Guest guest Posted January 30, 2002 Report Share Posted January 30, 2002 When I tested low on calcium my Dr. recommended Tums. My mother's Dr. recommended them to her too. > I have heard that Tums are not a good source of calcium. Anyone else > heard this, and why? Not to mention it is very popular. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 18, 2008 Report Share Posted April 18, 2008 > > If there isn't a serious problem with the study review, I am confused. > If all the evidence that led us to believe beta-carotene, C, and E > had cancer prevention properties in the first place came from > administering food to test subjects, and not isolated nutrients, as > the summary states, where did the idea that these specific vitamins > had this property come from in the first place? An unprocessed food > contains hundreds of biologically effecting substances... that we know > about. It seems like the prior studies would have indicated eating > certain kinds of foods and not mentioned nutrients at all. > > Another question I have is whether this finding would apply to people > who engage in activities that cause greater than normal oxidative > tissue damage - aerobic athletes, for instance. It seems possible > that the vitamins have the previously accepted antioxidant effect and > also some kind of other toxic effect, that is not yet understood, when > taken as supplements. Perhaps if one does a lot of oxidizing, the > supplements are still worth the tradeoff. ***** The below information may generate discussion: Bill Misner wrote (adapted from the Sportsci list): Many replies were exchanged to the list and in addition, I received several positive and negative replies OFF-list. I am attempting to represent both sides without distortion or bias. If I have misrepresented your position please correct me. " BALANCED DIET " MICRONUTRIENT DEFICIENCY QUESTION: On December 28th I reported that whole food (excluding supplements and enriched dairy and breads/cereals) does not replace the disease-deficiency preventative micronutrient Recommended Dietary Intake (RDI) levels. From nearly 10 years of analysis Recommended Dietary Intake (RDA)-micronutrients and calorie-macronutrients in whole foods, I found NO single menu that replaced 100% of the RDA micronutrients (or current RDI), however a high percentage of subjects replaced more than the required 100% calories (macronutrients). From over 70 menu diets analyzed, I originally selected those menus listing between 70-120 foods from 10 men and 10 women, 17 of whom were 20 were competitive endurance athletes, 3 sedentary non-athletes. Ten (10) vitamins and Seven (7) minerals from the selected 20 diets submitted were analyzed based on RDA. Of the 17 micronutrients analyzed, 40.5% of 340 micronutrient entries were at less than the 100% RDI preventative disease-disorder deficiency level. This paper was subsequently published in the " Townsend Letter for Doctors and Patients " April 2005 issue. MICRONUTRIENTS SUPPLIED BY " BALANCE DIET? " : Sport Nutritionists proclaim that a " Balanced Diet " provides 100% of the RDA micronutrients for 80% of the population. To stimulate discussion from sport nutritionists on the list, I perused the internet selecting recommended foods high in each of 10 vitamins and 7 minerals. When entering enough food volume to produce RDA levels (where my default remains set), this menu required 17 Foods...28.75 lbs...17,854 K/Cals to meet the RDA level micronutrients. =========================== Forbes-Ewan Ph.D., Seiler Ph.D., Annie Wetter Ph.D., Deborah Shulman Ph.D., Louise Burke Ph.D. suggested that a variety of whole foods selected (plant-food base) from the food pyramid replaces 100% RDI micronutrients. Concerns were expressed that unsupervised supplementation, in the hope of avoiding deficiency or boosting performance, is potentially harmful. ============================= Annie Wetter Ph.D. sent a website link table that outlined recommended food choices for a 2,000 calorie intake. She suggested that I follow the link for foods that replaced the RDI values. I followed the link directions and food list recommendations for a 2000 calorie menu, but 10 micronutrients failed to meet the micronutrient RDA level, much less the RDI level standard. Next, Dr. Wetter accepted the offer to design a 1-day diet that would be composed of minimally processed whole foods in an attempt to supply roughly 100% of the current DRI's for the man in question (40 yrs old, 70kg, 69 " ). Since much of our discussion revolves around the reference 2,000kcal diet, I set this individual's activity level to " lightly active " such that his energy needs would be close to 2,000kcals. Clearly, if this client were an athlete, he would be consuming far more food and thus nutrients. But, we must focus first on one scenario (2,000kcals) and then use it as a reference for subsequent conditions (e.g., " heavily-active " male). ===================== Dr. Wetter's diet analyzed, reported (quote): " The following micronutrients were below recommended: vit E (78%), folate (79%), biotin (79%), and molybdenum (54%). Unfortunately, the nutrient content data for each food is incomplete in the database I have access to (Nutritionist Pro, 1.1.96). Molybdenum was often not listed, and vitamin E was often absent as well, including from peanut butter which is a vit E rich food. In addition, folate was not listed in some of the whole grain items. Thus, I am confident that the amount of these nutrients in my 1-day diet are actually present in higher amounts. All of the following nutrients were present at or safely above (not in excess, i.e., UL) of recommended: vits A, C, D, thiamin, riboflavin, niacin. B6, B12, pantothenic acid, K (despite its absence from the analysis of several foods); Cr, Se, Mg, Cu, Zn, Mn, P, Fe, and Ca. Iodine was not available, nor was there a complete