Dietitian Rehab with Doug Cook RD

Dietitian Rehab. Episode 004 with Dr Traj Nibber

Dr Traj Nibber 300x300 - Dietitian Rehab. Episode 004 with Dr Traj Nibber

 

Detoxing from dogmatic dietitian education and attitudes for a mind wide open

But first, “you must unlearn what you have learned” YODA

 

Misconceptions about supplements persist. Many have been confused by headlines that seem to discredit their value in supporting health or, many worry about quality control and safety; are you really getting what you pay for? Industry leader AOR’s founder, Dr. Traj Nibber, a pharmacist by training with a Master’s in Toxicology, sheds light on these misconceptions. He also emphasizes the importance of using high-quality products that go far beyond industry standards.

More about Dr. Traj Nibber

AOR’s origins lie in the pharmacy of the organization’s Research Director, Dr. Traj Nibber, when he was contacted in the late 1980s by People With AIDS (PWA) advocacy groups searching for a source of hard-to-find formulations for AIDS buyers’ groups. His initial surprise at the lack of access to these nutritional supplements soon turned to empathic frustration, as he realized how many people were suffering from the failure of the dietary supplement industry to make available nutrients whose role in health were well-established by rigorous scientific investigation – and the simultaneous willingness of the same companies to promote supplements on flimsy scientific evidence.

 

Dr. Nibber found a supplement industry which refused to evaluate new evidence or to hold their existing lines up to the light of clear standards of evidence; which was happy to keep selling yesterday’s products when a superior, innovative supplement was better-documented by research.

 

He also found that most companies were unwilling to develop genuinely novel orthomolecular interventions, preferring to respond passively to the marketing of supplement raw materials – new or old – by their suppliers. He also found that the industry was too willing to be cowed by government regulators and by bureaucratic red tape and to skimp on quality control to lower prices even at the expense of clinical efficacy.

 

In response, he began to immerse himself more in the literature on nutritional factors in health, he began to develop formulations of his own and to launch new natural health products into a wider audience of health-conscious individuals, life extension radicals, and health practitioners seeking a new generation of more effective natural solutions to the chronic health concerns of their patients. The outcome? AOR has become a leading provider of genuinely innovative nutraceuticals in North America and around the world.

Connect with AOR:

Check out AOR’s learning center

AOR has a bunch of great resources for continuing education for health professionals or anyone whose interested in the nitty-gritty details that support the role of various nutrients, supplements, etc have in promoting and maintaining health like this one, for example, ImmunityDiabetes – A New Approach

 

  • For lots more, check out the Learn section on their website

 

Thanks for listening!

Read the transcript

Doug Cook:

Welcome to the Dietitian Rehab podcast where we not only challenge and inspire dietitians to think outside the traditional dogmatic education, training and attitudes for a mind wide open but also to challenge anyone to think differently about your own health. We’ll talk all things food, health and nutrition related as we explore points of view, evidence and strategies for better health that will allow you a fuller understanding of the hot topics that everybody’s talking and asking about.

 

Hey, everyone. Welcome to today’s show. I’m your host Doug Cook and today we get to speak with somebody from one of my all-time favorite supplement companies and to say I’m a fanboy would be an understatement. Dr. Nibber is the founder of Advanced Orthomolecular Research Canada or AOR for short. Dr. Nibber is a pharmacist by training who in the late 80s and early 90s was contacted by people with AIDS advocacy groups searching for a source of evidence-based, high quality yet hard to find supplement formulations for AIDS buyers groups. Dr. Nibber found a supplement industry which refused to evaluate new evidence and that also refused to hold their existing lines up to the light of clear standards of evidence which was happy to keep selling yesterday’s products when superior innovative and better formulated supplements were not only available but desperately needed to be developed.

 

Fast forward to today and AOR is recognized as the most advanced supplement formulator in North America. Today Dr. Nibber will talk about the key concept to consider for successful supplement use which is the driving principle of AOR which he refers to—which I find amazing—the four Rs, the right molecule at the right dose in the right place at the right time. And for listeners today, AOR is offering a discount coupon for anyone who would like to buy their products. The coupon is Doug5 so Doug, D-O-U-G and the number 5. And this will give you 5% off and it is stackable with other discounts and purchases.

 

So, let’s get to the show. Great. Well, welcome to the show, Dr. Nibber. I’m very excited to have you on. I’ve been looking forward to this for a while when I first started thinking of having a podcast two years ago because I love the brand and I love the company and I’ve been personally using it and recommending it for years. So, thank you so much for taking the time to be here today.

 

Dr. Nibber:

Great. You’re welcome. Thank you for interviewing me.

 

Doug Cook:

So, just to help orient the listeners to you and the company if they’re not familiar or familiar with the background, you’re the founder of Advanced Orthomolecular Research or AOR for short which is, as a Canadian, I’m proud to say it’s a Canadian-based supplement formulator that has high quality supplements and sometimes the words we interchange with that are nutriceuticals and natural health products impressively many of which have been the first of their kind in both the world and North America. But I think what’s more interesting is before we dive into that if you could talk a little bit about yourself. I’m thinking specifically your journey and how you got to the place where AOR is recognized as the most advanced supplement formulator in North America.

