Do I Need Supplements?

Do I Need Supplements?

It’s a common thing to hear that nutritional supplements are not needed, period. Nutritional supplements will never replace a balanced diet but to say “If you eat proper meals you won’t need nutritional supplements” is to simplify, or to quote Per Arne Öckerman, professor emeritus of clinical chemistry:

“Bruce Ames is one of our time’s giants in the medical field. He’s famous all over the world among the medical scientists over his methods to measure the impact on genes and carcinogenicity. He was early with a methodology to measure the damages by free radicals. Bruce Ames has recently published a study where he shows that too low levels of essential nutrients, which demonstrably is a common among the population, increases the risk of serious diseases such as cancer and arteriosclerosis. It deals with the potential damages on the genome, and Bruce Ames is saying, too low levels of essential nutrients has a thousandfold bigger impact on the population than all the pesticides and heavy metals combined. That’s why Bruce Ames recommends nutritional supplements to the whole population, claiming this would be highly cost-effective in regard to the fact people wouldn’t become as ill.”

There are multiple studies pointing out the danger in nutritional supplements or it’s lack of efficacy; those studies always include isolated synthetic supplements. There are, however, no studies which point to damages or lack of efficacy from 100% whole food supplements, on the contrary.

Bruce Ames is a professor of biochemistry and molecular biology at the University of California, Berkley, USA as well as a Senior Scientist at Children’s Hospital Oakland Research Institute. He’s also a member of the prestigious National Academy of Science. Bruce Ames has also obtained the U.S National Medal of Science. His 450 scientific publications have resulted in him being number 23 in the list of the one hundred most cited scientists in the world (all sciences included) over a ten year period. Bruce Ames is one of the worlds most reputable scientists when it comes to biochemistry and molecular Biology and it’s probably better to trust him than a lot of others when he recommends nutritional supplements for the whole population. Nutritional supplements should, of course, be of the highest quality since nutritional supplements of poor quality could do more harm than good.

 

What if you have a balanced diet?

Whether nutritional supplements are needed or not, is not black or white but depends on various factors such as gender, age, whether you work-out or not, medical history, diet, if you’re pregnant, breastfeeding, your geographic stay etc. Sure you could probably say nutritional supplements are not needed if you eat a balanced diet with animal protein, oily fish several times a week, plentiful vegetables, some fruit and a bit of grain. Even if you feel you eat a balanced diet a Swedish study conducted by sifo shows that 70 percent of the Swedish population feels they eat a balanced diet while 30 percent of the population only eats about 500 grams of fruits and vegetables per day (as recommended by the Swedish FDA). Only seven percent eats fish three times a week(as recommended by the Swedish FDA). The numbers show what we all probably already know: we feel we eat a balanced diet but in practice, we’re not. So the study done by sifo showed that we don’t eat as a balanced diet we think we do. Keep in mind, the Swedes has a better diet than we do.

There are however studies showing a balanced diet could cause a nutrient deficiency. In the scientific journal of the International Society of Sports Nutrition 2006, 3:51-55 published a study where they chose to study people who exercised, were athletes or were sedentary. All of whom ate a balanced diet and yet none of the subjects had sufficient levels of vitamin- and mineral nutrients. First of all, there’s only a handful who eats a balanced diet, secondly, the study shows that even if you eat a balanced diet it could be hard for you get enough vitamins and minerals. Worth noting is that the referred levels are limits and not optimum values; that being said people who ate a balanced diet didn’t even reach the threshold for deficiency diseases. Could it be that the Healthy Eating Pyramid or healthy Eating Plate needs updating and is maybe not that good from a nutritional standpoint due to its high content of cerealier in its base? What we consider to be a balanced diet is probably not optimal when looking at its content and the absorption levels of vitamins and minerals. Time will tell whether this is the case or not. Several studies show us our soil doesn’t contain the same amount of vital nutrients as they once did.

