Today we interview nutrient researcher Dr Jeffry Blumberg, Professor Emeritus in the Friedman School of Nutrition Science at Tufts University. He unpacks the real evidence on supplements to help you personalize what you should take.
Vitamin and mineral supplements are the most commonly used dietary supplements by populations worldwide. They are called supplements because that is the intention: to fill in nutritional gaps in your diet, not to make up for a bad diet.
No supplement replaces a healthy plant forward diet but what should you take to help make sure you are getting all the nutrients you need for good health? The aisles are full of vitamins, minerals and all kinds of supplements – in all kinds of forms – promising all kinds of benefits.
Today we interview nutrient researcher Dr Jeffry Blumberg, Professor Emeritus in the Friedman School of Nutrition Science at Tufts University. He unpacks the real evidence on supplements to help you personalize what you should take.
Children, young women, older adults, vegetarians, and vegans are at the greatest risk of several deficiencies.
A diet rich in whole, nutrient-dense foods is the best way to prevent deficiency.
Taking more than the recommended dose could result in toxicity.
Consult your physician if you suspect you have a nutrient deficiency and to check if your medications could interfere with nutrient absorption.
Form doesn’t matter (eg pill vs gummy vs liquid). What matters is to take your supplements regularly.
Supplements do not prevent chronic disease.
Supplements lack standardization so one multivitamin can be very different from another.
Center for Science and Public Interest
National Institutes of Health Office of Dietary Supplements
Linus Pawling Institute at Oregon State University
Your physician, registered dietician and pharmacist
Dr Tom: [00:00:00] Lifestyle is medicine when done, right? Especially food choices has the potential to eliminate 80% of chronic disease. Our mission is to be the trusted signal of truth, based on the weight of the evidence that rises above the definitely noise of misinformation.
Kathleen: We offer you a no nonsense and enjoyable approach to the fundamentals of nutrition and wellness.
Our goal is to give you simple and actionable strategy so you can make smart. Health promoting decisions every day. Welcome to the true health revealed podcast. I'm your co-host Kathleen Salman, registered dietician nutritionist with my, my ample. Co-host Dr. Tom. Raphi so good to have you here, buddy. Thank you, Kathleen.
Yeah. Today we're talking about vitamins and mineral supplements. They are the most commonly used dietary supplements by populations, world. They're called supplements because the intention is to [00:01:00] fill in nutritional gaps in your diet, but you can't make a good diet healthy by taking supplements. And you should know what you're looking for.
Their aisles are full of them, and they promise all kinds of benefits from weight loss, muscle strength, brain power. But are these empty promises? Can you really get, um, build your muscles from taking these supplements? So today we unpack the real evidence on supplements to help you personalize. What should you take?
And our guest today is Dr. Jeffrey Bloomberg friend and prolific nutrition researcher. He's a professor Emertis in the Friedman school of nutrition, science, and policy at Tufts university in Boston. His research has been primarily focused on antioxidant nutrients, their requirements, promoting health, how, how to prevent disease during aging he's published more than 400 scientific articles is on the editorial boards of several [00:02:00] scientific journals, uh, numerous esteemed committees, including the world health organization, FDA recipient of numerous notable awards.
And he's also a member of the true health initiative council of experts. So thank you, Dr. Bloomberg for joining us today. Uh, it's a real honor to have you, uh, with us.
Jeffrey: Thank you. It's actually my pleasure to be here and, and join the, the many distinguished people you've had as guests before.
Kathleen: Well, thanks.
Well, we, yeah, we count ourselves quite fortunate, so let's just tee it off. And why don't you take us? A little bit behind the history of how, how have we gotten to the point where the aisles are just chalk full of vitamins and minerals and supplements that where have we come from and where, where do we need to navigate?
Jeffrey: Sure I'd be happy to do this. I mean, it's really important to understand that modern nutrition sciences it's young, it's been less than a century [00:03:00] 96 years to be precise since the first vitamin vitamin a was isolated in 1926 and the whole first half of the 20th century focused on the discovery and the isolation and the synthesis of these essential micronutrients.
These vitamin. And the role that they play in preventing deficiency diseases. This is really, really important work. And what's happened though, is that it created a strong precedent for a reductionist, nutrient focused approach to dietary research and guidelines and policy to address malnutrition. And that was all well and good.
Um, through the early 1950s, um, And when we saw all sorts of things happening because of this science, we saw, um, foods fortified, uh, because people weren't getting enough in their diet. So we started fortifying milk with vitamin [00:04:00] a and vitamin D. We started, um, enriching, refined flowers with the, the B vitamins.