 

Dr. Nibber:

Yes. Interesting. I grew up in the UK and my education was all from the UK and I emigrated to Canada over 30 odd years ago. I came as a pharmacist which was my primary degree and I quickly opened a pharmacy right after I got my licensing in Canada. Unfortunately, the pharmacy was in a place which was an area that was very quiet. It was dead almost all the time. So, I had to put in these long hours and unfortunately, I could not get any relief pharmacists to come and assist me. So, I had to put in all the hours and I was young at that time and had to resort to my family to help me out. And because I was a new kid on the block, I couldn’t compete with the existing pharmacies in that area. So, through luck or fate, I just decided one day that instead of having my pharmacy with contact lens solution, sanitary towels and diapers and candy and all that typical what pharmacies carried, I would just put supplements in and my education was very orthodox, very pharmaceutical. My knowledge on supplements was very poor but I did it out of necessity because I couldn’t compete.

 

And as it so happened, this was at the height of the AIDS epidemic in the late 80s and I started getting these calls from Ontario largely, all over Ontario when people started asking can I get this supplement and that. And most of these enquiries were from people with AIDS. So, we ended up setting up the first AIDS buyers club in Canada from my pharmacy and the word got out quickly that there was this odd pharmacy that carries a lot of nutritional products and a lot of these inquiries were for things that were unknown and underground stuff, supplements that weren’t available at the time but patients, AIDS patients wanted them. So, that was my first learning into compounding and into the supplement world and from that a [inaudible 00:05:07] kind of was formed out of my pharmacy and then eventually we moved to Calgary where we are now.

 

Doug Cook:

So, that’s fascinating. So, you’re an independent pharmacy, couldn’t compete with the big chains and then you moved into supplements and I’ve been using supplements my whole life, varying degrees of quality obviously growing up with Flintstones chewables and then one-a-day and then Centrum. But I started working as a dietician in the mid-90s I guess. I was working with a pharmaceutical company specifically in the population with HIV/AIDS, going to health food stores and I know to me there’s a lot of interest rightfully so in the role of nutraceuticals or supplements. But I think it’s so fascinating that somehow they got your name and you opened up this buyers club which is fascinating. So, that was really filling a real niche at the time and it still is today because they play an important role for anybody but still within that patient population. So, I guess at the time, you also were aware of the quality of those supplements back in the day. They weren’t the best.

 

Dr. Nibber:

No indeed. And as along with supporting the buyers club which many of them couldn’t afford to pay so really it was mostly free service that we offered. But the questions were started getting us all worried. To the existing supplements they were getting through my pharmacy, why did they have so many fillers? Why did they have so many excipients? And that led me to thinking well, indeed, why so? So, the whole idea of a clean label and not including these fillers and excipients which were unnecessary kind of gave the incentive to develop a line which was a clean label ingredient line as well as being innovative because I mean typically in those days as you will remember were very [inaudible 00:06:55] two type of supplements, exactly what everybody else carried. And they weren’t really looking at the science or the research to formulate what the research was saying, what the needs for the bodies were different. So, I remember clearly in those days and to this day in fact if you wanted a B complex and every supplement supplier in those days offered a B50 where all the B vitamins B1 to B2, B6, B12, all were in 50 milligrams of micrograms. It was a standard thing and it led me to well, why? Surely the body needs different amount of Bs and it’s not the same requirements for every B vitamin. It can’t be 50 milligrams and indeed, if you delve into the research, body needed different amounts of B1 vs B2 vs B6. So, we came out in those days with a different B complex which was the research was talking about.

 

Doug Cook:

I think that’s really interesting if people will want to know more about that. But before we get into that, I’m wondering if you could talk about your educational background and how that has informed your work at AOR. Because like you as a dietician, we’re very conventionally trained. For me as a dietician, it’s oh, all you need is a healthy diet, whatever that means. You’ll get all the vitamins and minerals you need. We know that’s not true. There’s surveys like the Canadian Community Health Survey that shows that Canadians are missing the mark. My experience with pharmacists in hospitals has been a little resistant to vitamins and supplements beyond treating an overt clinical deficiency. So, how has your education as a pharmacist informed your work and do you think that is a strength for the company?

 

Dr. Nibber:

Indeed. I think that’s a fundamental innovation that AOR is all about. It came through largely through the education. So, besides my bachelor’s in pharmacy and I was well aware. I was a practicing pharmacist. I was well aware of the pharmaceuticals and how they dispensed and prescribed by the physicians. I had a Master’s in toxicology also from the UK and then I had a PhD which was in experimental histopathology and liver pathology actually. So, there’s a lot of actually as part of the surgery team where I experimented a lot on animals to look at liver. So, my education whether from bachelor’s, Master’s or PhD allowed me to think things through of the pharmaceutical approach through the research approach. If we are going to make any headway, it has to be through research. So, my education played a huge role and continues to play a huge role in formulation as well as the vision of AOR.