The British Department of agriculture

The plants siphon off the nutrients found in the soil. With the entry of fertilizers, you return potassium, nitrogen, and phosphorus which in time results in other minerals macerated since the primary nutrient returned to the soil is fertilizer. You say the soil is becoming depleted. This means vegetables from fertilized arable land with time will have significantly lower levels of mineral content than vegetables which are not fertilized. Medical Research Council in England, who answers to the Department of agriculture, did a study on the mineral content of different crops and how it has worsened during the years 1941-1999 and the results were horrific. Some of our most important minerals had been reduced to alarmingly low levels:  Potassium -16%, Magnesium- 24%, Iron -27%, Calcium -46%, Sodium -49%, Zinc -59%, Copper -76%. (So despite the added fertilizer potassium had been reduced). So crops from fertilized soil do have a significantly lower level of nutrients. Sadly most of our food comes from the fertilized soil which in turn means that your intake has lower levels of minerals than you need from eating a “balanced diet”.

Swedens University of agriculture (SLU)

When Swedens University of Agriculture did an analysis of a long-term experiment with höstvete (winter wheat) that stretches back to 1960:s scientists found heavily reduced contents of minerals such as iron, copper, zinc among the fields.

American College of Nutrition

An American study published 2004 in the Journal of the American College of Nutrition, has compared how the nutritional content has worsened in 43 different fruits and vegetables between the years 1950-1999. Six out of 13 nutrients had been significantly reduced: protein, potassium, phosphorus, iron, riboflavin and vitamin C. This is probably caused by the fact we today use crops that bring higher yields but with lower nutritional value compared to before.

The UN and the Earth Summit Report

At the UN:s large conference in 1992, the so-called Earth Summit Report 1992, were scary facts presented: We had 100 years ago considerably more minerals in our soils. The minerals have reduced 85% in North America, in South America 76%, in Asia 76%, in Africa 74%, in Europe 72% and Australia by 55%.

The UN and the World Health Organization (WHO)

The World Health Organization stated in 1993 that our soils have diminished its nutritional contents by 95% when it comes to the main nutrients we need.

There’s a big likely hood, no matter if you eat a balanced diet or not, that you, after all, need nutritional supplements. If you fall within some of the below categories you probably have an even bigger need for supplementation.

 

Working-out regularly 

It’s not uncommon you start working- out after a break, to then after a few weeks get a cold. Rats, you were just getting into it and then you feel a cold sneaking up on you with the consequence of having to take a break from working- out, you start to feel better again and start working- out, again you are hit with a cold after a few weeks or a month. When you do endurance training your whole body is heavily stressed because it during training releases large amounts of free radicals. Lester Packer, scientist at the University of California, Berkley, USA, has for a long time studied how antioxidants minimize damages from free radicals. He says in an article in the Journal of Sports Science that “There exists a delicate balance between free radicals and antioxidants in biological systems and both are needed to convert food into energy. However, working- out can just like an illness tip the scale toward an excessive production of free radicals”. Free radicals, meaning molecules missing an electron, is produced among others when cells metabolize glucose and fat to create energy. The oxygen during workouts can increase between 10 to 20 times compared to when you’re not working- out, and thereby massive amounts of free oxygen radicals are created in significantly larger amounts than by the metabolization process. It overloads the bodies antioxidative defense and can lead to significant damages on cells due to free radicals. Studies done on both animals and people have shown that free radicals induced by exercising dramatically increase the oxidation in the cells particularly oxidation of DNA can lead to serious long-term effects such as premature aging and increased risk of more serious illnesses. It’s no coincidence if you get a cold after a few weeks of exercising. You probably have too few antioxidants in your body. Should you stop exercising? Of course not, nutritional supplements is a cheap way of ensuring your body against damages caused by free radicals. Lester packer found antioxidants could prevent damages from free radicals on a cellular- and DNA- level caused by exercise. The Finnish scientist Tommi J. Vasankari from Turku University in Finland gave a group of endurance athletes either placebo or supplements with antioxidants (vitamin E, vitamin C, and CoQ10) daily for four weeks. The group who were given antioxidants increased the antioxidant capacity in LDL with 30-40 percent, both before and after exercising. It’s not a coincident, and we recommend you supplement with a vitamin- and mineral supplement and possibly with CoQ10.

