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NIFS Healthy Living Blog

Should You Take CoQ10 for Heart Health? A Look at the Research

GettyImages-940463278Coenzyme Q10, also known as ubiquinone, is a commonly used supplement by those with cardiovascular risks and disease, and especially those using statins. CoQ10 acts as a carrier in our cells to assist in oxygen utilization.  It also assists enzymes in the mitochondria. This allows the production of energy in a cycle referred to as the Krebs Cycle, and hints at why the mitochondria are the “powerhouse of the cell.” Some believe that those with heart failure have a buildup of reactive oxygen species (ROS), which can lead to adverse effects. Furthermore, they suggest CoQ10 antioxidant properties can combat the buildup of ROS. Additionally, CoQ10 is thought to balance calcium-dependent ion channels within the heart, which is critical for heart function. As far as supplementation with statins goes, people are led to believe that supplementing CoQ10 is essential because statins block the pathway that leads to CoQ10 production.

Researchers looked into these claims. Some found many studies that showed CoQ10 had no clear effect on how much blood the heart was able to pump (left heart ejection fraction), and other studies were inconclusive with poor research design. On the other hand, a Large study (a meta-analysis of clinical trials) revealed that those who supplemented CoQ10 had lower risk of death and increased exercise capacity, but no correlation between CoQ10 and how much blood the heart was able to pump. Lastly, another study observed those with heart failure receiving medical therapy. In addition to medical therapy, some of the participants received a placebo and some received Coenzyme Q10. Although the concentration of CoQ10 in the blood serum increased dramatically, those patients saw no greater effect in ejection fraction, peak oxygen consumption, and exercise duration. 

Drug Interactions and Additive Effects

CoQ10 has been known to interact with Vitamin K Antagonists, such as warfarin, a commonly prescribed drug in cardiovascular disease cases. Some cases have shown that CoQ10 blocks the anti–blood clotting (aka anticoagulant) effect of Vitamin K Antagonists, especially warfarin, which can lead to fatal blood clotting (according to Lexi-Drugs Online). On the other hand, some studies have shown that CoQ10 has done the complete opposite to Vitamin K Antagonists and actually enhanced the anti-blood-clotting effect, which leads to excessive bleeding.

Side Effects

Some side effects reported include severe gastrointestinal (GI) bleeding, allergic reactions, headaches, vomiting, urine discoloration, and abdominal pain.

Further Research

Much of the research that shows a positive outcome when supplementing CoQ10 had small trial groups (not enough people). The number of participants in the trials, known as sample size, is too small for the evidence to be conclusive. Moving forward, is it possible to get a bigger sample size that can give conclusive results? As of now, many are torn on this topic.

The Clinical Bottom Line

There is not enough evidence to support the use of CoQ10 for treating heart failure or even lessening the risk of muscle weakness (myopathy) in those taking statins. Until more research emerges, I would suggest those with cardiovascular disease not take CoQ10, especially if they are taking a Vitamin K Antagonist. If you are torn about taking CoQ10, consider speaking with your Primary Care Provider and Registered Dietitian to see if it's right for you.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: nutrition cardiovascular supplements drugs heart health dietary supplements cardiovascular disease

Choosing and Using Probiotics for Gut Health

Screen Shot 2020-07-21 at 12.20.41 PM“Take a probiotic; it helps with your gut.” We have all heard it from friends, doctors, and Registered Dietitians. Is it really that simple, though? It is no secret that probiotics really do help with a variety of gastrointestinal (GI) issues. However, did you know that there are specific strains of probiotics that help with specific symptoms, and while one strain may help with one GI symptom, it may not help with another? Not all probiotics are created equal, and not all supplements labeled “probiotic” will yield health benefits.

What Are Probiotics and Prebiotics?

