How Digestive Enzymes Probiotic Supplement Help Your Digestive Health

A digestive enzymes probiotic supplement is what you most likely need if you are suffering from a sluggish metabolism or having digestion problems. Digestive enzymes are protein molecules that break down food groups into forms that would benefit the body. Examples of these enzymes are protease, amylase, lipase, lactase, cellulose, and sucrase. These enzymes serve to ensure the complete digestion of proteins, carbohydrates, fats, milk, fiber, and sugar, respectively, and in so doing contribute to overall wellness.

Probiotics, meanwhile, are live microorganisms that also offer plenty of benefits. The body is faced with trillions of microorganisms everyday, and not all of them are good. Consuming probiotics of some form help to fight the bad bacteria, thereby improving resistance against certain diseases. Because both are beneficial, you will need a blend of digestive enzymes probiotic for optimum health.

Probiotics are exactly what antibiotics are not. Antibiotics kill both the bad bacteria and the good bacteria, and this perhaps is the reason why antibiotics often come with side effects, the most common of which are nausea, vomiting, and loss of appetite. Probiotics are different; they increase the body's supply of the good bacteria and in so doing naturally increase your resistance. Many people use probiotics to reduce the impact antibiotics have on the body. People with lactose intolerance (a condition that means the inability to digest sugars in milk) are also said to benefit by taking probiotics. Researchers are also looking into the possibility of probiotics interfering with the growth and development of microorganisms in problems like irritable bowel syndrome, Chron's disease, ulcerative colitis, diarrhea (of the infectious kind), and infections involving the vagina, skin, and stomach.

There are foods that contain good amounts of probiotics. Yogurts and cultured milk such as Kefir (a fermented beverage made from cow's milk or goat's milk) and Yakult. There are also specially-formulated probiotic juices, cereals, breads, and many more, if you want variety. If you look around some more, you'll discover that probiotics are available in capsule form, too. Many are preferring such kind, in fact, as they are enteric-coated and will not likely cause adverse reactions in the digestive system.

Priobiotics are considered to be generally safe, given all the benefits they appear to have. Yet, there are individuals who may react negatively to probiotics. These people who do may manifest with mild gastric disturbances, such as bloating and flatulence. Though these manifestations are only mild in nature, the fact that they are causing some discomforts still warrants precautions.

If you are a candidate for digestive enzymes and probiotics, first consult your doctor about taking supplements with these components. Also make time to look into reviews made by health practitioners on the effectiveness of priobiotic supplements. It's true that the reactions may not the same for everybody, still it's wise to find useful information from those who obviously know what they are talking about. Medical journals, both online and offline, make excellent sources of information, so keep that in find when researching for digestive enzymes probiotic supplements of any kind.

Here is a natural digestive enzyme supplement that I personally recommend (I bought it myself), check it out at http://www.bestdigestiveenzymesupplement.com for details.

 

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Taking Digestive Enzyme Pills After The Loomis Urinalysis Test

If someone suggested you take digestive enzyme pills, it might be a good idea to undergo the Loomis 24-hour urinalysis procedure to confirm if indeed it is absolutely necessary that you take digestive health supplements.  It's not that it really is a matter of life or death that you go through this procedure but doing so can help you take the right treatment approaches and improve the quality of your life.

The Loomis 24-hour urinalysis procedure is a special procedure that requires collection of urine over the 24-hour period. This unique test determines the indican level, a test of how good (or bad) your digestion is.  Indican levels above the normal value suggest a poor digestive system. This means to say that your digestive system is not able to completely digest the food that you eat, and so part of it goes into the bloodstream causing a host of problems. The undigested or partially digested food may also enter the colon, rot, and become toxic. A high indicant level requires the aid of digestive enzymes to improve the capability of the digestive system to absorb all the foods being eaten.

The pH level , which can also be measured using the Loomis urinalysis test, is, too,  a determinant for the need for digestive enzymes. A low pH level means the person is acidic, while a high pH level means the person is alkaline. Between the two, excess acidity might look like the lesser "evil" since the body has more capability in dealing with excess acidity. The acid reserves are normally very high first thing in the morning, but once they are released, the urine turns alkaline. Acid reserves at a high level may suggest protease deficiency.

The Loomis urinalysis test also measures the specific gravity as it compares to the volume. Low specific gravity that comes with normal or low urine volume suggests difficulty in concentrating urine, which may be due to lymphatic congestion. If this is the case you are a strong candidate for digestive enzyme pills because taking digestive enzymes can go a long way in decongesting the lymphatic system.

The Loomis urinalysis test may also be used to determine the amount of calcium and Vitamin C in the body. Too much calcium in the urine suggests poor protein metabolism, and this can lead to bone problems.  Vitamin C deficiency, which may show in the urinalysis, can be corrected by taking the right blend of digestive enzymes.

Once it is confirmed that you are deficient in digestive enzymes, you can now start shopping for digestive enzyme supplements. Supplements that aid in digestive health can be bought over the counter, but getting your doctor's advice is always deemed wiser than heading to the drugstore not knowing what exactly to look for. Your doctor will tell you what blend of enzymes are most suitable for you, and there's a good chance our doctor will suggest one brand of particular that he believes is better than the other brands of digestive enzyme pills.

Here is a natural digestive enzyme supplement that I personally recommend (I bought it myself), check it out at http://www.bestdigestiveenzymesupplement.com for details.

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Garden of Life Digestive Enzymes Supplement

The Garden of Life Digestive Enzymes supplement is a powerful blend of digestive enzymes, herbs and minerals to support a healthy digestion. There are 21 digestive enzymes contained in each OmegaZyme Ultra capsule by Garden of Life, that aid in the absorption of carbohydrates, proteins, and fats, milk and dairy products, even hard to digest foods such as nuts, beans, seeds, and broccoli. The absorption of these foods enables you to benefit from the nutritional value of these foods. Without sufficient digestive enzymes, eating a heavy meal composed of carbohydrates, proteins and fats, will result to indigestion problems. 

Ever wondered why you feel bloated and experience gas pains after eating? Isn't eating supposed to give you more energy? But why do you feel sleepy rather than energetic? The reason is because your body is working too hard to compensate for the lack of digestive enzymes that would have otherwise made things less stressful for your digestive system. Are you losing weight even though you are not on a diet? This is also because without sufficient digestive enzymes, the body is unable to make full use of the calories that are in the foods you eat.

You can always try to increase your supply of digestive enzymes on your own or preserve them to prevent their depletion, or you can take a digestive enzyme supplement, such as the Garden of Life Digestive Enzymes. If choose the former, here's a short to-do list:

1. Eat raw foods. Before you start to think this is going to make you a carnivore, raw foods here actually refer to vegetables and fruits, not foods from animal sources. Digestive enzymes from plant sources are what your body needs, and these plant enzymes, unlike animal enzymes, can survive in an acidic environment, such as the environment in your stomach. Eating raw vegetables (the greener the vegetables, the better) and fresh fruits provides your body with the necessary live enzymes to support your digestive system. Having outside sources of live enzymes is in fact vital to the health of your digestive system.

2. Eat slowly. Are you guilty of downing your foods with a glass of water without even chewing them? Not only do you put yourself at risk for death by choking, you are also causing the eventual depletion of your digestive enzymes. Foods that are not broken down and which go straight to your stomach will require your digestive system to produce more digestive enzymes to break them down and absorb them. Over time, though, this practice is going to stress your digestive system out.

3. Drink a probiotic beverage. Probiotic drinks boost intestinal health as they increase the body's supply of the good bacteria. If you are not yet aware, not all bacteria are bad. Bacteria can also be good, and these good bacteria help fight off the bad bacteria, boosting your immunity.

On the other hand, if you would rather take a digestive enzyme supplement, the Garden of Life Digestive Enzymes supplement is a good choice as it contains powerful ingredients and comes in a vegetarian capsule.

Here is a natural digestive enzyme supplement that I personally recommend (I bought it myself), check it out at http://www.bestdigestiveenzymesupplement.com for details.

 

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What Are Super Digestive Enzymes?