 

Want to become or are pregnant

A woman who’s of fertile age and wants to get pregnant will need despite a good and balanced diet folic acid supplementation. Folic acid is a water-soluble vitamin sometimes called vitamin B9 and is a part of a group consisting of a total of eight B-vitamins in the so-called b-complex. Folic acid and folate are used synonymously but folic acid is mostly used in supplements or calculations of foodstuff it’s however not found in food witch the natural form folate does. Folate is an important substance to avoid children being born with spina bifida. A lack of folate, which is common in Sweden could lead to brain damage and spina bifida in the fetus. Folate supplementation does also lower the risk for ADHD in the child. There is plenty of folate in leafy green vegetables, broccoli, liver, and yeast. If you plan on getting pregnant you should supplement with folic acid or folate 3-6 months before you get pregnant. However, you should not take separate B vitamins for any extended period since all of the eight B-vitamins works as acts as a complex; for that reason, it’s better to take the whole B-complex as a supplement. It’s been shown that supplementation of zinc during pregnancy lowers the risk of dysmorphology and postnatal stillbirth that’s caused by alcoholic intake during the first trimester. A research group from the University of Kansas led by John Colombo has shown that children to women with a higher amount of DHA (the most important type of omega-3) when giving birth has a better attentiveness up to two years of age and develops faster up to the age of six months than who’s mothers with lower levels of DHA in their blood by the time they give birth. Attentiveness is seen as an important component in intelligence development during adolescence. DHA plays an important role in the brains development of fetuses and children. Fish contains EPA and DHA (omega-3 fatty acids), however, women who’re pregnant are warned of eating fish too often due to the environmental toxins. Flaxseed oil, Chia seeds, and plant oils are usually sometimes marketed as a good source of omega-3. That’s not true whatsoever. Seed and plant oils contain a fatty acid by the name of ALA (alpha-linolenic-acid) that’s an omega-3 fatty acid. So far it’s true. Nevertheless, ALA needs to be converted to EPA and then to DHA for the body to fully utilize its omega-3 fatty acids. The conversion rate from ALA to EPA and DHA is between 0-9% which means in practice you have to pour yourself in flaxseed oil, Chia seeds or something like it to reach a relevant dosage of omega-3. It’s not healthy with those amounts of seeds needed to reach adequate levels of omega-3. Seeds also contain omega-6 fatty- acids. Even though omega-6 is an essential fatty- acid this is something we already get too much of in today’s diet. In other words, much of the fish sold contains heavy metals while seeds, nuts, and plant oils are not a good source of omega-3. Thus it’s a good idea to supplement with omega-3 if you’re planning on becoming pregnant or already are. The same goes for folic acid (folate) and thereby all other B-vitamins. Iron is a mineral pregnant women can be deficient in and it’s hard to obtain sufficient levels with diet alone. This is when supplementation is necessary.

 

Breastfeeding

First of all, a woman breastfeeding needs more calories per day than a woman who’s not breastfeeding. This is however provided by food. Concerning individual nutrients for breastfeeding women is to take additional supplementation of 10 mcg vitamin-d according to the English FDA. There are studies suggesting children breastfeeding has better cognitive abilities than children who get infant formulas which are believed to do with the content of the essential fatty- acid DHA (omega-3) in the breast milk. Dr Bruce Holub, professor emeritus at Human Health and Nutritional Sciences of Canada, University of Guelf, and former head of Nutrition Society of Canada says: ” 200 mg of DHA supplementation every day for four months post natal# resulted in higher levels of DHA circulating in the bloods plasma phospholipids and a higher score on the Bayley psychomotor development index by 30 months of age”. It has also been reported a positive correlation between high levels of DHA in the mother’s milk and visual development with mature infants together with an optimized activity of newborns. A Norwegian study has shown that women who were given supplements with 1183 mg DHA and 808 mg EPA per day during a 3 month period postnatal, and from week 18 of pregnancy#, gave rise to children who by the time they were four years old had a more favorable psychological development based on IQ-tests. Benisek, Shabert, and Skornik reported the year 2000 that pregnant and breastfeeding women in the United States consume on average 54 mg DHA per day. An expert panel from Society for the Study of fatty acids and lipids recommends that pregnant and breastfeeding women should consume 300 mg DHA per day. The levels of DHA in breast milk stands in direct correlation to DHA in the mother’s dietary intake. Again, DHA should come from fatty fish and grass-fed meat, and not nuts and seeds containing ALA. It could thus #be wise to supplement with DHA for both pregnant and breastfeeding women. If you ask your midwife, friend or doctor if you should supplement with omega-3 when you breastfeed and they tell you no, ask them why? You will probably not get a clear answer. A woman who breastfeeds should completely avoid ginseng products and should be careful when it comes to algae products containing a lot of iodine.