assessment of omega-3 and -6 FA's. You're correct in asserting that adding vitamin D to milk is not different than taking a vit D supplement. In the end however, I'm not sure what the practical implications of this assertion are other than to confirm that some nutrients are difficult to obtain in the diet. We knew that decades ago when my mother was forced to take a spoonful of fish-oil every week. So what. Now we add vitamin D to milk. I'm grateful for that because now I don't have to endure fishy smelling burps. " =================== Bill Misner Ph.D.: " I agree with Dr. Wetter's comment that " Ninety-five percent (95%) of the RDA is not typically considered deficient, just as 105% of the RDA is not typically considered excessive. I have been told that intakes of 70% of recommended can be considered adequate, especially when evaluating the intake of only 1 day (more on that below). I also agree that a 1-day assessment is not as accurate as a 3-day or 7-day assessment and then computing micronutrient %-averages. " Amby Burfoot: " Bill: Pretty interesting. Do you have a PDF or other doc of your published article in this area? " Shari Lieberman Ph.D.: " The Real Vitamin & Mineral Book also explains that even if you eat a great diet - you cannot get everything you need just from food alone. Also, when we look at preventive or therapeutic levels of dietary supplementation - the RDI becomes a moot point. " Deborah Shulman Ph.D.: " Supplements can play an important role, but not in place of food. In foods there are complex nutrient interactions, substances we have not yet identified, synergistic relationships within foods, and physiological effects that we have yet to discover. " , Ph.D. FACSM: " Have you published this in any science journal? I think you are so right on. I've talked about this for years. " : " I read this and am personally shocked by the lack of scientific methodology in their responses. Even Dr. Wetter failed to directly refute your claim. These people call themselves scientists but they have their sacred cows just like everyone else. Funny how angry some get when they hear truth. " CONCLUSION: Bill Misner Ph.D. concludes " Food alone, unless it is enriched, fails to supply the 100% RDI-micronutrient repletion level. The ideal micronutrient sources are from a variety of whole foods, including enriched dairy and whole grains, with emphasis on the plant-food menu. Secondary supplementation of micronutrients is required (more by exercising athletes) depending on their calorie expense and calorie repletion near the 100% mark necessary for optimal recovery. I hypothesize that as calorie expenditures increase, micronutrient deficit increases leading to suboptimal performance or performance plateau complaint. If micronutrient supplements are taken by athletes, they should be from respected sources, manufacturers who confirm by certificate of analysis their products contain safe micronutrient dose levels excluding harmful performance-enhancing banned substances. I am persuaded that unless enriched foods or supplements are taken by athletes during training, chronic deficient micronutrient malnutrition will contribute to suboptimal performances. The list consensus appears is divided. Some completely the use of dietary supplements to insure adequacy, while others insist that the more an athlete exercises, the greater micronutrient deficiency potentially presents. DISCLOSURE: I am employed by a dietary supplement manufacturer. My informed bias is supported by observations recorded from 70 individual dietary analysis conducted on both athletes and sedentary subjects between 1996-2005. " It appears that this question is sharply contested. One side feels completely against dietary supplement use while the other side concludes that unless enriched foods or encapsulated micronutrients are secondary to whole food balanced nutrition, that the risk of micronutrient deficiency may contribute to suboptimal athletic performance. =========================== I have followed this discussion. I am not a nutritionist and don't do research in this area. As a scientist, it seems that the crucial step is the definition of " deficiency " . This was pointed out by some of the responses and the proponents of the micronutrients did not respond adequately to this concern. It would help tremendously if the proponents would submit the references showing that performance/health is impaired if one does not ingest 100% RDA of the specific micronutrients in question. More subtle arguments relate to whether one needs to eat 100% every day, or if one can eat more on one day to compensate for lower amounts ingested in the preceeding days. If these studies have not been done, please submit studies that show ingestion of supplements improve health/performance when eating a well-balanced diet that does not meet the 100% RDA requirements. If these studies have also not been done, then any conclusion suggesting that there is a diet or supplment that is optimal represents a hypothesis based on extrapolation that remains to be tested. Ian Shrier MD, PhD, Dip Sport Med, FACSM Past-president, Canadian Academy of Sport Medicine check out: www.casm-acms.org ===================== Some of the comments require a responsible reply: Annie Wetter: " I would also like to make a few comments regarding your guidelines and justify why I might have deviated from them in designing my diet. I apologize in advance if I have misunderstood anything you wrote previously. If I have, please clarify. " ================= Bill Misner: Yes, there is a misunderstanding, I am not opposing a variety of whole foods listed in the " Mythical Balanced Diet " for sedentary subjects. I am questioning the micronutrient value however of that diet for high-energy athletes unless it is micronutrient enriched. My original post was based on and originated from