WEBVTT 00:00:00.000 --> 00:00:02.552 align:middle line:90% [MUSIC PLAYING] 00:00:02.552 --> 00:00:11.776 align:middle line:90% 00:00:11.776 --> 00:00:13.650 align:middle line:84% HELEN TRUBY: All governments around the world 00:00:13.650 --> 00:00:16.239 align:middle line:84% make recommendations about what their population should 00:00:16.239 --> 00:00:18.910 align:middle line:84% eat, in terms of servings of fruit and vegetables, and dairy 00:00:18.910 --> 00:00:21.430 align:middle line:84% products, and meat groups, et cetera. 00:00:21.430 --> 00:00:23.090 align:middle line:84% But what we know from dietary surveys 00:00:23.090 --> 00:00:25.150 align:middle line:84% is that the majority of people don't actually 00:00:25.150 --> 00:00:27.120 align:middle line:90% follow those guidelines. 00:00:27.120 --> 00:00:30.780 align:middle line:84% They have been made to ensure that the population gets 00:00:30.780 --> 00:00:33.640 align:middle line:84% enough micronutrients as well as their macronutrients, 00:00:33.640 --> 00:00:35.805 align:middle line:90% and to support a healthy diet. 00:00:35.805 --> 00:00:38.550 align:middle line:84% But a lot of people these days rely on supplements, 00:00:38.550 --> 00:00:41.160 align:middle line:84% and it's become a multimillion dollar industry. 00:00:41.160 --> 00:00:43.180 align:middle line:84% So I've got a panel of experts here with me 00:00:43.180 --> 00:00:45.632 align:middle line:84% today, who are going to discuss some of these things. 00:00:45.632 --> 00:00:47.090 align:middle line:84% And we're going to think about, why 00:00:47.090 --> 00:00:50.080 align:middle line:84% do people use those supplements, where are they useful, 00:00:50.080 --> 00:00:52.930 align:middle line:84% are there particular population groups that we 00:00:52.930 --> 00:00:54.860 align:middle line:90% should be using supplements? 00:00:54.860 --> 00:00:57.940 align:middle line:84% And just think about how we can get best value for our money 00:00:57.940 --> 00:00:59.465 align:middle line:90% from supplements or food. 00:00:59.465 --> 00:01:00.840 align:middle line:84% CATE LOMBARD: Groups that I would 00:01:00.840 --> 00:01:04.120 align:middle line:84% be most concerned about are those that are thinking 00:01:04.120 --> 00:01:06.700 align:middle line:84% about becoming pregnant, or are pregnant, 00:01:06.700 --> 00:01:09.045 align:middle line:84% and those are probably reaching mid-age 00:01:09.045 --> 00:01:12.400 align:middle line:84% and older, where their intake, it 00:01:12.400 --> 00:01:16.400 align:middle line:84% is important to get a very good, healthy, lots of nutrients 00:01:16.400 --> 00:01:17.120 align:middle line:90% in their diet. 00:01:17.120 --> 00:01:19.830 align:middle line:84% The other time is for those women 00:01:19.830 --> 00:01:22.490 align:middle line:84% at around the time of menopause where the calcium requirement 00:01:22.490 --> 00:01:23.860 align:middle line:90% goes up quite a bit. 00:01:23.860 --> 00:01:26.650 align:middle line:84% If they haven't been great milk drinkers all their lives, 00:01:26.650 --> 00:01:29.620 align:middle line:84% they may need to consider a calcium supplement depending 00:01:29.620 --> 00:01:31.870 align:middle line:84% on their bone density and family history. 00:01:31.870 --> 00:01:34.730 align:middle line:84% JANEANE DART: And I think certainly 00:01:34.730 --> 00:01:37.130 align:middle line:84% encouraging people to be conscious 00:01:37.130 --> 00:01:40.427 align:middle line:84% of the amounts, or the labels of different nutrients, 00:01:40.427 --> 00:01:41.510 align:middle line:90% or rather, to supplements. 