| Nutritional Supplements: Has the Fringe Become | | | | vegetables and fruits. Lutein acts as an |
| the Cutting Edge? | | | | antioxidant, protecting cells against the damaging |
| Just a few years ago, doctors were telling their | | | | effects of free radicals. Chances are you're not |
| patients that multivitamins were a waste of time | | | | getting the lutein you need because most |
| and money and that you could get all the | | | | Americans simply don't eat enough vegetables |
| nutrients you need from your diet. In the June | | | | rich in lutein. A recent survey of eye doctors |
| 2002 issue of The Journal of the American | | | | indicated that 91% believe that lutein promotes |
| Medical Association, the AMA reversed its | | | | eye health and can be beneficial in treating AMD. |
| long-standing anti-vitamin policy and began advising | | | | A recent study sponsored by the National |
| all adults to take at least one multivitamin pill each | | | | Institutes of Health found that people who ate |
| day. What was once considered fringe medicine or | | | | the highest amounts of leafy green vegetables |
| quackery has now become cutting edge medicine. | | | | like kale, collard greens, and spinach had a 57% |
| It is estimated that over 80% of Americans do | | | | lower risk of developing AMD than those who ate |
| not eat at least five helpings of fruits and | | | | these foods the least. In an AMD study published |
| vegetables a day, the recommended minimum | | | | in the Journal of the American Optometric |
| amount believed to provide sufficient essential | | | | Association, it was shown that a diet rich in |
| nutrients. Humans don't make their own vitamins | | | | spinach may help stop AMD and even reverse |
| and minerals, except for some Vitamin D, and we | | | | some of the effects of the disease. |
| must get them from outside sources to prevent | | | | Nutritional supplements are a beneficial alternative |
| degenerative disease. | | | | for those people who cannot get nutrients directly |
| There is also growing concern that the | | | | from fruits and vegetables. The recommended |
| recommended daily allowances of vitamins and | | | | daily dosage is a minimum of 6 mg for prevention |
| minerals, or the RDA, are set too low. RDAs | | | | and maintenance and 20 mg per day for |
| were originally established to prevent the | | | | therapeutic use. Nutritional studies show the |
| symptoms of vitamin deficiency disorders, not to | | | | average person consumes less than 1 mg of |
| prevent disease itself. The National Academy of | | | | lutein per day. Subsequently, supplements are a |
| Sciences is now looking at its recommendations | | | | sensible answer. |
| based on the new evidence that has been | | | | One thing that you must be careful of is being |
| released. | | | | mislead into thinking that you are getting an |
| We now know that vitamins, minerals and herbs | | | | adequate amount of lutein from the heavily |
| can prevent and treat degenerative diseases such | | | | advertised popular multivitamins that tout they |
| as macular degeneration, cancer, osteoporosis, | | | | include lutein. Most of them only have 250 mcg of |
| heart disease, and birth defects just to name a | | | | lutein, which less than 5% of the recommended |
| few. In this chapter we will discuss specific | | | | daily dosage. There are 1000 mcg in 1 mg, so 250 |
| vitamins, minerals and other supplements that are | | | | mcg is only one quarter of 1 mg. Remember, 6 |
| proving to be effective in the battle against AMD. | | | | mg is the "minimum" recommended dosage. |
| The Age-Related Eye Disease Study (AREDS) | | | | Recommended Dosage: |
| For years, cutting edge eye doctors have been | | | | Lutein : 6 - 20 mg per day |
| recommending antioxidants for AMD patients, | | | | TAURINE |
| many times enduring criticism from their fellow | | | | Taurine is an amino acid found naturally in egg |
| doctors who are entrenched in orthodox medicine. | | | | whites, meat, fish, and milk. High concentrations |
| That all changed in October 2001 when the | | | | are found in the heart muscle, white blood cells, |