Probiotics are live microorganisms (tiny living things), mainly bacteria and sometimes yeast, and are intended to have health benefits when ingested. They are similar to the helpful microorganisms naturally found in the gut. Probiotics are found in supplements and fermented foods, such as Greek yogurt with added Lactobacillus and Bifidobacterium, kombucha, tempeh, kefir, and sauerkraut.

Do not confuse these with prebiotics, which are the food source for the “good” bacteria in our GI tract. Prebiotics are “a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon the host’s well-being and health.” They are carbohydrate compounds, primarily oligosaccharides, that withstand digestion in the GI tract and reach the colon where they then are fermented by the gut microflora, helping the good bacteria to grow. In short, they fall under the categories of soluble fiber and fermentable fiber. This is important, because even if you are taking a probiotic or eating foods rich in probiotics, you may not be receiving the maximum amount of benefits if you are not eating enough prebiotics (soluble and fermentable fiber). Foods rich in prebiotics include green bananas, onion, garlic, asparagus, artichokes, and leeks.

How Do Probiotics Work?

The human GI tract is colonized by many microorganisms, such as bacteria, viruses, fungi, archaea, and protozoa. The totality of these organisms is known as the gut microbiota, microbiome, or intestinal microflora and can affect the health and disease state of a human. Probiotics typically work in the GI tract to alter the intestinal microflora, adding good bacteria to the microbiome. The mechanism of action depends heavily on the species and strains because different species and strains have different effects. Some of the known mechanisms include the following:

  • Inhibit the growth of some pathogens (microorganisms causing disease or sickness).
  • Help with vitamin synthesis (B vitamins and vitamin K).
  • Increase absorption of protein.
  • Reinforce the gut barrier, keeping food and other GI contents from leaking into the bloodstream.
  • Neutralize toxins.
  • Lower the pH in the colon, which could help speed up stool for those who are constipated.
  • Replenish good bacteria after taking antibiotics, which may help resolve diarrhea from antibiotics.

Probiotics and Gut Health

The gut microbiota is the center of much current research. Researchers are suggesting that an imbalance in the gut microbiota could lead to several health issues including immune dysfunction, infection, obesity, and GI problems. The imbalance can come from medical conditions, stress, and antibiotic usage (which destroys bad and good bacteria).

Using a probiotic to restore balance has been shown to alleviate symptom persistence in irritable bowel syndrome (IBS) by 21% using both single-strain and multiple-strain supplements, with the mixtures being most effective. Studies also found symptom relief in ulcerative colitis, reduction in acute diarrhea duration and frequency, and lower risk of diarrhea from antibiotic use by 51% or clostridium difficile infection.

A healthy gut with plenty of good bacteria has also been shown to improve the immune system, combat inflammation, and potentially reduce bad cholesterol (total and LDL cholesterol).

Picking Probiotic Supplements

Remember, not all probiotic strains and species are created equal. Trying to figure out exactly what strain, species, and genus of probiotic will work for you and your needs can be tedious, because there are thousands upon thousands of variations. It may take some trial and error to finally find a probiotic that meets your needs.

The good news is that both Lactobacillus and Bifidobacterium are the most studied probiotic genera. There are several studies of strains from these two genera that have produced positive results. Below is a list of conditions with the genus and strain of probiotic that has shown promise in helping with the condition.

  • Acute diarrhea: Lactobacillus paracasei or Lactobacillus rhamnosus or Saccharomyces boulardii
  • Antibiotic-associated diarrhea: Lactobacillus casei, Lactobacillus bulgaricus, Lactobacillus acidophilus, Lactobacillus rhamnosus
  • Overall symptoms of IBS: Bifidobacterium bifidum, Escherichia coli
  • Abdominal pain: Bacillus coagulans, Bifidobacterium bifidum, Lactobacillus plantarum
  • Bloating/distention: Bifidobacterium animalis, Bifidobacterium bifidum, Lactobacillus reuteri
  • Constipation: Bacillus coagulans, Bifidobacterium animalis, Oligofructose (prebiotics)
  • Lactose maldigestion: yogurt with Lactobacillus delbruecki susp bulgaricus and Strepococcus thermophilus
  • High Cholesterol and LDL: Lactobacillus acidophilus, a mixture of Lactobacillus acidophilus and Bifidobacterium lactis, Lactobacillus plantarum (more research is needed here)

If you are struggling with GI symptoms and considering a probiotic supplement, it is important to talk this over with your Registered Dietitian (RD) and primary care provider. They can help to identify the correct genus, strain, species, and dose you need.

