Don't be confused by marketing hype when choosing supplements

In an effort to distinguish one brand from another, supplement manufacturers have devised their own jargon to promote their products. These terms commonly appear on labels and in advertisements. Each term implies a superior product, but none has a standard definition agreed upon by experts or specified in the regulations governing the manufacture and sale of supplements. However, manufacturers must hold evidence that substantiates the use of such terms, or they could be prosecuted in Australia under the Therapeutic Goods Act or the Trade Practices Act and in New Zealand under the Fair Trading Act, or similar acts in other countries. Pay attention to the specific ingredients and directions on a label rather than the hype of such terms as these:

■ Clinically Proven
■ Highly Concentrated
■ Maximum Absorption
■ Natural (or Naturally Occurring)
■ Pure
■ Quality Extract

When buying standardized extracts...

The amount of an active or main ingredient in a standardized herbal extract is often expressed as a percentage: milk thistle 'standardized to contain 80% silymarin' means that 80% of the extract contains that ingredient. Accordingly, recommendations in this blog for most standardized products are given as percentages. For example, a 150 mg dose of milk thistle standardized to contain 80% silymarin contains 120mg silymarin (150 x .80 = 120). Sometimes, though, a standardized extract product will simply state the actual amount of active ingredient you're getting (for example, 120 mg silymarin), rather than listing a percentage.

Helping you buy supplements - Their preparations and forms

The many choices available allow you to find supplements that are safe, effective and convenient. But some 'special' formulations appear to provide little additional benefit and are often not worth the extra expense.

Supplements come in a variety of forms that affect both their ease of use and, in some cases, their rate of absorption. (Each supplement entry lists the available forms for that supplement.)

Tablets:
Easily stored, tablets will usually keep longer than other forms in which supplements are marketed. In addition to the vitamin itself, tablets often contain generally inert additives known as excipients. These compounds bind, preserve or give bulk to the supplement and help tablets to break down more quickly in the stomach. Increasingly, supplements are becoming available in capsule-shaped, easy-to-swallow tablets called 'caplets'.

Capsules:
The fat-soluble vitamins A, D and E are typically packaged in 'softgel' capsules. Other vitamins and minerals are processed into powders or liquids and then encapsulated. Like tablets, capsules are easy to use and store. They also tend to have fewer additives than tablets, and there is some evidence that they dissolve more readily (although this doesn't mean that they are better absorbed by the body - just that they may be absorbed more quickly).

Powders:
People who find pills hard to swallow may prefer to use powders, which can be mixed into juice or water or stirred into food. (Ground seeds such as psyllium and flaxseed often come in pow­dered form.) Powders also allow dosages to be adjusted easily Because they may have fewer binders or additives than tablets or capsules, powders are useful for people who are allergic to certain sub­stances. In addition, powders are often cheaper than tablets or capsules.

Liquids:
Liquid formulas for oral use are easy to swallow and can be flavored. Many children's for­mulas are in liquid form. Some supplements (such as vitamin E) also come in liquids for applying topically to the skin. Eyedrops are another type of liquid.

Chewables:
Such supplements - usually sold as flavored tablets - are particularly recommended for those who have trouble getting whole pills down.

Lozenges:
A number of supplements are available as lozenges or 'drops' that dissolve gradually in the mouth, either for ease of use or, in the case of zinc lozenges, to help in the treatment of colds and flu.

Sublingual tablets:
A few supplements, such as vitamin B12, are formulated to dissolve under the tongue, providing quick absorption into the blood­stream without interference from stomach acids and digestive enzymes.

Special formulations - You will usually pay more for a supplement if the label says 'slow-release' or 'chelated'. Does it provide extra benefits? Hardly ever, according to the available data.

Slow-release formulas:
These formulas contain microcapsules, or have a coating of protein, that gradually breaks down to release the vitamin steadily into the bloodstream over 2-10 hours. 'Sustained-release' is another term for the same process.

There are no reliable studies showing that slow-release formulas are more efficiently utilized by the body than conventional capsules or tablets - in fact, in the case of the fat-soluble vitamins A, D and E, the gel-like substance that delays release may interfere with absorption.

Chelated minerals:
Chelation is a process in which a mineral is bonded to another substance, or 'chelator' - usually an amino acid. This attached substance is supposed to enhance the body's absorp­tion of the mineral.

In most cases, there's no evidence that chelated minerals are absorbed any better or faster than non-chelated minerals. In fact, there's no solid proof that any process or addition of ingredients improves the absorption of vitamins or most minerals.

Herbal remedies - You can buy whole herbs and make up your own formulations. But for ease of use, tablets, capsules and the other conveniently packaged forms described here (including forms for external use) are readily available in pharmacies, supermarkets and health-food shops.

Tablets and capsules:
You can avoid the taste of the herb if you take it in tablet or capsule form. Both tablets and capsules are prepared using either a whole herb or an extract containing a high concen­tration of the herb's active components. In either form, the constituents are ground into a powder that can be pressed into tablets or encapsulated. Some herbs are available in enteric-coated capsules, which pass through the stomach to the small intestine before dissolving, minimizing potential gastro­intestinal discomfort and, for some herbs, enhancing absorption into the bloodstream.

