Should You Take Dietary Supplements?

supplementsThe NIH offers a look at supplements including vitamins, minerals, botanicals and more. 

When you reach for that bottle of vitamin C or fish oil pills, you might wonder how well they’ll work and if they’re safe. The first thing to ask yourself is whether you need them in the first place.

More than half of all Americans take one or more dietary supplements daily or on occasion. Supplements are available without a prescription and usually come in pill, powder or liquid form. Common supplements include vitamins, minerals and herbal products, also known as botanicals.

People take these supplements to make sure they get enough essential nutrients and to maintain or improve their health. But not everyone needs to take supplements.

“It’s possible to get all of the nutrients you need by eating a variety of healthy foods, so you don’t have to take one,” says Carol Haggans, a registered dietitian and consultant to NIH. “But supplements can be useful for filling in gaps in your diet.”

Some supplements may have side effects, especially if taken before surgery or with other medicines. Supplements can also cause problems if you have certain health conditions. And the effects of many supplements haven’t been tested in children, pregnant women and other groups. So talk with your health care provider if you’re thinking about taking dietary supplements.

“You should discuss with your doctor what supplements you’re taking so your care can be integrated and managed,” advises Dr. Craig Hopp, an expert in botanicals research at NIH.

Dietary supplements are regulated by the U.S. Food and Drug Administration (FDA) as foods, not as drugs. The label may claim certain health benefits. But unlike medicines, supplements can’t claim to cure, treat or prevent a disease.

“There’s little evidence that any supplement can reverse the course of any chronic disease,” says Hopp. “Don’t take supplements with that expectation.”

Evidence does suggest that some supplements can enhance health in different ways. The most popular nutrient supplements are multivitamins, calcium and vitamins B, C and D. Calcium supports bone health, and vitamin D helps the body absorb calcium. Vitamins C and E are antioxidants—molecules that prevent cell damage and help to maintain health.

Women need iron during pregnancy, and breastfed infants need vitamin D. Folic acid—400 micrograms daily, whether from supplements or fortified food—it is important for all women of childbearing age.

Vitamin B12 keeps nerve and blood cells healthy. “Vitamin B12 mostly comes from meat, fish and dairy foods, so vegans may consider taking a supplement to be sure to get enough of it,” Haggans says.

Research suggests that fish oil can promote heart health. Of the supplements not derived from vitamins and minerals, Hopp says, “Fish oil probably has the most scientific evidence to support its use.”

The health effects of some other common supplements need more study. These include glucosamine (for joint pain) and herbal supplements such as echinacea (immune health) and flaxseed oil (digestion).

Many supplements have mild effects with few risks. But use caution. Vitamin K, for example, will reduce the ability of blood thinners to work. Ginkgo can increase blood thinning. The herb St. John’s wort is sometimes used to ease depression, anxiety or nerve pain, but it can also speed the breakdown of many drugs—such as antidepressants and birth control pills—and make them less effective.

Just because a supplement is promoted as “natural” doesn’t necessarily mean it’s safe. The herbs comfrey and kava, for example, can seriously damage the liver.

“It’s important to know the chemical makeup, how it’s prepared, and how it works in the body—especially for herbs, but also for nutrients,” says Haggans. “Talk to a health care provider for advice on whether you need  supplements in the first place, the dosages and possible interactions with medicine you’re already taking.”

For vitamins and minerals, check the % Daily Value (DV) for each nutrient to make sure you’re not getting too much. “It’s important to consider the DV and upper limit,” says Haggans. Too much of certain supplements can be harmful.

Scientists still have much to learn even about common vitamins. One recent study found unexpected evidence about vitamin E. Earlier research suggested that men who took vitamin E supplements might have a lower risk of developing prostate cancer. “But much to our surprise, a large NIH-funded clinical trial of more than 29,000 men found that taking supplements of vitamin E actually raised—not reduced—their risk of this disease,” says Dr. Paul M. Coates, director of NIH’s Office of Dietary Supplements. That’s why it’s important to conduct clinical studies of supplements to confirm their effects.

Because supplements are regulated as foods, not as drugs, the FDA doesn’t evaluate the quality of supplements or assess their effects on the body. If a product is found to be unsafe after it reaches the market, the FDA can restrict or ban its use.

