Presented by: Nikki force Vitamins, herbs, & nutritional supplements HW499-01: Bachelor’s Capstone in Health & Wellness Unit 4 December 05, 2017 Presented by: Nikki force

Introduction What are vitamins, herbs, and nutritional supplements? What are they used for? Vitamins – Calcium, fiber, magnesium, potassium, Vitamin A, Zinc, etc. Herbs - Abscess root, ginger, lavender, lemon balm, turmeric, etc. Nutritional supplements - Amino acids, botanicals, minerals, vitamins, etc. First bullet: Dietary supplements, herbal medicines, and multivitamins taken for overall wellness are considered to be complementary to traditional medicine and therefore are part of complementary and alternative (CAM) practices (Koslo, 2011). Second bullet: Vitmains, herbs, and nutritional supplements can be used for providing nutrients that may otherwise be eaten in less than recommended amounts (USDA, 2017). Third, fourth, and fifth bullet: It’s important to know what is missing from your diet, how much you need, as well as how to get them from natural food sources. For example, adults should be intaking 1,000 mg of calcium per day and can be found in products such as milk, fortified nondairy alternatives like soy milk, yogurt, hard cheeses, fortified cereals, kale, and in vitamin form (WebMD, 2017).

Need to know: The dietary supplement label All products labeled as a dietary supplement carry a Supplement Facts panel. Supplement Facts panel includes: the contents, amount of active ingredients per serving, and other added ingredients, such as fillers, bindings, and flavorings. The manufacturer suggests the serving size, but you or your health care provider might decide a more appropriate amount for you. (U.S. Department of Health and Human Services, 2011).

Need to know: Effectiveness If you don’t eat a nutritious variety of foods, some supplements might help you get the adequate amounts of essential nutrients your body needs. Supplements cannot take the place of foods that are important to a healthy diet however. The U.S. Department of Health and Human Services (2011) state, “Scientific evidence shows that some dietary supplements are beneficial for overall health and for managing some health conditions.” The FDA however, does not determine whether or not dietary supplements are effectives before they are marketed. (The U.S. Department of Health and Human Services, 2011).

Need to know: Safety & Risk Be alert to the possibility of unexpected side effects, especially when taking new products. Dietary supplements can interact with certain prescription drugs in ways that may cause problems. Some ingredients in dietary supplements are added to a growing number of foods, as a result, you may be getting more of these ingredients than you think which could be harmful. Most dietary supplements have not been tested for safety in pregnant women, nursing mothers, or children. If you suspect you had a serious reaction from a dietary supplement, let your doctor or health care provider know. (U.S. Department of Health and Human Services, 2011).

Need to know: Federal regulation of dietary supplements The FDA oversees both dietary supplements and medicines. Manufacturers must follow certain good manufacturing practices to ensure the identity, purity, strength, and composition of their products. The Federal Trade Commission, which polices product advertising, also requires all information about a dietary supplement product to be truthful and to not be misleading. (U.S. Department of Health and Human Services, 2011). First bullet: The FDA can take legal action against companies and Web sites that sell dietary supplements when the companies make false or deceptive statements about their products (U.S. Department of Health and Human Services, 2011). Second bullet: If the FDA finds a product to be unsafe or otherwise unfit for human consumption, it may take enforcement action to remove the product from the marketplace or work with the manufacturer to voluntarily recall the product (U.S. Department of Health and Human Services, 2011). Third bullet: Once a dietary supplement is on the market, the FDA and The Federal Trade Commision monitors information on the product’s label and package insert to make sure that information about the supplement’s content is accurate and that any claims made for the product are truthful and not misleading.

Questions to ask before taking vitamins & mineral supplements Do I really need them? Should I talk to my doctor about taking vitamin/mineral supplements? Where can I find scientifically sound information about vitamin/mineral supplements? What should I do if I suspect I may be having a side-effect from a dietary supplement? First bullet: The USDA (2017) states that if you are already eating the recommended amount of a nutrient, you may not get any further health benefit from taking a supplement, and that supplements and fortified foods may actually cause you to exceed safe levels of intake of nutrients. Second bullet: The USDA (2017) states that if you are already taking dietary supplements, then you should inform your doctor, especially since some dietary supplements can cause side effects if taken with other medications or if certain health conditions exist. Even if you are currently not taking any medication or don’t have any chronic health issues, the wrong dietary supplement or the wrong amount can cause problems so it is advised to speak to your doctor prior to taking any dietary supplement. Third bullet: You can talk to your doctor, as well as talk to pharmacists, or registered dieticians. The National Institute of Health (NIH) of Dietary Supplements has a series of vitamin and mineral fact sheets that include scientifically-based overviews of a number of vitamins and supplements. Also, see slide #10 for more scientifically sound information about vitamin/mineral supplements. Fourth bullet: Stop taking the supplement(s) immediately. Tell your doctor or health care professional. If you would like to report a problem to the FDA, you may do so by seeking information through the MedWatch Report Program (USDA, 2017).

Summary Talk to your doctor or health care provider before taking any vitamins, herbs, and/or nutritional supplements. If you are already taking vitamins, herbs, or nutritional supplements, make sure to inform your doctor and/or health care provider, especially if you are taking prescriptions and/or over-the-counter medications. Before taking supplements, make sure to ask yourself a few questions, such as, “What are the potential health benefits of this dietary supplement product?” They are not drugs and, therefore, are not intended to treat, diagnose, mitigate, prevent, or cure diseases. (U.S. Department of Health and Human Services, 2011).

