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WHY IS NUTRITIONAL ABSORPTION A CONCERN?
by Dr. Marc Grossman and Jeannette Manning
Presently, we are witnessing new breakthroughs in vision loss prevention. The National Institute of Health
(NIH) is studying 4,600 people to follow the effects of nutritional supplementation on cataracts, macular
degeneration and glaucoma. The human eye requires more nutrition to maintain healthy tissue and
function than any other organ in the body! The study is identifying "which" supplements are most important
and "how" these nutrients should be taken.
Your ability to absorb nutrients from the food you eat and the supplements you take may decrease
between the ages of 40 to 60 years as much as 70-90%! Research on senior absorption characteristics
indicates that reduced levels of digestive enzymes in your mouth, pancreas and intestines, coupled with
reduced hydrochloric acid production in your stomach are culprits contributing to this condition.
When you can't completely digest your food or nutritional supplements, your body can't absorb the vitamins
they contain. Vitamins are "locked up" and your body's digestive system uses enzymes and hydrochloric
acid (HCI) as keys to release them for absorption into the bloodstream.
Whole raw foods come naturally packaged with their own digestive enzymes but are destroyed by cooking.
Digestive enzyme supplements derived from plants are helpful replacements and begin their work in the
upper stomach. Amylase for carbohydrate digestion, protease for protein digestion, lipase for fat digestion
and cellulase for cellulose (fiber) breakdown are all available in supplement formulas. Animal enzymes
such as pancreatin and pepsin are also available and help in the digestion of food once it has reached the
lower stomach and the intestinal tract.
Stomach acid is responsible for the activation of the specific enzymes needed for digestion as nutrients
travels into the small intestine and colon. Low levels of stomach acid may allow undigested nutrients to
travel farther along the digestive tract than the optimal distance for efficient absorption. In older people, this
may contribute to lowered levels of vitamins B2, B6, and B12, as well as decreased absorption of zinc from
vegetables.
As you pass your 50th birthday, you are likely to produce less stomach acid than you did at age 25.
According to estimates, between 24 and 37 percent of adults aged 60 to 80 years suffer from a lack of
digestive acid also known as atrophic gastritis. Many people over 50 will benefit from taking HCI with
meals. The acid in your stomach is a key player in the thorough breakdown of food. Those who don't have
enough stomach acid often can't digest fiber rich food, whole foods or vitamin pills, and end up turning to
highly processed foods for energy. Vitamin and mineral deficiencies often already exist because of poor
food choices and poor digestion compounds the problem.
Often times we know the therapeutic dosage for a specific condition, but we do not know how much of the
prescribed nutrient is absorbed into the bloodstream via the gastrointestinal system when taken orally by
tablet, capsule or gel cap. We do know that after age 40 and continuing on as we age, our gastrointestinal
absorption rate reduces significantly. (1-4) This problem becomes even more serious when combined
with health conditions or digestive disorders that further reduce absorption such as ulcers, diverticulitis,
acid reflux, dysbiosis, etc.
Again, it’s not how much you take but how much your body tissues absorb that is important. With a higher
level of absorption, more nutrients reach their intended destination thereby requiring a lower dosage
intake. More nutrients in a pill or capsule is not necessarily better. What is important is how we can best
insure the uptake of recommended "therapeutic dosages".
One way around this problem is to take nutritional supplements using the most efficient delivery system
available. The most important
nutrients should be taken in the form of sprays when available. Spraying inside the mouth (intraoral) or
under the tongue (sublingual) has the best absorption rate.
The following chart compares absorption rates of delivery systems:
Delivery System / Rate of Absorption*(5)
Pill or tablet - 10%
Capsule - 20%
Gel Cap - 30%
Transdermal Patch - 45%
Sublingual Liquid - 50%
Intramuscular Injection - 90%
Intraoral or Sublingual Spray - 95%
Intravenous Injection - 100%
Intraoral and sublingual sprays have become a viable solution with the introduction of liposomes.
