Harmful effects of supplements can send you to the emergency department

For many people, a healthy lifestyle means more than eating a good diet and getting enough exercise — vitamins, supplements, and complementary nutritional products are also part of the plan. But though there is much publicity about their potential benefits, there is less awareness of their possible harmful effects.

In fact, using these products can land you in the emergency department.

A study published today in The New England Journal of Medicine found that adverse effects of supplements were responsible for an average of about 23,000 emergency department (ED) visits per year. That’s a lot for something that is supposed to be good for you.

In this 10-year study, researchers looked at surveillance data from 63 hospital emergency departments to estimate the annual number of ED visits associated with adverse effects from dietary supplements. The authors defined “dietary supplements” as herbal or complementary products, and vitamin or amino acid micronutrients. Patients visiting the ED for symptoms related to supplement use were an average of 32 years old, and women made up more than half of all visits. Just over 10% of these visits resulted in admission to the hospital, especially among adults older than 65.

Weight-loss products accounted for one quarter of all single-product ED visits and disproportionately affected women, while men were more likely to experience adverse effects from products advertised for sexual enhancement and body building. Energy-boosting products made up another 10% of these visits.

Young adults weren’t the only ones affected. Many children under 4 years of age suffered allergic reactions or digestive symptoms (nausea, vomiting, abdominal pain) from unsupervised, accidental ingestion of vitamins. Patients older than 65 were more likely to have trouble swallowing after taking vitamins or micronutrients of large pill size.

Although the study’s findings are annual estimates based on ED visits to a relatively small number of hospitals, they reflect the growing use of dietary supplements and micronutrients. These products are widely available without prescription and are advertised as alternatives or complements to therapeutically prescribed pharmaceutical drugs. As a result, dietary or herbal supplements are widely perceived to be natural and safe. The most recent figures indicate that there are more than 55,000 such products available in the United States.

What you need to know before you take a supplement

While the Food and Drug Administration (FDA) is charged with overseeing dietary supplements, there is no safety testing or FDA approval required before a new supplement goes on the market. In addition, there are no requirements that dietary supplement packaging list potential adverse effects, nor are there standards for maximum pill size (a clear risk for older people).

Health care providers also may neglect to ask patients about the use of over-the-counter or natural dietary supplements. Without that information, they may not recognize that any signs and symptoms their patients may be experiencing could be related to these products.

To be sure, some dietary supplements can be beneficial. That’s because these products contain active ingredients — molecules that interact at receptors in our body and cause physiological changes. However, because they contain active ingredients, they can also cause unwanted effects, such as elevated blood pressure, racing or irregular heartbeat, headache, dizziness, or digestive symptoms.

What is the safe approach to the use of these dietary supplements? Staying healthy requires a multifaceted approach to self-care. Being aware and knowledgeable about any supplement—whether it is advertised as natural, herbal, or non-drug — is part of that care.

If you do take vitamins, supplements, or herbal products, always read any safety labels that are included with the packaging. Ask a pharmacist, your doctor, or a nurse to review everything you take to ensure that supplements will not cause harmful effects, either alone or in combination with regularly prescribed or over-the-counter drugs. If you do develop concerning symptoms after taking a dietary supplement, stop taking it and call your doctor.

Top 10 herbal or complementary products associated with emergency department visits

  1. Weight loss
  2. Energy
  3. Sexual enhancement
  4. Heart health
  5. Sleep
  6. Laxative
  7. Bodybuilding
  8. Immunity or infection
  9. Pain or arthritis relief
  10. Detoxification or cleansing

Top 4 vitamins associated with emergency department visits

  1. Multivitamin, or unspecified vitamin
  2. Iron
  3. Calcium
  4. Potassium

Choosing a calcium supplement

What you should know about taking calcium to boost your nutrients

Experts agree that the ideal way to get the nutrients you need to stay healthy is from food. But when it comes to taking calcium, some people may not find it practical or possible to meet the recommended daily intake (RDI) from diet alone. For adults, the RDI is 1,000 milligrams (mg) daily, which rises to 1,200 mg per day for women over age 50 and men over age 70.

If your doctor advises you to take a calcium supplement, how do you choose among the dizzying array of available choices, which include pills, chewable tablets, flavored chews, and liquids? The following information may help you decide.

