Posts Tagged ‘supplements’

Originally published on HVMN by Nate Martins.

The moment every athlete wants to avoid.

POP!

A muscle gives at the gym or on the track, leading to weeks of rehab. Sometimes it’s not even a single moment, but rather, countless hours of overuse that leads a muscle to strain or tear.

To avoid rehab, athletes need to be thinking about pre-hab. Get ahead of an injury before it happens.

Muscle recovery should be part of every training plan (specifically post-workout). But there are multiple strategies athletes can employ that lead to muscle health–even things like diet can impact how your muscles recover. Knowing what to do, and when to do it, can help avoid the injuries that’ll set you back weeks.

Why is Recovery Important?

An important goal of every training session is to break down muscle. Without recovery, a significant portion of that work might be a waste of time. So, what exactly happens during recovery? That’ll depend on the person and activity, but generally, four different things are happening while you’re resting.

Synthesis of protein: This is what leads to muscle growth. During recovery is when most muscle is built, because muscle protein synthesis increases by 50% four hours after a workout (like resistance training).1

Rebuilding of muscle fibers: Microtears in muscle fibers are a normal part of exercise, happening when we put strain on our muscles. Recovery allows these fibers to heal and become stronger during that process.

Fluid restoration: We sweat (and lose a lot of fluid through exhaled air).2 Hydrating before, during and after a workout is important, because these fluids help deliver nutrients to organs and muscle through the bloodstream.

Removal of metabolic waste products: Acids (via that pesky little proton associated with lactate) accumulate during a workout, and recovery gives the body time to restore intramuscular pH and reestablish intramuscular blood flow for oxygen delivery (among other things).

While you’re resting, your muscles kick into overdrive.

Recovery can be attacked several ways–some may be surprising, because they don’t directly target the muscles themselves. By approaching recovery through a few different avenues, it can be optimized.

Consuming Your Way to Recovery

It may not seem obvious, but a combination of hydration, diet, and supplements can do wonders for the muscles.

Hydration: During and After Exercise

Drinking fluids is a mantra repeated by coaches everywhere for good reason: muscles are 75% water.

Before and during exercise, hydration is key to maintaining fluid balance and can even improve endurance (it’s equally important to not over-consume water as well).3,4 But post-workout, consuming enough water is vital to helping digest essential nutrients and repairing damaged muscle.

The sought after protein resynthesis requires muscles be well-hydrated. And coupled with post-workout eating, saliva–which is comprised mostly of water–is necessary to help break down food, digest, and absorb all the nutrients you’re hoping to receive. In one study, adequate hydration after a 90-minute run on a treadmill showed significantly faster heart rate recovery;5 this illustrates that hydrated bodies recover from exercise-induced stress faster.

Don’t rely on the age-old test of urine to determine if you’re hydrated; that has been debunked.6

A good rule of thumb is to weigh yourself before and after a workout, drinking 1.5x the amount of weight lost.

Diet: Protein, Carbohydrates and Fat All Work Together

Nailing the right nutrition strategy post-workout can encourage quicker recovery, reduce soreness, build muscle, improve immunity and replenish glycogen.

Your next workout starts within the hour your last workout ended.

Since exercise triggers the breakdown of muscle protein,7 it’s beneficial to consume an adequate amount of protein after a workout. Protein provides the body with necessary amino acids needed to repair and rebuild, while also promoting the development of new muscle tissue.8

Good sources of protein include: whey protein, whole eggs, cheese and smoked salmon.

Carbohydrates have a similarly important effect–they replenish glycogen stores. The type of exercise will depend on how much carbohydrate is needed. Consuming about 0.5 – 0.7 grams of carbohydrate per pound of bodyweight within 30 minutes of training can result in adequate glycogen resynthesis.7 Insulin secretion promotes glycogen synthesis, and is more stimulated when carbs and protein are consumed simultaneously.9

Carb sources are everywhere; but look to slow-release sources such as sweet potatoes, fruit, pasta and rice.

Fat shouldn’t be the main focus of an after workout meal, but should be part of it. Good fat sources include avocados and nuts. Milk is also a popular choice; one study found whole milk was more effective at promoting muscle growth than skim milk.10

Supplements: Protein, BCAAs and Omega-3s Build Muscle and Reduce Inflammation

We’ve outlined which supplements runners should take; it’s best to focus on protein, BCAAs and omega-3s–all these supplements help optimize muscle recovery.

