Dietary Supplements: What You Need to Know!
In today's society, nutritional supplements is one of the fastest growing industries in the world. More commonly known as the Vitamins, Minerals and Supplements, or VMS group, it produces about a $32 billion in revenue to date. But, why? Do you know what you are really digesting into your body? This presentation will explain all that is relevant to this growing hot topic today!
dietary supplements
Overview on supplements
Definition
Facts about Supplements
Should you be taking supplements?
What about protein powders?
Regulation of dietary Supplements
Dietary Supplement and Health Education Act
Dietary Supplements Efficacy, Safety and RegulationsAli Alhammad
The use of dietary supplements increased in the last decade to maintain or improve health or specifically to supplement a vitamin deficiency, lose weight, or support organ function. Mostly, consumers believing them to be more natural, potent or safer than pharmaceutical drugs. However, that it not always the case. The current FDA Dietary Supplement regulations do not require premarketing efficacy and safety studies of any dietary supplement product. I will explore these issues in some details in my lecture.
Dietary Supplements: What You Need to Know!
In today's society, nutritional supplements is one of the fastest growing industries in the world. More commonly known as the Vitamins, Minerals and Supplements, or VMS group, it produces about a $32 billion in revenue to date. But, why? Do you know what you are really digesting into your body? This presentation will explain all that is relevant to this growing hot topic today!
dietary supplements
Overview on supplements
Definition
Facts about Supplements
Should you be taking supplements?
What about protein powders?
Regulation of dietary Supplements
Dietary Supplement and Health Education Act
Dietary Supplements Efficacy, Safety and RegulationsAli Alhammad
The use of dietary supplements increased in the last decade to maintain or improve health or specifically to supplement a vitamin deficiency, lose weight, or support organ function. Mostly, consumers believing them to be more natural, potent or safer than pharmaceutical drugs. However, that it not always the case. The current FDA Dietary Supplement regulations do not require premarketing efficacy and safety studies of any dietary supplement product. I will explore these issues in some details in my lecture.
As defined by Congress in the Dietary Supplement Health and Education Act, which became
law in 1994, adietary supplement is a product (other than tobacco) that
-- is intended to supplement the diet;
-- contains one or more dietary ingredients
(including vitamins; minerals; herbs or
other botanicals; amino
acids; and other substances) or their constituents;
-- is intended to be taken by mouth as a pill, capsule,
tablet, or liquid; and
-- is labeled on
the front panel as being a dietary supplement.
http://ods.od.nih.gov/
Presentation gives an overview of the inter-relationship between nutrition and pharmacy. Its importance is an imperative consideration in patient care. The presentation begins with an introduction to both areas but then focuses on specific drug-nutrient interactions with specific drug categories.
Lecture 3 Dietary requirements and guidelineswajihahwafa
1. Define the Dietary Reference Intakes (DRIs)
2. Present four (4) levels that represent five (5) food group in Malaysian Food Guide Pyramid
3. Read and understand a nutrition facts label.
4. Present the 14 key Messages of Malaysian Dietary Guidelines and 15 Key Messages Malaysian Dietary Guidelines for Children and Adolescents
Drug interactions (DIs) represent an important and widely under recognized source of medication errors. Interactions between food and drugs may inadvertently reduce or increase the drug effect. Some commonly used herbs, fruits as well as alcohol may cause failure of the therapy up a point of to serious alterations of the patient’s health. The majority of clinically relevant food-drug interactions are caused by food induced changes in the bioavailability of the drug. Major side-effects of some diet (food) on drugs include alteration in absorption by fatty, high protein and fiber diets.
Underlying factors:
Classification of drug-food interactions:
Pharmacodynamic interactions
Pharmacokinetic interactions
I. Absorption interactions
II. Transport and distribution interactions
III. Metabolism interactions
IV. Excretion interactions
Grapefruit juice
Alcohol and Medication Interactions
Common Alcohol-Medication Interactions
Specific Alcohol-Medication Interactions
Packaging, Label claims. Regulatory aspects of nutraceutical products in India.Mohammad Khalid
Packaging,
label claims.
regulatory aspects of nutraceutical products in India.
INTRODUCTION (Packaging)
TYPES OF PACKAGING
Objective of Packaging
Consideration for packaging
FUNCTIONS OF PACKAGING
Factors for package design in international market
Introduction (Labelling)
Function of labels
Objective of labeling
Which Information Is Mandatory
Contents in a Nutraceutical label
Definition of Nutrition Claim/s
Definition of Health Claim/s
New FDA Labeling Requirements
Regulation of Nutraceuticals in India
Food Safety and Standards Authority of India (fssai)
Regulatory Requirements in India
Registration Process in India
“FUNCTIONAL FOODS: CLAIMS AND LABELING” -- AN OVERVIEW OF THE LAWMichael Swit
Presentation to the Regulatory Affairs Professionals Society (RAPS) & University of Southern California School of Pharmacy conference on Dietary Supplements & Supplemental Foods." November 2000, Pasadena, CA., covering:
♦ What is a Functional Food
♦ Claims under Nutritional Labeling and Educations Act (NLEA)
♦ FDAMA Claims
♦ FTC Advertising Regulation
CHAPTER 5Nutrition, Weight Management, and AgingPOWERPWilheminaRossi174
CHAPTER 5
Nutrition, Weight Management,
and Aging
POWERPOINTS TO ACCOMPANY
1
2
Food guide pyramid to MyPlate
No distinctions within food categories
Nutrition bull’s-eye
Includes distinctions within food categories
Can be personalized
Food Guide Pyramid
3
Nutritionism versus eating whole food
Basic categories of nutrients
Carbohydrates
Fats
Proteins
Fiber
Water
Vitamins
Minerals
Good Nutritional Habits
4
Trans fat banned
Increased risk of heart disease and diabetes
Mediterranean diet—high fat, yet healthy
Unsaturated fats
Monounsaturated fats
Polyunsaturated fats
Polyunsaturated fats: omega-3 versus omega-6
Saturated fats converted into low-density lipoproteins
Fat
5
Complex carbohydrates and fibers
Refined carbohydrates and simple sugars
Unrefined whole grain kernels contain germ and protective bran coating
Vegetables and fruits
Carbohydrates
6
Fructose, glucose, dextrose, maltose, etc.