Feed Your Gut

For those healthy individuals, you most likely do not need a probiotic supplement. If you really want to help your gut, follow these tips:

  • Eat foods rich in probiotics. When seeking foods with probiotics, the product must have active and live bacterial culture and indicate that on the label. A good rule of thumb is at least 1 billion colony-forming units or 1 billion CFUs, containing the genus Lactobacillus, Bifidobacterium, or Saccharomyces boulardii. Probiotic-rich examples include Greek yogurt, kombucha, tempeh, kefir, and sauerkraut. Be sure to check the label for the specific genus of probiotics(s) in the products, as they will differ. Also note that the starter cultures in Greek yogurt are Streptococcus thermophilus and Lactobacillus bulgaricus, but these are often destroyed by our stomach acid and offer no benefits. Get the Greek yogurt brands that add extra bacteria to the starter cultures (check the label).
  • Feed your probiotics with prebiotics to help the probiotics multiply in your microbiome.
  • Sleep at least 7–8 hours each night.
  • Maintain a healthy weight and body fat percentage.
  • Manage stress.
  • Balance your diet, keeping it loaded with fruits, veggies, lean proteins, fiber, and whole grains.

As always, reach out to the NIFS Registered Dietitian for nutrition help, including nutrition management of gut-related issues. We are here for you.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: nutrition digestion gut health supplements dietitian probiotics dietary supplements

Taking Dietary Supplements Safely: Advice from a NIFS Dietitian

GettyImages-505820296Dietary supplement usage is reaching an all-time high. The 2019 Consumer Survey on Dietary Supplements revealed that 77% of Americans consume supplements. This is a dramatic increase from the 53% reported by the NHANES in 2010. Americans are spending $38.8 billion a year on supplements, with more than 85,000 supplements on the market. Reasons for consumption are widespread, ranging from athletes hoping to boost performance to people who need more Vitamin D for bone health.

With the rise in supplement usage, it is important to be an informed consumer. While there are numerous reasons for this, one of the biggest is that supplements are loosely regulated by the FDA, meaning labels may not display what is truly in the supplement. Also, claims marketed about the benefits of a supplement may be false because companies are not required to obtain authorization from the FDA prior to making such nutritional support claims.

How can you know whether what you’re taking is safe and effective? Let’s dive in!

What Is a "Dietary Supplement?"

According to the Dietary Supplement Health and Education Act of 1994 (DSHEA), a dietary supplement means “a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following ingredients:

  • Vitamin
  • Mineral
  • Herb or other botanical
  • Amino acid
  • A dietary supplement used by man to supplement the diet by increasing dietary intake
  • A concentrate, metabolite, constituent, extract, or combination of any ingredient described in the above.”

Are Dietary Supplements Regulated? Can Supplements Be Trusted?

Technically, yes, supplements are regulated by the FDA under the DSHEA. However, there are loopholes to consider:

  1. The FDA does not inspect products before they are sold, nor do they require registration unless the supplement contains a new ingredient not yet on the market.
  2. The only formulation standard is the Current Good Manufacturing Practice (GMP); however, 2013 report by the FDA revealed that 70% of inspected manufacturers were in violation of GMPs. Not all products even get inspected after being on the market. The FDA states the manufacturer is responsible for ensuring safety and quality, but clearly some manufacturers are doing a poor job, and the FDA is only catching some.
  3. Nutrition supplements may not claim to diagnose, cure, prevent, or treat diseases. Sure enough, some manufacturers have managed to ignore this. A 2003 study found that 81% of 338 herbal supplement retail websites made one or more health claims, and 55% claimed to diagnose, cure, prevent, or treat specific diseases.