The need to take super digestive enzymes becomes more urgent if eating has become a less pleasurable experience for you. It is not that you have anoxeria, an eating disorder whereby you lose the desire to eat for one reason or another. You have cravings, as a matter of fact, but you don't want to give in to these cravings for fear of the consequences you will have to face when you do.

So the truth is, you love to eat, but you suffer indigestion after consuming a high protein or a high fat diet. Your tummy feels kind of funny and it's bloated. There are times when you feel like loosening your pants. There are times, too, when the food seems to be just inside your chest, and all you want to do is to vomit it out. Sometimes, you experience diarrhea; other times it's constipation. When all these things happen, who, indeed, would take pleasure in eating?

But not eating at all is not the solution, surely. You'll die of hunger eventually. And before that, you'll have ulcer, bleeding in the gastrointestinal tract, constipation, and so much more. Actually, your problem is just that you have trouble digesting the food you eat, in which case taking super digestive enzymes may do the trick.

Digestive enzymes are enzymes that provide the necessary help to your digestive system. The body produces these essential enzymes, but certain conditions result to their depletion, and so you will need to outsource them somewhere. Plants and animals have enzymes, but what your body requires are enzymes coming from plants as these are absorbed well by the body and do not get destroyed during the process of digestion. The best plant enzymes you can find are papain and bromelain, and these can be found in papaya and pineapple, respectively.

You may say that papaya and pineapple are super fruits. Not only do they have the enzymes needed to facilitate digestion and help regulate bowel movement, but they are also high in Vitamin C and antioxidants. Having these fruits in your diet everyday boosts your immune system, keeping diseases at bay. But the trick here is to eat them fresh and immediately after a meal. Cooked desserts with these fruits do not have nutritional value anymore. Preserved papaya and pineapple fruits also do not have as much nutritional value because cooking in any way destroys the live enzymes in these fruits. So in order to benefit greatly from these fruits, eat them as they are – without dips, without sugar, without anything.

Eating these fruits often has immediate results; it can almost instantly relieve you of bloating and flatulence. However, if you intend to take them for the purpose of regulating your bowel movement, treat your colds or improve your immunity, and losing weight, don't expect midnight miracles. It normally takes some time for your digestive system to adjust, but for as long as you consume these super digestive enzymes consistently, improvements can happen in a week or two weeks' time.

To learn more about digestive enzymes supplement, go here: http://www.bestdigestiveenzymesupplement.com for details.

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Safe And Natural Cures For Alcoholism

Alcohol abuse is a type of disease. Individuals who abuse alcohol will drink it in excess despite the fact that it negatively impacts every aspect of their lives. Approximately two thousand individuals aged less than twenty one die in alcohol related crashes every year. Around one half of violent teenage deaths are tied to alcoholic beverages as well. Natural cures for alcoholism combine to successfully end the cycle of destruction. Using the correct balance of counseling, sound therapy, herbs, and minerals, sufferers can greatly improve their health and quality of life.

 

People of all age groups and ethnicities can develop this problem. Although consuming excess alcohol has different effects depending on sex, age, and body type. Warning signs of problems are if an individual drinks by themselves or to escape reality. Drinking just to get drunk is also a cause for concern. Those who feel they must hide their supply or get angry when drinks are not available should seek help.

 

Symptoms of serious problems include smelling of alcohol, having bloodshot eyes, displaying hostile or passive behavior, and a declining hygiene. Over time a tolerance to alcohol may develop or people will have withdrawal symptoms after reducing their intake. This causes them to drink more and for longer periods of time, making it difficult to break a harmful pattern.

 

Risk factors include having parents who are alcoholics or experiencing feelings of low self-esteem. Mood disorders such as anxiety and depression are also key factors. However, it normally takes many reasons, not just one alone. Problems are often the result of environmental, psychological, and genetic factors.

 

Treatments include group or one on one counseling, attending prevention programs, and taking medications. However, the pharmaceutical drugs that are often used to combat problems can cause additional ones of their own. It is much safer to use a natural form of treatment that repairs damage to tissues and organs without side effects.

 

By supplying the body with mineral and vitamin supplements, individuals can combat alcohol caused malabsorption. B vitamins are essential for the body and often deficient in alcoholics, requiring supplementation. Providing the body with a balanced mixture of fatty acids is a good idea as well.

 

Because the liver and gallbladder are often damaged, homeopathic treatments should be taken to support their functioning. The liver can store toxins, which can be eliminated from the body with the correct natural formula. Natural ingredients are also capable of repairing damaged tissues and promoting healthy cell regeneration.

 

Memory and concentration also becomes impaired, but can be improved and optimized with the correct homeopathic remedy. Certain herbs and minerals stabilize emotions and promote calm behavior. They also fight against disturbed sleep patterns and dangerous cravings.

 

Beyond herbal and mineral treatments, psychoacoustic therapy is an additional beneficial option. It impacts the subconscious mind, promoting a healthy brain balance. Wave and ultrasonic sounds played at night or during the day promote brain health and fight addiction.

 

Substance abuse is a serious problem that can affect every aspect of an individuals life. It can affect all age groups and people from any background, but is common in those with mood disorders or genetic predispositions. Natural cures for alcoholism include herbal, mineral, and audio forms of therapy, which are extremely effective when paired with counseling.

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An further Factor About Almond Milk Advantages

Almond milk is a milk substitute designed by finely grinding almonds together with h2o. It enjoys a lengthy background as being a well-liked meals. Medieval European recipes frequently known as for almond milk. Also, it's always been a well-known beverage in the Middle East. The contemporary blender tends to make the composition of it a lot less complicated than it might have been within the Center ages, mainly because the blended almonds are considerably finer, resulting inside a finer consistency milk. Almond milk, as opposed to animal milks, includes no lactose or animal fats. A favorite of vegans for many years, it is actually being much more and far more favorite with non-vegetarians for its numerous well being advantages. This non-traditional milk is also a fantastic option for all those with allergic reactions to dairy and soy.

Created from ground almonds, this milk is definitely an opaque substance which could be applied in a lot of recipes as a substitute for cow's milk. Groceries market it in plain, vanilla and chocolate flavors. You'll be able to also make your personal by soaking almond overnight in h2o and draining them, combining one cup of almonds to three cups of drinking water and straining the combination through cheesecloth. Beneath are almond milk rewards.

It helps in losing body weight. Plain, unsweetened of this milk has about 60 calories per eight ounce glass, that is about 25 % much less than the same quantity of skim cow's milk. Also, it really is good to the heart well being. Since it includes no cholesterol and extremely little sodium, it is superior for overall heart wellness than animal milks. What's more, it consists of potassium, a mineral that's beneficial in reducing blood strain.

It is also very good with the eyes. An eight-ounce glass of it is made up of 10 percent from the everyday recommended allowance of vitamin A, a substance vital to help keep eyes performing property. Vitamin A also straight influences the eye's ability to modify to different ranges of light. Furthermore, it assists increase immune system. A glass of almond milk consists of 25 % from the suggested daily allowance of vitamin D, a nutrient with antioxidant attributes that's been revealed to reinforce the immune system. It helps in blood sugar control. With fewer carbohydrates than animal milk, it converts far more easily to power and doesn't cause the spikes in blood sugar that other milks can.

If you're into skin treatment, this really is also excellent as well. A glass of it contains fifty % from the every day recommended allowance of vitamin E, a major nutrient for keeping skin wellness. It maintains muscle mass. Though low on protein, almond milk contains vitamin D and iron, each beneficial in building and maintaining muscular tissues. Do not believe that it is not very good for the bones like animal milk. The consume consists of thirty % from the suggested daily allowance of calcium, the nutrient required to construct and preserve strong bones.

Of course, not all the almond milk rewards are wholesome ones. This product has an pleasant crisp, nutty flavor and features a extended shelf everyday living than cow's milk. Possibly it is time to provide it a try.

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Visit the site for more information on Almond Milk Benefits and Spring Valley Vitamins.