having analyzed by computer program dietary intake of 85% athletes and 15% non athletes for over 9 years and not having 1 food-alone menu reported replace 100% RDA micronutrient levels. Then when I selected 10 males and 10 females whose food item reports (70-120 foods) for 3-7 days were averaged, they also exhibited similar trend, none of which generated 100% of 10 vitamins and 7 minerals isolated. Based on energy expense's affect on micronutrient loss in athletes, I asked if diet fails to regenerate at least 100% RDA or RDI micronutrients in chronic fashion, " Will suboptimal performance predictably result? " ================== Annie Wetter: " Regarding micronutrients, the following micronutrients were below recommended: vit E (78%), folate (79%), biotin (79%), and molybdenum (54%). Iodine was not available, nor was there a complete assessment of omega-3 and -6 FA's. " Bill Misner: You also used a similar outdated program and confirmed my finding from an analysis of Nutritionist-Ph.D. menu, and likewise failed to provide 100% RDI. Annie Wetter: " You did not explain why you eliminate enriched foods from the diet. If your aim is to show the necessity of enriching grains with iron and several B-vitamins as we have done in the US for decades, then your point is well made. You're correct in asserting that adding vitamin D to milk is not different than taking a vit D supplement. In the end however, I'm not sure what the practical implications of this assertion are other than to confirm that some nutrients are difficult to obtain in the diet. " Bill Misner: I do not oppose consuming enriched foods nor taking the same micronutrients enclosed in capsules with whole foods. My point is clearly that whole food fails to supply RDI micronutrients, especially in athletes whose training requirements may require more water soluble vitamins, iodine, and some electrolytes compatible with and parallel to glycogen depletion and repletion recovery cycling. Annie Wetter: " Your diet based on the Food Guide Pyramid violates at least one cardinal rule of creating a healthful diet: variety. One can consume almonds and this food will in part meet the " Meat and meat alternative " servings. I see no logical, practical, or scientific reason to limit one's intake to the foods you have listed. " Bill Misner: I completely agree...variety from the food pyramid does not suggest that a 1-day menu provides variety unless it is applied over longer periods of time. You can only consume so many calories per day, hence variety can only occur over multiple days. If exercise-induced energy expense is high, the need for at least the RDI micronutrient level presents. Some in their books such as Shari Lieberman and Colgan insist that optimal athletic performance requires chronic micronutrient levels replaced higher than current RDI levels. For a sedentary subject, the RDI may be 70% occasionally without consequences. But day after day during a 14-week training-to-peak fitness, suboptimal performance may result if micronutrients are not replaced at the rate they are lost. ======================== I feel this is / has been one of the most interesting and potentially powerful / practical debates by the group. First let me declare my background which is as an active sportspersons in (stupidly?) long distance endurance events up to 24 hour 1000km runs, multi day triathlons kayaking etc. Most of these have been in hot and humid temperatures in Africa. I have been heavily involved in coaching from novice to international level for 20 years. I have also been involved in the sports nutrition field through the development / testing of supplements for 25 years, but this is not to imply that I support the use of all supplements by athletes / or that all athletes need supplements. My professional education is in Civil and structural engineering. With the above declaration made. I have some doubts over the correctness of RDI, but for this discussion would accept that there is some level applicable to each micronutrient that is a safety factored value below which there is insufficient of the micronutrient to support the normal processes. There seems some logic to suggest that diets that don't meet the minimum RDI (as defined here) would edge into the safety factored buffer but would be corrected if this was an occasional occurrence. However if this became a chronic situation then at some stage the gradual degradation would take the amount of available micro-nutrient below the critical level and cause an imbalance. Furthermore if this is the case - (could) the situation can be further exacerbated by either non or self-diagnosis and rampant use of supplement which are typically compound micro-nutrients. Coaching experience strongly suggests that a high (very high in case of endurance females) of endurance athletes fail to match their calorie intake and expenditure let alone get close to micro- nutritionally balance. While short term performance may not appear affected, (and may in fact be increased strength to weight ratios) the longer and life time health may in my opinion see the results of chronic nutritional degradation. I would value comments on this viewpoint and feel strongly that this debate is one that has great practical potential in the sports world. Is it possible for the group to come to some form of consensus of exemplary diets (with 'real' food) for sportspersons based on calorie expenditures of say 3000, 4000, 6000 etc calories - a) for endurance and for strength / power activities. If this proved impossible perhaps a 20% calorie allowance would be acceptable for the use of sports supplementation in terms of Protein, carbs, essential fats (and if necessary micro-nutrient supplement guideline ranges) in order to correct the macro nutritional balance to the activity. Norrie on ====================== Hi all, As a non-nutritionist