What Can You Do to Be Safe When Taking Supplements?

Blind trust in supplements is unwarranted; however, there are steps you can take to ensure your safety while taking them.

  • Check the label for a stamp indicating third-party verification. Independent third parties are hired by manufacturers to thoroughly test products, ensuring accuracy of ingredients, potency, and amounts; absence of toxic compounds; and production in compliance with FDA GMPs. Credible third parties include NSF International and US Pharmacopeia (USP).
  • Athletes: look for the NSF Certified for Sport stamp. The USA Doping Agency (USADA) has recognized this program as best suited to assist athletes in choosing supplements that do not contain banned substances for sports.
  • Download the NSF International App. It shows which products are NSF approved—right at your fingertips anytime, anywhere.
  • Check out the Dietary Supplement Fact Sheets published by the National Institutes of Health: Office of Dietary Supplements. This government agency has quick fact sheets about a variety of dietary supplements, including vitamins, minerals, probiotics, botanicals and herbs, and more.

Speak with a Registered Dietitian for supplement guidance and which supplements may (or may not) be right for you. NIFS Registered Dietitians are available to help you!

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: NIFS nutrition supplements dietitian drugs sports nutrition dietary supplements registered dietitian

Using Peppermint Oil for Irritable Bowel Syndrome

GettyImages-1030882342Peppermint oil is a commonly used nutrition remedy for Irritable Bowel Syndrome (IBS), other digestive problems (abdominal pain), the common cold, and headaches. We will focus on gut health in this blog. This remedy has been mentioned in records from ancient Greece, Rome, and Egypt and is becoming more popular in the modern age.

It is suggested that peppermint oil in enteric-coated capsules may improve IBS-related symptoms, such as abdominal pain. A meta-analysis evaluated 726 patients across nine studies, all of which were assessing the use of peppermint oil for treatment of IBS. All the studies showed a significant improvement in IBS symptoms and abdominal pain. The only adverse effect commonly noted was heartburn. Furthermore, another study was done where 65 IBS patients completed the study. There was a placebo group and a group treated with peppermint oil. Over the course of six weeks, those taking peppermint oil said abdominal pain (upset stomach, bloating, and gas) markedly improved, whereas the placebo group saw no significant changes. No other IBS symptoms improved. Two weeks after trials ended, the pain score increased back to the normal (same report as prior to treatment).

Drug Interactions and Additive Effects

According to the literature, the most common drug interaction is enteric-coated peppermint oil capsules taken at the same time as antacids. It is suggested that the two not be taken together, because the enteric coating will be broken down too quickly, which can result in heartburn.

Side Effects

Peppermint oil has been recognized as safe. Possible side effects associated with peppermint oil include allergic reaction and heartburn. The most common side effect associated with peppermint oil supplementation is heartburn, especially among those with IBS.

The Clinical Bottom Line

A significant amount of research shows that peppermint oil supplementation in those with IBS helps reduce abdominal pain. Additionally, it is safe. I would suggest someone struggling with IBS take peppermint oil. However, if they begin to experience excessive heartburn, I would suggest not taking peppermint oil or making sure they are not taking it with an antacid. Furthermore, it is important to remember that peppermint leaf is NOT the same thing as peppermint oil. Peppermint oil is going to be more concentrated and has the research to back up the benefits. On the contrary, peppermint leaf will be less toxic and does not have the research to support usage. 

Further Research

Much of the research done to prove peppermint oil helps with IBS was short term. Not many studies have looked into the long-term effects and safety of supplementing peppermint oil. Thus, I believe future research should look into that.