 

IS OVER 70 YEARS

People over the age of 70 could need calcium and vitamin D supplementation. Calcium and vitamin D is needed to lower the risk of different types of bone fractures witch older people is more easily affected by. Vitamin D is a fat-soluble vitamin (actually a group of prohormones) that exists in two main forms: D2 (ergocalciferol) and vitamin D3 (cholecalciferol) where D3 is the most easily absorbed form. Vitamin D is needed for the body to obtain a correct balance between calcium and phosphate. The balance is important for the formation of bone tissue and proper functioning of the nervous system. Vitamin D also affects the immune system, inhibits uncontrolled cell division, reduces high blood pressure, among other things. A minor vitamin D deficiency leads to a lot of diffuse health problems such as cramps, energy loss, dental loss and increased heart rate. A serious deficiency of vitamin D leads to rickets which is an umbrella term# for insufficient storage of calcium and phosphorus in the bone. In children, there are various problems related to bone tissue (flexible and soft bones, fontanelle that contract slowly, slow tooth development). Vitamin D3 is formed mainly when the sun’s ultraviolet rays reach cholesterol in the skin. Application of sunscreen factor 8 reduces vitamin D production by 95%. In addition, sunlight in the Nordic and North American regions is strong enough only during the summer for vitamin D to be formed. Calcium is a mineral needed for the formation of teeth, bones, blood clotting and nerve function, among other things. Lack of calcium can cause constipation, catarrh, muscle cramps, insomnia, decreased gastric acid production, menstrual pain, and dental damage. Serious deficiencies of calcium can lead to osteoporosis (brittle bones) and rickets. In order for calcium to be absorbed, adequate levels of gastric acid and vitamin D and vitamin C are required. The phytic acid that’s found in cereals inhibits the absorption of calcium. Low-grade forms of calcium carbonate, calcium oxide, calcium gluconate, calcium citrate and dicalcium phosphate that are commonly used in dietary supplements should be avoided.

 

IS A VEGETARIAN, VEGAN OR FRUITARIAN

People who eat a vegetarian diet are at risk to have nutrient deficiencies. The level of nutritional deficiency depends on how strict one is on their vegetarian diet. Fruitarians and vegans often get iron and in time vitamin-b12 deficiency. Protein deficiency is also common. Zinc deficiency can easily occur due to the high content of phytic acid in a normal vegetarian diet. Furthermore, lack of omega-3 in the body-important forms EPA and DHA is common. ALA can be obtained from seeds and nuts but the conversion rate to those bodies readily absorbed forms EPA and DHA is 0-9%. Vitamin D is difficult to obtain as non-vegetarian during the northern winter months. Strict vegetarians are even harder to get adequate levels of vitamin D3 during these months.

 

Have any disease, smoke or the like

Did you know that studies indicate that smokers have significantly lower levels (almost 30%!) of vitamin C in the blood no matter how good they eat, regardless of gender, age, weight, ethnicity and alcohol consumption. It’s not particularly strange because vitamin C is an antioxidant and cigarettes regardless of active or passive smoke contains amounts of free radicals which take from the body’s resources of antioxidants. There are studies showing that supplements of antioxidants for as short as three months reduce the risk of chromosomal damage in people who survived myocardial infarction. Supplements of antioxidants were found to reduce genetic damage. Journal of the National Cancer Institute in the United States published an article as early as 1993 which showed that supplements of vitamins and minerals reduced the risk of cancer in a population in China. Serious illnesses should, of course, be treated by professional healthcare providers, but it is probably not wrong to supplement the diet with nutritional supplements as a cheap assurance that you get the myriad of nutrients that the body daily needs to obtain a proper immune system.

 

Having an inflammation of the gastrointestinal tract

Persons suffering from gastrointestinal disorders, by definition, have problems melting and/ or absorbing nutrients. For example, there are studies indicating that dietary supplements are a safe and effective long-term treatment of Crohn’s disease. There are also many studies that show that probiotics (good intestinal bacteria) have a beneficial effect on the majority of stomach and intestinal ailments.