Added sugars versus natural sugars
Hidden sugars
Sugar consumption
Americans consume more than double the recommendation
Low-fat food trend correlated with increased sugar intake
Sugar
7
Forms antibodies
Contain eight essential amino acids
Vegetables as a healthy source
Recommended consumption
12% to 20% of total calories
Older, ill adults most likely to experience deficiency
Protein
8
Reduced thirst perception with aging can lead to inadequate hydration
Effects of dehydration
Symptoms
Development of diseases
Additional hospital days
Water
9
Meeting hydration needs
Water, juice, and milk
Foods
80% of many fruits and vegetables
50% of meat
One-third of bread
More modestly hydrating fluids: coffee, carbonated beverages, but not alcohol
Water—cont’d
10
Vitamins
Growth, digestion, alertness, and infection resistance
Minerals
Regulate cell function; provide cell structure
Recommended Dietary Allowance (RDA)
Difficult to establish
Changing requirements with age
Age-related classifications still too few and too broad
Vitamins and Minerals
11
Keeps muscles and nerves working properly
Attracts water to retain body fluid
Consumption
Average: 3,400 mg/d
Recommended: 2,300 mg/d
Sodium sensitivity increases with age
Debate over target for some at-risk individuals
Sodium
12
Challenges meeting recommendations
Processed foods
Restaurant foods
Benefits of sodium reduction
National Salt Reduction Initiative
Sodium—cont’d
13
1993 Nutritional Labeling and Education Act
Proposed label changes in near future
Serving size changes, note added sugars, and other recommendations
Food rating systems
Affordable Care Act
Restaurants with 20+ locations post calorie counts
83% of restaurant diners want information posted
Nutrition Labels
14
Serious problem among those age 75+
Undernourished
Malnourishment
Risks for malnourishment for older adults
Consume fewer fruits and vegetables
Greater propensity to select easily prepared foods
Loneliness, bereavement, and social isolation
Difficulty preparing meals
Loss of appet ...
As defined by Congress in the Dietary Supplement Health and Education Act, which became
law in 1994, adietary supplement is a product (other than tobacco) that
-- is intended to supplement the diet;
-- contains one or more dietary ingredients
(including vitamins; minerals; herbs or
other botanicals; amino
acids; and other substances) or their constituents;
-- is intended to be taken by mouth as a pill, capsule,
tablet, or liquid; and
-- is labeled on
the front panel as being a dietary supplement.
http://ods.od.nih.gov/
Presentation gives an overview of the inter-relationship between nutrition and pharmacy. Its importance is an imperative consideration in patient care. The presentation begins with an introduction to both areas but then focuses on specific drug-nutrient interactions with specific drug categories.
Lecture 3 Dietary requirements and guidelineswajihahwafa
1. Define the Dietary Reference Intakes (DRIs)
2. Present four (4) levels that represent five (5) food group in Malaysian Food Guide Pyramid
3. Read and understand a nutrition facts label.
4. Present the 14 key Messages of Malaysian Dietary Guidelines and 15 Key Messages Malaysian Dietary Guidelines for Children and Adolescents
Drug interactions (DIs) represent an important and widely under recognized source of medication errors. Interactions between food and drugs may inadvertently reduce or increase the drug effect. Some commonly used herbs, fruits as well as alcohol may cause failure of the therapy up a point of to serious alterations of the patient’s health. The majority of clinically relevant food-drug interactions are caused by food induced changes in the bioavailability of the drug. Major side-effects of some diet (food) on drugs include alteration in absorption by fatty, high protein and fiber diets.
Underlying factors:
Classification of drug-food interactions:
Pharmacodynamic interactions
Pharmacokinetic interactions
I. Absorption interactions
II. Transport and distribution interactions
III. Metabolism interactions
IV. Excretion interactions
Grapefruit juice
Alcohol and Medication Interactions
Common Alcohol-Medication Interactions
Specific Alcohol-Medication Interactions
Packaging, Label claims. Regulatory aspects of nutraceutical products in India.Mohammad Khalid
Packaging,
label claims.
regulatory aspects of nutraceutical products in India.
