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Health

The right supplements for you

Vitamins can heal – or harm. Here's the inside scoop on supplement safety
By Denise Dalhousie; With additional research by Abby Blinch

The right supplements for you

Pop the right vitamins and you'll slash your risk of developing cancer, heart disease and a host of other disorders, right? Well, yes, supplements can go a long way, but they're not always straightforward. Take vitamin E supplements? Well, maybe you shouldn't. A study published in the Annals of Internal Medicine found that taking 400 iu or more of vitamin E daily – a once-touted cancer fighter that is considered safe at this level – might in fact shorten rather than prolong people's lives. And it turns out that while antioxidants (such as beta carotene and vitamins C and E) go after cell-damaging free radicals in the body, consuming too much of any antioxidant can negate its effect.

Tempted to shelve the supplements you were confidently taking yesterday? Don't give up on them yet. The trick is to tailor what you're taking to your age, eating habits and overall health (including any prescriptions you're on), says Susan J. Whiting, a nutrition and dietetics professor at the University of Saskatchewan in Saskatoon. Most experts agree, for instance, that for women of childbearing age a daily multivitamin with iron can provide a good base for just pennies a day. Be cautious about taking specific supplements because exceeding recommended amounts can cause real harm, says A. Venketeshwer Rao, a professor of nutritional sciences at the University of Toronto. To help you figure out what to take, we've consulted with experts to come up with the safest supplements for women.

Use the drop-down menu to craft your own personalized supplement plan. Always ask your doctor or a registered dietician for the final nod on what's right for you.

Are you:


Vegetarian or vegan
Vitamin(s) needed
· Vitamin B12
· Iron

What to eat
· Foods fortified with B12
· Soy products
· Legumes and beans

What to take
About 2.4 grams daily. Consider B12 an energy booster – a deficiency can cause anemia, fatigue and weakness.

Over 50?
Vitamin(s) needed
· Vitamin B12
· Calcium and vitamin D

What to eat
· Milk and dairy products
· Fortified soy beverages
· Canned salmon with bones
· Fish
· Poultry
· Meat and eggs

What to take
1,200 milligrams of elemental calcium if you're over 50. Opt for a supplement that includes 400 iu of vitamin D.

For optimal effect, split calcium supplements into morning and evening doses

About 2.4 grams Vitamin B12 daily. Consider B12 an energy booster – a deficiency can cause anemia, fatigue and weakness.

Not eating much low-fat dairy?
Vitamin(s) needed
· Calcium and vitamin D

What to eat
· Milk and dairy products
· Fortified soy beverages
· Canned salmon with bones

What to take
About 1,000 milligrams of elemental calcium from food or supplements every day; closer to 1,200 milligrams if you're over 50. Opt for a supplement that includes 400 iu of vitamin D.

Don't eat much fish?
Vitamin(s) needed
· Omega-3 fatty acid

What to eat
· Salmon, mackerel, herring, trout, sardines
· Canola and flaxseed oils
· Omega-3 eggs

What to take
At least 800 - 1, 000 milligrams a day of omega-3 from a fish-oil supplement.

Family history of heart disease?
Vitamin(s) needed
· Vitamin B12
· Vitamin C
· Omega-3 fatty acid

What to eat
· Green peppers
· Broccoli
· Citrus fruit (especially oranges)
· Cantaloupe
· Canola and flaxseed oils
· Dairy products
· Fish
· Poultry
· Meat and Omega-3 eggs

What to take
At least 800 - 1, 000 milligrams a day of Omega-3 from a fish-oil supplement.

About 2.4 grams Vitamin B12 daily. Consider B12 an energy booster – a deficiency can cause anemia, fatigue and weakness.

About 75 milligrams Vitamin C, preferably from food.

Smoker
Vitamin(s) needed
· Vitamin C

What to eat
· Green peppers
· Broccoli
· Citrus fruit (especially oranges)
· Cantaloupe

What to take
At least 100 milligrams, preferably from food.

Under 50
Vitamin(s) needed
· Folate or folic acid

What to eat
· Green vegetables
· Beans
· Peanuts
· Asparagus
· Oranges
· Papaya
· Avocado
· Enriched wheat flour

What to take
400 micrograms every day, either in food, as a multivitamin or in a separate supplement.