Manufacturers are also responsible for the product’s purity, and they must accurately list ingredients and their amounts. But there’s no regulatory agency that makes sure that labels match what’s in the bottles. You risk getting less, or sometimes more, of the listed ingredients. All of the ingredients may not even be listed.

A few independent organizations conduct quality tests of supplements and offer seals of approval. This doesn’t guarantee the product works or is safe; it just assures the product was properly made and contains the listed ingredients.

“Products sold nationally in the stores and online where you usually shop should be fine,” Coates says. “According to the FDA, supplement products most likely to be contaminated with pharmaceutical ingredients are herbal remedies promoted for weight loss and for sexual or athletic performance enhancement.”

To make it easy to find reliable information, NIH has fact sheets on dietary supplements at http://ods.od.nih.gov/factsheets/list-all/.  NIH also recently launched an online Dietary Supplement Label Database at www.dsld.nlm.nih.gov. This free database lets you look up the ingredients of thousands of dietary supplements. It includes information from the label on dosage, health claims and cautions.

“Deciding whether to take dietary supplements and which ones to take is a serious matter,” says Coates. “Learn about their potential benefits and any risks they may pose first. Speak to your health care providers about products of interest and decide together what might be best for you to take, if anything, for your overall health.

Safe Use of Supplements

  • Tell all of your health care providers about any dietary supplements you use. Some supplements can interact with medications or affect medical conditions.
  • Read the label instructions for use.
  • “Natural” doesn’t always mean safe. For up-to-date news about the safety of particular supplements, check http://nccam.nih.gov/news/alerts.
  • Too much might be harmful. Don’t take more than the recommended dose.

Source: NIH News in Health

NIH Office of Communications
and Public Liaison
Building 31, Room 5B64
Bethesda, MD 20892-2094
nihnewsinhealth@od.nih.gov
Tel: 301-402-7337

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Balance Food and Activity

The following message on maintaining a healthy weight by creating a balance of foods consumed and  food calories burned through activity comes from the National Institutes of Health.

balance

What is Energy Balance?

Energy is another word for “calories.” Your energy balance is the balance of calories consumed through eating and drinking compared to calories burned through physical activity. What you eat and drink is ENERGY IN. What you burn through physical activity is ENERGY OUT.

Your ENERGY IN and OUT doesn’t have to balance every day. It’s having a balance over time that will help you stay at a healthy weight for the long term. Children need to balance their energy, too, but they’re also growing and that should be considered as well. Energy balance in children happens when the amount of ENERGY IN and ENERGY OUT supports natural growth without promoting excess weight gain.

That’s why you should take a look at the Estimated Calorie Requirement chart, to get a sense of how many calories (ENERGY IN) you and your family need on a daily basis.

Estimated Calorie Requirements

This calorie requirement chart presents estimated amounts of calories needed to maintain energy balance (and a healthy body weight) for various gender and age groups at three different levels of physical activity. The estimates are rounded to the nearest 200 calories and were determined using an equation from the Institute of Medicine (IOM).

Estimated Calorie Requirements (in kilocalories) for Each Gender and Age Group at Three Levels of Physical Activity.

Gender

Age (years)