INTRODUCTION (Packaging)
TYPES OF PACKAGING
Objective of Packaging
Consideration for packaging
FUNCTIONS OF PACKAGING
Factors for package design in international market
Introduction (Labelling)
Function of labels
Objective of labeling
Which Information Is Mandatory
Contents in a Nutraceutical label
Definition of Nutrition Claim/s
Definition of Health Claim/s
New FDA Labeling Requirements
Regulation of Nutraceuticals in India
Food Safety and Standards Authority of India (fssai)
Regulatory Requirements in India
Registration Process in India
“FUNCTIONAL FOODS: CLAIMS AND LABELING” -- AN OVERVIEW OF THE LAWMichael Swit
Presentation to the Regulatory Affairs Professionals Society (RAPS) & University of Southern California School of Pharmacy conference on Dietary Supplements & Supplemental Foods." November 2000, Pasadena, CA., covering:
♦ What is a Functional Food
♦ Claims under Nutritional Labeling and Educations Act (NLEA)
♦ FDAMA Claims
♦ FTC Advertising Regulation
CHAPTER 5Nutrition, Weight Management, and AgingPOWERPWilheminaRossi174
CHAPTER 5
Nutrition, Weight Management,
and Aging
POWERPOINTS TO ACCOMPANY
1
2
Food guide pyramid to MyPlate
No distinctions within food categories
Nutrition bull’s-eye
Includes distinctions within food categories
Can be personalized
Food Guide Pyramid
3
Nutritionism versus eating whole food
Basic categories of nutrients
Carbohydrates
Fats
Proteins
Fiber
Water
Vitamins
Minerals
Good Nutritional Habits
4
Trans fat banned
Increased risk of heart disease and diabetes
Mediterranean diet—high fat, yet healthy
Unsaturated fats
Monounsaturated fats
Polyunsaturated fats
Polyunsaturated fats: omega-3 versus omega-6
Saturated fats converted into low-density lipoproteins
Fat
5
Complex carbohydrates and fibers
Refined carbohydrates and simple sugars
Unrefined whole grain kernels contain germ and protective bran coating
Vegetables and fruits
Carbohydrates
6
Fructose, glucose, dextrose, maltose, etc.
Added sugars versus natural sugars
Hidden sugars
Sugar consumption
Americans consume more than double the recommendation
Low-fat food trend correlated with increased sugar intake
Sugar
7
Forms antibodies
Contain eight essential amino acids
Vegetables as a healthy source
Recommended consumption
12% to 20% of total calories
Older, ill adults most likely to experience deficiency
Protein
8
Reduced thirst perception with aging can lead to inadequate hydration
Effects of dehydration
Symptoms
Development of diseases
Additional hospital days
Water
9
Meeting hydration needs
Water, juice, and milk
Foods
80% of many fruits and vegetables
50% of meat
One-third of bread
More modestly hydrating fluids: coffee, carbonated beverages, but not alcohol
Water—cont’d
10
Vitamins
Growth, digestion, alertness, and infection resistance
Minerals
Regulate cell function; provide cell structure
Recommended Dietary Allowance (RDA)
Difficult to establish
Changing requirements with age
Age-related classifications still too few and too broad
Vitamins and Minerals
11
Keeps muscles and nerves working properly
Attracts water to retain body fluid
Consumption
Average: 3,400 mg/d
Recommended: 2,300 mg/d
Sodium sensitivity increases with age
Debate over target for some at-risk individuals
Sodium
12
Challenges meeting recommendations
Processed foods
Restaurant foods
Benefits of sodium reduction
National Salt Reduction Initiative
Sodium—cont’d
13
1993 Nutritional Labeling and Education Act
Proposed label changes in near future
Serving size changes, note added sugars, and other recommendations
Food rating systems
Affordable Care Act
Restaurants with 20+ locations post calorie counts
83% of restaurant diners want information posted
Nutrition Labels
14
Serious problem among those age 75+
Undernourished
Malnourishment
Risks for malnourishment for older adults
Consume fewer fruits and vegetables
Greater propensity to select easily prepared foods
Loneliness, bereavement, and social isolation
Difficulty preparing meals
Loss of appet ...
by: Chris D’Adamo, Ph.D. - Assistant Professor and Director of Research; University of Maryland Center for Integrative Medicine
Dietary supplementation is growing in popularity. While most Americans take at least one dietary supplement, many people are confused by the regulation, safety, and efficacy of the supplements that they consume. Dr. D’Adamo will clarify these issues and present the latest research on specific dietary supplements that are effective as well as those that may be best to avoid. Learn about popular dietary supplements that are being taken for a wide variety of health conditions — ranging from arthritis, to immune system enhancement, to depression — and become a more informed consumer when choosing supplements.
Cristin Stokes, RDN, LN, discusses how to navigate the multi-billion dollar nutritional supplement industry. Learn how to discern what are the best and safest supplement options for you.
If you love eating fruit, then you must include these blue fruits in your diet to maintain your health and weight. Check out what types of blue fruits you should eat.
5 Extremely good foods to help prevent cardiovascular disease effectivelyKnhHn
Experts point out 5 foods to prevent cardiovascular disease should be included in the family daily meal, extremely good support for the health of cardiovascular patients.
Few tips to keep your liver healthy. Presented by UrgentMed Urgent care center, best urgent care center of Davie FL and Plantation FL. For more details visit www.urgentmed.us
5 reasons why you should start eating plant based foods todayRonaldSsekittoK
5 Reasons Why You Should Start Eating
Plant Based Foods Today
As our society evolves, we are constantly facing the need
to change our behaviors and habits to increase our health
and quality of life. We are now facing climate change, food
insecurity and over 40% of our population is suffering from
chronic disease.
One of the recent ideas put forward to improve our world
and health is the plant-based nutrition. Even though food
regiments are not something our doctor prescribes (yet),
research is showing that food has a lot to contribute to our
health. It is also a less costly option to our society than
prescribe medication.