Educational & informational tools & resources Dietary Guidelines for Americans - https://health.gov/dietaryguidelines/. Food and Drug Administration (FDA) - https://www.fda.gov/Food/DietarySupplements/default.htm. Journal articles - http://ajcn.nutrition.org/content/85/1/277S.short. Medline plus – https://medlineplus.gov/druginformation.html. MedWatch Reporting Program - https://www.fda.gov/Safety/MedWatch/HowToReport/ucm053 074.htm. First bullet: The Dietary Guidelines for Americans is a good source of information on eating well. It is updated every 5 years and provides information on the current body of nutrition science which helps health professionals and policy makers guide Americans to make healthier food and beverage choices. It also serves as a science-based foundation for vital nutrition policies, as well as programs across the United States (ODPHP, 2017). Second bullet: The Food and Drug Administration (FDA) has a variety of articles on dietary supplements, and PubMed Dietary Supplement Subset is a good data base to search for scientific studies on dietary supplements, just to name a few (USDA, 2017). Third bullet: Peer-reviewed journals can be useful in learning more about vitamins, herbs, and/or nutritional supplements. This journal article for example provides information about multivitamin-multimineral supplements, who uses them, and how much growth their has been in the use of supplements in the United States (Rock, 2007). Fourth bullet: Medline Plus includes information about drug prescriptions and over-the-counter medications, as well as includes side-effects, dosage, special precautions, and more (U.S. National Library of Medicine, 2015). Fifth bullet: The MedWatch Reporting Program provides information on how to report a problem to the FDA due to serious reactions, product quality problems, therapeutic inequivalence/failure, and product use errors with human medical products, which includes drugs, biologic products, medical devices, dietary supplements, infant formula, as well as cosmetics (U.S. Food and Drug Administration, 2016).

Educational & informational tools & resources Cont’d MyPlate - https://www.choosemyplate.gov/. PubMed dietary supplement subset - https://ods.od.nih.gov/Health_Information/IBIDS.aspx. Vitamin and mineral fact sheet - https://ods.od.nih.gov/factsheets/list-VitaminsMinerals/. First bullet: MyPlate is a good source of information on eating well. It illustrates the five food groups that are building blocks for a healthy diet including fruits, vegetables, grains, protein, and dairy, and uses the image of a plate to make you think about what should go on it for each meal (USDA, 2017). Second bullet: The PubMed dietary supplement subset includes the International Bibliographic information on Dietary Supplements (IBIDS) that provides scientific studies on significant supplement-related content (U.S. Department of Health and Human Services, 2017). Third bullet: The National Institute of Health (NIH) of Dietary Supplements has a series of vitamin and mineral fact sheets that include scientifically-based overviews of a number of vitamins and supplements (U.S. Department of Health and Human Services, 2017).

Works Cited Koslo, J. (2011). Workplace wellness: Complementary and alternative medicine. Retrieved from http://healthandwellness.kaplan.edu/articles/CAM/Workplace%20Well ness%20- %20Complementary%20and%20Alternative%20Medicine.html#cont. Office of Disease Prevention and Health Promotion (ODPHP). (2017). Dietary Guidelines: Food and nutrition. Retrieved from https://health.gov/dietaryguidelines/. Rock. C. (2007). Multivitamin-multimineral supplements: Who uses them? The American Journal of Clinical Nutrition, 85(1), 2775-2795. Retrieved from http://ajcn.nutrition.org/content/85/1/277S.full. United States Department of Agriculture (USDA). (2017). MyPlate. Retrieved from https://www.choosemyplate.gov/.

Works Cited Cont’d United States Department of Agriculture (USDA). (2017). Questions to ask before taking vitamin and mineral supplements. Retrieved from https://www.nutrition.gov/dietary-supplements/questions-to-ask-before- taking-vitamins-and-mineral-supplements. United States Department of Agriculture (USDA). (2017). Vitamin and mineral supplement fact sheet. Retrieved from https://ods.od.nih.gov/factsheets/list-VitaminsMinerals/. U.S. Department of Health and Human Services. (2017). A new PubMed subset for dietary supplements. Retrieved from https://ods.od.nih.gov/Health_Information/IBIDS.aspx. U.S. Department of Health and Human Services. (2011). Dietary supplements: What you need to know. Retrieved from https://ods.od.nih.gov/HealthInformation/DS_WhatYouNeedToKnow.aspx.

Works Cited Cont’d U.S. Food and Drug Administration (FDA). (2017). Dietary supplements. Retrieved from https://www.fda.gov/Food/DietarySupplements/default.htm. U.S. Food and Drug Administration (FDA). (2016). How consumers can report an adverse event or serious problems to FDA. Retrieved from https://www.fda.gov/Safety/MedWatch/HowToReport/ucm053074.ht m. U.S. National Library of Medicine. (2015). Drugs, herbs, and supplements. Retrieved from https://medlineplus.gov/druginformation.html. WebMD. (2017). Food sources for vitamins and minerals. Retrieved from https://www.webmd.com/food-recipes/guide/vitamins-and-minerals- good-food-sources#1.