Spring Valley Vitamins - Accessories to Your Wellness

Spring Valley vitamins are fantastic products to add your every day regimen. You are able to obtain them at your neighborhood Walmart, and they are part of the store's own line of items. The vitamins are available in a wide range of herbs and minerals. Walmart uses many organizations to manufacture the products, but high quality standards are often enforced. Usually, individuals confuse these vitamins having a different corporation. Its Herbs and Natural Foods Organization does not offer the products for Walmart. They're a small store located in Springfield, Missouri and are not involved within the manufacturing of any of the vitamins located at Walmart.

Should you are adding vitamins to your everyday routine, the costs can begin to rise substantially. They vitamins are an affordable solution to this trouble. Because they are a store brand, they tend to expense less than other vitamins sitting on the identical shelf. The identical ingredients are utilized for the store brand along with the far more highly-priced name brand vitamins. Additionally, they've identical amounts of key ingredients. As the cost of food has increased recently, the prices of a lot of brand vitamins have also increased. On the other hand, Spring Valley has maintained the same prices and can still offer you with reasonably priced vitamins.

Walmart has a large choice of Spring Valley Vitamins. You can come across vitamin C, vitamin D and alpha lipoic acid. They are just as efficient as other brands and have the exact same ingredients. Furthermore, it makes the vitamins accessible in various forms. It is possible to discover gelcaps, tablets, capsules and chewables. It also has immune system vitamins. The advantages of each item are clearly explained on the labels, along with the amount of each and every ingredient is listed on the back. Even non-essential ingredients are included, so when you have allergies to gluten or lactose it truly is easy to identify them. The Spring Valley line includes a full range of vitamins. You are able to obtain every thing from eye supplements to menopause relief. The vitamins tend to cost from $2 to $10, but the cost depends on the size and type of product.

Spring Valley vitamins are an excellent alternative to more expensive brand name merchandise. It is possible to sometimes discover them as a double pack at Walmart. This will save you even much more money. You ought to constantly consult a physician or other medical expert before taking any vitamins or herbs. Lots of goods can interact with medications and cause side effects, so caution is suggested.

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Colostrum Supplements For Boosting Gastrointestinal Immunity

Colostrum is the clear or cloudy "premilk female mammals secrete after giving birth and before producing milk. Colostrum for dietary supplements is usually derived from bovine sources and contains various immunoglobulins (also called antibodies) and antimicrobial factors (i.e., lactoferrin, lactoperoxidase, lysozyme) as well as insulin-like growth factors such as IGF-I and IGF-M. The concentration of IGF-I in bovine colostrum is 200-2,000 mg/L, whereas normal milk contains less than 10 mg/L. In normal, healthy adults, IGF-1 occurs at a concentration of approximately 200 mg/L in serum. In terms of immunoglobulins, colostrum generally provides concentrations of IGF, IgM, and IgA that are 100-fold higher than in normal milk. The most prevalent claims for dietary supplements containing colostrum are in the area of generalized immune function as well as the specific areas of diarrhea prevention and treatment, overall gastrointestinal support, and improved recovery from intense exercise.



The amino acid sequences of human and bovine IGF-I are identical. The increase in serum ICF-I observed in several human studies is most likely a result of an enhanced stimulation of endogenous IGF-I synthesis rather than a direct absorption of the growth factor from the adult gastrointestinal tract. It is likely that the natural target of colostrum-derived growth factors is the gastrointestinal tract, whereby the increased growth and turnover of the intestine provides for a healthier gut and an increased uptake of dietary components that may enhance growth, immune competence, and athletic performance generally.



Bovine colostrum contains the same disease-resistance factors (immunoglobins) found in human breast milk and unpasteurized cow's milk. Among the many immune factors that may be effective against various viruses, bacteria, yeast, and other invaders are immunoglobins (IgA, JgG, IgM) lactoferrin, laclalbum'm, glycoprote'ins, cytokines (such as interleukin 1, interleukin 6, and interferon Y) and various polypeptides, growth factors, vitamins, and minerals. The antibodies present in colostrum are thought to combine with disease-causing microorganisms in the gastrointestinal tract. By adhering to pathogens, colostrum antibodies may be able to reduce the adhesive properties of bacteria and decrease their ability to attach to the intestinal wall (which could prevent their entrance into the body). Ii is unlikely that the "full" antimicrobial benefits of colostrum can be realized unless the user happens to be a baby cow, because the immunoglobulins are largely digested in the adult gut and cannot be absorbed intact (Mero et al,, 2002). It may be possible, however, for partially digested immunoglobulin fragments to retain a small portion of their functional properties and deliver these immune benefits on absorption.



Numerous studies have been conducted in adults and children to show the benefits of ingesting colostrum in neutralizing the activity of several strains of bacteria and parasites that cause diarrhea (Ashraf et al., 2001; Bolke et al., 2002; Huppertz et al., 1999; Mitra et al., 1995; Nord et al., 1990; Okhuysen et al., 1998; Plettenberg et al., 1993; Rump etal., 1992; Sarkeretal., 2001; Tacketetal., 1988; Tawfeek et al., 2003). Both the prophylactic and treatment effects of colostrum feeding against bacterial and parasitic infections of the gastrointestinal tract may be the result of the direct antimicrobial effects of colostrum-derived immune factors and/or a generalized stabilization of gut barrier function (Bolke et al., 2002; Playford et al., 2001). In studies of chronic gastritis, symptoms were improved and inflammation was reduced, but there was no evidence that colostrum was directly effective against Helicobacter pylori (the bacteria that cause stomach ulcers).



In terms of sports performance, several studies have investigated athletes who consumed colostrum (up to 60 g/day) compared with a placebo or whey protein. These studies found variable effects on IGF-I levels. In terms of overall athletic performance and exercise recover)', they found no differences in plasma IGF-1 concentrations in either group during the study period but they did find that the colostrum group ran further and did more work than the placebo group (equal to a 2% increase in performance; Antonio et al., 2001; Brinkworth et al., 2002; Buckley et al., 2002, 2003; Coombes et al., 2002; Hofman et al., 2002). One study examined rowing performance in a group of elite female rowers. Eight rowers completed a 9-week training program while consuming either colostrum (60 g/day) or whey protein. By week 9, rowers consuming colostrum had greater increases in the distance covered and work done compared to the whey protein group (Brinkworth ct al., 2002).



Additional studies on bovine colostrum consumption suggest that it can also deliver some generalized anti-inflammatory benefits (Bolke et al., 2002; Playford et al., 2001) and help prevent and treat the gastric injury associated with nonsteroidal anti-inflammatory drugs. Such effects may also be of value for the treatment of ulcerative conditions of the bowel, such as colitis and irritable bowel syndrome (Khan et al., 2002).



Taken together, the available evidence for bovine colostrum is supportive of its benefits as an effective immune-supporting supplement, particularly when interactions with pathogens in the intestinal tract are possible. It is unlikely; however, that colostrum would provide immune benefits against airborne pathogens and upper respiratory tract infections such as cold and influenza or against pollen-related allergic responses (Leifer-man et al., 1975).



No adverse side effects are expected up to doses of 60 g/day, but people with milk allergies should avoid bovine colostrum. Doses of 10 g and up have been used in most human studies; it is unknown if lower doses provide any meaningful immune or gastrointestinal benefits. Many capsule-form products provide no more than 1 g of colostrum per serving, but powder forms may deliver levels associated with clinical effectiveness (10 g and higher).

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Georgiy Kharchenko - lipodrene ephedrine hcl, eca stack, caffeine weight loss

Garlic Supplements

Garlic has been used for centuries for its reported benefits in promoting heart health and preventing infection. For more than 5,000 years, humans have been cultivating garlic for use as a spice and a medicine, and records document its medicinal use by Egyptian pharaohs, Chinese emperors, and soldiers from the middle Ages to World War II; among the latter, garlic juice was known as "Russian penicillin" for its antibiotic effects in wound healing.



