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The
Malnutrition Epidemic
By Michael Lam, MD, MPH and Maria Sulindro, MD
Disease
Without Symptoms
80% of us will die of a heart attack, stroke, cancer, or diabetes.
It's a rude awakening for those unprepared. A serious look at these
and other deficiency-induced illnesses showed that they develop
slowly and subtly, results of decades of dietary and lifestyle abuses.
Consider
arthritis, high blood pressure, prostate problems, memory loss,
obesity, periodontal disease, and poor circulation. These conditions
do not appear overnight. They are not even results of the natural
progression of aging as many age without getting these diseases.
Many of these illnesses can be traced to or exacerbated by some
nutrient shortfall that has persisted for decades.
While
Americans are overfed in terms of calories, they are malnourished
in terms of nutrients. No wonder they ranked 17th in terms of life
expectancy, despite having the best doctors and most modern medical
technology in the world.
In an
overfed but malnourished nation, this problem is an epidemic because
80% of the adults are afflicted, whether they are aware of it or
not. Furthermore, it is silent because the symptoms of deficiency-induced
illness take 10-20 years to surface. During this silent period,
we are all lead to believe that we are in a state of "normal"
health, supported by "normal" laboratory test results.
The reality is that we are in a sub-clinical phase of illness with
abnormalities where current laboratory test is not sensitive enough
to pick up.
What Can You Do?
The average American consumes 2 pounds of food a day. This equates
to over 20 tons of food over a lifetime. If your body does not have
access to the optimum amount of building blocks it needs when it
needs them, the aging process accelerates.
It would be wonderful if the body comes with an internal alarm clock
that monitors levels of all important nutrients and alerts you when
their levels are low. Since this alarm system does not exist, it
is impossible to accurately anticipate what the body's demand is
for each nutrient on any given day or week, much less correlating
this information with an intake.
You
can be chronically deficient in many nutrients and not know about
it for years. By the time the symptoms surfaces, the disease have
often already progress beyond the stage of reversal.
Providing
the body with abundant supplies of right nutrients is therefore
critical. The combination of eating healthful foods - foods of plant
origin, which are rich in essential nutrients, antioxidants, and
phytochemicals - and taking nutritional supplements guarantees efficient
cellular protection, repair, and replacement.
Consider
the Evidence
Thousands of studies have shown that nutritional supplementation
enhances life expectancy and prevents diseases if taken at the optimum
dosage. Complete testing will take decades more, and even then,
no one will be sure due to the many interacting factors. Review
of significant research done so far, however, paints a picture with
overwhelming supporting evidence that supplementation works.
Here
are just a few studies
- In
a landmark article published in Science (2000 Sep 1;289:1567-1569),
researchers have found that drugs that mimic some natural
antioxidants are able to extend the life-span of worms (Caenorhabditis
elegans) by nearly 50%. The scavenging compounds also restored
normal life spans to a subgroup of nematodes that would
otherwise have aged and died prematurely due to a genetic
defect linked to oxidative stress. The drugs are synthetic
versions of the oxygen-free radical scavengers superoxide
dismutase (SOD) and catalase.
-
Common and more well-known antioxidants, such as vitamins
C and E, work by interrupting chain reactions that would
otherwise result in oxidation of cells caused by release
of substances, from cell membranes. Dr. Irwin Fridovich,
PhD, professor of biochemistry at Duke University, notes
that "Antioxidants like vitamin E are called chain-breaking
antioxidants, because they react with one of the species
that's going to propagate and stop the chain reaction. So
instead of a process that might involve a hundred molecules,
if you have vitamin E around it might stop after only five,
so it inhibits oxidation by breaking the chain, preventing
the propagation of chain reactions.. According to the study's
authors, "It appears that oxidative stress is a major
determinant of life-span and that it can be counteracted
by pharmacological intervention."
- A
study of 11,000 Americans showed that intake of 300 mg a
day of vitamin C adds 6 years to a man's life and 2 years
to a woman's life and decreases cardiovascular disease by
40%.
- Subjects
who take 11,000 IU of beta carotene a day (1/4 cup of carrot
juice or 5 carrot sticks) have a 22% lower risk of heart
disease than those getting less than 3,000 IU a day in a
Harvard study.
- A
Harvard study of 16,000 women and 9,500 men showed those
who take 700 mcg of folic acid a day had two-thirds the
risk of getting pre-cancerous polyps in the colon compared
to those taking only 166 mcg a day. The average American
over 50 years old takes in 130 mcg a day.
- 24
percent of people over 69 years old are deficient and 40%
of those over 80 years old are deficient in vitamin B12,
which produces pseudo Alzheimer's symptoms. Simple oral
supplementation of vitamin B12 is all it takes to reverse
the condition.
