November 24, 2017, 10:34 pm
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Dosage controversy

THERE have been controversies about the safe dose for our intake of calcium, Vitamin D, and sodium (salt). Obviously, the amount we take of any substance or medications, either too high or too low, is important, when it comes to efficacy, benefit, and adverse side-effects.

Calcium and Vitamin D
In October 2016, a new guideline was published stating that Calcium and Vitamin D intake “does not adversely affect cardiovascular health” as was suspected a decade ago.

Based on a meta-analysis published in the Annals of Internal Medicine, the National Osteoporosis Foundation and the American Society for Preventive Cardiology “have determined that calcium in food or supplements (and even with the addition of Vitamin D), doesn’t have an effect on incident cardiovascular or cerebrovascular disease, disease-related mortality, or all-cause mortality in most healthy adults.”

Total consumption of less than 2000-2500 mg daily “should be considered safe from a cardiovascular standpoint,” according to this group. However, most individuals do not need more than 500 mg of supplemental calcium a day, which could even be provided by a regular diet. Vitamin D, in its D3 form, is recommended as essential in this study and the dosages stated are 600 IU/d for those up to age 70 and 800 IU/d for those older.

The caveat is, when it comes to food or medications, more is not necessarily better.

Sodium – Salt
When it comes to sodium (salt), more is definitely not better. As a matter of fact, excessive salt intake has an adverse side effects on the cardiovascular system. Those with hypertension (high blood pressure) and those with heart failure almost instantly experience the ill effects of eating foods that are too salty, anything more than the prescribed “low salt diet.” The blood pressure immediately goes up among hypertensives and those with heart failure soon develop shortness of breath and leg swelling, depending on the degree of cardiac failure.

An article in the October 3, 2016 issue of the Journal of American College of Cardiology reported that a study covering more than two decades shows that those with the lowest sodium (salt) intake have the lowest rate of mortality (death).

The controversy with regards to sodium was not how bad excess sodium was, since it has always been clear that too much salt was bad for practically everyone, not only for those with cardiovascular diseases. The question was what the safe lowest salt intake was. 

The new finding in this study by Dr. Nancy R. Cook and her partners at Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, debunked the previous studies that reported people who consumed the lowest amount of sodium had increased mortality, or had no increased risk at all.

The study shows that “for every added 1000 mg/day of sodium (the equivalent of about a half-teaspoon per day), the risk of premature death went up by 12%. And that’s only for an excess of about half a teaspoon! A lot of salt “addicts” consume greater excesses than that, oblivious that this is most unhealthy.

The details of the study: “Cook and colleagues calculated mortality over 24 years for the patients in phase 1 (1987–1990) and phase 2 (1990–1995) of the Trials of Hypertension Prevention (TOHP), which analyzed the effect of sodium-reduction interventions on all-cause mortality based on multiple 24-hour urine samples from prehypertensive adults ages 30 to 54 years old. They found no disadvantage to ingesting the lowest levels of sodium, as reflected by 24-hour urinary sodium excretion, and a direct linear association between average sodium intake and mortality.”

The current guidelines from the US Food and Drug Administration is below 2300 mg a day, or roughly less than 2 teaspoons a day.

Food labels on cans and bottles provide, among other ingredients, the sodium content, and one can precisely tell the amount of salt in each. The guesswork comes with regards to home cooked food, unless the cook is vigilant, conscious, and careful in the use of table salt or other spices and additives that also contain salt. Many restaurants today are also showing on their menus nutritional facts, including amounts of calories, proteins, total fats, cholesterol, carbohydrates, and sodium, which helps. And their chefs also accept request for low salt, no MSG, less sugar, and less spices, or putting the sauces on the side on food orders.

So, before adding salt to your food, think of health and longevity. Indeed, salt shaker is out and sodium counting is in.

Vitamin-mineral supplements
If you are eating properly every day, you are just wasting your money taking multivitamin-mineral supplements, according to experts.

Three studies published three years ago in the journal Annals of Internal Medicine, found that multivitamins and minerals supplements “did not work any better than placebo.”

The report says these supplements would not boost the immune system or provide added health benefits, like preventing heart disease or memory loss, or enhancing longevity. to those who are eating properly daily and suggests abandoning their use. 

Only the multibillion-dollar multivitamin-mineral industry benefits, especially from those who take meg-dose supplements, which have been deemed detrimental to health and have resulted in deaths. There are also doubts that most of these and other food supplements on the market (pills, potions, and lotions) may not have the proper and right amount or quality ingredients in them. Not to mention the side effects from them that could take years to show.

Dr. Eliseo Guallar, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, stated that “it’s clear that vitamins are not working.” 

The studies did not show that multivitamins and minerals cause any adverse health effects, except when they are taken in a megadose (overdose) manner. Those below age 60 who are healthy and eating well may not need multivitamins, minerals, or any supplements. 

For the elderly and those who do not eat properly or adequately, multivitamins and minerals would be beneficial, taken at the recommended dosage. Be sure to discuss your concerns with your physician.

The main objective of this column is to educate and inspire people, especially parents, whose way of life inevitably impacts the health of their children, to live a healthy lifestyle to prevent illnesses and disabilities, and achieve a happier and more productive life for themselves and for their offspring. My articles are general medical information for the public and not intended to be applicable to, or appropriate for, anyone. The data, statistics, and personal commentaries presented here are not a substitute for, or inferred to be superior to, the professional opinion and recommendation of your physician, who knows your total condition well and who is your best ally when it comes to your health. 

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