We Value Your Health!
00013190 11/09
Orthomol pharmazeutische Vertriebs GmbH Herzogstr. 30 40764 Langenfeld Germany export@orthomol.de www.orthomol.com
Dr. Kristian Glagau
A longer and healthier life All you need to know about the orthomolecular principle
Contents Dear Reader, More than 30 years ago, the biochemist Linus Pauling caused a small-scale revolution in the field of nutritional medicine. His findings established that micronutrients, in particular vitamins, protect the body against chronic diseases and are even able to prolong a person’s life – a fact that has since been confirmed by physicians and nutrition experts all over the world. However, this is only possible if the body receives an optimum supply of micronutrients. And that is exactly the problem. Many people have a greater need for micronutrients – i.e. vitamins, antioxidants, minerals and essential fatty acids – than they realize. An optimum supply of these components is fundamental to health and is particularly important in times of increased mental and physical activity, during growth phases, during pregnancy, or as people grow older. Often enough, people fail to reach even the minimum requirements due to poor eating habits. This results in deficiencies which have negative effects on your health and performance over the long term. We hope that this brochure will inspire you to track down your own nutritional deficiencies. However, at the same time we hope to show you how to guarantee an optimum supply of micronutrients with the consistent usage of orthomolecular substances. So that you live a longer and healthier life.
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A longer and healthier life Ideal conditions with orthomolecular medicine Substances present in the body – the key to good health Valuable supplement to traditional medicine
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Successful usage of orthomolecular substances The correct dosage is essential Long-term usage Suitable and well-balanced combination
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Micronutrients – components of good health The foundation Vitamins Characteristics and features of vitamins Oxidative stress and the importance of antioxidants Vitamin-like compounds Minerals and trace elements Phytonutrients Essential fatty acids Probiotics and prebiotics
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Objectives of the orthomolecular principle Improving the micronutrient balance Taking care of the cardiovascular system Strengthening the body’s regeneration and defense system Promoting mental development across all age groups
51 Notes
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A longer and healthier life Ideal conditions with orthomolecular medicine The human body needs a number of different micronutrients in order for all organs to stay healthy and function properly. These include vitamins, minerals, trace elements and essential fatty acids. Orthomolecular medicine is based on the realization that the correct quantity and concentration of micronutrients offers the best health protection and can protect the body against disease. The founder of this therapeutic principle, Linus Pauling – the American biochemist and two-times Nobel Prize laureate, defined the operating principle as follows: “Orthomolecular medicine is the preservation of good health and the treatment of disease by varying the concentration of substances that are normally present in the body and are required for health.” Pauling remained mentally alert and physically fit until the advanced age of 93. He was regarded as the best proof of the success of orthomolecular medicine. The term “orthomolecular” is derived from “orthos” (Greek) meaning “right, good”, and “molecular, molecule” (Latin) meaning “structural unit of substances”. Linus Pauling chose this term in 1968 because it reflects the therapeutic principle so well.
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Substances present in the body – the key to good health Orthomolecular medicine exclusively uses substances that are found naturally both in food and in our bodies. These substances are micronutrients. However, our body cannot produce all these substances by itself. An adequate supply of micronutrients must be regularly ingested to ensure that we remain fit and healthy. The individual micronutrient levels are dependent on various external and internal factors, e.g. eating habits and lifestyle, age, general health and environmental influences. Under certain circumstances, these factors increase the need for micronutrients to such a degree that an optimum supply frequently cannot be achieved even with a healthy, balanced combination of foods. A micronutrient deficiency is almost unavoidable. Pauling drew attention to the nutritional problem resulting from an inadequate supply of micronutrients and the health-related consequences in the scientific journal “Science” as early as 35 years ago. Pauling’s recommendation: health protection and preventative health care with an optimum dosage of orthomolecular substances.
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Orthomolecular medicine, i.e. influencing the body’s functions and diseases by varying the concentration of substances that are normally present in the body, has long been used in the field of medicine. The term “orthomolecular” has simply not yet been used to describe this practice. The aim of orthomolecular therapy is to prevent and rectify the causes of disease. The basis of this therapy is the intake of an adequate dosage and suitable combination of orthomolecular substances that are normally present in the body. There is acceptance of any necessary therapeutic medicaments. However, special attention is paid to the weighting of effects and side-effects.
Valuable supplement to traditional medicine In Anglo-Saxon regions, orthomolecular medicine is described as “complementary medicine”. It is thus regarded as an adjuvant nutrition-based therapy alongside orthodox medicine. Orthomolecular medicine is based on medical and biochemical foundations. Many scientific studies have since confirmed the orthomolecular concept first published in 1968 by the molecular biologist Pauling.
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Orthomolecular therapy for selected diseases Disease
Orthomolecular method
Arteriosclerosis
Omega-3 fatty acids, folic acid, vitamins B12 and B6
Age-related eye diseases
Zinc, vitamin C, lutein, beta-carotene, omega-3 fatty acids
Rheumatism
Vitamin E and omega-3 fatty acids
Cancer
Selenium, vitamins E, C and A, mixed carotenoids
Celiac disease
Wheat-free diet
Phenylketonuria
Reduction in the amino acid phenylalanine
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Successful usage of orthomolecular substances The correct dosage is essential One of the most important maxims in the orthomolecular principle is ensuring an optimum dosage instead of being satisfied with the minimum levels. This means using a large quantity of vitamins – excluding A, D and K, with a sufficiently high dosage of minerals, trace elements, vitamin-like compounds and antioxidants. From the viewpoint of orthomolecular therapy, multivitamin preparations, even if they also contain minerals, have minimum benefit. At most, they are able to prevent deficiencies. However, they cannot achieve a preventative or even a therapeutic effect in an orthomolecular sense if the dosage of the substances is too low. Long-term usage Chronic as well as a large number of nutrition-related diseases develop over a long period of time. It is not possible to gain control of them with short-term therapeutic measures or treatments of limited duration. The same is true for complaints and diseases that were caused by an undetected micronutrient deficiency over a long time span. As has since been confirmed by numerous studies, it is only possible to achieve an ideal result with orthomolecular substances if they are used regularly for a long time and with a sufficiently high dosage. A Swedish study established that the risk of heart attacks in men and women could be lowered by 21% and 34% respectively as a result of the regular intake of multivitamins. It therefore follows that the combined intake of micronutrients in addition to long-term usage is a component of active health protection.
