A recent publication in the American Journal of Cardiology called into question the safety of high dose Vitamin D supplementation. In the paper, researchers from Johns Hopkins University School of Medicine investigated a proposed link between Vitamin D levels and an inflammatory protein (CRP) which is considered a risk factor for heart disease. Their conclusions report that levels of D below 21 ng/ml are associated with higher CRP or C-reactive protein. This determination came as no surprise. However, participants with Vitamin D concentrations significantly above 21 ng/ml also demonstrated elevated or undesirable CRP readings. The lead author of the piece, Dr. Muhammad Amer, stated that “Clearly vitamin D is important for your heart health, especially if you have low blood levels of vitamin D. It reduces cardiovascular inflammation and atherosclerosis, and may reduce mortality, but it appears that at some point it can be too much of a good thing.”

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It’s ironic, but the concept of holistic wellness isn’t always popular with some of my clients. Not everyone is interested in learning the root causes of their conditions or “dis-eases” and/or taking the necessary steps to address them through meaningful lifestyle changes. Recently, a client wanted to know what simple steps he could take to help him through a particularly stressful time at work. Options such as aerobic exercise, dietary adjustments and yoga were summarily dismissed by this “Type-A” personality due to time constraints. What to do?

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Whether you know it or not, you’ve probably consumed astaxanthin at one point or another in your life. Arctic shrimp and wild salmon are among the most common dietary sources of this crimson colored carotenoid. But, these days you’re also likely to find astaxanthin in everything from multivitamins to sports drinks. In many instances, it’s included as a way of increasing the antioxidant content of functional foods and nutritional supplements. Other times, its primary purpose is to act as natural preservative for delicate fatty acids such as those contained in fish or krill oil.

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The exact number of supplements you take should be predicated upon a variety of personal issues. Finances, diet and lifestyle and the ability to swallow pills are important considerations. In addition, genetic factors, pre-existing health conditions and the potential for drug-supplement interactions ought to be evaluated as well. The following list of supplements is what I consider valuable “add-ons” to my core list of recommendations. These are not essential for everyone. However, the health benefits they impart appeal to a broad cross-section of the population at large. They also adhere to my personal standards with regard to efficacy and safety.

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“Is there a short-list of supplements that everyone should take?”. This may seem like a simple enough question, but it might surprise you to know that if I had to answer strictly ‘yes’ or ‘no’, my reply would be ‘no’. There are simply too many individual considerations and requirements that make blanket recommendations inappropriate and unreliable. Having said that, there is a select group of supplements that tend to fill important nutrient gaps in many diets. These very same nutritional aids also safely promote greater well being.

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The majority of my clients use nutritional supplements. Some only take a capsule or two a day. Others literally swallow a handful of carefully selected supplements. Each person has a unique set of needs and requirements that is considered in my evidence-based recommendations. However, there is one suggestion that I make across the board. I strongly recommend that everyone make a list of the supplements they use, with a little note next to the name that describes why each capsule, soft gel and tablet is being taken. This list should be reviewed occasionally as a reminder of why you’re making the effort and spending your hard earned money on this regimen. I personally do this when preparing my family’s supplements for the week.

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S-adenosylmethionine or SAM-e, a natural antidepressant, has been in the news lately thanks to Dr. Andrew Weil. In Dr. Weil’s new book, Spontaneous Happiness, he recommends SAM-e for prompt relief of low mood states that don’t respond to other dietary and lifestyle modifications. A review in the June 2011 issue of the journal Canadian Family Physician also presents a largely optimistic view of this nutritional supplement. In the summary, the primary criticism of SAM-e is how much it costs. In order to reach a therapeutic dosage, the author of the piece estimates a monthly expense of $80 – an amount that likely won’t be covered by most insurance plans. In reality, savvy online shoppers can find even lower prices in the $60/month neighborhood.

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Most of my columns are inspired by material that’s pieced together from numerous medical journals. Today, the exact opposite is true. The majority of studies referenced below can be found in recent editions of the Iranian Journal of Nursing and Midwifery Research. What’s more, almost all of the original studies I link to can be reviewed in their entirety for free. This may be invaluable to patients and physicians who are interested in the finer details and nuances of a medical trial.

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Wheatgrass juice (Triticum aestivum) is one of the more popular “super greens” included in dietary supplements and offered in juice and smoothie bars throughout the world. What’s more, if you browse the Internet you’ll find countless sites dedicated to extolling the virtues of daily wheatgrass therapy. But, anecdotal testimonials and brisk sales aren’t exactly a solid basis for making an informed decision about any given food or supplement. Fortunately, there is also a growing body of scientific research that can assist anyone interested in seriously evaluating wheatgrass.

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The “heart health” sections of most health foods stores are flush with supplements containing coenzyme Q10 (CoQ10), a naturally occurring compound found in small quantities in fish and organ meats. There’s good justification for this strategic product placement. In fact, the most current studies using CoQ10 in patients with cardiovascular disease have turned up very positive findings. In particular, improvements in endothelial function, oxidative status and physical performance in those with coronary artery disease and chronic heart failure have been noted. But, there’s much more to the CoQ10 story than just that. Because this coenzyme possesses antioxidant properties and the ability to support cellular energy, it also has applications in other areas ranging from aging skin to migraine headaches.