Activity Level

Sedentary

Moderately Active

Active

Child

2-3

1,000

1,000 – 1,400

1,000 – 1,400

Female

4 – 8

1,200

1,400 – 1,600

1,400 – 1,800

Female

9-13

1,600

1,600 – 2,000

1,800 – 2,000

Female

14-18

1,800

2,000

2,400

Female

19-30

2,000

2,000 – 2,200

2,400

Female

31-50

1,800

2,000

2,200

Female

51+

1,600

1,800

2,000 – 2,200

Male

4-8

1,400

1,400 – 1,600

1,600 – 2,000

Male

9-13

1,800

1,800 – 2,200

2,000 – 2,600

Male

14-18

2,200

2,400 – 2,800

2,800 – 3,200

Male

19-30

2,400

2,600 – 2,800

3,000

Male

31-50

2,200

2,400 – 2,600

2,800 – 3,000

Male

51+

2,000

2,200 – 2,400

2,400 – 2,800

Source: HHS/USDA Dietary Guidelines for Americans: 2005

  • These levels are based on Estimated Energy Requirements (EER) from the IOM Dietary Reference Intakes macronutrients report, 2002, calculated by gender, age, and activity level for reference-sized individuals. “Reference size,” as determined by IOM, is based on median height and weight for ages up to age 18 years of age and median height and weight for that height to give a BMI of 21.5 for adult females and 22.5 for adult males.
  • Sedentary means a lifestyle that includes only the light physical activity associated with typical day-to-day life.
  • Moderately active means a lifestyle that includes physical activity equivalent to walking about 1.5 to 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
  • Active means a lifestyle that includes physical activity equivalent to walking more than 3 miles per day at 3 to 4 miles per hour, in addition to the light physical activity associated with typical day-to-day life.
  • The calorie ranges shown are to accommodate needs of different ages within the group. For children and adolescents, more calories are needed at older ages. For adults, fewer calories are needed at older ages.

Energy Balance in Real Life

Think of it as balancing your “lifestyle budget.” For example, if you know you and your family will be going to a party and may eat more high-calorie foods than normal, then you may wish to eat fewer calories for a few days before so that it balances out. Or, you can increase your physical activity level for the few days before or after the party, so that you can burn off the extra energy.

The same applies to your kids. If they’ll be going to a birthday party and eating cake and ice cream—or other foods high in fat and added sugar—help them balance their calories the day before and/or after by providing ways for them to be more physically active.

Here’s another way of looking at energy balance in real life.

Eating just 150 calories more a day than you burn can lead to an extra 5 pounds over 6 months. That’s a gain of 10 pounds a year. If you don’t want this weight gain to happen, or you want to lose the extra weight, you can either reduce your ENERGY IN or increase your ENERGY OUT. Doing both is the best way to achieve and maintain a healthy body weight.

  • Here are some ways to cut 150 calories (ENERGY IN):
    • Drink water instead of a 12-ounce regular soda
    • Order a small serving of French fries instead of a medium , or order a salad with dressing on the side instead
    • Eat an egg-white omelet (with three eggs), instead of whole eggs
    •  Use tuna canned in water (6-ounce can), instead of oil
  • Here are some ways to burn 150 calories (ENERGY OUT), in just 30 minutes (for a 150 pound person):
    • Shoot hoops
    • Walk two miles
    • Do yard work (gardening, raking leaves, etc.)
    • Go for a bike ride
    • Dance with your family or friends

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E-cigarettes…What Do We Know About Their Safety ?

e-cigarettes are not safe

In an effort to quit,many people who smoke, are turning to e-cigarettes to help ease the process of giving up cigarettes entirely. Adolescents are experimenting with e-cigarettes. Yet little is known about the long term effects of using e-cigarettes.

What follows is a press release that speaks to the concerns of The  American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO) with regard to e-cigarettes.

 Press release... The American Association for Cancer Research (AACR) and the American Society of Clinical Oncology (ASCO), in a joint letter responding to a proposal by the U.S. Food and Drug Administration (FDA) to extend its regulatory authority over tobacco products, today urged the agency to regulate electronic cigarettes (e-cigarettes), cigars, and all other tobacco products and to strengthen the proposed regulations for newly deemed products.

“There is no safe form of tobacco use,” said Margaret Foti, PhD, MD (hc), chief executive officer of the AACR. “Tobacco is the leading cause of preventable deaths in the United States, and among its dire health consequences are 18 different types of cancer. It is imperative that the FDA takes action to regulate all tobacco products. The future health of the American people, in particular our nation’s children, depends on it.”

The AACR and ASCO applauded the FDA’s proposal to regulate e-cigarettes. “We believe it is vitally important for the FDA to begin regulating these products,especially because we don’t know much about the health effects of e-cigarette use. We are also quite concerned that e-cigarettes may increase the likelihood that nonsmokers or former smokers will use combustible tobacco products or that they will discourage smokers from quitting,” said Peter P. Yu, MD, FASCO, president of ASCO.

“There are insufficient data on the long-term health consequences of e-cigarettes, their value as tobacco cessation aids, or their effects on the use of conventional cigarettes. Any benefits of e-cigarettes are most likely to be realized in a regulated environment in which appropriate safeguards can be implemented,” said Roy S. Herbst, MD, PhD, chair of the AACR Tobacco and Cancer Subcommittee and chief of medical oncology at Yale Comprehensive Cancer Center.