Tinctures:
These concentrated liquids are made by soaking the herb in water and ethyl alcohol. The alcohol extracts and concentrates the herb's active components. (Non-alcoholic concentrations can be made using glycerin.) Tinctures are usually taken in small doses - for example, 20 drops, or 1 ml, three times daily - diluted with water or juice.

Teas, infusions and decoctions:
Less concen­trated than tinctures, teas and infusions are brewed from the fresh or dried flowers, leaves or roots of a herb. These can be bought in bulk or as teabags. Although tea is usually made with boiling water, the herbal teas recommended in this book are prepared as infusions, using hot water on the verge of boiling, which preserves the beneficial oils that can be dissipated by the steam of boiling water. To make decoctions, the tougher parts of a herb (stems or bark) are usually simmered for at least half an hour.

Use these liquid remedies as soon as possible after brewing them, because they start to lose their potency within a few hours of exposure to air. Store them in tightly sealed glass jars in the refrigerator. and they'll retain some strength for up to three days.

Oils:
Oils extracted from herbs can be commer­cially distilled to form potent concentrations for external use. These so-called essential oils are usually placed in a neutral 'carrier' oil, such as almond oil, before being applied to the skin. (Milder infused' oils can be prepared at home.) Essential herbal oils should never be ingested. The exception is pepper­mint oil: a drop or two on the tongue may be helpful for bad breath, and peppermint oil capsules are beneficial for irritable colon.

Gels, ointments and creams:
Gels and oint­ments, which are made from fats or oils of aromatic herbs, are applied to the skin to soothe rashes or heal bruises or wounds. Creams are light oil-and-water mixtures that are partly absorbed by the skin, allow­ing it to breathe while keeping in moisture. Creams can be used for moisturizing dry skin, for cleansing, and for relieving rashes, insect bites or sunburn.

Standardized extracts - When herbs are recommended in this book, we often suggest you look for 'standardized extracts'. Herbalists and manufacturers use this term to describe the consis­tency of a product. When producing a herbal supplement, manufacturers can extract the active components from the whole herb. These active ingre­dients - for example, the capsaicin in cayenne peppers - are then concentrated into a supplement (tablets, capsules or tinctures). They are standardized to supply you with a precise amount in each dose.

Sometimes, instead of standardized extracts, manufacturers process the whole, or crude, herb. The herb is simply air- or freeze-dried, made into a powder, and then packaged into a supplement - again a capsule, tablet, tincture or other form.
Whether a standardized extract or the crude herb is better is an ongoing controversy among herbalists. Supporters of crude herb supplements contend that the whole herb may contain still unidentified active ingredients, and that only through ingesting the entire herb can all the benefits be obtained. Advocates of standardized extracts argue that the active ingredients in whole herbs can vary greatly, depending on where they're grown and how the herbs are harvested and processed, and that the only way to be sure you're receiving a consistent amount of active ingredients is to take standardized extracts.

Although standardized products are more consis­tent from batch to batch, this doesn't guarantee that they are more effective than whole-herb products. But in many cases, you would have to use a much greater amount of a whole herb to achieve a similar therapeutic effect. Moreover, reliability and consis­tency can be of great value, particularly when a product proves to be beneficial for a specific disorder.

Which ones are better, natural or synthetic health supplements?

Advertising claims imply that vitamins derived from 'natural' sources are better than 'synthetic' vitamins created chemically in a laboratory. They may state that their natural products are more potent or better absorbed - and manufacturers generally charge more for natural products. But what is 'natural'?

Most supplements, no matter what their source, are processed with chemicals in laboratories. Some that are labelled 'natural' are really synthetic vitamins with plant extract, or minute amounts of naturally derived vitamins, mixed in. Even the most natural products have undergone some refining and processing and contain some additives - to hold them together or to preserve them so that they don't deteriorate too quickly. However, most reputable manufacturers try to keep their products as pure as possible.

Some vitamins, such as vitamin B, are commonly synthesized, as the natural alternatives, such as yeast, can cause adverse reactions in many people. Others, such as vitamin B12 and coenzyme Q10, are grown on specific bacteria. However, the way the fat-soluble vitamins are processed can make a difference. For example, 'natural' vitamin E - made from soya bean or wheatgerm oil - is absorbed about twice as efficiently as the synthetic form. This is usually reflected in the price, as the naturally sourced product is more expensive to produce. Vitamin A from cod liver oil or halibut liver oil appears to be a little less toxic than the synthesized versions (though you still need to be careful with dosage, as vitamin A is stored in the liver), and beta-carotene naturally sourced from foods or algae is clinically more effective - perhaps because the naturally sourced versions also have small amounts of other substances (such as carotenoids) working synergistically in the supplement. Many companies are now manufacturing tablets and powders directly from fruits and vegetables to gain the broad spectrum of antioxidants and other nutrients needed for health.

