Super Supplements

Gain a Nutritional Edge from Vitamins and Minerals

Stroll down the vitamin and supplement aisle at your local supermarket, drugstore, or health food store. You'll find neat rows of products?everything from multivitamins to Geritol, garlic to hawthorn, assortments of antioxidants, and bottles upon bottles of specific vitamins, minerals, and herbs. Contents measured in RDAs, DVs, IUs, milligrams, and micrograms.

Whew. Sorting through all this stuff is a lot like trying to do your taxes without the instruction book (or, for that matter, with the book). The names and numbers are all there, but how do you put it all together? How can you concoct a regimen that puts all the B₆s, B₁₂s, coenzymes, and a lot of things you've never heard of into a protective package to reduce your risk of heart disease, cancer, and stroke?

Over-60 Supplements

"Some studies suggest that specific vitamin and mineral supplements can help reduce your risk of heart disease by up to 30 to 40 percent and even slow the disease's progress," says Jeffrey Blumberg, M.D., associate director and chief of the Antioxidants Research Laboratory at the U.S. Department of Agriculture Human Nutrition Research Center on Aging in Boston.

It involves nothing more fancy than over-the-counter supplements. They're relatively inexpensive, and some of them may go a long way toward cutting high blood pressure and stopping the blood clots that lead to strokes.

Vitamins can boost the immune system, which is important in battling cancer cells. The bottom line: "Older people who take vitamin and mineral supplements have stronger immune systems," says John Bogden, Ph.D., professor of preventive medicine and community health at the New Jersey Medical School in Newark. "Generally, the immune system starts to decline around age 50 and may already be compromised by age 60." If your immune system can't protect you, the door is wide open for cancer and other diseases.

But it doesn't have to be this way. When researchers in Italy looked at healthy 100-year-olds, they made a surprising discovery?immune systems so strong that they could easily have belonged to people 80 years younger. "That's probably why these people got to be 100-plus. Their immune systems never deteriorated," says Dr. Bogden.

Supplements will help strengthen the immune system, but they don't work miracles. "While supplements are cheap, easy to take, and?in many cases?beneficial, they're not magic bullets," says Dr. Blumberg. "They're supplements, not substitutes for healthy eating."

You can't do the bacon-and-eggs, burgers-and-fries routine, pop a pill, and think that everything will be fine. Still, researchers estimate that up to one-third of older adults may not be getting enough important vitamins and minerals through diet alone.

Pop a Pill to Prevent Disease

You get the benefits of a vitamin supplement if you are over 55, although your system may not really register the improvement for six months to a year. That's not an excuse to procrastinate. As you get older, getting the nutrients that you need?through a combination of diet and supplements?becomes increasingly important to shore up your body's defenses, says Dr. Bogden. Here's how supplements help.

Keep low-cal eating low-risk. It's a catch-22 situation: Take in too many calories and you don't want to face the bathroom scales, let alone the extra risk of cancer, heart disease, and stroke. But if you try to lose weight (or maintain the weight that you have) by cutting calories, you may end up low on vitamins and minerals and high on risk, especially if you make poor food choices, unless you add key vitamins and minerals through carefully chosen supplements, explains Dr. Bogden.

Dietitians at Utah State University tried to create balanced diets of less than 2,200 calories?probably close to the number of calories you take in. They found it nearly impossible to do that and meet the recommended daily amount of important vitamins and minerals.

Sidestep the slowdowns. As you get older, a lot of your body's systems seem to shift into semi-retirement. They just slow down and work less efficiently. The right supplements help compensate. For instance, you just don't have as much of the beneficial stomach acid that helps your system get what it needs from your food. That means that up to 40 percent of the nutrients you take in may go unused. You're likely to be low in such protective components as vitamins D, B₆, B₁₂, riboflavin, folate (the natural form of the supplement folic acid), and calcium.

Your body's system for storing the nutrients that you take in isn't what it used to be either. That's because your percentage of body fat increases with age, notes Sharon Miller, Ph.D., associate dean of the College of Health and Human Sciences at Northern Illinois University in DeKalb.

Bypass the by-products. "The body's metabolism keeps you alive and healthy, but it also produces harmful by-products. It's very much like the fire that gives you warmth?along with the unpleasant smoke," says Richard Cutler, Ph.D., president, chief executive officer, and scientific research director at Genox in Baltimore, where he specializes in antioxidant research.

The body's "smoke" includes free radicals and other compounds that damage the cells' DNA and lead to many of aging's effects. Your body makes antioxidants to fight off these substances. As you get older, production levels drop, probably because your metabolism slows with time.

It becomes harder and harder to get enough antioxidant protection from food alone. Supplements can make big contributions to the cause.

The Must-Have Micronutrients

Some researchers think that deficiencies in the diet pave the way for heart disease, stroke, and cancer. Many experts believe that an extra dose of key vitamins and minerals?often difficult to get through diet alone?provides maximum protection from the killers.