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The current issue of The Lancet, a prestigious medical journal, features a meta-analysis assessing the efficacy of influenza vaccines. The review evaluated 14 observational studies and 17 randomized controlled trials. The conclusions of the summary brought forth several key findings. Among them, the researchers noted that the effectiveness of the vaccines was not consistent across all age groups and varied from season to season. For instance, live attenuated influenza vaccines (LAIV) were found most protective among young children aged 6 months to 7 years. On the other hand, the authors commented that, “Evidence for protection in adults aged 65 or older is lacking”. Ultimately, a call for new and improved vaccines is trumpeted as a necessity in order to reduce “influenza-related morbidity and mortality”.

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A review in the December 2009 edition of the Indian Journal of Physiology and Pharmacology describes Tulsi or holy basil as a traditional herbal remedy with a promising track record in animal and in-vitro studies. The authors of the analysis report numerous medicinal properties including anti-inflammatory, immunomodulatory and neuro-protective effects as exhibited in preliminary experiments. The one criticism laid out in the paper is the paucity of data stemming from trials involving human subjects. In the months and years since the review, several human studies have quietly been published in the medical literature.

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It’s estimated that more than 10% of men and women over the age of 50 have a chronic skin condition known as senile purpura. Even if the name isn’t familiar, the characteristic purplish bruises or lesions are easily recognizable. In many instances, physicians aren’t terribly concerned about senile purpura provided that potentially serious causes such as medication side effects and platelet abnormalities are ruled out. In general, it is believed that age related capillary fragility and thinning of the skin are the primary culprits of easy bruising. Fortunately, there are a number of dietary, supplemental and topical approaches one can take to address both of these risk factors.

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Circumstances and genetics undoubtedly affect many of the changes associated with growing older. But, there are countless ways to interfere with the so-called “normal” aging process. Here are several practical steps you can take to kick start this type of anti-aging momentum. 1) A new study in the journal Menopause reports that supplementing with a natural, soy derivative known as S-equol (10 – 30 mg/day) can safely reduce the appearance of facial wrinkles in postmenopausal women. 2) Researchers in Paris, France recently revealed that seniors who learn new skills such as contemporary dance can improve “flexible attention” – a form of cognitive processing that typically declines with age. 3) In Canada, a new trial confirms prior evidence showing that the mind-body practice of Tai Chi improves “balance, gait and fear of falling” in adults over the age of 65. 4) Aspirin is commonly prescribed to middle-aged patients in the hope of preventing cardiovascular events. Unfortunately, emerging evidence from the Netherlands and UK explains that frequent aspirin use may also be associated with a higher risk of early and “wet” age-related macular degeneration or AMD.

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There are a great many diseases and disorders that come mind when pondering the topic of inflammation. Typically, depression isn’t included in that rather lengthy list. A new review compiled by researchers from the Emory University School of Medicine postulates that there’s reasonable cause to do so. The authors of the paper note that “individuals with major depressive disorder (MDD) demonstrate increased levels of a variety of peripheral inflammatory biomarkers”. If this emerging theory is justified, how can patients and physicians use this information to help alleviate poor mood states? One of the most promising, natural candidates is fish oil. The omega-3 fatty acids in fish, namely DHA and EPA, are known to decrease pro-inflammatory cytokines present in a variety of diseases, including arthritis. What’s more, reducing inflammation via fish oil supplementation has recently been shown to blunt stress-induced anxiety. But, supplementing with just any fish oil may not be the optimal approach. A recent meta-analysis in the Journal of Clinical Psychiatry recommends looking for omega-3 supplements that contain a minimum of 60% EPA (eicosapentaenoic acid). A daily dosage of up to 2,200 mg of EPA daily is also singled out as important. A separate review from August 2011 revealed similar findings with respect to fish oil therapy in those with bipolar disorder or manic depression. This is not to say that DHA or docosahexaenoic acid is not significant or valuable in it’s own right. For instance, a current study appearing in the British Journal of Nutrition cites that while EPA-rich fish oil was more effective at reducing depressive symptoms, DHA-rich fish oil alone improved cognitive performance (verbal fluency) and “self-reported physical health” in a group of seniors. Even with all of this encouraging scientific data, it still may be too soon for many conventional psychiatrists to recommend EPA to depressed patients. However, because of fish oil’s other health benefits and relative safety, I would argue that it’s worth considering prior to any future mainstream consensus.

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According to an alarming report in the September issue of the journal Lancet Oncology, the number of new cases of cancer worldwide is expected to reach 27,000,000/year by the year 2030. The authors of the paper call for a comprehensive effort to better manage cost and human suffering by emphasizing “real value from new technologies”. One of the “new” technologies that’s being examined is the use of bitter melon (Momordica charantia) in prevalent malignancies such as prostate cancer. In June of 2010, a scientific review described this tart, functional food as having “anti-tumor activity” and “no-to-low side effects in animals, as well as in humans”. Later in 2010 and onward into 2011, preliminary evidence emerged showing that bitter melon extract (BME) successfully interfered with prostate cancer progression in animal models and in vitro. But, why get so excited about a handful of trials that weren’t even conducted in humans? The reason for my optimism stems from seemingly unrelated studies that have explored the potential of bitter melon in managing diabetes in animals and humans alike. For instance, a publication appearing in the March 2011 issue of the Journal of Ethnopharmacology found that a daily dosage of 2,000 mg of BME effectively lowered blood sugar and fructosamine levels in a group of type 2 diabetics. Meanwhile, a study from August 2011 involving diabetic rats likewise discovered that BME “powerfully lowered (blood) glucose levels”. In fact, the excitement surrounding bitter melon is so great that nutritional experts are desperately trying to find ways to make it more palatable in order to promote greater consumption in the population at large. Here’s hoping they succeed in their objective and that more research continues to be published supporting the use of bitter melon in the fight against cancer and beyond.

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