| National Institutes of Health and the National Eye | | | | skeletal muscle, and central nervous system. In |
| Institute released the results of The Age-Related | | | | the retina there are two binding proteins specific |
| Eye Disease Study which conclusively stated that | | | | to taurine. Intracellular concentrations are higher in |
| patients with extensive AMD could benefit from | | | | the retina than in any other region derived from |
| certain high doses of antioxidants and minerals. | | | | the central nervous system. |
| While the study was not complete in terms of | | | | Taurine plays a role in the process of rhodopsin |
| evaluating all of the possible nutrients that can help | | | | regeneration necessary for night vision. It is |
| AMD, it did come out with findings that 25-27 | | | | essential to the retinal pigment epithelium and the |
| percent of patients with advanced AMD could | | | | photoreceptors where it is found at levels ten |
| preserve their vision and prevent further vision | | | | times higher than other amino acids. Taurine helps |
| loss by taking specific antioxidants plus zinc. The | | | | to protect the cell membranes from oxidative |
| study did not evaluate the effect of nutritional | | | | attack. It helps transport nutrients across cell |
| supplements on those with early or moderate | | | | membranes, acts as a catalyst to retinal cells that |
| stages of AMD, which in the author's opinion is the | | | | remove cellular debris and assists in the elimination |
| group that stands to benefit the most from | | | | of potentially toxic substances. Taurine in |
| nutritional therapy. | | | | combination with retinol protects lipids twice as |
| The study used the following formula: | | | | much as retinol by itself. Taurine also protects the |
| Beta Carotene - 15 mg | | | | rod outer segment lipids during exposure to cyclic |
| Vitamin C - 500 mg | | | | light. |
| Vitamin E - 400 IU | | | | Several studies have shown definite correlations |
| Zinc - 80 mg | | | | between taurine deficiency and retinal |
| Zinc can, at high doses, cause anemia in some | | | | degenerations. Taurine deficiency is often |
| patients as well as exacerbate the symptoms | | | | associated with an imbalance of intestinal flora, |
| associated with Alzheimer's. As will be | | | | commonly called "leaky gut" and inhibits taurine |
| demonstrated later in this chapter, it may be | | | | absorption. Taurine levels can also be lowered by |
| prudent to cut back on the amount of Zinc from | | | | overgrowth of candida, physical or emotional |
| the amount used in the controlled study. | | | | stress, and excessive consumption of alcohol. The |
| Nevertheless, the point is that mainstream | | | | drugs chlorpromazine (a tranquilizer) and |
| medicine is now waking up to the fact that | | | | chloroquine (an anti-inflammatory agent and |
| nutritional therapy should be included as part of | | | | anti-malarial) also inhibit the uptake of taurine and |
| every patient's treatment when they have AMD. | | | | have been known to cause retinal damage with |
| According to Paul A. Sieving, M.D., Ph.D., Director | | | | prolonged or excessive dosage. |
| of the NEI, "This is an exciting discovery because, | | | | Recommended Dosage: |
| for people at high risk for developing advanced | | | | Taurine (or L-Taurine): 400 - 500 mg per day |
| AMD, these nutrients are the first effective | | | | DHA (DocosaHexanoic Acid) Essential Omega-3 |
| treatment to slow the progression of the | | | | Fatty Acids |
| disease." Frederick Ferris, M.D., Director of Clinical | | | | Is it really possible that eating more fat is the key |
| Research at NEI and Chairman of the AREDS | | | | to better health? Several years ago the following |
| said, "The AREDS formula is the first | | | | headline was in one of the medical journals |
| demonstrated treatment for people at high risk | | | | "Canned Tuna Reduces Risk of AMD." The |
| for developing advanced AMD." | | | | headline was obviously a bit sensational, but it |
| The Antioxidant-Zinc Recommendation For AMD | | | | caught my attention and I investigated further. In |