00:01:41.510 --> 00:01:44.140 align:middle line:84% So I think people generally being aware 00:01:44.140 --> 00:01:46.590 align:middle line:84% of what recommended daily intakes are 00:01:46.590 --> 00:01:49.210 align:middle line:84% for different nutrients, so they can actually make informed 00:01:49.210 --> 00:01:52.730 align:middle line:84% choices, and trying to ensure that the supplements 00:01:52.730 --> 00:01:57.030 align:middle line:84% that they're taking, somewhere between 50% to 150% 00:01:57.030 --> 00:02:00.020 align:middle line:84% of the recommended daily intake, rather than overdosing, 00:02:00.020 --> 00:02:03.001 align:middle line:84% because toxicity can be an issue in some circumstances. 00:02:03.001 --> 00:02:04.750 align:middle line:84% CATE LOMBARD: I think it's extraordinarily 00:02:04.750 --> 00:02:07.790 align:middle line:84% difficult for people to understand the complexities 00:02:07.790 --> 00:02:10.009 align:middle line:90% of nutrition today. 00:02:10.009 --> 00:02:13.950 align:middle line:84% We have so much information, we have access to information. 00:02:13.950 --> 00:02:16.580 align:middle line:84% We also have access to misinformation. 00:02:16.580 --> 00:02:20.050 align:middle line:84% And I think that's where the general population has 00:02:20.050 --> 00:02:23.660 align:middle line:84% to be very careful about where they seek their information, 00:02:23.660 --> 00:02:24.910 align:middle line:90% and who they seek it from. 00:02:24.910 --> 00:02:27.349 align:middle line:84% DAVID KANNAR: Maybe I can just add to that. 00:02:27.349 --> 00:02:28.890 align:middle line:84% I'm not opposed to supplements, but I 00:02:28.890 --> 00:02:32.860 align:middle line:84% guess the thing that supplements versus food-- 00:02:32.860 --> 00:02:34.800 align:middle line:84% the argument for food for me is that there's 00:02:34.800 --> 00:02:38.460 align:middle line:84% a lot of known and unknown substances in foods 00:02:38.460 --> 00:02:40.420 align:middle line:84% that we just can't account for in supplements. 00:02:40.420 --> 00:02:43.830 align:middle line:84% And so I think, to add to what Kate said, 00:02:43.830 --> 00:02:45.730 align:middle line:84% obviously that's the first part is 00:02:45.730 --> 00:02:48.200 align:middle line:84% to actually make sure dietary invention 00:02:48.200 --> 00:02:50.270 align:middle line:90% is as effective as possible. 00:02:50.270 --> 00:02:53.260 align:middle line:84% LIZA BARBOUR: I've worked as a community dietitian, 00:02:53.260 --> 00:02:56.290 align:middle line:84% and predominantly with people who are experiencing hardship 00:02:56.290 --> 00:02:58.810 align:middle line:90% of various kinds. 00:02:58.810 --> 00:03:02.130 align:middle line:84% And unfortunately, I've seen a lot of situations 00:03:02.130 --> 00:03:06.620 align:middle line:84% where people are subjected to really convincing marketing 00:03:06.620 --> 00:03:10.310 align:middle line:84% saying that they need to have certain supplements to maintain 00:03:10.310 --> 00:03:13.410 align:middle line:84% a healthy life, and I just have to spend this amount of money 00:03:13.410 --> 00:03:18.760 align:middle line:84% to get-- whether it's protein, whether it's iron, calcium, 00:03:18.760 --> 00:03:20.990 align:middle line:84% things that we can actually get from food. 00:03:20.990 --> 00:03:23.406 align:middle line:84% TRACY MCCAFFREY: I think that's a really good point, Liza, 00:03:23.406 --> 00:03:26.050 align:middle line:84% and one supplement that's a good example of that are 00:03:26.050 --> 00:03:28.170 align:middle line:90% like, lutein and zeaxanthin. 00:03:28.170 --> 00:03:30.510 align:middle line:84% They're forms of vitamin A, and they're 00:03:30.510 --> 00:03:33.700 align:middle line:84% sold for helping promoting vision. 00:03:33.700 --> 00:03:36.900 align:middle line:84% And in some clinical trials that does work, 00:03:36.900 --> 00:03:39.900 align:middle line:84% but it's mainly for developing countries that 00:03:39.900 --> 00:03:43.280 align:middle line:84% have high levels of deficiency, and particularly 00:03:43.280 --> 00:03:49.270 align:middle line:84% in children where they can become deficient very quickly. 