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Pantothenic acid

Description	Pantothenic acid is also sometimes referred to as Vitamin B5. It is water soluble and part of the B-vitamins group. Pantothenic acid and calcium pantothenate (a more stable form of pantothenic acid) are available in the form of tablets and capsules, but they are found mainly in multivitamin and mineral preparations.
Function/ Used for	Pantothenic acid forms part of two substances, co-enzyme A and the acyl carrier protein. These have key roles in the release of energy from foods. Pantothenic acid is involved in the metabolism of protein and fat, and is also needed for healthy growth. It is important for mental performance, synthesis and metabolism of steroid hormones, vitamin D and some neurotransmitters, while reducing tiredness and fatigue.
Intake	Recommended intake EU NRV: 6mg UK average daily intake Requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes¹.
As a supplement	Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources)	Fortified breakfast cereal, wholegrains (such as brown rice and wholemeal bread), dairy products, liver, kidneys and eggs.
Deficiency	Deficiency of pantothenic acid is extremely rare. Symptoms include poor muscle co-ordination, muscle cramps, numbness and tingling, painful burning feet, depression, fatigue, weakness, headache and loss of appetite.³
Precautions and contraindications	None known. Safe Upper Level (Guidance Level): 210mg total dietary intake per day²
Use in pregnancy and breastfeeding	There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications	Excessive alcohol intake may increase requirement for pantothenic acid. Oral contraceptives may also increase requirement for pantothenic acid. Adequate amounts of all B vitamins are required for optimal functioning as deficiency or excess of one B vitamin may lead to abnormalities in the metabolism of another.³
Adverse effects	No adverse effects, except for occasional diarrhoea, have been reported in humans.
References	1. https://www.gov.uk/government/collections/national-diet-and-nutrition-survey 2. Expert Group on Vitamins and Minerals, 2003. 3. Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.

Page content last reviewed: March 20, 2017

Peppermint

Description	The peppermint plant is a hybrid of spearmint and water mint. Its active ingredient is a volatile oil made up of more than 40 components, including menthol, flavonoids and phenolic acids.
Function/ Used for	Peppermint is primarily used for indigestion relief. It is also used as an inhalant, for clearing congestion in coughs and colds. Peppermint soothes the digestive tract, helps relieve nausea, and sweetens breath. Peppermint oil may be effective in irritable bowel syndrome (IBS)². Menthol and peppermint oil can be applied externally to treat headache².
Intake	N/A
As a supplement	Peppermint can be found in its essential oil form (not to be taken internally), as a tea, or as enteric coated capsules containing 0.2ml oil. Dosage: powdered herb 2-4g up to 4 cups of peppermint tea per day 2 drops of peppermint oil in a steam bath to inhale up to 2 enteric coated capsules containing 0.2ml oil daily
Found in (dietary sources)	N/A
Deficiency	N/A
Precautions and contraindications	Peppermint oil acts as a relaxant on the muscles of the stomach and gastro-intestinal tract, and can aggravate acid reflux or the symptoms of hiatus hernia. Peppermint oil should not be put on the nostrils or chests of children under 5 years old. When taken internally, peppermint oil should be in enterically coated products to reduce possible irritation.³
Use in pregnancy and breastfeeding	External use is suitable during pregnancy. However peppermint is not recommended to be taken internally during pregnancy, unless as a tea which may be taken to help relieve morning sickness.¹
Interactions e.g. with other medications	No significant interactions reported.¹
Adverse effects	When taken as a tea, peppermint is usually considered safe, although hypersensitivity reactions have been reported. Rare negative reactions to enteric-coated peppermint oil capsules may include skin rash, heartburn, slowed heartbeat, and muscle tremors. Menthol or peppermint oil applied topically could cause contact dermatitis or rash.¹
References	1. Braun & Cohen. Herbs and Natural Supplements: An evidence-based guide. Churchill Livingstone, 2005. 2. Williamson, E. M. Potter’s Herbal Cyclopaedia. C.W. Daniel Co Ltd. 2003 3. National Center for Complementary and Integrative Health https://nccih.nih.gov/health/peppermintoil (September 2016)

