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Buying supplements can raise many questions. Should you choose supplements derived from natural ingre- dients? Do brand-name supplements have any advan- tage over less expensive store brands? Are the health claims plausible? Are the suggested dosages safe? e following advice should help answer these questions and guide you as you make your choices.

Consider your particular nutrient needs. en do a little sleuthing. Start by checking the label of your multivitamin-multimineral supplement, look- ing at the recommended amounts listed in Table 1, page 9, and Table 2, page 12, and assessing your diet (see “Decoding your diet,” page 41). Are you getting too little vitamin D? Need extra calcium? Looking for lutein or other potentially bene cial phytochemi- cals? Your rst line of defense should be through food. Rearrange your diet to include more sources of the nutrients you’re lacking. For those nutrients that may be hard to get through food, such as vitamin D and calcium, consider buying separate supplements.

Look for a seal of approval. Choose products that bear the U.S. Pharmacopeia Dietary Supplement Veri cation Program (USP-DSVP) mark, which indi- cates that the supplement manufacturer has com- plied with certain standards. Supplements vetted by the USP-DSVP should contain the ingredients noted on the label in the amounts and strengths stated. e product should dissolve within 30 to 45 minutes so that the nutrients enter your bloodstream, rather than passing through your body intact. It shouldn’t contain more than allowable levels of contaminants. Other product safety organizations include Consu- merLab.com, which ranks herbs and supplements based on quality and content, and NSF International, a nonpro t organization that develops standards and certi es products related to public health, safety, and environmental protection.

onsider safe levels. Supplements vary so widely, it’s essential to read the labels. Much like packaged foods, all dietary supplements have a “Supplement Facts” label that lists the DVs of nutrients in a single serving. It also notes the actual amount of each nutri- ent included. For trace minerals, such as iron, uoride, and zinc, it’s safest not to exceed the DV at all. Some experts even recommend getting these micronutrients only through food. If you take individual supplements (such as extra vitamin D tablets) as well as a multivi- tamin, be sure to total up the amounts you’re getting from every source, including food. Forti ed breakfast cereals can bump up your intake of vitamins and min- erals considerably. A single serving of certain breakfast cereals can deliver as much as or more than your daily multivitamin. at may not be a problem with vitamin C, but it might pose health risks with iron or vitamin A.

Consider price. Compare active ingredients on the labels, then let price be your guide. Store brands spend less on advertising than nationally known brands and pass on the savings to the consumer.

Ignore marketing gimmicks. It doesn’t matter whether vitamin C is derived from organic rose hips or synthesized in large batches in a laboratory; your body will use the resulting product similarly. In fact, your body absorbs certain micronutrients more e – ciently in synthetic rather than natural forms. Vita- min K and folic acid are two examples. If you’re not sensitive to speci c ingredients, such as wheat, rice, or lactose, there’s no need to pay more for allergen- free products. “High potency” isn’t a plus in cases when more is not better.

Avoid gummy vitamins, unless you cannot swal- low pills. Gummies typically contain fewer vitamins and minerals and in lower amounts than multivitamin tablets—plus you have to take them twice a day, they have more calories and added sugar, and they are not as cost-e ective as tablets, since a single gummy costs more than a supplement pill.

Don’t pay more for unproven extras. Generally, if you’re hoping for phytochemical bene ts, you’ll do better in the produce department than the supple- ment aisle. ere is virtually no evidence that herbs and other nonvitamin ingredients added to supple- ments, such as echinacea, are essential for your health. Supplements that list substances such as PABA (para- aminobenzoic acid) and ubiquinone (coenzyme Q10) are trading on good press from research that shows them to be essential for growth in bacteria or other life forms, rather than substantial evidence from studies in people.

Beware of potentially dangerous interactions.

Pay attention to warnings on the label, and tell your doctor and pharmacist what supplements you take (see “Medications and micronutrients,” page 45).

Report any serious ill effects. Let your doc- tor know about any side e ects that you attribute to a supplement. He or she may pass along the infor- mation to FDA MedWatch, if appropriate. Or you can contact MedWatch directly at 800-FDA-1088 or through the MedWatch website at www.fda.gov/med- watch/report/consumer/consumer.htm. Also inform the manufacturer or distributor and the store where you purchased it

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