We were putting iodine into salt. Um, and these kinds of things came from that, that strong research past. But what's happened now, I feel is that this re reductionist approach looking at single vitamins and minerals, um, has been extended to address the, the rise in diet related non-communicable diseases from cardiovascular disease to cancer, to diabetes and obesity.
And, and it's really wrong to think that we can focus on. Smaller metrics, vitamins, or just saturated fats, or just added sugar rather than overall diet quality. We, we know now today that it's really whole foods and diet patterns, rather than focus on single vitamins or single amino [00:05:00] acids or single minerals that can help explain the effects of diet on these non-communicable diseases.
Um, so, you know, with that, when you ask about what the health effects of vitamin and minerals are, it's, it's really important to understand the health effect is that they help you stay alive to, to live and be healthy. And when you're not getting all you need from your diet, then dietary supplements are really just what they say.
They are. They're supplements to a. hopefully supplements to a healthy diet, um, not substitutes for a healthy diet. You already introduced this concept, um, that you can't make your diet healthy by taking any kind of dietary supplement. But we, we know that Frank deficiencies, which are not too common in the, in the us can result in serious [00:06:00] syndromes of sickness and can lead to death.
If they. Treated, but it's not a matter of you either don't have enough and you get sick and die or you have enough vitamins. You have an adequate intake and you are healthy. There really is this huge continuum between being sick, being not sick, but not healthy and not well. And this is where vitamin and mineral supplements can come in to play a.
Because you need a certain amount. Um, and I wanna stress that you can get too much from supplements. We do have in dietary reference intakes upper levels. So you can reach levels of toxicity if you go too high, but what, what vitamins and minerals you need and how much is really where the focus of discussion should be placed on and what you.
Depends on you and it depends on your [00:07:00] diet and it depends on your genetics and it depends on your microbiome. And we can talk about all of those other, um, factors that affect your vitamin and mineral needs. But one way you can help to meet them because we know the American typical American diet is, or we call it the standard American diet or sad.
And it's sad, sad, sad. Um, mm-hmm , you know, uh, for, we have a tool, we call it the healthy eating index or EI, and it's a way to score how, how adherent your diet is to the dietary guidelines for Americans. Um, and the average score for Americans is 50 out of perfect 100. And I don't care what school you went to a 50.
Is a failing
Kathleen: that's the truth. So. You know, it's really what you said is [00:08:00] it's what you need your, how to personalize it. So other than your age and your sex, it's kind of hard to determine what you do need. So you can go and buy a, you know, a generic once a day, multivitamin mineral for women over the age of.
You know, 40. So other than that, are there, what are your guidelines to help people choose which nutrients they ought to be focused on for their own personal health? Well,
Jeffrey: I think one of the things that, um, understand is that, you know, I've just, we've just agreed that the standard American diet is pretty yeah, pretty horrendous mm-hmm , but there's another term that I think it might be useful for people to understand, and we call that hidden hunger.
You know, it denotes a lack of vitamins and minerals whose effects may not be immediately apparent, but whose consequences may be long term and profound. This idea of hidden [00:09:00] hunger of vitamin and mineral inadequacy, doesn't produce a hunger. As we know it, you know, you, you might not feel it in the belly, but it strikes at the core of your health and vitality.
And so you really need to know. Which of these micronutrients, these essential vitamins and minerals, um, you need, and we do have dietary reference intakes that that include recommended dietary allowances, but you need to understand even those recommendations are broken down, as you said, um, into male and female and into different age groups.
But I think it's also important to understand there are. Um, other parts of the life cycle. So if you are, um, uh, a woman trying to become pregnant, or if you are pregnant or lactating, your needs are different than others. If you are an [00:10:00] older adult, your needs are different than younger people. For lots of reasons, some of them have to do with age related changes in your ability to absorb nutrients or to metabolize.
but other factors like drug use medications can interfere, um, with the absorption and the utilization of many vitamins and minerals. And so depending on what drug therapies you may be receiving, um, you and your healthcare provider need to talk about how that changes your nutrient needs, but most simply, you also need to understand your diet.
Um, we know that that most people are falling far short of, um, their intake of plant foods. 90% of Americans are falling short of recommended intakes of vegetables, 80% falling, short of recommended intakes of [00:11:00] fruit, 95% fall short of the recommended intakes for whole grains. Although I must say Americans do great at exceeding the maximum guidelines.
For added sugars and saturated fat over 90% of Americans are consuming too much sodium. But if you look at your diet by yourself or preferably with the, the help of a council, like a registered dietician, for example, or a certified nutrition specialist who can help you understand and assess what your diet is, then you can best understand, um, what your needs.