While most athletes think protein is best left to bodybuilders, protein can repair the muscle damage that occurs during a workout, reduce the response from the “stress hormone” cortisol, and speed up glycogen replacement. Protein also accelerates the resolution of muscle inflammation.11,12

Whey, casein and soy are some of the most popular proteins. Whey is absorbed the fastest by the body, and is largely considered the most effective protein for muscle protein synthesis.13 Casein protein is geared more toward long-term recovery because it takes hours to absorb. Try introducing whey immediately post-workout, while using casein protein before bed; protein ingestion before sleep has been shown to stimulate muscle protein synthesis.14

Serious athletes should be taking about one gram of protein per pound of bodyweight.

If someone doesn’t consume enough protein, branched-chain amino acids (BCAAs) can be a useful supplement.

Amino acids are the building blocks of protein. During exercise, the body breaks down protein into amino acids; those are absorbed and transported through the body to create new proteins that encourage building muscle. BCAAs help enhance muscle protein recovery by introducing more amino acids into the body. They preserve muscle glycogen stores, which fuel the muscles and minimize protein breakdown. Studies show BCAAs as effective for muscle recovery (as well as immune system regulation).15

Omega-3s, found in fish oils, have anti-inflammatory properties that help sore muscles.16 Kado-3, by HVMN, is a supercharged krill and fish oil stack designed to assist daily brain and body metabolism. Ingredients in Kado-3 work together; like astaxanthin oil (a powerful antioxidant) to fight against the buildup of free radicals, and Vitamins K and D to protect bone health.17,18,19

HVMN Ketone can also help muscle recovery. Those using HVMN Ketone have seen decreases in the breakdown of intramuscular glycogen and protein during exercise when compared to carbs alone.20 It also expedited the resynthesis of glycogen by 60% and protein by 2x when added to normal carb / protein post-workout fuel.21,22

Resting Your Way to Recovery

Rest should be accounted for in any training program.

Sleep: A Necessary Reset

On its face, sleep should be the easiest way to recover. One study found that lack of sleep can lead to muscle degradation.23 But many find it difficult to get the ideal seven-to-nine hours per night.

Sleep improves other facets of health that tangentially affect muscle recovery; the central nervous system (CNS) also recuperates during sleep, which is important for muscles, because the CNS triggers muscle contractions and reaction time. Hormones like cortisol and testosterone, which produce protein synthesis, are also working while we sleep.

To help optimize sleep, it’s important to set a routine.

Our screens can negatively impact sleep,24 so 60 – 90 minutes of screenless time before bed can do wonders. The blue light emitted from our devices tricks the brain into thinking it’s daytime and we need to be awake, decreasing our natural melatonin.

It’s also important to create an optimal environment for sleep. Things like blackout curtains, a cooler temperature setting in the bedroom, or a quality mattress can all encourage better, more restful sleep.

Rest Days: Muscles Don’t Take Breaks, But You Should

On a much smaller scale, what’s happening during sleep is also happening on rest days. Work rest days into your training program because they give the body time to repair tissues that have been broken down.25

Depleted muscle energy stores, micro-tears, fluid loss–all the things that happen during a workout need time to recuperate and grow stronger.

Recovery time depends on your specific routine. Runners can have an especially difficult time doing this. For highly active runners who log miles six days per week, they should also incorporate recovery runs. About half of these runs should be at recovery pace, a slower less-strenuous pace that allows the body to recycle lactate as it’s produced. By increasing blood flow, recovery runs may actually accelerate the recovery process.

Also try to avoid intense workouts or hard runs on back-to-back days. Complete rest days vary by person, but a good goal is one or two rest days every week or ten days. Injury-prone athletes may increase the number of complete rest days during this period.

Techniques & Exercises for Recovery

Let’s get into the specifics of what you can do to help the body recover faster. By using exercises targeted at certain muscles, not only will those muscles recover faster–they’ll also get stronger in the process.

Active Recovery: Getting Stronger and Building Muscle

This type of recovery focuses on exercise intensity at low-to-moderate levels. Studies have shown that it’s best for the performance of endurance athletes.26 Active recovery is successful mostly due to its ability to more rapidly remove blood lactate, facilitating blood flow and giving the body the ability to process excess lactate produced during periods of intense exercise.27

Cross training is also a great way to engage in active recovery while enhancing aerobic fitness without putting the body through the same stress as your normal workouts. Try:

 

  • Cycling: The motion is similar to running without the joint impact. Ride at an easy pace in the low-intensity zone (around 120 – 140 heart rate)
  • Yoga: A beginner’s class should do just fine. Practicing basic yoga through online videos is sufficient, using poses such as sun salutation (to boost circulation and release tightness) and warriors one and two (to activate thigh and calf muscles while helping stretch hips)
  • Plyometrics: Even 15 – 30 minutes of bodyweight exercises can help boost circulation while stretching muscles. They’ve even been shown to increase sprint performance.28 Try exercises like planks, calf raises and lunges

Ice Baths: Taking the Plunge

Some athletes and coaches swear by ice baths, with trainers mandating post-practice cold water immersion (CWI). They consider ice baths essential to helping tired muscles, and feeling better for the next intense training sessions.