- A
French study of 3270 women over age 80 showed that those
took 1,200 mg of calcium daily plus 800 IU of vitamin D3
had 43% less fracture of the hip and 32% less fracture of
the wrist, arm, and pelvis.
- Chromium
supplementation has been shown to normalize blood sugar
and reduce insulin resistance in diabetic patients.
- Ascobyl
palmitate (a fat soluble form of vitamin C) in conjunction
with L-lysine and L-proline, has been show to reduce atherosclerosis
and reverse already existing plaque as demonstrated by serial
ultrafast CT scans.
- A
University of Texas Southwestern Medical Center study found
that taking 800 IU of vitamin E for 3 months slashed LDL
("bad") cholesterol oxidation and heart disease
by 40%.
- A
large scale Harvard study of 87,000 female nurses showed
those taking 100-250 IU of vitamin a day for 2 year have
a 41% lower incidence of major heart disease compare to
the controlled group.
- Monkeys
fed 108 IU of vitamin E a day for 3 years showed only a
20% blockage of artery despite a high-fat diet in a study
conducted at the University of Mississippi's Atherosclerosis
Research Laboratory.
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Aging
and Nutrition
After reaching the peak of health at age 25 or thereabouts, the
disease of aging creeps in. Modern concepts defined aging as nothing
more than a disease state characterized by symptoms clearly definable
into three phases:
- Sub
Clinical Phase (between age 25-35) where cellular damage
has started without outward symptoms or measurable laboratory
results.
- Transitional
Phase (between age 35-45) where cellular damage now produces
outward symptoms.
- Clinical
Phase (age 45 and beyond) where deterioration of bodily
function accelerates with illness setting in.
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From a nutritional perspective, the price paid for sub optimum nutrition
rises with age. During the clinical phase of aging (age 45 and beyond),
the gastrointestinal track begins losing its absorptive power. Few
of the nutrients in the food you eat actually make their way into
the bloodstream. At a time when the body needs the nutrient most
to fight disease, it is absorbing less.
During
this phase of aging, the body's production of digestive enzymes
gradually declines. Without digestive enzymes, food breakdown is
less efficient.
Decreased
nutrient absorption means reduced nutrient levels in the cellular
level of critical organs and tissues. This in turn leads to accelerated
aging. To compound the problem, the gastrointestinal track becomes
even less able to absorb nutrients efficiently in a state of malnourishment.
This vicious cycle of downward decline accelerates the aging progress
with each round.
How About A Healthy Diet?
Unfortunately, you simply cannot get the optimal levels of some
of the key vitamins and minerals even if you eat a healthy anti-aging
diet rich in dense complex carbohydrates, low in fat and protein.
For example, a daily intake of 5,000 calories per day (mostly as
fat) is necessary to get the 400 I.U. of vitamin E needed for anti-aging
effect. A daily intake of 5,000 calories per day is needed to obtain
the minimum requirement of 50 mcg of chromium per day. To get the
optimum intake of 200 mcg of chromium, you have to take in more
than 12,000 calories a day! A daily intake of 2,400 calories is
needed just to get reach the RDA for zinc. An intake of 2,000 calories
per day is needed to get enough Magnesium. Intake of 1 pound of
sardines, or 2.5 pounds of pancreas, is needed to get 30 mg of Coenzyme
10 (healthy people need 30 mg and chronic patients need 50-150 mg).
The
consensus among researchers in the forefront of longevity medicine
is that diet alone cannot satisfy the body's nutrient needs from
an anti-aging perspective.
A
Smart Move
While a calorie restriction diet to attain the ideal body weight
is a must for anyone interested in living a long and healthy life,
such calorie restriction must be accompanied by adequate nutritional
supplementation to ensure that the body stays in a state of undernourished
in terms of calories but over-nourished in terms of specific nutrients
critical for optimum for anti-aging.
Daily
supplementation therefore provides powerful protection against age-accelerating
nutritional deficiencies by supplying all the important nutritional
building blocks required by the body for optimum function and protection
against free radical attacks from poor dietary habits, lifestyle,
and environmental pollution.
Nutritional
supplementation also enriches the internal biochemical soup, increasing
nutrient bioavailability and facilitating the complex set of biochemical
reactions that we call life. As each of the body's cells renews
itself in this nutrient rich environment over months, years, and
decades, your body is able to defend itself better against diseases
and cancer. This is therefore a cornerstone and foundation of any
comprehensive anti-aging program.
The
Nutritional Cocktail
There is no single magical nutritional bullet for optimum health
and anti-aging.