There maybe we can come back to it. But I would say that there's some real, um, advancement in science. That's cutting edge right now. That's called precision nutrition where they really do a deep pheno typing. They really, um, want to know everything about your genome and your microbiome, your [00:12:00] physiology, the blood levels of your vitamins and minerals and, and help you then to, um, decide how you might change your diet.
Or take a dietary supplement or most likely, and for most people, I think both. Um, mm-hmm so, you know, if, if you really just love citrus fruits, which have lots of vitamin C, you probably don't need a vitamin C supplement. Although interestingly people will take, will focus on a particular vitamin, um, when it's really not the one that's that where there's a shortfall in their diet.
Dr Tom: You know, uh, Jeff, you brought up something that, uh, since you brought up your background in pharmacology and what we've seen a lot in, in medicine, as far as, uh, drug interactions, uh, with nutrients, there are some, I think worth maybe digging a little further into Metformin, widely prescribed. So, um, associated with B12 insufficiency, it's in the package insert.
I mean, you don't even have to look it up online. You can just grab the [00:13:00] package, insert. Even some emerging evidence on, uh, potential folate and riboflavin deficiencies, long term use with Metformin and then the proton pump inhibitors, which have similar overlap in terms of B12, uh, probably related to the, uh, acid reduction reduction with age, and then further reduced with a acid reducing medicine.
Like these proton pump inhibitors and magnesium as well. So there are some really widely prescribed drugs that definitely have an interaction with micronutrients that in, in metabolic medicine we've, uh, taken the opportunity to, to measure and, and not so, and often find some significant, um, insufficiencies that would require supplementation.
Any, any further comment on that?
Jeffrey: Well, I I'm glad you raised that. I mean, this is something, um, for reasons I can only guess. Many patients are reluctant to talk their physician about their use of supplements. I think some fear that their doctors will say, you're wasting your money and [00:14:00] you shouldn't be doing that.
And rather than be reprimanded, they just don't mention it. Um, but this is where your, you should talk to your physician or pharmacist can also help you understand the drugs that you're taking and how they might. Um, uh, Tom, I think the examples you raised are, are really good ones. I just want to add another one.
Um, diuretics or water pills are really commonly prescribed for lots of reasons, but, um, including treatment of, of hypertension and diuretics help to excrete sodium, um, you, you eliminate it in urine and that's just great. It's what those drugs are supposed to. but they also help to eliminate water soluble vitamins.
So you're losing, um, uh, some B vitamins. You're losing vitamin C at the same time. Importantly, the, um, uh, the thing to do is not to stop taking your medications is to understand that your requirement for vitamin C or those B vitamins has [00:15:00] gone. To address what the drug is doing
Kathleen: or potassium. I'm just concerned that there are lots of physicians out there that are not, um, as, um, informed as both of you are about the supplementation needed with these drugs.
So, you know, you need to read those inserts and, you know, be your own advocate as.
Jeffrey: Yeah, let me just reinforce that. Um, even if you think your doctor might not know or understand, um, enough about, um, um, where dietary supplements might come into your own, um, treatment plans or your own health promotion plans.
Ask. I mean, I really feel that if, if you push your healthcare provider, um, they may, the, the next time you go, they may have done some homework. And if they hear it from enough patients that gee, I'm interested in nutrition, I want to improve my diet. I want to understand supplements. They, they wanna help you.
They really do. Yeah. Um, but [00:16:00] you, you need to remind them, um, that that's, that's their role.
Dr Tom: That's. The question of distraction effect. I, I did want to see if we can drill down a little bit on the topic that you had. Well, we all started with right. I mean, primarily it's, it's our food patterns, our eating patterns we've even, uh, gone back and forth in a couple different shows.
Uh, Kathleen and I extended sad to crap, sad crap being calorie, rich refined, and highly processed. C R R a H P. So it sounds like the other crap you were thinking about, but acronym spelled differently. Um, The the basis for that. And then sometimes we get into, uh, many patients who develop a AB obsession over supplements to a point of a, a distraction effect.
In other words, we're filling gaps in here. We can't, uh, how do you, um, put it in a proper balance perspective where, you know, no matter what we do, if you're gonna continue to eat at an EI of 40, 50, 60, Um, you know, there, there's not much we're gonna be able to, to do with, with supplements to try to [00:17:00] make up that level of a gap, um, that we call the distraction effect being, uh, uh, sidelined by how can I, you know, what supplements can I take?
