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Are vitamins and supplements beneficial or harmful to students?
Are vitamins and supplements beneficial or harmful to students?

[My Education Room Summary] The health benefits of vitamins and supplements have been touted for generations, but are they safe and effective for students? Do they really work? There are strong proponents on both sides. Consult with your doctor and exercise caution.



- By Richard Pasin


Each day we wake up and prepare our children for school. A nutritional breakfast is followed by vitamins and supplements tailored to keeping them healthy. This tradition had been passed down from our parents with the benefits reinforced by our friends, what we learn on tv, and information we read online or in magazines. Often the only debate was which vitamins, fish oils, or probiotics were best NOT whether they were safe or effective.

That changed after watching a recent PBS Frontline episode (http://www.pbs.org/wgbh/frontline/film/supplements-and-safety/) outlining the serious concerns amongst health officials and scientists with the supplement industry. As a parent I thought it important to share the concerns stated in the program.


Safety & Effectiveness

  1. The Food & Drug Administration (FDA) in the United States does not (unlike prescription drugs) review the safety or effectiveness of supplements BEFORE they hit the market. Suppliers only need to show that they follow good manufacturing practices. The burden of proving whether a product is safe or not lies with the FDA NOT the manufacturer. With prescription drugs the opposite is true.

    1. The obvious concern? What of supplemental products imported from other countries where rules are not as strict?
    2. The FDA has no means to test every product before it hits the market and has no registration system of domestic US manufacturers making supplementary products. They can only inspect the ones they know about. The concern again is where are these products coming from and what is the level of safety being adhered to by these suppliers?
    3. In Canada industry regulations are meant to ensure manufacturing quality and safety standards are met, but suppliers may make efficacy claims based on "traditional uses" and are NOT required to conduct detailed scientific analysis (used in prescription drug testing) before products are brought to market.
    4. https://www.sciencebasedmedicine.org/supplement-regulation-be-careful-what-you-wish-for/

  2. Should we be providing students (kids) with vitamins, minerals or supplements assuming they are safe? Are we over reacting? Read on...


What's stated on the labels may not necessarily be what is in the package!

  1. In 2013 Children's Hospital in Philadelphia became worried about the quality and safety of the products their patients were taking so they decided to have their pharmacists check the accuracy (ingredients and dosages) of packaged supplements brought to them by the patients. What did they find?

    1. They found a number of labelling errors. For instance a vitamin D liquid stating 400 UI per dosage was actually 213% higher. Given that vitamin D may be recommended to premature infants this was cause for alarm.
    2. The hospital has challenged manufacturers to meet the labelling standard
    3. http://annals.org/article.aspx?articleid=1789253
  2. At the University of Guelph (Ontario) botanist Dr. Steven Newmaster - a user of supplements himself - tested 44 random herbal products purchased off the shelf in Canada and the US and analyzed the DNA. His findings? The trend continues...

    1. 60% of the products had ingredients not listed on the label
    2. One in three of the products he tested proved to be outright fakes
    3. http://www.nytimes.com/2013/11/05/science/herbal-supplements-are-often-not-what-they-seem.html?_r=0

  3. NY Attorney General - Eric Schneiderman - ordered DNA tests conducted on various supplements purchased in New York State from Walmart, Walgreens, Target & GNC

    1. Few products tested contained all the products listed on the label
    2. What was in the product then? Fillers like asparagus and house plants
    3. Is there massive fraud happening?
    4. http://well.blogs.nytimes.com/2015/02/03/new-york-attorney-general-targets-supplements-at-major-retailers/
       
  4. With the industry expending a massive effort (and money) on lobbying some companies have stepped up to adopt policies and procedures to instill consumer confidence in their products.

    1. Companies like DNC and Nature's Way have decided to adopt DNA bar coding to authenticate the product they sell
    2. http://www.natureswaycanada.ca/


The Danger

  1. Dr. Herbert Bonkovski MD (Wake Forest Baptist Medical Centre) - an investigator for the liver injury network funded by the National Institutes of Health - has raised serious concerns with the amount of liver injuries caused by supplements.

    1. The frequency of cases has tripled in last ten years - http://onlinelibrary.wiley.com/doi/10.1002/hep.27317/full

  2. In 2013  the state of Hawaii experienced and outbreak of liver problems linked to diet and workout supplements (OxyElite Pro)

    1. The state transplant center was overrun
    2. 29 people reported being affected - two needed new livers
    3. One mother of seven died
    4. The cause? According to the Frontline investigation Angilene was added to the supplement - purchased from a Chinese manufacturer (See concerns raised above!)
    5. http://www.reuters.com/article/us-hepatitis-hawaii-idUSBRE9970YA20131008

  3. The US Food and Drug administration banned the use of Ephedra - a dietary supplement in weight loss products - in 2004 but not before 160 people died including major league pitcher Steve Bechler.

    1. The concern? How many diet and fitness pills are being taking by kids seeking to excel in sports or trying to lose weight? What are the short and long term effects of taking these supplements on kids?
    2. https://nccih.nih.gov/health/ephedra


Vitamins and Fish Oils are ok right?

  1.  Pediatrician Paul Offett wrote a book entitled "Do you believe in magic." He states:

    1. The amounts listed on child and adult vitamin labels are much greater than the recommended amounts
    2. The public take too many vitamins and fish oils
    3. Multivitamin won't hurt you (daily recommended amounts) but most people get the recommended amount of vitamins from foods they eat each day. Are we wasting our money?
    4. Megavitamins may be dangerous

      1. Frequent intake of such vitamins may lead to increased risks of cancer and/or heart disease
      2. Few people know the risk they are taking

    5. Your stomach is only so big for a reason - Do not bypass your safety level

      1. Vitamin C

        1. 1000 mg of vitamin C = 7-8 cantaloupe 
        2. You are not meant to eat 7-8 cantaloupe!

