“Can I get all the nutrients I need from food?” a patient will occasionally ask. On the surface, this makes sense. After all, if you are eating a whole, fresh, unprocessed foods diet, shouldn’t you be able to get an abundant supply of vitamins, minerals, antioxidants, and other nutrients?"
Unfortunately, things aren’t that easy. Even with a perfect diet, the combination of many things –including our depleted soils, the storage and transportation of our food, genetic alterations of traditional heirloom species, and the increased stress and nutritional demands resulting from a toxic environment – make it impossible for us to get the vitamins and minerals we need solely from the foods we eat1.
Simply put, the evidence shows we cannot get away from the need for nutritional supplements2.
Doctors used to think you got all your vitamins and minerals from food. Any extra nutrients were excreted, or worse, became toxic. But the tide is shifting. Doctors now prescribe over one billion dollars in fish oil supplements. Most cardiologists recommend folate, fish oil, and coenzyme Q10. Gastroenterologists recommend probiotics. Obstetricians have always recommended prenatal vitamins.
Emerging scientific evidence shows the importance of nutrients as essential helpers in our biochemistry and metabolism. They are the oil that greases the wheels of our metabolism. And large-scale deficiencies of nutrients in our population – including omega-3 fats, vitamin D, folate, zinc, magnesium, and iron – have been well documented in extensive government-sponsored research.
4 Main Reasons We Are Nutrient Depleted
There are numerous reasons most of us are nutrient malnourished, anything from eroding topsoil depleting our mineral supply, to a toxic environment and the abundance of junk food many Americans eat. If I had to narrow nutrient depletion down to four primary reasons, this is what I would say:
- We evolved eating wild foods that contained dramatically higher levels of all vitamins, minerals, and essential fats.
- Because of depleted soils, industrial farming, and hybridization techniques, the animals and vegetables we eat have fewer nutrients.
- Processed factory-made foods have no nutrients.
- The total burden of environmental toxins, lack of sunlight, and chronic stress leads to higher nutrient needs.
These are among the reasons why everyone, at the very least,needs a good multivitamin, fish oil, and vitamin D. I also recommend probiotics because modern life, diet, and antibiotics, as well as other drugs, damage our gut ecosystem, which is so important in keeping us healthy and thin.
Nutrient Deficiencies and Diabesity
Paradoxical though it might seem, obesity and malnutrition often go hand in hand. Processed, high-sugar, high-calorie foods contain almost no nutrients, yet require even more vitamins and minerals to metabolize them. It’s a double whammy.
Obesity and diabetes both stem from malnutrition. Experts have described diabetes as starvation in the midst of plenty. The sugar can’t get into the cells. Your metabolism is sluggish, and the cells don’t communicate as a finely tuned team.
Nutrients are an essential part of getting back into balance and correcting the core problem, which is insulin resistance.
There are two ways in which supplements work:
- They make your cells more sensitive to insulin and more effective at metabolizing sugar and fats.
- Special fibers (that I will discuss in a minute) can slow the absorption of sugars and fats into the bloodstream.
If you have diabesity – and keep in mind most people do to some degree – I recommend additional nutrients to reset and correct metabolic imbalances, improve insulin function, balance blood sugar, and reduce inflammation. But first, let’s delve a little further into this perplexing topic.
Why are Nutrient Studies so Confusing?
I’m sure you are confused by conflicting studies about supplements. One day folic acid is good; the next it is found to cause cancer. One day vitamin D is a lifesaver; the next it is found to be not helpful.
This media whiplash is enough to make you give up altogether. The problem with these studies is that they treat nutrients as drugs, where researchers give one nutrient alone and see what happens.
But nutrients work as a team. Broccoli is great for you and can help prevent and cure many diseases, but if all you ate was broccoli, you would get sick and die. You need to eat a well rounded diet to stay healthy. Similarly, nutrients work synergistically to maintain the proper balance in your body.
Potential Problems with Choosing Supplements
You know what you are getting when your pharmacist fills your prescription. The government makes sure of it. Over-the-counter supplements are not controlled in this same way. Manufacturers often cut corners and this can become problematic for the average consumer.
The issues you might experience with over-the-counter supplements that you buy at your local drugstore or warehouse store include:
- The form of the nutrient may be cheap and poorly absorbed or used by the body.