And instead of, uh, how can I start on a basis of, uh, healthy plant predominant flexitarian if you will. That's my, uh, my preferred angle on it, uh, a approach. How do you really strike
Jeffrey: that balance? Well, um, you have to work at it. And, and I mean, I, I hate to sound like a professor, but you need to get, but you are , but I, but you need to get educated, you know, I mean, um, I don't think Googling everything is always the best way to find information.
Um, but you can find reliable resources to help you better understand this. Um, I think, um, you know, again, I said, I mentioned earlier, Some people, um, focus on what they think is a magic vitamin or a magic mineral. Um, and you know, they're all necessary. One of the things when I talked about this reductionist [00:18:00] approach is that what we now need to do is really move to a Systems's biology or a functional condition approach.
So people need to understand, it's not one nutrient, one condition. I want strong bones. I need calcium. I mean, if you wanna talk about bone health. Yes. Calcium is important. Um, but so is fluoride and magnesium and phosphorus and vitamin K and vitamin C and vitamin D. Um, it, it's not a simple thing. And you, if you can understand better, um, how these, these networks of vitamins and minerals work together, you might be able to better understand your needs.
I mean, certainly in the age of COVID people. Are really interested in dietary supplements that support immune health? Well, the best way to support immune health is to eat a more plant-based diet because you want to be able to ensure that you're getting all of these essential, um, [00:19:00] micronutrients and other bioactive components that are present in the diet.
But we know that vitamin a and vitamin C and vitamin D and vitamin E um, are very important. in promoting immune resilience that, that minerals like iron and selenium and zinc are also important in the immune system. Um, and I do understand that people want to improve bone health or immune health or brain health.
Um, although I think we, it would be, and, and that's one way you can reach your patient or reach consumers. , but we need to understand it's it's overall health and wellness. If, if you're doing a great job, um, with your diet and with supplements for your heart, you're probably also doing a great job for your immune support and your brain health as well.
Kathleen: And I think you make an excellent point. Is that how we come up with these dietary [00:20:00] recommendations about the diet quality and the patterns, and why do we advocate for so much plant food is because they're so rich in these nutrients that you need for health. So if you focus on those whole foods, The synergy that works between them and helps enhance absorption.
Um, it's really where your better focus is, and then use the supplements to fill in those gaps. So who are the, who are the people that really stand to benefit the most from supplements? Um, and you mentioned, uh, pregnant and lactating women, but how about some other groups that really need to target? Um, specific nutrients.
Sure.
Jeffrey: Well, it's, it's, it's interesting because it depends in part on who you ask. Um but, but let me, let me refer to, um, the academy of nutrition and dietetics, um, you know, they have position papers and they say that that women of childbearing age. Yep. That that's a really big [00:21:00] group of Americans. I might add.
Mm-hmm and, and yes. Um, If, if you're thinking about that carefully, you know, that they need folic acid, um, to prevent neural two birth defects, they need Cho to promote, um, uh, growth and particularly brain health of the baby. They need iodine, which is falling short for many, uh, young women, but it's critically important.
Um, in pregnancy, um, the academy also talks about, um, older adults, um, As defined older. Well, I, I, I will tell you that, um, the, um, uh, the academy and the, um, uh, NIH, the national institutes of health office of dietary supplements define older as 50 and above. Okay. So, um, that's another huge audience. And, and again, they tend to focus on some specific nutrients, um, because older adults fall short in those nutrient.[00:22:00]
um, things like calcium and vitamin D some of the B vitamins, uh, magnesium, but again, um, it's not entirely prejudicial to say that, um, many, if not most older adults are also on one to 10 different medications. And so that role of drug nutrient interactions comes in. Yes. Um, and which of course makes them really.
Excellent candidates, um, for a cohort who should consider, um, a rational use of dietary supplements. Um, the, um, academy also talks about, um, vulnerable people as being those who are food insecure. Um, and that's a serious problem, um, in a country where, um, low incomes and, um, homelessness are, are real problems.
Um, adults with alcohol use disorder. Um, is identified as a vulnerable group group, um, [00:23:00] which indeed they are, um, their need for B vitamins, particularly. Um, I is critical, but we're talking about, you know, a, a problematic group to get them on more healthful lifestyles to start with. And then one that, um, uh, both the, um, uh, academy and the, um, office of dietary supplements talk about is people who are at risk for suboptimal vitamin D status.
Um, and so this is the sunshine vitamin of course. And, um, you can synthesize it from sunlight, but that makes everybody in the more Northern latitudes, um, at higher risk than those people at more Southern latitudes in, in, uh, north America, um, needing it. But it also, I mean, it's one of those things that there's not very much vitamin D and our diet, right.
