1. Focus On Nonvitamin/ Nonmineral Supplements

2. Copyright 2010, John Wiley & Sons, Inc. Types of Dietary Supplements

3. Copyright 2010, John Wiley & Sons, Inc. What is a Dietary Supplement? Traditionally referred to products designed to supplement the diet with essential nutrients Now include any product intended for ingestion as a supplement to the diet Must carry a standard label that meets the specifications of the Dietary Supplement Health and Education Act (DSHEA) Not strictly regulated in terms of dose or constituents

4. Copyright 2010, John Wiley & Sons, Inc. Dietary Supplement Labels Must include:  The words “Dietary Supplements”  A “Supplement Facts” panel which lists The recommended serving size Name and quantity of each ingredient per serving

5. Copyright 2010, John Wiley & Sons, Inc. Manufacturing Standards for Dietary Supplements No mandatory standards exist. The U.S. Pharmacopeia (USP) has developed a voluntary dietary supplement verification program.

6. Copyright 2010, John Wiley & Sons, Inc. Regulations of Dietary Supplements Not regulated as strictly as drugs Manufacturers are responsible for product safety. Supplements do not require FDA review before being marketed. If problems arise, the FDA must prove that the supplement represents a risk before it can be removed from the market. Safety data is required by the FDA for ingredients not sold before Oct. 15, 1994.

7. Copyright 2010, John Wiley & Sons, Inc. Macronutrient Supplements A varied, balanced diet will meet nutrient needs for most healthy people. Supplements containing carbohydrates, proteins, individual amino acids and fatty acids are used by some people for additional benefits.

8. Copyright 2010, John Wiley & Sons, Inc. Specific Macronutrient Supplements Amino Acids Popular among athletes and dieters Lack of scientific evidence to prove their effectiveness Share transport systems Fatty Acids Omega-3 fatty acids are proved to protect against heart disease Supplements may not contain a large enough dose

9. Copyright 2010, John Wiley & Sons, Inc. Substances Made in The Body Enzyme Supplements Enzymes are broken down in the GI tract. Most have little effect on body function. Hormone Supplements Protein hormones are not absorbed through the GI tract. Most hormone supplements lack long-term studies examining the efficacy, toxicity and other side effects.

10. Copyright 2010, John Wiley & Sons, Inc. More Substances Made in the Body Coenzyme Supplements Not necessary for most healthy people May be beneficial for individuals who have inherited defects or take certain medications Supplements Containing Structural and Regulatory Molecules Effectiveness may vary Some have benefits proved by scientific evidence, some don’t

11. Copyright 2010, John Wiley & Sons, Inc. Phytochemical Supplements Carotenoids Antioxidants and vitamin A activity Most are marketed for their antioxidant properties May also become oxidants Flavonoids Antioxidants Supplements have not been shown to have the same health effects as flavonoid-rich foods.

12. Copyright 2010, John Wiley & Sons, Inc. Herbal Supplements Popular in treating illness and promoting health Possible problems with using herbal supplements: Inaccurate dose Possible toxicity, alone or interaction with other medication/supplement/food Can be used inappropriately Excessive dose and/or unusual combinations of herbs and medications may cause serious side effects, even death.

13. Copyright 2010, John Wiley & Sons, Inc. Considerations When Choosing Herbal Supplements

14. Copyright 2010, John Wiley & Sons, Inc. Considerations When Choosing Herbal Supplements

15. Copyright 2010, John Wiley & Sons, Inc. Considerations When Choosing Herbal Supplements

16. Copyright 2010, John Wiley & Sons, Inc. The Seven Most Popular Herbal Medicinal Products in the U.S. Ginkgo Biloba Used in Chinese medicine to treat asthma and skin infections No measurable benefit on memory or other aspects of cognitive function in healthy adults May cause side effects and interactions with a numbers of medications

17. Copyright 2010, John Wiley & Sons, Inc. The Seven Most Popular Herbal Medicinal Products in the U.S. St John’s Wort May be effective for the treatment of depression Side effects and interactions with a number of medications Ginseng Long history in traditional medicine Suggested benefits on cardiovascular health and prevention of cancer May not be safe for everyone

18. Copyright 2010, John Wiley & Sons, Inc. The Seven Most Popular Herbal Medicinal Products in the U.S. Garlic High intake may lower cholesterol May not be safe for everyone Echinacea Used as a cold remedy Hypothesized to act as an immune system stimulant Allergies possible

19. Copyright 2010, John Wiley & Sons, Inc. The Seven Most Popular Herbal Medicinal Products in the U.S. Saw Palmetto May provide mild to moderate improvement in urinary symptoms and flow measures Long-term safety and effectiveness unknown Possible side effects Kava Short-term administration effective in reducing anxiety May cause liver damage Warning issued in 2002 by FDA

20. Copyright 2010, John Wiley & Sons, Inc. Focus On Nonvitamin/Nonmineral Supplements Copyright 2010 John Wiley & Sons, Inc. All rights reserved. Reproduction or translation of this work beyond that permitted in section 117 of the 1976 United States Copyright Act without express permission of the copyright owner is unlawful. Request for further information should be addressed to the Permissions Department, John Wiley & Sons, Inc. The purchaser may make back-up copies for his/her own use only and not for distribution or resale. The Publisher assumes no responsibility for errors, omissions, or damages caused by the use of these programs or from the use of the information herein..