Maggie Ward, with the Via Christi Cancer Outreach and Risk Assessment program, discussed cancer genetic testing at the October, 2015, Women's Connection luncheon.
Miki Matsuda, a podiatrist with Via Christi Health in Wichita, KS, recently presented about common foot and ankle issues to a Via Christi 50+ audience. Topics included ingrown toenails, onychomycosis, callouses and more.
Via Christi Women's Connection: Six ways to a better youVia Christi Health
Via Christi Clinic physicians Tara Katz, DO and Sara Purdy, DO, share their top 6 list for better health at the August Via Christi Women's Connection luncheon.
"The Beauty of BOTOX" presentation by Heidi LaForge, DO, Via Christi Clinic family medicine physician. Dr. LaForge explains how BOTOX is made and how it can help eliminate wrinkles.
Via Christi Women's Connection presentation on summer safety tips from Safe Kids Wichita Area. Tips for safe swimming, biking, camping, car seats and walking.
Lisa D. Sandell, OD, with Via Christi Clinic, presented "Keeping an Eye on Your Health" to Via Christi 50+ May 21, 2014, at the Sedgwick County Extension Office in Wichita, KS.
Via Christi Women's Connection presentation on advance in depression treatment by Matthew Macaluso, DO, medical director of Via Christi Psychiatric Clinic.
Oct. 2013 Via Christi Women's Connection presentation on breast cancer genetic testing featuring Patty Tenofsky, MD, with Via Christi Clinic in Wichita, Kan.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. What You Need to Know
About Dietary Supplements
Lyndsey N. Hogg, PharmD, BCACP
Clinical Pharmacy Specialist, Ambulatory Care
Via Christi Clinic, P.A.1 July 8th, 2014
2. 2
Introductions and Disclosures
About the Speaker
Clinical Pharmacist at Via Christi Clinic
Doctor of Pharmacy (PharmD)
Board Certified Ambulatory Care Specialist (BCACP)
Disclosures
Dr. Hogg has nothing to disclose concerning possible financial or personal relationships with
pharmaceutical manufacturers that may have a direct or indirect interest in the subject matter of this
presentation
Via Christi Health and Dr. Hogg do not endorse any specific medications or indications which may be
discussed during today’s presentation.
Always discuss with your health care provider(s) before starting, stopping, or changing any medications or
dietary supplements.
3. 3
Today’s Goals
1) Provide you with knowledge to safely
utilize dietary supplements
2) Guide you to reliable resources
3) Inform you on questions to ask about
dietary supplements & medications
4. 4
Interesting Facts
More than 50% of Americans use dietary
supplements on a regular basis
Regulated as foods, not drugs
5. 5
Key Points
Do not self-diagnose any health condition
Check with your health care providers
before starting any supplements
Supplements should not replace
prescribed medications or a healthy diet
Do your research- use reliable sources
7. Dietary Supplements
Dietary supplements
include:
Vitamins
Minerals
Herbals & botanicals
Amino acids
Enzymes
Many other products
Variety of forms:
Tablets
Capsules
Powders
Drinks
Energy bars
7
8. 8
Who Regulates Supplements?
U.S. Food & Drug Administration (FDA)
Different set of regulations compared to
“conventional” foods & drug products
9. 9
Supplements: How are they
different from drugs?
Research studies to prove safety are
not required
FDA cannot take action against manufacturer until
after product is marketed
Proven efficacy is not required
All claims must be followed by statement:
This statement has not been evaluated
by the Food and Drug Administration.
This product is not intended to diagnose,
treat, cure, or prevent any disease
10. 10
Which Products Do I Buy?
“Seals of Approval”
U.S. Pharmacopeia
NSF International
Consumerlab.com
Seal of approval does NOT mean “safe & effective”.
Rather provides assurance the product:
Was properly manufactured
Contains listed ingredients
Does not contain harmful levels of contaminants
12. 12
RDA vs. DV
RDA: Recommended Daily Allowance
Food & Nutrition Board at the Institute of Medicine of
the National Academies
Vary by age, gender and pregnancy status
Recommended intake amount of nutrient per day
DV: Daily Value
Food & Drug Administration
Do NOT vary by age or gender
(one DV for anyone >4 years old)
Suggest how much nutrient per serving
Often match or exceed RDA for most people
13. 13
Reading a Supplement Label
Serving Size
varies among
products
% DV
Not the RDA
Supplement
Components
Fillers,
binders,
flavors, etc.
Adapted from FDA’s “Dietary Supplement Labeling Guide”
14. Dietary Supplements
Don’t replace variety of foods important to a
healthy diet
Dietary Guidelines for Americans
Choose MyPlate
Natural does NOT
mean safe
14
16. 16
Calcium
Use
Osteoporosis (prevention & treatment)
Evidence
Well-documented: adequate intake is important for
keeping bones strong & reducing bone loss
Regular weight-bearing & muscle-strengthening
exercises are also important
17. 17
How Much Calcium Should I Take?