Check the additives in any supplement in case you're allergic to any of them - and you may have to pay more for a supplement with fewer of these inert fillers. If in doubt, contact the manufacturer.

Getting real - What supplements won't do for you

Despite the many promising benefits that supplements can offer, its important to note their limitations - and to question some of the extravagant claims currently being made for them.

As the word itself suggests, supplements are not meant to replace the nutrients available from foods. Supplements will never make up for a poor diet: they can't counteract a high intake of saturated fat (which is linked to an increased risk of heart disease and cancer), and they can’t replace every nutrient found in food groups that you ignore. Also, although scientists have isolated and extracted a number of disease-fighting phytochemical compounds from fruits, vegetables and other foods, there may be many others that are undiscovered - and ones you can get only from foods. In addition, some of the known compounds may work only in combination with others in various foods, rather than as single, isolated ingredients in supplement form.

Supplements won't compensate for personal habits that are known to contribute to ill health, such as smoking or a lack of exercise. Optimal health requires a healthy lifestyle - this applies particularly to people who are determined to age as well as they can.

Although some of the benefits ascribed to supplements are unproved but plausible, other claims are far-fetched. Weight-loss preparations are the leading example. Though they're extremely popular, it's questionable whether any of them can help you to shed weight without the right food choices and regular exercise. Products that claim to 'burn fat' won't burn enough on their own for significant weight loss.

Similarly, claims of boosting performance, whether physical or mental, are difficult to prove - and any 'enhancement' will be limited at best in a healthy person. Although a supplement may improve mental functioning in someone experiencing mild to severe episodes of memory loss, it may have a negligible effect on the memory or concentration of most adults. Likewise, a supplement shown to combat fatigue isn't going to turn the average jogger into an endurance athlete. Nor is it clear that 'aphrodisiac' supplements enhance sexual performance if you aren't suffering from some form of sexual dysfunction.

No supplements have been found to cure any serious diseases - including cancer, heart disease, diabetes and AIDS. The right supplement, however, may help to improve a chronic condition and relieve symptoms such as pain or inflammation. But first you need to consult a health professional for treatment.

How supplements help relieve and treat ailments

Many complementary healthcare professionals recommend supplements for a wide range of health problems affecting virtually every body system. For most of these conditions, conventional doctors would be likely to prescribe drugs rather than supplements, though they might treat some disorders with supplements. For example, iron may be prescribed for some types of anemia, vitamin A (in the drug isotretinoin, or Roaccutane) for severe acne, and high doses of the B-vitamin niacin for reducing high levels of cholesterol.

In this blog, certain vitamins and minerals are suggested for the treatment of specific ailments. However, the use of nutritional supplements as remedies, especially for serious conditions, is controversial. Many doctors practicing conventional medicine are skeptical of their efficacy and believe it is sometimes dangerous to rely on them. But based on published data and their clinical observations, nutritionally oriented doctors and other health professionals think the use of these supplements is justified - and that to wait years for unequivocal proof would be wasting valuable time. Until there is clearer, more consistent evidence available, you should be careful about depending on nutritional supplements alone to treat an ailment or injury.

For thousands of years, however, various cultures have used herbs to soothe, relieve or even cure many common health problems, a fact not ignored by medical science. The pharmaceutical industry, after all, arose as a consequence of people using herbs as medicine. Recent studies suggest that a number of the claims made for herbs are valid, and the pharmacological actions of the herbs covered in this blog are often well documented by clinical studies as well as by historical practice. In Europe, a number of herbal remedies, including St Johns wort, ginkgo biloba and saw palmetto, are now prescribed as medications to treat disorders such as allergies, depression, impotence and even heart disease.

Of course, even herbs and other supplements with proved therapeutic effects should be used judiciously to treat an ailment. Study the guidelines for advice on using these remedies safely and effectively.

Tai Chi Chuan

Performed as a series of graceful postures, one flowing into another, the Chinese 'soft' martial art of tai chi chuan — or simply tai chi — works on both the body, by providing exercise, and the mind, by helping you concentrate. The movements relax the muscles, freeing the joints and easing tension. The gentle exercise provided by tai chi is suitable for most people.

Professional consultation
The best way to learn tai chi is to go to a class run by an experienced teacher. You will learn a sequence of movements known as a 'form' — either a short form, lasting 5 to 10 minutes, or a full-length long form, which can take up to 40 minutes. Once you have learned a tai chi form, you will be able to practice it every day at home.

Sound Therapy

Scientists now know that sound can alter our brainwaves. This therapy uses the power of sound to encourage healing. Treatment may be a simple matter ol playing soothing sounds (such as chanting, the noise of waves or the calls of dolphins) to induce relaxation. This type of sound therapy can help with stress, anxiety and other emotional problems.

