Dr. Daniel Fabricant: Why supplement? Why not!

People are popping vitamin pills as if it was the most natural thing in the world to do. We take Vitamin A to have good eyesight, so we can see better at night (especially if you’re a night owl). We take Vitamin B (or the B complex family of which there are 11 members) to ease stress (or for anything mind- and mood-related) and reduce our heart disease risk. We reach for our Vitamin C to ward off the common cold, which is really common these days, what with the erratic weather. We take Vitamin D (a.k.a. the sunshine vitamin) to be able to absorb calcium for strong bones and muscles. We take Vitamin E for healthy skin and a healthy sex life (no wonder it’s called the sex vitamin). And the vitamin alphabet goes on.

But the nagging question is: Do we really need all these supplements?  Are you sure the supplements you’re taking are accurately labeled? That all the listed ingredients are really found in the product? That all the ingredients are listed and no dangerous ingredient was omitted? Are you sure the product was manufactured in a clean, pest-free facility?

To answer all these questions and fortify our knowledge of supplements, Healthy Options brings Dr. Daniel Fabricant, Ph.D., executive director and CEO of the Natural Products Association in the US, the largest trade group in North America for natural nutritional-supplement companies. A portrait of good health, the charming and energetic Dr. Fabricant is the perfect walking advertisement for supplement companies. His vast experience in the industry (he once served as director of the Division of Dietary Supplement Programs in the US Food and Drug Administration) makes him the perfect spokesman for supplements. Excerpts from our one-on-one interview:

PHILIPPINE STAR: In a perfect world, we don’t really need supplements. All we need is a balanced diet to get all the nutrients we need for optimum health.

DR. DANIEL FABRICANT: In a perfect world, yes, but it doesn ’t exist. This morning, I came from training the staff of Healthy Options and talking about why supplement. People are always saying you get everything from your diet; that’s not true, nobody does. You just look at the makeup of food worldwide and you see an increase of packaged foods that are rich in refined starches, processed foods rich in carbohydrates but not rich in fiber, vitamins, minerals, and other nutrients we may need. And so, where do you get those from? We see more and more studies on the importance of vitamins, minerals, and other ingredients. Like today, we talked about Vitamin D.

It’s the sunshine vitamin!

You get Vitamin D from the sun, but how many hours a day are you indoors? More and more, you’re seeing good studies that associate optimum Vitamin D levels with better health status.

How important is calcium?

It’s incredibly important, especially as we get older. Once we hit age 50, we can use a lot of calcium. You wanna look for a calcium supplement with Vitamin D to build strong bones — generally about 1200mg calcium a day and 400-1000IUs Vitamin D to start. It’s something people should talk about with their health provider.

 And what’s all this hype about fish oil? Today, a lot of people are taking fish oil.

The Omega-3s in fish oil play an incredible role in cardiovascular health and you’re also seeing it for developing children as it plays an incredible role in the development of the brain.

There are so many good, very strong studies on fish oil. There’s prescription fish oil so it clearly does something. You wanna look at the Omega-3s — a balance of DHA and EPA in a ratio of 3 to 2. Most of the good clinical studies show there’s health benefit in about 1.5 grams a day of DHA and EPA. Here’s where you see a profound healthy effect on cholesterol, or on the different cardiovascular diseases.

What’s the best supplement you can recommend to boost the immune system, which is key to health?

For both adults and children, Vitamin C is the best supplement to boost the immune system. To boost the immune function is a combination of Vitamin C, zinc, and echinacea using the species purpurea.

People are also talking about CoQ10 (Coenzyme Q10). How important is it?

CoQ10 is really important for your metabolism, it’s involved in a lot of biological functions. These days, a lot of people use statin drugs and one of the things they do is they deplete your CoQ10, which may affect your level of energy. So, if you’re taking statin, you should have your doctor look at CoQ10.

There’s also alpha lipoic acid, which we don’t get a lot of because it’s from sources like liver, but it’s got a lot of good effects on metabolism and for the skin and healthy aging.

