In 2013, a group of five physicians from the Johns Hopkins School of Public Health and Warwick Medical School in the U.K. made a bold statement:

“We believe that the case is closed—supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful. These vitamins should not be used for chronic disease prevention. Enough is enough,” they wrote in Annals of Internal Medicine, one of the most popular medical journals in the US.

Their declaration was based on decades of that found no evidence multivitamins reduced the risk of heart disease or cancer, prevented memory decline, or lowered heart attack rates.Ìę

In science, however, the case is almost never truly closed.Ìę

This year, of more than 3,500 people over the the age of 60 who took multivitamins every day for three years found they performed better on memory tests after a year. After three years, the multivitamin group showed none of the age-related memory decline evidenced by the placebo group.Ìę 

Does this mean the multivitamin naysayers should start taking vitamin supplements? Who can benefit from them, and who shouldn’t bother?

Vitamins and Memory Loss

Dr. Adam Brickman, a neuropsychologist and a professor at Columbia University, led the study on the impact of multivitamins on cognitive decline in older adults. He found people taking multivitamins (in this case, the study used Centrum Silver vitamins, though Brickman says it’s likely any high-quality multivitamin will replicate the same results) experienced a significant improvement in their memory as compared to those in the placebo group after one year, an effect that was sustained on average over the three years of the study.Ìę

“It’s certainly not a panacea for cognitive aging,” Dr. Brickman says, “but it is a reliable effect.”

He pointed out that multivitamins are not a treatment for Alzheimer’s or dementia, and everyone should consult with a doctor before taking any supplements. While this study only included people over the age of 60, some research shows cognitive decline .Ìę

A daily multivitamin is a for those interested in covering all bases, but this approach should not come at the expense of eating a varied diet full of fruits and vegetables. A found that while getting adequate amounts of vitamin A, vitamin K, magnesium, zinc, and copper were associated with a lower risk of early death, those benefits were only found when vitamins came through food, not supplements.Ìę

“No one is saying that taking vitamins is a replacement for having a healthy diet,” Dr. Brickman says, adding, “This is truly just a supplement that might enhance or bump things up a little bit.” 

This means that if you do decide to take a multivitamin supplement to hedge your bets, it’s essential to also prioritize good nutrition, which means filling your plate with whole, unprocessed foods and eating a wide variety of fruits and vegetables, whole grains, and lean protein.Ìę

Vitamins for Athletes

While the science isn’t clear about multivitamin supplements for the general population, , a Canada-based certified holistic nutritionist who specializes in sports nutrition, says there are certain instances when a vitamin supplement is highly recommended: folic acid for women trying to conceive and during pregnancy, or with a condition like Crohn’s disease, which makes it difficult for the body to absorb nutrients.Ìę  

“In some situations like that, a multivitamin could help fill some gaps where the food might not be processed by the body the way it’s supposed to be,” says Boufounos.

If most people don’t need to take a multivitamin, what about athletes—especially endurance athletes who regularly push their bodies to the limit? 

is a Minnesota-based registered dietitian who works exclusively with endurance athletes. She says when it comes to nutrition, she always starts with food.

“That’s always the gold standard,” Larson explains, “and a supplement is not a replacement for a balanced diet.”

Larson does recommend her athletes get an annual or semi-annual blood test to find out if they have any vitamin deficiencies, as well as consult with a primary care physician to make sure there aren’t any underlying medical conditions or medications that might conflict with supplements. Many of the female endurance athletes she works with find their iron levels are low, and she recommends an iron supplement—or better yet, iron-rich food—to help with performance and energy levels.Ìę  

Boufounos agrees, saying she always takes a food-first approach with athletes. She approaches supplementation as a short-term solution to bridge any gaps while trying to correct dietary patterns.Ìę

“I never want to tell an athlete that they have to supplement long term because you also get into a situation where I think some people unintentionally rely on the supplement,” says Boufounos.Ìę

She especially sees this phenomenon with green powders, which often contain multivitamins.Ìę

“I’ve seen so many athletes supplement with a green powder that also had the multivitamin in it and then they’re like ‘Sweet, I don’t need to ever eat a vegetable ever again,’” says Boufounos.Ìę