I have tried to follow along in the excellent discussion catalyzed by Dr. Bill Meisner's original posting. The crux of the discussion from my exercise physiologist's perspective has been " do athletes need micronutrient SUPPLEMENTATION to optimize performance? " I am going to throw the discussion a wicked curveball now by asking essentially the OPPOSITE (and perhaps heretical?) question: " Do athletes need nutritonal DEPLETION to optimize adaptive signalling and, thereby, performance? " Let me explain with reference to some key examples. I will begin with the macronutrient carbohydrate and the issue of glycogen depletion. Over the last 30 years I think it is fair to say that prevention of intramuscular glycogen depletion during exercise and competition (and rapid repletion after) has been a major focus of human performance research and a major cash cow for the sports nutrition industry. During this same period, the sheer volume of training performed by endurance athletes has risen substantially, if not dramtically. The goal of training is to signal adaptive processes that enhance performance (and not just to accumulate hours in training diaries). So the question I pose is this: " Are certain aspects of nutritional depletion during, or subsequent to, exercise stress actually important modulators of the adaptive signalling process? " In this case of glycogen depletion, I believe the answer may well be " YES. " Read for example this abstract (this paper came out electronically a year ago): __________________________________________ Hansen AK, Fischer CP, Plomgaard P, Andersen JL, Saltin B, Pedersen BK. J Appl Physiol. 2005 Jan;98(1):93-9. Skeletal muscle adaptation: training twice every second day vs. training once daily. Low muscle glycogen content has been demonstrated to enhance transcription of a number of genes involved in training adaptation. These results made us speculate that training at a low muscle glycogen content would enhance training adaptation. We therefore performed a study in which seven healthy untrained men performed knee extensor exercise with one leg trained in a low-glycogen (Low) protocol and the other leg trained at a high-glycogen (High) protocol. Both legs were trained equally regarding workload and training amount. On day 1, both legs (Low and High) were trained for 1 h followed by 2 h of rest at a fasting state, after which one leg (Low) was trained for an additional 1 h. On day 2, only one leg (High) trained for 1 h. Days 1 and 2 were repeated for 10 wk. As an effect of training, the increase in maximal workload was identical for the two legs. However, time until exhaustion at 90% was markedly more increased in the Low leg compared with the High leg. Resting muscle glycogen and the activity of the mitochondrial enzyme 3-hydroxyacyl-CoA dehydrogenase increased with training, but only significantly so in Low, whereas citrate synthase activity increased in both Low and High. There was a more pronounced increase in citrate synthase activity when Low was compared with High. In conclusion, the present study suggests that training twice every second day may be superior to daily training. __________________________________ So, we glycogen load, push carbohydrate, and preach to our athletes the importance of a high carbohydrate diet. And yet, part of the adaptation process seems to actually DEPEND on periods of marked cellular depletion of glycogen. Perhaps one reason we need so much training volume these days is that it takes longer to reach a level of cellular depletion that is necessary to signal further adaptation in already adapted muscle? What about free radicals (reactive oxygen species, ROS)? ROS production is an obligatory side-effect of aerobic metabolism. Oxygen is volatile and poisonous. Clearly, excessive ROS production is toxic to aerobic organisms because evolution has equipped them with an impressive array of ROS quenching compounds and enzymes that occupy both the aqueous (ascorbic acid and glutathione, for example) and lipid regions (a-tocopherol or Vit E, for example) of cells. This defence system has captured the attention of biomedical science for the last 20 years. HOWEVER, it did not take very long after the " ROS as intracellular enemy " wave of research kicked in that serendipitous observations were made suggesting that these ROS were not all bad. I actually had one of these myself 15 years ago. I was using isolated heart perfusions to study some aspects of heart recovery after a " heart attack " . I wanted to artificially induce free radical damage by infusing H2O2, hydrogen peroxide, into the perfusate of thse rat hearts. To my surprise, a low dose of H2O2 actually increased myocardial contractility! Higher doses did do damage, but what I observed was nowhere in the literature, and I figured people would think I was nuts if I tried to say that free radicals enhanced contractile function, so I moved on. Now we know that ROS play a role in numerous intracellular signalling processes, including adaptive signalling. Read for example, this abstract: ----------------------------------------------------------- Gomez-Cabrera MC, Borras C, Pallardo FV, Sastre J, Ji LL, Vina J. Decreasing xanthine oxidase-mediated oxidative stress prevents useful cellular adaptations to exercise in rats. J Physiol. 