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An Australian study with 2,873 people revealed that the development of a cataract was significantly reduced by the regular intake of multivitamin supplements over a long period of time. In summary: in order to prevent disease, the daily dosage previously recommended by official sources should be multiplied many times over, e. g. four times for vitamin C = 400 mg/day, at least six to eight times for vitamin E = 75-100 mg/day.
Suitable and well-balanced combination Why isn’t it a good idea to take a vitamin or mineral as an individual substance, e. g. only vitamin C, vitamin E or magnesium? And why are incomplete combinations of the antioxidants vitamin C, vitamin E and beta-carotene unsuitable for preventing disease? Chronic diseases are normally the result of several circumstances. There is consequently also a need for several micronutrients. According to the orthomolecular principle, a disease should be treated with a suitable and well-balanced combination of essential micronutrients; this provides an optimum supply which balances out the micronutrient levels. In the case of disease, a combination should be selected that is ideally tailored to the specific condition. Opponents of the orthomolecular principle are skeptical about this approach. They maintain that a complex, high-dosage treatment with various substances present in the body is not necessary for some patients and that the substances are partially eliminated from the body with the urine without having any effect. With this in mind, would it not be more intelligent to use a suitable and also well-balanced combination of orthomolecular substances and accept a harmless elimination of partially unused substances rather than take an unnecessary risk with your health?
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Micronutrients – components of good health The foundation The energy value and nutrient content of food must be well-balanced and suited to individual needs. Both a deficiency and an oversupply can interfere with your health and performance. In this context, it is alarming that when a person suffers from a micronutrient deficiency, their calorie intake is usually far too high. Nowadays even children frequently suffer from this nutritional deficiency. A healthy diet, as well as vitamins, vitamin-like compounds, antioxidants, minerals, trace elements and essential fatty acids are therefore the foundation of the orthomolecular principle. Listed below are several orthomolecular recommendations for a healthy diet and lifestyle which can be followed by everybody in the long term – without affecting their enjoyment and quality of life:
Orthomolecular rules for a healthy diet and lifestyle* 1. Eat whatever tastes good – as long as your diet is varied, healthy and balanced, not too fatty or high-calorie. Meat and eggs are good foods, but smaller quantities are better for your health. 2. Emphasis on complex carbohydrates; sugar consumption should be drastically reduced. 3 . Eat more fresh fruit, salads and vegetables, if possible five portions per day in total (five-a-day campaign by the German Nutrition Society [DGE – Deutsche Gesellschaft für Ernährung]). 4 . Plan two meals with fish every week. 5 . Drink a large volume of mineral water or unsweetened fruit/herbal teas, approx. 1-1.5 liters per day.
Overall, more than 40 micronutrients are necessary to ensure that our body’s metabolism functions properly. As some of these micronutrients cannot be provided by our body – or only to an inadequate extent – they must be ingested through food or in the form of supplements. Micronutrients are absolutely essential, for example, for strengthening the body‘s defenses, boosting cell regeneration and preserving our metabolic functions – to name just a few of their important responsibilities.
6 . Reduce or give up alcohol and nicotine consumption. 7 . Integrate orthomolecular micronutrient combinations in your daily diet as a contribution to the daily supplementation of your need for micronutrients. * N.B.: These rules for a healthy diet do not apply to the specific dietary situation with metabolic disorders.
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Vitamins Chemically, vitamins are completely different substances which have one thing in common: they are essential. A vitamin deficiency leads to major health problems, a complete lack of one or several vitamins even leads to death. In the past, classical diseases as a result of vitamin deficiencies were therefore greatly feared, e. g.: Classical diseases with vitamin deficiencies
Lack of …
Scurvy
Vitamin C
Rachitis
Vitamin D
Beriberi
Vitamin B1 (thiamin)
Pellagra
Predominantly vitamin B3 (nicotinamide)
Pernicious anemia
Vitamin B12 (cobalamin)
Over the past 100 years, successful research has been performed into the causes of these diseases. When the operating mechanisms were clarified, the deficiencies could be treated with corresponding vitamin supplementation. No shortage of deficiencies Nowadays, most people receive an adequate supply of macronutrients and therefore calories, but their vitamin intake remains insufficient. In our modern, affluent society we can even say that there is no shortage of deficiencies because many people do not consume the quantity of vitamins that has been established as necessary by present-day findings. In the case of many micronutrients, the majority of the population does not even reach the very moderate reference values for dietary supplements. For instance, the nutrition report from 2004 revealed that the intake levels recommended by the German Nutrition Society (DGE – Deutsche Gesellschaft für Ernährung) were not reached for a number of micronutrients. 14
Among others, the intake of calcium, folic acid and vitamin D3 was rated as particularly critical. 6 steps downwards to deficiency The various stages set out by the vitamin researcher Brubacher clearly illustrate that vitamin deficiencies develop gradually and remain undetected for a long time until they finally escalate into a health risk. • Stage 1 The vitamins stored in the tissue are partially depleted. The laboratory values and general health are initially unchanged. • Stage 2 The body’s reserves are increasingly drained. The laboratory values show a reduced elimination of vitamins in the urine. The blood levels still remain unchanged, however. People can feel slightly unwell at this stage. 15
• Stage 3 Limited vitamin-dependent enzyme reactions are discernible. There is a slight change in the blood level values. Physical, mental and emotional capacities are reduced. In the long term, the causes of chronic diseases that will occur at a later stage can develop during the first three stages. • Stage 4 Although a dramatic drop in the vitamin values still fails to be revealed in the vitamin level, degeneration of the general health is increasingly noticeable, e. g. increased vulnerability to infections, deterioration in the general condition, nervous complaints, decreasing resilience, reduced vision in the dark, headaches, etc. • Stage 5 Characteristic symptoms of vitamin deficiencies are recognizable. However, it is possible that these symptoms can be cured with appropriate vitamin supplementation. • Stage 6 Tissue and organs are irreversibly damaged, leading to major, long-term diseases or death. The stages show that a vitamin deficiency is only recognizable beyond doubt in the blood values when it has developed into a major, clinical deficiency, i.e. when it is far too late. The vitamins stored in the cells could be entirely depleted even though the blood values are still “normal”. As a consequence, people who are foresighted and health-conscious regularly supplement their daily diet with additional vitamins.