Modern-day use of garlic as a dietary supplement generally centers on promotion of heart health by reducing scrum lipid levels (total cholesterol, LDL, triglycerides), lowering blood pressure, and inhibiting blood clotting. The cardio protective benefits associated with garlic are generally attributed to the various sulfur compounds that can be isolated from the raw clove. These compounds, which include allicin, allicin, S-allyl-cysteine, and S-methyl-cysleine, are found in varying concentrations.



in garlic, chives, leeks, shallots, and onions, but the chemical composition may vary considerably depending on processing methods and are generally highest in garlic compared with, other plants in the allium family. The chemical responsible for the pungent smell of garlic, allicin, is produced from allicin (an odorless amino acid derivative) through the action of allicin and is thought to contribute to many of the health effects associated with garlic supplements.



A major concern with all garlic supplements is the total level of sulfur-containing compounds or the total allicin potential of commercial products. Raw garlic is more potent than cooked garlic, and fresh garlic is more potent old garlic. Deodorized and aged garlic supplements typically contain only a fraction of the allicin found in fresh garlic.



Because allicin is converted to the active allicin form (the source of garlic's unique odor) in the body, and because the precise mechanism by which garlic helps lower cholesterol is unknown, it is prudent to select a product with high allicin potential. General considerations for dosing are that each milligram of allicin yields approximately 50% of that amount as allicin; thus, 500 mg of a garlic extract standardized to 1% allicin would yield approximately 2,500 jig allicin (compared with a clove of fresh garlic, approximately 4 g, with 1% allicin yielding about 20,000 u.g allicin). Owing to differences in strength and preparations of various commercial garlic supplements, consumers should pay attention to die allicin potential of a particular product.



Garlic is mostly used for its antihyperlipidemic and antihypertensive effects. It also has been reported to possess antibacterial, antiviral, and antifungal effects, but these are generally confined to topical applications. In patients with hyperlipidemia, garlic might lower cholesterol levels by acting as a mild HMG-CoA reeducates inhibitor. Garlic is thought to protect vascular endothelial cells from injury by reducing oxidative stress and inhibiting LDL oxidation. Garlic has also been shown to have antithrombotic activity by increasing fibrinolytic activity and decreasing platelet aggregation. For hypertension, garlic is thought to reduce blood pressure by causing cell relaxation and vasodilation by activating production of nitric oxide.



The benefits of garlic supplements are controversial. Although quite a large number of studies appear to indicate a beneficial cardiovascular effect of garlic supplements, die most well-controlled studies generally suggest a lack of any beneficial effects or suggest benefits only at high doses. For example, in a study of children with elevated blood cholesterol and triglycerid.es, 8 weeks of garlic supplementation (900 mg/day) produced no significant effect on total cholesterol triglycerides, LDL, or HDL (Jepson et al., 2000). It is possible that these children, who had severe cases of familial hyperlipidemia, did not respond to the garlic supplements because their medical conditions were too advanced for treatment with a mild approach such as dietary supplementation. In support of this "non effect," however, a multicenter study carried out over 12 weeks (also using 900 mg/day) showed no significant lipid or lipoprotein changes following garlic supplementation (Jepson et al., 2000). The FDA has gone so far as to issue a ruling to prohibit claims on dietary supplements promoting a relationship between garlic, decreased serum cholesterol, and the risk in adults of cardiovascular disease.



The lack of effects in the above-mentioned studies may have been the results of the dose used, with 900 mg/day being too low. Larger doses of garlic (4-10 g/day) have been more consistently associated with beneficial effects. For example, in a study of 30 patients with coronary artery disease (Simons et al., 1995), garlic supplements (4 capsules per day equivalent to 4 g of raw garlic) showed a significant reduction in serum cholesterol and triglyceride levels as well as an inhibition of platelet aggregation (reduced blood clotting). Further supporting the cardiovascular benefits in humans is a well-controlled study that compared the effect of aged garlic extract on blood lipids in a group of 41 men with moderately elevated cholesterol levels. Each subject received about 7 g of garlic extract per day over the course of 6 months. The major findings were a reduction in total serum cholesterol of approximately 7%, a drop in LDL of 4-5%, a 5.5% decrease in systolic blood pressure, and a modest reduction of diastolic blood pressure. The study concluded that "dietary supplementation with aged garlic extract has beneficial effects on the lipid profile and blood pressure of moderately hypercholesterolemic subjects, "but this dose of garlic would certainly pose numerous practical issues such as compliance.



Adverse side effects associated with garlic supplements are rare. Occasionally, mild gastrointestinal symptoms such as heartburn and nausea may occur with high intakes. In some cases, high doses of garlic may potentiate the antithrombotic (blood-thinning) effects of anti-inflammatory medications such as aspirin and dietary supplements such as vitamin E and fish oil.

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Dong Qua, Damiana and Evening Primrose Oil Supplements

Dong qua! has a long history of use in both Traditional Chinese Medicine and Native American medicine, and it continues to he used for female conditions to balance the effects of menopause (hot flashes and night sweats) and PMS (cramping). The active components in dong quai are thought to be the coumarins, ferulic acid, and ligustilide. The coumarins are known to increase blood flow, and ferulic acid and ligustilide are known to have muscle-relaxing effects. Although there have been no known estrogenic compounds found in dong quai, it has been confirmed to have both esirogenic and antiestrogenic activity in vitro (Amato et al., 2002). Dong quai is sometimes used in "bust-enhancing" herbal products, but no clinical studies have been conducted on it for this purpose (Fugh-Berman, 2003). Dong quai has been shown to possess nonspecific immunomodulatory activity in vitro (Wilasrusmee et al., 2002a, 2002b).



Dong quai was included in a phytoestrogen combination that a clinical study found to be beneficial in treating migraines associated with the menstrual cycle, but how much dong quai contributed to its efficacy is unknown (Burke et al., 2002). After only one negative clinical study, dong quai was abandoned from clinical practice by many in the United States; however, considering its long history of use and reported success in alternative medicine settings, ilseems dong quai deserves more clinical research and more credit.



Hirata et al. (1997) examined the use of dong quai in postmenopausal women in a double-blind, randomized, placebo-control led clinical trial. Outcome parameters measured its effects on endometrial thickness (by ultrasonography), cellular maturation of vaginal cells, the Kupperman index (for determining menopausal symptoms), and frequenq' of hot flashes. Seventy-one women were included in the study and given either dong quai or a placebo for 24 weeks. No statistically significant differences were found between the treatment and placebo groups for any of the parameters measured. The authors concluded that dong quai does not produce estrogen-like responses in postmenopausal women for the parameters measured.



Generally, dong quai is administered in the dosage range of 250-1,000 mg/day (taken in divided doses) for the relief of menopausal or menstrual symptoms. There is no consensus on the standardization of dong quai because activity has been found in different fractions of the plant extracts. Dong quai is considered quite safe, but there is some concern of its potential to increase photosensitivity because of the coumanns it.

No clinical support on the single phytotherapeutic preparation is available.



Generally, damiana is recommended in the dosages of 400-800 mg 3 times daily if used singly. Not much is known about the long-term safety of damiana, but it has been noted to cause a euphoric and mild laxative effect at high dosages. Another concern is a potential drug interaction with aspirin because of dong quai's aniiplatelel activity (Abebe, 2002, 2003).



Evening primrose oil is made from the seeds of the herb Qtmothera biennis, which grows wild in arid environments like sand dunes. True to its name, the bright yellow evening primrose flowers open in the evening and fade in bright sunlight. First documented medicinally in England, evening primrose oil is most commonly used for relieving premenstrual syndrome, fibrocystic breasts, and menopausal symptoms such as hot flashes.

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Mastic From Pistacia Lentiscus to Treat Ulcers, Heartburn and Treatment and Prevention of Bad Breath and Slipperyelm Supplements For Digestive Health

Mastic is a resin, or gum, extracted from a tree grown in Mediterranean or Middle liastern regions. Long used as a chewing gum and a traditional medicine, mastic resin also has been developed for use in numerous industrial applications (Milovet al., 1998). Preliminary clinical evidence has confirmed that mastic resins are useful in the treatment of ulcers. Further, mastic has been shown to exhibit antibacterial activity against Helicobacter pylori, explaining its efficacy in ulcers. Mastic has also shown antibacterial, antiplaque, and autigirigival activity in the saliva and on the teeth (Takahashi et al., 2003).