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This blog was written by Sabrina Goshen, NIFS Registered Dietitian. To learn more about the NIFS bloggers, click here.

Topics: digestion supplements illness prevention dietary supplements IBS irritable bowel syndrome

Vitamin C: How Much and Which Sources Are Best for Boosting Immunity?

GettyImages-993119894During cold and flu season, we try to do all we can to prevent illness or speed up how fast we recover from illness. One such strategy many employ is the use of Vitamin C for a natural remedy. Several products are marketed as immune system boosters because they contain large amounts of Vitamin C. Do these products really work? We set out to investigate!

What Vitamin C Can Do for You

Vitamin C, also called ascorbic acid, is not made by our bodies. We must take in this vitamin in our diet. It is needed for not only immune function but also for these uses:

  • Form collagen (skin, tendons, ligaments, and blood vessels),
  • Repair and maintain bones and teeth
  • Heal wounds and form scar tissue
  • Aid in iron absorption

It can also help prevent cancer as an antioxidant by blocking damage that we are exposed to from air pollution, cigarettes, and UV rays from the sun.

Vitamin C deficiency is extremely rare today, but in the mid-1700s scurvy in sailors was very prevalent. Those at risk of low vitamin C intake are smokers, those with medical conditions that affect absorption (cancer cachexia), and individuals with little variety in their diets.

How Much Vitamin C Do You Need?

The recommended Dietary Allowance for men is 90 milligrams per day and 75 milligrams per day for women. Fruits and veggies are the best source of vitamin C—especially citrus fruits. It can be destroyed by heat, so cooking slightly reduces your intake. However, most of our best sources of vitamin C are consumed raw naturally, and we usually do not have to worry about this. To get a better idea of how to meet your daily requirement with food, here are the vitamin C contents of some common fruits and vegetables that are good sources:

  • Red bell pepper (½ cup, raw): 95mg
  • Orange, 1 medium: 70mg
  • Green bell pepper, ½ cup raw: 60mg
  • Broccoli, ½ cup cooked: 51mg
  • Cantaloupe, ½ cup: 29mg

In short, you can skip the megadoses of Vitamin C at the pharmacy.

Can Vitamin C Treat or Prevent the Common Cold?

In the 1970s, research was released that suggested Vitamin C could successfully treat or prevent the common cold. Several studies since then have been inconsistent and have resulted in some confusion and controversy. To date, the most compelling evidence comes from a 2007 study that showed preventative treatment in the general population did not affect cold duration or symptom severity. However, in the trials involving marathon runners, skiers, and soldiers exposed to extreme physical exercise or cold environments daily as well as the elderly and smokers, there could be somewhat of a beneficial effect. It was concluded that taking Vitamin C after the onset of illness did not appear to be beneficial. Furthermore, at doses above 400mg, Vitamin C is excreted in the urine. A daily dose in the 1000–2000mg range can cause upset stomach and diarrhea.

If you want the benefits of Vitamin C, it is best to consume the recommended Dietary Allowance daily, before the start of symptoms. Ideally, you will get Vitamin C from your food instead of a supplement; you will also get several other important nutrients in addition to your Vitamin C. Remember to make half of your plate fruits and veggies at every meal or blend up a quick smoothie for an easy on-the-go snack, slice up peppers and dip in hummus, or ask for extra veggies on that sandwich, pizza, or salad.

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This blog was written by Lindsey Hehman, MA, RD, CD. To learn more about the NIFS bloggers, click here.

 

Topics: nutrition healthy eating immunity vitamins supplements fruits and vegetables viruses Vitamin C

Adding Nutritional Supplements to Your Diet and Workout

Most of us have specific goals in mind when it comes to an exercise program. We work hard to achieve these results day in and day out, but sometimes our bodies may need an extra push to get over that hump. Many people question the importance of adding supplements to a healthy diet and workout routine, as well they should.