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Supply and demand Although they are unaware of the fact, many people need more vitamins than they consume. There are special phases in life when the need for vitamins is particularly high: • For children and young people during periods of growth • In times of increased mental and physical strain • During pregnancy and breast-feeding • In the change of life • In old age and with (chronic) diseases • During longer-term medicine intake Smokers and alcoholics are particularly at risk with regard to vitamin deficiencies. This is not only because tobacco and alcohol increase the need for vitamins, but also because these people tend not to follow a healthy diet. They are therefore faced with a wide range of negative consequences.
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Vitamin dosage How many vitamins do we need? Nutritionists and physicians are becoming increasingly aware that a daily supplementation of vitamins and other micronutrients is good for the health. The official recommendations by the German Nutrition Society (Deutsche Gesellschaft fßr Ernährung – DGE), as shown in the following table, only refer to healthy people in order to protect them against nutrition-related health problems. People who are ill or recovering are not taken into account, nor are the long-term consequences that can occur after disease. Even though the level of vitamin dosages is a subject of animated discussion, it is clear that a much larger amount of vitamins should be taken than previously assumed. Characteristics and features of vitamins Vitamin C Ascorbic acid, which is familiar to us all as vitamin C, has been thoroughly researched during recent years. Newly obtained findings have fundamentally changed views with regard to possible applications and dosage. It has been revealed that vitamin C can do more than simply protect people against colds. Its most important characteristic is its antioxidant effect. A series of studies have examined the role played by vitamin C in cancer prevention. The results of many studies indicate a connection between a high vitamin C intake and a low rate of susceptibility to cancer. The effects of heavy metal exposure can also be reduced by vitamin C supplementation. Furthermore, vitamin C prevents the formation of nitrosamines from nitrite that is contained in cured sausage products, for example.
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Nitrosamines enter the body via tobacco smoke, for example, and contain cancer-inducing properties. In addition, a low vitamin C level is associated with the occurrence of coronary heart disease and arteriosclerosis. Smokers also have an increased need for vitamin C. There is still controversial discussion surrounding how much vitamin C would be ideal in order to protect against disease. If you take the requirement figures in human biogenesis as a basis, then a daily dosage of 500 mg is ideal. Scientists have established that this was the daily dosage of precivilization man. Vitamin B complex The vitamins in the B group are absolutely indispensable to all metabolic processes in the human body. They are closely connected with each other and never remain stationary. In addition, the vitamin B complex is essential for supporting and regenerating the nervous system. Latent deficiencies are frequently detected with nervous disorders, bowel diseases, alcoholism, or reduction diets. But pregnant women, high-performance athletes and older people also usually intake insufficient supplies of B-group vitamins. Vitamin A This vitamin is known to most people as the “eye vitamin� because a lack of vitamin A can lead to vision disturbances or in severe cases even to blindness. However, such deficiencies are rare in industrialized countries as they are based on a lack of nourishment. So why is it important to ensure an optimum vitamin A intake?
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In addition to the aforementioned function, this fat-soluble vitamin has other responsibilities in the human organism and is necessary for ensuring that many metabolic processes run smoothly. Vitamin A also plays a role in the development of the skin and the mucous membranes as well as in reproduction. In addition, it is vital for cell division and differentiation processes. Vitamin E The numerous therapeutic and preventative effects of vitamin E are predominantly based on its antioxidant function for protection against free radicals. A series of studies have proved the benefits of vitamin E for various diseases. For example, smokers, sufferers of cardiovascular diseases and patients undergoing radiation therapy or chemotherapy should consider an additional vitamin E intake. However, it should be noted here that individual intake of vitamin E alone is not recommendable. Vitamin E is regenerated by vitamin C. Scientists therefore emphasize that both micronutrients should be supplemented in combination.
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Essential vitamins for good health and well-being Vitamin
Chemical term
Primary origin*
Reference value**
Characteristics and features
Vitamin C
Ascorbic acid
Citrus fruit, fruit, vegetables
G: G (smokers): USA:
Prevents scurvy, regenerates vitamin E, powerful antioxidant, improves immune response, positive influence on cardiovascular diseases, beneficial effect on emotional disorders, anticarcinogenic
Vitamin B1
Thiamin
Meat, fish, pulses, whole-grain products
G: USA:
1.0-1.3 mg 1.1-1.2 mg
Prevents beriberi, energy metabolism, beneficial effect on diabetic sequelae such as diabetic neuropathy
Vitamin B2
Riboflavin
Milk, eggs, cheese, fish, liver, whole-grain products
G: USA:
1.2-1.5 mg 1.1-1.3 mg
Protein and energy metabolism
Whole-grain products, pulses, nuts, meat, fish
G: USA:
13-17 mg 14-16 mg
Nicotinamide
100 mg 150 mg 75-90 mg
Prevents pellagra, beneficial effect on cardiovascular diseases, central role in carbohydrate, fat and protein metabolism, positive influence on cerebral metabolism
Vitamin B6
Pyridoxine
Meat, poultry, fruit, milk, vegetables, cereals
G: USA:
1.2-1.5 mg 1.3-1.7 mg
Vitamin B12
Cyanocobalamine
Liver, eggs, meat, cheese, milk, fish
G: USA:
3.0 μg 2.4 μg
Vitamin A / Beta-carotene
Retinol Beta-carotene
Vitamin A: Liver, eggs, milk, butter Beta-carotene: Yellow and orange vegetables, spinach
G: USA:
0.8-1.0 mg (2,640-3,300 IU) 0.7-0.9 mg (2,310-2,970 IU)
Anticarcinogenic, strengthens the immune system, provides support for skin diseases such as acne or pigment disturbances, antioxidant, centrally important to vision, important for reproductive functions, growth and differentiation of bone and epithelial tissue
Vitamin E
Tocopherols
Vegetable oils, wheatgerm, pulses, fennel
G: USA:
12-15 mg 15 mg
Antioxidant, anti-inflammatory, e. g. for rheumatism, positive influence on cardiovascular diseases and neurodegenerative diseases
Vitamin D
Cholecalciferol
Fish, liver, chanterelles, egg yolks
G: USA:
5-10 μg (200-400 IU) 5-15 μg (200-600 IU)
Vitamin K
Phylloquinone
Vegetables, pork, liver, milk, soybean oil
G: USA:
60-80 μg 75-120 μg
Folic acid
Pteroylmonoglutamate
Vegetables, lettuce, whole-grain products, meat, milk
G: USA:
400 μg 400 μg
Pantothenic acid
Widespread/particularly large amounts in beef, salmon, herring, avocado, liver
G: USA:
6 mg 5 mg
Biotin
Fish, pork, liver, eggs, pulses, cereals
G: USA:
30-60 μg 30 μg
* Souci-Fachmann-Kraut. 2007.
