Vitamin D supplementation of 2000 IU/day does not prevent fractures in the general population of healthy midlife and older adults.
Steve Parker, M.D.
Category Archives: Supplements
Vitamin D Supplement Did Not Prevent Fractures in Healthy Adults.
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Is Cinnamon a Legitimate Treatment for Diabetes?
What type of cinnamon is this?
Be aware that there are several types of cinnamon.
Pharmacist Scott Gavura writes at Science Based Medicine:
Given the consequences of diabetes, self-management is something I want to encourage, not discourage. Without a commitment from the patient to take an active role in managing their diabetes, any treatment plan is doomed to fail. So is self-treatment with dietary supplements a wise idea? There’s an array available, and patients regularly ask about the latest treatment “Big Pharma doesn’t want you to know about”. That treatment used to be chromium. Ginseng was popular for a time, too. Fenugreek and bitter melon are used as well. One of the most persistently popular treatments is cinnamon. Like any other herbal remedy, most sources will tell you that it’s been used for “thousands of years” as a medicinal herb. As a treatment for diabetes, I have my doubts. While reports of diabetes go back to 1552 BCE, the ability to measure the effectiveness of any diabetes treatment only goes back a few decades. Interest in cinnamon as a treatment seems to have started with in vitro tests but gained some plausibility in 2003, when a study from Alam Khan suggested several grams of cassia cinnamon per day could lower fasting blood glucose. Khan randomized Type 2 diabetes to 1g, 3g, or 6g of cinnamon for 40 days. All three groups improved their fasting blood glucose, and blood lipid levels, but there was no effect on A1C.Like trials with any other supplement or herbal product, the primary question we must answer is “What exactly was studied?” The cinnamon you have in your kitchen may be a single species of plant or a mix of different cultivars. Ceylon cinnamon (Cinnamommum verum) is more commonly found in the West. Cassia cinnamon (Cinnamomum aromaticum) is the version of cinnamon that’s been studied in trials. The chemical hydroxychalcone has been identified as a potential active ingredient, which is believed to modify the sensitivity of cells to insulin, enhancing their uptake. If that’s the true mechanism of action, then it would work in a manner similar to that of the drugs Avandia, Actos, and metformin (Glucophage). Given the active ingredient (or ingredients) have not yet been definitively isolated, the issue of studying cinnamon is problematic. There’s no way to assess the potency of any batch, which complicates any evaluation. And that may be a reason why the research with cinnamon is inconsistent, and on balance, not impressive.
While the Khan study looked promising, supplementary studies have failed to consistently show beneficial effects.
Source: How effectively does cinnamon treat diabetes? – Science-Based Medicine
Steve Parker, M.D.
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Filed under Drugs for Diabetes, Supplements
Do Nutritional Supplements Help Control Diabetes?
From Diabetes Care…
“The routine use of chromium or vitamin D micronutrient supplements or any herbal supplements, including cinnamon, curcumin, or aloe vera, for improving glycemia in people with diabetes is not supported by evidence and is therefore not recommended.”
Source: Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report | Diabetes Care
Did Big Pharma pay for this article in Diabetes Care?
Steve Parker, M.D.
PS: The Low-Carb Mediterranean Diet typically reduces or eliminates the need for drugs or supplements to control diabetes.
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Which Supplements REALLY work for Osteoarthritis?
Does running promote osteoarthritis? Probably not.
If you live long enough, you’ll probably develop osteoarthritis, aka degenerative joint disease. Getting old ain’t for sissies!
Science Based Medicine has a new article on supplements for osteoarthritis pain. A snippet:
“Based on their review, the authors do not recommend omega-3 fatty acids, vitamins D and E, willow bark extract, collagen hydrolysate, glucosamine, chondroitin, combinations of glucosamine and chondroitin, and rose hip. Based on the review, Boswellia serrata extract and pycnogenol appear to demonstrate the most clinically important effects. They also note that while curcumin and MSM demonstrated clinically important effects, the quality of that evidence was low.”
Furthermore…
“The authors conclude that in those with osteoarthritis who are enthusiastic about using supplements, short-term trials of the pycnogenol, curcumin, Boswellia serrata extract, or MSM could be attempted, and should be discontinued after 4-6 weeks if no obvious benefits are noted. Importantly, drug-supplement interactions are not always well understood or well documented, and any supplement should be used with caution (and preferably, consultation with their pharmacist) if being combined with prescription or non-prescription drugs. There is also the very real concerns about supplement quality and batch-to-bath consistency, which complicates evaluations of risk, and determining whether or not they work.”
The SBM writer (Scott Gavura, a pharmacist) also points out the benefits of ongoing exercise, appropriate weight loss, and topical nonsteroidal anti-inflammatory drugs.
Source: Supplements for Osteoarthritis – Evaluating the Evidence – Science-Based Medicine
Steve Parker, M.D.
