Multivitamin and Mineral Formulas

Transcription

Practitioner Dietary Supplement Reference Guide 2015 Update
Multivitamin and Mineral Formulas
Goal
The purpose of supplementing the diet with a properly designed multivitamin and mineral formula (MVM) should
be to not only supply essential nutrients in an attempt to prevent nutrient deficiencies, which in developed
nations are rare since food fortification, but to primarily overcome marginal deficiencies from today’s common
limitations (see obstacles listed below including maintaining low body fat) in obtaining sufficient and optimal
nutrient intake.1,2,3 Therefore, using the latest research and recommendations from the industry’s leading
experts,4,5,6,7,8,9,10 the goals of the dotFIT multivitamin and mineral formulas (MVM) are to deliver a combination of
nutrients in proper forms11,12,13,14 and in controlled release preparations15,16,17 that, when used properly, have the
greatest ability to raise blood/tissue levels to amounts shown in people who have reduced risks of chronic and
age-related disease,18,19,20,21 especially when compared to typical mass market formulas in which inexpensive, less
effective forms and dosages are incorporated into a NON- controlled release preparation in order to compete on
price.97,98
Rationale
While it's well documented that the vast majority of Americans or others who reside in Western nations fail to
adopt recommended dietary guidelines for food consumption,1,3,134 an even more insurmountable rationale for
MVM use is the fact that defining or prescribing the "perfect diet" is unrealistic22 as proven not only by continuous
changes in recommendations4,23,24 but also the inability of health professionals to create ideal palatable food plans
containing all necessary nutrients and amounts.25,26 Likewise, specifying the optimal intake of vitamins and
minerals is difficult in the face of continuing nutrient research. This makes giving concrete nutrient
recommendations challenging. For most nutrients, there is a large therapeutic range within which the average
person will receive benefit and simultaneously remain below the threshold that can yield adverse events (See
Table 3 Safe and Probable Optimal Range Including Food sources). It is one matter to define nutrient
recommendations, but another more challenging endeavor to actually consume the recommended dosages
through the course of a normal day with typical foods.1,6,7,27,28,29,30 The notion that food alone will satisfy all
physiological needs of the body for proper and ideal nutrient intake, especially in advanced aging,7,20 is outdated
and potentially irresponsible.8,21,31,32 Obstacles to proper eating and ideal nutrient intake include:
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Insufficient food intake4,5,7,33,34
Increased needs that are not met by diet alone2,33,35,36,37,38,39,40,41,,42,43,44,45
Special populations, age-related requirements or practicality of foods sources7,20,42,45,46,47,48,49,50,51
Lack of interest in or avoidance of essential food groups1,52,53,54,55,56,57,58
Low body fat maintenance5,34,59,60,61,62
Variables of actual nutrient content of food63,64,65,66,67,68,69,70
Sedentary lifestyles which lower daily calorie intake needs 71,72
o In the modern world, where many people maintain a sedentary lifestyle, maintaining a healthy
weight often requires eating too few calories to get proper nutrition through food alone71,72,73
Low sun exposure45,74,75,76,77,78,79,80,81
Inability to define the perfect diet24,25,34,82,83,84
It is in the context of all the above that dotFIT multivitamin and mineral supplements are formulated.
Additionally, formulas are developed with consideration for the nutrient values contained in today’s typical diet,
and the different overall nutrient needs based on age,20,41,46,85,86,87,88 gender, and activity.2,4,5,6,21,29,38,44,47,48,50 The
Practitioner Dietary Supplement Reference Guide
This information is educational material for dotFIT certified fitness professionals.