ThinkstockPhotos-471775270.jpgWith so many different supplements flooding the shelves these days, it’s hard to know which ones will truly help you achieve your desired results. Although I agree that some supplements might not be necessary to include in your program, others could be beneficial to many individuals no matter what their fitness goals are.

Not a Substitute for Proper Nutrition

Before I go any further, I want to note that supplementation is simply an addition to your diet and exercise regime. These are not meant to replace a well-balanced whole-food diet; they are meant to be used in conjunction.

Most of the nutrients we need are already being produced by our own bodies to a certain extent, as well as existing in foods we eat daily. Some essential nutrients such as protein, creatine, and branched-chain amino acids (BCAAs) are naturally produced in the body and can be found in meat products, including (but not limited to) red meat, fish, and ground turkey. These amounts are just large enough to support daily functioning, but may not be produced in large enough quantities to aid in dramatic physique enhancements. If you are looking to take your physique to the next level, supplementation might be just what you need.

Which Ones Should I Use?

Here are the top five supplements (in my opinion, and that of many top professionals) you could add to your exercise and diet program.

  1. Branched-chain amino acids (BCAAs): BCAAs are essential nutrients that help the body slow down protein and muscle breakdown, which can aid in preventing muscle fatigue during intense workouts. It works by stimulating the building of protein in muscles, which in turn helps prevent muscle breakdown. I would not recommend using BCAAs when trying to gain muscle hypertrophy (or size), as muscle breakdown is essential for muscle growth. Instead, try a pre-workout or caffeinated drink before your workout for extra energy.
  2. Creatine: Creatine is an organic acid that is produced in the liver and helps supply energy to cells all over the body (especially muscle cells). People take creatine because it allows the body to produce more energy, and with more energy a person is able to increase the intensity of their workouts. Many athletes use creatine to improve their overall performance. It also helps aid in quicker muscle recovery after an intense workout.
  3. Protein: Your muscles need protein grow and recover from muscle breakdown caused by exercise. You can get plenty of protein in your diet; however protein shakes are generally lower in calories than a high-protein meal. They are also portable and more convenient that carrying around whole-food meals (here are some ideas for making your own). Two widely used proteins are whey and casein. Whey is a fast-digesting protein that aids in muscle recovery and muscle growth. Casein is a slow-digesting protein that creates a longer-lasting supply of muscle-building nutrients. Many experts recommend taking a mixture of the two proteins to ensure a release of amino acids into the blood for as long as possible, therefore aiding in lean muscle gain as well as body fat decline.
  4. Multi-vitamins: Multi-vitamins are essential to support the body’s everyday functioning. Your body needs a variety of complex nutrients for optimum efficiency and performance. Taking a high-potency multi-vitamin can ensure your body is getting those essential nutrients to support thousands of metabolic reactions. Here’s more information on the importance of a multi-vitamin for your health and fitness goals, including a list of the essential vitamins and minerals you need.
  5. Fish oil: Fish oil tablets are the most efficient way to get the purest and most concentrated dose of Omega-3s into your diet. Omega-3s have been proven to improve blood circulation, which in turn will allow nutrients such as protein and carbohydrates to reach muscles. Omega-3s also help with maximizing metabolic rate, which in turn helps with fat loss.

Dietary supplements can have many health benefits as well as many performance-based benefits. If you are not concerned with taking supplements for their potential performance enhancements, you should at least be taking supplements such as multi-vitamins and fish oil tablets for your general health. They can be an easy addition to your diet and exercise regimen that may have huge effects on your overall health. Add supplements on an as-needed basis after conducting a needs analysis, and implement one at a time.

If you have additional questions or concerns about supplementation, please stop by and ask any Health Fitness Specialist at NIFS or contact our Registered Dietitian, Angie Mitchell for more information.

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This blog was written by Darius Felix, Health Fitness Specialist at NIFS. To find out more about the NIFS bloggers, click here.

Topics: fitness nutrition fitness center protein muscle mass vitamins supplements