Liposomes hold both water and fat soluble nutrients in little fat containers to provide an efficient transport
system that allows for maximum absorption by the body. These fat containers bypass the stomach and
take a quicker more efficient route by slipping through the mucosal membrane under the tongue and
directly into the bloodstream. (6-10) The intraoral or sublingual spray method of delivery is also very helpful
for individuals who have difficulty swallowing pills or capsules and, since a lower dosage of nutrients is
required, it is cost effective .
To aid in absorption:
1) Manage Chronic Stress. Stress restricts the flow of blood in the body by tightening muscles, and
restricting the free flow of fluids. Meditation, yoga, tai chi or even daily walks in nature can all help reduce
stress significantly.
2) Exercise Daily. Exercise helps the body rid itself of the daily accumulation of harmful toxins. Numerous
studies have shown that even a brisk walk of 20 minutes per day can be preventive in the development of
heart disease and has even been shown to reduce high eye pressures in cases of glaucoma.
3)Think Positively. In Chinese medicine, excessive thoughts of anger, worry, resentment, grief and fear all
have significant effects on the free flow of "energy" in our body.
4) Eat Whole Healthy Foods. Our bodies crave fresh food, particularly fruits, vegetables and grains. These
foods provide energy to our bodies in the form of vitamins, minerals and natural enzymes. Excessive
intake of "dead" food such as fast foods, or highly processed foods, require our bodies to use their own
enzymes and energy to digest food in an attempt to separate whatever limited nutrients may be available.
5) Eat slowly & Chew Well. We should be eating our food slowly and thoughtfully. Try never to eat on the
run, and don’t eat while working, conversing, writing, etc. Make eating a special time for yourself.
TIPS FOR TAKING NUTRITIONAL SUPPLEMENTS
AND MAINTAINING GOOD DIGESTION
1) Use sublingual and/or liquid nutritional supplements when possible (order below). They provide the
most efficient and reliable system for nutrient delivery to the bloodstream (50-95% absorption). Gel Caps
and capsules are the next best choice, but rely on gastrointestinal efficiency for good (20-30%) absorption.
2) Sublingual liquid supplements are best taken at least ten minutes
after drink and one hour after food. To take sublingual liquid supplements, place under the tongue and
wait two minutes without talking before swallowing. Wait ten minutes before taking food or drink. When
taking more than one sublingual formula at the same time, wait 5-10 minutes between supplements.
3) Take vitamins with food when possible. Digestive enzymes are stimulated when eating and aid in
nutrient absorption.
4) If vitamin capsules cannot be swallowed, open up the capsule and mix the contents with juice or yogurt.
5) A small amount of apple cider vinegar, taken just prior to a meal, will stimulate production of digestive
juices.
6) Take digestive enzyme supplements and limit fluids during meals to improve digestion. Adding fluid to
the stomach while eating dilutes the concentration of digestive enzymes and impairs digestion. Especially
avoid cold or iced drinks when eating.
7) Spinach is a good source of lutein. However, because of the oxalic acid content, excessive consumption
can block the uptake of calcium and result in the development of kidney stones and/or worsen
osteoporosis.
8) Beta Carotene (pro vitamin A) and lutein compete for absorption at the same mid-intestine receptor
sites if taken orally (by tablet or capsule). So, if you are taking both of these antioxidants, take them at
separate times during the day.
9) If taking antibiotics, take acidophilus supplements between doses. This will help build up the good
bacteria in the digestive tract destroyed by the antibiotics. It is especially important for elderly patients to
take acidophilus on a regular basis for the maintenance of intestinal health.
REFERENCES:
1. Weiner, Dietz & Laue, Senile changes in absorption and elimination processes and their importance in
pharmacotherapy, Zeitschrift fur Alternforschung/Journal of Aging Research, (ZFA), 38(5):355-60, Sep-Oct
1983.
2. Dietz, Lane & Laue, Digestion and absorption in the elderly, ZFA, 33(1): 65-78, 1978.
3. Scarpace, J. Am. Geriatr Soc, Decreased receptor activation with age, 36(11):1067-71, 1988 Nov.
4. Baker, Jaslow & Frank, Severe impairment of dietary folate utilization in the elderly, J Am Geriatr Soc, 26
(5):218-21, 1978 May.