 

Doug Cook:

Yeah. And I think this is what is so great about the company is whether we like it or not, there’s tons of people out there with science degrees who have Master’s and PhDs in various things but whether we like it or not, there is a credibility that is lent to somebody like yourself who’s a pharmacist or a doctor who stands behind these products and formulates them. So, I think is a huge credit to the brand and to get the buy-in from other people that this isn’t just some willy-nilly kind of formulation. So, that’s a real strength I would say. So, what is AOR stands for? Like what does that mean, Advanced Orthomolecular Research? And how does that maybe shape your mission, your values, what you stand for?

 

Dr. Nibber:

So, AOR stands for Advanced Orthomolecular Research. I always wanted to be a researcher during my education. I wanted to be first and foremost a researcher. So, I like the word research and then when I had the opportunity to form AOR, I wanted to use the word researcher. Even that’s what it is. But orthmolecular is the key focal point of AOR and this was coined by the great Linus Pauling, the doubled Nobel laureate who I happen to once listen to his lecture just before he passed away around 1994. I think I went in ‘91 or something. And Linus Pauling came up with this word orthomolecular which meant in 1968 in his paper which he highlighted was the white molecule. And at that time, he was looking into the use of vitamin C as a molecule that could help the body for lots of ailments and I think despite his double Nobel Prize, he was kind of ostracized because of his renowned researcher looking into natural products and vitamin C. But he coined the word as the right molecule. And then, of course, over the years, we kind of, dare I say, modified that definition to the four Rs. We took the one orthomolecular and we made it four Rs. The right molecule at the right place in the right dose at the right time and that is what AOR is about.

 

Doug Cook:

Yeah. That’s amazing. I think that makes perfect sense because I think a lot of people, I know all about Linus Pauling and unfortunately, he did get made fun of because of his high dose vitamin C. But it underscores the point that I think a lot of people have forgotten. I’m talking about people like myself or yourself who might have some formal education in human physiology and anatomy and biochemistry that vitamins and minerals are molecules that help biochemistry and they have the ability to modify those biochemical reactions and may need a different form of vitamin depending on a person’s genetics or whether things that are going on in their body. So, this idea of the right molecule the right dose at the right time is key as opposed to just taking any old thing and thinking it’s going to work. Does that make sense?

 

Dr. Nibber:

Well, absolutely. And I think these four Rs actually lend themselves to the ultimate goal for this industry and for health of individual is personalized nutrition. You only way we can do that is not just look at the but how to get that molecule at the right place and at the right time. So, these four Rs I think encompass the whole vision of AOR. It’s not just developing new molecules or uncovering new natural molecules but also how to get them in the body in the right dose. It’s a moot point or immaterial if we can’t, we have the right molecule but just not viable. It can’t be absorbed get to the place where it’s intended to.

 

Doug Cook:

Yeah. It reminds me the expression we used to say you are what you eat or in this case maybe take a supplement. But it’s really what you absorb and you utilize. So, going back to the original part of your story where you were being approached by people for requests for supplements and you mentioned that some of these weren’t even on the market yet or available through other routes. So, I’m wondering how then and today you learn about or decide what kind of innovative ingredient that you might consider in formulation or even when you reformulate an existing product. Because I’ve been following your products from using them myself for 15 it seems plus years and there’s been tweaks and things as we go along away which makes sense because science evolves. So, I’m just wondering how you decide on an ingredient or tweaks.

 

Dr. Nibber:

For me as a researcher, probably the most important and the fun part of my day-to-day work is to actually I come up with the ideas through just researching and reading. I spend all there just reading scientific papers. I love it. It doesn’t bore me and it’s very exciting to see that so much research is done by academics, universities throughout the world and yet they never get translated into opportunities to impact people’s lives in a positive way. Unfortunately, research is just published for the sake of publishing and then they move on because of pressures of publish or die kind of thing. But we uncovered very early on in my career that there are lots of opportunities through the published world. So, the first and foremost was well, read the papers and if there’s an exciting ingredient that does something to the body, reduce cholesterol, impacts the heart health or whatever it is, cognition and so forth, then you look at the safety of the product and you say okay, well, is this nutrient have safety and it’s safety, then it’s a goal to develop a product. Then obviously regulatory comes in, marketing comes in and formulation comes in. All those things come in but the starting point is just reading the research and there’s tons of research out there, exciting research.

 

Doug Cook:

Yeah. That’s something I think a lot of people don’t know. So, I’ve always been—well, today I’m more of an out of the closet supplement user. My profession has a resistance to supplement use even though 70% I think based on surveys of dieticians use supplements but they’re closeted. And it’s interesting how quick people are to dismiss whether something works or doesn’t work or a study without delving into doses. But to your point, there’s a ton of research out there that’s being missed and/or not being—well, being missed and also not being leveraged for the improvement of people’s well-being. So, yeah, it’s a bit frustrating for me for sure.

 

Dr. Nibber:

Yeah. I think the one also has to exercise caution just because there’s so much research. You have to sift through that and try to distinguish cream of wheat from chaff and say okay, what is relevant? Is this research robust enough? Is the clinical, human clinical—I mean it isn’t a basic study in a petri dish. Well, a petri dish is a petri dish. It’s not a human. Similarly with animal studies. Okay. It’s a great indicator but we’re not animals. We need human studies and sometimes you have to, you uncover well, this human study isn’t very robust. It’s very biased or it wasn’t properly conducted and so forth. So, there is still a lot of research that goes into deciding if this research is worthwhile pursuing form a formulation perspective.