This literature is not to be used to imply that dotFIT products may diagnose, cure or prevent disease.
www.dotFIT.com/PDSRG2015Update
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dotFIT multivitamin and mineral formulas are used at the specified times throughout one’s lifetime, and include
the coverage of an active person’s basic antioxidant needs.44,48,49,50,89,90,91,92,93
dotFIT formulas are engineered with ideal health and functioning as the goal, as opposed to the ever changing
media driven need to see popular ingredients in a pill. An example is the decision to leave calcium out of the MVM
formulas since any effective calcium amount would double the pill size.94,95,96 Due to the variety of nutrients in a
MVM and size consideration, decisions are made based on what's needed in effective dosages while formulating
an acceptable pill size rather than throwing in everything as “window dressing dosages" (included but in
ineffective amounts just so it can appear on the label) to make people believe they're getting added in value when
in fact they are not.97,98
If one is failing at meeting calcium needs through the diet, then a calcium supplement is
warranted.39,95,96,99,100,101,102 This required dose will far exceed that included in any effective MVM formula,
otherwise the pill size is too large to ingest orally.
Another example of the dotFIT difference is that most experts believe the current recommendation for Vitamin D
is far too low, so dotFIT is taking the lead on ensuring optimal vitamin D intake.103,104,105,106
More and more research is emerging linking low vitamin D status with numerous chronic health issues.107,108
Population studies have shown that those with the lowest vitamin D intakes have a higher rate of mortality from
all factors, especially cardiovascular disease and cancer.106,109
The Institute of Medicine (IOM) suggests that a 25-hydroxyvitamin D blood level of 20 ng/mL (50nmol/L) is
sufficient for bone health, based on integrated measures of calcium absorption, bone mineral density,
osteomalacia, and rickets.110 Based on current data, many experts disagree with the IOM recommendation and
instead believe a 25-hydroxyvitamin D blood level of at least 30 ng/mL (75 nmol/L)111,112 is ideal, since this level is
associated with up to a 31% risk reduction in all cause mortality, falls and fractures.106,113 Generally,
supplementation would be required to achieve and maintain this potentially beneficial blood level.114,115,116 Typical
dosing with dotFIT MVM formulas will give the user 1,000-1,200 IUs.
Mass Market Vitamins and Minerals
Many mass market multivitamin and mineral formulas including liquid formulations claim the nutrients are
immediately and fully absorbed. Even if true this condition is EXACTLY what you do not want from a vitamin and
mineral formula (MVM). This may be good marketing, but very bad science. The last thing you want is for a MVM
to release all its contents at once, AND get absorbed quickly. This would simply overwhelm the bodily cells' ability
to utilize the nutrients, causing you to excrete the excess and leaving you without a steady stream of nutrients
throughout the day.15,117
Liquid Vitamin Mineral Delivery Systems
Whatever vitamin and minerals remain in the fluid when you purchase the product and remain intact following
ingestion through the acid environment of the stomach will likely be absorbed. But therein lies the problems.
There is a reason the vast majority of prescription drugs are in tablets or capsules. They must be effective to treat
a disease/condition and are thoroughly tested. Tablets/capsules give the manufacturer the ability to protect the
ingredients and control their release so they reach the proper site of desired action, AND in the effective amounts.
It is methodically impossible to accomplish the following tasks using a liquid carrier: complete long-term
ingredient integrity/stability, protection from unfriendly acid environments (pH that can destroy or alter
ingredients), unwanted nutrient interactions, and control of the rate of release of the ingredients to maintain
desired target tissue levels throughout the day.15,118,119 Additionally, there are no clinical trials to date which
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incorporate the use of liquid vitamins or minerals to study outcomes because they have not been shown to raise
tissue levels as desired.
The Practitioner's dotFIT Multivitamin and Mineral Formulas Control Release Delivery
All dotFIT multivitamin and mineral formulas (MVMs) are prepared in a delivery system to control the release of
their contents using hydroxypropylmethylcellulose (HPMC), a form of cellulose, within the coating.120 The goal of
“controlled release” is not to simply protect a product's ingredients through the harsh acidic stomach
environment, which in itself can negatively affect nutrient availability, 15 but to also allow the release of the active
ingredients only as the body can utilize them, as opposed to having all substances released immediately or soon
after ingestion. Interestingly, the latter is how most mass market MVM formulas are designed because they can
be produced at a far lesser cost.121 HPMC controls the rate of release of the dotFIT MVM's active ingredients just
as it does for many prescription drugs in which it is imperative that active ingredients are delivered to the
appropriate bodily tissues in the proper therapeutically documented amounts.122 This technology alone separates
the dotFIT MVM's from all others.