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Cinnamon for Diabetes? It May Work, But Just Barely
In a meta-analysis…
Cinnamon lowered A1C by 0.09%, versus the usual 1% with medication. [Given that] A1c reflects overall glucose trends, cinnamon doesn’t look that impressive. Even at the extreme of the confidence interval, cinnamon has, at best, 10% of the efficacy of drug treatments. At worst, it’s completely ineffective.
One tasty component of a Cinnabon cinnamon roll
See all the wonky details in a post by pharmacist Scott Gavura at Science-Based Medicine. I would only add that average changes in blood sugar and hemoglobin A1c in clinical studies don’t necessarily apply to an individual; some folks may respond much better than others.
Steve Parker, M.D.
Filed under Drugs for Diabetes, Supplements
Do Calcium Supplements Cause Heart Attacks?
A new European study suggests that calcium supplements almost double the risk of having a heart attack, at least in Germans. You can read the full report in the current issue of Heart.
The medical literature on this issue is a confusing mess. In other words, lots of conflicting results.
Huge numbers of women in the U.S. are taking calcium supplements either to treat or prevent osteoporosis and the associated broken bones (e.g., hips, wrists, spine).
What I’d like to know, and what nobody knows, is what is the effect of calcium supplementation on average longevity and quality of life. Maybe I’d accept a higher risk of heart attack if calcium supplementation prolonged lifespan by two years.
In the interest of brevity, I’ll just say that the best way to get your calcium is probably through food rather than supplements.
Shereen Jegtvig has an article at About.com listing foods rich in calcium.
Exercise can also help keep your bones strong and break-resistant.
PS: If your doctor has you on a calcium supplement, you’d best get his blessing before you stop it.
Filed under Heart Disease, Supplements
Do We Need Supplements Because Our Soils are Depleted?
In my recent review of The Blood Sugar Solution, I noted the numerous supplements recommended by Dr. Mark Hyman: between 11 and 16 supplements. And one of those supplements is a multivitamin/multimineral supplement that has 20 or so different components.
One reason we need the supplements, according to Dr. Hyman, is because the soils in which we grow food over the years has been depleted of minerals and other basic plant building blocks.
I know one doctor who told his patients the same thing while selling them over-priced supplements straight from his office. According to the reviews of Dr. Hyman’s book at Amazon.com, Dr. Hyman sells supplements at his website. The guy’s got an impressive marketing machine!
So is there any truth to the “soil depletion” argument for supplements?
Not much, if any, according to Monica Reinagel. She reviewed the topic in 2010 at her Nutrition Diva blog: http://nutritiondiva.quickanddirtytips.com/are-fruits-and-vegetables-getting-less-nutritious.aspx. I trust Monica. In the same article, you’ll find links to her opinion on whether organic vegetables are healthier and worth the cost.
I’ve not done a comprehensive review of the soil depletion issue myself. It’s quite a difficult area to research; try it and you’ll see. The Soil Science Society of America, founded in 1936, sounds like a great place to find the answer. No such luck.
The U.S. is a huge country with lots of different soil types and usage histories. Soils in one field may be depleted in certain components whereas the field across the road may be quite rich. Soils are not static. Farmers are always making amendments to the soil, either with fertilizers or other additives, or by rotating crops.
Wouldn’t you think farmers, whether small family units or huge corporate enterprises, would do what’s necessary to keep their soils productive?
Another way to look at soil depletion would be to look at the nutrient content of the plants and animals that depend on soil for life. The U.S. Department of Agriculture did that in its 2004 publication, “Nutrient Content of the U.S. Food Suppy, 1909-2000.” This paper includes 10 vitamins and nine minerals. For the boring details, see http://www.cnpp.usda.gov/publications/foodsupply/foodsupply1909-2000.pdf. Some excerpts:
Levels for most vitamins and minerals were higher in 2000 than in 1909.
Levels for vitamin B12 and potassium were lower in 2000 than in 1909, but over the series, met or exceeded current recommendations for a healthy diet….
The authors attibute lower potassium availability to lower consumption of plant foods, especially fresh potatoes. I’m increasingly interested in the possibilty that low potassium consumption may contribute to heart disease and premature death. But that’s a topic for another day.
I’m skeptical about claims of widespread soil depletion in the U.S. as a cause of food supply degradation. Supplement sellers are sure to disagree. To be sure you’re getting the nutrients you need, eat a wide variety of foods.
PS: The American Council on Science and Health has a brief article on whether everybody needs a multivitamin/multimineral supplement.
New research is questioning the benefits of taking supplemental vitamins and minerals, suggesting that, for the general population, such supplements may actually pose more risks than benefits.
Click for the full article: http://www.acsh.org/factsfears/newsid.3067/news_detail.asp
PPS: Oregon State University’s Linus Pauling Institute published a long article on the multivitamin/multimineral supplement issue. It seems fairly balanced to me. The Institute notes the 2006 National Institutes of Health assessment that we have insufficient evidence to recommend either for or against such supplementation (Annals of Internal Medicine, 145(5), 2006: 364-371). Nevertheless, the Linus Pauling Institute recommends supplementation as “insurance.” You know, just in case.
Filed under Supplements
Diabetic Mediterranean Diet 