2005 Aug 15;567 (Pt 1):113-20. Epub 2005 Jun 2. Reactive oxygen or nitrogen species (RONS) are produced during exercise due, at least in part, to the activation of xanthine oxidase. When exercise is exhaustive they cause tissue damage; however, they may also act as signals inducing specific cellular adaptations to exercise. We have tested this hypothesis by studying the effects of allopurinol-induced inhibition of RONS production on cell signalling pathways in rats submitted to exhaustive exercise. Exercise caused an activation of mitogen-activated protein kinases (MAPKs: p38, ERK 1 and ERK 2), which in turn activated nuclear factor kappaB (NF-kappaB) in rat gastrocnemius muscle. This up-regulated the expression of important enzymes associated with cell defence (superoxide dismutase) and adaptation to exercise (eNOS and iNOS). All these changes were abolished when RONS production was prevented by allopurinol. Thus we report, for the first time, evidence that decreasing RONS formation prevents activation of important signalling pathways, predominantly the MAPK-NF-kappaB pathway; consequently the practice of taking antioxidants before exercise may have to be re-evaluated. ---------------------------------------------------------------- This brings me to the passage posted by Annie Wetter that prompted me to play devil's advocate here in the first place: ------------------------------------------------------ One last point and then I will let you go. A recent study (Christensen Br J Nutr 88:711-717;2002) assessed the dietary intake of 12 adolescent male Kenyan runners. These boys were of Kalenjin ethnicity, the group from which most of the Kenyan distance running talent emerges. Although micronutrient intake was not determined, their average daily intake of 3100 kcals was composed of foods only locally available. Most (90%) of their calories were provided by plant foods, with 81% of their energy coming from two foods, maize and beans. How such a limited, unfortified diet allows for youth in this area to develop world-class potential is a very interesting research question. ------------------------------------------------------------ I don't want to stretch this notion to far, but is it possible that we should look at this seeming mismatch between diet and performance among these great runners as another indicator that we may be actually " over nourishing " our athletes during certain phases of the training process? If we never allow glycogen levels to bottom out in training, do we dampen the adaptive signals of training? If we flood the system with antioxidants prior to exercise, do we dampen intracellular signalling in important ways? One thing I think we can agree on is that the environmental pressures that formed intracellular signalling mechanisms over many thousands of years were NOT characterized by nutritional EXCESS and easily accessed carbo-loading bars, antioxidant cocktails and the like. Just a little food for thought. ======================= Greetings Sports Science List, Thank you for responding to the original question I asked in digest 657 (Message 2787): " Does a " Balanced Diet " supply the RDI deficiency-disease preventative level, and if not, is micronutrient deficiency a factor in suboptimal performance? " There were excellent replies received from Forbes-Ewan, Annie Wetter, Seiler, Deborah Shulman, Norrie on, Ian Shrier, and several I received off list. QUESTION ORIGIN: From over 70 menu diets analyzed 1996-2005, I selected those menus, which listed between 70-120 foods from 10 men and 10 women, 17 were competitive endurance athletes, 3 were sedentary subjects. Ten (10) vitamins and Seven (7) minerals from the selected 20 diets submitted were analyzed based on RDA/RDI. Of the 17 micronutrients analyzed, 40.5% of 340 micronutrient entries were at less than the 100% RDI preventative deficiency level. A broader perspective for interpreting this data is from the 340 micronutrients (10 vitamins + 7 minerals X 20 subjects = 340 micronutrient data analyzed) from 20 individual menus, that 138 micronutrient deficiencies were found. This represents 40.6% of the total 340 micronutrient data. All enriched foods were analyzed along side non-enriched foods, yet 138 of the possible 340 micronutrients from food only were deficient in this group. These limited findings beg 2 questions: 1. Why did not one menu attain the 100% RDA/RDI micronutrient goal? 2. Does chronic micronutrient deficiency contribute to suboptimal performance? Several list members commented on these questions: Forbes-Ewan (Message 2790) stated: " There are particular nutrients that may be marginal in some areas or circumstances. Two examples are iodine and iron. There is a debate about the adequacy of iodine in the food supply in parts of Australia and New Zealand, partly because of iodine-deficient soils in those areas. And 'sports anaemia' may lead to an increased need for iron in some endurance athletes. " ====================== Annie Wetter (Message 2792) stated: " The Dietary Guidelines for Americans 2005 has a beautifully straightforward illustration of how foods can meet micronutrient needs on relatively few calories. Go to http://www.healthierus.gov/dietaryguidelines/ and click on the 4.8MB PDF link. You'll get the full document for downloading including a chapter-by-chapter breakdown. Click on Chapter 2, entitled " Adequate nutrients within calorie needs. " One table outlines recommended food choices for a 2,000 calorie intake following the Food Guide Pyramid and DASH diet plans. " =================== Bill Misner (Message 2794) stated: Following Annie Wetter's message 2792 directive, " I measured RDA with the -Benedict equation for energy expenditure for a heavily-active 69-inch height, 70-kg, 40-y male. The 2000-calorie " Balanced Diet " menu analysed was deficient (less than RDA standard) in Iodine, Zinc, Vitamin E, alpha-Tocopherol, Biotin, Pantothenate, Omega-3 Essential Fatty Acid, and Copper. In addition Three micronutrients, Iron, Vitamin B-12, and Folate were adequate at the former RDA level but did not meet the new RDI standard. ========================== Deborah Shulman (Message 2793) stated: " Supplements can play an important role, but not in place of food. In foods there are complex nutrient interactions, substances we have not yet identified, synergistic relationships within foods, and physiological effects that we have yet to