Page content last reviewed: March 20, 2017

Phosphorus

Description	Next to calcium, phosphorus is the most abundant mineral in the body, making up about 1% of total body weight.
Function/ Used for	Phosphorus is essential for bone health. Calcium, which gives strength to bones and teeth, needs to be combined with another mineral, such as phosphorous, to become stabilised before it can be effective. Phosphorus also helps to release energy from food as it plays an important role in the metabolism of carbohydrate, fat and protein, and also helps to keep cell membranes working as they should.
Intake	Recommended intake EU NRV: 700mg UK average daily intake Unknown (in the UK)
As a supplement	Not generally available as a single supplement. Commonly available as part of a multivitamin and mineral formula. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources)	Good sources include red meat and poultry, dried milk and milk products, wheat germ, yeast, grains, hard cheeses, canned fish, nuts, potatoes, eggs and soft drinks.
Deficiency	Symptoms include abnormal calcification of soft tissue, tetany (spasm and twitching of the muscles, particularly those of face, hands and feet), lethargy and anorexia. However, deficiency is unlikely as it is so widely distributed in food.
Precautions and contraindications	Consuming high doses of phosphorus for a short time can cause diarrhoea or stomach pain.¹ The long term over-consumption of foods high in phosphorus can deplete calcium resources and lead to reduced bone mass, which means that bones are more likely to fracture.² Safe Upper Level (SUL): · Total intake of not more than 2,400mg/day¹ · Supplemental intake should not exceed 250mg /day
Use in pregnancy and breastfeeding	Safety of the use of phosphorus during pregnancy and breastfeeding is unknown.
Interactions e.g. with other medications	No clinically significant interactions between phosphorus and conventional medications are known to have been reported in literature to date. Long term intake of aluminium hydroxide, an antacid, may deplete phosphorus levels.^3,4
Adverse effects	Phosphates can be toxic at levels over 1,000mg per day, leading to diarrhoea, calcification of organs and soft tissue, and preventing the absorption of iron, calcium, magnesium, and zinc.¹
References	1. Expert Group on Vitamins and Minerals, 2003. 2. Calvo, MS. Advances in Nutritional Research. 1994:9 pp183-207 ‘The effects of high phosphorus intake on calcium homeostasis’ 3. Reynolds JEF, ed. Martindale: The Extra Pharmacopoeia. 31st ed. London: Royal Pharmaceutical Society; 1996:1181-1182, 1741. 4. Gaby A.R et al. A-Z Guide to Drug-Herb-Vitamin Interactions. Health Notes. Three Rivers Press. New York. 2006

Page content last reviewed: March 20, 2017

Potassium

Description	Potassium is an essential nutrient naturally present in many foods and which is found in all of our body tissues. It is sometimes referred to as an electrolyte, alongside sodium and chloride, which play important roles in maintaining homeostasis within the body.
Function/ Used for	Potassium is important for the normal functioning of cells and helps to keep the nervous system and muscles working as they should, as well as keeping blood pressure on an even keel¹.
Intake	EU NRV: 2000mg/day. EFSA have set the adequate intake (AI) level for potassium at: 3500mg/day². UK average daily intake: requirements vary depending on age and gender. The UK National Diet and Nutrition Survey lists up-to-date intake requirements and average intakes³.
As a supplement	Available as a single supplement. Also, commonly available as part of a combined electrolyte supplement. Different multivitamin and minerals products will vary in the percentage NRVs they include. People should always check the label for information about a specific product.
Found in (dietary sources)	Potassium is commonly found in fish, pulses, nuts and seeds, meat, milk, fruit, leafy green vegetables and potatoes.
Deficiency	Insufficient potassium intake can cause increased blood pressure, risk of kidney stones and bone turnover. Symptoms can include constipation, muscle weakness and fatigue. Severe potassium deficiency (hypokalaemia) is often associated with increased potassium losses (e.g. from diarrhoea and vomiting), shifts in intracellular potassium levels or (rarely) from severe hypocaloric diets².
Precautions and contraindications	Safe Upper Level (Guidance Level): Not established. Those with impaired renal function should follow a low potassium diet with medical guidance and should not take supplements.
Use in pregnancy and breastfeeding	There is no evidence of adverse effects in pregnancy at normal intakes. The adequate intake (AI) level for lactating women is set at 4000mg/day².
Interactions e.g. with other medications	ACE inhibitors and potassium-sparing diuretics can reduce urinary potassium excretion, leading to hyperkalemia. Loop diuretics and thiazide diuretics can increase urinary potassium excretion, leading to hypokalemia.
Adverse effects	Gastrointestinal symptoms are possible with potassium supplement use in some individuals.
References	¹EU Community Register of Nutrition and Health Claims ²Dietary reference values for potassium (2016). EFSA Journal. 14(10):4592. ³https://www.gov.uk/government/collections/national-diet-and-nutrition-survey