How to Choose Your Multivitamin

If you decide you do want to start taking a multivitamin, Boufounos says it’s important to make sure your supplement meets the recommended dietary allowance (RDA) for as many of the micronutrients as possible. Some supplements have 100 percent of the RDA for only a few vitamins, and the other ones don’t come close to the daily recommendations.Ìę

More than price, however, look at what’s included in the multivitamin. Boufounos says it’s not worth paying for extra micronutrients if they are in negligible amounts.Ìę 

Both Larson and Boufounos say it’s essential to buy supplements that are third-party tested, especially if you’re an athlete in a tested sport, but also to make sure the supplements are safe and contain exactly what the label claims. Supplement companies that are third-party tested will always state that distinction clearly on their website or marketing materials.Ìę

Larson also recommends serious athletes who might be tested for their sport take supplements that are labeled NSF Certified for Sport or Informed Choice for Sport.Ìę

“I would be very careful about just typing in ‘multivitamin’ on Amazon and buying something because there are most definitely knockoffs on Amazon and that can get sketchy pretty quickly,” Boufounos says. She recommends buying supplements directly from the company’s website, not an online storefront.Ìę

If you plan to start taking vitamin supplements without consulting with an expert, Boufounos recommends sticking with a multivitamin, instead of selecting individual vitamins on their own.

“It would be safer for an athlete to use a multivitamin if they’ve never done a blood test and never worked with a dietician or a sports nutritionist than it would be for them to just randomly pick any supplement off the store shelves,” Boufounos says, because you might pick supplements that work against each other.

The science so far is clear about two things: multivitamins appear to help age-related cognitive decline but don’t seem to prevent chronic disease. The best multivitamin strategy—whether you’re an athlete or not—is to focus on food first, supplements second.Ìę

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When Lara Crawford stopped into her local vitamin and supplement store a few months ago, she was in search of something to alleviate her acid reflux, which causes a burning sensation in her chest and acid regurgitation. But the conversation quickly took a turn when a staff member learned Crawford wasn’t taking electrolyte supplements.

Crawford lives at 9,000 feet in the Colorado Rockies, a place considered to be high altitude. Even after living in the mountains for years, she never saw a need for additional electrolytes. However, the staff member told Crawford those who live at altitude tend to get dehydrated overnight—and suggested she start taking sports salts pills and a daily electrolyte powder.

“I thought those were just for ultra athletes or like serious athletes, but he told me everybody should be taking them,” Crawford says. He spoke so convincingly about their benefits that she decided to give the electrolytes and sports salts a try.

After using the sports salts in the morning and the electrolytes at midday for a few months, she noticed a moderate improvement in her acid reflux. However, the biggest change was in her face: She no longer woke up with dry, puffy eyes.

Spotting the meaningful difference, she wondered if the staff member was right. Was the shift due to her new electrolyte supplements? Maybe these weren’t just for endurance athletes after all. Perhaps even people who only engaged in moderate exercise still needed to supplement with electrolytes at altitude.

, an Utah-based sports nutritionist who works with outdoor athletes, including ultra runners, cyclists, and triathletes, says that while we do lose more fluids at altitude, there’s nothing special about nighttime.

However, the electrolyte and hydration question, and how much each of us should be consuming each day, is a bit more complicated.

How Hydrated Do You Need to Be at Altitude?

At higher elevations, your body has to work harder to get oxygen, which causes your breathing rate to increase. Since you lose water through respiration, this results in greater fluid loss. The air is also drier at altitude, which makes your sweat evaporate faster and causes additional fluid loss. Each of these factors contribute to your body losing more water than at sea level, requiring you to hydrate more frequently.

However, the longer you stay up in the mountains, the better it gets. Johnson says people who live at altitude are able to adapt to the lack of oxygen. Their bodies become more efficient, producing more red blood cells to carry oxygen through the body, which reduces the amount of fluid lost.

“It’s going to be pretty stressful on your body for a couple of weeks,” Johnson says, referring to spending time at elevation. “That’s the most crucial time to increase fluid intake. Then things will kind of regulate, and you won’t have to compensate quite so much.”

However, even longtime residents of high altitude towns—Crawford has lived at 9,000 feet for 29 years—typically need about a liter to (about four to six cups) than people living at lower altitudes. But hydration isn’t a one-size-fits-all prescription. Whether you’re in the mountains or at sea level, your fluid intake varies based on the weather, the amount you exercise, and your overall health.