Rolfing

The aim of rolfing is to improve the structural alignment of the hotly. Rollers compare the human body to a tower of children's building blocks - if one block is pushed out of alignment, the structure of the entire tower is threatened. By manipulating the body's connective tissues and muscles — using the knuckles, fingers, palms and elbows the roller tries to realign your body, increasing its range of movement, improving your balance and enhancing your posture. Rolfmg may be of benefit to people with poor posture and low vitality.

RDI - What does it mean?

RDIs indicate the average quantities of key nutrients that children and adults should obtain from their food every day to achieve and maintain long-term health. RDIs are the same in both countries. They are often quoted on food labels; for example, the amount of iron in a typical serving may be shown as a percentage of the RDI for iron.

• RDIs are different for men, women and children, for different age groups and for pregnant and breast­feeding women. Where RDIs apply to an 'average adult', they are meant only as a rough guide to healthy eating.

• Deficiencies resulting from getting too little of a given nutrient, and any adverse effects from getting too much, are also indicated when they are known.

Are they enough?
It's important to remember that the RDIs are recommendations - not requirements - for large groups of people. The levels are those assumed to supply the nutrient needs of most peo­ple, plus a generous margin of safety. Many experts, however, think that current RDIs (especially those for vitamins) are still much too low for maintaining optimal health or for treating certain diseases.

While RDIs vary according to age and sex, the values can't take into account such variables as smoking, alcohol consumption, exposure to pollu­tants and medication use, all of which can interfere with nutrient absorption. Nor do they allow for indi­vidual differences in nutritional needs according to occupation, weight and other factors, such as emotional stress or illness.

A very long list of benefits, is it just too good to be true?

When you see a supplement label or promotional leaflet that lists a variety of functions or benefits for a single herb or substance, you might wonder if this is more marketing hype than facts. In many countries, labels are checked for accuracy of ingredients and claims made on labels must comply with the government regulations in each country. As you read the entries in this blog, you'll see that some supplements do have multiple effects that are well documented.

Consider a herb such as green tea. According to many studies, its benefits may include helping to control several cancers, including colon and pancreatic cancer; protecting against heart dis­ease; inhibiting the action of bacteria; combating tooth decay; and acting as an antioxidant to bol­ster the immune system. All these benefits aren't so surprising, given that researchers have identi­fied various active components in green tea.

You should be aware that many common medications were initially developed for one purpose. As more people take the drugs and their effects are studied, new uses come to light. Imagine a drug that can cure headaches, relieve arthritis, help to prevent heart disease, ease the pain of athletic injuries and reduce the risk of colon cancer. Its aspirin, of course - and its pre­cursor came from a herbal source, the bark of the white willow tree.

Do supplements really help prevent disease and slow ageing?

For many years, it was thought that a lack of nutrients was linked only to specific deficiency diseases such as scurvy, a condition marked by soft gums and loose teeth that is caused by too little vitamin C. In the past three decades, however, thousands of scientific studies have all indicated that specific nutrients appear to play an important role in the prevention of a number of chronic, degenerative diseases common in contemporary Western societies.

Many recent studies highlighting the disease-fighting potential of different nutrients are mentioned throughout this blog. What most of these studies reveal is that the level of nutrients asso­ciated with disease prevention is often significantly higher than the current RDIs. And to achieve these higher levels, the participants in these studies often had to depend on supplements.

As well as slowing or preventing the development of disease, some experts suggest that nutrients, particularly antioxidants, can delay the wear and tear involved in ageing by reducing the damage done to cells. It doesn't follow from this that vitamin E or coenzyme Q10, for example, are 'youth potions'. But several recent studies, including work done at the Nutritional Immunological Laboratory at Tufts University in Boston, have found that supplementa­tion with single nutrients, such as vitamin E, or with multivitamin and mineral supplements, appears to improve the immune response among older people.

For example, a study of 11,178 elderly people, conducted by researchers at the National Institute on Aging in the US, showed that the use of vitamin E was associated with a lowered risk of death in general, and especially of death from heart disease.

In fact, vitamin E users were only half as likely to die of heart disease as those taking no supple­ments. In addition, there's evidence that antioxidant supplements lower the risk of cataracts and macular degeneration, two age-related conditions in which vision slowly deteriorates.

Other supplements that act as high-potency antioxidants and so offer protection against ageing disorders include selenium, carotenoids, flavonoids, certain amino acids and coenzyme Q10. Some experts also believe that the herb ginkgo biloba may improve many age-related conditions, especially those involving reduced blood flow, such as dizzi­ness, impotence and short-term memory loss.

Substances found in echinacea and other herbs are reported to strengthen the immune system, and phyto-oestrogens such as soy isoflavones are thought to help delay or prevent some of the effects of menopause, as well as helping to prevent cancer and heart disease.

How supplements can benefit your health

Many people take a daily multivitamin and mineral supplement as nutritional 'insurance' against deficiencies. But recent research provides additional reasons for using a variety of supplements, including herbs, to both prevent and heal diseases - and indicates that optimal levels may be higher than conventional wisdom has long dictated.