Page content last reviewed: May 10, 2022

Prebiotics

Description	Prebiotics are forms of dietary fibre which cannot be digested, but which can be fermented within the gut by specific colonies of gut bacteria that are recognised as being beneficial to health. The fermentation process feeds the bacterial species and produces chemical byproducts which are also thought to be beneficial.¹ Different types of fibre support different species of bacteria.
Function/ Used for	There are a number of different types of prebiotic recognised which support different types of gut bacteria; the two most researched forms are: Fructo-oligosaccharides (FOS) which is fermented by the Lactobacillus forms of gut bacteria Galacto-oligosaccharides (GOS) which is fermented by the Bifidobacterium colonies in the gut The benefits of prebiotics are still being explored and may go beyond those conferred by probiotics (the colonies of beneficial bacteria that FOS and GOS support). Current understanding of prebiotics indicates that they support the health of the gastrointestinal tract, may reduce blood lipid levels and may support the immune system.²
Intake	N/A
As a supplement	Both FOS and GOS are widely available in health food stores across the UK. Dosage will vary between products; however it is a regulatory requirement that dosage is noted on the packaging of any food supplement.
Found in (dietary sources)	N/A
Deficiency	N/A
Precautions and contraindications	None known.
Use in pregnancy and breastfeeding	No known problems.
Interactions e.g. with other medications	None reported.
Adverse effects	Some reports of flatulence, bloating and diarrhoea which is reversed on stopping treatment.
References	Schrezenmeir J, de Vrese M. Probiotics, prebiotics, and synbiotics – approaching a definition. The American Journal of Clinical Nutrition 2001; 73:2 361s-364s Gibson GR, Hutkin R, Sanders ME, Prescott SL, Reimer RA, Salminen SJ, Scott K, Stanton C, Swanson KS, Cani PD, Verbeke K, Reid G. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nature Reviews GI & Hep 2017; 14:491–502

Page content last reviewed: November 22, 2018

Probiotics

Description	A probiotic is a live microbial food supplement that contains microbial substances normally found in the gut.
Function/ Used for	Probiotics such as acidophilus and bifidus are consumed to improve digestion. Once in the gut they work by multiplying and restoring the balance of the normal bacterial population of the intestine. Probiotics may also help to support the health of the immune system.
Intake	N/A
As a supplement	Available as bio-yoghurts or fermented milk based drinks. Also as capsules and tablets. To be effective, they should be consumed daily. Many probiotics should be kept refrigerated and should be consumed before the expiry date. There is no established dose for these products.
Found in (dietary sources)	N/A
Deficiency	N/A
Precautions and contraindications	None known.
Use in pregnancy and breastfeeding	There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications	None reported¹.
Adverse effects	None known.
References	1. Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.