00:03:49.270 --> 00:03:52.770 align:middle line:84% In adults it takes, perhaps, one to two years. 00:03:52.770 --> 00:03:55.350 align:middle line:84% But in the Western population, we 00:03:55.350 --> 00:03:59.550 align:middle line:84% have a problem with age-related macular degeneration. 00:03:59.550 --> 00:04:01.440 align:middle line:84% And some of the studies have really 00:04:01.440 --> 00:04:06.140 align:middle line:84% shown that for those people with advanced age-related macular 00:04:06.140 --> 00:04:08.560 align:middle line:84% degeneration supplements are useful, 00:04:08.560 --> 00:04:11.440 align:middle line:84% but really in the early stages of the disease, 00:04:11.440 --> 00:04:16.459 align:middle line:84% or in disease prevention, supplementations-- the evidence 00:04:16.459 --> 00:04:19.290 align:middle line:90% isn't really there as yet. 00:04:19.290 --> 00:04:21.750 align:middle line:84% But if we eat a healthy diet, that 00:04:21.750 --> 00:04:23.830 align:middle line:84% will really help us and to try and prevent 00:04:23.830 --> 00:04:25.850 align:middle line:84% those diseases in the first place. 00:04:25.850 --> 00:04:29.290 align:middle line:84% But as we get older, we do experience more incidence 00:04:29.290 --> 00:04:30.180 align:middle line:90% of disease anyway. 00:04:30.180 --> 00:04:32.310 align:middle line:84% LIZA BARBOUR: We know that fish oils have 00:04:32.310 --> 00:04:36.060 align:middle line:84% some really beneficial long-chain fatty acids, 00:04:36.060 --> 00:04:41.080 align:middle line:84% and they can help prevent coronary heart disease, stroke, 00:04:41.080 --> 00:04:44.580 align:middle line:84% amongst a range of other health benefits. 00:04:44.580 --> 00:04:48.640 align:middle line:84% The problem is that here in Australia, we're 00:04:48.640 --> 00:04:51.280 align:middle line:84% recommending at least three servings of fish 00:04:51.280 --> 00:04:54.120 align:middle line:90% a week to the adult population. 00:04:54.120 --> 00:04:58.050 align:middle line:84% And this is being promoted globally, 00:04:58.050 --> 00:05:00.430 align:middle line:84% that we should be eating more and more fish to get 00:05:00.430 --> 00:05:02.660 align:middle line:90% those beneficial fatty acids. 00:05:02.660 --> 00:05:05.380 align:middle line:84% And from an environmental perspective, 00:05:05.380 --> 00:05:08.780 align:middle line:84% devastatingly, our fish stocks are plummeting. 00:05:08.780 --> 00:05:12.870 align:middle line:84% And so we've overfished, and marine ecologists 00:05:12.870 --> 00:05:15.570 align:middle line:84% have predicted that in the next 40 years, 00:05:15.570 --> 00:05:20.080 align:middle line:84% we'll see the fish stocks absolutely collapse. 00:05:20.080 --> 00:05:23.460 align:middle line:84% So, while there's benefit from a health perspective 00:05:23.460 --> 00:05:28.870 align:middle line:84% to have the fish oils, I think that it's worth, definitely 00:05:28.870 --> 00:05:31.820 align:middle line:84% from a nutrition practitioner perspective, 00:05:31.820 --> 00:05:35.410 align:middle line:84% we should be open to the idea of recommending supplementation 00:05:35.410 --> 00:05:37.232 align:middle line:90% to replace that whole fish. 00:05:37.232 --> 00:05:39.190 align:middle line:84% TRACY MCCAFFREY: So one argument against taking 00:05:39.190 --> 00:05:42.540 align:middle line:84% supplements would be the fact that our body does regulate 00:05:42.540 --> 00:05:45.710 align:middle line:84% our intake of nutrients very well. 00:05:45.710 --> 00:05:48.280 align:middle line:84% For example, if we take our fat-soluble vitamins, 00:05:48.280 --> 00:05:51.040 align:middle line:84% such as vitamin A, D, E, and K, they're 00:05:51.040 --> 00:05:52.690 align:middle line:90% typically stored in the liver. 