What form of calcium?

The calcium in supplements is found in combination with another substance, typically carbonate or citrate. Each has benefits and downsides. Calcium carbonate supplements tends to be the best value, because they contain the highest amount of elemental calcium (about 40% by weight). Because calcium carbonate requires stomach acid for absorption, it’s best to take this product with food. Most people tolerate calcium carbonate well, but some people complain of mild constipation or feeling bloated. Some well-known calcium carbonate products include Caltrate, Viactiv Calcium Chews, Os-Cal, and Tums.

Calcium citrate supplements are absorbed more easily than calcium carbonate. They can be taken on an empty stomach and are more readily absorbed by people who take acid-reducing heartburn medications. But because calcium citrate is only 21% calcium, you may need to take more tablets to get your daily requirement. Calcium citrate products include Citracal and GNC Calcimate Plus 800.

How much calcium per serving?

Reading the labels with an eye toward cost and convenience may help you sift through your options. Check the serving size and the “% Daily Value” for calcium and multiply the percentage by 10 to find out how much elemental calcium the product contains. For example, if the label says a serving of the product contains 40% of the Daily Value, it has 400 mg of elemental calcium.

While products that yield a high amount of calcium may seem to be the best bet at first blush, they may not serve you best. Because your body has difficulty absorbing more than 500 mg of calcium at a time, more of the mineral may go to waste. So, while you may think that you’ve met your daily requirements by taking that 1,000-mg calcium pill, you may actually be only halfway to your target. Calculate your cost per serving based on how many tablets or chews the package contains, and consider whether you might find it inconvenient to take several tablets a day.

Here are some final tips for choosing and taking calcium supplements as found in the Harvard Special Health Report Osteoporosis: A guide to prevention and treatment:

  • Avoid products made from unrefined oyster shell, bone meal, dolomite, or coral, as they may contain lead or other toxic metals.
  • Don’t exceed the daily dose recommended by the manufacturer—doing so increases the risk for side effects.
  • If you take iron or zinc supplements, tetracycline antibiotics, or levothyroxine (used to treat hypothyroidism), take them several hours before or after takingcalcium to avoid affects potential negative interactions.
  • Make sure you’re also getting enough vitamin D, which helps your body absorb calcium. If you aren’t getting enough from sunlight, your diet, or your multivitamin, you may want to choose a calcium supplement that contains vitamin D.

Which foods don’t belong in a healthy diet?

Keep unhealthy foods to minimum, balanced with nutritious choices

What exactly is a healthy diet? The basics are pretty simple. Everyone needs a mix of proteins, carbohydrates, and fats, plus enough vitamins and minerals for optimal health. But science is revealing that some of the food choices within these categories are better than others.

Go slow on unhealthy foods

Are there foods you never should eat? Not really. If you crave an ice cream sundae occasionally, have a small one. But don’t make it a daily event. Offset the chips you ate at your neighbor’s barbeque with healthier snacks at home. Healthy eating doesn’t mean eliminating certain foods altogether. However, there are some things that are best eaten only rarely.

Harvard nutrition scientists have compiled the following list of unhealthy foods you should keep to a minimum. Research suggests that eating these foods regularly (and to the exclusion of healthier choices) can set the stage for life-threatening illnesses such as heart disease, high blood pressure, diabetes, and even some cancers.

Added sugar. Whether it’s white granulated sugar, brown sugar, high-fructose corn syrup, corn sugar, or honey, sugar contains almost no nutrients and is pure carbohydrate. When you eat a lot of sugar you are filling up on empty calories, causing your blood sugar to rise and fall like a roller coaster, and can keep you from eating foods that with important nutrients and fiber.

Research cites soft drinks and other sugar-sweetened beverages as the primary source of added sugar in the American diet and a major contributor to weight gain. In fact, just one extra 12-ounce can of a typical sweetened beverage a day can add on 15 pounds in a year. That’s not only because the drinks themselves add calories, but also because those liquid calories aren’t as satisfying as solid food.

Baked sweets. Cookies, snack cakes, doughnuts, pastries, and many other treats are hard to pass up, but these commercially prepared versions are packed with processed carbohydrates, added sugar, unhealthy fats, and often salt.