discover. " ===================== Annie Wetter (Message 2795) stated: " I took you up on your offer to design a 1-day diet that would be composed of minimally processed whole foods in an attempt to supply roughly 100% of the current DRI's for the man in question (40 yrs old, 70kg, 69 " ). Since much of our discussion revolves around the reference 2,000kcal diet, I set this individual's activity level to " lightly active " such that his energy needs would be close to 2,000kcals. Clearly, if this client were an athlete, he would be consuming far more food and thus nutrients. The balance of macronuts as a percent of total kcals is 20% protein, 50% CHO (35g fiber), 30% fat. Based on the FGP rec's, my diet is slightly low in grains (~7 servings), high in veggies (4.5) and meat (3), moderate in fruits (2.5) and dairy (2.5). Regarding micronutrients, the following micronutrients were below recommended: vit E (78%), folate (79%), biotin (79%), and molybdenum (54%). Molybdenum was often not listed and vitamin E was often absent as well, including from peanut butter which is a vit E rich food. In addition, folate was not listed in some of the whole grain items. Iodine was not available, nor was there a complete assessment of omega-3 and -6 FA's. " ===================== Bill Misner (Message 2797) stated: " You (Annie Wetter) also used a similar outdated (dietary analysis) program and confirmed my findings from an analysis of menu and likewise failed to provide 100% RDI/RDA. " ====================== Norrie on (Message 2804) stated: " There seems some logic to suggest that diets that don't meet the minimum RDI (as defined here) would edge into the safety factored buffer but would be corrected if this was an occasional occurrence. However if this became a chronic situation then at some stage the gradual degradation would take the amount of available micro-nutrient below the critical level and cause an imbalance. " ======================= Deborah Schulman (Message 2805) stated: " The other aspect of this discussion that should be addressed is the fallability of the nutrient analysis programs. Anyone who works with these programs knows that analysis of a considerable number of foods is incomplete and could result in artificially low nutrient readings. " =================== Annie Wetter (Message 2808) stated: " There is plenty of evidence that nutrition professionals concede that sometimes we need help getting all the micronutrients we need. On page vi of the Dietary Guidelines for Americans 2005 (which I use as a resources because of the large body of scientific research to support its recommendations) it is stated that " fortified foods and supplements may be useful source of one or more nutrients that might otherwise be consumed in less than recommended amounts. " On page vii, the DG further lists certain populations for whom fortified foods and supplements are especially important. Thus, in this document generated by a consensus of the nutrition research community, nowhere is it stated that fortified foods should be avoided and that adequate nutrient intakes are always achievable without them.......I have more closely inspected the data on page 11 of Chapter 2 of the Dietary guidelines for Americans 2005 (DG). The 2,000kcal DASH diet meets the RDA/AI (i.e., the DRI's) for all micronutrients listed. I'm not sure why copper and vitamin A levels were not listed, but I would assume this is due to incomplete data available for foods (as we have experienced using different nutrient content databases -- we just don't know the content of every single nutrient in every single food). The 2,000kcal Food Guide Pyramid diet is low is 2 micronutrients: potassium (86%) and vitamin E (63%). Vitamin E intake is unfortunately low in the FGP plan, but a potassium intake of >3,500mg is a very healthful intake. Generally, the potassium to sodium ratio is good to assess. We want the ratio of sodium to potassium to be low (less sodium than potassium). In the FGP diet, the sodium intake is well below (1,800) the recommended (<2,300) and thus slightly lower K intake is fine. Thus, I stand by my conclusion that these two eating plans provide an adequate intake of micronutrients. " ======================= Seiler (Message 2810) stated: " I don't want to stretch this notion to far, but is it possible that we should look at this seeming mismatch between diet and performance among these great runners as another indicator that we may be actually " over nourishing " our athletes during certain phases of the training process? If we never allow glycogen levels to bottom out in training, do we dampen the adaptive signals of training? If we flood the system with antioxidants prior to exercise, do we dampen intracellular signalling in important ways? " ==================== Bill Misner (Personal Reply Off List) replied: " Coins have two sides, I wonder how much better the Kenyons would have performed had their micronutrient RDI been 100%? " ==================== FINAL COMMENTS: I have been asking this question for several years especially from observed deficiencies in 70 diets analyzed, which questions if the food guide pyramid plan supplies 100% micronutrients at RDA/RDI micronutrient levels. There are discrepancies and inconsistencies in evaluating food lists, including computerized software for analysis of food-born macro- & micro- nutrient levels. This was demonstrated by Deborah Shulman, Annie Wetter, including my numerous attempts to design a menu that supplied 100% RDA or RDI micronutrients. The original question, " Is optimal performance possible with suboptimal micronutrient supplementation? " The specific answer from the literature is inconclusive. The literature does not support performance-gain association with micronutrient dose, but it clearly indicates that suboptimal performance occurs as a result of dehydration, over-reaching, and