The Awesome Foursome: Nutrients for Health

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Nutritional supplements come and go. Just think of the coral calcium craze that attempted to turn it into a cure-all.

But a team of four nutrients is showing promise of a long-lasting presence among healthy nutrients. Why? A number of leading doctors, especially cardiologists, are especially keen on this quartet consisting of magnesium, Coenzyme Q10, carnitine, and ribose. 

When we think of energy problems, we may look toward new technologies that will provide power for the grid. But you could have a personal energy problem -- when your body doesn't have enough power to work right -- a problem with ATP.

In fact, all life depends on ATP, adenosine triphosphate. This "miraculous molecule" transfers energy to where it's needed inside every cell in the body.

A deficiency of ATP is linked to diseases that afflict 50 million Americans. Those afflictions include type II diabetes, Parkinson's disease, Alzheimer's disease, cancer, clogged arteries, stroke, and heart failure.

Cardiologist Stephen Sinatra finds particular applications for the heart.

"When you fortify the heart with energy in terms of ATP, then the heart muscle thrives. And look, look at our country, the number one cause of death is cardiovascular disease and there's like 5 to 6 million people with heart failure," he said.

Sinatra routinely recommends four nutrients that can boost ATP: magnesium, coenzyme Q10, carnitine, and ribose. He calls them "The Awesome Foursome."

Fish Oil and Magnesium

Fellow cardiologist Seth Baum says the four have great benefits, but he would start with fish oil -- omega-3 fats -- to provide the foundation for energy production. 

Baum nicknames that fat "The Awesome Onesome" and wonders if fish oil should be added to the other four to make up a quintet. He also encourages patients not to overlook basic nutrients.

Baum finds that, in addition to nutrition, another building block for more long-term energy is exercise. Bringing the loop full circle, magnesium helps that exercise by promoting better blood flow, stronger bones, and overall health.

In fact, Baum describes magnesium as no one-trick pony.

"It is really, really important. And then the other problem is that most Americans actually take in on a daily basis less than the recommended daily value which is 400 milligrams," he said.

That means about 75 percent of the populace consumes under 400 milligrams a day. Thus, most people aren't adequately energizing their hearts -- or getting magnesium's benefits for helping protect the brain from toxins such as MSG and other excitotoxins.   

In medical circles, magnesium is often overlooked. For instance, magnesium as an intravenous (IV) drip used to be a standard and effective treatment following heart attack. In that same intravenous form, magnesium has also demonstrated effectiveness following concussions.

Supplements are the most reliable way to get magnesium, but a diet rich in broccoli, peanuts, halibut, plantains, and leafy greens not only provides magnesium but many other nutrients as well.

Coenzyme Q10

Another of the fantastic four is Coenzyme Q10, widely known and available in supplement form. Baum says it not only helps the body make ATP but serves as an antioxidant as well.

"I've used it in patients with heart failure effectively. I'm convinced it works and usually use very high doses in those patients, 200 to 400 milligrams a day," he said.

That's the amount heart patients may need.  But our bodies normally use only a few milligrams a day which we get it from two sources. Half the CoQ10 we use in our body we make in our body and half the coQ10 we consume.

That is, we get small amounts of CoQ10 from foods such as beef, chicken, herring, and canola oil.  That may be enough for many people.

For fighting diseases, supplements in fairly large amounts may be needed -- partly because only a portion of the substance is absorbed. Baum explains, "If you're taking 50 milligrams of CoQ10 a day and you're absorbing five percent, you're getting 2.5 milligrams."

CoQ10 becomes especially important for those taking certain drugs which interfere with its production. Those pharmaceuticals include statins, beta blockers, some blood pressure medications, and all hypoglycemic agents used for Type II diabetes.


The third energy booster is L-carnitine. Sinatra describes it as being like a ferry boat or a freight train, "It shuttles in the fatty acids -- we call it that beta-oxidation of fat. The fat is burned -- and remember 60% of all the energy of the heart is from the burning of fat."

That burning produces lots of ATP molecules. Carnitine is found in the highest concentration in tissues that use fats as a primary fuel. Not surprisingly, that means the heart as well as skeletal muscles. In other words, cardiology and exercise applications are the most common.

Some carnitine is found in beef, pork, and cow's milk. For battling diseases, a dose of several hundred milligrams is often recommended.

Sinatra says a unique form of carnitine helped his hospitalized son suffering from severe chronic fatigue. He asked his son's doctor, "Can we give him IV carnitine?"

His son's muscles were in a constant state of contraction. Sinatra explains that to relax a muscle it actually takes more ATP than to stimulate a muscle. This reality could make carnitine and its three cohorts beneficial for the muscle pain in fibromyalgia.

Carnitine is found in the highest concentration in tissues that use fats as a primary fuel - that is the heart and skeletal muscles. In other words, it is helpful in cardiology and exercise applications.


Finally, there's is a relatively new kid on the block: ribose. Though other sugars are burned for body fuel, this six-sided sugar is not.

Ribose actually provides the raw material for the central portion of the ATP molecule. Another aspect is that ribose works quickly - in about half an hour after consumption.

That speed of action helps enable longer workouts. This could be especially useful for the frail elderly who may need a boost to exercise at all.

Others who could benefit include young moms whose heart valves don't have the energy to close properly (mitral valve prolapse) and anyone trying to exercise longer for better workouts.  Sinatra explains the effects of giving ribose, "You're giving rocket fuel to those muscles -- and they relax and contract and they do it the right way."

On a foundation of omega-3 fats, increasing evidence shows that magnesium, Coenzyme Q10, carnitine, and ribose can combine to fight disease and help people feel energized. And that could be a true awesome foursome for better health.

*Originally published June 9, 2009

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