How Do You Figure Out the Right Hydration Level?

To help his athletes find the amount of hydration they need, Johnson performs a sweat rate test. He starts by weighing them before they exercise. While they work out, he keeps track of the fluids they drink and any urine they lose. After they’ve finished, he weighs them again and plugs each data point into an equation to figure out how many milliliters of sweat per hour they lose. (If you’d like to try this for yourself, use a to finding out your own sweat rate.)

It’s important to note that even once you’ve figured out your sweat rate, completely replacing your lost liquids isn’t necessarily the goal. It’s not bad to be slightly dehydrated and . For many, drinking to quench your thirst is sufficient. (Those in their 70s or 80s need to monitor their intake a bit more, because our thirst sensation can decrease with age.)

Do You Need Electrolyte Supplements?

Electrolytes are electrically-charged minerals such as sodium, calcium, magnesium, and potassium that regulate your muscle contractions, keep you hydrated, and balance your pH levels. Every fluid and cell in your body has electrolytes, which aid the function of your nerves, muscles, brain, and heart. Electrolytes also manage the balance of fluids in your body’s cells and are lost through sweat and urine, or if you’re sick, through vomiting and diarrhea.

While electrolytes are essential, Johnson says most of us get all we need from food. “A normal, varied diet should provide you with plenty of electrolytes, even at altitude.” Johnson says, “For the recreational athlete, it’s honestly not that big of an issue.”

If you aren’t engaging in high-output endurance activities lasting longer than three hours, and if you’re eating a nutrient-dense diet with whole grains, legumes, vegetables, fruits, nuts, and seeds, Johnson says you should be getting enough electrolytes without needing additional supplementation. However, endurance athletes who engage in high-output endurance activities lasting longer than three hours have different hydration needs, and may find electrolyte powders and capsules are a good way to stay hydrated and keep their electrolytes balanced.

That doesn’t mean these supplements are the secret to unlocking a new PR. conducted by researchers at Stanford University found that electrolyte supplementation does not improve performance or protect against illnesses caused by a change in sodium levels, including exercise-associated hyponatremia (EAH).

If an endurance athlete wants to take in some sodium, Johnson recommends turning to salty foods, such as pretzels or even a peanut butter sandwich.

“For the most part, when our serum sodium levels drop, the body can usually take care of that and regulate that on its own,” he says.

The Power of Hydration

So, if electrolyte supplementation isn’t really necessary for most people, why did Crawford see a noticeable difference in her face after months of supplementation?

The answer most likely lies in what Crawford took with the powder and capsules.

Before going to the supplement store, Crawford says she struggled to drink enough water. However, while doling out instructions for the supplements, the staff member instructed Crawford to drink a full bottle of water with her morning sports salts capsules (which contain sea salt, magnesium, and potassium) and to mix the flavored electrolyte powder with at least 16 ounces of water later in the day. The supplements provided the structure for her to consume more water, improving her overall hydration and reducing the puffiness in her eyes.

If you live at altitude and find it difficult to drink adequate fluids, a flavored powder might help. For most people, however—including serious athletes—drinking when you’re thirsty is usually enough.

The post Do You Need Electrolyte Supplements at Altitude? appeared first on șÚÁÏłÔčÏÍű Online.

When , a professor of nutrition at the University of Illinois, Chicago, began studying intermittent fasting 20 years ago, she couldn’t wait for this way of eating to become mainstream.

Then in 2012, Varady got her wish. The popularity of intermittent fasting—a way of eating that involves switching between fasting and eating on a regular schedule—exploded with Michael Mosley’s television documentary , his book , and Kate Harrison’s book that same year, .

After the initial wave of excitement and claims that intermittent fasting can reduce inflammation, boost immunity, and prevent chronic disease, the backlash began. In the last few years, professionals in the health and fitness industry began to sound the alarm, saying women should avoid intermittent fasting because it causes , disrupts menstrual cycles, and interferes with sleep.

But Varady says doesn’t support these claims.

“We’ve done about 30 clinical trials in intermittent fasting, and about 85 percent of our samples are women,” she says. “This diet either has no effect on reproductive hormones, or it actually benefits people with (PCOS).”