The AACR and ASCO support many of the FDA’s proposals for regulating e-cigarettes and other products, but urge the agency to do more. Specifically, preventing children from using tobacco products is crucial and can be achieved by efforts such as banning youth-oriented advertising and marketing, self -service product displays, and tobacco company sponsorship of youth-oriented events, in addition to restricting sales to minors and implementing age-verification procedures for internet sales.

Expressing grave concern about the proliferation of flavored e-cigarettes, the AACR and ASCO encouraged the agency to ban e-cigarette flavors or flavor names that are brand names of candy, cookies, soda, and other such products, and to prohibit e-cigarettes containing candy and other youth-friendly flavors, unless there is evidence demonstrating that they do not encourage young people to use these products.

The AACR and ASCO strongly discouraged the FDA from exempting “premium” cigars from regulation, an option the agency is considering. “All cigars pose serious health risks,” said Graham Warren, MD, PhD, chair of ASCO’s Tobacco Cessation and Control Subcommittee. “As the FDA itself noted in the proposed rule, even cigar smokers who do not inhale have a seven to 10 times higher overall risk of mouth and throat cancer compared with individuals who have never smoked.Exempting these dangerous products from FDA regulation is clearly not in the best interest of public health.”

Noting that both large and small cigars are of increasing interest to youth and adult users, the AACR and ASCO underscored that the continued availability of premium cigars in an unregulated market, compounded with the ability of the tobacco industry to strategically market its products to youths and young adults, could reverse the progress made in reducing youth tobacco use.

Finally, the AACR and ASCO urged the FDA to drop the “consumer surplus” discount used to assess the net impact of the proposed deeming rule. This discount allows the FDA to only consider 30 percent of the benefits achieved via tobacco cessation due to the costs associated with this proposed regulation, including the “lost pleasure” of smoking. The AACR and ASCO stressed that addiction is an unwelcome burden for many tobacco users and that many consumers are not making rational and fully informed choices when initiating and continuing their use of tobacco products.

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Tips for Selecting a Summer Day Camp

 camp

Many of us still have snow on the ground, others are bracing for still another wintery blast, which makes it hard to think about selecting a summer day camp. But, if you have a child that needs to be in an out-of school program during the summer recess, now is the time to do research to find the camp that meets your child’s needs and interests and is within your budget.

The American Camp Association offers the following guides when considering a day camp:

Day camps offer experiences that are unique from resident camps. Because of this, there are specific points to consider when choosing a day camp.

  1. Does the American Camp Association accredit the camp? ACA has specific standards applicable only for day camps.
  2. What training does the staff receive on safety, supervision, counseling, problem solving and other issues unique to working with young children?
  3. Is the price all-inclusive or are there extra charges for: · Transportation · swimming lessons · food service · horseback riding · group pictures · T-shirts · extended care · field trips
  1. If camp transportation is offered, where is the closest pick-up location?
  2. Does the camp have an “express bus” which transports children quickly?
  3. If before- and after-camp extended care is offered, who is with the children and what activities take place?
  4. Is lunch served or do campers bring their own sack lunch? Are snacks and drinks provided?
  5. If the camp offers swimming, are there swimming lessons or is it simply recreational swimming?
  6. Are campers in a group with a counselor all day? Or, are campers free to go from one activity to another with appropriate supervision? In this case, whom would you talk to if you had a question or concern about your child?
  7. Is an open house offered before camp starts where you can meet your child’s counselor and van/bus driver?
  8. Are parents allowed to drop by for visits or is there a special parent visitation day?

 

Most frequently asked camp questions by children who will be attending day camp and how you might want to answer them:

What will I do all day? You’ll get to do so much — things like swimming, tennis, basketball, arts and crafts, softball or baseball, cooking, ceramics, gymnastics, soccer, dancing, football… the list goes on and on. There are also special events and entertainment.

Who will help me have fun at camp? How do they know how to care for me?
Counselors are selected because they love working with kids. They are trained before camp begins to help you have a good time, make new friends, and enjoy a variety of activities. Their job is to help you have fun, be safe, and know your limits.