Pregnant
Vitamin(s) needed
· Folate or folic acid
· Iron

What to eat for folate
· Green vegetables
· Beans
· Peanuts
· Asparagus
· Oranges
· Papaya
· Avocado
· Enriched wheat flour

What to eat for iron
· Clams
· Beef
· Shrimp
· Fish
· Tofu
· Legumes

What to take
Pregnant women need 600 micrograms, either in food, as a multivitamin or in a seperate supplement and 27 milligrams of iron.

Your supplement glossary
Folate (or folic acid, in synthetic form)
This B vitamin is essential for healthy cell division.

A deficiency during the first trimester of pregnancy can lead to neural tube defects (such as spina bifida) in the baby. Bonus: studies link folic acid to a reduced risk of colon and cervical cancers and stroke.

Omega-3 fatty acid People who eat five or more servings of omega-3-rich fish – think salmon, mackerel or herring – a week have about a 40 per cent lower risk of dying from heart disease, says Bruce Holub, a professor of nutritional sciences at the University of Guelph in Ontario. Yet few North Americans eat more than one serving a week.

Calcium and vitamin D These work together to keep bones strong and prevent osteoporosis. "If you're not drinking four glasses of milk a day, particularly if you're over 50, you need a calcium supplement," says nutrition professor Susan Whiting. But don't exceed 2,500 milligrams of calcium daily – this can cause constipation and potential kidney damage. Most of us aren't getting enough sunlight, so we need vitamin D supplementation to help absorb calcium, too.

Vitamin B12 This nutrient affects almost every cell in the body. Along with vitamin B6 and folate, it may also help lower levels of heart-damaging homocysteine in the blood. Large amounts of vitamin B12 are stored in the body, so you can go for some time without consuming any, but as we age, we become less efficient at absorbing it from food. A blood test can determine this deficiency.

Vitamin C Vitamin C-rich fruit and vegetables protect against coronary heart disease, according to researchers at Harvard University in Boston.

Ones worth watching
More research needs to be done, but the following nutrients look promising. Always check with your doctor before trying something new.

Phytonutrients Found in fruit and vegetable skins and in supplements such as Greens+, these plant chemicals appear to have powerful antioxidant effects. They may play a role in preventing some cancers and help slow brain aging. Plus, says Rao, they seem to boost the immune system.

Eat bright foods, including tomatoes, berries, red cabbage, red onions, broccoli, parsley, garlic, soybeans, spinach and green tea, to get some of the best sources of phytonutrients.

Coenzyme Q10 Used as a treatment for cardiovascular disease in some countries, initial studies suggest that Q10 may help improve symptoms of heart disease, slow Parkinson's disease and enhance cancer treatment. Our levels of Q10 tend to decrease as we age, but it's not clear whether that means we should take supplements.

It's found in lean beef, soy, mackerel, sardines and peanuts.

Selenium Several studies suggest that high levels of this antioxidant may protect against prostate cancer. The recommended intake of 55 micrograms is easily obtained by eating a healthy diet, including tuna, Brazil nuts, shellfish, poultry and eggs, or by taking a supplement.

Ones to avoid
Health Canada's Natural Health Products Regulations came into force in January 2004. Until then, not all natural health products were uniformly reviewed for safety, quality and health claims. "People think if it comes from a plant, it's not dangerous, and that's not true," says Theresa Glanville, a nutrition professor at Mount Saint Vincent University in Halifax. "When you take herbal supplements, you don't know what the combination of active ingredients is." In fact, herbals can be as powerful as – and interfere with – prescription medications, says Heather Boon, an assistant professor in the faculty of pharmacy at the University of Toronto. Yet few people tell their doctors they are taking herbal supplements – a dangerous practice, especially for pregnant women. Talk to your physician and, in the meantime, steer clear of the following.

Aristolochic acid, found in some traditional Asian remedies for colds and allergies, has been linked to permanent kidney damage, kidney failure and certain cancers.

Comfrey has been associated with sometimes irreversible liver damage, according to Health Canada. It's found in some herbal and homeopathic remedies for digestive problems, arthritis, ulcers and other conditions.

Weight-loss products containing ephedra (also know as ma huang) and caffeine are not approved for sale in Canada, but black-market sales are still widespread. Ephedra can trigger heart palpitations and has contributed to at least one death in Canada.

Kava, promoted as an aid for anxiety, insomnia, pain and muscle tension, has been linked to liver damage. Health Canada issued a recall on all products containing kava in 2002, but Boon says they may reappear when manufacturers reapply to sell them under the Natural Health Products Regulations.

Are you:

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