Although mastic has not yet been well studied as an herbal medicine, preliminary clinical evidence is promising 10 confirm the efficacy of its historical use in treating ulcers (AI-Habbal, 1984; Huwez, 1986).



Al-Habbal et al. (1984) performed a double-blind, clinical study on mastic for treatment of duodenal ulcer. Twenty patients were given mastic (I g/day) and 18 received a placebo (lactose, 1 g/day) to for 2 weeks. Mastic treatment resulted in highly statistically significant improvements in both the symptomatic relief (80% of the treatment group versus 50% of the placebo group) and the clinical manifestation of disease as proven by endoscopic examination {70% of the treatment group versus 22% of the placebo patients). Additionally, mastic was found to be well tolerated with no side effects.



Antiplaque, Antigingival, and Antibacterial Activity of Mastic Chewing Gum

A chewing gum of mastic resin was tested in two double-blind, randomized, placebo-controlled studies for the control of dental plaque. In the first study, saliva was collected from the mouths of participants after mechanical brushing and chewing gum and examined for its antibacterial activity by mastic or placebo gum. The mastic chewing gum group showed statistically significant reductions in bacterial growth compared with the placebo group during the 4 hours of chewing gum. In the second study, mastic and placebo gum chewing (and no brushing) were tested over 7 days for their ability to control new plaque formation on tooth surfaces and on gingival inflammation. The mastic group showed significantly reduced plaque index measures and gingival index compared with the placebo group (Takahashi et al., 2003).



For treating ulcers and gastrointestinal discomfort, 1 g of mastic is used. Mastic is not known to produce any side effects and is thought to be safe (Al-Habbal et al., 1984).



Slippery elm contains mucilaginous compounds that are the reason why slipper}' is in its name and why it has herbal therapeutic uses. The mucilaginous effect of slippery elm has been used traditionally and safely for soothing irritated mucous membranes in the throat and sinuses during colds and sore throat, in the digestive system during digestive complaints (e.g., diarrhea, constipation, Crohn disease), and on the skin during minor irritations (e.g., poison oak and wound healing).



Although slippery elm lacks clinical support, the soothing effect of the mucilaginous components is well known. Additionally, related elm species have shown evidence of antimicrobial activity and promise for inflammation and diseases of the mucous membranes (Jun et al., 1998; Song et al., 2003; Ye el al., 1990; Youn et al., 2003).

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Glucosamine Amino Acid Supplements

Glucosamine is an amino polysaccharide (a combination of an amino acid glutamine and sugar glucose). Glucosamine is concentrated in joint cartilage where it is incorporated into longer chains known as glycosaminoglycans and finally into very large structures known as proteoglycans. The proteoglycans function to attract water into the joint space for lubrication of the cartilage during movement. Glucosamine is available in supplements as glucosamine sulfste, glucosamine hydro-chloride, and N-acetylglucosamine. Chondroitin sulfate (also covered in this chapter) is often combined with glucosamine. These supplements are generally promoted with claims for protecting joints and joint cartilage from injury, alleviating the stiffness and pain of osteoarthritis, and reducing inflammation.



Glucosamine supplements typically take 1-3 months to exert noticeable effects (reduced pain and stiffness) in people with mi Id-to-moderate degrees of osteoarthritis. Because arthritis pain is one of the most debilitating conditions, most people dealing with such pain would gladly invest a dollar or two per day in a supplement that relieved their discomfort and helped repair their damaged cartilage tissue. For people with existing chronic joint pain, glucosamine supplements (whether or not combined with chondroitin sulfate) are worth the modest dollar investment for the benefits they deliver.



The major principle behind glucosamine supplementation is that the glucosamine is delivered to the joint space and incorporated into proteoglycans of joint cartilage to maintain structure and repair damage. Glucosamine may also stimulate chondrocytes (cartilage cells) to begin produ-ng healthy new cartilage matrix (both collagen and proteoglycans). Numerous European studies and a handful of North American reports low a clear benefit of glucosamine supplements for relief of joint pain and stiffness associated with arthritis. One Australian udy has even suggested a pain-relieving effect in osteoarthritis of topic-ly applied glucosamme/chondroitin (Cohen et al., 2003), but that "feet may have been the result of camphor in the topical formulation. rhile glucosamine supplements have been reported to modify disease ctivity in studies of rheumatoid arthritis (Lard etal., 2001), the majority Fglucosamine studies have examined osteoarthritis of mild-to-moder-te severity. Most studies examine patients with osteoarthritis of the nee and hip, but examples of glucosamine's pain-relieving effects can e found in studies of osteoarthritis of die fingers and temporomandibu-ar joint (Nguyen et al., 2001; Thie et al., 2001). Several studies have ompared the pain-relieving effects of glucosamine (1,500 mg/day) to ISAIDs such as ibuprofen (1,200 mg/day). These studies generally find



that although NSAIDs tend to exert their pain-relieving effects faster (within the first week of treatment; Muller-Fassbender et al., 1994), the difference between treatments lessens with time (similar benefits at 2-4 weeks), with fewer side effects reported among glucosamine users (6% versus 35% on ibuprofen). When followed post treatment, glucosamine shows a carryover effect, whereby pain and use of pain relievers is reduced for 3-4 months following cessation of supplementation (Qiu ei al., 1998; Thieetal., 2001).



Many of the existing studies have been criticized for lack of scientific control, short duration, and small size (Towheed et al., 2000), and indeed not all studies of glucosamine supplementation show benefits in terms of relief of pain or stiffness (Houpt etal., 1999; Rindone et al., 2000).



Mela-analyses of several smaller studies, however, have supported the beneficial role of glucosamine supplements as a safe and effective approach to treating osteoarthritis (McAlindon et al., 2000a, 2000b; Towheed et al., 2000). In general, 1-3 months of glucosamine supplementation seems to be as effective as many analgesics and NSAIDs, like acetaminophen and ibuprofen, in reducing the joint pain of osteoarthritis. In perhaps the longest-duration trial to date (Reginster et al., 2001), 3 years of glucosamine supplementation (1,500 mg/day) improved pain scores (while symptoms with placebo worsened) and maintained radiographic joint space of the knee (while placebo users experienced significant losses). At least two studies have shown that glucosamine may even slow or stop the destruction of cartilage in the knee joints of people with osteoarthritis (Bruyere et al., 2003; Pavelka et al., 2002); this effect may be especially dramatic in patients with less severe radiographic knee damage in whom intervention is started early (Bruyere et al., 2003). In these studies, oral glucosamine supplements (1,500 mg/ day for 3 years) were shown to virtually halt the progressive joint space narrowing observed in the placebo group, suggesting a retardation of osteoarthritis progression. Studies of glucosamine supplementation in more severe forms of osteoarthritis are less positive than studies of mild to-moderate forms of the disease (Das and Hammad, 2000).



Occasional symptoms of gastrointestinal discomfort have been noted but no significant adverse effects are associated with glucosamine supple mentation. Although no long-term safety studies have been conduclec in humans, animal studies on glucosamine have found it to be nontoxic (Towheed et al., 2005). Diabetics have been cautioned about using glucosamine supplements, based on findings from several animal studies that have suggested an increase in blood sugar levels caused by glucosamine (Monauni et al., 2000). Most of the animal studies have used injections of glucosamine, and recent feeding studies in humans have shown no changes in plasma levels of glucose or insulin (Scroggie et al., 2003) insulin sensitivity (Pouwels et al., 2001), or glucose oxidation (Monauni et al., 2000), suggesting lhat glucosamine has no significant effect on blood sugar metabolism when used as directed.



No dose-response studies have been conducted with glucosamine supplements. Virtually all oral supplementation studies on glucosamine have used 1,500 mg/day, usually in 2-3 divided doses of 500-750 mg each, but some recent studies have used higher levels of glucosamine [2,000 mg/day; Braham et al., 2003) or higher levels combined with chondroitin and other ingredients (Das and 1 lammad, 2000). Although higher doses appear to be effective, there is no information to suggest that a higher dose works better or faster or that a lower dose is less effective.