Do I get to choose what I want to do?
Some camps schedule the entire day so you have an opportunity to try all the different things at camp. At many camps, you’ll get to select one or even more activities every day. You can ask about how the day is planned for you.

Who will be my friends?
You will make a lot of new friends at camp. Camp counselors will help you make friends the very first day you arrive at camp. It’s nice to have winter friends and summer friends.

What’s so great about camp?
Camp is a special place where grownups help kids feel good about themselves. You get to make choices on your own, but you always feel safe. Camp is like a little community, where everyone’s opinion is heard, and kids work and play together. There’s just no other place like camp, because camp is built just for kids!

Why shouldn’t I just stay home and do what I want?
You might think it will be more fun to just stay home and do nothing, but believe us, camp is nonstop fun! There are such a variety of activities that you never get bored. And you always have friends; everyone’s always home at camp!

What would a day at camp be like?
Camp is filled with different kinds of activities. The fun begins as soon as the bus picks you up. You will spend the day doing activities you really like. Of course you’ll stop for lunch – maybe a barbecue or a picnic. Day campers will go home on their buses in the late afternoon, and look forward to returning to camp the next day.

What if I’m not good at sports?
Camp staff will encourage you, and you will succeed at your level. You are never measured at anyone else’s ability level. Camp is not all sports, but a combination of athletics, the arts and hobbies.

What if I have a problem?
There are lots of people at camp, besides your counselors, to help take care of you, depending on what you need. There is usually a nurse, so if you don’t feel well they have a place where you can rest until you feel better. You can count on the grownups that are at camp to help you with any problem you may have.

Once you have answered these questions, visit ACA’s Camp Database to find a camp just right for your child. Parents may call ACA National Headquarters 800-428-CAMP8camp800-428-CAMP  for further information about a specific camp or for the ACA section in their region, visit the American Camp Association website…http://www.acacamps.org/.

 

 

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Writing: Storytelling on a Page

storytelling

Storytelling is a key building block for developing writing skills in young children.


The common cry a parent is sure to hear from their child at one time or another is, “I have to write about what I did over the summer and I don’t know what to say. I hate writing! I can’t write.”! Translation…I am not comfortable writing.

Unfortunately, most of us don’t prepare our children to write the way we prepare them to know the alphabet, to count and to develop other learning skills during their preschool and kindergarten years. Yet, writing is a skill that most of us will need and use for the rest of our lives. Being comfortable writing and writing well is critical to our academic and employment success.

I am not talking about grammar, punctuation or understanding sentence structure. These skills will be taught in school. I refer to the ability to describe something on paper that was seen, heard, read or told about.

It’s about storytelling.

Not just the stories you read to your child from a book but the storytelling that comes from sharing family history or events or making up stories about everyday activities as you spend time with your child. While being read to captures a child’s interest, expands his/her knowledge and fosters creative thinking, which are all building blocks of writing skills, the ability to tell and write a story must be practiced like any other skill.

Most of my life I’ve earned an income from writing…a biography, articles, technical writing, reports, recipes, programs for children, grants,web content and blogging. I owe my comfort and enjoyment of writing to my extended family. By the time I was two years old, my godmother and grandparents were telling me stories and helping me to tell stories about the things I saw when out walking or visiting with them. Even before I could write, they encouraged me to tell them stories and they wrote them down for me. Then the stories were scotch taped to their refrigerator for all to read. I couldn’t wait until I had the skills to write my own stories. It was all the motivation I needed to learn the alphabet and begin writing.

There is no more undivided attention a child can have than time spent with an adult or older sibling exploring something new, talking about it, making up a story about it. It can be as simple as a trip to the supermarket, a walk in the park, helping to wash the family car or assisting in preparing a meal.

As important as talking about what you see or hear or are doing is guiding your child through making up a story about what he or she is seeing or doing. At first, you will need to ask your child questions to trigger storytelling. After awhile that won’t be necessary.

Storytelling is a family affair and one that offers a role for grandparents and other relatives. Photo albums, attics full of stuff, and scrapbooks are just some of the things that can spark stories. Recording the story is a critical part of the process. Being able to look at and refer to his or her story, in writing, builds a child’s confidence and establishes a comfort level about writing.

If a child can view writing as storytelling on a page, be it paper or computer, he or she is on track for enjoying and not dreading writing.

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