- The dosage on the label may not match the dose in the pill.
- It may be filled with additives, colors, fillers, and allergens.
- The raw materials (especially herbs) may not be tested for toxins, such as mercury or lead, or may not be consistent from batch to batch.
- The factory in which it is produced may not follow good manufacturing standards, leading to inconsistent quality.
Whether you follow my product recommendations or not, be sure to pick quality supplements and ones that contain nutrients and compounds that research has shown to be helpful in the treatment of diabesity and insulin resistance3.
Think of them as part of your diet. You want the best-quality food and the best-quality supplements you can buy. Guidance from a trained dietitian, nutritionist, or nutritionally oriented physician or health care practitioner can be helpful in selecting the products that are right for you.
If you haven’t done so already, I encourage you to read my book – The Blood Sugar Solution, which provides a comprehensive nutrient plan that discusses the benefits of each supplement. To get you started, I will discuss how the supplements I recommend benefit you and then tell you my basic plan. Read on…
The Basic Nutrient Plan
Everyone reading this blog should get on the basic plan of supplements and stay on them for life. Even if you are “cured” of diabesity, you will need to keep taking them, because you need special vitamins, minerals, and herbs to help compensate for your genetic tendency toward insulin resistance.
Let’s take a few moments to review the specifics about each of these supplements or ingredients to understand why they are so important in the treatment of diabesity.
High-Quality, High-Potency, Complete Multivitamin
The right multivitamin will contain all the basic vitamins and minerals. Keep in mind that getting the optimal doses usually requires 2 to 6 capsules or tablets a day. Some people may have unique requirements for much higher doses that need to be prescribed by a trained nutritional or functional medicine physician.
Note that B complex vitamins are especially important for those with diabesity, as they help protect against diabetic neuropathy, or nerve damage, and improve metabolism and mitochondrial function. Antioxidants such as vitamin E, C, and selenium are also important as they may help reduce oxidative stress, which is a significant cause of diabesity.
The vitamin D deficiency is epidemic, with up to 80 percent of modern day humans are deficient or suboptimal in their intake and blood levels. Depending on what’s in your multivitamin, I recommend taking additional vitamin D. Vitamin D3 improves metabolism by influencing more than 200 different genes that can prevent and treat diabetes4 and metabolic syndrome5.
There are several important things to keep in mind when taking vitamin D:
- Take the right type of vitamin D— D3 (cholecalciferol), not D2. Most doctors prescribe vitamin D2. Do not take prescription vitamin D; it is not as effective and not very biologically active.
- For serious deficiencies, you may need more vitamin D, as much as 5,000 to 10,000 IU a day for 3 months or more. Do this with your doctor’s supervision, if needed.
- Monitor your vitamin D status with your doctor. Get your blood level to 45 to 60 ng/dl. Be sure to request the right blood test, which is the Vitamin D 25 Blood test to accurately check vitamin D levels.
- Give time to fill up your tank. It can take 6 to 12 months for some people. The average daily dose for maintenance for most people is 1,000 to 2,000 IU a day.
These important fats improve insulin sensitivity, lower cholesterol by lowering triglycerides and raising HDL, reduce inflammation, prevent blood clots, and lower the risk of heart attacks6. Fish oil also improves nerve function and may help prevent the nerve damage common in diabetes7.
Diets low in magnesium are associated with increased insulin levels, and magnesium deficiency is common in diabetics. Magnesium helps glucose enter the cells and turn those calories into energy for your body.
Some people with severe magnesium deficiency may need more than the amount outlined below. If you are concerned you may be severely deficient, discuss the details with your doctor.
Diarrhea is often a sign that you are getting too much magnesium. If this occurs, just back off on the dose, and avoid magnesium carbonate, sulfate, gluconate, or oxide. They are the cheapest and most common forms found in supplements but are poorly absorbed. Switch to magnesium glycinate. If you tend to be constipated, use magnesium citrate.
People with kidney disease or severe heart disease should take magnesium only under a doctor’s supervision.
Alpha Lipoic Acid
Alpha lipoic acid is a powerful antioxidant and mitochondrial booster shown to reduce blood sugar and heal a toxic liver. It may also be useful in preventing diabetic nerve damage and neuropathy. It can improve the clearance of glucosefrom the blood by 50 percent8.