So supplementation might. Um, kind of obvious. We know that, um, vitamin D levels in blood tend to be lower than optimal. [00:24:00] Um, but that, um, uh, you know, you can E E even many doctors now are willing to test for your 25 hydroxy vitamin D status. And that will give you a very good idea about where you stand. And like I was, uh, mentioning before, um, the idea between.
Um, deficiency and inadequacy and adequacy and optimal, um, is a continuum. And there seems to be a lot of good science to talk about that kind of continuum existing for vitamin D. So again, looking at your diet, looking at whether you, um, live in a sunny place, but always put on, um, sunscreen mm-hmm and keep yourself covered to avoid skin cancer.
Um, might make you a very good candidate, um, for a vitamin D supplement. The
Dr Tom: question has, uh, come up and, and I think we, we should, uh, get your perspective on it on the, the recent. Us, uh, [00:25:00] preventive services, uh, task force guidelines, uh, position statement on, on supplements and, you know, some of the, um, emerging concern, even around vitamin D with the vital trial and it's, uh, you know, its outcomes and, and what now is, and, uh, inadequate level of 25 hydroxyvitamin D is it really less than 20 instead of 30, but, um, you know, these kind of things are out there and your perspective on, uh, for instance, the us.
PSTF um, position statement would be, you know, very helpful for our listeners.
Jeffrey: Sure. Well, it's a little complicated because the answer is vitamin D is a vitamin DC vitamin D supplement. Um, really important. My question is important for what I mean, we know pretty well, how much vitamin D you need together with calcium and vitamin K and magnesium and phosphorus, how much you need to help support bone.
but the evolving evidence that vitamin D plays [00:26:00] important roles in other systems in immune function, for example, or in muscle health or in brain health is another question. And they're very interesting studies that just came out this year using the national health and nutrition examination study, showing that people with higher intakes or higher blood levels of vitamin D perform better on certain cognitive tests that reflect psychomotor speed and.
So vitamin D may play a much bigger role than the dietary reference intakes might suggest. I think when the us preventive services task force both originally in 2014 and now in 2022, where they said, you know, what is the value of multivitamins for the prevention of cardiovascular disease or cancer said, the evidence is insufficient to determine the balance of benefits and harms.
So that evidence is lack. Um, uh, that evidence is lacking in the balance for benefits and [00:27:00] harms cannot be determined, but this is what I was talking about in inappropriately. Applying reductionist, thinking to this very complex multifactorial non-communicable diseases like cancer and cardiovascular disease.
The irony is it's a funny question as I'm unaware of any evidence that people. Take a multivitamin for this purpose. I don't know anybody says, oh, I take my multivitamin. So I don't get cancer. The, the usual answer is I take it for overall health and wellness to, and to fill in nutrient gaps in my diet.
So the us preventative services task force was asking a question. I don't think anybody was really asking, but more importantly, it's important to, to know that the approach that the task force has always. Is that the evidence must be from double blind placebo controlled randomized clinical trials that were really developed to test drugs.
There's a real problem [00:28:00] in nutrition about relying exclusively on randomized clinical trials, because the design doesn't fit the science of nutrition. For example, in a randomized clinical trial, it's really important to have a placebo. So you expose somebody to the drug and you expose another group who doesn't get the drug.
It's pretty straightforward, but in a vitamin study, for example, everybody's eating even in the placebo group. So they're already being exposed and have been exposed from, in utero for their whole lives to vitamins and minerals. So it's no longer really the kind of gold standard that the randomized clinical trial was designed to.
and it's very hard to do these kinds of studies in the first place, even with something as simple as a multivitamin, because everybody in those large studies has different diets, but when they do a study and they find a benefit, then oftentimes it's [00:29:00] interestingly it's dismissed. So I'm certain Tom and Kathleen that, you know, the physician's health study.
Two did a randomized clinical trial with multivitamins in American physicians. It took them 15 years of the intervention and they found that there was an 8% reduction in the incidence of total cancers. And the results were dismissed because they said, well, these were only men. They were only physicians and they probably you eating pretty well.
And so that study needs to be replicated in women and in poor people, land in children. And so. But it's the best evidence we have to date. And I don't know of any reason to presume that male American physicians are so wildly different in their human biology, that this kind of information wouldn't translate.
But I think more importantly, this is a modest effect, and I think that's really important to understand in the role of dietary supplements for vitamins and minerals, you shouldn't expect [00:30:00] major. Prevention major treatment without changing other aspects of your lifestyle, your diet physical activity, and so on.