5. Physicians’ Desk Reference, NPPDR No. 18:676, 1997.
6. Liposomes a practical approach. RRC New Editor, IRL press at oxford university press. 1990.
7. Liposome technology, Gregodadis Ed. Vol 1, 11, 111. 2nd Edition, CRC Press, 1993.
8. Elias Fattal, Technological aspects of liposomes preparation, University of Paris-Sud, School of
Pharmacy, URA CNRS 1218, Chatenay-Malabry, France.
9. Weiner, Dietze & Laue, Age-dependent alterations of intestinal absorption. Arch Gerontol Geriatr, 3(2):97-
108, 1984 Jul.
10. Scientific American, 256 (1):103-111, 1987.
DR. MARC GROSSMAN, Optometrist and licensed Acupuncturist, is the director of Integral Health
Associates located in New Paltz, New York and Rye Learning Center in Rye, New York. Dr. Grossman has
been in practice for 20 years, lectures internationally on eye disease, nutrition and alternative approaches,
and is the co-author of Natural Eye Care – An Encyclopedia, published by Keats, April. 1999. CONTACT
INFORMATION: For more information on eye disease, nutrition and prevention, Dr. Grossman can be
contacted through his web site at
http://www.visionworksusa.com, by calling 888-735-8475, or by writing to 3 Paradise Lane, New Paltz, New
York 12561.
JEANNETTE MANNING is a Vision Nutrition Consultant focusing on prevention and improvement of visual
loss from macular degeneration and other related visual disorders. She speaks and writes on nutrition
and vision health, maintains a private nutritional practice and serves as staff Nutritional Consultant for a
supplement manufacturer in Southern California. Her areas of expertise include the unique challenges of
senior digestion and absorption. CONTACT INFORMATION: For more information on nutritional and visual
health, contact Jeannette Manning, Nutritional Consultant; 10855 Sorrento Valley Road, Suite 101, San
Diego, CA 92121; Phone 800-819-5631, Fax 858-455-9399; Email jeannettemanning@hotmail.com.
To order liquid vitamins, go to: www.drjanesvitamins.com
by Dr. Marc Grossman and Jeannette Manning
Presently, we are witnessing new breakthroughs in vision loss prevention. The National Institute of Health
(NIH) is studying 4,600 people to follow the effects of nutritional supplementation on cataracts, macular
degeneration and glaucoma. The human eye requires more nutrition to maintain healthy tissue and
function than any other organ in the body! The study is identifying "which" supplements are most important
and "how" these nutrients should be taken.
Your ability to absorb nutrients from the food you eat and the supplements you take may decrease
between the ages of 40 to 60 years as much as 70-90%! Research on senior absorption characteristics
indicates that reduced levels of digestive enzymes in your mouth, pancreas and intestines, coupled with
reduced hydrochloric acid production in your stomach are culprits contributing to this condition.
When you can't completely digest your food or nutritional supplements, your body can't absorb the vitamins
they contain. Vitamins are "locked up" and your body's digestive system uses enzymes and hydrochloric
acid (HCI) as keys to release them for absorption into the bloodstream.
Whole raw foods come naturally packaged with their own digestive enzymes but are destroyed by cooking.
Digestive enzyme supplements derived from plants are helpful replacements and begin their work in the
upper stomach. Amylase for carbohydrate digestion, protease for protein digestion, lipase for fat digestion
and cellulase for cellulose (fiber) breakdown are all available in supplement formulas. Animal enzymes
such as pancreatin and pepsin are also available and help in the digestion of food once it has reached the
lower stomach and the intestinal tract.
Stomach acid is responsible for the activation of the specific enzymes needed for digestion as nutrients
travels into the small intestine and colon. Low levels of stomach acid may allow undigested nutrients to
travel farther along the digestive tract than the optimal distance for efficient absorption. In older people, this
may contribute to lowered levels of vitamins B2, B6, and B12, as well as decreased absorption of zinc from
vegetables.
As you pass your 50th birthday, you are likely to produce less stomach acid than you did at age 25.
