Seattle Treatment Education Project (STEP) Perspective, Vol. 7, No. 1 - Spring 1995; A Publication of the Seattle Treat- ment Education Project, 127 Broadway E. Ste. 200, Seattle, WA 98102 * (206) 329-4857. Published 3 times a year
T. Michael Culp

During World War II, the government published the first Recommended Daily Dietary Allowances (RDAs) for nutrients. Their intent was to prevent nutritional deficiency diseases (such as scurvy or beri beri) in the general population. A common fallacy is to use the RDA as the optimum nutrient recommendation for a particular individual. Rather, the RDA is more like the nutritional equivalent of the minimum wage: it is a baseline, not an ideal. The RDAs are statistical inferences based on short term research, designed to prevent nutritional deficiency diseases in an otherwise disease-free population. They do not take into consideration the effects of lifestyle (stress, environmental toxins, alcohol, smoking, etc.), nor do they consider nutritional needs associated with other disease processes (AIDS, cancer, diabetes, etc. ). Optimum nutrition for an individual may be something entirely different from the US RDAs. RDAs are minimum guidelines to prevent frank deficiencies, nothing more, nothing less.

But then the question arises, "What are the optimal dosages for various vitamins and minerals?" Unfortunately, there is no easy universal answer. A number of general factors affect micronutrient (vitamins or trace minerals) need in the individual. Chief among these are general health status, lifestyle, digestion and absorption status. For example, a reasonably healthy person will get diarrhea after taking 4-5 grams of vitamin C, but a person with a severe cold can take 20-30 grams in a day with no effect on his/or her bowels. Or, alcohol consumption has long been known to leech B vitamins and some minerals from the body. Smoking tobacco increases the need for anti-oxidants like beta-carotene, vitamin E, selenium, and vitamin C. Optimum vitamin and mineral supplementation for an individual will take into account all of these factors. If a person is going to be using large amounts of vitamins or minerals it is esential to consult a health-care professional, and be aware of symptoms associated with toxic overdose. In general, fat soluable vitamins (A, E, D, and K) have a greater potential for toxic side-effects, as do the metals among minerals (iron, copper, zinc, nickel, lead, aluminum, etc.). But this is only a relative distinction since any substance in excess can overload the body's ability to use and eliminate it. Just because it's natural does not mean it's not toxic.

To make matters even more confusing, research is often done on individual nutrients to determine their specific effects. Such effects include anti-viral or anti-bacterial activity and specific stimulatory effects on our immune systems. It is very difficult to apply the results of such studies in a clinical setting because these studies often do not look at long term effects, nor at effects on other nutrients or other systems in the body. For example, the results of a study looking at the effects of high dose zinc supplementation would be suspect if levels of copper were not also monitored since the two metals compete with each other in the body. Excess zinc causes a relative copper deficiency, which is associated with immune suppression. Thus, unopposed zinc supplementation could theoretically cause immune suppression. Therefore, it is important to read nutritional studies with caution and with a critical eye.

Finally, to quote Hippocrates, "Let your food be your medicine". While nutrient supplementation can have innumerable benefits, it cannot replace a well-rounded diet replete with lots of fresh vegetables and fruits, whole grains, quality proteins and polyunsaturated fats. There is a spiritual dimension to food that cannot be measured by science. In a sense we literally become what we eat. It is a mystery as great as life itself. Revel in the mystery. Bon appetit et bonne santer

Michael Culp is a fourth year medical student at Bastyr University and has been HIV+ since 1983.

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Copyright © 1995 - Seattle Treatment Education Project (STEP) - All rights reserved. Noncommercial reproduction is encouraged. STEP is published four times a year by the Seattle Treatment Education Project, 127 Broadway East, 3rd Floor, Seattle, WA 98102.    Email: step100@aol.com  STEP web page