Listed below are two kinds of guidelines for vitamin and mineral consumption. The Daily Values are the U.S. government's general guidelines for basic daily nutritional needs. Also listed are recommendations for protection offered by the doctors who were interviewed in this chapter. You can get most of these nutrients in a multivitamin. But you may want to take extra supplements of some vitamins and minerals to promote optimum health, says Dr. Blumberg. Regardless, always keep your doses within the recommended range?some vitamins and minerals are toxic when taken in large doses, he cautions.

Vitamin A/Beta-carotene: For All-Purpose Protection

Daily Values: Vitamin A, 5,000 international units; beta-carotene, no Daily Value

Experts recommend: Keep to the Daily Value of vitamin A. Six to 20 milligrams of beta-carotene.

Is a multivitamin likely to contain enough? Vitamin A, yes; beta-carotene, no

Multivitamins may contain vitamin A, beta-carotene, or a combination of the two. To the body, beta-carotene and vitamin A are one and the same. But experts note that it's safer to take beta-carotene. That's because the body stores beta-carotene and converts it into vitamin A whenever it needs it. Vitamin A stays in the system. Too much can damage your liver. An excess of beta-carotene will turn your skin orange.

You can get the recommended levels by adjusting your diet instead of popping a pill. "You can get the equivalent of the Daily Value of vitamin A just by eating a carrot a day," says James Goodwin, M.D., director of the Center on Aging at the University of Texas Medical Branch in Galveston.

Heart disease. Beta-carotene keeps the harmful low-density lipoprotein (LDL) cholesterol from getting a grip on artery walls.

In the Harvard Physicians' Health Study, doctors with heart disease took 50 milligrams of beta-carotene on alternate days for six years?and had one-half as many fatal heart attacks and angioplasties.

Stroke. The Harvard study also showed that the doctors who took beta-carotene had half as many strokes over the six-year period.

Cancer. Vitamin A contributes to the body's first line of defense against bacteria and viruses by maintaining the protective mucous membranes that line the digestive, respiratory, urinary, and reproductive tracts. It also produces the bacteria-fighting chemicals in tears, saliva, and sweat.

In one study smokers with precancerous oral lesions took 30 milligrams of beta-carotene for eight weeks. Seventy percent of their lesions stopped growing or actually got smaller.

In a study conducted in Linxian, China, the diets of 30,000 people ages 40 to 69 were supplemented with either a placebo or different combinations of vitamins and minerals in doses one to two times the U.S. Recommended Dietary Allowances. After five years of daily supplementation, those taking a beta-carotene, vitamin E, and selenium combination saw their rates of cancer death drop by 13 percent.

If you take a supplement. "I want to be alone," said Greta Garbo. Well, beta-carotene doesn't. It needs the company of a little fat to get into your system, since it's a fat-soluble nutrient. Take it with a meal or snack.

Monitor Your Medications

If you are on medication, check with your doctor about whether you should take supplements. Some vitamins and minerals can interfere with your body's ability to use certain medicines, says Jeffrey Blumberg, M.D., associate director and chief of the Antioxidants Research Laboratory at U.S. Department of Agriculture Human Nutrition Research Center on Aging in Boston.

This clash can work in reverse, too. Some drugs may make vitamins pass through your system more quickly than they should?or stick around too long.

So if you're taking medicine, especially those listed below, ask your doctor whether you need to increase or decrease your intake of vitamins and minerals, advises Dr. Blumberg.

The B vitamins: Key Players for Protection

Daily Values: Vitamin B₆, 2 milligrams; vitamin B₁₂, 6 micrograms; folic acid, 400 micrograms; niacin, 20 milligrams; riboflavin, 1.7 milligrams; pantothenic acid, 10 milligrams

Experts recommend: Vitamin B₆, 2 to 10 milligrams; vitamin B₁₂, 2 to 10 micrograms; folic acid, 400 to 800 micrograms (some experts maintain that 400 or more micrograms of folic acid can interfere with your body's ability to use zinc). Stick to the Daily Value levels for niacin, riboflavin, and pantothenic acid.

Is a multivitamin likely to contain enough? Yes.

Getting older usually means ending up with lower levels of the protective B vitamins. It just becomes harder for the body to get them in and use them. If you're a vegetarian, you're probably particularly low on vitamin B₁₂, since it's found primarily in animal products.

Heart disease. "We see evidence that folic acid and vitamins B₆ and B₁₂ reduce heart disease by 10 to 25 percent, and since heart disease is a major disease of aging, it's important that older people get enough," says Dr. Blumberg.

Low levels of the B vitamins could saddle you with high blood levels of homocysteine, increasing your risk for heart disease and heart attack. "The relationship of high homocysteine levels to low levels of the B vitamins, particularly folic acid, is quite clear," says Dr. Blumberg. Homocysteine is also poisonous to your cells.

