Prevention (cont.)

Medical Author:

Dennis Lee, MD

Dennis Lee, MD

Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.

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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Vitamins and mineral supplements are important both in preventing deficiency states as well as in preventing diseases. Most diseases resulting from vitamin deficiencies such as scurvy (vitamin C deficiency), blindness (vitamin A deficiency), and beriberi (thiamine deficiency) occur mainly in third-world countries and are almost nonexistent in the United States. But certain special populations in the United States can develop vitamin or mineral deficiencies, and thus require dietary supplements. For example,

• severely malnourished alcoholics can develop nerve damage from thiamine deficiency;
• elderly individuals lacking sun exposure can develop bone disease from vitamin D deficiency;
• pernicious anemia is a condition, along with nerve damage, than can result from vitamin B12 deficiency; and
• people with celiac sprue can also develop vitamin deficiencies as well as iron deficiency.

For these special populations, vitamin supplements are important to prevent these deficiencies.

Vitamin supplements are not only used to prevent deficiencies but also used to prevent diseases. Certain vitamin supplements (such as folic acid, vitamin B6, and B12) have been used to lower blood levels of homocysteine, which may help prevent heart attacks. Folic acid fortification in cereals and vitamin supplements has been found to decrease the risk of birth defects in women of childbearing age.

Diets low in simple sugars are important in controlling blood glucose levels in people with diabetes mellitus. When the condition cannot be adequately controlled by diet alone, medications (sometimes including insulin) are required.

• The DASH diet is recommended to lower blood pressure. If dietary measures alone are not sufficient, medications are frequently prescribed by doctors (sometimes in combination) to lower blood pressure.
• A gluten-free diet is the primary treatment for celiac disease (celiac sprue). Since people with celiac sprue may have difficulty absorbing nutrients and vitamins, some people with this condition may also need calcium, iron, and vitamin supplements.
• Therapeutic lifestyle changes (TLC) are important treatments for high blood levels of cholesterol, especially the "bad" ( LDL) cholesterol. When TLC are not sufficient, then medications are usually indicated to lower blood lipid levels.

Reference: USDA, http://www.MyPyramid.gov