White carbohydrates. Bread, pasta, potatoes, rice, cookies, cake, or pancakes — if you enjoy these foods, opt for whole-grain versions. Yes, you can find or make whole-grain pancake mix. Whole-wheat pastas and breads are luckily easy to find. And you can always make your own homemade cookies or bars using grains such as oatmeal, and less sugar and unhealthy fats.

Processed and high-fat meats. Shun the cold cuts and “pigs in a blanket.” Despite some conflicting reports, the balance of the evidence confirms that processed meats like bacon, ham, pepperoni, hot dogs, and many lunch meats are less healthy than protein from fish, skinless chicken, nuts, beans, soy, and whole grains.

Salt. Current dietary guide lines and the American Heart Association recommend reducing sodium to 1,500 mg per day and not exceeding 2,300 mg per day. But most of us get 1 ½ teaspoons (or 8,500 mg) of salt daily. That translates to about 3,400 mg of daily sodium. Your body needs a certain amount of sodium, but too much can increase blood pressure and the risk of heart disease and stroke.

11 Simple Steps to a Healthier Diet

Do you think eating healthy means you have to radically change your diet and give up all your favorite foods? Think again. Improving your health could be as easy as switching from white to whole-wheat bread, adding a tablespoon of ground flaxseed to your afternoon yogurt, or ordering your favorite coffee drink with skim milk instead of whole. Making little changes to your diet can add up to BIG health benefits.

Here are 11 steps you can take to improve your diet starting today. Do them all if you can.

Healthy Eating Tip No. 1: Switch to 100% whole-wheat or whole-grain bread.

Just switching to whole grains from refined grain products benefits your body about 10 different ways, from lengthening your life span to helping control weight to reducing your risk of type 2 diabetes, heart disease, stroke, and cancer.

Every sandwich made with 100% whole wheat bread instead of white bread, for example, adds about 4 grams of fiber along with an assortment of vitamins, minerals, and phytochemicals.

Healthy Eating Tip No. 2: Use mustard on sandwiches instead of mayo.

Mayonnaise or mayo-based spreads are one of the worst condiment choices because they’re usually high in calories, fat grams, and omega-6 fatty acids.

Every sandwich made with a teaspoon of mustard instead of a tablespoon of mayonnaise, for example, trims 100 calories, 11 grams of fat, 1.5 grams saturated fat, and 7.2 grams omega-6 fatty acids from your daily total.

Healthy Eating Tip No. 3: Make your oatmeal with skim or 1% milk instead of water.

Whether you prefer instant or regular oatmeal, this simple step will boost the protein and calcium in your breakfast. Using 2/3 cup of skim milk instead of water adds 6 grams of quality protein, 255 milligrams (mg) potassium, 205 mg calcium, 14% of the Recommended Dietary Intake for vitamin B-12, and 67 international units (IU) of vitamin D.

Healthy Eating Tip No. 4: Add a little ground flaxseed to yogurt and smoothies.

Do this every time you reach for a yogurt or order a smoothie. Adding 2 tablespoons of flaxseed adds 4 grams of fiber, 2.4 grams of healthy plant omega-3s fatty acids, and some healthy phytoestrogens (lignans) to your snack.

Healthy Eating Tip No. 5: Use spinach leaves instead of iceberg lettuce in salads.

A 4-cup serving of raw spinach leaves has 20 milligrams of omega-3s, 9800 IU vitamin A, 5,890 micrograms (mcg) of beta-carotene, 260 mg potassium, 26 mg Vitamin C, 150 mcg folic acid, 2 mg vitamin E, and 68 mg calcium more than the same-size serving of iceberg lettuce.

Healthy Eating Tip No. 6: Drink unsweetened tea instead of sweetened tea or soda.

A serving of bottled or canned sweetened tea, sweetened tea from a restaurant, or soda has about 140 calories and 32 grams of sugar per 12-ounce serving. Switching to unsweetened tea can save 7,840 calories and 448 teaspoons of sugar per month if you drink about 2 servings of soda or sweetened tea a day.

Healthy Eating Tip No. 7: Order broiled or grilled fish instead of steak when dining out.