Age RDA for Men1 RDA for Women1
19-50 1,000 1,000 mg
51-70 1,000 mg 1,200 mg
71+ 1,200 mg 1,200 mg
1
1
300
200
750
Estimating your daily calcium intake:
Table & Recommended Daily Allowances (RDA) obtained from National Osteoporosis Foundation:
Clinician’s Guide to Prevention and Treatment of Osteoporosis (2014 Issue, Version 1)
18. 18
Forms of Calcium
Carbonate
Most common (inexpensive & convenient)
Take with food for best absorption
Tends to cause more side effects (bloating,
constipation)
Citrate
Take with or without food
Other forms: gluconate, lactate, phosphate
19. 19
Tips on Taking Calcium
Optimizing your calcium intake
No more than 500 mg per dose (your body can’t
absorb more than this at one meal)
Take at separate time from multivitamin
Calcium can decrease absorption of:
Certain antibiotics (Levaquin, tetracycline)
Bisphosphonates (Fosamax, Boniva, etc)
Levothyroxine (Synthroid)
Phenytoin (Dilantin)
20. 20
Vitamin D
Use
Bone health
Helps with calcium absorption
Daily requirements
National Osteoporosis Foundation
• <50 years: 400-800 IU/day
• 50 years & older: 800-1000 IU/day
Institutes of Medicine Dietary Reference Intake
• <70 years: 600 IU/day
• 71 & older: 800 IU/day
Most people with osteoporosis need >1000 IU/day
21. 21
Folate (Folic Acid)
Critical for women of child-bearing potential
prevention of certain birth defects (spina bifida
and anecephaly)
Recommended intake
Childbearing potential: 400 mcg/day
Pregnant: 600 mcg/day
Most women will not obtain sufficient amounts
through their diet alone
22. 22
Black Cohosh
Reported Uses:
Menopausal symptoms
Evidence
Preliminary evidence encouraging but not sufficient
(use < 6 months)
Side Effects
Few reported (stomach upset, headaches)
Long-term safety data unavailable
Who should not take it:
Pregnant women
Breast cancer
Liver disorders
23. 23
Cranberry
Reported Uses:
urinary track infections
Evidence
Prevention- preliminary evidence not definitive
Treatment- not effective
Side effects
Stomach upset or diarrhea (when used in excess)
Who should not take it:
Those taking warfarin (Coumadin)
Possibly those on medications which affect the liver
24. 24
Vitamin C
Reported Uses:
Common cold
Evidence
Prevention: data does not support
Duration/severity: no effect to mild
effect
Foods Containing Vit C† Amount of Vit C†
Citrus fruits Medium orange = 70 mg
Red & green peppers ½ cup red pepper = 96 mg
Other fruits & veggies
(broccoli, strawberries,
cantaloupe, tomatoes, etc)
½ cup broccoli = 39 mg
½ cup strawberries = 40mg
Medium tomato = 17 mg
Fortified foods & beverages
Recommended Amount†
Adult women 75 mg
Pregnant
women
85 mg
Breastfeeding
women
120 mg
Smokers add 35 mg
† National Institutes of Health Office of Dietary Supplements- “Vitamin C Quick Facts”
25. 25
Fish Oil & Omega-3 Fatty Acids
Side effects
Bad breath, belching, heartburn, nausea, loose stools
Who should not take it:
Fish or seafood allergy
Liver disease
Possibly those at high bleeding risk
Reported Uses† Evidence†
Heart disease Reduces all-cause mortality
High cholesterol May lower triglycerides
(dose-dependent)
Cognitive function (memory) Inadequate evidence
Asthma No conclusions possible
† National Institutes of Health Office of Dietary Supplements- “Summary of AHRQ Report on Omega-3”
26. 26
Glucosamine/Chondroitin
Reported Uses
Osteoarthritis
Evidence
Does not slow joint destruction or relieve pain†
Pregnancy
Use caution
Who should not take it:
Allergy to shellfish (glucosamine)
† National Institutes of Health Office of Dietary Supplements- “Summary of GAIT Study”
27. 27
Coenzyme Q-10
Reported Uses:
Heart disease
Drug-induced muscle weakness (e.g. statins)
Reproductive disorders
Cancer
Evidence varies among uses
Side effects
No serious effects reported
Insomnia, rash, nausea, dizziness, headache
Use during pregnancy or breastfeeding- NO
35. 35
Other Reliable Sources
NIH fact sheets
Nutrient recommendations (NIH)
PubMed Dietary Supplement Subset
MedlinePlus (National Library of Medicine)
Food & Drug Administration
Federal Trade Commission
36. 36
Tips on Searching the Web for
Information on Supplements
Questions to think about:
Who operates the website?
What is the purpose of the website?
• Educate the public vs sell a product
What is the source of the information & is it
referenced?
• Reputable peer-reviewed journals
Is the information current?
How reliable is the internet or e-mail solicitations?
• UPPERCASE LETTERS & LOTS OF !!!!!!!!!!!!
Questions adapted from FDA.gov
37. 37
More Tips
Ask yourself: Does it sound too good to be true?
Think twice about chasing the latest headline
Contact manufacturer for more information
Check your assumptions:
“Even if a product may not help me, it at least won’t
hurt me.”
“When I see the term ‘natural’, it means that a product
is healthful and safe.”
“A product is safe when there is no cautionary
information on the product label.”
Questions adapted from FDA.gov
40. 40
Questions?
Who Should I Ask?
Your doctor or other provider
Your pharmacist
When should I ask?
New medication started
Medication stopped
Medication dose change
Significant change in diet
41. 41
General Questions to Ask
What is the name of my medicine?
Why am I taking this medicine?
How much do I take and how often?
What side effects are possible?
What should I do if they occur?
What should I do if I miss a dose or double
the dose?
Is there anything I should avoid while taking
this medicine?
42. 42
Questions About Interactions
Is the interaction something my doctor can
monitor for or should the medication/food
be stopped?
If I take them at different times, will this prevent
the interaction?
What side effects should I watch for? What
should I do if they occur?