| Vitamins should generally be taken in a | | | | a study from Australia it was determined that a |
| combination or multivitamin formula whenever | | | | higher frequency of fatty fish consumption was |
| possible. The reason for this is that vitamins and | | | | associated with decreased incidence of advanced |
| minerals work synergistically with one another for | | | | cases of AMD. Yes, fish consumption actually |
| better absorption and assimilation. So instead of | | | | seemed to prevent or slow down the disease. |
| taking a Vitamin A capsule and a separate Vitamin | | | | What subsequent studies have found is that there |
| C pill, a multivitamin with adequate doses of each | | | | is a direct correlation between the consumption of |
| is preferable. | | | | certain species of fish high in DHA and a reduced |
| Furthermore, capsules are preferred over tablets | | | | incidence of AMD. |
| because evidence indicates that they are easier | | | | We have known for some time that Omega-3 |
| to absorb and assimilate than tablets. | | | | Fatty Acids are critical in the development of the |
| BETA-CAROTENE / VITAMIN A | | | | retina and in brain tissue. DHA is typically found in |
| Beta-carotene is a substance made from plants | | | | cold water or fatty fish, such as tuna, salmon, |
| that the body can convert into Vitamin A. It also | | | | and mackerel. To get adequate amounts of DHA, |
| acts as an antioxidant, an immune system | | | | an individual should consume 3 - 4 servings of |
| booster,helps cells reproduce normally, protects | | | | these fish each week. Since this can be difficult |
| the photoreceptors against free radicals, and | | | | for many people, especially those who don't like |
| enhances night vision. Other members of the | | | | fish, supplementation is advised. |
| carotene family are beta-carotene's cousins, | | | | It is interesting to note that DHA has recently |
| zeaxanthin, lutein, and lycopene. However, unlike | | | | been approved by the FDA as a supplement for |
| beta-carotene, most of these nutrients do not | | | | baby formula. Studies show advanced neurological |
| convert to significant amounts of Vitamin A. | | | | development and more mature retinal function in |
| Beta-carotene does not cause any side effects; | | | | those children who were either breast fed (breast |
| however, excessive intake may sometimes give | | | | milk contains DHA naturally) or those who were |
| the skin a yellow-orange hue. Several years ago | | | | fed formula with the DHA supplement. It has also |
| there was a study published showing that | | | | been reported that DHA can prevent or reverse |
| beta-carotene could increase the risk of lung | | | | heart disease, diabetes, neurological disorders, and |
| cancer by 35% in those individuals who smoked. | | | | cancer. Bottom line, DHA is a critical nutritional |
| This is not true of the pure form of Vitamin A | | | | supplement to add to your supplement war chest. |
| however. While otherwise harmless, it may be | | | | Recommended Dosage: |
| prudent for smoker's to stay away from | | | | DHA: 500 - 1000 mg per day |
| beta-carotene and stick with Vitamin A. Better | | | | GINKGO BILOBA EXTRACT |
| yet, stop smoking! | | | | Ginkgo Biloba is a tree that lives as long as 1,000 |
| Recommended Dosage: | | | | years and grows to a height of 120 feet. It is the |
| Beta-Carotene: 15 - 25 mg per day (or) | | | | world's oldest living tree species as it can be |
| Vitamin A: 5,000 - 10,000 IU per day | | | | traced back more than 200 million years. The |
| VITAMIN C | | | | medicinal use of Ginkgo Biloba can be traced back |
| Vitamin C is a water-soluble vitamin that functions | | | | to China in 2800 B.C. Ginkgo Biloba Extract are is |
| as a powerful antioxidant. It is critical to make | | | | among the leading prescription medicines used in |
| collagen, the glue that strengthens many parts of | | | | Europe and it is backed by more than 400 |
| the body, such as blood vessels. Vitamin C also | | | | scientific studies. |
| plays an important role in wound healing. This | | | | Clinical studies have shown Ginkgo Biloba Extract |
| vitamin also aids in the formation of liver bile and | | | | (GBE) to be effective for macular degeneration as |