Glucosamine is also routinely combined with chondroitin sulfate, but no information currently exists to suggest lhat sucli a combined formulation is superior lo either agent consumed alone at the proper dosage. There appear to be few, if any, differences among the various forms of glucosamine (sulfate, hydrochloride, N-acetyl), and each form has been shown to reduce pain and stiffness in studies of mild-to-moderate osteoarthritis (Talent and Cracy, 1996).

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Devil's Claw (Harpagophytum Procumbens)Supplements

This herb's name definitely stimulates the imagination, but imagination may not be far from reality: devil's claw produces a hard fruit with large claw like appendages that lie waiting for a passerby on which to grip and hitch a ride for dispersal, only to eventually work its way into or tear out of the skin of its host. It is native to South Africa {though unrelated "devil's claws" are found in Noith America) and traditional healers have used it to reduce pain and inflammation. Today, its anti-inflammatory attributes are being confirmed by science, and it is primarily used as an herb for the pain and inflammation of arthritis and back pain. The German Commission E has approved its claims for "degenerative disorders of the locomotor system" (Bltimenthal et al., 11J98).



Preclinical and clinical studies showed mixed results, indicating that perhaps only certain types of inflammatory disease benefit from devil's claw (Chrubasik el al., 2003). More recent clinical data, however, have indicated a benefit for back pain and osteoarthritis of die knee and hip (Chantre el al., 2000).



In a randomized, double-blind, double-placebo clinical study involving patients with low back pain, Chrubasik et al. (2003) compared a devil's claw extract (Dolotcffin) totheCOX-2 inhibitor rofecoxib. Fifty eight patients were split into two groups and given either devil's claw extract (60 mg/day) or rofecoxib (12.5 mg/day) for 6 weeks. Rescue medication of'100 mg/day of tramadol was allowed all participants. No significant differences between outcome measures were observed, but there was a trend toward greater pain reduction and fewer side effects from the devil's claw group.



A postmarketing survey was performed to assess die safety and efficacy of a proprietary devil's claw extract (Doloteffin) in 227 people suffering from back pain or osteoarthritis pain of the knee or hip. The parameters measured were several validated and unvalidated measures of pain and for joint, low back, and arthritis pain.



Symptoms. The authors concluded that 50-70% of the participants benefited from the treatment with Doloteffin, and that both the generic and disease-specific outcomes improved in all groups. Few adverse effects were reported, with 10% found to be possibly caused by Doloteffin (Ghrubasik et al., 2002a, 2000b).



Gobel et a!. (2001) examined the effect of devil's claw extract (480 mg of Rivoltan 2 times a day or placebo for 4 weeks) in a randomized, double-blind, placebo-controlled study on people with slight to moderate muscular tension or slight muscular pain of the back, shoulder, and neck. The treatment group showed clear improvement in clinical global scores and in patient and physician subjective ratings. Highly significant results were found in the test measures of the visual analogue scale, pressure algometry test, muscle stiffness test, and muscular ischemia test. The mechanism of action of the extract was reported to have an influence on sensor)' and vascular muscular response and to reduce muscle stiffness without affecting the central nervous system. No serious adverse effects were noted, and tolerability was good.



Patients suffering from nonradicular back pain were studied in an open, multicenter study of devil's claw extract (480 mg of Rivoltan 2 times a day for S weeks). Significant improvement of pain symptoms and mobility were found (using die multidimensional pain scale, Arhus back pain index, finger-floor distance, and Schober's sign). No serious side effects were found, and the authors reported that iL appeared to be an excellent herbal alternative for chronic back pain, though further studies were needed (Laudahn and Walper, 2001).



A double-blind, randomized, multicenter, comparison study was performed on a 4-month treatment of Harpadol (six 435-mg capsules per day) versus diacerhein (100 mg/day) in 122 patients with knee and hip osteoarthritis. Although there were no significant differences between the two groups in efficacy, by the end of the study, patients in the devil's claw treatment group were using significantly less of other pain medications and had fewer reported adverse effects. The authors concluded that Harpadol is safer than and equally as effective as diacerhein (Chantre et al., 2000; Ghrubasik et al., 2002a, 2002b). A similar study vas performed to compare the efficacy of devil's claw extract versus diacerhein, and after 4 months of treatment, the same overall results vere found. The devil's claw extract showed similar efficacy for knee and hip osteo arthritis and fewer side effects than diacerhein, and the need for other pain medications was reduced in the devil's claw group (Leblanetal., 2000).



In a randomized, double-blind study involving 197 patients with chronic back pain, two doses of devil's claw extract (1531, 600 and 1,200 mg containing 50 and 100 mg of the marker compound larpagoside, respectively) were compared with a placebo over 4 weeks of treatment. Using the principal outcome measure of die number of patients free from pain without using the rescue medication (tramadol), the results were 3 for the placebo group, 6 for the 600-mg group, and 10 for the 1,200-mg group. Using analysis based on the Arhus back pain index, however, the 600-mg group showed more benefits. The only minor reported side effects were mild and infrequent gastrointestinal upset (Chrubasik et al, 1999).



The typical dosage of devil's claw extract is between 600 and 6,000 mg/day (standardized between 1% and 3% of iridoid glycosides, often calculated as harpagosidc), taken in divided doses. Only mild side effects of transitory gastrointestinal upset have been reported, if any. Because devil's claw extract is able to stimulate gastric acid secretion, it is not recommended for people with ulcers.

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HMB Supplements

HMB could ultimately turn out to be a bona fide natural alternative to dangerous steroids for athletes who desire to build muscle. But further testing is needed to determine the safety of HMB, particularly if taken in large doses.



Available as bars, in cans, or as mix-it-yourself powders, meal-replacement diet aids, also called "meal replacers," are formulated to reproduce as closely as possible the nutrition you would get from food, complete with carbohydrates, protein, fat, fiber, vitamins, minerals, and other natural ingredients.



Meal replacements were originally developed to feed patients in hospitals and nursing homes (where they are still used), but are now marketed for general use. Manufacturers recommend replacing a meal or two with their products to help you shed pounds or using them as healthful between-meal snacks.



Presented at the 1997 annual meeting of the American Society of Clinical Nutrition, a study from the University of Ulm in Germany found that a meal-replacement diet can help take pounds off and even keep them off. One hundred people participated in the study and were divided into two groups. The first group followed a prescribed low-fat meal plan that consisted of 1,500 calories a day. The second group consumed the same amount of calories, obtained through one low-fat meal a day and two meal replacements of 220 calories each. The diets were followed for 12 weeks.



All the participants completed the program. The dieters in the meal-replacement group lost an average of 17 pounds significantly more than those who followed the low-fat meal plan.



The researchers followed up with the dieters after two years to see how well they had kept their weight off. The dieters who had lost weight by using meal replacements maintained their losses much more successfully than those on the prescribed meal plan. The researchers concluded that using meal replacements as part of a diet program is an effective way to lose way and keep it off for at least 2 years.



But another study begs to differ. According to a poll of 95,000 readers of Consumer Reports, 24 percent of the readers who had tried liquid meal-replacement diets gave them low marks. The readers' major complaints included an average loss of just 3 to 4 percent of their weight; feelings of hunger; and weight regain as soon as they stopped using the diet aid.



What's more, other studies suggest that if you eat meal replacements at breakfast and lunch, you're more likely to binge-eat on real food at dinner undoing any calorie-cutting good achieved earlier in the day.



The safest and best use of meal replacements is as a supplement to your diet rather than as a substitute for meals. Occasional use, when you're going to miss a meal, is fine, and then you might want to drink two at a time, rather than one. Meal replacements are also great supplements for athletes and exercisers, who typically require a higher-calorie diet, and are an excellent way to add calories and nutrients to the diet without adding much bulk.



To help shed pounds, use meal replacements as a midmorning or midafternoon snack. Eating five times a day (three main meals and two snack meals) encourages fat loss. That's because every time you eat a meal, your metabolic rate goes up. As part of digestion and absorption, heat is given off, and this elevates your metabolic rate. So if you eat meals throughout the day, your metabolism is constantly charged up. Meal replacements can help you squeeze in those extra meals.