 

Doug Cook:

That’s true. I completely agree with that but I guess what I was thinking about is even the stuff that’s out there in humans, people at least with my experience with my profession and others, there’s a lot of naysaying about that. But I guess you have to keep fighting the good fight.

 

Dr. Nibber:

Yes. I would say on that is absolutely. Well, there’s a question later on that you may ask but I think this industry has a battle to fight, a good battle as you say and that is to convince listeners, the pharmaceutical industry, pharmacists, professionals, regulators that there is good research, natural health product research that supports the industry. Yes, where you have to battle other issues, of course, but research is there.

 

Doug Cook:

Yeah. And as long as we have an open market, I hope that that doesn’t change here in Canada that we can keep having a safe and reliable market in terms of natural products, natural health products as they’re called here. But kind of along those veins, that vein, being in the business that you are, what would you say are or have been or continue to be some of the biggest barriers or challenges to supplement formulators in the natural health products industry? I mean I can think of a couple with Health Canada but you’re the expert and I just wondered if you’re comfortable talking about those challenges.

 

Dr. Nibber:

Well, indeed. I think the challenges are there. First and foremost, I think the industry is much maligned by different groups and in some cases, rightly so. If you look at the past, this industry unfortunately, the natural health product industry, there was a lot of wild claims, exaggerated claims, unsubstantiated claims which did not do justice to the industry which wasn’t very productive for the industry. And yes, I think the regulators had to come in. I think Health Canada coming in is not a bad thing. I think that’s a good thing. They establish standards for manufactures to meet and I think that’s a good thing. Consumers need to be satisfied that they are getting supplements or natural health products which are safe, which are efficacious and which do not have exaggerated claims. But the challenges are there. Challenges are from regulators. Challenges are from the medical community and the professional community of pharmacists. The challenges are they from the pharmaceutical industry and the challenges are there among consumers because we see these studies which sometimes are positive and then there is another study that’s very negative. So, we have to fight that fight. I think it can be done in the right way.

 

Doug Cook:

Yeah. When I think of Health Canada—I’m speaking for myself, I’m not putting words in your mouth—so something that really bothers me and I’ve always thought of Health Canada in many ways as a barrier to the health of Canadians. But I understand what you’re saying. Regulation was key. Before 2007, it was the wild, wild west before the natural product members came into existence. I remember all the different things that were on the market and who knows what was in those capsules. But when I think of something as simple and I’ll say benign as vitamin D because I’ve been obsessed with vitamin D for a long time, I’ve know Reinhold Vieth’s work and all the other vitamin D researchers. So, Health Canada is limiting vitamin D to a thousand units per dose. Above that, it’s considered a class A drug and so you can’t have vitamin D at 2,000 units or 4,000 units. As a dietitian, I can recommend four 1,000 units, for example. That’s okay. But if there was a product that snuck in, for example, that was 2,000 units from the U.S., I would be considered to be breaking the law if I recommended that one particular product. And then only to use this as an example, there’s a line of products from the U.S., they’re a liposomal formula and one of them is magnesium threonate and one of them is a B complex and a bunch of vitamins, all of which these nutrients are found in other supplements. So, it’s not a novel ingredient and this line, this particular company that I’m thinking about, already has four products approved and Health Canada has been reviewing these other two products, the magnesium theonate liposomal form and B complex for about three and a half years. All the company gets from them is oh, it’s under review. So, I sometimes wonder if we’re a little too reserved or a little too cautious there’s for sure a need for it but sometimes I wonder if that’s a big barrier to the industry that were just overly cautious as a culture in Canada.

 

Dr. Nibber:

Yeah, I agree with you. I think that is so while some having regulations is a very good, having standards to meet and exceed, you’re quite right. I think sometimes Health Canada is very cautious and that’s to the detriment of Canadians but also to Canadian innovation. So, whilst I’m a big proponent of Health Canada coming in, there are some negatives, yes. From a formulation viewpoint, taking the vitamin D example, that’s a very good example. Canadians need higher amounts of, more than 1,000 IUs. You’re right. Somebody can take four 1,000 IU pills but why not look at this research, Health Canada and then open this up. And I think in some ways this overly cautious approach of the regulators is very detrimental to the innovation part of Canadian companies.

 

Doug Cook:

Yeah. No, I would agree and it’s funny how some things just drag and then some things are approved very, very quickly. Without going into too much detail because I’m not asking you to review your proprietary steps but just to help listeners understand what goes into the formulating of a supplement from AOR, just for them to understand that the quality’s there, it’s a solid brand, what kind of things or what steps are taken to go from kind of idea to finished product?

 

Dr. Nibber:

Yes. It’s interesting. So, we always keep in mind the four Rs. How to get the right molecules in the right dosage. So, sourcing is very important, where do you get the ingredient and sometimes as an innovator, that’s always a challenge. You have to come up with it yourself. Obviously, because manufacture the actual ingredient but we have to source it or get a company to make that because the research has shown that this ingredient actually is very helpful. So, sourcing is the most important, getting the right molecule. Now take, for example, if it’s a herbal product, we need to make sure that this herbal product complies with what the researcher’s actually uncovered in their research paper which means the right part of the plant. So, if the research talked about the act is coming from the leaf or the root, we must use the root or the leaf, not just the wrong part of the plant.