Page content last reviewed: March 20, 2017

µg	Microgram a measurement of weight equal to one millionth of a gram (or one thousandth of a milligram). Microgram (µg or mcg) is used for a number of nutrients found in food supplements.
Amino Acid	The building blocks of protein, there are eight essential amino acids which cannot be synthesised within the body and therefore must come from the diet. These are: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine. In addition arginine and histidine are amino acids required by infants and young children which supports their rapid growth.
Antioxidant	A substance or nutrient which helps to protect our cells from damage caused by free radicals, damaging molecules which are found in pollution and tobacco smoke. Our bodies also produce free radicals as part of the normal biochemistry of living.
Deficiency	A lack of essential macronutrients or micronutrients which results in malnutrition and or disease. This may be the result of inadequate intakes or absorption issues associated with gastrointestinal disease. There are a number of recognised deficiency diseases including (but not exclusively): scurvy (vitamin C deficiency); rickets (vitamin D deficiency); anaemia (iron deficiency, but also deficiencies in B12 and folic acid) and Kwashiorkor (protein deficiency).
DH	The Department of Health is a UK Government department. It has responsibility for nutrition legislation and sets health policy for nutrition.
DHA	Docosahexaenoic acid; one of the key omega-3 fats that provides health benefits
Dietitian	An individual qualified in nutrition and dietetics who can assess, diagnose and treat health issues associated with nutrition and diet. Dietitians are governed by law with a statutory code of practice; they often work within the health service although increasing numbers are also working in a freelance capacity.
EFA	Essential fatty acids (omega 3 and omega 6) cannot be synthesised by the body and must be derived from the diet. EFAs do not provide fuel for energy production and are required for vital biological processes which support growth, development and health.
EFSA	European Food Safety Authority; the European Union food risk management agency which scientifically evaluates safety across all areas of food.
EPA	Eicosapentaenoic acid; one of the key omega-3 fats that provides health benefits.
Fat soluble vitamin	The fat soluble vitamins are vitamins A, D, E and K. Because they are fat soluble these substances can accumulate in the body, often being stored in fat cells, or in the liver. This can create health issues, particularly if intakes have been high for a prolonged period of time. For example, long term high intakes of vitamin D may lead to the laying down of calcium in tissues such as liver and kidneys which can cause nausea and vomiting.
Food supplement	A food supplement is a concentrated source of vitamins, minerals or other substances with a nutritional or physiological effect which is sold in small, measured unit doses.
FSA	The Food Standards Agency is a non-ministerial UK Government department responsible for food safety and food hygiene.
GLA	Gamma-linoleic acid is an omega-6 fatty acid (an essential fatty acid considered to be necessary for human health which must be derived from the diet). GLA is most commonly found in evening primrose oil (EPO), borage or starflower oil and blackcurrant seed oil.
Health claim	A health claim is any claim which states, or implies, that consumption of a specific food will have a beneficial effect on health. Claims may be written, verbal or pictorial.
Herbal medicine (herbal remedy)	A product is considered to be a herbal medicine if the main active ingredient/s are only herbal substances or preparations. Not all herbal products are medicines, some may be food supplements and some may be cosmetics. What determines if a product is, or is not a medicine is complex but generally rests with how the product is presented (i.e. does it make medicinal claims to treat, prevent or cure any disease) and what it does (i.e. does it have a physiological impact on, or alter, any body functions).
Macronutrient	Dietary constituents which are needed in significant amounts, generally protein, fat, carbohydrate, fibre and water.
Malnutrition	Malnutrition is a state in which the deficiency of nutrients such as energy, protein, vitamins or minerals results in measurable adverse effects on the body. Malnutrition may refer to insufficient intake of protein, carbohydrate and fats (macronutrients) which can result in overly low BMI. It may also be insufficient intake of vitamins, minerals and other micronutrients, which can impact on overall health and could include obese individuals with poor diets.
Mg	Milligram is a measurement of weight equal to one thousandth of a gram. Mg is used for a number of nutrients found in food supplements.
Micronutrient	A substance derived from food which is needed in extremely small amounts for the normal growth and development of living beings. Micronutrients are vitamins, minerals and essential fatty acids (omega-3 fats)