You can buy meal replacers in health food stores, gyms, sporting goods stores, pharmacies, and grocery stores. The bar and canned versions are a bit pricey up to $2 a serving. You can save money using the powder form, although the powders take more time to fix.

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Thiamin Supplements

Thiamin is a water-soluble vitamin. The active variety is a phosphorylated form called thlarnin pyrophosphate, which functions in carbohydrate metabolism to help convert pyruvate to acetyl coenzyme A for entry to the Krebs cycle and subsequent steps to generate ATP. Thiamin also functions in maintaining the health of the nervous system and the heart muscle. Food sources include nuts, liver, brewer's yeast, and pork. Dietary supplements containing thiamin are frequently marketed with claims of increased energy production, maintenance of memory, and improved carbohydrate tolerance.



Because exercise and stress can tax the metabolic pathways that depend on thiamin and riboflavin, it is logical that the requirements for these vitamins maybe increased in athletes, active people, and persons exposed to acute or chronic stressors. In these groups, marginally low intakes of thiarnin and riboflavin can be corrected easily and safely by supplements containing the recommended dietary allowance (RDA) of these nutrients; for such purposes, a balanced multivitamin is the best approach.



The term B complex simply refers to a mixture or combination of the eight essential B vitamins: thiamin (Bt), riboflavin (B2), niacin (B3), pyridoxine (B6), pantothenic acid, folic acid, cyanocobalamin (B12), and biotin. Most of the B vitamins play a critical role as cofactors in cellular energy metabolism. Cofactors can be thought of as "helper nutrients" that assist chemical reactions. For example, the process of glycolysis, which converts energy stored as glycogen into glucose molecules, requires vitamin B6 and biotin. The conversion of pyruvate (a metabolite of glucose) to acetyl coenzyme A (the first step in the Krebs cycle in energy metabolism) requires pantothenic acid, and further metabolism requires biotin, riboflavin, and niacin. Lack of any of the B vitamins can cause fatigue and lethargy, which is why B-complex supplements are often promoted as "energy boosters" and "stress formulas."



Because of thiamin's role in carbohydrate metabolism and nerve function, supplements have been promoted for increasing energy and maintaining memory. It is well known that thiamin deficiency (beriberi) is associated with generalized muscle weakness and mental confusion. Although beriberi is rare in industrialized countries, there continue to be reports of the condition in the medical literature. For example, thiamin insufficiency has been reported in Chinese prisoners (Chen et al., 2003), surgical patients (Nakasaki et al,, 1997), rural Cubans (Marcais-Matos et al., 1995), Gambian children (Bates et al., 1987), alcoholics (Walden-lind et al., 1981), and older women (Wouters-Wesseling et al., 2002). In addition to these populations, which may be "expected" to have deficient thiamin intakes, other populations that have been shown to have marginal or suboptimal thiamin intake include female collegiate volleyball players (Papadopoulou et al., 2002), collegiate wrestlers (Williams, 1989), and other athletes who may be restricting energy and/or food intake (Manore, 2000; van der Beek et al., 1994). Luckily, inad-equate thiamin status is easily and rapidly corrected by thiamin supplements in the range of 50-100 mg/day (Descombesetal., 2000; Nakasaki et al., 1997; Powers et al., 1985; Waldenlind et al., 1981).



Thiamin appears to be involved in the release of acetylcholine, a neurotransmitter, from nerve cells a fact that may account for isolated studies showing thiamin supplementation to benefit cognitive functioning (Benton et al., 1995). As a coenzyme for carbohydrate and branched-chain amino acid metabolism, thiamin has been touted as both a performance and an energy supplement, but supplementation studies of subjects already at normal thiamin status have not shown a beneficial effect. Because dietary thiamin requirements are based on caloric intake, people who consume more calories, such as athletes, are likely to require higher-than-average intakes of thiamin to help process the extra carbohydrates into energy. In persons who consume "whole" forms of carbohydrates, intakes of thiamin and other B vitamins will increase along with carbohydrate intake.



During acute periods of stress, including exercise, thiamin needs may be temporarily elevated, but outright thiamin deficiencies are rare except in persons consuming a severely restricted diet. On the basis of metabolic studies (Manore, 2000), there is biochemical evidence that riboflavin and/or thiamin status is poorer in persons who exercise moderately (2~ 5 hours/week) and who diet (restrict their food intake for weight loss).



Suboptimal dietary intakes of thiamin, riboflavin, vitamin B6, and vitamin C are known to compromise physical performance with reductions in mitochondrial metabolism and aerobic power (van der Beek et al., 1994). In one study, subjects consuming a diet low in thiamin and riboflavin (55% of RDA for 11 weeks) showed 7-11% reductions in oxygen uptake and power output (van der Beek et al., 1994). Exercise has also been shown lo compromise riboflavin status an effect that may be compounded and more severely affect performance when dietary intake is marginal (Soares et al., 1993; Winters et al., 1992).



No adverse side effects are known with thiamin intakes at RDA levels or even at levels several times the RDA. The daily value (DV) for thiamin is 1.5 mg (RDA is 1.2 mg/day for men, LI mg/day for women). The Food and Nutrition Hoard (FNB) has not established an upper-limit intake level for thiamin, but a level of 50 mg has been established by the Council for Responsible Nutrition as the NOAF.L (no observed adverse effect level). Virtually every multivitamin contains thiamin at 100% DV levels (1.5 mg) or higher. Isolated supplements of thiamin are not necessary.



When it comes to defining optimal amounts of vitamins and minerals, confusion is more the rule than the exception. Before 1997, the benchmark of nutritional adequacy was the RDA, established by the I7NB, which is part of the National Academy of Sciences. In general, the RDAs have always been viewed (as judged by the FNB) "to be adequate to meet the known nutrient needs of practically all healthy persons." Because scientific knowledge regarding the roles of nutrients, and their role in health and disease, has expanded dramatically since the inception of the RDAs, a new set of terminology dietary reference intakes (DRIs) has been established. The DRIs are based on contemporary scientific studies related to the role of nutrients in reducing the risk of osteoporosis, cancer, cardiovascular disease, and other chronic conditions. DRI is a generic term used to refer to the following reference values:



Estimated average requirement (EAR): the intake value that meets the nutrient requirements of 50% of an age and gender-specific population.



Recommended dietary allowance (RDA): the intake value that meets the nutrient requirements of nearly all people in an age- and gender-specific group.



Upper intake (UL): maximum intake of a specific nutrient that is unlikely to pose health risks.



Adequate intake (Al): suggested levels of nutrient intake that are established when insufficient data exist to establish a true RDA.

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Vitamin B2 - Riboflavin Supplements

Vitamin B2, or riboflavin, is a water-soluble vitamin. It functions primarily as a coenzyme for many metabolic processes in the body, such as red blood cell formation and nervous system function. Riboflavin is involved in energy production as part of the electron transport chain that produces cellular energy. As a building block for flavin adenine dinucleotide (FAD), riboflavin is a crucial component in converting food into energy. FAD is required for electron transport and ATP production in the Krebs cycle. FAD is also the cofactor for methylenetetrahydrofolate reductase, the enzyme that catalyzes the formation of 5-methyltetrahy-drofolate and acts as a methyl donor for homocysteine remethylation. Through this methylation pathway, riboflavin supplementation, together with folate, may act to reduce plasma levels of homocysteine.



Liver, dairy products, dark green vegetables, and many seafoods are good sources of riboflavin. Dietary supplements containing riboflavin, in addition to being marketed as general nutrients, will frequently contain claims for increased energy levels, treatment of chronic fatigue, improved concentration and mood, reduced plasma homocysteine, and promotion of heart health.