 

So, sourcing is very important. And then the whole chain of custody, the transparency and traceability part so where does this product originate all the way up to the finished product. So, quality control, quality assurance programs are the most important. It’s great to be talking about a novel ingredient but then you have to make sure that this traceability part is always kept in mind and we’re true to that. And then, of course, a large part of that is quality control, the testing part where there’s heavy metals, microbial pesticides as well as the potency. And then finally to the finished product testing. Now it’s interesting to note that Health Canada allows a 20% variation and they will still accept that product. So, if you’re consuming say let’s take a very easy product, vitamin C, for example, they will allow and the label says 500mg, they will allow a 20% variation and they will still say that’s okay, acceptable for you to put that product. AOR’s internal controls, where we go plus or minus 5% because we believe 20% is a big variation. So, I think all those combinations of sourcing right up to the finished products and internal checks and balances that we’re pulling and the quality assurance program are very important.

 

Doug Cook:

That’s really important I think for consumers to understand is that you get a product, like you source it, maybe it comes from, who knows where it comes from, South America. It comes in. You test the product so you’re looking at like you said contaminants, heavy metals, other types of things before it goes into the formulation and that’s a crucial step that I think people aren’t thinking about because I hear people toss around oh, well, these products aren’t regulated and you don’t know what you’re getting and it’s just not true. So, that’s a key thing for consumers to understand. What I find really interesting is the point that you made about the variation. I knew that was the case with foods so if you look at a chocolate bar and it says 100 calories, I knew was anywhere from 80 to 120. So, I didn’t know that that applied for supplements as well. If it’s vitamin C, it’s not a drug obviously. So, it’s not the end of the world I guess but to know that you’re taking it even more tightly controlled to ensure that what’s on the label is the best in the industry is really encouraging for me to hear. I’m hearing this for the first time so I think that’s amazing that you do that.

 

Dr. Nibber:

Yes. I think, Doug, on that point, I would say if the natural health product or the supplement industry is going to convey the right message and fight all these challenges that are there from the regulators as well as from the consumers and the pharmacists, we have to follow the pharma model. We have to be very vigilant about checks and balances just like the pharma industries and that’s a good thing.

 

Doug Cook:

Yeah. No, I agree. I think it is a good thing. I didn’t mean to undermine your efforts. Like if somebody wanted extra vitamin Dan:, yeah, you want them to be getting close to whatever you’re recommending as practitioner, 2,000 units, 3,000. So, I didn’t want to make it sound like it’s not important. But yeah, it really should follow that model in terms of standardization for sure. Yeah, I’m just wondering with your work with consumers and other players in the industry and other health professionals, so what would you say are the misconceptions about supplements? Has it changed since you started this company? Are there any that are persistent? Anything that you think are easier to fix than others?

 

Dr. Nibber:

Yes. I think so. I think Health Canada imposing regulations from testing from quality is a good thing and that I think has brought the whole industry into a positive light. But challenges still remain. Consistency is a huge problem, traceability, these contaminants are always—I mean there’s challenges where it’s easy to get, the focus gets away from you when you are under pressure when people say well, release the product because otherwise we will go out of stock situation. And for companies to be responsible and say well, no, we cannot release this product because the testing hasn’t come in or the finished product analysis hasn’t come in or the stability data hasn’t come in which is another good thing that the industry has started developing.

 

There are challenges. And for example, AOR sometimes goes out of stock on a certain product and we get complaints from consumers. Well, why are you out of stock when others are not? Well, and again it’s part of our internal control system where the material is coming from say another country and has a toxin and it’s failing to pass the test and we cannot release it. But I think the biggest problem, another problem is unfortunately the whole industry is painted with the same brush across the world and we still have certain members of the industry that unfortunately do convey the wrong message where there’s still some claims of unsubstantiated claims which are not good for the industry.

 

Doug Cook:

So, a big misconception might be the claims and/or I guess what you’re saying about quality control or quality ingredients.

 

Dr. Nibber:

Yes, indeed. I mean and it’s easy to say I mean AOR, just looking at AOR, AOR spends a lot of resources towards quality control side because we do have a customer base to AOR brand as something that is going to definitely assist them in their wellness. And so, we spend a lot of time in ensuring that the quality is there, that the label claim is met, not just a plus or minus five% but inconsistency. For example, take a supplement, a multivitamin mineral that has 20 or 30 or up to 40 different ingredients, all the vitamins, all the minerals and other nutrients, the challenge is how to make sure that every capsule or every tablet that a consumer takes contains all those 40 or so ingredients, what the label is saying. It’s a huge challenge because it comes to part of the blending process, becomes a part of consistency and it’s a huge challenge even for the pharmaceutical industry. How for at least in the supplements, how do you make sure that every ingredient is the same especially in the multi ingredients.

