Nothin’ fishy about omega-3s
BY MICHAEL JOHNSEN avoid,” Fabricant said.
Supplementing with omega- 3 fatty acids helps reduce the risk of heart disease, the leading killer of Americans today, said Daniel Fabricant, vice president of scientific and regulatory affairs for the Natural Products Association at the Drug Store News Pharmacy Development Series on vitamins, minerals and dietary supplements. Omega-3s are a common nutrient found in fish, but with the low rate of fish consumption in this country, coupled with concerns of mercury levels in fish, Americans are just not getting enough of the heart-healthy supplement. The upper recommended consumption of omega- 3 fatty acids is only around 3 grams per day, Fabricant said. Further, the Food and Drug Administration recommends that only 2 grams of that amount come from dietary supplements.
“The science [on omega-3s] is emerging to the level of folic acid— where it’s really starting to be critically recognized across the board.”
Conducting a search on clinical-trials.gov will yield 83 govern-ment-funded clinical studies on omega-3s and 56 on fish oil supple-
Omega-3s are an essential nutrient that people don’t get enough of, explained the Natural Products Association’s Daniel Fabricant.
“The big concern right now is you’re seeing omega-3s added to a lot of traditional food products, and companies are making a claim when there’s really been very little critical science on it. It’s a very different product matrices, so some of the products actually have some of the omega-6s that you’re trying to
ments in general. “The majority of those are on cardiovascular health, but there are some other functions [being studied],” Fabricant said. “A lot of these studies are going to move fish oil up the chain to that folic acid level where you get a full health claim.”
And currently, the price of the raw ingredient supply of omega- 3 fatty acids is on the rise because of a dwindling plant-source supply, he said.
There are several condi- keep them refrigerated,” tions associated with an Karpa said. “Generally, the altered digestive flora that rule of thumb is you lose 25 can be addressed by using percent of your cell count probiotics, including the use every three to four months at of antibiotics and several roomtemperature.”
digestive issues, such as diar- That could be problematic rhea, irritable bowel syn- for retailers, Karpa acknowl-drome and Crohn’s disease, edged, with both the logistics Kelly Karpa, assistant profes- Kelly Karpa, assistant involved in keeping probiotic sor in the department of phar- professor of pharmacology solutions refrigerated, as well macology at Penn State Uni- at Penn State University as informing the consumer versity, said at the recent Drug Store where the probiotics are located so that News Pharmacy Development Series on they know to ask for them. vitamins, minerals and dietary supple- However for pharmacies, Karpa said, ments. Live bacteria help supply up to recommending probiotic therapy, espe- 75 percent of the energy used by intes- cially with the dispensing of an antibi-tinal cells, are a good source of vitamins otic, is a win for all involved—it brings E and K and help boost the immune in incremental profit dollars for phar-system, she said. macy operators and improves health
There are three key factors regarding outcomes for patients, she said. In 2005, probiotic therapy that help ensure effi- estimated retail sales of probiotic foods cacy of the beneficial flora, Karpa said: and supplements in the United States The fact that the probiotics must con- reached $764 million, Karpa said, and tain live organisms at the time of con- by 2010, sales are expected to reach $1 sumption, the knowledge that probi- billion. Last year, more than 150 food otics have a finite shelf life and the productscontainingprobioticsandpre-number of actual microorganisms is biotics were introduced to the U.S. mar-important—clinical studies of probi- ket, compared with only 100 in 2006 otics generally use between 10 billion and 40 in 2005. “These trends reflect the and 100 billion active bacteria per dose. growing interest Americans have in the
“The best chance for ensuring that relationship between diet and overall [the probiotic solution] is alive is to health,” she said.
Carotenoids, a class of natural, fat-soluble pigments found principally in plants, include beta-carotenes found in carrots, lycopene found in tomatoes and both lutein and zeaxanthin, which can be found in green leafy vegetables, said Elizabeth
Johnson, assistant professor at the School of Nutrition at Tufts University. “But of those that we eat, only about 20 or 30 end up in our body,” Johnson said. “And those Tufts’ Elizabeth Johnson are the ones we’re really interested in.”
And there are a number of health benefits associated with each of the carotenoids, she said. Beta-carotene works as an antioxidant and is a precursor to vitamin A, which is not true of the other carotenoids. “That’s important because with vitamin A, there is a risk of vitamin A toxicity, which has been linked to bone fractures,” Johnson cautioned. “Unlike vitamin A, beta-carotene is not toxic,” except potentially for smokers, she said. High doses of beta-carotene could increase the risk of lung cancers in those people who smoke.
Lycopene is an antioxidant that has been linked to a reduction in cancer; and lutein and zeaxanthin help decrease the risk of age-related macular degeneration, Johnson said. “Unfortunately many [elderly people] don’t get the fruits and vegetables they need, so supplementation is warranted,” he said.
Coenzyme Q10, a supplement that helps improve heart health, is a vitamin-like compound found in abundance in the heart, liver, kidney and pancreas cells, said Roberta Lee, medical director of the Center for Health and Healing at Beth Israel Medical Center. Further, the compound is depleted with the use of statins, and that depletion increases with a correlated increased dosage of any statin. “The [core] of where co-Q10 may be useful is in complex medical conditions,” she said, which, for the retailer, may mean providing additional education to pharmacists and pharmacy technicians so that they are better able to communicate the benefit of supplementing with co-Q10 to their customers.
Glucosamine coupled with chondroitin assists in joint health, she said, and there is some evidence that glucosamine/chon-droitin helps relieve pain associated with osteoarthritis. There are basically three forms of glucosamine on the market, Lee
Disease
state
Congestive heart failure
Other cardiovascular events
Hypertension
Huntington’s disease
Parkinson’s disease
Migraine prevention
Use with statins
Dosage
(mg/day)
100
100-200
120-200
1,200-2,400
1,200-2,400
300
100-200
noted: glucosamine hydrochloride, glucosamine sulfate and n-acetyl glucosamine. All three appear to be equally active, she said, “but most of the research looking at the [unit] of joint disease have used glucosamine sulfate.”
Specifically, glucosamine is required for the synthesis of tendons, ligaments, synovial fluid, mucus membranes, structures of the eye, blood vessels and heart valves, as well as cartilage.
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