Just alone in the United States of America, more than half of the population take some form of supplement, spending more than U.S.$20 billion a year in an effort to help maintain good health and well-being. Around the world, more and more people are reaching to vitamin supplements to attempt to better their health.But how do consumers know that they’re spending their money on the right supplements and using them in the right dosages?

According to Edward C. Geehr**, M.D.,a member of the National Scientific and Medical Advisory Board of LifeScript, a leading provider of personalized nutritional supplements, there are certain questions consumers should ask themselves before starting a supplement program. Although most individuals can benefit from a well-designed supplement program, there are important things to consider when making decisions about supplements. Here is his list of some of the more important questions you should be asking before you begin taking supplements.

* Do I even need nutritional supplements?

Be informed before taking vitamin supplements

There is no substitute for a well-rounded diet. Whole foods contain protein, energy and fiber that are difficult to obtain from supplements alone. Balance is the key. A good diet, coupled with a well-designed supplement program, can satisfy the dietary requirements of most people. For those on a restricted diet, however, such as vegans, athletes, body builders or dieters constantly trying to lose weight, supplements may be essential for good health. Restricted diets also diminish nutrients intake. Supplements can help fill in the nutrient gaps in diets such as these.

* Am I taking supplements to try to treat a disease or illness?

You should never treat yourself for a disease or illness with supplements. There is little or no conclusive evidence that supplements are beneficial for many serious medical conditions. Those with chronic diseases or taking prescribed medications should discuss their medical condition with their physician before taking supplements to avoid potential serious drug interactions and harmful side effects.Having said that, it is important to note that there is an emerging body of evidence suggesting that some vitamins and herbal preparations may be useful for managing certain conditions. Talk to your doctor or dietitian to get the most up-to-date and accurate information about promising dietary supplements for certain medical conditions.

* Are the supplements and the quantities I’m taking right for me?

Its always best to consult with an expert before beginning a regimen of supplements. Registered Dietitians, Certified Nutritional Specialists and physicians are all well qualified to review your diet and make supplement recommendations.

* Does it matter if my supplements are natural?

There appears to be little difference between synthetic and naturally occurring vitamins. Natural vitamins are no more effective at delivering nutrients than synthetic ones and may be much more expensive. Herbal preparations are usually naturally derived, although it may be difficult to determine the actual content or purity of the active ingredients. The most important factor is the quality and reputation of the manufacturer and whether or not assays are performed to verify the supplement ingredients.

* Will taking more of a supplement provide me with beneficial results faster?

More is not always better. Certain vitamins and minerals considered to be essential to maintaining normal health can be toxic in high doses. For example, too much vitamin A can cause liver toxicity, adversely affect bone growth, and cause yellowing of the skin and palms. In general, supplements should not be taken in amounts that exceed the daily RDI (Reference Daily Intake) unless directed by your dietitian or physician.

* Can I mix my medications with my supplements?

Some supplements may interfere with certain medications, resulting in serious side effects. The medications of greatest concern include blood pressure and heart medications, blood thinners (Coumadin or warfarin), certain antidepressants, immuno-suppressant drugs, seizure medications, certain cancer therapies, and anti-arrhythmic drugs. If you are taking any medications, check with your physician or medical specialist before taking supplements.

* Should I stop taking supplements if I’m scheduled to have surgery?

Recent reports note a higher incidence of bleeding problems (either hemorrhage or blood clots) during or after surgery in patients who were taking certain supplements. Some supplements may also interfere with anesthetics used in surgery. Its recommended that all supplements be stopped at least four weeks before surgery unless specifically permitted by your physician.

**Edward C. Geehr, MD, is a member of the National Scientific and Medical Advisory Board of LifeScript, a leading provider of personalized nutritional supplements. Dr. Geehr formerly was national Chief Medical Officer with Inpatient Consultants, and is a member of the American College of Sports Medicine, the Wilderness Medical Society (co-founder) and the National Association of Inpatient Physicians. He previously was Clinical Associate Professor of Medicine and Surgery at the University of California, San Francisco, and is a graduate of Yale University and Duke University Medical School.

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If for some reason you need encouragement to wash your hands after changing your child’s diaper, consider this:

People who change diapers have a greatly increased risk of contracting an unpleasant infection known as giardiasis.

Caused by a microscopic parasite, giardia lamblia, giardiasis produces diarrhea, stomach cramps,bloating, nausea, fatigue and sometimes joint pain in those it afflicts. It’s usually transmitted through contaminated water.

However,a study at the University of Auckland, New Zealand found a link between the infection and “nappy changing,” as the New Zealanders call diaper duty. Nursing mothers and housewives had twice the infection rate of other adults, and diaper-changing increased the risk fourfold, the study says.

The researchers identified 183 people with giardiasis and matched them by age with 336 people selected randomly from the Auckland phone book. They then analyzed and compared the range of things the two groups had been exposed to during the preceding three weeks.Diaper-clad children, they say, proved to be a common thread and could be an important source of infection in any community.

To prevent spread of the infection, simply wash your hands thoroughly after changing a diaper, public health officials say.

Giardiasis has become the third most commonly reported infectious disease in New Zealand, and the most common waterborne disease, with nearly 2,000 cases each year.In the United States, cases appear to be on the rise as well, says a spokesman for the Centers for Disease Control and Prevention.

It is most commonly transferred to people through contaminated water.The parasite is found in the fecal matter of humans and animals, but we also know that people can become ill when they do not wash their hands after changing diapers.

Because the parasite can survive on hard surfaces and in food that is not cooked thoroughly, special care should be taken in the kitchen.