If you're basically healthy, is there any advantage in taking supplements regularly? And if you develop a disorder or ailment, can you expect supplements to offer an)- help? What follows is a summary of the major benefits that, according to researchers, most people can expect if they use the supplements cov­ered in this blog. More detailed information about the therapeutic effects of specific supplements can be found in the entries in the 'Supplements' category.

Enhancing your diet - Conventional wis­dom has long held that, as long as people who are healthy eat well enough to avoid specific nutritional deficiencies, they don't need to supplement then-diet. The only thing the)' have to do is consume a diet that meets the RDIs - Recommended Dietary Intakes - developed by government health agencies for vitamin and mineral intakes.

But even if one accepts the government’s stan­dards for vitamin and mineral intakes as adequate for good health, there is evidence that the diets of many people fall short of these nutritional requirements. In Australia, a recent 'snapshot' survey of 14 000 people revealed that, while Australians generally consume the right amounts of meats and fats for good health, 'we need to eat more breads, cereals and cereal prod­ucts, another serve of fruit each day, several more serves of vegetables, another serve of milk and milk products, and to include fish two or three times a week' in order to obtain the minimum level of nutri­ents believed necessary to prevent illness.

Its common knowledge that many people make nutritionally poor food choices: for example, they're more likely to select chips than broccoli as a veg­etable serving, and will opt for a soft drink rather than a glass of skim milk as a beverage. Not only may these and other foods contribute too much fat and sugar to your diet, but they can also result in less-than-optimal intakes of vitamins, minerals and disease-fighting phytochemicals.

Even with the best nutritional planning, its difficult to maintain a diet that meets the RDIs for all nutrients. For example, vegetarians, who as a group are healthier than meat eaters (and who tend to avoid junk foods lacking in vitamins and miner­als), may still be deficient in some nutrients, such as iron, calcium and vitamin B12. And most people who want to follow a healthy, low-fat diet will have a problem obtaining the recommended amounts of vitamin E from their food alone, because so many of the food sources for vitamin E are high in fat. Another complication is that a so-called balanced diet may not contain the more specialized substances - fish oils or soy isoflavones, for example - that researchers think may promote health. For people who are generally healthy but for some reason can't eat a well-balanced diet even- day, a supplement can fill in these nutritional gaps or boost the level of nutrients they consume from adequate to optimal.

There are various other reasons why even those who have good eating habits might benefit from a daily supplement. Some experts now believe that exposure to environmental pollutants - from car emissions to industrial chemicals and wastes - can cause damage in myriad ways inside the body at the cellular level, destroying tissues and depleting the body of nutrients. Many supplements, particularly those that act as antioxidants, can help to control the cell and tissue damage that follows toxic exposure. Recent evidence also indicates that certain medications, excess alcohol, smoking and persistent stress may interfere with the absorption of certain key nutrients. And even an excellent diet would be unable to make up for such a shortfall.

Specific nutritional programs of vitamins, minerals and other supple­ments can be designed that will take into account these and other environmental and lifestyle factors that affect nutrient levels in the human body.

The best tips for a longer, healthier life

Staying well hinges on a wide range of lifestyle choices that can enhance the quality of your life so that you feel better physically and mentally. Equally important, these habits can promote longevity.

Below is a summary of the most important actions to take.

• If you smoke, give it up. Thousands of premature deaths each year in many parts of the world are related to smoking.

• Eat a varied, low-fat diet. Experts recommend seven servings of fruits and vegetables each day, plenty of whole grains (which are high in dietary fiber as well as vitamins and minerals) and low-fat dairy products (for bone-strengthening calcium).

• If you drink alcohol, do so in moderation. Excessive consumption of alcohol (more than four standard drinks a day for men, two for women) can lead to high blood pressure, heart disease, cancer and other health problems.

• Exercise regularly. Studies show that as little as 30 minutes of exercise - such as walking, swimming or playing tennis - at least three times a week can help to lower your risk of disease and premature death.

• Avoid becoming seriously overweight. A large weight gain in adults (10 kilograms or more) is linked to increased mortality in middle age. Keep your weight in check by watching your kilojoules and exercising regularly.

• Protect yourself from the sun. Too much sun damages your skin, promoting skin cancer and cataracts. Use sunscreen (at least 15 SPF, but preferably 20 SPF), avoid long exposure (especially between 11 a.m. and 3 p.m.), cover up, wear sun­ glasses and a hat, and examine your skin frequently.

• Control stress. You can't avoid this consequence of modern life altogether. But by exercising, meditating and pursuing other activities you enjoy, you can keep stress from becoming overwhelming.

Reiki

The word reiki means 'universal life energy', and this therapy offers a way of transferring healing energy from a giver to a receiver. Practitioners gain their ability to heal through reiki by studying with a reiki master teacher. The student practitioner undergoes 'attunement', which is said to open up a channel through which healing energy can flow. Practitioners also learn specific hand positions for use during therapy sessions.