The idea here is that cold therapy constricts blood vessels and decreases metabolic activity, reducing swelling and tissue breakdown, flushing metabolic debris from the muscle.

But one study showcased that the “hypothesized physiological benefits surrounding CWI are at least partly placebo related.”29 This suggests that if you think ice baths help, then they may have a beneficial impact on recovery and subsequent training.

If you’d like to try an ice bath, fill a tub or large container with water, enough to submerge your hips. Add enough ice so the temperature of the water drops to about 55 degrees. Then sit in the bath for about 15 minutes.

Stretching & Foam Rolling: Increase Range of Motion

Stretching is important both before and after a workout because exercise can shorten muscles, decreasing mobility. Stretching helps flexibility, allowing muscles and joints to work in their full range of motion.30 One study found that hamstring flexibility led to increased muscle performance.31

Post-workout stretches are often forgotten by athletes in a rush, but it’s essential to account for these stretches in a training schedule. Generally, it’s best to hold stretches for about 30 seconds and repeat each once or twice. Target these muscles, which usually take a beating from a variety of workouts:

  • Piriformis
  • Chest and Anterior Deltoids
  • Hamstrings
  • Lats
  • Quads
  • Lower Back

Complementary to stretching, foam rollers help sore muscles,32 and they can be used on almost every muscle in the body.

Our muscles go through a constant state of breakdown, then repair. Fascia, the connective tissue surrounding our muscles, gets thick and short over time because the body is attempting to protect itself from more damage. Sometimes, trigger points form–sore spots, caused by fascia contraction, need release.

Ultimately, this affects range of movement and causes soreness.

Foam rolling (called myofascial release) can help release those muscular trigger points, and as one study found, can lead to overall improvement in athletic performance.33 The result is decreased muscle and joint pain, and increased mobility.

Selecting a foam roller depends on your needs; a larger roller can allow you fuller sessions (meaning, if it’s large enough, you can lie on the foam roller and do some great shoulder / upper back workouts). A denser roller will also mean a more intense massage.

Target these often overused areas: glutes, iliotibial band (IT band), lower back, shoulders and sides.

Technology: All the Data You Need

While technology and wearables can’t directly help with recovery, they’re able to gather important data that may inform recovery techniques. Being able to track aspects of training, sleep, heart rate and hydration can provide insight into how the best tackle specificities of recovery.

 

  • Hydration: Wearables like Nobo B60 and Hydra Alert help monitor hydration through different means, but mostly through sensors. Nobo is like a watch, mounted to the wrist or calf, while the Hydra Alert is placed in a urinal or toilet to monitor hydration through urine. However, many of these types of devices haven’t been independently validated for accuracy.
  • Training: It seems there are countless devices to measure training. The IMeasureU is versatile, using motion data to track training. Similar to hydration wearables though, there isn’t clinical validation for this technology.
  • Heart Rate and Breathing: The Hexoskin is like a smart t-shirt with electrocardiogram (ECG) and breathing sensors, along with an accelerometer. This measures heart rate, heart rate variability, breathing rate, steps, etc.
  • Sleep: Many training devices also can monitor sleep. These devices can illuminate what we don’t know happens during our sleep, and can also showcase our sleeping patterns to help us understand why we may be waking up so tired. The Fitbit Charge 2 is especially responsive to monitoring sleep, and has been validated through a third-party study.34

Understanding our inputs with data provides us with a way to maximize our outputs and reach peak performance–even in recovery.

Recovery is the First Step to Better Training

 

Recovery takes time and dedication; it often gets overlooked in workout schedules because it isn’t accounted for.

Active recovery, sleep, diet, and supplements like HVMN Ketone can be used to kickstart the recovery process and make training more effective.

The best training starts with mindful recovery to help muscles rebuild for the next training session. This, ultimately, can improve training by putting your body in the best position to perform. The process of muscle breakdown happens during exercise; immediately after, the process of muscle restoration and strengthening begins–you could be compromising gainful training by skipping these all-important techniques to help the body rebuild.

