The case against nutritional supplements

Here is a hyperlink with slides from the talk I gave today at the Ancestral Health Symposium 2013 in Atlanta.  I will upload a video of the talk once the organizers make it available.  Until then, you can click on the “Link to audio recording”  to listen to a recording that one of the conference attendees made and posted on YouTube.   The sound is a bit faint, but still audible, and should make the slides more intelligible.

Todd question AHS2013 - Copy

This presentation is based on material from several previous blog posts

The talk includes some new material not covered in those previous posts, in particular addressing antioxidant recycling, supplementation of calcium and the essential fatty acids EPA and DHA.  I have also provided a list of references of supporting studies and literature in the final 3 slides.

I enjoyed meeting many new faces and recognizing old ones at this year’s AHS.

 

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8 Comments

  1. aerobic1

    Todd:

    Excellent presentation, thank you.

    The dose-response curves of hormetins show the potential for benefit effect of exogenous agents at lower intake levels and an adverse effect at higher intake levels. I understand the concept. How do we relate this effect to actual intake amounts of those agents? I too am skeptical of exogenous antioxidant substances, particularly at high doses as they, at some point, become prooxidant and likely cause defective autophagy.

    Reply
    • Todd

      Yours is the 64 dollar question. Ideally, we would consult dose response curves before consuming a hormetic compound or engaging in a hormetic activity like exercise in fasting. In practice, the data collected in a lab is an average for some highly controlled population of animals, plants or microbes. Not many experiments of this type are ever performed on humans, so there is just not much published data we can use for dosing compounds like curcumin and alcohol, much less activities like lifting weights or cold showers.

      Add to that the fact that all of us differ in our biological tolerance to different compounds. Some of this is genetic (e.g. we have different levels of detoxification enzymes like alcohol dehydrogenase) and some is experiential, based on our prior exposure to hormetins. So each of us will have a different dose-response curve, and it probably changes over time.

      The best I can suggest is self-experimentation. Start with a low or modest level and frequency of the hormentin and observe the effects on your functional performance and certain biomarkers of health or fitness. Some have suggested that wearing a heart rate monitor and measure HRV (heart rate variability) is a good way to get a picture of the short term impact of some intervention (diet or exercise) on your health.

      This is a very interesting topic and one I’m actively exploring. Would love to hear suggestions.

      Todd

      Reply
  2. aerobic1

    From a free radical point of view, measuring SOD and Glutathione levels may offer clues as to effectiveness of hormetin efficacy. Low levels of these endogenous antioxidants should improve with optimal levels of hormetin intake. One would need an assay to determine their baseline and then follow-up assays as the level of hormetins are increased. Once the SOD and GSH begin to decline with increased intake may indicate one has passed the optimal intake level and is on the downside of the dose-response curve.

    Oxidative stress assays such as TBARS (thiobarbituric acid reactive substances) which is direct measure of lipid peroxidation may be another useful tool. It could be applied in a similar manner to the above SOD and GSH.

    I use recovery time from strenuous physical exercise as a marker for dose-response physical stress. Too hard, or too long of duration will exacerbate tissue damage and stall recovery time. This is very subjective but works well if one knows their physical capability and is in tune with how they feel.

    Reply
  3. Oliver

    Todd, without a perfect diet i.e. strict paleo (say you were eating mostly non-organic animal meat and fish, complex carbs such as potatoes/rice with each meal, and a “okay” amount of veggies per day + some dairy products and a a couple cheatmeals per week/eating out) so “healthy” but not “perfectly primal” does your general thesis on the use of certain supplements change?

    I’m just trying to find some balance here since context is everything. When you give advice regarding certain supplements you seem to do so from the context that “everything else is perfect” rather than “pretty good considering how busy you are”.

    Reply
    • Todd

      Oliver,

      You are correct that “context is everything”; the value or harm from supplementation depends upon the context of diet, general health, and genetics. The studies out there give us at best the average effects on study populations that are typically composed of diverse individuals. So what they tell us about a group may or may not apply to you specifically.

      The general point of my blog post is that the purported benefits of most nutritional supplements (reduction in oxidative stress, strengthening of bone bass, hormonal balancing) are better addressed by attending to diet and exercise — and without the risks of down-regulating your in-built defenses. If your diet and exercise are not “perfect” but still mostly based on non-inflammatory whole foods, and you are physically active — then you are probably better off without supplements. Supplements are useful mainly if you need to redress an acute deficiency, if you are ill, have an infection, are pregnant, or have special athletic goals. You can always check your status with blood tests, but I would pay more attention to your functional health (i.e. your energy, strength, fitness, quality of sleep, etc.) than blood levels. If you are going to supplement, I would think about doing so only intermittently or for relatively short periods of time (months), rather than as a daily routine for the rest of your life.

      I realize this answer may not be very definitive, but it is hard to give you an absolute answer. The studies on supplements are themselves not definitive or consistent. So to some extent you have to rely on an understanding of what “health” means. Is health merely a set of numbers, and freedom from overt illness or — as I believe — a functional state of strength and resilience: the ability to take on life’s challenges without being “propped up” from artificial interventions like medications, supplements, immune boosters and suppressors, eyeglasses, and all manner of human inventions that promise immediate relief at the cost of sapping our longer-term fortitude?

      Todd

      Reply
  4. Cu Chulainn

    hello Todd,
    i know you praise Art De Vany, who swears by glutathione supplementation–

    http://www.artdevanyonline.com/1/post/2012/09/the-free-radical-theory-of-graying.html

    any comments on this? this is the product he uses:

    http://www.glutathionescience.com/glutathione_science_019.htm

    thanks for your work.

    Reply
    • Todd

      Hi Cu,

      I do agree with DeVany on the key role that gluthione plays in combatting oxidative stress. But rather than taking exogenous glutathione, I would prefer to focus on how to improve your ability to recycle and “recharge” your glutathione levels, particularly intracellular levels. Glutathione is most effective when it is at the right place, at the right time, at the right level. (In fact, excess antioxidant levels in the wrong place can interfere with the positive role that oxidation plays in intracellular signaling and muscular activity).

      DeVany himself is eloquent on this point in another of his posts on glutathione:
      http://drknews.com/glutathione-recycling-for-autoimmune-disease/

      “Glutathione recycling is a separate function from just boosting glutathione levels through a liposomal cream, intravenously, a nebulizer, a suppository, or other means. These forms of glutathione delivery will help one’s antioxidant status but they do not raise levels of glutathione inside the cells.”

      Glutathione is “recharged” by chemically reducing it — adding back hydrogens. This is done via the enzyme glutathione reductase. And how is that done? The best way is to be sure your diet includes Nrf2 activators, principally phytonutrients typically found in plants, just as I advise in my post on “The case against antioxidants“. DeVany also recommends this:

      “Fortunately studies also show various botanicals, nutritional compounds, and their cofactors have been shown to activate glutathione reductase and the synthesis of reduced glutathione.”

      Among the phytonutrients he recommends are cordyceps, gotu cola, and milk thistle. I would highlight others such as curcumin, and sulforaphone found in cruciferous vegetables.

      Todd

      Reply
  5. Cu Chulainn

    thank you. interruption of taking De Vany’s product (Guardian) did led to premature greying, which supports your argument. do you have any suggestions on how such damage (De Vany article above, free radical theory of graying) might be reversed, by analogy with your other hormetic approaches e.g. myopia? grey hair does seem to be an accurate indicator of overall oxidative damage.

    Reply


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