Riboflavin powers up folic acid and vitamin B₆. Niacin probably protects against heart disease, but experts caution against taking more than the Daily Value. In experiments, very high amounts of niacin raise the beneficial high-density lipoprotein (HDL) cholesterol levels, but they can also cause liver damage and worsen stomach ulcers, diabetes, and arthritis.

Cancer. Studies of older adults show that low levels of vitamin B₆ depress the immune system. Fortunately, the system gets back in gear when it gets more B₆.

The high levels of folic acid can protect you against cervical and colon cancer, possibly by keeping both tissue growth and DNA (your cells' genetic material) production normal and healthy.

If you take a supplement. Don't exceed recommended levels. Megadoses of vitamin B₆ can cause nerve damage.

Vitamin C: See a Longer Life

Daily Value: 60 milligrams

Experts recommend: 250 to 1,000 milligrams

Is a multivitamin likely to contain enough? No.

Some researchers believe that the added boost from vitamin C supplements can give men six more years of life and women an additional two years.

You can get protective levels of vitamin C from foods or supplements. One 8-ounce glass of orange juice, for example, contains 100 milligrams.

Studies show that as you get older you absorb vitamin C less easily. To counteract this, Dr. Blumberg says that it is advisable to take vitamin C at doses higher than the Daily Value. Men probably need at least 125 milligrams a day and women around 75 to 80 milligrams a day.

Heart disease. High levels of vitamin C generally accompany highs in the beneficial HDL cholesterol levels and lows in the harmful LDL cholesterol and triglyceride levels. In a 10-year study men who consumed 300 milligrams of vitamin C per day (partly from supplements) had almost half the death rate from heart disease as those who took less than 50 milligrams a day.

Stroke. Since vitamin C helps keep arteries clear of the LDL that clogs and narrows them, it leaves you less vulnerable to strokes.

Cancer. Vitamin C seems to prevent cancer-causing agents from getting down to business. It keeps certain cells from mutating and scarfs up free radicals.

If you take a supplement. You can lose the benefits of vitamin C if you smoke or breathe in secondhand smoke. You'll need at least 100 milligrams of vitamin C a day to help replenish your supply.

Both natural and synthetic vitamin C are equally effective, though chewable vitamin C may damage your tooth enamel.

Don't over-supplement; you may end up with diarrhea. Taking too much could lead to kidney problems. Plus, very large doses may keep your body from absorbing copper, an important immune-system protector.

Vitamin D: Direct from the Sun

Daily Value: 400 international units (10 micrograms)

Experts recommend: 400 international units (10 micrograms)

Is a multivitamin likely to contain enough? Yes.

To get vitamin D, you need to go outdoors and get into the light?both window glass and sunscreen block the signals that tell your system to start the production of vitamin D. As you get older, your skin becomes less able to synthesize vitamin D from sunlight. And it is harder for your body to convert vitamin D into its active form. Some studies suggest that between one-half and three-fourths of all older people get less vitamin D than what they need.

You can also stock up on vitamin D with fortified milk (especially during the winter months if you stay indoors).

But don't overdo it if you're taking supplements. High levels of vitamin D can be toxic, and anything over 400 international units should be taken only with a doctor's supervision.

Vitamin E: Leader of the Pack

Daily Value: 30 international units

Experts recommend: 100 to 400 international units

Is a multivitamin likely to contain enough? No.

Vitamin E is emerging as the quarterback in the game of protection, but few Americans get more than 6 to 12 international units in their diets, well below the Daily Value. "It's incredibly difficult to get enough vitamin E. The biggest source in the American diet is mayonnaise, followed by potato chips?foods that you want to stay away from," says Dr. Goodwin. You get the most vitamin E from eggs and oils, also troublesome foods in today's low-fat world.

Heart disease. In study after study, vitamin E protects against heart disease, partly because it seems to go with the flow, traveling alongside the LDL cholesterol in the bloodstream to help ambush it before it can clog arteries.

In one study, researchers looked at the diets of more than 87,000 nurses between the ages of 34 and 59 and followed their eating habits for eight years. They found that those who took at least 100 international units of vitamin E a day for two years had 36 percent fewer heart attacks than those who did not supplement their diets. Scientists have also found that vitamin E actually helps slow the development of heart disease in cardiac patients by reducing the size of lesions.

Stroke. Vitamin E can help keep your blood from clotting and sticking to artery walls. In an East Carolina University Medical School study, 52 people who had experienced small strokes, or transient ischemic attacks, took aspirin (the standard treatment) plus 400 international units of vitamin E. After two years, it turned out that this group had 25 percent fewer strokes than people in a control group who just took aspirin.

Cancer. Some researchers theorize that, as you get older, your body produces prostaglandin E₂ (PGE₂), which interferes with the infection-fighting T cells. Vitamin E reduces PGE₂ levels and jump-starts the immune system.

At the U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston, people ages 62 to 70 took 800 international units of vitamin E for 30 days?and ended up with improved immune responsiveness.