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Neurotransmitter synthesis, helps to reduce homocysteine, beneficial effect on cardiovascular diseases, positive influence on PMS Used for pernicious anemia, involved in build-up of red blood cells, helps to reduce homocysteine, beneficial effect on cardiovascular diseases, involved in DNA synthesis, important for cell division and growth processes
Prevents rachitis, supports bone mineralization, beneficial for osteoporosis together with calcium, positive influence on cardiovascular and immune system
Prevents bleeding (synthesizes blood coagulation factors), supports bone metabolism, beneficial for osteoporosis Involved in DNA syntheses, cell differentiation and cell division, growth processes, helps to reduce homocysteine, beneficial effect on cardiovascular diseases, neurotransmitter metabolism, build-up of red blood cells, beneficial effect on neurological diseases, reduces neural tube defects during pregnancy Energy metabolism, neurotransmitter synthesis Energy metabolism, supports skin, hair and fingernail metabolism
** Adequate for healthy people in order to prevent visible deficiencies.Reference values for Germany (G) according to D-A-CH 2000; for USA National Institute of Health 2001.
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Oxidative stress and the importance of antioxidants The aforementioned vitamins A, C and E belong to the group of antioxidants. Together with selenium, zinc, beta-carotene and other micronutrients, they are responsible for neutralizing free radicals and therefore rendering them harmless. Free radicals are aggressive, extremely reactive compounds and metabolic products that harm the body’s own protein and fat, and also the genetic substance DNA, with oxidative processes and can prevent them from functioning properly. At worst, the cells degenerate into tumor cells. If there are an excessive number of free radicals, and the concentration of the body‘s own antioxidants is insufficient, an “oxidant stress situation” arises. This is frequently the case in situations with increased physical and mental activity, infections and inflammatory processes in the body and within the context of natural aging. Additional strain as a result of free radicals is created, for example, by cigarette smoke, UV radiation, environmental pollution, medicaments and chemicals. The body’s defense system, which protects against attacks from free radicals, consists of antioxidants and the body’s own antioxidant enzymatic protection system. These substances are rapidly depleted when combating radicals in the body. Continual supplementation of cell-protecting antioxidants with a suitable and well-balanced combination and dosage has therefore proved to be beneficial in view of the increasing internal and external strain, to preserve good health and to protect against disease.
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And this is all the more important because it is now regarded as certain that free radicals contribute to the development of cancer, cardiovascular and neurodegenerative diseases, for example. The antioxidants complement each other well. While vitamin E and betacarotene scavenge the free radicals in the cell membrane, vitamin C is active in the watery inner cell. They form an effective defense team together with selenium and zinc as components of the enzymatic protection system. Supply and demand There is no difference between nutrition which is occasionally recommended as antioxidant and the rules for a healthy diet that were established by the orthomolecular principle decades ago: more fresh fruit and vegetables, less meat, etc.
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The necessary quantities of antioxidants cannot be fully guaranteed even with a healthy, varied diet, however. Antioxidant dietary supplementation is unavoidable for effective protection against disease. From the viewpoint of the orthomolecular principle, daily supplementation is recommended for the following antioxidants, for example: Dietary supplementation
Recommended additional supply (daily)
Vitamin C
at least 300-500 mg
Vitamin E
100 -200 mg
Mixed carotenoids
approx. 5-20 mg
Selenium
approx. 50-100 μg
There are other micronutrients with an antioxidant effect, such as bioflavonoids, anthocyanins, zinc and iron, which can also be used for active health protection.
The following information on important vitamin-like compounds shows that such risks can be reduced by orthomolecular dietary supplementation. Carnitine This vitamin-like compound plays a key role in fat burning. In general, the daily carnitine intake is 10-70 mg. High carnitine levels are found in meat, but also in milk and rice. In contrast, vegetable foodstuffs have a very low carnitine content, which means that vegetarians should consider carnitine supplementation. Ubiquinone (coenzyme Q10) Responsible for important functions in the energy metabolism. Natural sources of ubiquinone are meat, eggs and vegetable foodstuffs, in particular germ oils. When a person reaches the age of 40, the concentration of ubiquinone reduces in the body, particularly in the heart. Supplementation of coenzyme Q10 therefore seems sensible as a person grows older and for patients with cardiovascular diseases.
Vitamin-like compounds These vital substances have vitamin-like characteristics and were previously known as vitaminoids. The body can produce a limited quantity itself and they are also ingested through food. Deficiencies do not develop as long as there are no problems with the body’s own production or the external supply. The need for coenzyme Q10, in particular, increases considerably when a person is ill or growing older. And if the supply through food is also inadequate, then an undetected deficiency in vitamin-like compounds develops. This does not have an immediate effect, but harms your health over the long term.