00:05:52.690 --> 00:05:54.420 align:middle line:84% And it takes about one to two years 00:05:54.420 --> 00:05:56.820 align:middle line:84% for those vitamins to actually deplete 00:05:56.820 --> 00:05:59.020 align:middle line:84% out of the liver if we didn't consume anything 00:05:59.020 --> 00:06:00.640 align:middle line:90% within our diet. 00:06:00.640 --> 00:06:03.110 align:middle line:84% Whereas B vitamins, C vitamins, they 00:06:03.110 --> 00:06:06.672 align:middle line:84% are water-soluble vitamins, and they are excreted daily. 00:06:06.672 --> 00:06:08.130 align:middle line:84% So really, if you do happen to take 00:06:08.130 --> 00:06:12.250 align:middle line:84% supplements that are B vitamin complexes, or vitamin C 00:06:12.250 --> 00:06:14.420 align:middle line:84% really you end up with very expensive urine. 00:06:14.420 --> 00:06:17.450 align:middle line:84% So I think it's actually better to consume our vitamins 00:06:17.450 --> 00:06:21.610 align:middle line:84% from our whole food diet rather than targeted supplements 00:06:21.610 --> 00:06:23.097 align:middle line:90% such as B and C vitamins. 00:06:23.097 --> 00:06:24.430 align:middle line:90% DAVID KANNAR: Good point, Tracy. 00:06:24.430 --> 00:06:25.560 align:middle line:84% The only other thing to add to that 00:06:25.560 --> 00:06:27.670 align:middle line:84% is the protein, just to make sure we don't take 00:06:27.670 --> 00:06:30.370 align:middle line:84% too much protein because there's a propensity with weight 00:06:30.370 --> 00:06:33.700 align:middle line:84% gain, muscle bulk, increased to then put pressure 00:06:33.700 --> 00:06:35.864 align:middle line:84% on the other organs, particularly in the kidneys. 00:06:35.864 --> 00:06:37.530 align:middle line:84% So that would be the only other caution. 00:06:39.140 --> 00:06:40.460 align:middle line:84% HELEN TRUBY: So one way that people can try and make 00:06:40.836 --> 00:06:42.255 align:middle line:84% sense of the information that's available 00:06:42.905 --> 00:06:43.982 align:middle line:84% to them is to have a look at the label 00:06:44.400 --> 00:06:49.097 align:middle line:90% on the side of the supplement. It should give you information on how much is 00:06:49.634 --> 00:06:54.266 align:middle line:84% in that supplement and the dosage for an adult. And again, as we've talked about, 00:06:54.910 --> 00:06:57.594 align:middle line:84% the amount of the percentage recommended daily intake. 00:06:58.323 --> 00:07:01.230 align:middle line:84% So that gives you a sense of whether it's reasonable, has it 00:07:01.495 --> 00:07:04.353 align:middle line:84% given you all your daily intake, or is it giving you a megadose? 00:07:04.696 --> 00:07:10.103 align:middle line:84% And generally, people don't require those megadoses unless they've been recommended by a health practitioner. 00:07:11.183 --> 00:07:13.598 align:middle line:84% CATE LOMBARD: It's extraordinary, the number of supplements that are out there, 00:07:14.201 --> 00:07:18.601 align:middle line:84% and it shows how effective marketing can be in this case. 00:07:19.516 --> 00:07:23.850 align:middle line:84% You just have to go into the supermarket aisle, and you can see a wall of supplements. 00:07:25.039 --> 00:07:33.900 align:middle line:84% Someone is buying them, it's a multi-million dollar industry. So I think supplement use is becoming normalised, and it's not necessary. 00:07:34.771 --> 00:07:39.939 align:middle line:84% DAVID KANNAR: There may not be a whole lot more benefit through megadoses, if you've got a good fundamental dietary 00:07:40.574 --> 00:07:45.689 align:middle line:84% intake of some of these nutrients. But again, it's very specific, so it needs to be handled with a professional. 