 

So, a lot of effort is spent in there are how to get consistency. Those are challenges that the industry has to resolve quickly and work towards and that takes a lot of time and patience. So, for example, one of the things that we often get is well, why do I have to take six capsules to get my daily needs of a multivitamin mineral? Whereas I can go to another store, food and mass drug store that I can get one-a-day. Well, if you look at the research to get all the nutrients that the research is talking that the body needs, it’s virtually impossible to get it in one-a-day. So, unfortunately, we have been sold on these one of days which are not right. I mean so a lot of effort has to go into convincing consumers and everybody else well, this is the right ingredient formulated in the right way and we’ll give you what you’re looking for.

 

Doug Cook:

Yeah. And when people ask me something similar, I just say it’s an issue of real estate. I mean some of these molecules are big and they just can’t fit into a one-a-day. So, if you really want to get the proper formulation in adequate amounts, it might be a multi pill a day. For me, I find I don’t get it myself but I tell people because of Health Canada, take four 1,000 units of vitamin D and they’re like oh my God, it’s so many pills. I’m like well, just think of it as 20 minutes in the sun in July with your shirt off. So, that’s an aside but yeah, I find people, that’s a bit of a barrier for people to appreciate that it might take more than one pill. I think a big misconception for me and you will know this firsthand is this idea that they’re kind of quote all the same.

 

You alluded to it. So, why would I take yours if I can take a one-a-day and I think for me, when you look at the research, it’s like well, multivitamins in this study found didn’t do anything. But they’re not talking about well, what kind of multivitamin, what were the different formulas. You would never do that with a drug. Like you would just never use different strengths of Tylenol and say that it was effective or ineffective. So, I think there’s misconceptions around putting, as you already said, painting them with a broad stroke as they’re all the same. So, if one formula failed, they’re all useless. So, in thinking about that and thinking about all the products you have and all the research behind them, how would you see orthomolecular nutrition in this context, the right molecule the right dose at the right target tissue, etc.? I’m paraphrasing. What role do you see at play in health and wellness and disease and how can these products help people?

 

Dr. Nibber:

Yeah. I think a big role because the reality is the body is a fascinating but very complex physiological biochemical mix and you have to satisfy these right molecules and their doses so delivery systems come into play, targeting the right tissue comes into play. I mean we often think it’s a natural molecule so I’ll just take this supplement or something and I must be absorbing it. It must get to my sore knee or my elbow or my eyes or whatever and that’s not the case. The pharma industry struggles getting the nutrients, the drugs into the body in high enough doses so they can make an impact and the same applies to the natural health product industry. Just because they’re natural molecules doesn’t mean that they will automatically get to the body. So, delivery systems are a challenge.

 

So, following the four Rs I believe can make a and if you look at all of those aspects can make a big improvement on people’s lives in a positive way. Otherwise, unfortunately, we are left with these, when we often read about a study or this study has failed again, these natural health products studies or a multivitamin study or vitamin D study, all these failed because it was the wrong formulation. It was poorly formulated and it didn’t address all those four Rs, the right molecule in the right dose at the right place at the right time. We have to be true to those in order to make people’s lives better.

 

Doug Cook:

Yeah. And that’s a huge learning opportunity I think for me, the perfect example that I kind of informing my colleagues with is the role for higher doses of vitamin C in a bunch of cases. And so, what people don’t understand is you take vitamin C, it kind of peaks two to three hours after you take in your blood and then it returns to baseline about five hours later, six hours later. So, if you want slightly higher doses which research is supportive for various things, one well studied health condition is colds. It helps to reduce symptoms and duration. You kind of have to dose it several times through the day. So, this is I think a perfect example of the four Rs.

 

It has to be the right molecule, the right dose which will then certainly get to where it needs to be in a timely manner if the blood levels are slightly high enough. So, yeah, it really is much more nuanced and I think people think that it’s too good to be true that it can do what it’s supposed to do. They don’t understand the biochemistry of it. But how could one little vitamin or something—anyway, I’m kind of just thinking out loud because they don’t hold that same bias towards medication. Right? So, something as simple as one Tylenol can reduce a head pain. So, they’re both molecules. I think there’s a bit of a bias or prejudice or historical issue there. But I’m kind of digressing here. Did you want to say anything before I ask you another question?

 

Dr. Nibber:

No, I completely agree with you.

 

Doug Cook:

Yeah. And just on a side note, a little story. So, I work at a hospital and I wrote a medical directive for dietitians to—there was an existing medical director for multivitamins and I added on a handful more. I went to P&T which is pharmacy and therapeutics. It’s this big committee meeting, doctors, pharmacists, all that kind of stuff to argue my case as to why we should be able to do that and everyone was resistant. But eventually, it passed and I finally had to say like I think there’s a bias here. If you take a nutrient and you put it into a pill, people kind of get uncomfortable and lose their mind because they’re looking at it like a drug.

 

But nobody has a problem if dietitians order Boost or Ensure, forget that it’s full of sugar, which is a liquid multivitamin. But if I recommend a pill form, people just thought we were crazy. So, it’s just a lot of these weird misconceptions and conceptions, conceptualization around these products that people think that they’re like a medicine. So, just I wouldn’t mind spending a little bit of time talking about some of the products that I think are amazing which are really innovative and they really are great examples I think of North America firsts and/or world firsts. So, some of the ones from your website, some of the ones that I’ve used personally things are like D-Ribose, R-Lipoic acid—I don’t know how to pronounce this properly—is it benfotiamine?

