Kevin M Connolly, PhD
Urinary tract infections (UTIs) result from elevated
levels of bacteria colonizing the urogenital tract
(including the bladder and urethra; the tube that
carries urine from the bladder to the outside of
the body), and are one of the most commonly acquired
bacterial infections in both non-hospitalized and hospitalized
individuals. UTIs lead to about 8 million visits to doctor’s
offices and emergency rooms each year in the U.S., and
are a substantial burden to healthcare costs.1 Although UTIs are
generally not serious if treated promptly, they can cause significant
discomfort and difficulty with urination; complications of
an untreated UTI include kidney infection with the possibility of
permanent damage.
Depression is characterized by low mood, loss of
pleasure, or changes in sleep or energy, that are not
associated with recent grief or another underlying
medical condition. At any time, it affects an estimated 9 percent
of the U.S. population, and is projected to have the second
greatest contribution to lifetime disability (behind cardiovascular
disease) by the end of the decade.1,2 Part of the multimodal
approach to management of chronic clinical depression can
involve the biochemical balance of brain chemicals to alleviate
symptoms; most first-line pharmaceutical treatments function
by increasing the activity of one or more neurotransmitters (brain
chemicals responsible for many of the aspects of cognitive
function), particularly serotonin. In the central nervous system
(CNS), serotonin has been implicated in regulation of sleep,
depression, anxiety, aggression, appetite, temperature, sexual
behavior, and pain sensation. 3
The lipids are the third class of macronutrient.
They are as ubiquitous in the diet as proteins and carbohydrates,
where they occur predominantly as storage lipids called
triglycerides (formed from fatty acids), and cholesterol, a lipid with
roles in both cell structural and communication.
What Your Father Never Told You
Ask the average American man what his greatest
health concerns will be as he ages, and his answer
would likely be drawn from a familiar list: heart
disease, prostatic hyperplasia, prostate cancer,
osteoarthritis, erectile dysfunction. Few would list
osteoporosis, the degenerative skeletal condition that is generally
considered a “woman’s disease.” Most would be surprised
to learn that the prevalence of male osteoporosis is close to that
of prostate cancer; about 20 percent of the 10 million Americans
with osteoporosis are men. Men account for over a quarter of
all osteoporotic fractures annually. It is estimated about 25 percent
of men will suffer an osteoporotic fracture in their lifetime,
more than the estimated 16 percent that will be diagnosed with
prostate cancer. Yet, male osteoporosis remains a relatively over
looked condition that is poorly understood amongst men. For
example, on the National Health and Nutrition Examination
Survey (NHANES) only one percent of male survey takers over
65 reported they had osteoporosis; bone mineral density (BMD)
testing revealed that four times as many actually had the disease.
In this article, we will briefly discuss the progression of male
osteoporosis, its specific risk factors, and potential treatments.
They are used to construct the cells and tissues that form our bodies,
provide sources of energy to power metabolism (as well as provide
a mechanism for storing energy between meals), and are used
to form the countless enzymes that drive our metabolism. Unlike
the micronutrients (vitamins and minerals) which are needed in
small amounts and are generally reused, macronutrients undergo
a constant flux in our body, necessitating a consistent intake to
provide enough energy for our survival and enough building blocks
for the growth, maintenance, and repair of our bodies.
Many medical organizations advise against
routine supplementation of vitamins and minerals (citing
“safety concerns,” lack of evidence of benefit,” or
that they are simply “unnecessary”) and recommend a
focus on acquiring nutrients from the diet. Which, for
the most part, is a good suggestion: no combination
of supplemental vitamins, minerals, or other nutrients
could possibly emulate the diversity of known (and
unknown) beneficial compounds found in the diet.
However, general dismissals of dietary supplements
often fail to acknowledge the significant portion of
micronutrients in the average diet that may come from
the fortification of foodstuffs. Food fortification (addition
of nutrients to foodstuffs for commercial benefit
or as a part of public health policy) has been credited
for the eradication of several diseases of nutrient deficiency
in the U.S.
Taking Supplementation Seriously Part I:
There is an ongoing debate on whether dietary supplements deserve to be part of a health-promoting strategy. Several medical organizations do not advise routine supplementation for people, without underlying deficiencies, citing safety concerns or lack of clear evidence of benefits, and suggest that an adequate diet should be sufficient in obtaining proper nutrition. Prophylactic use of supplemental vitamins or minerals, like iron, has sparked controversy. On the other hand, there is a wealth of published, peer-reviewed scientific data that present strong correlations between adequate nutrient intake and lowered disease risk/incidence, as well as studies in which nutrient interventions demonstrated significant health benefits. Hyperbolic media reports that “resveratrol may make you live longer” or “multivitamins may cause prostate cancer” further complicate the dialog.
Taking Supplementation Seriously Part II:
Last month, we started a dialogue on whether supplementation
is the appropriate course for insuring a nutritionally complete
diet. We examined a very simple case, the multivitamin:
a supplement designed to provide the base set of essential
nutrients that are requisite for normal human metabolism. In
response to the case against multivitamin usage (“proper diet
alone should be adequate in providing essential nutrients”),
we considered how 1) widespread deficiency of several nutrients
in the U.S. diet, 2) the demonstrated reduction in nutrient
availability in the modern food supply, and 3) the subclinical
deficiencies in several nutrients that can result from caloric
restriction and exercise, suggest that supplementation of essential
nutrients may be warranted in some individuals. Here
we expand the list of observations to consider when making
the decision whether to include a multivitamin in your daily
health regimen.
Taking Supplementation Seriously Part III
There is little debate that a balanced diet is the most
desirable method for obtaining essential nutrients,
but there are cases when the use of supplemental
nutrients may be requisite for insuring adequate
nutrient intake. When negotiating the vast number
of choices in dietary supplements, one criteria for deciding
upon a product is whether it contains natural versus synthetic
vitamins and minerals.
Taking Supplementation Seriously Part IV
In past articles, we presented the case for insuring nutritional sufficiency of the essential vitamins and minerals through supplementation. There is little debate that these micronutrients are requisite for human survival, and that their supplementation may be an apt course for some. A healthy diet also provides several other nutritionally-beneficial elements which, like the vitamins and minerals, are not always present at optimal levels and thus can potentially benefit from supplementation.
Taking Supplementation Seriously Part V
Choosing a quality dietary supplement can be an exercise
in abstraction. As a class of product nestled somewhere in
between food and drug, they lack many of the obvious quality
measurements inherent to these two other categories (such as
the sensory properties one uses to select quality produce, or
the strict quality control procedures inherent to the manufacture
of a government-regulated pharmaceutical). Until recently,
the only way to assess the quality of a supplement (short of
spending a personal fortune on lab testing), was from the synthesis
of subjective data (brand reputation, marketing claims,
and personal experience).
Carbohydrates are the most abundant biomolecules on our planet and in our food supply. They exhibit some of the largest differences in their metabolism by different members of the animal kingdom. At one extreme, herbivores can almost completely break down dietary plant material with the help of beneficial bacteria that dwell within their gastrointestinal tract; at the other extreme, true carnivores can’t process most dietary carbohydrates. Humans fall somewhere in between; we derive a great deal of nutrition out of some dietary
carbohydrates, but are unable to process others.
