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Australian Journal of Pharmacy : November 2006
t ary medicine Nutrients, RDI and chronic diseases Many Australians still don’t eat sufficient amounts of fruit and vegetables on a reg- ular basis to meet the nutritional require- ments necessary for good health. In addi- tion, the new National Health and Medical Research Council guidelines state: ‘there is some evidence that a range of nutrients could have benefits in chronic disease aetiology at levels above the RDI [recommended daily intake] or AI [ade- quate intake]’.12 Many nutrients are associated with reduced risk of chronic disease when consumed in quantities higher than the RDI like: the antioxidant vitamins C, E and A and mineral selenium, nutrients such as folate, omega 3 fatty acids and dietary fibre. While nutritional supple- ments can never provide all the benefits of eating whole foods, they can prove life-saving in an overt deficiency state and enhance an individual’s nutritional status when dietary intake is insufficient to meet physiological requirements, such as during periods of increased biological demand. Nutritional supplements may also act as therapeutic agents and achieve a desired health outcome through means other than dietary supplementation. For exam- ple, high-dose vitamin E supplements (1,200mg/day) are effective in relieving pain in rheumatoid arthritis according to several double-blind studies, with one study finding the effects are as strong as the NSAID diclofenac. High-dose pyridoxine supplements (up to 75mg/day) significantly reduce the severity of morning sickness. And three clinical studies of varying design have found that treatment with high-dose riboflavin (400mg) can reduce the fre- quency of migraine headache.13 Nutrigenomics A fascinating area of research which has emerged alongside the Human Genome Project is that of ‘nutrigenomics’—the study of nutrients and their effects on gene structure and expression. It is anticipated that many future studies will start to focus on isolating nutrients and their effects on genomic stability and the role of dietary and genetic interactions in patient health. As the interplay between nutrients and genes is better understood and individual patient needs are revealed, the use of dietary manipulation and nutritional sup- plementation will become more sophisti- cated than we currently have; individuals will receive customised diet plans, with or without additional nutritional supple- mentation, to help prevent or mitigate their specific disease susceptibilities.1 References available on request