glycogen depletion. ================================== Annie Wetter's (Message 2808) stated: " The ACSM position stand recommends that athletes consume " at least " the DRI's established for the general population as no separate recommendations have been set for athletes. Research concludes athletes may need slightly higher intakes of certain B vitamins, but the position statement concludes that " these increased needs can generally be met by the higher energy intakes required by athletes. " Manore's review of the literature specific to female athletes (Sports Med 32(14):887-901;2002) found that female athletes may need up to 2 times the RDA for the B vitamins riboflavin and pyridoxine (B6). " ==================== Dr. Shrier's question (Message 2802) request: " It would help tremendously if the proponents would submit the references showing that performance/health is impaired if one does not ingest 100% RDA of the specific micronutrients in question. " Eight (8) papers associate both macro- and micro- nutrient malnutrition with less than optimal health and disease. Others not listed for brevity confirm an association between caloric malnutrition associated with disease. #1 Micronutrient Adequacy vs Exercise-Induced Vitamin Loss " The micronutrient status of 12 obese male subjects was evaluated before and after a 14-week period of a LOW ENERGY DIET (3.0-3.9 MJ) with or without an exercise (5 h p/w) treatment. The subjects were matched on the basis of their body mass index (BMI kg/m2) into a diet group (D; average BMI 32.2) and a diet-exercise group (DE; average BMI 32.9). After 14 weeks both groups showed similar results in term of weight loss (D 15.1; DE 16.4 kg), fat loss (D 11.7; DE 13.6 kg) and loss of fat free mass (FFM) (D 3.4; DE 2.8 kg). With respect to changes of the micronutrients in blood plasma only the decrease in ferritin was significantly different between D and DE (P less than 0.05), with a larger decrease for DE. In both groups significant decreases of -20% IN FAT SOLUBLE VITAMINS were observed. Water soluble vitamins demonstrated a large variation between individuals and decreases were not significant. " Abstract from van Dale D, Schrijver J, Saris WH. Changes in vitamin status in plasma during dieting and exercise. Int J Vitam Nutr Res. 1990;60(1):67-74. PMID: 2387673 [PubMed - indexed for MEDLINE] ============================== #2 Micronutrient Adequacy (vitamin C) vs Exercise-Induced Free Radicals " Vitamin C supplementation (VC) (either 500 or 1000 mg/d for 2 wk) was compared to a placebo treatment (P) to ascertain if VC could influence oxidative stress. Twelve healthy males (25 +/- 1.4 y) were randomly assigned in a counter-balanced design with a 2-wk period between treatments. Data were analyzed using repeated measures ANOVA. Exercise intensity measures (VO(2), RER, RPE, HR, lactate) were similar across treatments. Resting blood oxidative-stress markers were unaffected by treatment. Exercise decreased total blood glutathione (TGSH) and reduced glutathione (GSH) and increased oxidized glutathione (GSSG) (P < 0.01) independent of treatment. Protein carbonyls (PC) increased 3.8 fold in the P (P < 0.01). VC attenuated the PC exercise response in a dose-dependent manner ( P < 0.01). Thiobarbituric acid reactive substances (TBARS) was not influenced by exercise (P = 0.68) or VC. These data suggest that Vit C supplementation can attenuate exercise-induced protein oxidation in a dose-dependent manner with no effect on lipid peroxidation and glutathione status. " Abstract from Goldfarb AH, SW, Bryer S, You T. Vitamin C supplementation affects oxidative-stress blood markers in response to a 30-minute run at 75% VO2max. Int J Sport Nutr Exerc Metab. 2005 Jun;15(3):279-90. PMID: 16131698 [PubMed - indexed for MEDLINE] Colgan in the 1990's compared urinary Vitamin C excretion rate among competitive elite athletes and reported urinary excretion from as little as 500 mg to as much as 5000 mg per athlete. This demonstates that " one-size-does-not-fit-all " principle. =========================== #3 Micronutrient Adequacy vs Oxidative Cell Damage Dysfunction " Severe oxidative stress progressively leads to cell dysfunction and ultimately cell death. Oxidative stress is defined as an imbalance between pro-oxidants and/or free radicals on the one hand, and anti-oxidizing systems on the other. Although current data indicate that antioxidants cannot prolong maximal life span, the beneficial impact of antioxidants on various age-related degenerative diseases may forecast an improvement in life span and enhance quality of life. " Excerpts from Bonnefoy M, Drai J, Kostka T. [Antioxidants to slow aging, facts and perspectives] Presse Med. 2002 Jul 27;31(25):1174-84. Review. PMID: 12192730 [PubMed - indexed for MEDLINE] ============================ #4 Micronutrient Adequacy vs Ovarian Cancer " The levels of vitamins C and E associated with the protective effect were well above the current US Recommended Dietary Allowances. These findings support the hypothesis that antioxidant vitamins C and E from supplements are related to a reduced risk of ovarian cancer. " Excerpts from Fleischauer AT, Olson SH, Mignone L, Simonsen N, Caputo TA, Harlap S. Dietary antioxidants, supplements, and risk of epithelial ovarian cancer. Nutr Cancer. 