1000 i.u. as a good compromise, 2000 i.u. as a max.
Plant Sterols The "Portfolio" study suggests that the western diet cannot provide enough sterols to counter cholesterol absorption. Their study used margarine with added plant sterols. The margarine provides necessary fatty acids. As an alternative, as the Plus diet recommends using vegetable oils in cooking such as olive oil, margarine may be used less, and a plant sterol supplement becomes advisable. We need over 2000 mg a day of plant sterols, and even a vegetable-strong diet such as the Plus diet provides a lot less than this. Phytosterol capsules 650 mg. two or three times a day helps make up the difference. Studies do not suggest any danger from excess plant sterol, so any danger from the higher dosage seems to be financial, not medical.
Folic Acid
Pregnant women or women contemplating pregnancy should take folic acid to prevent neural tube defects in the baby. The recommendation is 5 mg. a day. Folic acid is necessary in men and women for the lowering of homocystein, a chemical associated with increased risk of heart disease. Your MD may test your homocystein level when you are having a cholesterol screen. (More on homocystein click here).
Women's hormones are broken down and detoxified in the liver. Alcoholic men and women are less capable of breaking down these hormones, elevating the risk for hormone-dependant cancer. The liver's ability to detoxify alcohol is enhanced by folic acid. Women at risk for breast cancer as in those with a strong family history or women who are breast cancer survivors are advised to avoid alcohol. If these women do take alcohol, folic acid supplementation may mitigate the risk. Taking folic acid does not mean that women should ignore the recommendation not to drink: we recommend folic acid for those women who are going to include alcohol in their diet despite the recommendation against alcohol.
We recommend folic acid 1mg. per day for men and women to help homocystein.
Vitamin B12 Vitamin B12 requires stomach acid for absorption. The acid activates 'intrinsic factor" which allows B12 to be absorbed. B12 helps the liver in may ways to detoxify hormones, breakdown products of cholesterol etc.
B12 500 mg. once or twice a day.
Magnesium Heart muscle cell contraction is in part controlled by a balance between calcium and magnesium levels in the blood. Arrhythmias can result from imbalance between these minerals. Calcium blood levels are maintained by the parathyroid gland, even if it has to steal calcium from the bones. The body figures that low bone calcium which may cause broken bones is less deadly than low blood calcium which may cause a fatal arrhythmias. However magnesium has no equivalent back up system.
Low magnesium may be the cause of leg cramps and stiff muscles in some people who exercise. The plus diet recommends daily exercise so magnesium may help prevent leg pains associated with this exercise recommendation. The calcium supplementation recommendation is stronger than the magnesium recommendation.
Magnesium 500 mg. once or twice a day.
Fish oil Fish oil provides omega 3 fatty acids which are protective to the heart. Omega 3 from fish seems more effective than from plant sources. Eat fatty fish such as salmon at least once a week, but if you want to be sure, take a fish oil capsule daily.
Your doctor may have suggested that you take a mini-aspirin once a day. Aspirin makes platelets less sticky. This is important because many heart attacks start with the artery wall becoming irritated perhaps by a change in the plaque (cholesterol deposit) on the artery wall. The body responds by trying to cover up and heal the irritated area with a platelet band-aid. Platelets stick to each other, and if enough of them stick together they block off the artery. The area of the heart fed by that artery becomes short of blood and dies if the circulation is not re-established. The first sign of a heart attack may be cardiac arrest from ventricular fibrillation. The death rate from cardiac arrest is high, even in this day of defibrillators in malls, workplaces, and firetrucks.
People who have high levels of fish oil in their diet have less sticky platelets. As a result thay suffer less from fibrillation and sudden death as a first sign of heart disease. If they develop heart disease it is more likely to present as angina or a non-fatal heart attack. They have the time and opportunity to have an intervention such a coronary bypass and live another 10 or 20 years.
If your doctor says you need aspirin, take it. But eat that fiah, and consider taking a fish oil supplement.
Their used to be a danger from fish oil. It was obtained from fish at the high end of the food chain. These fish accumulate all the poisons ingested by the food sources lower on the food chain. New technology allows the manufacturers of fish oil supplements to remove mercury, pesticides, PCBs and other poisons.
Fish oil capsule once a day, optional if you are a big fish eater.