They're always gonna be modest. The effects of supplements are gonna be modest in size, but not unimportant. So in the physician's health study too, when you looked at the men who are over the age of 70, there's actually an 18% reduction in their risk of cancer, uh, incidents. And if you looked at those who had before the study started, had some history of cancer.
There was a 27% reduction in the risk of having a second cancer. So to me, these are compelling results, but if you take that study and you throw it in with 20 other randomized clinical trials where the results were known and of other audiences, then you come up with the, um, the task force saying, well, in totality, there's not enough evidence to support this, but [00:31:00] without being.
Too facetious. Um, I, I wanna point out that the absence of evidence is surely not, uh, an example of the evidence of absence. That is the evidence of no effect, um, for vitamin and mineral supplements. Um, there are lots of things we know that any, everybody knows, um, that we don't need a randomized clinical trial for, um, you know, there's never.
randomized clinical trial for jumping out of airplanes without a parachute. um, you know, you, you don't have to tell, uh, you don't have to know that that children shouldn't run with scissors or look both ways before crossing a street. We know from experiential evidence that these things are good. And we know that the role that vitamins and minerals play is so essential to our entire.
Metabolism that they can, that we shouldn't have shortfalls in them that our [00:32:00] diets are currently having many shortfalls of these nutrients, even on the dietary guidelines, like to point out what they call nutrients of concern or shortfall, nutrients, where for example, over 90%. Of Americans are falling short of the estimated average requirement.
The average requirement over 90% are falling short of vitamin E and choline and vitamin D and potassium. You know, these are places where I think everybody needs to understand. There may be a real value while we try to eat better. While we try to change our diets, that you can take these supplements today.
They have an effect today not to prevent cancer or diabetes. But to help your body run in a more healthful way, even nutrients like magnesium and calcium and vitamin a more than 40% of Americans are falling short of this estimated average requirement. [00:33:00] So there are a lot of big shortfalls and because we aren't, we're talking about vitamins and minerals today, I won't mention fiber.
But fiber, we should fiber is so, so important and there are fiber supplements, but I, I, I don't want get distracted by that, but, but we really, our diets need to be changed and supplements can be a tool to help
Dr Tom: that. Yes, I, if I can be for full disclosure, Uh, maybe a case study in this regard, I probably get about over 50 grams of intact fiber per day.
So I don't need to supplement in that regard, but the physician's health study, I, I do take a, a multivitamin I've been taking since the diabetes prevention program and my mild, uh, prediabetes at the end of, uh, internal medicine residency, because we all, we all know that. Residents eat so healthy after 36 hours up straight.
I mean, you know, I don't want cookies or anything like that afterwards. Sorry. Top pull my tongue outta my cheek now. Uh, and since I've been taking Metformin, For all that [00:34:00] time. Uh, Jeff, you know, I got, I got burned with a peripheral neuropathy and had to do my own research on how it not only depleted B12, but also folate.
So, you know, doctor who has a, uh, treats themselves as a fool for a patient. So I went to, you know, the doc neurologist and you know, what's going on here? I, you know, let's just check your folate, you know? Nah, I so healthy. I'm gonna have fol to the sky. What are you talking about? I didn't just supplement fo it was, it was zero.
It was undetectable low. As far as magnesium goes, I do. I take couple hundred milligrams of magnesium, uh, in the form of magnesium crate per day. So I think for honesty and dis full disclosure, I think I've dis disclosed. Okay. Plant predominant. Flexitarian okay. Got that out there. Uh, okay. What I'm taking for some multivitamin.
Yeah. Multivitamin. I got the magnesium crate going and as far as resources, I know we Don. I have no financial relationship with consumer reports at all, but people or the center for science or public interest are Tufts. That what are some resources obviously feel free to wave your own flag that [00:35:00] people can go to.
I've mentioned some, and again, I don't have any financial relationship with them, although I should disclose, I have donated to the center for science and the public interest, but they are donating to them. They're not donating to me. Uh, what are some resources that people can rely on? Do independent testing and, and so forth that, uh, are out there.
Um, other than, you know, Dr. Google,
Jeffrey: uh, right. Well, I mean, so the, the national institutes of health office for dietary supplements, mm-hmm, , mm-hmm has really good web pages, um, each and every individual vitamin and mineral, so true. And it's really a, a well referenced resource and quite credible, and it comes in two sizes.
It comes in consumer pages and health professional pages. That's right. Which I think is really. But there are others. I would point out that, um, the line is Pauling Institute at Oregon state university also has, um, uh, consumer directed, uh, uh, nutrition information website. I can't remember quite the name of it, but it's easy to find.