 

Scientific Citations

1. MacDougall JD, Gibala MJ, Tarnopolsky MA, MacDonald JR, Interisano SA, Yarasheski KE. The time course for elevated muscle protein synthesis following heavy resistance exercise. Can J Appl Physiol. 1995 Dec;20(4):480-6.
2. Mitchell, J W. Nadel, E R. Stolwijk, J. A. J. Respiratory water losses during exercise. Journal of Applied Physiology 32(4):474-6. May 1972.
3. Montner P, Stark D M, Riedesel M L, Murata G, Robergs R, Timms M, Chick T W. Pre-Exercise Glycerol Hydration Improves Cycling Endurance Time. Int J Sports Med 1996; 17(1): 27-33.
4. Hew-Butler T, Rosner M H, Fowkes-Godek S, et al. Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference, Carlsbad, California, 2015. Clinical Journal of Sport Medicine: July 2015 – Volume 25 – Issue 4 – p 303–320.
5. Moreno I L, Vanderlei L C M, Pastre C M, Vanderlei F M, Carlos de Abreu L, Ferreira C. Cardiorespiratory effects of water ingestion during and after exercise. Int Arch Med. 2013; 6: 35. Published online 2013 Sep 23.
6. Heneghan C, Gill P, O’Neill B, Lasserson D, Thake M, Thompson M, Howick J. Mythbusting sports and exercise products. BMJ 2012;345:e4848.
7. Kerksick C, Harvey T, Stout J, et al. International Society of Sports Nutrition position stand: nutrient timing. J Int Soc Sports Nutr. 2008 Oct 3;5:17.
8. Biolo G, Tipton KD, Klein S, Wolfe RR. An abundant supply of amino acids enhances the metabolic effect of exercise on muscle protein. Am J Physiol. 1997 Jul;273(1 Pt 1):E122-9.
9. Rasmussen BB, Tipton KD, Miller SL, Wolf SE, Wolfe RR. An oral essential amino acid-carbohydrate supplement enhances muscle protein anabolism after resistance exercise. J Appl Physiol (1985). 2000 Feb;88(2):386-92.
10. Elliot TA, Cree MG, Sanford AP, Wolfe RR, Tipton KD. Milk ingestion stimulates net muscle protein synthesis following resistance exercise. Med Sci Sports Exerc. 2006 Apr;38(4):667-74.
11. Rieu I, Balage M, Sornet C, Giraudet C, Pujos E, Grizard J, Mosoni L, Dardevet D. Leucine supplementation improves muscle protein synthesis in elderly men independently of hyperaminoacidaemia. The Journal of Physiology, 08 August 2006.
12. Yang C, Jiao Y, Wei B, Yang Z, Wu JF, Jensen J, Jean WH,4, Huang CY, Kuo CH. Aged cells in human skeletal muscle after resistance exercise. Aging (Albany NY). 2018 Jun 27;10(6):1356-1365.
13. Tang J E, Moore D R, Kujbida G W, Tarnopolsky M A, Phillips S M. Ingestion of whey hydrolysate, casein, or soy protein isolate: effects on mixed muscle protein synthesis at rest and following resistance exercise in young men. American Physiological Society. 01 September 2009.
14. Res P T, Groen B, Pennings B, Beelen M, Wallis G A, Gijsen A P , Senden J M G, Van Loon L J C. Protein Ingestion before Sleep Improves Postexercise Overnight Recovery. 0195-9131/12/4408-1560/0 MEDICINE & SCIENCE IN SPORTS & EXERCISE Copyright 2012 by the American College of Sports Medicine.
15. Negro M, Giardina S, Marzani B, Marzatico F. Branched-chain amino acid supplementation does not enhance athletic performance but affects muscle recovery and the immune system. J Sports Med Phys Fitness. 2008 Sep;48(3):347-51.
16. Mori T A, Beilin L J. Omega-3 fatty acids and inflammation. Current Atherosclerosis Reports November 2004, Volume 6, Issue 6, pp 461–467.
17. Barros MP, Poppe SC, Bondan EF. Neuroprotective properties of the marine carotenoid astaxanthin and omega-3 fatty acids, and perspectives for the natural combination of both in krill oil. Nutrients. 2014 Mar 24;6(3):1293-317.
18. Pashkow FJ, Watumull DG, Campbell CL. Astaxanthin: a novel potential treatment for oxidative stress and inflammation in cardiovascular disease. Am J Cardiol. 2008 May 22;101(10A):58D-68D.
19. Machlin L J , Bendich A. Free radical tissue damage: protective role of antioxidant nutrients. The Federation of American Societies for Experimental Biology. Vol. 1, No. 6 December 1987.
20. Holdsworth, D.A., Cox, P.J., Kirk, T., Stradling, H., Impey, S.G., and Clarke, K. (2017). A Ketone Ester Drink Increases Postexercise Muscle Glycogen Synthesis in Humans. Med Sci Sports Exerc.
21. Stubbs, B.Cox, P.; Evans, R.; Santer, P.; Miller, J.; Faull, O.; Magor-Elliott, S.; Hiyama, S.; Stirling, M.; Clarke, K. (2017). On the metabolism of exogenous ketones in humans. Front. Physiol.
22. Cahill, G.F., Jr. (1970). Starvation in man. New Engl J Med 282, 668-675.
23. Dattilo M, Antunes H K M, Medeiros A, Mônico Neto M, Souza H S, Tufika S, de Mello M T. Sleep and muscle recovery: Endocrinological and molecular basis for a new and promising hypothesis. Medical Hypotheses Volume 77, Issue 2, August 2011, Pages 220-222.
24. Exelmans L, Van den Bulck J .Bedtime mobile phone use and sleep in adults. Soc Sci Med. 2016 Jan;148:93-101.
25. Parra J, Cadefau J A, Rodas G, Amigo N, Cusso R. The distribution of rest periods affects performance and adaptations of energy metabolism induced by high‐intensity training in human muscle. Acta Physiologica Scandinavica, 169: 157-165.
26. Crowther F, Sealey R, Crowe M, Edwards A, Halson S. Influence of recovery strategies upon performance and perceptions following fatiguing exercise: a randomized controlled trial. BMC Sports Science, Medicine and RehabilitationBMC series – open, inclusive and trusted. 2017 9:25.
27. Monedero J, Donne B. Effect of Recovery Interventions on Lactate Removal and Subsequent Performance. Int J Sports Med 2000; 21: 593–597
28. Rimmer E, Sleivert G. Effects of a Plyometrics Intervention Program on Sprint Performance. Journal of Strength and Conditioning Research, 2000, 14(3), 295–301 q 2000.
29. Broatch JR, Petersen A, Bishop DJ. Postexercise cold water immersion benefits are not greater than the placebo effect. Med Sci Sports Exerc. 2014 Nov;46(11):2139-47.
30. Page P. Current Concepts in Muscle Stretching for Exercise and Rehabilitation. Int J Sports Phys Ther. 2012 Feb; 7(1): 109–119.
31. Worrell T W, Smith T L, Winegardner J. Effect of Hamstring Stretching on Hamstring Muscle Performance. Journal of Orthopaedic & Sports Physical Therapy, 1994 Volume:20 Issue:3 Pages:154–159.
32. Pearcey G E P, Bradbury-Squires D J, Kawamoto J E, Drinkwater E J, Behm D G, Button D C. Foam Rolling for Delayed-Onset Muscle Soreness and Recovery of Dynamic Performance Measures. Journal of Athletic Training: January 2015, Vol. 50, No. 1, pp. 5-13.
33. Peacock CA, Krein D D, Silva T A, Sander G J, Von Carlowitz K A. An Acute Bout of Self-Myofascial Release in the Form of Foam Rolling Improves Performance Testing. Int J Exerc Sci. 2014; 7(3): 202–211. Published online 2014 Jul 1.
34. de Zambotti M, Goldstone A, Claudatos S, Colrain IM, Baker FC. A validation study of Fitbit Charge 2™ compared with polysomnography in adults.