According to estimates, between 24 and 37 percent of adults aged 60 to 80 years suffer from a lack of
digestive acid also known as atrophic gastritis. Many people over 50 will benefit from taking HCI with
meals. The acid in your stomach is a key player in the thorough breakdown of food. Those who don't have
enough stomach acid often can't digest fiber rich food, whole foods or vitamin pills, and end up turning to
highly processed foods for energy. Vitamin and mineral deficiencies often already exist because of poor
food choices and poor digestion compounds the problem.
Often times we know the therapeutic dosage for a specific condition, but we do not know how much of the
prescribed nutrient is absorbed into the bloodstream via the gastrointestinal system when taken orally by
tablet, capsule or gel cap. We do know that after age 40 and continuing on as we age, our gastrointestinal
absorption rate reduces significantly. (1-4) This problem becomes even more serious when combined
with health conditions or digestive disorders that further reduce absorption such as ulcers, diverticulitis,
acid reflux, dysbiosis, etc.
Again, it’s not how much you take but how much your body tissues absorb that is important. With a higher
level of absorption, more nutrients reach their intended destination thereby requiring a lower dosage
intake. More nutrients in a pill or capsule is not necessarily better. What is important is how we can best
insure the uptake of recommended "therapeutic dosages".
One way around this problem is to take nutritional supplements using the most efficient delivery system
available. The most important
nutrients should be taken in the form of sprays when available. Spraying inside the mouth (intraoral) or
under the tongue (sublingual) has the best absorption rate.
The following chart compares absorption rates of delivery systems:
Delivery System / Rate of Absorption*(5)
Pill or tablet - 10%
Capsule - 20%
Gel Cap - 30%
Transdermal Patch - 45%
Sublingual Liquid - 50%
Intramuscular Injection - 90%
Intraoral or Sublingual Spray - 95%
Intravenous Injection - 100%
Intraoral and sublingual sprays have become a viable solution with the introduction of liposomes.
Liposomes hold both water and fat soluble nutrients in little fat containers to provide an efficient transport
system that allows for maximum absorption by the body. These fat containers bypass the stomach and
take a quicker more efficient route by slipping through the mucosal membrane under the tongue and
directly into the bloodstream. (6-10) The intraoral or sublingual spray method of delivery is also very helpful
for individuals who have difficulty swallowing pills or capsules and, since a lower dosage of nutrients is
required, it is cost effective .
To aid in absorption:
1) Manage Chronic Stress. Stress restricts the flow of blood in the body by tightening muscles, and
restricting the free flow of fluids. Meditation, yoga, tai chi or even daily walks in nature can all help reduce
stress significantly.
2) Exercise Daily. Exercise helps the body rid itself of the daily accumulation of harmful toxins. Numerous
studies have shown that even a brisk walk of 20 minutes per day can be preventive in the development of
heart disease and has even been shown to reduce high eye pressures in cases of glaucoma.
3)Think Positively. In Chinese medicine, excessive thoughts of anger, worry, resentment, grief and fear all
have significant effects on the free flow of "energy" in our body.
4) Eat Whole Healthy Foods. Our bodies crave fresh food, particularly fruits, vegetables and grains. These
foods provide energy to our bodies in the form of vitamins, minerals and natural enzymes. Excessive
intake of "dead" food such as fast foods, or highly processed foods, require our bodies to use their own
enzymes and energy to digest food in an attempt to separate whatever limited nutrients may be available.
5) Eat slowly & Chew Well. We should be eating our food slowly and thoughtfully. Try never to eat on the
run, and don’t eat while working, conversing, writing, etc. Make eating a special time for yourself.
TIPS FOR TAKING NUTRITIONAL SUPPLEMENTS
AND MAINTAINING GOOD DIGESTION
1) Use sublingual and/or liquid nutritional supplements when possible (order below). They provide the
most efficient and reliable system for nutrient delivery to the bloodstream (50-95% absorption). Gel Caps
and capsules are the next best choice, but rely on gastrointestinal efficiency for good (20-30%) absorption.
2) Sublingual liquid supplements are best taken at least ten minutes
after drink and one hour after food. To take sublingual liquid supplements, place under the tongue and
wait two minutes without talking before swallowing. Wait ten minutes before taking food or drink. When
taking more than one sublingual formula at the same time, wait 5-10 minutes between supplements.