While intermittent fasting isn’t the magic bullet for perfect health, as many claimed in the beginning, it also doesn’t appear to damage women’s reproductive hormones, as long as you consume enough calories and maintain a healthy body fat percentage in the process.

A Look at the Science

Much of the concern about intermittent fasting’s effect on women’s fertility stems from on three- to four-month-old rats. Intermittent fasting did negatively affect the reproductive health of these young rats, but the same result has not been replicated in adult human women. Additionally, a three-month-old rat is equivalent to a nine-year-old human, an age group that shouldn’t be fasting. Doctors recommend against fasting for children and teens because they experience periods of rapid growth and could potentially develop disordered eating habits.

A 2022 of human trials published in Nutrients found that intermittent fasting lowers androgen levels and increases sex hormone-binding globulin (SHGB) in premenopausal women with obesity, both of which aid fertility. on premenopausal and postmenopausal women found that following a time-restricted eating plan resulted in mild weight loss and had little effect on participants’ hormones.

That study did find that dehydroepiandrosterone (DHEA), a hormone produced in the adrenal glands, decreased about 15 percent in each group. Low levels of DHEA can lead to a lower cancer risk in premenopausal women, but it is also connected to higher rates of vaginal dryness and diminished skin tone. Varady says those levels aren’t clinically significant, and the participants didn’t report any adverse effects, but she says it’s something her team will keep in mind for future studies.

“We’ve studied thousands of people of childbearing age, including women who are doing CrossFit and resistance training,” Varady says. “They do show slight decreases in testosterone but no changes in muscle mass or training capacity.”

James Nodler, MD, a reproductive endocrinologist at CCRM Fertility, says he thinks intermittent fasting is a fine option for women who are experiencing fertility issues as a result of obesity. However, in general, he does not recommend it for people trying to conceive.“Studies in humans have shown that intermittent fasting is not effective for long-term weight loss,” he says.

The current research suggests that this diet doesn’t have a negative effect on women’s hormones. However, more studies need to be done in order to confirm this. the lack of studies conducted on intermittent fasting make it difficult to draw any solid conclusions.

Part of this murkiness lies in the as a whole that often leads to conflicting or inconclusive results. Unlike other fields of research, nutrition science relies on observational studies that aren’t controlled in a lab setting and use self-reported food surveys, which are unreliable. Additionally, people often react very differently to the same diet, making it difficult to reach consistent conclusions.

The other problem with much of the discussion around intermittent fasting is many conflate it with severe calorie restriction, since the diet doesn’t offer guidelines about how much, or what, to eat.

Who Should Avoid Intermittent Fasting

Carrie Forrest, a blogger and who has a master’s in public health, is always on the lookout for ways to improve her health through nutrition. When intermittent fasting first became popular around 2012, Forrest, then in her late 30s, tried it out. She followed the Fast Five diet, which has a five-hour eating window. Even though her hunger woke her up in the middle of the night, Forrest, who struggled with disordered eating as a child, kept following the diet, restricting herself more and more.

“I got really scared of food, and then the fasting just seemed to reinforce that,” she says. “I thought that was the healthiest way to do it because I kept hearing how healthy fasting was,” Forrest says.

After a few years of intermittent fasting, Forrest began showing signs of under-eating. She developed peach fuzz on her back, a sign her body was undernourished and struggling to keep warm, and lost her period.

Her experience underscores that intermittent fasting is not for everyone. explains that intermittent fasting (and calorie restriction in general) is not recommended for people with a BMI below 18.5, those with a history of eating disorders, children, adolescents, women who are pregnant or lactating, or individuals over the age of 70. Women who don’t eat enough calories during their eating window or whose body fat drops below 16 percent can experience fertility and hormone issues.

Many people find intermittent fasting an easy eating plan to follow because it doesn’t require special foods or calorie counting, but it’s not for everyone. As always, the key is listening to your body’s cues and following a balanced nutritional approach that works best for you.

Hilary Achauer is a health, fitness, and wellness writer based in San Diego. Her work has appeared in The New York Times, The Washington Post, Slate, and Eating Well, among other publications. She writes marketing content for health and wellness companies and nonprofits and spends her free time surfing, doing CrossFit, and working her way through the massive pile of novels on her nightstand.Ìę

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