| helps to fight viruses and detoxify alcohol and | | | | well as diabetic retinopathy. In addition, GBE is |
| other toxic substances. | | | | being explored as a therapy for Alzheimer's |
| Natural sources for Vitamin C are broccoli, red | | | | Disease. It is believed that GBE may help reverse |
| peppers, Brussels sprouts, parsley, citrus fruit and | | | | or delay mental deterioration during the early |
| strawberries. | | | | stages of Alzheimer's and may help the patient |
| Recommended Dosage: | | | | maintain a normal life and avoid life in a nursing |
| Vitamin C: 500 - 1,000 mg per day | | | | home. |
| VITAMIN E | | | | As we will learn in the next chapter, every cell in |
| Vitamin E is a powerful antioxidant that protects | | | | the body has an electrical charge that is |
| cell membranes and other fat-soluble parts of the | | | | maintained by a pump that transports potassium |
| body. In addition to Vitamin E's benefit for the | | | | in and sodium out of the cell. GBE has been |
| eyes, two studies published in the New England | | | | shown to enhance the activity of this pump, |
| Journal of Medicine show that both men and | | | | leading to a better electrical charge. This effect is |
| women who supplement with at least 100 IU of | | | | particularly important in excitable tissues, such as |
| vitamin E per day for at least two years have a | | | | the photoreceptors of the eye. |
| 37-41% drop in the risk of heart disease. | | | | Recommended Dosage: |
| Natural sources of Vitamin E are wheat germ oil, | | | | Ginkgo Biloba Extract (GBE): 120 mg per day |
| nuts, seeds, vegetable oils, whole grains, egg | | | | As medical science continues to embrace |
| yolks, and leafy green vegetables. However, the | | | | nutritional therapy, research will undoubtedly find |
| high levels found in supplements, over 100 IU per | | | | additional nutritional supplements and herbal |
| day, are not obtainable from eating food. | | | | remedies that are beneficial in treating AMD. |
| Recommended Dosage: | | | | Eye On Nutrition(TM) Dietary Risk Assessment |
| Vitamin E: 200 IU per day | | | | Since it can be challenging to know if and how |
| ZINC | | | | much of these nutrients your diet is providing, the |
| Zinc is a component of more than 300 enzymes | | | | American Optometric Association provides an |
| that are needed to repair wounds, maintain | | | | online dietary risk assessment at no charge. The |
| fertility, synthesize protein, help cells reproduce, | | | | assessment is based on the latest published |
| preserve vision, boost immunity and protect | | | | scientific research on nutrition and age-related eye |
| against free radicals, among other functions. The | | | | disease and is adapted from the National Cancer |
| average diet frequently provides less than the | | | | Institute's Diet History Questionnaire, which uses |
| recommended daily allowance for zinc. Zinc | | | | nutrient intake data from both the U.S. |
| deficiencies are more common in alcoholics and | | | | Department of Agriculture and the University of |
| individuals with sickle cell anemia, and chronic | | | | Minnesota's Nutrition Data System for Research. |
| kidney disease. | | | | Eye on Nutrition(TM) was created as a |
| Good sources of zinc include oysters, meat, eggs, | | | | user-friendly tool to help patients and |
| seafood, black-eyed peas, tofu, and wheat germ. | | | | optometrists talk about nutrition and other risk |
| Also, zinc can inhibit copper absorption, however | | | | factors for AMD. |
| this is typically not a concern since most | | | | You can access the Eye On Nutrition(TM) Dietary |
| supplements include copper in the formulation. | | | | Risk Assessment through the American |
| Recommended Dosage: | | | | Optometric Association's website at: |
| Zinc: 20 - 70 mg per day | | | | This simple quiz, which will take about 20 minutes, |
| Other Supplements For Macular Degeneration | | | | will help you find out if your diet is 20/20 and |
| LUTEIN | | | | what you can do to help protect your eyes from |
| Lutein (loo-teen) is a carotenoid found in | | | | AMD. |