The body needs a continuous supply of 50 or more nutrients - none
of which it can make for itself. Deficiency in any one of these
nutrients affects the overall function of the body. Nutrients are
raw materials of the body. Chronic deficiency undermines heath and
promotes degenerative disease. Running low on beta-carotene, for
example, opens the door to most types of cancer. A shortage of calcium
depletes bone mass and leads to osteoporosis. Deficiency of folic
acid precipitates heart attack, and deficiency of selenium weakens
the immune system.
24%
of people over 69 years old and 40% of those over 80 years old are
deficient in vitamin B12. Sub-optimum levels of vitamin B12 are
a prescription for pseudo-Alzheimer's symptoms. Sad to say, the
definition of "deficiency" from optimum heath and aging
perspective is not currently measurable in routine laboratory test.
One can be "normal" in blood calcium level and be osteoporotic.
Current tests are simply not sensitive enough to measure nutrient
deficiency from a cellular level.
Each
nutrient is a specialist. Each performs a specific set of functions
within the body to effect cellular energy production, repair, and
replacement. They work synergistically as a group. One nutrient
is more effective in an environment supported by another nutrient.
Vitamin C, for example, has shown to have higher antioxidant effect
in an environment rich in vitamin E. A network of mutually beneficial
interactions is created. Only by working together can nutrients
dramatically slow the aging process.
This
is well demonstrated in a Harvard study of 87,000 female nurses,
where there was a 34% drop in heart disease in those taking vitamin
E alone for 2 years or more; 22% drop in heart disease in those
taking beta carotene alone; and 20% drop in heart disease in those
taking vitamin C alone. For those taking the highest amount of all
three antioxidants, the rate of heart disease dropped 50%.
The
whole is truly greater than the sum of the parts. In this respect,
nutritional supplements together in the form of a "cocktail"
is the best approach and offers the maximum insurance against aging.
By supplying your body with the optimal dosages and combinations
of supplements, your body is able to defend itself better against
diseases and cancer.
The
key in a successful supplementation strategy lies in knowing the
optimum intake for each of the key nutrients.
What Is the Optimum Intake?
The National Academy of Science establishes Recommended Daily Allowance
(RDAs) for many common nutrients. These guidelines are created to
establish minimum requirements for healthy people to avoid deficiency
disease states, such as scurvy (deficiency of vitamin C) or rickets
(deficiency of vitamin D). They do not represent the amounts most
researchers now believe are needed to achieve optimal health and
prevent a variety of diseased, including aging.
Taking
the amount recommended by the RDA is the minimum each person must
have to avoid deficiency disease. It is sad to say that the majority
of Americans over 60 years old do not even meet the minimum RDA
for many nutrients.
In a
recent USDA survey, more than 80% of women and more than 70% of
men consumed less than two-thirds of the RDA for one or more nutrients.
These individuals suffer from chronic malnutrition and experienced
unexplained symptoms such as fatigue, joint pain, and shortness
of breadth. Specifically, most adult women don. t meet the RDAs
for zinc, vitamin B6, calcium, magnesium, and vitamin E. Most adult
men don. t meet the RDAs for zinc and magnesium. While the overall
consumption of vegetables has increased the past 20 years, 25% of
the "vegetable" consumed is in the form of artery clogging
french fries. Fewer than 20% of people eat the recommended 5 servings
of fresh fruits and vegetables a day. In fact, 20% of all Americans
don. t eat any fruits and vegetables at all!
The
RDA assumes a healthy individual free of disease and consuming 2,000
calories a day. In particular, RDAs are inadequate for the elderly,
people who are ill, immune compromised, or on medication. The elderly
is especially at risk since they not only absorb nutrient less easily,
but also consume fewer calories and thus fewer nutrients from food.
Pollution also robs us of vital nutrients and increases our exposure
to a variety of dangerous toxins and synthetic hormones. Physical
and mental stress weakens the immunity system and ups our nutritional
needs.
As we
age, our nutritional needs increase. At the same time, the nutritional
content of our food is decreasing from over-farming. Over-fertilization
depletes fruits and vegetables of vital nutrients, as do food processing,
refinement, storage, and cooking.
It is obvious that the RDA is grossly insufficient in providing
the accurate level of nutrients for optimum health.
Optimum Daily Allowance (ODA)
The optimum daily allowance (ODA) represents a new reference level
beyond the RDA, which many researchers in anti-aging believe to
have disease preventive effects. These dosages are those frequently
used in research studies and commonly practiced among those nutritionally
minded professionals.