Eating fish a couple times a week will pump heart-healthy fish omega-3s into your diet. If the fish replaces a steak, you’ll also be dramatically reducing the amount of saturated fat in the meal.

The typical 8-ounce T-bone steak served at a restaurant (with 1/8-inch trim) has 635 calories, 17 grams saturated fat, and 140 mg of cholesterol – not including any fat added during cooking or as a garnish. The typical 4-ounce broiled salmon filet served at a restaurant has 206 calories, 9 grams fat, 1.4 grams saturated fat, 80 mg of cholesterol and 2.5 grams of omega-3s. Switching to fish trims 16 grams of saturated fat while adding 2.5 grams of omega-3s.

Healthy Eating Tip No. 8: Have pasta with tomato-based sauce instead of white sauce.

Butter or cream-based white pasta sauce (like Alfredo) is loaded with saturated fat and calories. Tomato-based sauce (like marinara) is generally lower-fat and also adds antioxidants and healthy phytochemicals.

Healthy Eating Tip No. 9: Order your sandwich or entrée with fruit or fresh veggies instead of fries or chips.

French fries or potato chips typically come with many of our favorite restaurant entrees. But most of the time you can substitute a side of fruit or fresh vegetables for the fries; you just have to ask for it.

Each time you order a side of fruit or vegetables instead of French fries, you shave around 350 calories and 18 grams fat (5 or more of which are saturated). You’ll also add 3 grams of fiber and an assortment of antioxidants.

Healthy Eating Tip No. 10: Order coffee drinks with skim milk – and skip the whip.

Many people treat themselves to a daily frothy coffee drink in the fall and winter, and when the days turn warmer, they trade in their lattes in for an iced or blended coffee drinks. Ordering your daily coffee treat with skim milk instead of whole lets you keep what’s nutritionally great about milk (good-quality protein, calcium and vitamin B-12) while cutting calories and fat grams. Skip the “whip” the baristas squirt generously on top, and you’ll save even more calories and fat.

A typical 16-ounce mocha latte contains about 360 calories and 19 grams fat, 10 of which are saturated fat. Order it with skim milk and no whip and it’s down to about 220 calories, 2.5 grams fat and .5 grams saturated fat.

Healthy Eating Tip No. 11: Switch your sugary breakfast cereal to a whole grain, lower-sugar type.

If you routinely eat cereal for breakfast, switching to a higher-fiber, lower-sugar variety could have a huge effect on your health.

If you have cereal 5 times a week, choosing a cereal like Post Grape-Nuts Flakes (3.4 grams of fiber and 19% calories from sugar) or Quaker Oatmeal Squares (5 grams of fiber and 19% calories from sugar) instead of a sugary cereal like Froot Loops will give you 17 extra grams of fiber while cutting more than 6 teaspoons of sugar each week.

10 Amazing Health Benefits of Hemp

Superseeds, aptly called because they mimic superfoods in health benefits, include varieties such as:

  • Pumpkin
  • Flax
  • Chia
  • Hemp
  • Sesame
  • Wheat Germ
  • Sunflower

But before you grab your festival attire and vinyls, there’s one glaring misconception we need to clear up before we get into the nutritional benefits of hemp (they do exist!).

Isn’t Hemp Marijuana?

Hemp and marijuana are both Cannabis plants. But that’s really where their similarities end.

Think of hemp as the harder working brother of marijuana. While marijuana’s psychotropic chemical tetrahydrocannabinol (THC) will get you high, hemp holds down a more straight-laced job in the industrial world.

Hemp is a high-growing plant with sturdy fibers perfect for making rope, fiber, and paper.

Hemp is extremely low in THC, which is why eating hemp products won’t get you stoned or make you binge on munchies.

Nutritional Forms of Hemp

Hemp is so versatile it can be added to your diet in four separate ways.

Whole Hemp Seeds

Hemp seeds have been illegal in some countries (due to their relation to marijuana), so they’re often sold as sterilized seeds. Bummer, you can’t plant a hemp garden in your backyard.

While sterilizing does damage some of the hemp seed oil, it doesn’t affect the fiber and protein content.

Speaking of fiber, you know how whole grain breads are better for you and have more fiber than processed and bleached white flour breads?

Well, the same can be said for hemp seeds. Hemp seeds in their hard shells are crunchy sources of insoluble fiber.