What To Do:

To prevent giardiasis in child-care settings, the CDC recommends that:

1. Diapered children be kept apart from toilet-trained children, if at all possible

Children and adults alike wash hands with soap and water, and dry with paper towels, after handling diapers or using the toilet and before handling food.

2. Only diapers that have waterproof outer coverings, or plastic pants, be used.

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Findings from a Stanford University Medical School study may come as no surprise: older and middle-age people reported sleeping better when they added regular exercise to their routine. After 16 weeks in a moderate intensity exercise program, subjects were able to fall asleep about 15 minutes earlier and sleep about 45 minutes longer at night.

Participants exercised at least four times a week. Twice a week they participated in an organized aerobics class, which included 30 minutes of endurance training. The other two times they exercised on their own, doing 40 minutes of brisk walking or stationary bike riding.

To assess impact on sleep, researchers looked at factors such as how long it takes to fall asleep, total hours of sleep per night, how often one wakes up, how one feels when waking up, and daytime function.

The link between aerobic exercise and sleep may seem obvious, but until this study, there has been very little controlled research to support this “conventional wisdom.” Though they are only 20% of the population, older Americans receive almost half the medications prescribed to aid sleep.

The potential side effects of these drugs-confusion, falls, extended drowsiness, agitation, and interactions with other medications-can be especially problematic for this age group. Until this study, there have been very few attempts to identify effective non-drug approaches to treating mild sleep disorders.

The study also provides further evidence of the interactions of mind and body. In this case improving physical health shows a positive impact on the mind.

RX: Self-Care Tips

Try exercise to help your sleep. Here are some tips:

A drop in body temperature aids sound sleep. So time your exercise five to six hours before bedtime.

Make your exercise vigorous enough to make you sweat a little. Previous studies have shown that non-aerobic stretching and concentration exercises alone did not impart sleep. Stick with it as participants in this study did not report improved sleep until they had been exercising for 16 weeks.

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Canadian researchers have identified physical criteria for identifying chronic fatigue syndrome, which is often confused with depression.

Researchers at the University of Alberta measured skin temperature and electrodermal activity with electrodes placed on subjects’ hands and found physical evidence for CFS and differences from patients with depression and healthy controls.

“There are a number of medical professionals who don’t believe that CFS exists in the first place,” researchers stated. “The problem is, both CFS and depression are characterized by very similar profiles.”

CFS is characterized by symptoms that include fever, sore throat, weakness, malaise and sleep disturbances. Patients often are misdiagnosed and given antidepressants that do not treat their condition, causing some physicians to assume patients are not really sick, researchers said.

Researchers said the stigma attached to the disorder takes an emotional toll on patients, interferes with insurance claims and undermines patient trust in doctors, making them less likely to seek treatment if the condition worsens.

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A new study finds that over-the-counter cough medications do not reduce nighttime coughing or improve children’s sleep any more than non-medicated syrup in children with upper respiratory infections. And OTC (Over the Counter) cough syrups also don’t help parents of a coughing kid themselves rest any better, the research found.

“Over the counter cough medicines don’t appear to provide any benefit for children with nighttime cough,” said the lead author of the study.”And because of the potential for side effects, parents should think twice before giving them to their children.”

Cough is the second most common reason for a child to visit a pediatrician.”Parents always ask what they can give their kids with cough, and there is little information as to what they can use,” the study revealed.

The study, published in the issue of the American professional journal Pediatrics, included 100 children and adolescents between the ages of two and 18 with upper respiratory infections.

The 100 participating children all had symptoms for four days prior to the study. On the day of the study, parents were asked to evaluate the severity and frequency of their children’s cough, as well as how the cough affected the parents’ nighttime sleep. The children were split into three groups and each assigned a different syrup to take 30 minutes before bedtime. One group tookdextromethorphan, often abbreviated DM and the most common active ingredient in OTC cough medicines. Another took diphenhydramine, an OTC antihistamine that’s available in many cold and allergy medications. And the third group took placebo, a non-medicated syrup.

The following day, the parents were asked the same questions to evaluate their child’s cough and the quality of their sleep. “We found no difference in the change in symptoms when you compared the active medicines with the placebo, suggesting that the medicines were no better than placebo,” said the lead author. The study examined also one aspect of nighttime cough in kids that has not been looked at before — how well do parents sleep if their kids are medicated? And the result? Parents did not sleep better when children the active medicines as compared with placebo.

Many experts maintain cough medicines provide no benefit except to alleviate parents’ worries and that the possible risks of cough syrups outweigh any perceived benefit. Pediatricians also say that parents are less likely to watch their child for changes or complications in their cold or cough if they have given them cough medicine. The risk is that a child who is treated may get a complication from the cold, like otitis or pneumonia, and the parent thinks that the child will be alright since the cold is ‘treated’ and the parent is not watching the child closely.”The risk is that most coughs are beneficial (keeping mucus/debris out of the lungs),” another expert added “This leaves few coughs that you would want to stop with OTC medication even if it worked.”

Not only do the OTC medications provide no benefit, but they also have many potential side effects. Although the study does not address side effects, the authors note that children who took dextromethorphan were more likely to suffer insomnia on the night they took the medicine.

So what should parents do? Wait for the cough to get better on its own.

Andrea C. S. McCoy, medical director of Temple Pediatric Care in Philadelphia agrees with the study authors and says that upper respiratory infections are self-limited illnesses that improve with time. But, she also says, “Those that last more than 10 to 14 days or are accompanied by fever for greater than 48 hours are concerning in that there may be secondary infections.” Concludes McCoy: “I really believe that many parents are not aware of the lack of benefit and potential side effects of these medications.”

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