A Patient's Guide to Dietary Supplements (Nutraceuticals) Nancy Dunne, ND What are nutraceuticals? Nutraceutical is a new word, invented by Dr. Stephen DeFelice in 1989. It is a combination of the words "nutritional" and "pharmaceutical". Nutraceuticals are dietary supplements that are sometimes also called “functional foods”. According to the US Food and Drug Administration, a nutraceutical is any substance that is a food or a part of a food that provides medical or health benefits. Nutraceuticals contribute to the prevention and treatment of disease. These products can be single nutrients, like Vitamin C, or dietary supplements like a multiple vitamin mineral combination. A nutraceutical can also be a genetically engineered “designer” food, an herbal product, or processed foods such as cereals with iron added, or sports beverages with electrolytes. The definition of nutraceutical also includes special diets, for instance a diet recommended to treat chronic inflammation. Nutraceuticals are most often thought of as a chemical product isolated or purified from foods. They have been shown to have health benefits or to provide protection against chronic disease. Examples of nutraceuticals other than vitamins and minerals that are particularly useful for spine and joint problems are glucosamine sulfate, chondroitin sulfate, fish oils and the herb Boswellia. What is a dietary supplement? The US Congress defined the term "dietary supplement" in the Dietary Supplement Health and Education Act (DSHEA) of 1994. “A dietary supplement is a product taken by mouth that contains any chemical ingredient meant to add to what a person gets in their usual diet. The "dietary ingredients" in these products may include: vitamins, minerals, herbs or other plant materials, amino acids, and substances such as enzymes or organ tissues. Dietary supplements can also be extracts or concentrates, and may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or
powders. They can also be in other forms, such as a bar, but if they are, information on their label must not represent the product as a conventional food or a sole item of a meal or diet.” How do nutraceuticals and dietary supplements work? Supplemental nutraceuticals work by providing you with extra nutrition. Whenever your diet is not able to meet all the demands for nutrients that illness, injury or extra hard work are making on your body, supplemental nutrients will be helpful. Nutrients are the chemical elements that make up a food. Nutrients are the basic elements of what you eat that give your body what is necessary for “running the show”, that is, for metabolism. Certain nutrients (called carbohydrates, fats, proteins and alcohols) provide energy; other nutrients (for instance water, electrolytes, minerals, vitamins) are essential to metabolic processes. Metabolism is the work your body does to change the food you eat into the tissues and organs of your body. Metabolic processes are the means by which you make the hormones and other chemical messengers that signal your organs to function properly. Metabolism also refers to the way your cells change the chemical energy in nutrients into mechanical energy or heat. Metabolism is the work of your cells and of the fluids and tissues and organs of your body. You can think of nutrients and metabolism as a kind of bucket brigade. You have a problem (the house is on fire) and a desired end result (put out the fire). You have a line of people, passing buckets of water to toss on the fire (nutrients doing the work of metabolism). If there are not enough people in the line to stretch between the water source and the fire, the process will not be complete- the fire will burn up the house. In the same way, if you have some, but not quite enough of the proper elements of nutrition, you may not heal a wound, or repair an injury as well or as soon as you could if you had all the nutrients you needed for the job. Good health and proper functioning requires a good diet that contains all the elements you need for whatever metabolizing you need to do. A person who is climbing a mountain will need to metabolize more
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than a person sitting at a desk all day. A person who is healing from surgery needs extra nutrition to meet the demands of tissue repair. Why are nutraceuticals prescribed? Nutraceuticals are prescribed in order to be sure you have all of the chemical elements you need to repair injured tissue. Nutraceuticals are used to provide the vitamins and minerals your body needs to fight infection. Dietary supplements make sure you have enough of the right raw material to rebuild tissue that has been damaged. An inadequate diet can be a cause of injury and disease. Excellent nutrition is an absolute requirement for full recovery and good health. Nutraceuticals are prescribed because a healthy diet is hard to find. Many people like to think that they eat a healthy diet, and they have everything they need for all that their body demands for good health. Studies have shown that while many people can describe a healthy diet, when they write down what they actually are eating, they do not eat a nutritionally complete diet. Other studies have shown that the standard American diet has more than enough calories, but the food does not have of the right amounts of vitamins, minerals, fiber, carbohydrate, protein and fat content to really be healthy. We tend to have not enough of some things (usually vitamins, minerals and protein) and too much of others (usually unhealthy fats and carbohydrates). Supplemental nutrition is needed because most people do not eat a perfectly healthy diet. Over time, your body will begin to show the effects of a less-than-perfect diet. Feeling tired, having frequent colds or experiencing regular joint stiffness and body aches, are some of the signals that nutritional deficiencies are beginning to be felt in your body tissues. When you are faced with additional challenges, like injury or surgery, nutraceuticals are a quick and reliable way to flood your system with all of the chemical elements you will need to restore and repair and return to excellent health. When should I consider taking nutraceuticals? You should use nutraceuticals when your diet does not provide all the nutrition you need for the situation you are in. Different situations