When you consult a reiki practitioner, the therapist lays his or her hands on your body, following intuition to adopt the positions that give the best flow of healing energy.

Psychotherapy

Trained to listen carefully and offer support in cases of distress, grief, stress and anxiety, psychotherapists treat many people with emotional and psychological problems. Therapists work by listening to you and talking with you about your exper­iences and relationships, so that you can gain insight into your problems. Gradually, you get closer to the roots of emotional difficul­ties that may be deep-seated.

Different psychotherapists employ differ­ent therapies, ranging from the warm and supportive to the more detached and analyti­cal. When choosing a therapist, it is impor­tant to find out which technique he or she offers. Some of the most popular are behav­ioral therapy (which helps you to 'unlearn' problem behavior or habits), group therapy (in which you share your problems with a group of other patients), neurolinguistic programming, or NLP (which works with the way personal experiences influence your perceptions), and gestalt therapy (which makes you more aware of such behavior as body language).

Depending on the type of therapy and the needs of the patient, psychotherapy may be short-term or may require a large number of sessions over months or even years. After a course of therapy, you should be able to con­front and overcome your difficulties.

Polarity Therapy

A mixture of Eastern and Western approaches, polarity therapy is based on the idea that a form of energy flows around the body from one pole to another, rather like a magnetic current. The energy, which may be positive, negative or neutral, flows between energy centres known, as in yoga, as chakras. Polarity therapists, use four techniques to balance energy and promote general health: bodywork (touch and massage), awareness, skills (helping you talk through your problems), dietary recommend­ations and yoga-like stretching exercises.

The power of antioxidants

Although oxygen is essential for life, it can have adverse effects on your body. In the normal physiological process of using oxygen, chemical changes occur that create reactive unstable oxy­gen molecules called free radicals, which can damage cells and structures within cells, including genetic material (DNA). Free radicals also may form in response to external factors such as cigarette smoke and alcohol, pollutants such as nitrogen dioxide and ozone, and ultraviolet light and other forms of radiation, including X-rays. If the genetic material in cells is affected by free radicals and not repaired, it can be replicated in new cells, con­tributing to cancer and other health problems. Free radicals may also weaken artery walls, allowing fatty deposits that can lead to heart disease to collect.

However, cells have special agents for combat­ing free radicals and repairing molecular damage. These free-radical fighters are called antioxidants. A great deal of recent research suggests that anti­oxidants may play important roles in preventing or delaying the onset of heart disease, cancer and other illnesses, and may even halt the damage to cells, thereby slowing the effects of ageing.

Vitamins C and E are perhaps the best-known antioxidants. The mineral selenium is also an antioxidant, as are carotenoids such as beta-carotene and lycopene. Enzymes and certain other compounds (such as glutathione) manufactured by the cells themselves also function as antioxidants. Some experts now think that a number of other substances, including certain herbs, may act as antioxidants as well. For example, green tea, grape seed extract and ginkgo biloba (among others) are all thought to have antioxidant properties.

Basic types of supplements

Anyone who has strolled down a shopping aisle devoted to nutritional supplements is aware of - and perhaps overwhelmed by -the huge variety. Taking into account the different brands and combinations of supplements, there are literally hundreds of choices. You're not likely to encounter this many in one place, but even a more limited selection in your local pharmacy, supermarket or health-food shop can be confusing.

One reason for so much variety is that marketers are constantly trying to distinguish their own brands from others, and so they devise different dosages and new combinations and spend a lot of money on advertising and promoting their products. At the same time, scientists have found new and better ways of extracting nutritional components from plants and synthesizing nutrients in a laboratory - discoveries that have resulted in many new products.

To be able to make informed decisions, it's essen­tial to understand the terms used on supplement labels, as well as the properties and characteristics of specific supplements. But to avoid feeling overwhelmed by all the choices open to you, its useful first to learn the basic types of supplements that are available and the key functions they perform in helping to keep you healthy.

Vitamins: A vitamin is a chemically organic substance (meaning it contains carbon) essential for regulating both the metabolic functions within the body cells and the biochemical processes that release energy from food. In addition, evidence is accumulating that certain vitamins are antioxidants -substances that protect tissues from cell damage and may possibly help to prevent a number of degen­erative diseases.

With a few exceptions (notably vitamins D and K), the body cannot manufacture vitamins, so they must be ingested in food or nutritional supple­ments. There are 13 known vitamins, which can be categorized as either fat-soluble (A, D, E and K) or water-soluble (eight B-vitamins and vitamin C). The distinction is important because the body stores fat-soluble vitamins for relatively long periods (months, or even years), whereas water-soluble vitamins (except for vitamin B12) remain in the body for only a short time and must be replenished more frequently

Minerals: Minerals are present in your body in small amounts. Altogether, they add up to only 4% of body weight. Yet these inorganic substances, which are found in the earth's crust as well as

in many foods, are essential to a wide range of vital bodily processes, from basic bone formation to the normal functioning of the heart and digestive system. A number of minerals have been linked to the prevention of cancer, osteoporosis and other chronic illnesses.