So if you’re looking to add more delicious fiber to your diet, crunch on hemp seeds in their shells.

Shelled Hemp Seeds

I prefer shelled hemp seeds not only because they taste better, but because they have higher protein levels than their unshelled version.

One ounce (or 2 tablespoons) of hemp seeds contains 10 g of protein!

Hemp seeds without their shells go by names such as hulled hemp seed, hemp hearts, shelled hemp, and even hemp nut (though it’s not a nut at all).

The hemp heart is a soft seed with a delicate, nutty flavor similar to pine nuts. My favorite ways to eat them are sprinkled in my Greek yogurt parfaits, topping my overnight oats, and added to almond butter dipped apples.

Hemp Seed Oil

Oil made from pressed hemp seeds is high in EFAs. These “good fats” come from long chain polyunsaturated fats.

However, these polyunsaturated fats have relatively low smoke points (lower than olive oil, but higher than flax), which means they can oxidize at high temperatures – something you don’t want.

I wouldn’t cook with hemp seed oil, but it makes a delicious nutty oil for salad dressings. Tip: keep your hemp seed oil in the fridge to prevent oxidation.

Hemp Protein Powder / Flour

If you’re vegan or vegetarian you probably know all about hemp protein.

Hemp protein is made from the leftovers of hemp seed oil pressings.

If there’s less than 35% protein listed on your powdered hemp product, it constitutes hemp flour instead of hemp protein because there’s more fiber than protein. Anything over 35% is considered hemp protein, which is what you want because hemp is a complete protein that contains all of our essential amino acids.

Unlike whey, there are absolutely no animal products or lactose in hemp protein, which makes it a decent option for vegans.

Here are some benefits of hemp seeds.

1. Lowers Bad Cholesterol

DHA and EPA have been proven to lower triglycerides, which is a fat in our blood. Elevated triglycerides have been linked to high cholesterol and heart disease.

Researchers from one study said that:

“Hemp seed oil’s high polyunsaturated fat content — compared to saturated fats — could help reduce people’s cholesterol levels and treat atherosclerosis, or the buildup of materials on the inside of arteries.”

2. Complete Protein Source

Whole hemp seed can be up to 25% straight protein. Like I mentioned before, one ounce (2 tablespoons) of hemp seeds contains 10 g of protein.

Hemp seeds have more protein per ounce than both chia seeds (4.7 g) and flax seeds (5.1 g).

Bonus: hemp seeds are a high quality protein for vegetarians and vegans.

Now, I’m not talking about expensive brands being high quality. Protein quality is based on the concentration of amino acids. As we know, hemp’s amino acid record is stellar.

“Proteins with more complete amino acid profiles are digested and used more efficiently by the body.”

How is this efficiency measured?

Well, one measurement known as the protein digestibility-corrected amino acid (PDCAA) score, is based on the digestibility of each chosen protein source.

A study in the Journal of Agricultural and Food Chemistry discovered that hemp seed protein PDCAA score is “greater or equal to many other vegan protein sources including grains, nuts and certain legumes.”

3. Dairy Milk Replacement

There are many non-dairy milks on the market these days, but they all have their downsides.

Vegans and lactose-intolerant people can’t have dairy milk. If you’re allergic to tree nuts you have to stay away from almond milk. Have a soy allergy? That knocks out soy milk for you.

Hemp milk is a fine alternative.

4. High in Magnesium

Magnesium is considered an essential macro mineral. It’s involved in over 300 enzymatic functions within our bodies, some of which include:

  • Metabolizing food for energy
  • Synthesizing fatty acids and proteins
  • Neuromuscular transmission and activity
  • Muscle relaxation
  • Bone formation and health
  • Anti-anxiety and stress reducer

The recommended daily dose of magnesium is 300-400 mg, depending on age and gender.

One ounce (2 tablespoons) of hemp seeds has 179 mg of magnesium, which equals roughly 45% of your DV.

Final Notes

Although I’ve written about chia seeds more times than I can count, I actually prefer hemp seeds if we’re speaking strictly about taste.

If you’re looking for a delicious way to get more healthy benefits from superseeds, pick up a bag of hemp hearts. Try a tablespoon right out of the package