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The Science Behind Dietary Supplements

January 10, 2019 2:26 p.m.

GUEST: Dr. Robert Bonakdar, Scripps Center for Integrative Medicine

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This is a rush transcript created by a contractor for KPBS to improve accessibility for the deaf and hard-of-hearing. Please refer to the media file as the formal record of this interview. Opinions expressed by guests during interviews reflect the guest’s individual views and do not necessarily represent those of KPBS staff, members or its sponsors.

Many of us are trying our best to live better healthier lives as we settle into the new year separating dietary facts from fads can be tricky. Scripps Center for Integrative Medicine is hosting a conference this Friday that will help people do just that. It's called the natural supplements conference and joining me is Dr. Robert Bond actor and expert on dietary supplements and the founder and director of the conference Dr. Ben Akhter thank you so much for joining us. Pleasure to be here. So let's define what a supplement is is it an herb is it a powder or is it a vitamin.

What is it.

It's all of those things. It's basically anything you take by mouth to supplement a diet. So it can be a vitamin. It can be a T. It can be a protein shake it can be all of the above.

And that's one of the confusing things about it don't most people get nutrients they need from food that they eat.

You hope our diets would be improving. The sad fact is that it is not. I think the latest CDC findings that only one in ten Americans gets enough fruits and vegetables tells us that we're not getting anywhere near the type of dietary quality or quantity that we need to get the nutrients to have you know a good future and stay away from diseases that we're trying to avoid.

So then how do our eating habits and lifestyles sort of create deficiencies and the need for supplements.

Well I think we tend to eat on the go. We don't plan very well. We tend to not really look at specific ways that we can get our five fruits and vegetables were just kind of getting through the day for the most part so it becomes a mindless type of died for many folks. The other problem is that we we tend to switch from one diet to another. So it might be a fad one day and then the next day and in that scenario we may not be looking at where that transition leaves us as far as deficits in our diet and that happens all the time.

I guess there's a large number of people then who are deficient in certain nutrients. How do you know what you're deficient in and what type of supplements you should be taking.

Sure. Great question. I don't always tell patients that we need to test in some cases like magnesium we know about 70 percent of the general population is deficient not getting enough in their diet. And as we age it's probably closer to 80 percent so we can pretty much tell that's an area that we can just recommend more in the diet and potentially in the supplement SAMe with vitamin D. But we do often when there are chronic symptoms that are happening like fatigue muscle soreness worsening of blood pressure or diabetes we do like to test and to figure out how low is that bucket how.

How much do we need to fill it to help this person you know kind of run you know optimally. And I think that's the key point. We don't always know until we see a health care provider and have a crucial conversation of what do I really need versus what other people need.

So you know if food is medicine and supplements are really just nutrients found in food could they then take the place of medication.

It's something that that we think about and it's confusing because most folks get these in the food aisle or somewhere in the supermarket. So we think of most food but we often think of them as something that may help our headaches or whatever medical condition so they are being used as a medicine. And I think if we are going to use it as medicine we need to treat it like medicine meaning get the most reputable source. Talk to a doctor about it. Who can help guide us.

And has there been enough research to prescribe specific dosage for supplements.

There have been studies on specific extracts for example turmeric as an example that's very common for multiple things including arthritis prevention you know multiple brands that are out there that have been tested. Usually about 500 milligrams twice a day is a typical dose. So if you're in that range with the right formulation that's been research tested. You have a pretty good chance of getting some relief whereas you can't say that for the vast majority of other supplements on the market.

So can you give me some examples of maybe some chronic conditions even diseases that could could have been avoided or treated with supplements.

Well I think an easy example that many people are familiar with is vitamin D deficiency. We have been told by the latest Institute of Medicine recommendations that you only need about 600 to 800 international units. That is a public health recommendation. However when we're dealing with folks with chronic disease we're seeing their health care provider in many cases these these folks are you know incredibly low levels. Typically anything below 30 is deficient. We have patients that don't even have double digit levels. And so when we test that we have to use a higher dose sometimes four or five thousand units internationally per day as one example.

Another example we in my in our practice of the Integrative center at Scripps we see a lot of headache patients they begin being deficient in coenzyme Q10 which is another part supplement. And some folks have been low for decades so they would need a supplementation based on their blood test to kind of get them again get that tank filled. So they have a better chance of avoiding future worsening headaches.

Those are just a few example and you mentioned vitamin D. What types of illnesses would someone. Could someone be susceptible to a vitamin D deficiency.

Absolutely since Vitamin D is a pre hormone. It's important in bone health. We know that it can help with diabetes prevention. It has some effects on the cardiovascular system so there's some studies looking at helping with blood pressure control. We know there's a number of studies that also show low vitamin D can be affected can be linked to depression and mood disorders. So really across the board I think vitamin D when it goes low a lot of the systems that we rely on have issues keeping up.

And what's the current supplement trend out there that you should take some caution with.

Well I think one of the trends that you should always look at with caution is supplements for performance enhancement. Multiple studies have shown that supplements are looking at helping you with quick weight loss sexual enhancement muscle building are typically too good to be true. And in many cases they can have dangerous adulterants that are added to that which can be worse than anything prescription and they can be quite toxic because they're undeclared. So I think in many cases that's a scenario one that's not that's relatively benign. We hear a lot about as probiotics and prebiotics and things that are going to help the guy.

We actually have a session and it will also be talked about with Dr. Katz on Friday as well of how to improve the function of the gut because we know more and more that helping the gut also helps the brain helps the heart etc..

So I think probiotics are going to hear more and more about something we actually recommend quite a bit at our center and we always see the warning label on supplements warning about interactions with medications and things like that. What types of interactions could you have.

That's a great point. On the label it states that these are not meant to prevent or treat or cure a disease. So number one if it says that anywhere on the Internet side or on a bottle there's something wrong with that supplement. Number two the warning also talks about using this in the right scenario and not using it with other medications unless they've been checked out. So blood pressure medications blood thinners sedatives anything that can have an additive effect when you add a supplement with a similar mechanism. It can be problematic and really needs to be checked out.

Really that's that's key.

It. I've been speaking with Dr. Robert Bone actor a supplements expert with the Scripps Center for Integrative Medicine which is hosting the 16th annual natural supplements conference this Friday 730 at the Sheraton San Diego hotel and Marina. You can catch him speaking there Dr. Robert van actor. Thank you so much for joining us. Pleasure again. Thank you.