ODA
is often many times higher than the RDA and for a good reason. To
prevent diseases caused by deficiency of nutrients such as scurvy
or rickets, follow the RDA. For optimum health and to prevent diseases
such as aging or cancer, consider the ODA. It is that simple.
Here
are just some examples of the differences:
|
Vitamin
C
|
RDA
is 85 mg
|
ODA
is 250-3,000 mg
|
|
Vitamin
E
|
RDA
is 15 IU
|
ODA
is 50-800 IU
|
|
Magnesium
|
RDA
is 350 mg
|
ODA
is 400-600 mg
|
|
Vitamin
B12
|
RDA
is 3 mcg
|
ODA
is 10-100 mcg
|
A complete
list in shown in the accompanying table. The optimum daily
allowance (ODA) and safe range assumes an completely healthy non-pregnant
(also not trying to get pregnant), non lactating adult who is not
on prescription drugs and who intends to use nutritional supplementation
to optimize heath rather than to avoid deficiency state diseases
such as scurvy or rickets. Figures reflect a compilation
of common intake levels among researchers and practitioners focused
on nutritional medicine as a way to better heath and longevity.
These figures are not reflective of recommendations set by any governmental
agency, as none exist, with the exception of vitamin C and E, which
the National Academy of Science has set as 2,000 mg and 1,500 IU,
respectively, for the first time in year 2000 as the recommended
upper limit.
There
is generally no benefit to exceeding the Optimal Daily Allowance,
except to treat or prevent specific disease conditions under expert
medical guidance (e.g. mega-dose niacin for elevated serum cholesterol).
Safe Range
The Optimal Daily Allowance is well within the upper limit of many
nutrients that can potentially cause side effects. While the ODA
of vitamin A is 10,000 IU, safe range is up to 20,000 IU. Beta-carotene
has been safely taken at dosage up to 100,000 IU a day, although
the ODA is only 25,000 . 50,000 IU. Some may experience slight diarrhea
or gastric discomfort after taking several grams of vitamin C, while
others are not bothered by ten times that amount. While the ODA
for vitamin E is up to 800 IU, one must be mindful that intake of
over 3,000 IU can cause headache, diarrhea, and increased blood
pressure. Over consumption of magnesium in dosage of over 1,000
mg can lead to diarrhea that resolves when the intake is decreased.
Rare liver problems have been reported in people taking niacin of
several thousand milligrams, while the ODA is only 25-100 mg. Calcium
at up to 2,500 mg a day for long term use has minimal side effects,
unless one has an ulcer as excessive calcium unabsorbed can cause
"milk alkali" syndrome.
Since
each person is different, always consult a knowledgeable professional
in nutritional medicine prior to embarking on any supplementation
program designed for anti-aging and health optimization.
Precautions
While nutritional supplementation is generally very safe, those
with specific health conditions should consult their nutritionally
minded physician first. If you are on a blood thinner, do not take
excessive amounts of vitamin E, which has blood-thinning properties.
If you have kidney disease or heart failure, magnesium can exacerbate
this problem. Zinc in high doses (over 300 mg a day) can inhibit
copper, iron, calcium, and magnesium absorption. People with Wilson's
disease should not take copper supplements.
If you
are in general good health, taking nutritional supplements should
not pose any heath hazards.
Conclusion
Aging is a disease accelerated by vitamin deficiency and malnutrition
of monumental magnitude ignored for the past century. This silent
epidemic affects 80% of all adults. Nutritional supplementation
in optimum intake levels is needed to ensure adequate levels for
cells to carry out repair and rejuvenation processes.
There
is very little doubt that supplements in optimum dosage enhances
life span and prevents diseases.
The
average American women lives to 76 years old, and men to 73 years
old. The average person performs less than 1 hour of physical exercise
a week and consumes an average of 2,000 calories a day. These calories
are consistent with that you find in fast-food restaurants - high
in fat, refined sugar, and low in fiber and dense carbohydrates.
If you
want to live an average life, follow what the average do. If you
want to live longer and heartily well into the eighties and nineties,
the reality is that you have to do things that the "average"
person does not do. It is quite simple.
Study
after study over the past 40 years confirms that nutritional supplementation
is a cheap insurance for longevity and cancer prevention if taken
at the optimum dosage. Nutritional supplementation is a food. It
is not giving your body something that your body does not have.
It is to supplement your body's existing level and to ensure that
the proper nutrient at the proper level is available for the body
at all times.
It is
an accepted fact that people have different nutritional needs based
on genetics, weight, gender, age, health status, physical activity,
and ability to absorb nutrients. If you don. t know what you need,
the safest strategy is to err on the side of slight excess if you
are in general good heath. Having a little extra of any nutrient
won't harm you. But a brief deficiency can, and a chronic will.