HPMC allows the continuous release of a product's ingredients as the compound moves down your digestive tract.
The pH in your gastrointestinal (GI) tract becomes less acidic the further down stream.118 Using this highly
sophisticated drug technology, the dotFIT MVM's are designed to release a certain percentage of the active
ingredients as it continues through the tract so that the active ingredients are absorbed as the body can use them,
thus maintaining the desired tissue saturation for optimal cellular performance throughout the day.123 The goal is
total tissue saturation with the nutrients needed to optimally perform all cellular activities, thus ensuring the cells
have the potential to function at full capacity, 24 hours a day. Otherwise cells simply down-regulate to the
available nutrition thus underperform, leading the body to do the same.
Ingredient Forms in dotFIT MVM Formulations
The vitamin and mineral ingredient forms (e.g. vitamin co-enzyme forms, mineral salts, etc.) in the dotFIT MVM's
are the known more active forms the body uses as compared to forms incorporated in "non-practitioner products"
(i.e. mass market retail).124 This means the ingredients have a higher potential to be "functionally absorbed," NOT
simply available or bioavailable to be absorbed. Bio-availability is only an ingredient's potential absorption into the
body.125 Functionally available is what gets into the area of action – i.e. it’s functionally absorbed and maintains
desired effect levels in the target tissues.11,12,13,14 Additionally, for some nutrients, equal absorption does not mean
equal biological effects because the nutrient sources are chemically different, resulting in differences in nutrient
activity.126,127,128 Although nothing can take the place of the synergistic effect of vitamins and minerals from
healthy consumed foods, often times vitamins or minerals properly prepared from supplements are better
absorbed than food sources because of common digestive problems including aging and dietary fiber
intake.13,129,130,131,132,133
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Table 1: dotFIT™ MVM Formulas & Ingredients (1 tablet)
Ingredient
Vitamin A
Vitamin D*
Beta Carotene
Vitamin C
Iron
Vitamin E
Vitamin B1
Vitamin B2
Niacinamide
Vitamin B6
Folic Acid
Vitamin B12
Biotin
Pantothenic Acid
Iodine
Magnesium
Zinc
Selenium
Copper
Chromium
Vitamin K
Boron
*Source: Cholecalciferol (D3)
**Dosage is 1-2 tabs
*** Dosage is 1-2 tabs
Unit
IU
IU
IU
mg
mg
IU
mg
mg
mg
mg
mcg
mcg
mcg
mg
mcg
mg
mg
mcg
mg
mcg
mcg
mg
Women’s
1000
1000
5000
300
10
100
6
1.7
20
2
400
10
100
15
100
100
12
50
0
50
50
1
Active**
500
600
4000
450
5
150
5
2.5
15
2
100
15
150
0
25
150
7.5
50
0.5
50
50
Over50
N/A
1000
10,000
400
0
50
6
6
20
10
400
100
100
10
75
100
15
70
1
100
50
Kids***
500
250
2000
50
5
20
1
1
6
1
100
3
10
2
50
20
5
20
0
0
30
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Table 2: dotFIT multivitamin and mineral recommendations
Multivitamin and
Mineral Formula
Males/Females: 2-4yr
ActiveMV
(1-tablet)
ActiveMV
(2 tablets)
Women’sMV
Over50MV
1
chewable
Males/Females: 5-11yr
Males: 12-17yr
Males: 18-50yr
Not athletes or
intense exercisers
Males 18-50yr
Athletes or intense
exercisers
Males: 51-64yrs
Not athletes or
intense exercisers
Males: 51-64yrs
Athletes or intense
exercisers
2
Chewables
X
X
X
X
X
Males: 65yrs+
Females: 12-17yrs
KidsMV
X
X
Females: 18-50yr
Not athletes or
intense exercisers
Females: 18-50yr
Athletes or intense
exercisers
Females: 51-64yr
Except below
Females: 51-64yr
Athletes or intense
exercisers >150LBS
X
X
X
X
Females: 65yrs+
X
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Summary
Purpose
 dotFIT formulas can be used by everyone to fill common nutritional gaps unless instructed otherwise for
medical reasons.