 

Dr. Nibber:

Yeah. Benfotiamine.

 

Doug Cook:

Yeah. A form of curcumin. And what I think is the standalone global leader is Total E. So, which one of these were North American firsts or world firsts?

 

Dr. Nibber:

Well, all of them were and all of them are at least North American first. Take example D-Ribose you mentioned. That was a first in the world. So, this was a discovery in 1997 or 1998 and I was just reading a Scientific American and it wasn’t an article. It was just a short clip in there. I remember December 1990. I read it in 1990, it was from December 1990. And I was fascinated. It was talking about his natural sugar, a five-carbon sugar that some German researchers had used to treat dogs to prevent heart attacks. I thought this is really fascinating and then the article talk about it doesn’t cause any diabetes because it’s a five-carbon unlike sugars which are six-carbon molecule and it’s very safe.

 

It led me to believe well, what about formulating this product for heart disease or at least preventing heart disease or people taking it for heart health and unfortunately, at the time, there was no company in the world making this because it was a D-Ribose. And then I struggled because I can’t make it in my pharmacy. I came across a Dutch company that made it and we got it and we promoted it for this. That was the first product in the world. Unfortunately, it was so ahead of the curve, nobody understood it, nobody took it, they [inaudible 00:37:23] to the point that we were going to discontinue. I mean we continued but then 5-10 years later, the bodybuilding industry picked that up because it is an energy molecule. That’s why it prevents heart attacks and so forth. And then it became very popular. So, it’s an example where it was way out of time but still the right path to follow.

 

The lipoic acid, our lipoic acid was another first in the world. This was also early 2000-2001 I believe. Again, a lot of research was from Germany where they used alpha lipoic acid which is a mixture of two molecules, R and S isomers. Think of the left hand, right hand. And the research showed that the R isomers is the active whereas the S isomer, the other, the twin we call it, the good twin and the evil twin, doesn’t contribute much. So, we thought why not introduce a pure R form which will be more beneficial. So, again, that was a first in the world. And same with benfotiamine. Benfotiamine is a B1, a novel type of a B1 which is bioavailable, much more effective.

 

People didn’t know about it and what it does is something very interesting and that is whether we like it or not, we have high enough sugar in our diet and sugar binds to protein. Protein is everywhere. In our blood vessels, in our skin, in our eyes, muscles and so forth. It binds with to form and twists the protein structures and makes them inefficient or not functional. That’s called AGEs, advanced glycation products. And benfotiamine kind of undoes that, the protein sugar complex and brings the protein back to its natural state so it can function. So, we thought it was a very interesting discovery. And in fact, it’s taken us so long that we just wrapped up a clinic human clinical study which was a two-year clinical study at Cornell University on a high dose of benfotiamine for Alzheimer’s. so, the results of that hopefully will be published very soon.

 

Curcumin is a fascinating molecule which is turmeric, used worldwide. It’s probably the most studied natural health product on the planet and it’s got fascinating research. So, if any naysayer comes along whether it’s a regulator or whether it’s an academic, whether it’s a physician or there’s a pharmacist or whomever, there is tons of good research on curcumin. But the problem is how do you get this curcumin molecule in a high enough concentration so it gets to the body parts wherever it has to function whether as an anti-inflammatory, analgesic, heart health and so forth. So, we were able to develop a novel form. You mentioned liposomal, this company that is struggling to get Health Canada approval.

 

So, we developed a new form to be able to get it into the body in a high enough concentration so it gets to the relevant part of the body which I believe was a quite a novel discovery. And totally you mentioned is a fascinating molecule. Even today this mentality exists. If you go to a pharmacy or you go any place and you want to get a vitamin E, typically what you will buy, what is on the shelf is a 400 RU international units of vitamin E and if you look at the label, it says vitamin E with D alpha tocopheryl. That’s the chemical name of the vitamin E form. When we looked at the research, vitamin E is not a single molecule. That’s a misconception. Vitamin E is an orchestra. It’s eight molecules all acting uniquely, synergistically to give you the benefit of vitamin E. So, a lot of these vitamin E studies that fail is because it continued to use the single molecule which unfortunately is what is still being sold across the globe. Vitamin E is not a single molecule. It is a mixture of eight isomers of different molecules that interact with each other and give you the benefit. So, that’s why we called it Total E and I thought it was a good thing, a good introduction and a benefit. So, people consuming vitamin E, they can get optimal vitamin E through these eight isomers.

 

Doug Cook:

Yeah. And these ones I love, two in particular, the benfotiamine and—how do you pronounce it?

 

Dr. Nibber:

Yeah, benfotiamine.

 

Doug Cook:

So, I work in a psychiatric and addictions hospital and so people who come in with alcohol use disorder are automatically put on thiamine 100 milligrams three times a day. If they think the tank is really low, they get I think it’s 200 milligrams intramuscular or through a syringe because alcohol really depletes thiamine and we need thiamine in the brain to burn carbs for fuel and from what I’ve read, you’re the expert. This formula of B1 can do everything thiamine can do in terms of regular tissue but it’s much better at raising neuronal or cell levels including the brain cells of B1. So, I’m sitting there looking at this thiamine that’s being used and I’m thinking why, I bet we could get more bang for our buck if they were using the fat, well, they call it a fat soluble form of B1. So, I think there’s like major opportunities for tweaking a lot of the practice guidelines that we do.