44. 44
Key Points
Dietary supplements do not replace necessary
medications
Do your research- utilize reliable resources
Natural ≠ safe
Some dietary supplements can interact with
prescription medications
Notify all providers of your current medications
ALWAYS ask your pharmacist or provider before
starting (or stopping) dietary supplements
49. 49
Tips from a Pharmacist
Keep a list of ALL your medications
This includes vitamins & supplements!
Keep copies in your wallet & at your house
Take to all provider appointments
Track any changes
Update after each provider appointment
Take medications exactly as prescribed
50. 50
Tips from a Pharmacist
Use ONE pharmacy
Check medications before leaving the pharmacy
All necessary refills present?
Any medications that were stopped?
When a medication is stopped:
Cancel automatic refills
Update medication list
53. What You Need to Know
About Dietary Supplements
Lyndsey N. Hogg, PharmD, BCACP
Clinical Pharmacy Specialist, Ambulatory Care
Via Christi Clinic, P.A.53 July 8th, 2014
Editor's Notes
Picture from
https://myds.nih.gov/en/content/background-information-botanical-dietary-supplements
In the United States, the U.S. Food and Drug Administration (FDA) has regulatory responsibility for dietary supplements. FDA regulates dietary supplements under a different set of regulations than those covering “conventional” foods and drug products (prescription and over-the-counter). Under the Dietary Supplement Health and Education Act of 1994, the dietary supplement manufacturer is responsible for ensuring that a dietary supplement is safe before it is marketed. FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market.
Manufacturers must make sure that product label information is truthful and not misleading. FDA’s post-marketing responsibilities include monitoring safety, e.g. voluntary dietary supplement adverse event reporting, and product information, such as labeling, claims, package inserts, and accompanying literature.
Research studies in people to prove that a dietary supplement is safe are not required before the supplement is marketed, unlike for drugs. It is the responsibility of dietary supplement manufacturers/distributors to ensure that their products are safe and that their label claims are accurate and truthful. If the FDA finds a supplement to be unsafe once it is on the market, only then can it take action against the manufacturer and/or distributor, such as by issuing a warning or requiring the product to be removed from the marketplace.
The manufacturer does not have to prove that the supplement is effective, unlike for drugs. The manufacturer can say that the product addresses a nutrient deficiency, supports health, or reduces the risk of developing a health problem, if that is true. If the manufacturer does make a claim, it must be followed by the statement…
In addition, there are a few independent organizations that offer “seals of approval” that may be displayed on certain dietary supplement products. These indicate that the product has passed the organization’s quality tests for things such as potency and contaminants. These “seals of approval” do not mean that the product is safe or effective; they provide assurance that the product was properly manufactured, that it contains the ingredients listed on the label and that it does not contain harmful levels of contaminants.
The following is a list of several organizations offering these programs:
Consumerlab.com approved quality product seal
NSF International dietary supplement certification
U.S. Pharmacopeia dietary supplement verification program
From NIH ODS (http://ods.od.nih.gov/Health_Information/ODS_Frequently_Asked_Questions.aspx#Information)
Q. What is the difference between the RDA and DV for a vitamin or mineral?
Many terms are used when referring to either the amount of a particular nutrient (such as calcium or vitamin D) you should get or the amount in a food or dietary supplement. The two most common are the Recommended Dietary Allowance (RDA) and the Daily Value (DV). These terms can be confusing.
RDAs are recommended daily intakes of a nutrient for healthy people. They tell you how much of that nutrient you should get on average each day. RDAs are developed by the Food and Nutrition Board at the Institute of Medicine of the National Academies. They vary by age, gender and whether a woman is pregnant or breastfeeding; so there are many different RDAs for each nutrient.
DVs, established by the U.S. Food and Drug Administration (FDA), are used on food and dietary supplement labels. For each nutrient, there is one DV for all people ages 4 years and older. Therefore, DVs aren’t recommended intakes, but suggest how much of a nutrient a serving of the food or supplement provides in the context of a total daily diet. DVs often match or exceed the RDAs for most people, but not in all cases.
DVs are presented on food and supplement labels as a percentage. They help you compare one product with another. As an example, the %DV for calcium on a food label might say 20%. This means it has 200 mg (milligrams) of calcium in one serving because the DV for calcium is 1,000 mg/day. If another food has 40% of the DV for calcium, it’s easy to see that it provides much more calcium than the first food.
The FDA has a Web page that lists the DVs for all nutrients and provides additional details.
Sample label from FDA’s “Dietary Supplement Labeling Guide: Chapter IV. Nutrition Labeling” (published April 2005)
http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/DietarySupplements/ucm070597.htm
(website accessed 7/6/14)
Even some vitamins and minerals, when taken in inappropriate amounts, can cause problems. For example, too much vitamin A can reduce bone mineral density, cause birth defects, and lead to liver damage, according to the National Academy of Sciences
MyPlate
By the U.S. Department of Agriculture
Includes “healthy eating on a budget”
From WebMD article “’Natural’ Dietary Supplements” (accessed 7/6/14)
http://www.webmd.com/fitness-exercise/naturual-dietary-supplements?page=2
“Many natural products can affect your body in ways that can potentially lead to serious illness, even death.
Androstenedione. A steroid precursor used by St. Louis Cardinals slugger Mark McGwire and others, claims to enhance athletic performance and boost testosterone levels. The FDA and many amateur and professional athletic organizations have banned androstenedione. But the supplement is still for sale through the Internet and other countries and many athletes use it, putting their health at risk.