00:07:47.702 --> 00:07:51.074 align:middle line:84% JANEANE DART: My view is that supplements fall way short of providing everything that we need. 00:07:53.296 --> 00:07:59.623 align:middle line:84% I have a preference in most instances, that we aim to get our nutrients through food, as we've said already that there are certain circumstances 00:08:00.473 --> 00:08:07.590 align:middle line:84% and subgroups where we need to get specific supplements. But food offers so much more than taking a pill, 00:08:08.805 --> 00:08:15.311 align:middle line:84% and it's for all the social and convivial reasons. And I guess sharing a meal is one of life's greatest joys, 00:08:15.298 --> 00:08:23.448 align:middle line:84% and I guess one of culture's longest traditions. And it connects us not only to food but, to people,to our family and our friends. 00:08:24.010 --> 00:08:31.424 align:middle line:84% So I think food offers so much more than supplements, and I guess, for example, even stimulating 00:08:32.790 --> 00:08:37.636 align:middle line:84% the gastrointestinal tract, when we're eating and chewing. So there are physiological benefits, as well as 00:08:37.961 --> 00:08:42.173 align:middle line:84% those social and emotional and personal benefits that eating offers. 00:08:42.175 --> 00:08:48.386 align:middle line:84% HELEN TRUBY: I think Janine is absolutely right, in terms of being able to have a wide variety of food's really important. 00:08:48.978 --> 00:08:57.255 align:middle line:84% And we know that early childhood's a very incredibly important time when our food choices are going to be influenced. 00:08:57.936 --> 00:09:04.491 align:middle line:84% So children are influenced by what their parents eat. But also, we know that young children who aren't very good at eating fruit and vegetables, 00:09:04.754 --> 00:09:10.482 align:middle line:84% they actually have to be exposed to one food eight or nine times before they might find it acceptable. 00:09:10.951 --> 00:09:15.569 align:middle line:84% So, just giving you child one teaspoon of peas and they spit it out doesn't mean they don't like peas. 00:09:16.302 --> 00:09:18.348 align:middle line:84% It just means that they haven't gotten used to that taste yet. 00:09:18.983 --> 00:09:24.934 align:middle line:84% So, introducing a wide variety of fruit and vegetables in that first year of life in those early years 00:09:25.793 --> 00:09:31.414 align:middle line:84% is very important in terms of being able to influence the sorts of foods that your child is going to be able to eat, 00:09:32.174 --> 00:09:38.499 align:middle line:90% and is going to accept later on. So perhaps some key messages to people to think about if you're going to go on to supplement, 00:09:38.721 --> 00:09:41.605 align:middle line:84% is really considering why you're actually going to take the supplement. 00:09:41.785 --> 00:09:42.835 align:middle line:90% Do you actually need it? 00:09:44.019 --> 00:09:47.077 align:middle line:84% If you can afford to buy that particular supplement, 00:09:47.172 --> 00:09:49.809 align:middle line:84% can you actually get what you need from food? 00:09:50.488 --> 00:09:56.527 align:middle line:84% And are there any reasons why you shouldn't be able to absorb those nutrients from foods? 00:09:57.049 --> 00:10:04.900 align:middle line:84% So, I think we are very much taking a view on food first, but with the recognition that the supplements are useful, 00:10:06.056 --> 00:10:10.491 align:middle line:84% and there are numerous reasons why humans eat, why we have food, the complexity of food, 00:10:11.764 --> 00:10:14.397 align:middle line:84% and just how it comes, how we cook food, 00:10:14.810 --> 00:10:17.657 align:middle line:84% are all very important as to what happens to the micronutrients. 00:10:18.182 --> 00:10:20.632 align:middle line:84% And that's what makes nutrition so interesting.