Senior Fitness Fun Program Outline Vitamine E

							                                     A Sourcebook of Lesson Plans and Activities for Educating
  Seniors Eating Well                        Older Adults about Nutrition and Health



          LESSON 7 – EVALUATING DIETARY SUPPLEMENTS FOR SENIORS

Overview: Seniors can be at risk for spending their limited income on unregulated and
often medically unsubstantiated dietary supplements. Many have questions on whether
they need dietary supplements and how to select them for safety and efficacy. After
attending this program, seniors will increase their knowledge of the safety, credibility,
efficacy, labeling, regulations, and pros and cons of dietary supplements. Time
anticipated: 45 minute program. Additional 10 minutes for Q & A, evaluation, and
collection.

Materials Needed:
PowerPoint Slides: 1-9, computer, projector
Handouts:
  1. How to Spot False Dietary Supplement Claims
  2. Web Sites with Information on Dietary Supplements and Nutrition from
      Government Agencies and Others
  3. Nutrition Facts – Dietary Supplement Labels (prepared by A. Shirk in cooperation with J.
       Lynne Brown, associate professor of food science, Penn State College of Agricultural Sciences
       extension publication #UK044)
  4. Evaluation for Dietary Supplements for Seniors
Supplies:
   samples of dietary supplements (such as a multivitamin, bottle of Vitamin E in a
      dose over 100% RDA, Omega 3 fatty acids or fish oil)
   nutritional shakes, bars

Format & Procedures:
1. (Slide 1 – Title) - Introduce self and program. State title of program.

2. (Slide 2 – Objectives) – Review -
State - After attending this lesson, participants will:
    Define dietary supplements
    Increase your understanding of supplement labels—including % Daily Value
    Identify safety concerns with dietary supplements
    Identify credible sources of information for dietary supplements

3. Pass out How to Spot False Dietary Supplement Claims handout. State that you will refer
to it towards end of program.

4. (Slide 3 – What is a Dietary Supplement?) – Review (cover all points with a paper and
uncover each line as you review):
          ―A Dietary Supplement was defined by Congress in 1994 law as:
Seniors Eating Well – Lesson 7: Evaluating Dietary Supplements for Seniors



                       Taken by mouth
                       Contain ―dietary ingredient‖ e.g. vitamins, minerals, herbs, botanicals, amino
                        acids, enzymes, glandulars—herbs and botanicals mean the same thing.
                        ―Plant part used for therapeutic properties‖; glandulars are made from
                        glands of animals (such as thyroid)
                       Many forms: tablet, gelcap, liquid, powder
                       Not used as meal replacement or regular food
                       Must be labeled as ―dietary supplement‖

5. (Slide 4 – What is a Dietary Supplement?) – Review – Supplemental Facts:
    ―Must be labeled as dietary supplement: says Supplement Facts on label (Not
       Nutrition Facts)‖
    ―Look for % Daily Value—is it established?‖ Point to the heavy black line on
       Supplement Facts label. ―By law, anything under that line, or as designated—shown
       here with cross, has no ―established Daily Value.‖ So this means there is no research
       to support an established health need for the substance. A Daily Value is only created
       for a nutrient, such as a vitamin, when there is an established need for health and then
       an amount is set by the National Institutes of Health based on an expert panel’s
       review of the research.‖
    Point out on label: ―Is % DV >100%?-Caution if >100%- if a nutrient’s Daily Value
       >100%-could make you sick. Do not take over 100% unless doctor recommends.‖
       100% of a Daily Value means that is the most of that nutrient that is recommended to
       have in one day.‖
    Point out on label: ―A label may not make claims to treat/cure disease—only to
       connect a substance in product to possibly reducing risk of disease and it must state
       FDA did not evaluate claim.
    $$$ – May also be very costly—for one purchase or add up over time.‖

6. (Slide 5 – Would I Benefit from a Dietary Supplement?) – State - ―Now let’s look at
one senior’s situation‖
Review and State - ―We will answer some of Bob’s concerns, as he represents many
senior’s situations:

    Bob retired and lives alone:
     Often skips meals—too tired or not hungry
     Will supplements give him more energy or improve his health?‖

7. (Slide 6 – Would I Benefit from a Dietary Supplement?) – Review -
―100% Daily Value Vitamin/Mineral Supplement (multivitamin) May Help All Seniors,
Especially if You:
    Have a chronic disease—for example, cancer, heart disease, diabetes
    Skip meals or food groups
    Drink alcohol excessively or smoke
    Are on a special diet—for example, vegetarian, low carbohydrate
    Check with Doctor, Registered Dietitian first before starting any dietary supplement.
       They know your medical and nutritional needs best.‖


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Seniors Eating Well – Lesson 7: Evaluating Dietary Supplements for Seniors




State the following points:
    ―After age 60, many seniors have decreased absorption of Vitamins B12, B6, D, and
       have higher needs for calcium. Iron, zinc, and calcium are often low in senior diets.
    Eating a balanced diet from all food groups is recommended first before trying any
       additional dietary supplements—other than a multivitamin. Coming to the senior center
       may be a good idea for seniors who eat alone often or skip meals, like Bob.
    There is no supplement that can provide all the nutrients you need. Eat a balanced,
       varied diet from food as recommended in USDA’s MyPyramid. By following these
       recommendations, it is the only way to assure you’re getting all the nutrients you need,
       unless otherwise recommended by your physician or Registered Dietitian.‖

8. (Slide 7 – What About Nutritional Shakes and Bars?) – State -
―Nutritional Shakes & Bars are not dietary supplements by definition, but:
    Could more easily offer needed energy, vitamins, minerals for seniors skipping meals
        like Bob, but not needed for active, healthy seniors eating balanced meals—could
        easily increase weight.
    Check Nutrition Facts labels for % DV. Again should not be >100%: 25-33% DV
        acceptable for nutrients—fiber also should be included—for example, 10% DV is a
        good source
    May be costly
    Check with Registered Dietitian to see if right for you

9. Activity: Show samples of dietary supplements, nutritional shakes and bars.
Ask for 1-3 volunteers to state what product is and to find:
       a. Is it a dietary supplement?
       b. % DV—are any over 100%?
       c. Any ingredients without established DV?
       d. Any health claims not evaluated by FDA?

10. (Slide 8 – Dietary Supplements—How Safe?) – State - ―Manufacturers are
responsible for ensuring product safety.
    No quality, effectiveness or safety requirements. Manufacturers don’t have to prove
      what ingredients and concentrations are really in product—or prove the supplement
      works, or is safe.
    FDA is only responsible for taking action if it receives reports of unsafe product or
      prove that product claims are false or misleading. Federal Trade Commission
      investigates false advertising claims.‖

11. (Slide 9 – More Safety Issues) – State - ―Some dietary supplements may:
    Interact with medications—prescribed and over the counter
    Increase risk of bleeding, affect anesthetics—caution with surgery and affect
      painkillers
    Have major side effects


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Seniors Eating Well – Lesson 7: Evaluating Dietary Supplements for Seniors




        Have lower or high dosages—or be contaminated
        Some Examples of Supplements FDA has Cautions on Safety:
         o Ephedra—increases heart rates and has been linked to causes of death
         o Kava, Comfrey, St. John’s Wort—all have serious drug interactions and side
            effects
        Bottom Line Summary: Check with FDA, Doctor, or health-care provider for warnings,
         recalls and product usefulness before taking any dietary supplement. There is more
         published scientific research now on dietary supplements and more clinical trials than
         ever before to learn if any are helpful in the future.‖

12. Refer to How to Spot False Dietary Supplement Claims handout. Point out Dietary
Supplement Facts label on the handout and the recommended sources for more information
(government, professional associations).

13. Ask for any questions.

14. Ask for volunteers to help pass out evaluations, review questions, and thank
everyone for their attention.



Prepared by: Lynn James, M.S., R.D., L.D.N., Extension Educator, Penn State Cooperative Extension




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