 

Living in northern latitudes during the winter months

Illustrerad Vetenskap (a Swedish scientific paper) published an article in September 2010 that Vitamin D is the key to the body’s immune system. What the article also stated was that the majority of Sweden’s population during the winter months suffer from vitamin D deficiency, which is not good at all because researchers worldwide find significant evidence of the connection between vitamin D deficiency and the risk of serious diseases. When the sun is shining during the summer (the sun is low in the winter), a small cholesterol molecule in the skin gets hit and converts it into vitamin D3. Vitamin D3, in turn, affects more than 2,000 genes, of which a gene called p53 counteracts cancer. Low levels of vitamin D3 significantly increase the risk of breast cancer and lung cancer but also other cancers. Researchers now believe that the many warnings of the sun’s light is one of the reasons that have led us to experience a noticeable increase in vitamin D deficiency in the population. The sun’s rays can cause skin cancer if you burn but can also be a source of reducing the number of other cancers as long as you do not burn. Application of sunscreen factor 8, for example, reduces the body’s vitamin D production by 95%. One way not to burn in the sun beside sunbathing with reason is to ensure that you have enough antioxidants in the blood, and thus the skin cells. Supplementation of vitamin-D3 may be in place during the winter months. Obviously, the diet doesn’t suffice since the majority of Swedes (thereby a large part of Northern America) suffer from vitamin-D3 deficiency during the winter.

 

ENDNOTE

We think we eat a balanced diet but in reality, we don’t. Even if we do eat a balanced diet there’s still the risk we don’t get enough nutrients, our soils are depleted. The Recommended Daily Intake (RDI) is set to the amount of “one given nutrient as an average healthy adult needs to avoid deficiency diseases”. Is there anyone who believes that he or she will get scurvy, which is a deficiency disease caused by vitamin C deficiency? No, that risk is probably non-existent. Today, dietary supplements do not concern avoiding deficiency diseases but to optimise performance, whether it’s sporting performance, or making sure that one’s child gets enough omega-3 so that he or she can reach maximum cognitive ability or reduce damage from cigarettes, car exhausts, and other free radicals or just as a cheap life ensurance because of the reduced nutritional content of todays food.

The article is based on the following research, among other things.

Brooke L. Summers, Allan M. Rofe, and Peter Coyle. Dietary Zinc Supplementation Throughout Pregnancy Protects Against Fetal Dysmorphology and Improves Postnatal Survival After Prenatal Ethanol Exposure in Mice. Alcoholism: Clinical and Experimental Research 2009 January
Hanson Institute/Institute of Medical and Veterinary Science (BLS, AMR, PC), Adelaide, SA, Australia.

Wolff Schlotz, Alexander Jones, David I.W. Phillips, Catharine R. Gale, Sian M. Robinson, and Keith M. Godfrey. Lower maternal folate status in early pregnancy is associated with childhood hyperactivity and peer problems in offspring. The Journal of Child Psychology and Psychiatry 2009 October
MRC Epidemiology Resource Centre, University of Southampton, UK.

References: Packer L, “Oxidants, antioxidant nutrients and the athlete,” J Sports Sciences, 1997;15:353-63; Vasankari TJ, Kujala UM, Vasankari TM, et al., “Increased serum and low-density-lipoprotein antioxidant potential after antioxidant supplementation in endurance athletes,” Am J Clin Nutr, 1997;65:1052-6.

The DIPART (vitamin D Individual Patient Analysis of Randomized Trials) Group Patient level pooled analysis of 68 500 patients from seven major vitamin D fracture trials in the US and Europe BMJ 2010 January

Jane A. Cauley, DrPH; Andrea Z. LaCroix, PhD; LieLing Wu, MS; Mara Horwitz, MD; Michelle E. Danielson, PhD; Doug C. Bauer, MD; Jennifer S. Lee, MD; Rebecca D. Jackson, MD; John A. Robbins, MD; Chunyuan Wu, MS; Frank Z. Stanczyk, PhD; Meryl S. LeBoff, MD; J Serum 25-Hydroxyvitamin D Concentrations and Risk for Hip Fractures Annals of Internal Medicine 2008 August Volume 149 Issue 4 | Pages 242-250
From University of Pittsburgh, Pittsburgh, Pennsylvania; University of Washington, Seattle, Washington; University of California, San Francisco, and San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, Cal

Key TJ, Appleby PN, Rosell MS: “Health effects of vegetarian and vegan diets” Proceedings of the Nutrition Society, 2006, 65:35-41.