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Minerals and trace elements Unlike vitamins, minerals are inorganic substances. However, they are necessary for the smooth running of essential biochemical reactions in the human body. A continual external supply is necessary as the body cannot produce them itself. Trace elements occur in the body in far smaller quantities than minerals – hence their name (only occur in traces). Minerals and trace elements are eliminated from the body with sweat, urine and feces. Their importance for health and performance can be easily comprehended if we consider the specific details for the individual substances in the table.
Dosage Recommended daily intake figures are available for minerals and trace elements as well. These substances also have a beneficial effect on a person’s health and can positively influence certain diseases. As synergy effects exist for several trace elements, these should preferably be taken in the form of micronutrient combinations and not as mono-products. Supply and demand A deficiency in minerals and/or trace elements can frequently be detected in a person’s appearance. For example, brittle nails, poor skin or lackluster hair with a tendency to break are all signs of a deficiency in these micronutrients. It is logical that a balanced consumption should be guaranteed in view of the importance of minerals and trace elements for health and performance. Anybody who intends to meet the daily requirements – both the quantity and variety – with a balanced diet alone must become very thoroughly acquainted with the topic. It is not just enough to know about the mineral content of individual foods. Practical knowledge about the correct storage and preparation is also necessary as storage, processing, preparation and conservation processes continually reduce the natural mineral content of foods. It is therefore becoming increasingly difficult to guarantee the necessary supply of minerals and trace elements from food. However, nutrition-related deficiencies and additional needs are not necessarily problematic because they can be covered very easily and specifically with orthomolecular dietary supplementation.
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The most important minerals and trace elements at a glance Minerals/ Trace elements
Recommended daily requirement*
Characteristics and features
Natural sources**
Magnesium
300-400 mg
Essential for nerve, heart and muscle functions, component of many enzymes
Pulses, whole-grain products, milk, dairy products
Calcium
1.0-1.2 g
Development and preservation of bones and teeth, nervous condition
Milk, cheese, broccoli, curly kale
Iron
2-15 mg
Hemoglobin production (oxygen transport)
Meat, pulses, lamb’s lettuce
Selenium
30-70 μg
Boosts immune system
Fish, meat, eggs
Copper
1.0-1.5 mg
Component of antioxidant protection system, build-up of red blood cells
Fish, shellfish, pulses
Manganese
2-5 mg
Component of antioxidant protection system
Whole-grain products, nuts, pulses
Important for thyroid gland function
Seafish, shellfish
Carbohydrate metabolism
Shellfish, eggs, oatmeal, tomatoes, mushrooms
Iodine
180-200 μg
Chromium
30-100 μg
Molybdenum
50-100 μg
Uric acid metabolism
Cereals, pulses, mushrooms
* Reference values according to D-A-CH 2000 or National Institute of Health 2001. ** Souci-Fachmann-Kraut. 2007.
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Phytonutrients The term “phytonutrients” was first used around 100 years ago by the plant physiologist and Nobel Prize laureate Albrecht Kossel. In English-language literature they are also labeled “phytochemicals”, and the term “phytoprotectants” is sometimes used as well. A large number of studies document their protective, health-promoting characteristics. Phytonutrients are numerous compounds with very different chemical structures. They only occur in very small quantities and, depending on the plant, in various forms. In an organism of plant origin, phytonutrients have various responsibilities, including defending against pests and disease, regulating growth and adding color. They influence the selection of food chosen by people in the form of aromas and flavoring. Approx. 1.5 g of phytonutrients are ingested daily with a mixed diet, considerably more with a vegetarian diet. It is not known how many phytonutrients occur in nature. The current assumption is between 60,000 and 100,000.
Characteristics of phytonutrients Anticarcinogenic
Anti-inflammatory
Antimicrobial
Regulate blood pressure
Antioxidant
Reduce cholesterol
Antithrombotic
Regulate blood glucose
Boost immune system
Digestive
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Phytoestrogens (isoflavones) The chemical structure of phytoestrogens is similar to that of estrogens. However, their estrogen activity is lower by a factor of 10-2 to 10-3. Phytoestrogens also possess antioxidant characteristics. In epidemiological studies, major differences were established between the development of hormone-dependent types of cancer, such as breast and prostate cancer. West European women have a 4-6 times higher risk of breast cancer than Asian women. But these are not the only differences. Asian people are also more rarely affected by ovarian and colon cancer. These differences are primarily attributable to their diet. In Asia soy is a basic foodstuff and the average intake of isoflavones is stated as 20-50 mg per day. In contrast, the intake in western countries amounts to less than 5 mg per day.
The better known phytonutrients include the carotenoids, such as betacarotene, lutein and the polyphenols contained in red wine, whose preventative effect for arteriosclerosis is the subject of discussion. The phytoestrogens from soy and linseed are the focus of current research. A number of studies have revealed that phytoestrogens can contribute to the protection against breast and prostate cancer. Their operating mechanisms also have a positive influence on symptoms during the change of life. Carotenoids (e.g. beta-carotene, lycopene, zeaxanthin, lutein) Carotenoids are colorings that are very common in plants. Approx. 700 carotenoids are known so far, of which only about 40-50 are ingested by humans and processed in the metabolism. Epidemiological studies show that high levels of carotenoids are associated with a lower rate of cancer, cardiovascular diseases and age-related macular degeneration.
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Polyphenols Flavonoids (flavonols, flavones, anthocyanins) belong to the group of polyphenols. Flavonols and flavones are responsible for yellow plant coloring; anthocyanins for red, blue and violet coloring. Polyphenols have antioxidant characteristics, among others, and can contribute to the protection against cardiovascular diseases. Flavonoids are contained above all in the outer layers of foods. This means that peeling apples or removing tomato skins reduces the flavonoid content. Phytosterines Phytosterines are similar to the animal sterines, such as the cholesterol. Sunflower seeds and sesame, as well as native soybean oil, are particularly rich in phytosterines. It is probable that phytosterines inhibit the absorption of cholesterol in the gut.