 

by Chris Kresser (web)

picture of man made by supplementsIn the first three articles in this series, we discussed which foods to eat and which foods to avoid. In this article we’re going to talk about when to supplement and how to do it wisely. We’ve got a lot of material to cover, so you might want to grab a cup of tea and get comfortable!

There are three principles to supplementing wisely:

  • Get nutrients from food whenever possible.
  • Take nutrients in their naturally occurring form whenever possible.
  • Be selective with your supplementation.

Get nutrients from food whenever possible

Humans are adapted to getting nutrients from whole foods. Most nutrients require enzymes, synergistic co-factors and organic mineral-activators to be properly absorbed. While these are naturally present in foods, they are often not included in synthetic vitamins with isolated nutrients.

In a paper published in the American Journal of Clinical Nutrition called Food Synergy: An Operational Concept For Understanding Nutrition emphasizing the importance of obtaining nutrients from whole foods, the authors concluded:

A person or animal eating a diet consisting solely of purified nutrients in their Dietary Reference Intake amounts, without benefit of the coordination inherent in food, may not thrive and probably would not have optimal health. This review argues for the primacy of food over supplements in meeting nutritional requirements of the population.

They cautioned against the risk of reductionist thinking, which is common in conventional medicine and nutritional supplementation. Instead, they urge us to consider the importance of what they call “food synergy”:

The concept of food synergy is based on the proposition that the interrelations between constituents in foods are significant. This significance is dependent on the balance between constituents within the food, how well the constituents survive digestion, and the extent to which they appear biologically active at the cellular level.