The term B complex simply refers to a mixture or combination of the eight essential B vitamins: thiamin (B, riboflavin (B2), niacin (B3), pyridoxine (B6), pantothenic acid, folic acid, cyanocobalamin (B2)- and biotin. Most of the B vitamins play a critical role as cofactors in cellular energy metabolism. Cofactors can be thought of as "helper nutrients" that assist chemical reactions. For example, the process of glycolysis, which converts energy stored as glycogen into glucose molecules, requires vitamin B(l and biotin. The conversion of pyruvate (a metabolite of glucose) to acetyl coenzyme A (the first step in the Krebs cycle in energy metabolism) requires pantothenic acid, and further metabolism requires biotin, riboflavin, and niacin. Lack of any of the B vitamins can cause fatigue and lethargy, which is why B-complex supplements are often promoted as "energy boosters" and "stress formulas."



Virtually every multivitamin/mineral supplement available contains the full complement of B-complex vitamins at RDA or higher levels. It is often a better value to get B vitamins through a multivitamin supplement than as a separate B-complex supplement. This chapter on energy supplements contains information on vitamins BI and B2, while other B vitamins, such as niacin, folic acid, BG, and El2l are covered in the "B-Complex Vitamins (B, B12, Folic Acid, Niacin.



Requirements for riboflavin, like most B vitamins, are related to calorie intake; therefore, the more food consumed, the more riboflavin needed to support the metabolic processes that convert food into usable energy. Women should be aware that riboflavin needs are elevated during pregnancy and lactation as well as by the use of oral contraceptives (birth control pills). Athletes may require more riboflavin because of both increased caloric intake and increased needs of exercise.



In cases of subclinical (biochemically defined) riboflavin deficiency, daily supplementation of diets with riboflavin (with or without other B vitamins) resulted in an increase in physical work capacity (Suboticanec etal., 1990). In other studies, adding riboflavin to an antianemia regimen (dietary changes plus ferrous sulphate) resulted in a significant increase in circulating plasma iron and in iron stores (hemoglobin) compared with iron supplements alone (Powers et al., 1987). As expected, riboflavin supplements have no effect on physical performance when added to a riboflavin-adequate diet (Manore, 2000).



There is no strong support for the efficacy of isolated riboflavin supplements in promoting health besides correcting a nutrient deficiency. Despite the role of riboflavin in a variety of energy-generating processes, the role for a supplement in directly improving energy levels in a well-nourished person is unlikely.



Isolated riboflavin supplements are not necessary. Virtually all multivitamins and B-complex formulas contain riboflavin at RDA or higher levels. When it comes to supplementing with B-complex vitamins, isolated single-vitamin supplements are not recommended. A more balanced approach is to supplement with the entire B-complex spectrum simultaneously or at least with several of the B vitamins in the same supplement. High-dose supplementation with any single B-complex vitamin can interfere with the absorption of another. For example, a folic acid supplement of 400 ug/day (a common level) has been shown to exacerbate a riboflavin deficiency and elevate plasma homocysteine levels (Moat et al., 2003). Likewise, studies of combined B-vitamin supplementation (folate plus B6 plus riboflavin) generally show that this approach has a more pronounced effect on metabolic parameters, such as plasma homocyst-eine levels, than supplementing with any single B vitamin (Jacques et al., 2001).



No serious side effects have been reported for supplementation with riboflavin at levels several times above the DV of 1.7 mg. Because the body excretes excess riboflavin in the urine, high supplemental levels are likely to result in brightly colored urine (fluorescent yellow).



The DV for riboflavin is 1.7 mg (RDA is 1.3 mg/day for men, 1.1 mg/ day for women). The Food and Nutrition Board sets no LJL intake of riboflavin, but as much as 200 mg/day of riboflavin is considered safe (the NOAIiL set by the Council for Responsible Nutrition).



When it comes to defining optimal amounts of vitamins and minerals, confusion is more the rule than the exception. Before 1 997, the benchmark of nutritional adequacy was the RDA established by the FNB. In general, the RDAs have always been viewed (as judged by the I'NB) "to be adequate to meet the known nutrient needs of practically all healthy persons." Because scientific knowledge regarding the roles of nutrients, and their role in health and disease, has expanded dramatically since the inception of the RDAs, a new set of terminology ((he DRIs) has been established. The DRIs are based on contemporary scientific studies related to the role of nutrients in reducing the risk of osteoporosis, cancer, cardiovascular disease and other chronic conditions. DRl is a generic term used to refer to the following reference values:



Estimated average requirement (EAR): the intake value that meets the nutrient requirements of 50% of an age- and gender-specific population.



Recommended dietary allowance (RDA): the intake value that meets the nutrient requirements of nearly all people in an age- and gender-specific group.



Upper intake (UL): maximum intake of a specific nutrient that is unlikely to pose health risks.



Adequate intake (AI): suggested levels of nutrient intake that are established when insufficient data exist to establish a true RDA.

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Creatine And Diet

To support muscle growth, creatine works best with a nutritious diet that supplies ample calories. Figure out your calorie needs, based on your present body weight. Here are some examples: To build muscle, if you're a man, eat 23 to 27 calories per pound of body weight a day. So if you weigh 165, your caloric range would be 3,795 to 4,455. If you're not yet within range, add calories gradually.



If you're a woman who wants to gain muscle, eat 20 calories per pound of body weight a day. If you weigh 120, you should eat 2,400 calories a day to build muscle.



As you gain muscle, recalculate your calories. Most of your additional calories should come from carbohydrates in the form of natural, unprocessed food and liquid carbohydrate supplements or sports drinks. Garbs supply the energy to drive the muscle-building process and are critical for replenishing lost glycogen following a hard workout. Approximately 60 to 65 percent of your total daily calories should come from carbohydrates when supplementing with creatine.



Protein intake is critical, too, especially for the repair and construction of muscle tissue following exercise. If you lift weights as part of your muscle-building program, you definitely need more protein. About 15 to 20 percent of total daily calories should come from lean protein. Another way to figure appropriate protein intake is 0.7 gram of protein per pound of body weight daily (slightly more about 0.9 gram per pound of body weight if you do aerobics, too). Thus, a strength-training man weighing 165 pounds should eat about 115 grams of protein daily; a 120-pound woman, about 84 grams.



Antioxidants such as beta carotene, vitamin C, vitamin E, and selenium are important, too, since they appear to help tissues recover better and regenerate more quickly following exercise. And the need for B-complex vitamins increases -with exercise. A good supplement program for strength-training exercisers is as follows: Antioxidants (daily): 200 to 300 mg of vitamin C, 100 to 400IU of vitamin E, 10,000 to 20,00 IU of beta carotene, up to 50 meg of selenium.



B-complex vitamins: For every 1,000 calories of carbs you consume daily, you need 0.5 mg of thiamin; 0.6 mg of riboflavin; and 6.6 mg of niacin. (An antioxidant multiple containing B-complex vitamins should help meet these needs.)



Creatine monohydrate is nontoxic, and studies have been unable to find any negative side effects from its usage. But if you take too much at once, you can experience stomach upset.



Creatine was in the news a couple of years ago, following the tragic deaths of three college wrestlers who tried to shed weight rapidly in order to qualify for their weight classes. One of the wrestlers, who attempted to lose 12 pounds in a single day, suffered kidney failure and heart malfunction while wearing a rubber suit during a 2-hour workout in 92-degree temperatures. His body contained high concentrations of creatinine, a component of urine that is a breakdown product of creatine. The finding prompted an investigation by the FDA into the effects of supplemental creatine. The FDA concluded that creatine was not a factor in the deaths.

So what led to this tragedy?



The deaths were most likely caused by the wrestlers' dangerous make-weight practices, including severe dehydration and self-imposed sweating. These practices can create a dangerous condition similar to heat stroke, which elevates the level of the creatine breakdown product creatinine in the body.



Creatine has also been associated with cramping and muscle spasms, according to some athletes' trainers, although they can't prove the problems result from the supplementation. Experts feel that these conditions are probably caused by insufficient water intake. Creatine tends to pull water from other parts of the body into cells, so it's important to drink an additional 8 ounces of water daily over and above your normal 8 to 10 cups a day.



Creatine supplementation is ill-advised if you have preexisting severe kidney disease (for example, renal dialysis or kidney transplant patients). Thus, people with kidney disease should not supplement with creatine. Always consult your physician before supplementing.

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