Chromium and Biotin
Chromium is very important for proper sugar metabolism and insulin sensitivity, and can help you make more insulin receptors9. Biotin has been shown to enhance insulin sensitivity, lower triglycerides, reduce expression of cholesterol-producing genes, and improve glucose metabolism10.
A number of herbs, including cinnamon11 and catechins from green tea12, are helpful in controlling blood sugar and improving insulin sensitivity. Green tea can even increase fat burning and metabolism. The best products provide combinations of herbs in one supplement.
PGX is a very viscous fiber from a Japanese tuber or root combined with seaweeds into a super fiber. It has profound effects on insulin,glucose, and hemoglobin A1c13.
PGX reduces the absorption of sugars and fats into your bloodstream and helps control appetite, weight loss, blood sugar, and cholesterol14.
When taken before meals with a glass of water, it can be a critical component to overcoming diabesity. It can lower your insulin response after a meal by 50 percent, while lowering LDL cholesterol by 20 percent and blood sugar by 23 percent. I have had patients lose up to 40 pounds just by using this super fiber.
Protein Powder for your Shakes
I strongly encourage the use of a high-quality, hypoallergenic rice, pea, hemp, chia, or soy protein powder. Some of these powders are anti-inflammatory and support detoxification. Soy protein from whole soy foods with isoflavones can lower blood sugar15 and cholesterol16. (Carol does not recommend soy protein)
A protein shake also makes an excellent breakfast and snack option, helping balance your blood sugar and heal your liver. See here for great shake recipes (and some other easy breakfast ideas).
My Basic Nutrient Plan
Now that you understand what these vitamins and nutrients do for your body, you might be wondering what your daily regimen should be. Below, I provide an overview of what I suggest for basic supplementation for my patients. All of the supplements should be taken with a meal, such as breakfast and dinner; PGX fiber should be taken before meals, as directed. Click on the links to purchase top-quality versions of these supplements in my store.
- A high-quality multivitamin and mineral – you can find an array of multivitamins at my store. This is the one I frequently recommend, especially if you have any degree of diabesity. To find out the degree of diabesity you have, log in and take this quiz.
- 1,000 to 2,000 IU of vitamin D3,once a day with breakfast – you can get this as a liquid or
- 1,000 to 2,000 mg of omega-3 fats (should contain a ratio of approximately 300/200 mg of EPA/ DHA), twice a day, once with breakfast and once with dinner
- 100 to 200 mg of magnesium, twice a day, once with breakfast and once with dinner – you can find several forms in my store, including citrate and glycinate.
- 300 to 600 mg of alpha lipoic acid twice a day, once with breakfast and once with dinner. Note the multi I recommended above contains 600 mg of alpha lipoic acid.
- 200 to 600 mcg of chromium, once a day (up to 1,200 mcg a day can be helpful). The multi I recommended above contains 500 mcg of chromium
- 1 to 2 mg of biotin, twice a day, once with breakfast and once with dinner The multi I recommended above has 4 mg of biotin.
- 125 to 250 mg of cinnamon, twice a day, once with breakfast and once with dinner
- 25 to 50 mg of green tea catechins, twice a day, once with breakfast and once with dinner
- 5 grams of PGX, three times a day, 15 minutes before each meal with 8 ounces of water
- (Optional) A hypoallergenic protein powder to add to a morning protein shake. 1 to 2 scoops of rice, soy, hemp, pea, or chia protein powder for breakfast. Follow the directions on the label. This can be added to your UltraShake.
In addition to these, most people should use high-quality probiotics, but this is optional.
Many of the components listed can be obtained by taking combination supplements. Getting these ingredients in the listed dosage ranges is important. So be sure to look for combination supplements that match my recommendations as closely as possible. And to make it even simpler for you, I have sourced the best brands I could find to create supplement kits so you can get all you need in one click – my Blood Sugar Solution Basic Plan Supplement Kits – Option 1 and Option 2.
I hope this blog provides you a better understanding about supplements and choosing the right formula for your needs. While many people do very well with this basic program, more advanced conditions require additional supplements. I highly recommend talking with an integrative nutritionist or physician to address your unique needs.
If you regularly supplement with a multivitamin and other nutrients, what biggest difference have you noticed in your health? Share yours below or on my Facebook fan page.