L-Carnitine is also important for metabolism, especially if you’re active or if you don’t eat well.

Is there an anti-aging supplement you can recommend?

Antioxidants are one of the things people should look for in terms of healthy aging. It’s not just Vitamins A, C, and E, but others like L-Carnitine. There are a lot of popular ingredients.

Is there a supplement for every age or stage in one’s life?

As you age, your nutritional needs differ. If you’re expecting to get pregnant, you probably need more iron, more folic acid. You may not  need as much of that as you grow older, but you may need additional calcium and additional Vitamin D. Those are the sorts of things you look at — the mineral balance, etc. If you really look at your diet, honestly, how many servings of fruit and vegetable are you getting? Once you do that, you can see where some of the gaps are and start to address them. If you don’t like fish unless it’s deep fried, you’re not gonna get Omega-3 so it’s important to really look at your diet and have a talk with your health care provider or somebody who’s knowledgeable.

For somebody just starting to take supplements, what would you recommend?

I think you would need everything because food is not as nutrition-rich as it used to be, so you should probably start with a multivitamin or a multimineral, especially if you’re active and you tend to lose water-soluble vitamins and some minerals, which are important for metabolism, muscular function, and also for sleep.

Who’s healthier — Filipinos or Americans?

It’s amazing to see some of the parallels with nutrition in the US and the Philippines — very, very similar. I think both Americans and Filipinos don’t eat the recommended five servings of fruit and vegetable today. In the 2013 CDC study, on average, Americans get 1.6 servings of vegetable a day and only 1.1 servings of fruit. So, where are people going to get their nutrition from if they don’t have time to make meals, we’re always on our cell phones, we work longer hours, we don’t have time to prepare meals?

What supplements do you take?

I take a multivitamin, multimineral, a probiotic, which helps my digestion. My kids and I take the same one. I use fish oil as well and I take extra magnesium and extra zinc. I take anywhere from six to eight pills a day.

Some people take as many as 30 pills a day. Is that too much?

No, no! They can be appropriate, things like fiber. If you don’t eat fruits and vegetables, you may not be getting fiber in your diet. Fiber is incredibly important for the intestinal as well as your cardiovascular system. You should get three to five grams a day of soluble fiber, that’s about 10 capsules, so it’s not uncommon for people to be taking so many supplements.

Can you overdose on vitamins?

Too much of anything is not good. We can overdose on water, on salt. That’s why you have to talk to a health care practitioner, talk to knowledgeable retailers, look for manufacturers who are transparent.

But if you can have only one supplement, which one should it be?

There’s no magic pill. Look at your fish consumption, Omega-3 is important, calcium, multivitamin and multimineral are important especially if you eat a lot of junk food. You need more things like fiber because you’re not getting it from your diet.

There have been reports of fake ingredients, false claims, mislabeling in supplements. How can we be sure we’re getting the right supplements?

I was with FDA and when I was there, we took action against those firms. I think the first place you go to is a reputable retailer, people like Healthy Options, really someone who has a knowledgeable staff. They’re getting questions from consumers 24 hours a day — what do I use, why is this a quality product? — and they gotta have answers to those questions; they screen manufacturers, making sure the products are good manufacturing practice-compliant and they have those quality standards in place. People buy things in a lot of different channels these days, they buy off the Internet. But if they buy from stores like Healthy Options, they get a lot more information; it’s a different experience and it’s also a different level of commitment.

Also, talk to your health care practitioner, and ask why you’re using what you’re using. If you’re pregnant, if you’re hypertensive, those sorts of situations, you wanna have a good talk with your physician. More and more, you’re seeing physicians use registered dieticians in their practice because they know people don’t eat a balanced, healthy diet because they don’t have time.

How long do you want to live?

(Laughs.) I don’t want to live forever. The focus should be not on how long but on how healthy. Healthy aging is key. We have more demands on our time, so convenience is key these days and you gotta have a way to bridge the gaps.

On that healthy note, we end our interview with Dr. Fabricant. And as he briskly walks away to his next appointment, I can only say to everyone, “Fish (oil) be with you!”