Unique Features
• All products are regularly updated with the most recent recommendations from the Institute of
Medicine (IOM) and the industry’s leading experts ( i.e. progressive evidence-based formulations)
• All formulas are part of the dotFIT program for safe and ideal compatibility with all products when
following program supplement recommendations
• Different formulas to meet the unique needs of different populations
• Formula and use follow strict scientific research criteria including 3rd party testing.( i.e. Practitioner
Product Guidelines)
• The nutrients are in their proper bioavailable and functionally available forms, ratios and strengths to
help maintain a safe and optimal range 24 hours/day
• Use of controlled-release delivery systems to ensure daily ideal nutrient levels and prevent tissue oversaturation and losses
• Manufactured in a regularly inspected NSF certified facility, in compliance with enforced Good
Manufacturing Practices (GMPs) exclusively for dotFIT, LLCActive MVM is NSF Certified for Sport which
ensures it is free of banned substances
Precautions
dotFIT multivitamin and mineral formulas are considered safe for the general population at the proper dosage.
Given the risk to benefit ratio, the long-term use of dotFIT multivitamin and mineral formulas is much safer
than consuming the typical American diet without nutrient augmentation.134,135
Contraindications
dotFIT multivitamin and mineral formulas are contraindicated in pregnancy and lactation. Pregnant women should
use a prenatal formula. Lactating women should use the Women’s MV formula unless advised otherwise by a
physician. The dotFIT multivitamin and mineral formulas are contraindicated for those with hemochromatosis (an
inherited disease that leads to iron-overload, affecting 0.5 percent of the population) because of the iron content,
and for anyone suffering adverse reactions to any of the supplement’s ingredients. The vitamin E and K content of
the ActiveMV in two tablets per day may be contraindicated for those individuals taking blood-thinning
medication. In all cases, consult with a physician. Smokers should stay below 66,000 IU of beta-carotene daily (the
multivitamin formula contains less than 15,000 IU) until a dose can be established for them.
Adverse Reactions
None known. At the recommended doses adverse effects are highly unlikely.
Upper Limit/Toxicity
See Table 3 for a list of known ULs and LOAELs for nutrients in the dotFIT multivitamin and mineral formulas.
No nutrient in these formulas is above the UL or LOAEL.
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Table 3: Safe and Probable Optimal Range including Food Sources
Nutrient
Pre-formed
Vitamin A[1]
Beta Carotene[2]
A[1]
Vitamin D (D3)
Vitamin E
Vitamin K
Vitamin C
Vitamin B1
Vitamin B2
Vitamin B3
(niacinamide)
Vitamin B6
Folic acid
Vitamin B12
Calcium[5]
Magnesium[5]
Iodine
Iron[5]
Zinc[3]
Copper
Selenium
Manganese
Potassium
Low – High
Upper Limit (UL)
LOAEL
0 IU - 10,000 IU
10,000 IU (3000 mcg)
21,645 IU
10,000 IU - 25,000 IU
400 IU – 4000 IU
100 IU – 800 IU
60-120 mcg
200 mg – 1000 mg
2 mg – 30 mg
5 mg – 30 mg
4000 IU
1,500 IU [4]
2,000 mg
-
30 mg – 50 mg
35 mg
6 mg – 50 mg
400 mcg – 900 mcg
6 mcg – 50 mcg
1200 mg – 1500 mg
420 mg – 600 mg
150 mcg - ?
15 mg – 25 mg
15 mg – 30 mg
2 mg – 4 mg
55mcg-200mcg
2 mg – 5 mg
2000 mg -?
