Thoughts at Large: Controversies in Clinical Nutrition and Functional Medicine
Issue #7 A Big Picture Question to begin 2018 - What is the Most Im- portant Yet Under Appreciated
Supplement? by: Jeffrey Moss, DDS, CNS, DACBN
INTRODUCTION As we all know, the end of one year and the beginning of the next is traditionally a time when we reflect on where we have been and where we are going from a “big picture” perspective. As health care professionals who specialize in nutritional and/or lifestyle oriented approaches to improvement of health, primarily in individuals suffering from one or more chronic illnesses, I feel it is important to look back periodically and consider success from a large- scale perspective. True, our most important determinant of success is and has always been our ability to assist our individual patients in achieving their healthcare goals. How well are we doing? Hopefully, we can all agree, given the overwhelming challenges our patients are often encountering, we are doing quite well. Nevertheless, as I suggested above, I feel it is important for us to occasionally evaluate success from a societal, chronic illness perspective. Is our success with patients making a significant dent in the overall nationwide chronic illness occurrence rate?
To answer this question I would like to present two sets of data. The first set comes from the RAND Corporation and its document entitled “Multiple chronic conditions in the United States,” which was published in 2017. The conclusions presented were based on the most recent data available (2008-2014). What the RAND Corporation found was the following: “In 2014, 60 percent of Americans had at least one chronic condition, and 42 percent had multiple chronic conditions.”
Furthermore: “These proportions have held steady since 2008.”
Finally, consider the following statistic that has particular relevance for us since we tend to treat middle-aged and older individuals: “The presence of multiple chronic conditions increases
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with age for both genders.”
Specifically, according to the report, 50% of individuals aged 45-64 years and 81% of individuals aged 65 or older present with at least one chronic condition.
The second set of data comes from the Council for Responsible Nutrition and its 2016 survey. Of the many data points presented, the following, to me, were the most interesting: • “71% of all U.S. adults reported taking dietary supplements.”
• “74% of U.S. adults 55+ take dietary supplements.” • Of these populations the most common dietary supplement was the multivitamin/mineral. Of the individuals who reported taking dietary supplements, 75% reported taking a multivitamin/mineral product.
What were the least popular dietary supplements among supplement users? Among the lowest was protein, which only 15% of dietary supplement users reported as using.
Is there any significant relationship between the data presented by the RAND Corporation and the Council for Responsible Nutrition?
To me, there are three possible ways to answer this question. First, there may be no relationship whatsoever. Second, it could be concluded that since the incidence of chronic illness has been fairly high for older populations but somewhat stable during the time when it is probable that many, if not most of these individuals, were ingesting at least a multivitamin/mineral product, the findings could have been much worse without the supplement ingestion. However, for me, there is still a third, equally important way to answer this question. It could be concluded that chronic illness rates could have actually decreased over time if only an important but rarely used supplement were used more often.
In this “big picture” commentary to begin the New Year, I would like to hypothesize that the third answer listed above is correct. Furthermore, I would like to hypothesize that this rarely used supplement is protein.
MAKING THE CASE THAT LOSS OF MUSCLE MASS IS A MAJOR REASON WHY CHRONICALLY ILL PATIENTS ARE AILING AND WHY THEY RESPOND POORLY TO OTHER INTERVENTIONS. Interestingly, it is my experience that supplement pur- chases by chronically ill individuals and the practitioners who treat them reflect the statistics indicated above. Multivitamin/mineral products are generally among the best-sellers and protein/amino acid products are among our lowest. In this commentary, I am going to make an effort to convince you that, if the supplement sales and recommendations in your practice reflect these statistics, no matter how good your results are with your chronically ill patients, you will do better if you increase your recommendations of protein/amino acid-based products. Furthermore, given the simplicity and low cost of this recommendation, it is very likely this recommendation will also improve the health of those people you casually encounter who are not directly involved in your practice,
THE ORIGINAL INTERNIST MARCH 2018 (Continued on next page)
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