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The most important phytonutrients at a glance Phytonutrients
Natural forms
Contained in
Characteristics and features
Carotenoids (plant colorings)
Contain oxygen: Xanthophylls, e.g. zeaxanthin, lutein
Vegetables, e.g. spinach, curly kale
Oxygen-free: Alpha-carotene, betacarotene, lycopene
e.g. tomatoes, carrots, apricots
Preserve vision, promote cell development and cell communication, possess antioxidant characteristics, protect against UV radiation
Isoflavones
Soybeans, peas, lentils, beans and other pulses
Lignans
Whole-grain cereals, berries, linseed, flaxseed
Phytoestrogens
Polyphenols
Phytosterines
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Flavonoids, e. g. flavonols
Almost all plants because they determine the coloring of flowers and fruit, etc.; for example, in onions, curly kale
Flavones
e. g. celery, parsnips
Anthocyanins
e. g. berries, red wine
e.g. beta-sitosterol
Particularly common in fatty parts of plants, e.g. sunflower seeds, sesame, native soybean oil
Risk reduction for certain carcinomas (primarily breast, prostate and colon cancer), reduction in menopausal symptoms such as hot flushes, influence on bone metabolism, positive influence on risk factors for cardiovascular diseases, e. g. cholesterol reduction Antioxidant, antimicrobial, anti-inflammatory, regulate blood pressure and blood coagulation, protect against cardiac disease and cancer
Essential fatty acids Many people not only eat too much, but they also eat fat that is unfavorable from a nutritional point of view. In order to preserve a strong heart and healthy vessels, therefore, physicians and nutritionists recommend on the one hand a reduction in fat consumption and on the other a preference for foods with a high proportion of unsaturated fatty acids. Unsaturated fatty acids A difference is made in dietetics between monounsaturated and polyunsaturated fatty acids. Unlike monounsaturated fatty acids, the body cannot produce polyunsaturated fatty acids itself. These must therefore be ingested in sufficient amounts through food. Polyunsaturated fatty acids belong to the group of essential nutrients and as they have fundamental structural responsibilities in the cell, they are indispensable for the human organism and are invaluable for preserving good health. Omega-6 fatty acids (linoleic acid family) The recommended daily amount is 6-8 g. If intake is too low over a longer period of time, deficiencies can develop that are connected with delayed growth, skin lesions or a reduced ability to reproduce. As today’s mixed diet commonly contains enough linoleic acid, there is not much probability of health problems as a result of a lack of nourishment. In contrast, it is frequently very difficult to guarantee an optimum supply of omega-3 fatty acids from a mixed diet.
Reduce cholesterol, anticarcinogenic with relation to colon carcinoma
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Omega-3 fatty acids (linoleic acid family) The recommended daily requirement for omega-3 fatty acids is around 0.3-0.4 g. This need increases in the case of common diseases, such as rheumatoid arthritis or cardiovascular diseases. High concentrations of omega-3 fatty acids are contained in coldwater fish such as mackerel, herring, salmon and cod. Game also has a relatively high omega-3 fatty acid content. A deficiency in adults only becomes noticeable after a long period. A lack of these fatty acids is related to restricted vision or reduced learning abilities. More attention should therefore be paid to ensuring a regular intake of the necessary quantities. Seafish could make a contribution here, but unfortunately fish consumption in western countries, with their predominant typically “western“ diet, is generally far too low. Only 100 g of fish is consumed on average per person/week; this is not enough to guarantee an optimum supply with a beneficial effect for your health. At the same time, it is very important in view of the risk reduction for cardiovascular diseases. There are good reasons for a targeted dietary supplementation of omega-3 fatty acids, e. g. in the form of fish oil capsules. It is particularly valuable due to the contribution to maintaining healthy vessels.
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Effects of omega-3 fatty acids: • Positive influence on inflammatory processes, e. g. in the case of rheumatoid arthritis • Positive influence on arteriosclerotic vessel changes • Inhibit conglutination of the blood platelets • Enlarge vessels and lower blood pressure • Improve blood fluidity Probiotics and prebiotics Probiotics (pro bio = for life) are defined, living microorganisms of which sufficient quantities enter the gut in active form and have a beneficial effect on a person’s health. Probiotics also contribute to a stable gut flora and a healthy intestinal mucous membrane. At the same time, they boost the gut-associated immune system. Probiotics can also prevent the settlement of pathogens. The usage of probiotics can restrict allergic reactions and proves to be good in cases of lactose intolerance, among other things. Therapeutic measures, such as chemotherapy or radiation therapy, or treatment with antibiotics, can lead to changes in the gut-associated microflora. Here too, the intake of probiotics can achieve a decrease in unwanted effects, such as diarrhea. More recent study findings imply that probiotic cultures have a positive influence on irritable bowel. Prebiotics are indigestible substances. They enhance the growth of certain microorganisms in the gut. The influence of prebiotics on the immune system is increasingly becoming a subject of discussion in literature. There are also indications that prebiotics have a beneficial effect on the development of colon cancer and tumor growth. One well-known member of the group of prebiotics is inulin, which is extracted from chicory. 39
Objectives of the orthomolecular principle Improving the micronutrient balance “Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” The above definition by the World Health Organization wholeheartedly underlines the objectives of the orthomolecular principle: • Considerable enhancement of individual health • Preservation of vitality and performance into advanced age • Prevention of diet-related and chronic degenerative diseases The basis of excellent health and physical resistance can only be achieved if preferably all the substances present in the body are available in ideal quantities. Unfortunately, there is an increasing imbalance in the micronutrient levels of many people as they approach old age. Frequently, people fail to reach even the reference values required by the German Nutrition Society (DGE – Deutsche Gesellschaft für Ernährung). Micronutrient levels could be considerably improved as a result of the additional intake of orthomolecular substances with a balanced quantity and dosage. This would actively contribute to the preservation of health. The previous chapters primarily described individual micronutrients. The following pages will provide you with an insight into orthomolecular treatment and its way of working.
