Tips on Becoming an Armed and Informed Consumer of Dietary Supplements

 

Note from Rebecca: I am so grateful for Dr. Megan Holt’s wisdom, experience and insight on all things nutrition and wellness. There is A LOT of offerings out there that make claims to better our health but many are lacking in solid research and/or regulation. We are all about helping those in our community be better informed consumers of time and resources. Below, Megan will share some important information about dietary supplements – looking forward to your thoughts and questions!

Many of us regard dietary supplements as ‘harmless’, but did you know that supplements vary tremendously in terms of potency and purity?

We need to be concerned with not only the supplement’s effectiveness, but also with whether or not the supplement actually contains the stated ingredients in the stated amounts. Adulteration is common, as manufacturers, as well as suppliers of the raw ingredients, often try to cut costs by cutting corners.

Manufacturers may have the best intentions in terms of adhering to ethical standards, but perhaps suppliers of the raw ingredients are more concerned with profit.

Have manufacturers’ done their homework? The industry is ‘regulated’, but loosely at best.

Dietary supplements can be a wonderful resource for those of us who need them, and many of the claims regarding their benefits are supported by sound evidence. Asking the following questions of your provider may be helpful upon receiving recommendations to begin taking a supplement.

  1. What is the optimal daily dosage for my condition?
  2. Can you offer any reliable brand recommendations?
  3. Are there any supplement-drug or supplement-food interactions that I should be aware of?
  4. Can I instead meet these needs through the diet? How? Which foods and in what amounts?
  5. Where can I find evidence-based information on the safety and efficacy of dietary supplements?
  6. What are the known side effects?
  7. Has the supplement been tested by an independent lab? Is it USP (United States Pharmacopeial Convention) verified?
  8. How much do they cost?

This fabulous documentary (free to watch) “Supplements and Safety” is a great place to start.

The NIH Office of Dietary Supplements offers a number of helpful fact sheets on individual vitamins and minerals.

Further, PubMed Dietary Supplement Subset provides a rich database should you be interested in reading the literature on specific dietary supplements.

Your provider may not have all of the answers to these questions, but it’s important that they be able to speak to most of them. Advocate and ask – use your voice!

Make sure to join us on Thursday August 3rd, 2017 at 10am PDT for a conversation with Secrets from the Eating Lab Author Traci Mann, PhD + Rebecca Ching, LMFT. Click here to register for the free webinar!

 

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Unpacking 5 Common Questions on Exercise and Wellness with Megan Holt, DrPH, MPH, RD

NoteRespect is looking at soreness

Note from Rebecca: The word “exercise” is often used in conjunction with the word “diet”. Exercise is indeed an important and necessary part of anyone’s wellness lifestyle. Yet the word itself is often misunderstood and loaded with expectations, shame and fear. Megan Hold, DrPH, MPH, RD unpacks some common questions and misunderstandings around exercise and how to care for our body when we are moving it and the importance of developing an intuitive relationship with exercise.

Q: Exercise is always a good thing, right?  I often read and hear that exercise makes our immune systems stronger.

A: Exercise is one of many stressors the body receives, and like other stressors, produces ill effects when introduced at a time when the body is overloaded.

Intermittent (spontaneous) very high intensity exercise and continuous over training (even if done at lower intensity) can compromise immune function.

For example, 90+ minutes of high intensity exercise may result in days of dampened immune function.  (“Intensity” can also look different from one person to the next, as we must consider baseline fitness levels).

During exercise, we experience an increase in cortisol ‘stress hormone’, which in turn increases blood pressure and cholesterol.  These effects are transient when exercise is balanced and appropriate, but over training can result in chronically high levels of cortisol, decreasing our immune function.

Other risk factors for infection include:

  • inadequate sleep,
  • weight loss,
  • poor quality of diet,
  • under nutrition/low calorie intake,
  • stress.

All of these things, including exercise, challenge homeostasis and therefore, can contribute to increasing susceptibility to illness.

On the flip side, exercise also attenuates stress, which bolsters our immune systems, though this occurs after the exercise but and in the scheme of a balanced training regimen.

Those who engage in moderate intensity exercise 4 days per week are nearly half as likely to use sick time relative to their sedentary and their ‘over trained’ counterparts.