Mineral	Inorganic micronutrient essential to health and wellbeing. Minerals are absorbed from soil by plants which are in turn eaten by animals or humans. Minerals may be split into minerals which are needed in relatively high amounts (calcium, phosphorus, magnesium, sodium, chloride and potassium) and trace elements (iron, zinc, cobalt, copper, chromium, fluoride, iodine, manganese, molybdenum, boron and selenium) which are needed in very small quantities.
Multivitamin	A product which contains more than one vitamin, often multivitamins will contain all 13 vitamins although some may contain only the eight B vitamins, or a combination of some of the vitamins and some additional minerals.
NDNS	The UK National Diet and Nutrition Survey is a continuous rolling survey of the dietary habits and nutritional status of adults and children in the UK. The results are used to assess whether intakes of food and nutrients are adequate across different ages and population groups.
NRV	Nutrient Reference Value is the amount set by the European Food Safety Authority (EFSA), primarily to support food labelling, which the majority of the population requires to maintain health. Previously known as RDA
Nutrient	A substance derived from food which provides nourishment to the body and is essential for the maintenance of life and for growth and development.
Nutritionist	Nutritionists generally work for public bodies or governments, although some do work with private clients. They tend to look at large populations to determine risk factors and make dietary recommendations that are applied at population levels. For example, evidence on the incidence of type II Diabetes led public health nutritionists to determine that some populations are more at risk of developing this disease, and to make recommendations for dietary changes to either reduce the risk or manage the disease. However, public health nutritionists do not practice with individual patients.
Omega-3 fats	Essential fatty acids which cannot be synthesised by the body and must be derived from the diet. Primary sources for omega-3 fats are oily fish and fish oil supplements with some also coming from enriched eggs and fortified foods. There are a number of scientifically proven health benefits for omega-3 fats including supporting the health of the eyes, brain and heart, maintaining an appropriate balance of triglycerides in the blood and reducing blood pressure.
Omega-6 fats	Essential fatty acids which cannot be synthesised by the body and must be derived from the diet. Primary sources for omega-6 are vegetable oils such as sunflower and corn oils as well as nuts and seeds. There are a number of health benefits associated with omega-6 fatty acids; they are thought to be beneficial in the management of premenstrual syndrome and in some skin conditions including eczema and psoriasis.
PAGB	Proprietary Association of Great Britain (PAGB) is the UK trade association which represents the manufacturers of branded over-the-counter medicines, self care medical devices and food supplements.
Prebiotics	Foods which promote the growth of probiotics, the beneficial bacteria that inhabit our gut. Prebiotics are generally fibres such as inulin, which our bodies cannot digest and absorb but which provide a food source for probiotics.
Probiotics	Live bacteria (and some yeasts) which inhabit the digestive tract which are viewed as being beneficial to human health. There are thousands of different bacterial strains; some are resident in specific areas of the digestive tract whilst others are transient, simply passing through.
Public Health England (PHE)	Public Health England is an agency of the Department of Health responsible for improving public health. They work with local government, the NHS and non-governmental organisations as well as communicating public health messages to the general public.
PUFA	Polyunsaturated fatty acids (PUFA) are found in nuts, seeds, fish (and fish oil), krill and some algae, small amounts are also found in leafy greens. The omega-3 and omega 6 fats are PUFAs, which are generally associated with health.
RDA	Recommended Daily Amount; previously used terminology for the amount set, primarily to support food labelling, which the majority of the population require to maintain health. Now described using nutrient reference value (NRV)
SUL	Safe Upper Levels of vitamins and minerals were established by the Expert Group on Vitamins and Minerals who published a report in 2003 (https://cot.food.gov.uk/sites/default/files/cot/vitmin2003.pdf). The UK food supplements industry works to the levels set in this report.
Vitamin	Organic micronutrient essential to health and wellbeing. Vitamins cannot be synthesised in sufficient amounts by the animal or human body and must therefore be obtained from the diet. Plants manufacture vitamins which move up the food chain as the plants are consumed by animals or humans. Vitamins can be divided into fat soluble (vitamins A, D, E and K) and water soluble (vitamins B1, B2, B3, B5, B6, B12, biotin, folic acid and vitamin C).
Water soluble vitamin	The B vitamins and vitamin C are water soluble. They are not stored in any significant quantities within the body and are generally either utilised or excreted in the urine. As they are not stored in the body, they tend to have low toxicity and are needed on a daily basis.