They go on to provide evidence that whole foods are more effective than supplements in meeting nutrient needs:

  • Tomato consumption has a greater effect on human prostrate tissue than an equivalent amount of lycopene.
  • Whole pomegranates and broccoli had greater antiproliferative and in vitro chemical effects than did some of their individual constituents.
  • Free radicals were reduced by consumption of brassica vegetables, independent of micronutrient mix.

In short: get nutrients from food, not supplements, whenever you can.

Take nutrients in their naturally occurring form whenever possible

Synthetic, isolated nutrients don’t always have the same effect on the body. It matters whether the nutrients have been produced by technologic or biological processes, because industrial processing sometimes creates an entirely new compound with different physiological actions. Trans fat produced in ruminant animals (such as conjugated linoleic acids in dairy products) are beneficial to health, whereas trans fats produced in the processing of industrial seed oils are highly toxic.

Folic acid is another example. The naturally occurring form of folate is not folic acid, a compound not normally found in food or nature, but tetrahydrofolate. While folic acid can be converted into folate, that conversion is poor in humans. It’s also important to note that unlike natural folate, folic acid does not cross the placenta. This is significant because folate is a crucial nutrient for pregnancy, and while folic acid can prevent neural tube defects it doesn’t have the other beneficial effects of folate. What’s more, several studies have shown that folic acid – but not natural folate – increases cancer risk. Unfortunately, folic acid is what’s often used in multivitamins, because it’s significantly cheaper than natural folate.

Be selective with your supplementation.

Multivitamins have become increasingly popular: half of Americans currently take one. But is this a good idea? Most studies show that multivitamins either provide no benefit, or may even cause harm. A study in the Archives of Internal Medicine showed that multivitamins have little to no influence on the risk of common cancers, CVD or total mortality in postmenopausal women. A now infamous meta-analysis in the Journal of American Medical Association, which looked at over 68 trials with 230,000 pooled participants, found that treatment with synthetic beta carotene, vitamin A and vitamin E may increase mortality.

The problem with multivitamins is that they contain too little of beneficial nutrients like magnesium, vitamin D and vitamin K2, and too much of potentially toxic nutrients like folic acid, calcium, iron and vitamin E. This means that multivitamins can actually cause nutrient imbalances that contribute to disease. Another problem is that multivitamin manufacturers often use the cheapest possible ingredients, such as folic acid instead of natural folate – the consequences of which we discussed above.

Which supplements may be necessary?

At this point you might be thinking I’m against supplementation entirely. Not so. No matter how well we eat, some nutrients are difficult to obtain enough of from food alone. There are also circumstances where are need for certain nutrients may increase, such as vitamin C during infections and magnesium with blood sugar imbalances or metabolic problems. In these cases, it makes sense to supplement selectively with beneficial nutrients.

The five nutrients I recommend most people supplement with are:

  • Vitamin A
  • Vitamin D
  • Vitamin K2
  • Magnesium
  • Vitamin C

Vitamin A (Retinol)

Vitamin A is important catalyst for a variety of biochemical processes in the body. It’s required for assimilation of protein, minerals and water-soluble vitamins, and it also acts as antioxidant > protecting body against free-radical damage and diseases like cancer. Vitamin A plays a crucial role in reproduction, promoting full-term pregnancy and proper development of face (eyes, nose, dental arches & lips).

The RDA for vitamin A (2,600 IU) is woefully inadequate, and even then, over 25% of American consume less than half of the recommended amount. Native populations such as the traditional Inuit – which were free of modern, degenerative disease – got much more vitamin A than the average American. The Greenland Inuit of 1953, prior to much contact with the Western world, got about 35,000 IU of vitamin A per day.

Vitamin A (retinol) is only found in significant amounts in organ meats, which explains why many Americans don’t get enough of it. If you follow my recommendations in #2: Nourish Your Body, and you do eat organ meats (especially liver), you’re probably getting enough vitamin A and thus don’t need to supplement. However, if you’re like most Americans and you’ve never eaten liver in your life, you would benefit from supplementing with A.

There’s been a lot of discussion in the media about the toxicity of vitamin A. Some researchers and doctors now recommend avoiding cod liver oil because of this concern. Even Dr. Mercola has jumped on the “vitamin A is toxic” bandwagon. But is this true?

It is true that vitamin A is potentially toxic. Some evidence suggests that excess vitamin A increases the risk of osteoporosis. For example, this study showed both low and high serum A carried double risk of fractures as did optimal levels.