Um, so that would [00:36:00] be another resource, uh, I would, uh, refer to. But in addition to Tom, as you were, you were saying, in addition to getting that kind of information and education, ask your health provider. To be tested you just especially for vitamin D, especially for vitamin D, there, there are precision or personalized nutrition services available that are sprouting up around the us that will do blood tests for you.
So you can do it in a, um, private way. There are direct to consumer testing companies. Um, and I, I don't. Promote brands here, but, but they're not that difficult to find. So are they
Kathleen: reliable, Jeff, can you rely on the results?
Jeffrey: The, the, the answer is yes. Uh, I mean, because I know several of them and I know that they do really good testing, like any other, they're all certified clinical chemistry laboratories that are doing this, or they employ them that do.
So it's something to consider, but I just think that, um, it's, you know, [00:37:00] Tom, you know, you mentioned a, a physician as his own doctor as a full, it might be a little foolish, but the fact is you did the right thing. You went and you got tested. So where there is a concern, we do know that that inadequacies due to drug interactions, due to genetic interactions in some people can make a big difference.
And indicate that, oh, well for folic acid, you know, because of these different alleles in your genome mean your requirement is actually twice as high as you might think it is. So I just think that's a really important point, but I, I think I just also use another little example to get across this idea that, you know, we need to understand what these nutrients these, these micronutrients are doing.
So I just point out that, um, every cell in your body. It needs to produce ATP. And let me talk about the brain. The, the human brain is 2% of our body weight, [00:38:00] but it consumes 20% of our total food energy just to produce ATP, that energy molecule, there are a billion ATP molecules in solution in a cell, and they are replaced every two minutes and, you know, Manufactures them.
What, what catalyzes these reactions, it's all of the B vitamins, except for folate and, and vitamin C and iron and magnesium. So if you think that, you know, you need these nutrients at the right levels in every cell for every minute that you are breathing, it's a little better, a little, maybe a little easier to understand why we call them essential and why they're important.
for human health.
Kathleen: That's excellent. Well, I think we all agree that the multivitamin it's a good, it, it there's nothing wrong with it. It might not prevent cancer or cardiovascular [00:39:00] disease, but it can fill in those nutritional gaps. So to wrap up Jeff, I wanna. A ask you, what do you take every day? I mean, Tom told us what he'd take.
I'll add. I, I do a multivitamin and I do vitamin D and just as a side, I just had a spinal fusion and my neurosurgeon had me on vitamin D two months before the surgery, which I thought was kind of interesting. But also just talk about the regulation of vitamins and minerals and supplements. And if there's any preferred form gummies versus pills versus, um, what's out there on the
Jeffrey: shelfs, right?
Well, no, the preferred form of your supplement is the one you like the most. Okay. And you'll take, okay. Mm-hmm because I guarantee, I guarantee you, if you will not swallow a pill, but you love to chew gummies. I, I think gummies have some limitations cuz they can't be formulated. with some nutrients or as high level of doses as, um, might be needed.
But believe me, anything that works for you, pills, [00:40:00] powders, gummies, as long as you take it. Yeah. Um, some of the research I've done previously have shown we're using the, um, NHANES data set and we found that, um, multivitamins really lower the prevalence of inadequacy of all of the short. Nutrients, but they do it less.
So if you're only taking them a couple times a week than if you're taking them four times a week than if you're taking them six or seven days a week. So compliance, adherence, mm-hmm I mean, this is just saying, you know, read the label. If it says take once daily, then that's what you. To take them when you feel like it, or when you don't feel as well as you might want to be is, is not the way to use them.
Absolutely.
Kathleen: And then what do you
Jeffrey: take. Well, you know, I always liked to preface, but you both were very good about doing this. You know, who you are and why. And so I, I would tell you that I too, based on, on the evidence [00:41:00] that, um, I've seen from studies like the physician's health study, but also from what I've seen from even the, the large scale observational cohorts, I absolutely do take a multivitamin and I'm very compliant.
I take it every day. But because multivitamins, most of them don't have enough calcium or vitamin D multivitamins are typically formulated about 100% of the daily value, but calcium is too big of a mineral to squeeze that need into a multivitamin. So I also take a calcium and vitamin D supplement on top of that.
I also. Which, um, I didn't hear in your regimens. I also take a, a probiotic, cuz I think that, um, even though I have no gastrointestinal issues, I, I increasingly realizing that a more diverse and robust gut microbiome is linked to immune health and it's linked to what we call the gut brain axis. [00:42:00] So brain health can be important and we're also seeing data now that the gut microbiome can be linked to bone.