As with vitamins, humans must replenish their mineral supply through food or with supplements. The body contains more than 60 different minerals, but only 22 are considered essential. Of these, seven - calcium, chloride, magnesium, phosphorus, potas­sium, sodium and sulphur - are usually called macrominerals, or major minerals. The other 15 are termed trace minerals, or micro minerals, because the amount of them that the body requires each day for good health is tiny. (Usually it's measured in micro-grams, or millionths of a gram.)

Herbs: Herbal supplements are prepared from plants - often using the leaves, stems, roots and/or bark, as well as the buds and flowers. Known for thousands of years as medicinal agents, many plant parts can be used in their natural form, or they can be refined into tablets, capsules, powders, tinctures and other supplement formulations.

Many herbs have several active compounds that interact with one another to produce a therapeutic effect. A herbal supplement may contain all the com­pounds found in a plant, or just one or two of the isolated compounds that have been successfully

extracted. In the case of some herbs, however, the active agents haven't been identified, so it's necessary to use the complete herb to obtain all its benefits.

Of the hundreds of remedies that are surfacing in the current rebirth of herbal medicines, the major­ity are being used to treat chronic or mild health problems. Increasingly, herbs are also being used to attain or maintain good health - for example, to enhance the immune system, to help keep blood cholesterol levels low, or to increase stamina and lessen fatigue. Less commonly, some herbs are now recommended as complementary therapy for acute or severe diseases.

Other nutritional supplements: These supple­ments comprise a diverse group of products. Some, such as fish oils, are food substances that scientists have concluded have disease-fighting potential. Flavonoids, soy isoflavones and carotenoids are phytochemicals - compounds found in fruits and vegetables that lower the risk of disease and may alleviate symptoms of some ailments.

Other nutritional supplements in this category, such as DHEA, melatonin and coenzyme Q10, are substances present in the body that can be re-created synthetically in a laboratory (DHEA and melatonin are available only on prescription in some countries). A similar example is acidophilus, a “friendly” bacterium in the body that, taken as a sup­plement, may be helpful in the treatment of digestive disorders. Amino acids, which are building blocks for proteins and may play a role in strengthening the immune system and in other health-promoting processes, have been known to scientists for many years. Only recently, however, have they been mar­keted as individual dietary supplements.

Osteopathy

This system of therapy treats the mechanics of the human body—the bones, joints, muscles, ligaments and other connective tissues. Osteopaths believe that many diseases are caused by problems with the body's structure; therefore, if they fix the structural problems, the body will be encouraged to heal itself. They use gentle, mani­pulative techniques to reduce tension and restore health.

Although osteopathy is especially effective in treating such problems as muscle and joint pains, an osteopath always tries to find out why these disorders are occurring, in case they are symptoms of some other disorder.


Professional consultation

A first visit usually lasts up to one hour. The osteopath asks about your lifestyle, work and leisure activities, as well as your illness. He or she examines you standing, sitting, and lying on the treatment table. You may be asked to bend or stretch to see how your body responds in different positions.

Soft-tissue manipulation, with a range of massage-like techniques that help relax tight muscles and tighten loose ones, is often the first stage in treatment. The osteopath uses his or her fingertips to probe your mus­cles to seek out tension and other problems.

If you have joint problems, the osteopath may use gentle rhythmic strokes and stretches to ease them. He or she may also try a tech­nique known as the high-velocity thrust. This is a rapid, painless movement, usually used on the spine. It makes the joint move and click and the muscles around the joint quickly relax. Pain around the joint can be relieved with this technique.

You may need several return visits, which usually last about half an hour each. The number of visits required will vary according to several factors—the condition itself, how long you have had the problem, and your age (younger people usually need fewer visits).

Besides, joint and muscle problems, disor­ders that may respond well to osteopathy include sports injuries, migraine, premenstrual syndrome, constipation and such respiratory problems as asthma.

Nutritional Therapy

This form of therapy analyzes your diet and finds ways in which your body's strength and ability to heal itself can be improved by making changes in your eating habits. Nutritional therapy is most commonly used by dietitians and nutritionists. Practitioners such as clinical ecologists and naturopaths also often use nutritional therapy as part of their treatment.

When you first consult a nutritional ther­apist, you fill in a questionnaire about your health, illnesses, lifestyle and diet. After the therapist has looked at your answers, he or she gives you dietary advice tailored to your particular situation. You should expect to make return visits so that the therapist can assess the diet's effectiveness and make any necessary adjustments. The practitioner may also advise you to consult your doctor if you have a condition that cannot be treated solely by adjusting your diet.

Metamorphic Technique

This technique involves work on the feet and hands, using techniques similar to reflexology. Just as reflexologists believe that different zones on the feet affect different parts of the body, so practitioners of meta-morphic technique believe that various areas on the feet affect the emotions.