ABOUT THE AUTHOR:
Mark Hyman, MD has dedicated his career to identifying and addressing the root causes of chronic illness through a groundbreaking whole-systems medicine approach known as Functional Medicine. He is a family physician, a eight-time New York Times bestselling author, and an internationally recognized leader in his field. Through his private practice, education efforts, writing, research, advocacy and public-policy work, he strives to improve access to Functional Medicine, and to widen the understanding and practice of it, empowering others to stop managing symptoms and instead treat the underlying causes of illness, thereby also tackling our chronic-disease epidemic.
Dr. Hyman is Chairman of the Institute for Functional Medicine, and was awarded its 2009 Linus Pauling Award for Leadership in Functional Medicine. He is currently medical editor at the Huffington Post and on the Medical Advisory Board at The Doctor Oz Show. He is on the Board of Directors of The Center for Mind-Body Medicine, and a faculty member of its Food As Medicine training program. He is also on the Board of Advisors of Memhet Oz’s HealthCorps, which tackles the obesity epidemic by “educating the student body” in American high schools about nutrition, fitness and mental resilience. He is a volunteer for Partners in Health with whom he worked immediately after the earthquake in Haiti and continues to help rebuild the health care system there. He was featured on 60 Minutes for his work there.
Dr. Hyman has testified before the White House Commission on Complementary and Alternative Medicine, and has consulted with the Surgeon General on diabetes prevention. He has testified before the Senate Working Group on Health Care Reform on Functional Medicine, and participated in the White House Forum on Prevention and Wellness in June 2009. Dr. Hyman was nominated by Senator Tom Harkin for the President’s Advisory Group on Prevention, Health Promotion and Integrative and Public Health, a 25-person group to advise the Administration and the new National Council on Prevention, Health Promotion and Public Health.
With Drs. Dean Ornish and Michael Roizen, Dr. Hyman crafted and helped to introduce the Take Back Your Health Act of 2009 into the United States Senate, to provide for reimbursement of lifestyle treatment of chronic disease. He continues to work in Washington on health reform, recently testifying before a Congressional hearing on Functional Medicine, nutrition and the use of dietary supplements. He has worked with President Clinton and the Clinton Foundation and presented at the Health Matters, Achieving Wellness in Every Generation.
Through his work with corporations, church groups, and government entities, such as CIGNA, the Veterans Administration, Google, and Saddleback Church, he is helping to improve health outcomes and reduce costs around the world. He initiated and is a key participant in the ongoing development of a faith-based initiative that enrolled over 14,000 people at Saddleback Church in a healthy lifestyle program and research study. In recognition of his efforts, he was recently awarded The Council on Litigation Management’s 2010 Professionalism Award, citing individuals who have demonstrated leadership by example in the highest standard of their profession. He also received The American College of Nutrition 2009 Communication and Media Award for his contribution to promoting better understanding of nutrition science. He has been featured on The Dr. Oz Show, 60 Minutes, Larry King Live, CNN, and MSNBC.
Dr. Hyman is founder and Medical Director of The UltraWellness Center in Lenox, Massachusetts, where he directs a team of physicians, nutritionists and nurses who utilize a comprehensive approach to health. Before starting his practice, he was co-Medical Director at Canyon Ranch Lenox, one of the world’s leading health resorts. While at Canyon Ranch, he co-authored the New York Times bestseller Ultraprevention: The 6-Week Program That Will Make You Healthy for Life (Scribner) – winner of the Books for a Better Life Award honoring the best self-improvement books each year. He has since written UltraMetabolism: The Simple Plan for Automatic Weight Loss, and a companion public television special. His latest book and PBS special, The UltraMind Solution, a comprehensive approach for addressing the causes of mental illness and cognitive disorders, was released in January 2009. The Blood Sugar Solution book and companion PBS special published in March 2012, addresses the global epidemic of obesity, diabetes and cardiovascular disease.
Dr. Hyman graduated with a B.A. from Cornell University, and graduated magna cum laude degree from the Ottawa University School of Medicine. He completed his residency at University of San Francisco’s program in Family Medicine at the Community Hospital of Santa Rosa.
Please join him in helping us all take back our health at www.drhyman.com, follow him on twitter @markhymanmd and on Facebook at facebook.com/drmarkhyman. - See more at: http://healthintegrations.com/service/blog/view?id=39978#sthash.5d4Wqudd.dpuf
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