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need different nutritional support. Most people understand that for instance a pregnant woman needs to eat more; she needs to eat a special diet because she is in a special situation. Pregnancy is a state that requires better nutrition for a better outcome. We know that if a woman does not have enough folic acid, she is much more likely to have a baby with certain birth defects. Too much of something can be as bad as not enough. A woman who eats too much sugar when she is pregnant can develop a kind of diabetes that will also make her baby sick at birth, and will increase the risk that child will be over weight and have diabetes as an adult. In the same way, many other situations require better nutrition for a better end result. If you are injured, you need more nutrition to provide the raw material to rebuild your damaged tissues. If you are sick with an infection, you need extra dietary chemistry to help your immune system perform the work of fighting the virus or bacteria that is making you sick. If you are having an operation, you will have injury that needs to be repaired. Chronic conditions like arthritis and degenerative disc disease include inflammation as part of the destructive, painful disease process. Inflammation is caused in part by poor nutrition and can be relieved by correcting your nutritional intake. Osteoporosis is a condition in which bone is weakened because of nutritional deficiency. Taking supplemental minerals and vitamins will improve the strength of osteoporotic bone. Especially once a disease is established, it is very hard for most people to eat enough of the right foods, and to digest it properly. It takes a special effort to get the extra nutrition needed to overcome an illness. Dietary supplements are used like medicine in this case, to get the necessary concentrated doses of nutrition required for healing damaged tissue. Surgery is a situation that requires better nutrition for the best possible recovery. In a hospital there are many extra challenges to the immune system. There are unusual bacteria and viruses you have to protect yourself against. There is the stress of being away from home, having pain, and having surgical wounds to heal. Spine surgery in particular requires a lot of blood-building; your nutrition is
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the source of all the chemistry you need to make new red blood cells. You will have an excited immune system with a lot of work to do to protect you and help you recover. You will need an extra supply of nutritional elements to help you replace the blood you will lose during surgery. You will need more than your usual amount of raw material to rebuild connective tissue, and to restore damaged nerves, muscles and skin after surgery. What is the evidence that nutraceuticals are effective? At this point, there has been decades of research and many thousands of articles published by medical researchers that tell us how individual nutrients and herbal medicines work in the bodies of animals and humans. This research is conducted in the same way that drugs are studied. There are strengths and weaknesses in using this method to figure out how any substance will work in the human body. We can study how a single chemical will affect a human cell. That information helps us make a reasonable decision about whether it will be useful for that cell’s function or not. We can also study how too much or not enough of a certain vitamin or mineral or a certain dietary item like fat, effects large groups of people. We know that groups of people who do not have enough of the mineral selenium in their diet get sick more often with everything from infections to cancer. These studies do not tell us if a particular person is sick because they do not have enough selenium. The study only suggests that if that person is part of the group of people studied, there is a good chance they are low in selenium, and therefore at risk of being sick more often because of it. Common sense tells us that selenium is an important nutrient for protection against disease for all people. Studies have shown that many people in the US do not get enough Vitamin D. More than 90%of people with chronic musculoskeletal pain, limb pain, and low-back pain are Vitamin D deficient. Research makes it clear that supplementation with vitamin D will reduce inflammation and safely treat musculoskeletal pain for many people.
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Similarly, research has shown that people with the brittle weak bones of osteoporosis can rebuild and restore the strength of their bone with mineral and vitamin supplements containing calcium, magnesium, Vitamin D and L-lysine. Glucosamine sulfate and chondroitin sulfate are two of the nutritional elements you can use to build connective tissue like the cartilage that cushions your joints. Studies have shown consistently positive results for people with osteoarthritis of the hands, hips, knees, jaw, and lower back when they take regular doses of chondroitin and gluscosamine sulfate.. What are the right nutraceutical supplements for me to take? No drug or herb is a single, simple chemical item. Furthermore, no single item, like Vitamin E for instance, can be swallowed by two different people and be digested and absorbed in exactly the same way. There is actually no way we can know exactly what a particular chemical, a drug, a vitamin, mineral or herb is going to do in a particular person’s body. It all depends on how a person digests things, how well their liver and kidneys for instance work, and whether they have all the other chemical elements that the pill they are taking need to work once inside the body. Research has given medical specialists a general idea about what amounts of different nutrients will be helpful to most people. It makes sense to take recommended amounts of nutraceuticals in situations where you know you will be challenged to fight and infection, heal a wound or meet any other kind of challenge that is an extra stress on your system. Eating right and supplementing with nutraceuticals will make sure you have all the raw material you need to heal everyday wear and tear as well as the damage from disease, accidental injuries or surgery. A healthy diet and the right nutraceuticals will:
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help you control chemical irritants inflaming your tissues reduce pain nerve stimulation minimize tightening and stiffening of muscles, connective tissue
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and joints insure you have all the raw material you need to heal a wound or prevent loss of bone or tissue function
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