Magnet Therapy

This therapy relies on the idea that the body responds to magnetism. The therapist applies magnets to your body, either in the form of a magnetic bracelet or as magnetic pads. Therapists claim success in treating the pain of rheumatism, but most research has shown that magnets have little or no therapeutic effect, and experts are therefore sceptical.

Light Therapy

One form of this therapy involves sitting in front of a specially designed light box, which produces light at a higher intensity than ordinary bulbs. This helps many sufferers of seasonal allective disorder (SAD), or winter blues—people who get depressed during the winter months. One theory suggests that SAD is linked to high levels of the hormone melatonin, which is produced by the pineal gland. The gland normally produces mela­tonin at night, and the morning light stops the secretion. But during winter, when there is less daylight, the pineal gland may go on producing melatonin. About two hours of daily light therapy may alleviate the problem, but it should be supervised by a doctor.

Laughter Therapy

When you laugh, you feel good. The reason for tins is partly that laughter boosts certain body chemicals, including endorphins, which are natural mood-enhancing and pain-relieving substances. There is also evidence that laughter has physical benefits—it relaxes tense muscles amd strengthens the immune system. A number of therapists run workshops in which you arc encouraged to laugh—for example, by watching a clown, listening to a comedian, or being shown the funny side of problems. This can make your difficulties seem more manageable, so laughter therapy can also provide an effective way ot managing stress.

Kinesiology

Like Chinese doctors, kinesiologists believe that an invisible form of vital energy circulates through the body. Treatment aims to restore imbalances in this energy How. A kinesiologist tries to learn about your health by testing your muscles, and tries to correct imbalances ot the muscles and other disorders by using gentle massage, acupressure and similar physical techniques. Kinesiology can sometimes relieve muscular aches and pains. Practitioners also claim success m treating food allergies, although there is no evidence supporting these claims.

Iridology

A technique said to help diagnose diseases, iridology is based on the idea that the iris of the eye contains a map of the body. Each part of the iris is believed to represent an organ. Iridologists believe that black marks on the irises indicate a disease and white marks signal some form of stress or inflammation. If an lridologist finds any problems, he or she should refer you to a doctor.

Hypnotherapy

This therapy uses hypnosis, creating a state of mind in which normal thought processes are suspended tor a short period of time. Hypnosis can be used to induce relaxation, to treat stress-related conditions, to help people overcome addictions, phobias and eating disorders, and to treat lack of confidence and sexual problems. Some forms of hypnosis are also effective for pain relief, especially during labor and dental treatment.


Professional consultation

There are various ways of inducing a hypnotic trance, but the hypnotist will create a relaxing atmosphere, perhaps asking you to visualize a restful scene or repeat a phrase or sentence over and over. The therapist may suggest that your limbs are feeling heavy and that your eyelids are closing. When you go into a hypnotic trance, you will feel relaxed and you may be willing to accept the suggestions of the hypnotist. You may then go into a deeper trance, in which your heartbeat and breathing slow down and you enter a state that feels similar to that of meditation. The hypnotist may make statements to address your problem—for example, ones that boost your self-esteem or tell you that you are going to stop a damaging form of behavior, such as smoking or drinking alcohol.

Hellerwork

Practitioners of Hellerwork believe that the bones and soft tissues of the body become misaligned from stress, illness or bad posture. Hellerworkers aim to realign your body, banish tension and correct the problems that originally caused the misalignment. They do this by manipulating the body and by teaching you how to move in a well-balanced way. People with a wide range of aches and pains, especially neck ache, back pain and headaches, have responded well to this form of therapy. It may also help internal processes affected by muscle function, such as digestive problems.


Professional consultation

You normally attend a series of 11 weekly sessions, making up a complete Hellerwork course. After taking your medical history and assessing your needs, the practitioner will begin the first group of sessions, known as the superficial sessions. These concentrate on freeing tension in the chest, arms and feet. Next come the core sessions, during which the therapist works on muscles that Hellerworkers believe to be at the core of the body—those of the pelvis, spine, head and neck. A final group of sessions, known as the integrative sessions, draw together the work of the previous weeks.

Healing

Healers usually talk about what they do in terms of energy—a vital life force, which everyone possesses. This force can become depleted when someone is ill, but healers believe that they can transfer their own vital energy to a sick person. There are many different types of healing, including faith healing, which is based on a religious faith shared by healer and patient, and spiritual healing, in which the healing energy is separate from the beliefs of the people taking part. Reiki is a form of healing therapy.

Some studies indicate that healing can be beneficial. It may help to relieve pain, or, by providing comfort, it may help the sufferer to cope with the illness more effectively, even though the actual disease remains.


Professional consultation

Healers work in a variety of ways. Some attempt to transfer their 'healing energy' through their hands, touching you gently. Some hold their hands a few centimetres away from your skin. Others channel healing energy by thinking or praying. You may feel a sensation of warmth as the practitioner places his or her hands on or near your body. A reputable healer may advise you to consult your doctor as well as undergoing healing. Beware of any healer who makes promises to cure or prevent disease, who charges an exorbitant fee or who challenges your religious faith.