Not only does androstenedione boost the concentration of estrogen (a female hormone), which can lead to breast development and impotence in men, it may cause abnormal periods, deepening of the voice and increased facial hair in women. It can also lead to serious liver disease and blood clots.”
Other examples in the article: ephedra (in wt loss products) & creatine (used by some athletes)
Scientific evidence shows that some dietary supplements are beneficial for overall health and for managing some health conditions. For example, calcium and vitamin D are important for keeping bones strong and reducing bone loss; folic acid decreases the risk of certain birth defects; and omega-3 fatty acids from fish oils might help some people with heart disease.
http://ods.od.nih.gov/factsheets/list-all/Calcium/
99% of body’s calcium supply is in the bones; when exogenous supply is inadequate, bone tissue from the skeleton is reabsorbed in order to maintain a constant calcium level
Intakes in excess of 1,200 to 1,500 mg per day may increase the risk of developing kidney stones, cardiovascular disease and stroke.
Scientific evidence shows that some dietary supplements are beneficial for overall health and for managing some health conditions. For example, calcium and vitamin D are important for keeping bones strong and reducing bone loss;
***separate Ca from fluoroquinolones (Levaquin) & tetracyclines, bisphosphonates, levothyroxine, & phenytoin- as Ca decreased absorption of these drugs
Calcium absorption
As amt increases, % absorption decreases
Absorption highest in doses <500 mg
***separate Ca from fluoroquinolones (Levaquin) & tetracyclines, bisphosphonates, levothyroxine, & phenytoin- as Ca decreased absorption of these drugs
Calcium absorption
As amt increases, % absorption decreases
Absorption highest in doses <500 mg
NOF guidelines:
Chief dietary sources of vitamin D include vitamin D-fortified milk (400 IU per quart, although certain products such as soy milk are not always supplemented with vitamin D) and cereals (40 to 50 IU per serving or more), salt-water fish and liver. Some calcium supplements and most multivitamin tablets also contain vitamin D. Supplementation with vitamin D2 (ergocalciferol) or vitamin D3 (cholecalciferol) may be used. Vitamin D2 is derived from plant sources and may be used by individuals on a strict vegetarian diet.
Many older patients are at high risk for vitamin D deficiency, including patients with malabsorption (e.g., celiac disease) or other intestinal diseases, chronic renal insufficiency, patients on medications that increase the breakdown of vitamin D (e.g. some antiseizure drugs), housebound patients, chronically ill patients and others with limited sun exposure, individuals with very dark skin, and obese individuals. There is also a high prevalence of vitamin D deficiency in patients with osteoporosis, especially those with hip fractures, even in patients taking osteoporosis medications. 35, 36
Since vitamin D intakes required to correct vitamin D deficiency are so variable among individuals, serum 25(OH)D levels should be measured in patients at risk of deficiency. Vitamin D supplements should be recommended in amounts sufficient to bring the serum 25(OH)D level to approximately 30 ng/ml (75 nmol/L) and a maintenance dose recommended to maintain this level, particularly for individuals with osteoporosis. Many patients with osteoporosis will need more than the general recommendation of 800-1,000 IU per day. The safe upper limit for vitamin D intake for the general adult population was increased to 4,000 IU per day in 2010.30
Scientific evidence shows that some dietary supplements are beneficial for overall health and for managing some health conditions. For example, folic acid decreases the risk of certain birth defects (neural tube defects such as spina bifida & anecephaly)
http://ods.od.nih.gov/factsheets/list-all/BlackCohosh/
http://ods.od.nih.gov/factsheets/BlackCohosh-HealthProfessional/
Herb
Evidence- preliminary evidence encouraging but not sufficient to support recommendation for use
NCCAM at NIH funding rigorous scientific study
Amer. College of Obstetrians & Gynecologists- may be helpful short term (6 month) for women w/ vasomotor sx (consensus & expert opinion)
http://ods.od.nih.gov/factsheets/list-all/Cranberry/
National Center for Complementary & Alternative Medicine (NCCAM)
http://nccam.nih.gov/health/cranberry
Future studies
NCCAM funding studies to better understand effects on UTIs
National Institute on Aging funding study of potential anti-aging effects
http://ods.od.nih.gov/factsheets/list-all/VitaminC/
http://ods.od.nih.gov/factsheets/VitaminC-QuickFacts/
Amount needed/day
Most people get enough through diet. Those who may not include:
Smokers (or those exposed to 2nd hand smoke): more needed for repairing damage from free radicals
Infants fed evaporated or cow’s milk
Those who eat limited variety of food
Certain dzs such as severe malabsorption, some types of cancer, & kidney damage requiring hemodialysis
http://ods.od.nih.gov/factsheets/list-all/FishOil/
http://ods.od.nih.gov/factsheets/list-all/Omega3/
Numerous uses:
Asthma
No conclusions could be drawn about the value of omega-3 fatty acid supplements in the prevention or treatment of asthma for adults or children other than the fact that they have an acceptable safety profile.
Cancer
CV & heart dz
Impact on cardiovascular disease: According to both primary and secondary prevention studies, consumption of omega-3 fatty acids, fish, and fish oil reduces all-cause mortality and various CVD outcomes such as sudden death, cardiac death, and myocardial infarction. The evidence is strongest for fish and fish oil supplements.