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Taking care of the cardiovascular system Nowadays, cardiovascular diseases and cancer are the most common disease-related causes of death. In order to reduce the frequency of these diseases, it is necessary to influence their development at an early stage by modifying lifestyles, such as adopting nutritional measures or exercising. Numerous orthomolecular substances can counteract the development of both cardiovascular diseases and cancer. These are chronic, degenerative diseases which are based on changes in important metabolic processes. Cancer is related to changes in the DNA and protein structures,
cardiovascular diseases focus on changes in the fat metabolism. Orthomolecular substances can have a beneficial effect with regard to the prevention of these changes. It is most effective for the prophylaxis and therapy of cardiovascular diseases if preferably all of the orthomolecular substances that are important for this area of application are taken continually and over the long term with a sufficiently high dosage. In addition, all orthomolecular substances that optimize the metabolism should be used. The table on the following double page provides an overview. At the same time, prescription heart medication from the physician should not be reduced or stopped by the patient without prior consultation! In addition to the intake of orthomolecular substances, a healthy lifestyle with sufficient exercise and a balanced diet with a large quantity of fruit, vegetables and fish also have a beneficial effect on the treatment and prevention of cardiovascular diseases. Alcohol should be greatly reduced and nicotine should be avoided completely.
It is clear, however, that even healthy people who follow a “normal” diet still receive an insufficient supply of vitamins in old age. This is also shown in the nutrition report from 2004: on average, people who are older than 65 years of age ingest less than 50 % of the recommended daily allowances for iodine, folic acid and vitamin D. Considerable deficiencies were detected in a study of pensioners who live in retirement homes. The study examined the micronutrient intake of 67 women with an average age of 86 years. It revealed that the reference values for vitamins recommended by the German Nutrition Society (DGE – Deutsche Gesellschaft für Ernährung) were not reached for any of the vitamins, even though the necessary quantities could be comprehensively covered in a relatively simple manner by regular dietary supplementation in the form of orthomolecular substances.
Vitamin deficiencies in pensioners living in retirement homes Own catering
Strengthening the body’s regeneration and defense system During research processes into the connections between nutrition and the aging process, several crucial questions repeatedly arise which are outlined here from the viewpoint of the orthomolecular principle. Which nutritional deficiencies are common as people grow older? A deficiency in important micronutrients presents a health risk much more frequently in old age than generally assumed. While the values for an ideal energy and protein intake have been established, the ideal intake for micronutrients is still being discussed by nutritionists and physicians.
Vitamin B1 Vitamin B6
Folate
Vitamin C Vitamin D
Calcium
Magnesium
Iodine 20
* Recommended DGE reference values (German Nutrition Society)
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Third-party catering
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60
80
100 *
Daily intake as a %
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Orthomolecular substances for the prophylaxis and nutrition-based therapy of the cardiovascular system Vitamins
Daily dosage
Vitamin C
> 500 mg
Vitamin E
100-500 mg
Vitamin A
2,000-5,000 IU
Vitamin B1
7.5-40 mg
Vitamin B2
7.5-40 mg
Nicotinamide
50-200 mg
Vitamin B6
7.5-40 mg
Vitamin B12
5-15 μg
Folic acid
0.4-1 mg
Characteristics and features in relation to the cardiovascular system
Minerals/ Trace elements
Antioxidant, lowers blood pressure, stabilizes blood vessels, lowers overall cholesterol levels, regenerates vitamin E
Magnesium
100-300 mg
Zinc
10-20 mg
Antioxidant
Selenium
50-200 μg
Antioxidant
Manganese
2-5 mg
Antioxidant Antioxidant
Antioxidant, prevents oxidation of the LDL cholesterol Antioxidant
Characteristics and features in relation to the cardiovascular system Cardiac excitation conduction, lowers blood pressure, positive influence on cardiac rhythm
Copper
0.5-4 mg
Chromium
30-150 μg
Component of glucose tolerance factor
Molybdenum
60-300 μg
Component of important enzymes
Lowers LDL cholesterol, central role in the carbohydrate, fatty acid and amino acid metabolism
Iodine
150-300 μg
Lowers homocysteine
Omega-3 fatty acids
Important for carbohydrate metabolism Central role in the carbohydrate, fatty acid and amino acid metabolism
Build-up of red blood cells, lowers homocysteine
10-30 mg
Biotin
100-500 μg
Vitamin K
30-120 μg
Carotenoids
5-20 mg
Antioxidants
Bioflavonoids
5-20 mg
Antioxidants
Important for the thyroid gland
Essential fatty acids
Important for build-up of red blood cells, lowers homocysteine
Pantothenic acid
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Daily dosage
In the form of fish oil, approx. 0.5-1 g
Prevent conglutination of the blood platelets, positive influence on cardiac rhythm, lower blood pressure, improve blood fluidity, lower blood lipids (triglycerides)
Vitamin-like compounds
Development and degeneration of carbohydrates, fatty acids and amino acids
L-carnitine
0.2-0.6 g
Energy provision in the heart, helps the heart to function normally
Involved in the development and degeneration of carbohydrates, fatty acids and amino acids
Coenzyme Q10 (= ubiquinone)
10-50 mg
Energy provision in the heart muscle cells, antioxidant, important for heart metabolism
Blood coagulation
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How important is nutrition for the immune system? The immune system acts simultaneously as the health police force and a repair service. It recognizes and combats harmful, exogenous intruders such as bacteria, fungi and viruses. But it also repairs damaged cells or destroys and disposes of them if they are irreparable. Good nutrition and a well-balanced supply of micronutrients are important prerequisites for a healthy immune system. A study of 96 pensioners who took a multivitamin and mineral supplement showed that they had a better immune response after 12 months than pensioners who did not receive a supplement (Chandra 1992). It therefore follows that supplementation with a suitable combination of micronutrients can improve the immune status of pensioners. There are also numerous connections between the development of cancer and the performance of the immune system. This explains why orthomolecular substances for strengthening the immune system can have a beneficial effect on the development of cancer and its progression. The gut – the largest immune organ of our body With a surface area of about 400 m², the gut is the central point of the immune system and therefore plays a significant role in a person‘s immune response. The intestinal mucous membrane forms a natural barrier against pathogens and pollutants with its immunocompetent cells. Disease which involves the gut or intestinal mucous membrane could result in a weakened immune response.