2001;40(2):92-8. PMID: 11962261 [PubMed - indexed for MEDLINE] ========================== #5 Micronutrient Adequacy vs Atherosclerotic Renal & Non-Renal Risk Factors " Atherosclerotic cardiovascular disease and malnutrition are widely recognized as leading causes of the increased morbidity and mortality observed in uremic patients. C-reactive protein (CRP), an acute-phase protein, is a predictor of cardiovascular mortality in nonrenal patient populations. Results indicate that the rapidly developing atherosclerosis in advanced CRF appears to be caused by a synergism of different mechanisms, such as malnutrition, inflammation, oxidative stress, and genetic components. Apart from classic risk factors, LOW VITAMIN E LEVELS and ELEVATED CRP LEVELS are associated with an increased intima-media area, whereas small molecular weight apo(a) isoforms and increased levels of oxLDL are associated with the presence of carotid plaques. " Excerpts from Stenvinkel P, Heimburger O, tre F, Diczfalusy U, Wang T, Berglund L, Jogestrand T. Strong association between malnutrition, inflammation, and atherosclerosis in chronic renal failure. Kidney Int. 1999 May;55(5):1899-911. ====================== #6 Micronutrient Adequacy vs Cardiovascular Disease " U.S. Preventive Services Task Force (USPSTF) concludes that the evidence is insufficient to recommend for or against the use of supplements of vitamins A, C, or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or cardiovascular disease. " Excerpts, recommendations on routine vitamin supplementation to prevent cancer and cardiovascular disease and the supporting scientific evidence from the U. S. Preventive Services Task Force. Routine vitamin supplementation to prevent cancer and cardiovascular disease. Nutr Clin Care. 2003 Oct-Dec;6(3):102-7. Review. PMID: 14979452 [PubMed - indexed for MEDLINE] ========================== #7 Micronutrient Adequacy vs Disease Associated Aging " The use of various dietary supplements, including vitamins, to prevent or delay disease or aging rests for the most part on epidemiological associations. It does appear from these data that a diet rich in vitamins is associated with a tendency to improved health; however, the results from controlled trials are dismal. The discrepancy between different types of studies is probably explained by the fact that dietary composition and supplement use is a component in a cluster of healthy behaviors. An alternative hypothesis is that there are as-yet-unknown essential organic compounds in certain foods. The most prudent approach is to recommend a daily intake of fruits and vegetables as a likely source of essential nutrients. Failing compliance with a natural source of essential nutrients, and in populations at high risk of vitamin deficiency, vitamin supplements should be encouraged. " Excerpts from DR. Vitamins in health and aging. Clin Geriatr Med. 2004 May;20(2):259-74. Review. PMID: 15182881 [PubMed - indexed for MEDLINE] ======================= #8 Micronutrient Adequacy vs Death and Disease " Antioxidants are a complex and diverse group of molecules that protect key biological sites from oxidative damage. They usually act by removing or inactivating chemical intermediates that produce the ultimate oxidant. Different sites in the body have evolved to use highly specialised strategies to deal with free radicals and other reactive oxygen intermediates. Recent epidemiological evidence suggests that the development of life-threatening disease, such as cancer and heart disease, is linked to our dietary intake of micronutrients including antioxidants. Modification of dietary habits together with supplementation may provide a simple YET PROFOUND WAY TO REDUCE DEATHS FROM THESE TWO MAJOR DISEASES. Sound scientific evidence to support a curative role for antioxidants in life-threatening diseases, however, is lacking. " Abstract from Gutteridge JM. Antioxidants, nutritional supplements and life-threatening diseases. Br J Biomed Sci. 1994 Sep;51(3):288-95. Review. PMID: 7881327 [PubMed - indexed for MEDLINE] ========================== These papers support asking the question including proposal of methodology to determine the role of micronutrients associated with optimal performance: METHODOLOGY PROPOSED: A methodology to determine if an association exists between optimal performance and micronutrient sufficiency. Group I trains 6 weeks on a prescribed balanced selection of food from the Food Guide Pyramid (FGP). A period of training tapers 10 days into a single attempt to exceed their performance best from mid-week 5 to the end week 6. Group II trains 6 weeks eats the same prescribed balanced foods taken from the Food Guide Pyramid and adds a daily RDI micronutrient supplement to insure minimal 100% RDI. They also train tapering 10 days into a single attempt to exceed their performance best from mid-week 5 to the end of week 6. Lastly, have both groups complete a crossover opposite protocol 6-weeks in like fashion. They also train tapering 10 days into a single attempt to exceed their performance best from mid-week 5 to the end of week 6. The final 6-week period completes exposure to each protocol to determine if an association between micronutrient sufficiency and performance exist. ========================= Food Alone May Not Provide Sufficient Micronutrients for Preventing Deficiency Bill Misner Townsend Letter for Doctors and Patients. Received January 25, 2006/Accepted June 5, 2006 ABSTRACT The American Dietetic Association (ADA) has stated that the best nutritional strategy for promoting optimal health and reducing the risk of chronic disease is to wisely choose a wide variety of foods. Seventy diets were computer analyzed from the menu of athletes or sedentary subjects seeking to improve the quality of micronutrient intake from food choices. All of these dietary analyses fell short of the recommended 100% RDA micronutrient level from food alone. Therefore, based on diets analyzed for adequacy or inadequacy of macronutrients and micronutrients, a challenging question is proposed: " Does food selection alone provide 100% of the former RDA or newer RDI micronutrient recommended daily requirement? " Journal of the International Society of Sports Nutrition. 3(1):51-55, 2006 =================== Carruthers Wakefield, UK Quote Link to comment Share on other sites More sharing options...
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