Exercise stimulates phagocytosis, which can essentially be described as the gobbling up of illness producing bacteria by macrophages (the ‘big eaters’ of the immune system).

Immune parameters are enhanced for hours after exercise (and even longer if program is balanced and ongoing/continuous) but the benefits are compromised when one pushes too hard and denies themselves the rest that they need.

Q. What does research tell us about exercising when feeling under the weather?

A. Generally, if symptoms are ‘above the neck’ (i.e. the common cold) low intensity exercise is OK, such as walking or gentle yoga, though listen to your body and rest when symptoms are at their worst.

Wait at least 5-7 days before reintroducing moderate to high intensity exercise.  Cold weather does not increase risk of catching a cold…it simply results in close contact to a greater number of people, which increases transmission of bugs.

When symptoms are ‘below the neck’ or more involved, wait 1 ½ to 2 weeks before reengaging in workouts of moderate or high intensity.

Q. What are overuse injuries, and what are the primary risk factors for overuse injuries?

A. Overuse, in short, result from a culmination of ‘too much too fast’, repetitive movements, improper training techniques, inadequate rest and musculoskeletal system overload.

Half of kids 6-18 engaging in athletics will incur an overuse injury, with highest risk going to runners. Other major risk factors include lack of a period (being on birth control doesn’t ‘count’ if the period is absent without birth control), prior injury and inadequate calorie intake, which stimulates muscle catabolism and hinders muscle recovery.

Q. I am feeling pressured (from self and/or others) to overdo my exercise? What can I do?

A. Give yourself permission to decrease intensity when you need to, and kindly thank yourself for showing up!

Increase the intensity again when you feel like you have the energy to challenge yourself. Resist adding intensity/weight/incline speed because someone else is doing so, or the instructor of your fitness class insists upon it if you know that it’s too much for you.

You’re there for you, not for them, and it’s OK to modify.  Remember, they won’t be around to nurse your injury, so it’s up to you to know your limits.

Believe it or not, cardio is not the only component of fitness. Equally important are flexibility and muscular strength building exercise, particularly for the sake of preventing overuse injuries and building/maintaining bone mass.

A ‘balanced’ regimen may include:

  • yoga,
  • strength training (‘sculpt’ classes)
  • swimming or running/hiking
  • bike riding (moderate to high intensity)

Try to engage other people in your workout regimen, even if this ‘compromises’ intensity just a little bit. Friends who move for fun and wellness can help to keep you from engaging in the craziness of calorie counting or compensatory exercise. Healthy relationships and interactions are also great for your health. =)

If you find that you’re worrying throughout the day about how you’ll fit in your workout, take a breather until you have time to make it a priority without adding to your already overfilled plate.

This is especially true if you’re active a few days/week, but feel inclined to stick to a rigid 5,6,7 days at any cost. If you’re exercising for health benefits, but obsessing daily about how to make it happen ‘perfectly’, the impact of the stress defeats the purpose.

Q. I missed my class and now I’ve blown it. I missed yesterday’s as well, and now I am in a real bind because I am going out to dinner, and I don’t feel like I have ‘earned’ the calories.

A. This is the picture of a not-so-healthy relationship with food and exercise.  Take a walk instead, even if it’s not what you had in mind, and thank yourself for being flexible.

Carbohydrate and protein are a MUST after exercise, as they serve to decrease muscle and joint tissue damage (and no, a low carb protein shake does not suffice, even if it has, like, fifty grams of protein).

This includes an adequate intake of grains. And grains are not the devil. We have decades of research supporting the health benefits of whole grains in the diet, including, but not limited to, their being a great source of antioxidants, fiber, and essential anti-inflammatory fats.

Finally, don’t neglect dietary fat. The anti-inflammatory benefits are tremendous (which means inflammation is buffered by protective qualities of fats, primarily the plant-based fats, which means lower risk of injury).

Don’t wait until you have an overuse injury and are stuck with a bandaid approach to ‘fixing’ it and explore the benefits of a few choice lifestyle modifications, which can prevent, delay onset or aid in healing. Aim for your intake to be at least 30% of calories consumed from fat sources.

How do you define your relationship with exercise?

Do your trust your body to tell you when you need to rest?

Thanks for reading and please post your questions below in the comments section regarding all things exercise and wellness.

In good health –

Megan

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