So the idea that the gut microbiome can play an important role in lots of our body systems has convinced me. Well, I, I like yogurt and kimchi and other fermented foods. Maybe I I'm not drinking enough kombucha. So I'll take a probiotic pill as well.
Kathleen: I do take one. I forgot to, uh, disclose yeah. In a different format in inulin fiber
Dr Tom: probiotic.
I, yeah, just to be careful on the, on the sodium, on some of the, uh, kimchi products.
Jeffrey: Yeah, no AB
Kathleen: absolutely. And you know, the other thing I think you raised that was an interesting point is. Supplements are not standardized. So even a prenatal is not necessarily gonna have the right amount of Coline and not all multivitamins are prepared the same.
So you need your glasses and you need to take a close look because there's not standardization within this arena.
Jeffrey: [00:43:00] Yes. So if, if necessary, get a magnifying glass or you're reading glasses and, and, and read the label. But. Before you do that, be a bit informed. What are you looking for and what doses are good?
You know, there is a little bit of a bottleneck. When I say, go, go talk to your physician or your registered dietician or your pharmacist. You know, some people find that that hard to do, but. You know, this is where, where the front line of defense should come in and, and you can get some of that information from reliable websites or talking to your healthcare provider.
Dr Tom: Can we ask, uh, one last question, Kathleen, I, I, you know, we've gone the supplements and all that, but since we've been talking about, and you you've made some references, but, uh, what did Jeff have for breakfast today or, or, or on average, you don't have to say today, you know, just, you know, give us an average or pick a meal.
You can pick lunch, dinner, breakfast, whatever, pick any one
Jeffrey: of them. Well, you know, she's healthy. Well, yeah, it's not, it's not that hard because, um, I, I, I'm really a kind of a routine guy. Yeah. So, so I have pretty much when I'm [00:44:00] home the same breakfast every day and that's yogurt, generally, a plain yogurt that I add fruit to.
I always have fruit around and I also throw in some granola into the, the bowl. So it's, it's a pretty healthy bowl. And then I, I mix a couple of 100% fruit juices, like orange juice and grapefruit juice together. To me, it, it's not only got better variety of some of these phytonutrients that are in the grapefruit versus orange, but I really like the taste and I love yogurt and granola and, and a whole variety of different fruit.
That would be my typical breakfast accompanied by a cup of tea. So
Dr Tom: you're combining some, some great, uh, uh, healthy gut microbiome promoters with the yogurt, right. And then obviously the fiber all intact, uh, good volume with the water filling of the yogurt and the fruit potassium. Magnesium is in there, you know, Hey, that's a, that's a pretty darn good, um, uh, supplement base right there.
Jeffrey: Absolutely. And I wanna stress. I mean, there are other healthy breakfasts. [00:45:00] You just need, need to find one that you love that you can do and then keep
Kathleen: doing it. Absolutely. Well, Jeff, this has been a wonderful conversation you've given us so much to think about and also so much to look for when we try to evaluate our own diets.
I love your recommendation to seek professional. It seems as though young women, older adults, but we didn't even talk about vegetarians and vegans and people who eliminate whole food groups, but there are risks in these groups for not getting all of the nutrients they need, even if they have that whole nutrient dense type plant forward diet.
Jeffrey: You're right. And I know that we've coming to an end, but I wanna stress that, that if you're gonna restrict your diet, if you really feel that gluten for example is bad for you, you give that. You're restricting a lot of very important, essential nutrients that you should be getting.
Kathleen: Absolutely. Right. So it's critical.
Remember that there's a reason for all of these nutrients, they're essential. They, they have roles in your body that are sometimes hard to understand, but [00:46:00] they're prolific, but there are upper limits and toxicities. You don't wanna overdo any kind of supplement. So, you know, take the eyeglasses and make sure you can see and try not to get over a hundred percent because there's potential for adverse effects.
And if you have, if you suspect anything, go see your healthcare provider. So thank you. Thank you. Thank you. Thank you, Tom. Thank you Jeff. For a great discussion. I really appreciate your time.
Jeffrey: Oh, it's it's been a real pleasure. Thank you so much for having me on
Kathleen: our
Jeffrey: pleasure.
Dr Tom: Thank you for listening to the true health revealed podcast.
We appreciate your time and hope you'll join us again for more information on today's episode and to subscribe to future podcast. Please visit true health initiative.org and help us continue the fight against fake facts. Please consider donating to our nonprofit true health initiative.[00:47:00]