3) Take vitamins with food when possible. Digestive enzymes are stimulated when eating and aid in
nutrient absorption.
4) If vitamin capsules cannot be swallowed, open up the capsule and mix the contents with juice or yogurt.
5) A small amount of apple cider vinegar, taken just prior to a meal, will stimulate production of digestive
juices.
6) Take digestive enzyme supplements and limit fluids during meals to improve digestion. Adding fluid to
the stomach while eating dilutes the concentration of digestive enzymes and impairs digestion. Especially
avoid cold or iced drinks when eating.
7) Spinach is a good source of lutein. However, because of the oxalic acid content, excessive consumption
can block the uptake of calcium and result in the development of kidney stones and/or worsen
osteoporosis.
8) Beta Carotene (pro vitamin A) and lutein compete for absorption at the same mid-intestine receptor
sites if taken orally (by tablet or capsule). So, if you are taking both of these antioxidants, take them at
separate times during the day.
9) If taking antibiotics, take acidophilus supplements between doses. This will help build up the good
bacteria in the digestive tract destroyed by the antibiotics. It is especially important for elderly patients to
take acidophilus on a regular basis for the maintenance of intestinal health.
REFERENCES:
1. Weiner, Dietz & Laue, Senile changes in absorption and elimination processes and their importance in
pharmacotherapy, Zeitschrift fur Alternforschung/Journal of Aging Research, (ZFA), 38(5):355-60, Sep-Oct
1983.
2. Dietz, Lane & Laue, Digestion and absorption in the elderly, ZFA, 33(1): 65-78, 1978.
3. Scarpace, J. Am. Geriatr Soc, Decreased receptor activation with age, 36(11):1067-71, 1988 Nov.
4. Baker, Jaslow & Frank, Severe impairment of dietary folate utilization in the elderly, J Am Geriatr Soc, 26
(5):218-21, 1978 May.
5. Physicians’ Desk Reference, NPPDR No. 18:676, 1997.
6. Liposomes a practical approach. RRC New Editor, IRL press at oxford university press. 1990.
7. Liposome technology, Gregodadis Ed. Vol 1, 11, 111. 2nd Edition, CRC Press, 1993.
8. Elias Fattal, Technological aspects of liposomes preparation, University of Paris-Sud, School of
Pharmacy, URA CNRS 1218, Chatenay-Malabry, France.
9. Weiner, Dietze & Laue, Age-dependent alterations of intestinal absorption. Arch Gerontol Geriatr, 3(2):97-
108, 1984 Jul.
10. Scientific American, 256 (1):103-111, 1987.
DR. MARC GROSSMAN, Optometrist and licensed Acupuncturist, is the director of Integral Health
Associates located in New Paltz, New York and Rye Learning Center in Rye, New York. Dr. Grossman has
been in practice for 20 years, lectures internationally on eye disease, nutrition and alternative approaches,
and is the co-author of Natural Eye Care – An Encyclopedia, published by Keats, April. 1999. CONTACT
INFORMATION: For more information on eye disease, nutrition and prevention, Dr. Grossman can be
contacted through his web site at
http://www.visionworksusa.com, by calling 888-735-8475, or by writing to 3 Paradise Lane, New Paltz, New
York 12561.
JEANNETTE MANNING is a Vision Nutrition Consultant focusing on prevention and improvement of visual
loss from macular degeneration and other related visual disorders. She speaks and writes on nutrition
and vision health, maintains a private nutritional practice and serves as staff Nutritional Consultant for a
supplement manufacturer in Southern California. Her areas of expertise include the unique challenges of
senior digestion and absorption. CONTACT INFORMATION: For more information on nutritional and visual
health, contact Jeannette Manning, Nutritional Consultant; 10855 Sorrento Valley Road, Suite 101, San
Diego, CA 92121; Phone 800-819-5631, Fax 858-455-9399; Email jeannettemanning@hotmail.com.
To order liquid vitamins, go to: www.drjanesvitamins.com
To order liquid
vitamins, go to:
drjanesvitamins.com
vitamins, go to:
drjanesvitamins.com
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