Taking
optimal amounts of nutritional supplements is a cornerstone and
key component of any comprehensive anti-aging program. You simply
cannot get enough of these nutrients from your diet for optimum
health, and having inadequate amounts can kill you.
|
Nutrient
|
|
Men
RDA
|
Women
RDA
|
Optimal
Daily Allowance
|
Healthy
Adult Safe Range
|
| Beta
Carotene |
IU
|
None
established |
None
established |
10,000-30,000 |
20,000-100,000 |
| Biotin |
mcg
|
100-200 |
100-200 |
200-500 |
200-800 |
| Boron |
mg
|
None
established |
None
established |
1-3 |
No
known limit |
| Calcium |
mg
|
800 |
800 |
1,000-1,500 |
1,000-2,000 |
| Chromium |
mcg
|
50-200 |
50-200 |
200 |
100-400 |
| Cobalt |
|
None
established |
None
established |
Not known |
No
known limit |
| Coenzyme
Q10 |
mg
|
None
established |
None
established |
25-100 |
No
known limit |
| Copper |
mg
|
2.0-3.0 |
2.0-3.0 |
2.0-3.0 |
3.0 |
| Cysteine |
mg
|
None
established |
None
established |
500-1,500 |
No
known limit |
| Folic
Acid |
mcg
|
400 |
400 |
400-1,000 |
800-3,000
Take with vitamin B12 |
| Glutamine |
mg
|
None
established |
None
established |
500-2,000 |
No
known limit |
| Iodine |
mcg
|
150 |
150 |
250 |
200 |
| Iron |
mg
|
10 |
10 |
Men: 10 mg; Women: (Pre-menopausal: 20 mg; Postmenopausal: 10
mg) |
50-100 |
| Lysine |
mg
|
None
established |
None
established |
500-2,000 |
|
| Magnesium |
mg
|
350 |
300 |
400-600 |
400-1,000 |
| Manganese |
mg
|
None
established |
None
established |
10 |
No
known limit |
| Pantothenic
acid |
mg
|
4-7 |
4-7 |
10-100 |
60-1,000 |
| Phosphorus |
mg
|
800 |
800 |
1,200 |
No
known limit |
| Potassium |
mg
|
None
established |
None
established |
Not
known, but the recommended number of servings of fruits and
vegetables supplies about 3,500 mg per day. |
15,000 |
| Selenium |
mcg
|
200-500 |
200-500 |
200 |
100-400 |
| Silicon |
|
None
established |
None
established |
Not
known |
No
known limit |
| Sodium |
mg
|
1,100-3,300 |
1,100-3,300 |
Not known, but most nutritionists recommend 3,000 mg per day
or less. |
|
| Sulfur |
|
None
established |
None
established |
Not
known |
No
known limit |
| Taurine |
mg
|
None
established |
None
established |
500-2,000 |
No
known limit |
| Tyrosine |
mg
|
None
established |
None
established |
500-1,500 |
No
known limit |
| Vitamin
A |
IU
|
3330 |
2664 |
10,000 |
5,000-20,000 |
| Vitamin
B1 (Thiamine) |
mg
|
1.2 |
1.0 |
5-10 |
10-300 |
| Vitamin
B12 (Cobalamin) |
mcg
|
3.0 |
3.0 |
100-100 |
500-2,000 |
| Vitamin
B2 (Riboflavin) |
mg
|
1.4 |
1.2 |
6-15 |
50-250 |
| Vitamin
B3 (Niacin) |
mg
|
16 |
13 |
25-100 |
Niacin:
10-200 mg; Inositol hexanicotinate: 100-3,000 mg (under a doctor's
supervision) Niacinamide: 10-300 mg |
| Vitamin
B6 (Pyridoxine) |
mg
|
2.2 |
2.0 |
10-20 |
10-400
mg. Long term use of over 200 mg daily requires a doctor's supervision. |
| Vitamin
C |
mg
|
90 |
75 |
250-3,000 |
250-10,000
mg depending on individual tolerance. |
| Vitamin
D |
IU
|
200 |
200 |
200-400 |
400-15,000
IU, but not normally necessary if you get 20 minutes or more
of sun exposure daily. |
| Vitamin
E (natural) |
IU
|
15 |
15 |
50-800 |
100-1,200
IU. If you have high blood pressure, 400 IU except under a doctor's
supervision. |
| Vitamin
K |
mcg
|
80 |
65 |
same
as RDA |
50-500 |
| Zinc |
mg
|
15 |
15 |
15-35 |
15-300 |
|
Article
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