Impact on CVD risk factors: Fish oils can lower blood triglyceride levels in a dose-dependent manner. Fish oils have a very small beneficial effect on blood pressure and possible beneficial effects on coronary artery restenosis after angioplasty and exercise capacity in patients with coronary atherosclerosis
Child & maternal health
Cognitive function
Diabetes, IBD, RA, renal dz, systemic lupus, osteoporosis
Omega-3 fatty acids can reduce joint tenderness and need for corticosteroid drugs in rheumatoid arthritis. Data are insufficient to support conclusions about the effects of omega-3 fatty acids on inflammatory bowel disease, renal disease, systemic lupus erythematosus, bone density, and diabetes.
Eye health
Mental health
The quantity and strength of evidence is inadequate to conclude that omega-3 fatty acids protect cognitive function with aging or the incidence or clinical progression of dementia (including Alzheimer’s disease), multiple sclerosis, and other neurological diseases.
Organ transplant
No conclusive evidence suggests specific benefits of omega-3 fatty acid supplementation on any outcome in any form of organ transplantation. However, available studies are small, have methodological problems, and may not fully apply to current transplantation procedures
http://ods.od.nih.gov/factsheets/list-all/Glucosamine/
Glucosamine- amino sugar produced by body & distributed in cartilage & other connective tissue
Chondroitin- complex carbohydrate that helps cartilage retain water
GAIT study
http://nccam.nih.gov/research/results/gait/qa.htm
For pts with mild pain- no difference for either agent alone or combo compared to placebo
For pts with moderate-severe pain- statistically significant pain relief compared to placebo (NOTE small group & thus only considered a preliminary finding, more studies needed)
http://ods.od.nih.gov/factsheets/list-all/CoenzymeQ10/
NIH- What you need to know:
http://nccam.nih.gov/health/supplements/coq10
Antioxidant necessary for cells to function properly
Used by cells to make energy they need to grow & stay healthy
Levels decrease as you age
Evidence
HF- associated w/ improved heart function & feeling better
Post bypass & heart valve surgery- CoQ10 plus other nutrients associated w/ quicker recovery
HTN- mixed results
Statin induced muscle weakness- mixed results (one study showed it helped ease myopathy but concluded results not definite; other study showed no better than placebo)
Reproductive health- some evidence to support improved semen quality & sperm count in infertile men but not know if this affects likelihood of conception
Cancer- no convincing evidence it treats or prevents cancer (although women w/ breast cancer have been show to have abnormal CoQ10 levels)
Interactions
Can make warfarin less effective
Side effects
most common side effects: insomnia, increased liver enzymes, rashes, nausea, upper abdominal pain, dizziness, sensitivity to light, irritability, headaches, heartburn, and fatigue
NIH sponsoring studies investigating effects on statin-induced muscle pain, fertility in older women & breast cancer treatments
can cause serious bleeding if combined with blood thinners such as warfarin
Warfarin
Decreased w/ vit K rich foods
Increased with cranberry juice
Calcium prevents antibiotic absorption (separate dosing time)
Levaquin & Cipro
NIH ODS
“Dietary Supplement Fact Sheets”- Available for many vitamins, herbals & supplements
DSLD (database from the NIH- launched June 2013)
17,000 products included initially, will grow to >55,000 products
The DSLD is a collaborative project of the Office of Dietary Supplements (ODS) and the National Library of Medicine (NLM) at NIH, with input from many federal stakeholders including most NIH institutes and centers, the U.S. Department of Agriculture’s Agricultural Research Service, the Centers for Disease Control and Prevention’s National Center for Health Statistics Division of Health and Nutrition Examination Surveys, and the U.S. Food and Drug Administration’s Center for Food Safety and Applied Nutrition.
NIH fact sheets
Includes links to helpful resources and information on many dietary supplements
Nutrient recommendations
Includes recommended daily allowance (RDA), adequate intake (AI), & tolerable upper intake level (UL)
PubMed Dietary Supplement Subset
Searchable database of articles on dietary supplements
Linked with Medline database
MedlinePlus
Searchable website which includes reliable information on health topics, drugs & supplements
Federal Trade Commission- info on how to evaluate claims for products related to your health (avoiding fraudulent claims)
http://www.consumer.ftc.gov/sites/all/libraries/games/weightlosschallenge/
1) causes weight loss of two pounds or more a week for a month or more without dieting or exercise;
2) causes substantial weight loss no matter what or how much the consumer eats;
3) causes permanent weight loss even after the consumer stops using product;
4) blocks the absorption of fat or calories to enable consumers to lose substantial weight;
5) safely enables consumers to lose more than three pounds per week for more than four weeks;
6) causes substantial weight loss for all users; or
7) causes substantial weight loss by wearing a product on the body or rubbing it into the skin.
“your pharmacist is trained to really understand what exactly a drug does, how it interacts with other drugs, and potential problems you might come across”
“this might include information your doctor doesn’t know”
“doctors aren’t always aware of every single possible drug interaction. So if you have a lot of prescriptions, especially if they’re from different doctors, it’s worth discussing the issue with your pharmacists because they have a lot more information than your doctor does”
http://lifehacker.com/your-pharmacist-is-more-useful-than-you-think-510727546
Not all interactions will cause problems but some interactions can be serious.
Not all interactions will cause problems but some interactions can be serious.
On average, a community pharmacy is located within two miles of every American home.
Why do I need to know my medications? Doesn’t my doctor keep track of them?
List should include OTCs, vitamins, herbals, supplements
Using 1 pharmacy:
Reduces chances for drug interactions
Using 1 pharmacy:
Reduces chances for drug interactions