100 mg
1,000 mcg [4]
2,500 mg
350 mg4
1,100 mcg
45 mg
40 mg
10 mg
400mcg
11 mg
-
3800 IU*
3,000 mg
1000 mg
500 mg
5,000 mcg
5,000 mg
360 mg
1,700 mcg
70 mg
60 mg
910mcg
15 mg
-
1. Supplemental amount can be zero if daily intake of beta carotene is within the safe and optimal range. 2. Smokers, those likely to develop, or those
that already have lung cancer, should avoid beta carotene supplementation.* Currently being revisited. 3. Upper range amount is from supplements
and fortified foods only. 4. From supplements and fortified foods only. 5. Supplemental amounts should be close to the low numbers shown.
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ActiveMV™ Formula
Goal
Fill the necessary nutritional gaps left from suboptimal diets to allow the body to function at full potential as
opposed to down regulating to the often unavoidable limitations from food alone. This is of particular importance
among physically active persons seeking to reach and maintain relatively low body fat while increasing or
sustaining lean body mass. This formula is also designed to be the multivitamin mineral formula of choice for all
amateur, collegiate and professional athletes since the ActiveMV is NSF Certified for Sport and approved by Health
Canada.
The ActiveMV formula is a multipurpose multivitamin and mineral formula. At one pill daily, it is the basic
multivitamin for individuals 12 years or older. At two pills daily, it is designed for athletes and others aged 18 to 65
with an active lifestyle and who consume the general variety of today’s typically available foods. (For the general
population over age 50, see the Over50MV formula and women 18 to 50 years of age, see the Women'sMV
formula).
Rationale
Studies demonstrate that athletes/exercisers require additional vitamins and minerals due to increased energy
demands and proper recovery from exercise including maintaining or increasing lean body mass compared to less
active or sedentary counterparts.48,50,62,93,136,137,138,139,140
Some, but not all athletes consume more nutrients simply by eating more food.2 This assumes the athlete is on a
relatively high-calorie, balanced diet and is able to consume enough nutritious food to match their daily energy
expenditure. Athletes trying to lose weight/body fat or maintain low weight/fat represent a different category
since they have increased requirements and a lower caloric intake, which can also lead to muscle loss as well as
low nutrient intakes.39,40,44,59,60,61,62,141,142,143,144,145 As such, the B vitamins are higher in this formula to assist in energy
production.146,147 The ActiveMV formula contains doses of specific antioxidants such as vitamins C, E and betacarotene at the higher end of the optimal range in order to assist in reducing muscle damage with goal of
improving recovery without altering the necessary exercise induced natural response.148,149,150,151,152,153 Of interest
to all adults, recently a systematic review and meta-analysis of randomized controlled trials of supplementation
with the antioxidant vitamins C, E, A and beta-carotene showed a significant reduction in arterial stiffness in
adults.154 Based on new recommendations, vitamin D levels are notoriously low in the general population and
especially in northern latitudes111,112 and higher levels are associated with a significant reduction in all cause
mortality.106,113,155 Obviously this potential reduction in mortality is also important to the athletic population but
athletes appear to have additional reasons for supplementing vitamin D related to exercise recovery,92,136 which
over time may affect performance and competitive lifespan.50 At least 50% of all athletes appear to have
insufficient levels of Vitamin D50 and all may have sub optimal levels without supplementation.114,115,116 Therefore,
the ActiveMV supplies 1200 IUs of vitamin D in the form of vitamin D-3 (cholecalciferol).155
The ActiveMV dose for athletes is two pills daily, one in the morning with a meal and the other at night with a
meal, to maintain the ideal nutrient levels in all tissues all day, every day. The Active MVM along with other
targeted supplementation is designed to help improve daily recovery to assist the user in maintaining desired
physical activity well into advancing age.156
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Typical Use
For all persons with an active lifestyle, 12-65 years of age, except those who are pregnant, trying to conceive, or
lactating.


12-17 yrs take one tablet per day with any main meal and favorite beverage
Active athletes and exercisers 18-65 yrs, two tablets per day. One with AM meal and one with PM meal
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Multivitamin and Mineral Formulas

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