But if we dig deeper we find that excess vitamin A only causes problems against a backdrop of vitamin D deficiency. In his excellent article Vitamin A on Trial: Does Vitamin A Cause Osteoporosis, researcher Chris Masterjohn summarizes evidence demonstrating that vitamin D decreases the toxicity of and increases the dietary requirement for vitamin A. Studies show that supplementing with vitamin D radically increases the toxicity threshold of vitamin A. In a hypothetical 160 lb. person, vitamin D supplementation increases the toxicity threshold of vitamin A to more than 200,000 IU/d. You’d have to eat 22 ounces of beef liver or take 5 TBS of high vitamin CLO each day to get this amount. Not likely!

To meet vitamin A needs (assuming you’re not up for eating organ meats), I recommend taking high vitamin cod liver oil (CLO) to provide a dose of 10-15,000 IU per day. Cod liver oil is really more of a food than a supplement, but since it’s not a normal part of people’s diet we’ll consider it as a supplement. CLO is an ideal vitamin A source because it also contains vitamin D, which as we just learned, protects against the toxicity of A.

Vitamin D

Much has been written about the need for and benefits of vitamin D supplementation over the past several years – and with good reason. It’s absolutely critical for health, and up to 50% of Americans are deficient.

We can get vitamin D from two sources: food, and sunshine. Seafood is the only significant source of vitamin D, but you’d still have to eat a lot of it to get enough. 8-9 ounces of herring provides about 2,000 IU of vitamin D, which is a minimum daily requirement for most people to maintain adequate blood levels.

Sunlight converts a precursor called 7-dehydro-cholesterol in our skin to vitamin D3. This D3, along with the D3 we get from food, gets converted by the liver into 25-hyrdroxy-vitamin D (25D), which is what typically gets measured when you have a vitamin D test. The optimal 25D level is somewhere between 35 and 50 ng/mL.

Contrary to what some researchers and doctors have recommended, there’s no evidence that raising blood levels of 25D above 50 ng/mL is beneficial, and there’s some evidence that it may cause harm. Studies show that bone mineral density peaks at 45 ng/mL and then falls again as 25D levels rise above 45. Other studies have shown that the risk of kidney stones and CVD increase with high 25D levels, due to elevated serum calcium levels that accompany excess vitamin D.

However, we also know that vitamin A and vitamin K2 protect against vitamin D toxicity, and vice versa. As I explained in the vitamin A section, fat soluble vitamins exist in a synergistic relationship. It’s possible that the people in the studies above that experienced problems with excess 25D levels were deficient in vitamin A or K2, or both. This is why it’s so important to supplement with all of the fat-soluble vitamins together.

What about sunlight? Well, in summer mid-day sun with pale skin, 30 minutes of direct sunlight will produce 10-20,000 IU of vitamin D. But this is a best case scenario. With darker skin, or different times of year, or buildings that block the sunlight, or increased time spent indoors, we won’t be producing that much. It’s also true that aging, overweight and inflammation reduce our conversion of sunlight to vitamin D. This is why sunlight alone isn’t normally a sufficient source of vitamin D.

With this in mind, most people should supplement with D. The amount needed to maintain blood levels of 35-50 ng/mL varies depending on some of the factors I’ve listed above, but in my clinical experience it’s usually somewhere between 2,000 – 5,000 IU. With vitamin D, it’s important to test your levels, begin supplementation, and then re-test a few months later to determine the correct maintenance dose.

As with vitamin A, the best source of vitamin D is high-vitamin cod liver oil. It contains not only vitamins A & D, but also natural vitamin E and other quinones.

Vitamin K2

Vitamin K2 may be the most important vitamin most people have never heard of. It’s needed to activate proteins and it also regulates calcium metabolism (keeping it in the bones and teeth where it belongs, and out of the soft tissue where it doesn’t belong). Elevated blood calcium significantly increases the risk of cardiovascular disease (CVD), which explains why vitamin K2 has been shown to prevent atherosclerosis and heart attacks. It also strengthens bones.

Unfortunately, many (if not most) of Americans are deficient in vitamin K2. It’s important to point out that vitamin K2 is not the same as vitamin K1, which is found in green, leafy vegetables like kale and collards. Some K1 is converted into K2 in our bodies, but that conversion is inefficient in humans. It is efficient, however, in ruminant animals – which is why grass-fed dairy is the most convenient source of vitamin K2 in the diet. This is only true in animals raised on pasture, because it is eating the K1-rich grass that allows them to convert it into K2.