BD and Butler T: “Cyanocobalamin (vitamin B-12) status in Seventh-day Adventist ministers in Australia” in American Journal of Clinical Nutrition, September 1999, 70:576S-578S; and Krajcovicova-Kudlackova M, Blazicek P, Kopcova J, Bederova A and Babinska K: “Homocysteine Levels in Vegetarians versus Omnivores” in Annals of Nutrition & Metabolism, 2000, 44:135-138; and VeganHealth.org: B12 and Chronic Disease: Homocysteine.

Drover, James, Hoffman, Dennis, Castañeda, Yolanda, Morale, Sarah, Birch, Eileen. Three Randomized Controlled Trials of Early Long-Chain Polyunsaturated Fatty Acid Supplementation on Means-End Problem Solving in 9-Month-Olds. Child Development, 2009 September Volume 80, Number 5, pp. 1376-1384(9) Retina Foundation of the Southwest, Dallas and Memorial University.

Artemis P. Simopoulos, MD, Alexander Leaf, MD and Norman Salem, Jr, PhD Workshop on the Essentiality of and Recommended Dietary Intakes for Omega-6 and Omega-3 Fatty Acids Journal of the American College of Nutrition, Vol. 18, No. 5, 487-489 (1999). Published by the American College of Nutrition

G Schectman, J C Byrd and H W Gruchow The influence of smoking on vitamin C status in adults.American Journal of Public Health, Vol. 79, Issue 2 158-162, 1989, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee 53226.

William J. Blot, Jun-Yao Li, Philip R. Taylor, Wande Guo, Sanford Dawsey, Guo-Qing Wang, Chung S. Yang, Su-Fang Zheng, Mitchell Gail, Guang-Yi Li, Yu Yu, Buo-qi Liu, Joseph Tangrea, Yu-hai Sun, Fusheng Liu, Joseph F. Fraumeni, You-Hui Zhang Jr. and Bing Li Nutrition Intervention Trials in Linxian, China: Supplementation With Specific Vitamin/Mineral Combinations, Cancer Incidence, and Disease-Specific Mortality in the General Population. National Cancer Institute Bethesda, Md. Cancer Institute, Chinese Academy of Medical Science Beijing, People’s Republic of China. Rutgers University Piscataway, N.J.

S. Verma, B. Kirkwood, S. Brown and M. H. Giaffer. Digestive and Liver DiseaseVolume 32, Issue 9, December 2000, Pages 769-774 Oral nutritional supplementation is effective in the maintenance of remission in Crohn’s disease. Department of Gastroenterology, Hull Royal Infirmary, Hull, UK

Macfarlane, GT, Cummings, JH. Probiotics, infection and immunity. Curr Opin Infect Dis 2002; 15:501.

Bohm, SK, Kruis, W. Probiotics: do they help to control intestinal inflammation?. Ann N Y Acad Sci 2006; 1072:339.

Mach, T. Clinical usefulness of probiotics in inflammatory bowel diseases. J Physiol Pharmacol 2006; 57 Suppl 9:23.

Ewaschuk, JB, Tejpar, QZ, Soo, I, et al. The role of antibiotic and probiotic therapies in current and future management of inflammatory bowel disease. Curr Gastroenterol Rep 2006; 8:486.

Hart, AL, Stagg, AJ, Kamm, MA. Use of probiotics in the treatment of inflammatory bowel disease. J Clin Gastroenterol 2003; 36:111.

Famularo, G, Mosca, L, Minisola, G, et al. Probiotic lactobacilli: a new perspective for the treatment of inflammatory bowel disease. Curr Pharm Des 2003; 9:1973.

Sartor, RB. Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: Antibiotics, probiotics, and prebiotics. Gastroenterology 2004; 126:1620.

Fedorak, RN, Dieleman, LA. Probiotics in the treatment of human inflammatory bowel diseases: update 2008. J Clin Gastroenterol 2008; 42 Suppl 2:S97.

Isaacs, K, Herfarth, H. Role of probiotic therapy in IBD. Inflamm Bowel Dis 2008; 14:1597.

Seksik, P, Dray, X, Sokol, H, Marteau, P. Is there any place for alimentary probiotics, prebiotics or synbiotics, for patients with inflammatory bowel disease?. Mol Nutr Food Res 2008; 52:906.

Textbearbetning om Bruce Ames: Helene Sandström, Näringsmedicinsk tidskrift.
Öckerman P.A. Den nya medicinen, 2 uppl. 2008. ISBN:91-970087-6-