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As already mentioned, the intake of pro- and prebiotics has a beneficial effect on the gut flora. Due to the special role played by the gut in the immune system, probiotics are also particularly good for the immune system. For example, supplementation with probiotics enhances the activity of important defense cells. A healthy and well-balanced diet, together with the intake of need-based, combined micronutrients, boosts the immune system. Physical performance and the immune system Sport has a beneficial effect on the emotional and physical state of health. In addition to other lifestyle factors, physical activity can counteract the civilization diseases in today’s society. An increased number of free radicals are generated as a result of the high oxygen consumption involved in sporting activities. This can lead to an “oxidative stress situation”. The neutralization of these free radicals places a strain on the immune system and is characterized by decreasing concentrations of vitamin C and the antioxidant enzymes, among others. In order to enhance regeneration of the body’s immune system and ensure preservation, athletes should take a supplement with antioxidants. 47
Embryonic development of the fetus Fetal development in the womb is characterized by a high cell division rate. The fetus is completely dependent on the mother to supply the essential micronutrients. An adequate supply of the omega-3 fatty acid DHA (docosahexaenoic acid) is particularly important. This is necessary for the healthy development of the brain and nervous system. At the same time, it also enhances the intellectual capacity and the development of vision for the growing organism. In order to enable a trouble-free pregnancy and reduce the risk of physical and mental disabilities in the child, other important micronutrients such as folic acid, iron, vitamin B6, vitamin B12, selenium and magnesium should be supplemented in addition to the omega-3 fatty acids. Promoting mental development across all age groups The brain controls many metabolic processes in our body. It enables us to store pieces of information and recall them as needed. At the same time, it is possible that even minimal deficiencies in micronutrient supplies which causes tiny, insignificant changes in the activity of an individual enzyme, can join together with additional, otherwise insignificant changes in activity. In the end, this causes measurable impairment of a person’s intellectual performance. In order to remain mentally alert until an advanced age and therefore meet the requirements of everyday life, the body should receive a continual supply of essential micronutrients.
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Notes Literature Biesalski HK, Fürst P, Kasper H, Herausgeber. Ernährungsmedizin. 3rd ed. Stuttgart: Thieme; 2004. (ISBN 978-3-13100-293-8) Chandra RK. Effect of vitamins and trace-element supplementation on immune responses and infection in elderly subjects. Lancet 1992;340(8828):1124-7. DGE/ÖGE/SGE/SVE. D-A-CH-Referenzwerte für die Nährstoffzufuhr. 1. Aufl. Frankfurt a.M.: Umschau/ Braus; 2000. (ISBN 978-3-82957-114-2) Deutsche Gesellschaft für Ernährung. Ernährungsbericht 2004. Frankfurt a.M.: DGE; 2004. (ISBN 978-3-88749-183-3) Dietl H, Ohlenschläger G. Handbuch der Orthomolekularen Medizin. Heidelberg: Karl F. Haug; 2001. (ISBN 978-3-83040-627-3)
Also important at an early age! Although the embryonic phase is the phase with the highest cell division rate, small children also have an increased need for micronutrients. This special requirement must be met in order to ensure optimum development. Supplementation with micronutrient combinations increased the intellectual performance of school children between the age of 6 and 12 compared with those who did not receive a supplement (Schoenthaler et al. 2000). Once again, this confirms the orthomolecular principle of using complex micronutrient combinations instead of mono-products. The fear of forgetting As a person grows older, their intellectual capabilities can diminish. Alzheimertype dementia (Alzheimer’s disease) is a disease of the central nervous system which is associated, among other things, with the loss of cognitive capabilities. An excessive attack by free radicals and the related increased oxidative stress are linked with the development of the disease. A diet which is rich in fruit and vegetables can possibly contribute to an individual reduction in the risk of developing Alzheimer’s disease. Studies have shown that pensioners whose cognitive performance had decreased benefited from a supplementation of antioxidants and also omega-3 fatty acids.
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Holmquist C, Larsson S, Wolk A, et al. Multivitamin supplements are inversely associated with risk of myocardial infarction in men and women. Stockholm Heart Epidemiology Program (SHEEP). J Nutr 2003;133(8):2650-4. Kuzniarz M, Mitchell P, Cumming RG, et al. Use of the supplements and cataract: The Blue Mountain Eye Study. Am J Ophthalmol 2001;132(1):19-26. National Institute of Health (NIH). Food and Nutrition Board. DRI Tables; 2001. Available under: www. iom.edu/Object.File/Master/7/296/0.pdf, www.iom.edu/Object.File/Master/7/294/0.pdf [01.09.2009] Schoenthaler SJ, Bier ID, Young K, et al. The effect of vitamin-mineral supplementation on the intelligence of American schoolchildren: A randomized, double-blind placebo-controlled trial. J Altern Complement Med 2000;6(1):19-29. Souci-Fachmann-Kraut. Die Zusammensetzung der Lebensmittel. Nährwert-Tabellen. [Food Composition and Nutrition Tables]. In German, English and French. 7. ed. Stuttgart: Medpharm Scientific Publishers, 2007. (ISBN 978-3-80475-038-8) Watzl B, Leitzmann C. Bioaktive Substanzen in Lebensmitteln. 3. unv. Aufl. Stuttgart: Hippokrates; 2005. (ISBN 978-3-83045-308-6) Journals American Journal of Clinical Nutrition, ISSN 0002-9165 Journal of Nutrition, ISSN 0022-3166 European Journal of Clinical Nutrition, ISSN 0954-3007 Nutrition Reviews, ISSN 0029-6643 Alternative Medicine Review, ISSN 1089-5159 Publisher/Further information Orthomol pharmazeutische Vertriebs GmbH Herzogstr. 30 • 40764 Langenfeld • Germany Phone +49 (0)2173 9059-0 • Fax +49 (0)2173 9059-111 export@orthomol.de • www.orthomol.com © Orthomol GmbH 2009. This work and all parts thereof are protected by copyright. All rights, particularly those relating to the reproduction, copying, distribution and translation, are reserved. No part of this brochure may be reproduced or stored, processed, reproduced or distributed using electronic systems in any form without the written permission of the company Orthomol.
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