Most people should aim for at least 100 mcg/d from a combination of food and supplements. If you eat a large amount of cheese from grass-fed cows and pastured egg yolks, you may be able to get this amount from food alone. 100 g of hard cheese contains 67 mcg, and 6 pastured egg yolks contain about 32 mcg. Otherwise, supplementation is probably beneficial. I recommend a dosage of 1 mg/d in the MK-4 form, which is the form of vitamin K2 found in pastured dairy and the one shown to have the most benefit in clinical studies. There is another form, MK-7, that is found in fermented foods like natto, but it has not demonstrated the same properties as MK-4 in clinical studies.

Magnesium

There are few compounds in the body more important to overall health than magnesium. Over 300 enzymes need it, including every enzyme associated with ATP, and enzymes required to synthesize DNA, RNA and proteins. Magnesium also plays an important role in bone and cell membranes, as it helps to transport ions across the membrane surface.

Studies show that most Americans are deficient in magnesium. The median intake across all racial groups is far below the RDA, which is 420 mg/d for men and 320-400 mg/d for women. Although half of Americans take a multivitamin daily, most don’t contain enough magnesium to prevent deficiency.

Magnesium is also difficult to obtain from food. Nuts and seeds are the highest source, but it’s difficult to eat enough of them to meet magnesium needs without getting too much polyunsaturated fat. Another issue is that magnesium levels in food have dropped as modern soils have become increasingly depleted. What this means is that if you’re not supplementing with magnesium, you’re probably not getting enough.

And magnesium deficiency is no small thing. It has serious – even fatal – consequences. It produces symptoms like muscle cramps, heart arrhythmias, tremor, headaches & acid reflux, and it’s associated with CVD, hypertension, metabolic syndrome, diabetes, migraines, PMS, asthma, hypothyroidism. In fact, it’s hard to find a modern disease magnesium deficiency isn’t associated with.

Because of this, I think everyone should supplement with magnesium. Intake of 400 – 800 mg/d from a combination of food and supplements is an optimal range to shoot for. Since most people get less than 250 mg/d from food, a dose of 400 – 600 mg/d in supplement form is ideal. I recommend using chelated forms of magnesium like glycinate and malate, because they’re better absorbed and tend to have fewer side effects.

Vitamin C

Vitamin C is needed for building the structural components of the body, and for maintaining levels of glutathione, the master antioxidant in the body. But vitamin C deficiency is also common: studies suggest that 34% of men and 27% of women don’t get enough. This is especially true for the elderly and those struggling with chronic illness.

400 mg/d is the saturation range in healthy people, and that number is probably higher in the elderly and the sick. As with the other micronutrients in this article, it’s difficult to obtain adequate levels of vitamin C from the diet. Acerola cherries are the highest food source, with 1677 mg per 100g. A cup of cooked red peppers has 235 mg, which is one of the highest dietary sources.

I’m somewhat less certain about the need to supplement with vitamin C, but in general I recommend approximately 500 mg to 1 g of vitamin C each day. If you’re dealing with a chronic health challenge, or fighting an infection, you can take several grams a day with no toxic effects. It’s best to space the doses out to avoid diarrhea, however.

Other contenders

In addition to the fat-soluble vitamins A, D & K2, and magnesium and vitamin C, some may want to consider supplementing with selenium and iodine. Selenium plays important role in thyroid function, which affects every aspect of physiology. The recommended dose is approximately 200 mcg/d.

Selenium is plentiful in organ meats, ocean fish, and in brazil nuts. One brazil nut contains 100 mcg of selenium, but it also contains a whopping 1 g of omega-6 linoleic acid, which as you know from previous articles in the series, we want to limit significantly. This is why I don’t recommend brazil nuts as a source of selenium. Ocean fish are also good sources of selenium. 100 g of cod contains about 150 mcg.

Iodine also plays a crucial role in thyroid function, and it prevents brain damage and strengthens the immune system. The amount iodine needed for thyroid function is incredibly small: we need about a teaspoon of iodine over a lifetime to avoid deficiency. I’m not convinced humans need to supplement with iodine above what can be obtained from seafood, but some research does suggest that increased intake of iodine is beneficial. This is especially true if you’re fighting a chronic infection or dealing with a hypothyroidism caused by iodine deficiency.

But be careful: iodine can trigger and flare autoimmune diseases, especially Hashimoto’s and Graves’(autoimmune thyroid disease). In the U.S., 9 out of 10 women with hypothyroidism actually have Hashimoto’s, so the typical advice to supplement with iodine if you are hypothyroid is dangerous. I’ve written extensively about this in my special report on thyroid disease.

For those without autoimmune disease, a dose of 12.5 mg – 50 mg per day may be beneficial, but it’s best to work up slowly over time, beginning at a much lower dose.