      2. Vitamin E

        1. 1000 IU of Vitamin E = 1,670 almonds
        2. Taking high amounts of vitamin E can be dangerous (major risk of prostrate cancer)

      3. Antioxidant's are good (i.e. fruits and vegetables) but too much is harmful

        1. Quantity and quality matters!

      4. Vitamin D

        1. The National Institutes of Health recommends children (over 1 years old) and adults get 600 UI - Not 5000-10000 UI suggested by some websites or vitamin pundits
          1. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
        2. There is no evidence or data to show its safe or effective to take such large dosages
        3. Taking over 4000 UI can lead to calcium in the urine associated with kidney stones, high blood calcium, calcium in the arteries, vascular calcification, soft tissue calcification
        4. Very high or low levels of vitamin D is associated with higher risks of cardiovascular disease
        5. Do not assume more is better

      5. Fish Oil - Omega 3

        1. Eating fish has proven to be an important source of omega 3's but what of fish oil? What of its health benefits? Is it safe?
        2. Based on clinical trials there appears to be little evidence fish oil provides any health benefits (Andrew Grey, University of Auckland)
        3. http://www.sciencetimes.com/articles/5235/20150401/are-you-wasting-money-on-fish-oil-supplements.htm
        4. A scientific report found that 83% of fish oil supplements tested in New Zealand were highly oxidised and failed to meet the industry's own PV levels standard. The industry association governing fish oils (GOED) conducted their own tests and still found 20% not compliant. Whichever number you go with that is a high percentage!
        5. http://www.sciencetimes.com/articles/5235/20150401/are-you-wasting-money-on-fish-oil-supplements.htm

 
Conclusion

Whether vitamins or supplements are necessary for you and/or your children will vary based on your needs, but we recommend speaking to your doctor first and exercising caution. To enhance the probability that the product you seek to purchase contains all of the listed ingredients (stated on the label) and the correct dosage check for companies employing DNA bar coding processes throughout their supply chain (like Nature's Way).


Anecdote

In my third year of university I purchased Professor Claude Olney's (Arizona State University) DVD "Where There's a Will, There's an A." I enjoyed listening to all the great study tips and put them into practice. They helped. In the accompanying DVD booklet (not the video) he also stated that vitamins could help nerve tissue (C), boost energy levels (B1), and aid concentration (B3) while lecithin and choline could help improve your memory. I went to Costco and purchased these products only to find they didn't help me in my studies. In fact, while studying up at Simon Fraser University on the sixth floor some nights (after taking lecithin or choline) my skin would turn bright red and get tingly. I never questioned for a second it could be dangerous. What happened? Other students started asking me if I was ok and asked what I was doing. I told them about the DVD and the suggestions to boost memory and they started taking the pills too! The lesson? Always consult your doctor before taking advice from friends, colleagues, or adhering to advice heard on tv or the internet!


Important Links

PBS Frontline Episode "Supplements & Safety": http://www.pbs.org/wgbh/frontline/film/supplements-and-safety/

Health Canada - Regulation of Natural Health Products: http://www.hc-sc.gc.ca/dhp-mps/prodnatur/faq/question_consum-consom-eng.php

The difference between Us and Canadian regulation of health products: https://www.sciencebasedmedicine.org/supplement-regulation-be-careful-what-you-wish-for/

Where There is a Will, There's an "A" - Tips for getting top grades by Professor Claude Olneyhttps://www.wcsu.edu/housing/documents/arm/20%20Tips%20for%20getting%20top%20grades.pdf

FDA Regulations: Dietary Supplements - http://www.fda.gov/Food/DietarySupplements/

Annals of Internal Medicine - Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements by  Doctor Eliseo Guallar: http://annals.org/article.aspx?articleid=1789253

Children's Hospital of Philadelphia bans Supplements: http://annals.org/article.aspx?articleid=1789253

Herbal Supplements Are Often Not What They Seem (NY Times): http://www.nytimes.com/2013/11/05/science/herbal-supplements-are-often-not-what-they-seem.html?_r=0

New York Attorney General Targets Supplements at Major Retailers: http://well.blogs.nytimes.com/2015/02/03/new-york-attorney-general-targets-supplements-at-major-retailers/

Skip the Supplements- New York Times editorial 12/15/2013 – by Paul Offit and Sarah Erush: http://paul-offit.com/skip-the-supplements-new-york-times-editorial-12152013-by-paul-offit-and-sarah-erush/

Do You Believe in Magic (Amazon) by Paul Offit: http://www.amazon.ca/Do-You-Believe-Magic-Supplements/dp/0062222988

Liver injury from herbals and dietary supplements in the U.S. Drug-Induced Liver Injury Network (Dr. Herbert Bonkovsky): http://onlinelibrary.wiley.com/doi/10.1002/hep.27317/full

Ephedra (NIH): https://nccih.nih.gov/health/ephedra

Hawaii - U.S. probes liver damage cases linked to supplement: http://www.reuters.com/article/us-hepatitis-hawaii-idUSBRE9970YA20131008

New Zealand - Are You Wasting Money on Fish Oil Supplements? (Andrew Grey): http://www.sciencetimes.com/articles/5235/20150401/are-you-wasting-money-on-fish-oil-supplements.htm


My Education Room is a social enterprise whose online platform is designed to allow certified K-12 teachers to provide educational assistance to children seeking to improve their grades, master a concept, get help with a learning disability, or go beyond the K-12 curriculum. We aim to help children, empower teachers, keep rates affordable for parents, and raise funds for our local school communities.

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Frontline: Supplements & Safety. (2016, January 27).
Retrieved from: http://www.pbs.org/wgbh/frontline/film/supplements-and-safety/
 
 
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