 

Dr. Nibber:

Yeah. This is a good example, Doug, what you say. Benfotiamine is uncovering another form of natural vitamin which has largely been ignored and yet it fulfills the four Rs. So, it’s the right delivery. So, the challenge is as you mentioned, how do you get the right amount into the brain to be able to have a cognitive enhancement of neural, neuronal protection properties and this was one molecule. So, it’s an active form of B1 which gets into the brain.

 

Doug Cook:

Yeah. And I think I’ve read like it will raise B1 levels, intracellular B levels anywhere from three and a half to five times regular thiamine or in that ballpark.

 

Dr. Nibber:

Correct. Yes.

 

Doug Cook:

Yeah. The other thing that I don’t think there’s a product like Total E on the market and when I say I don’t think there’s a product like it, as you said, there’s eight molecules, four tocopherols, four tocotrienols. I grew up taking alpha tocopheryl. Thank God, it’s been flushed out because I’ve switched, out of my tissues. So, this is a great example of not revisiting history. So, vitamin E was discovered to prevent spontaneous abortions I think it was in rats or rabbits or something like that. So, all the focus of research was on alpha tocopherol and it hasn’t really moved. Like we really need to challenge assumptions and look at the history of a topic to better understand it. To this day, I mean I’ve written about it a little bit, none of my peers know anything about the four isomers and then what’s really unique about this because I’ve seen other products have called themselves Total E to some variation of that, they’ll have small amounts of gamma tocopheryl relative to alpha but if you take too much alpha, it displaces gamma from the cells from what I’ve read and you really need a lot more, I think it’s about twice as much gamma to alpha which this product has. Is that right?

 

Dr. Nibber:

Yes. Quite true. You’re right. I mean largely the vast majority the products on the shelves are alpha tocopherol. In a few formulations, they’re called mixed tocopherols. So, they may have just the four tocopherols in different rations like the alpha, beta, gamma, delta. But they’re just the four. You’re still missing the large four tocotrienols. So, you have four tocopherols and four tocotrienols. And Total E is a combination of both in the right doses. There’s not a kitchen sink form. Let me just throw in all these eight molecules and hope for the best. It’s as per what the research indicates and it’s eight different molecules. The tocopherols and the tocotrienols work synergistically in such a manner that yes, you get more bang for your buck as it were in terms of tissue concentrations, in terms of efficiencies of those Vitamin E molecules working whether it’s neuronal health, whether it’s the cardiovascular health or heart health and so forth.

 

Doug Cook:

Yes. That’s hugely important. It’s the only one I would ever recommend and it’s the one I take myself precisely for that reason and it’s shocking. I’m sure the formulators know about this. It’s just kind of shocking that they’re out there. I don’t know. I’m only speculating. Maybe they’re just moving products.

 

Dr. Nibber:

I was just going to say on that note, I mean we introduced this group I would say 18-20 years ago and it still hasn’t become the mainstream in terms of the concept of eight isomers you need. It’s not a soloist. It’s an orchestra. Now you will know this, back in the day over 200 odd years ago, the British sailors used to get a lot of scurvy. Then a physician came along and he uncovered that the cause of the scurvy, the teeth falling out and weakness of bones and skin and so forth was because of lack of vitamin C. So, they started giving—and that took a long period of time before the British Admiralty, the Navy introduced the findings of this physician and in that time period, a large number of sailors lost their lives because the research was there, the physician talked about it yet it wasn’t implemented. So, these are the challenges we do still struggle with. I mean we’re 200 years after that point and we’re still trying to get everybody on board to say okay, look, this vitamin E research says we need this yet we continue still to use all concepts and all ideas.

 

Doug Cook:

Yeah. Good point. I mean we are kind of slow to pick up on that. So, that makes perfect sense. So, just to as we kind of head into the home stretch here, so there’s a mix of listeners. There’s both professionals but there’s also public and AOR just isn’t for professionals. So, I’m just wondering what kind of learning and continuing education or opportunities are there for both the public and the health professionals alike?

 

Dr. Nibber:

Yes. There’s quite a lot. As you said, we have a professional line with a lot of webinars, we do podcasts, our website is informative, there’s a lot of clinical papers, at least research papers that are posted on there. There are blog articles, independent blog articles, not just AOR but just the industry. There’s two publications that we produce which one is called the Truth Series. It’s an unbiased account of a certain ingredient we take and what is needed. And then also there is Advances Magazine that we’ve had for over 20 years. Advances Magazine picks on ingredients among many novel and conveys the educational part of that research to all sorts of clientele whether it’s from a general public or whether it’s professionals. So, we believe all these things are contributing towards the expansion of the knowledge that is necessary. We still believe in the concept, the old whoever said this, it wasn’t Jack Kennedy but it’s attributed to him, that a rising tide raises all boats. So, education is a key component of that. We need to put the industry in a favorable light and it can only come through proper research whether it is communicating through these social blogs or websites or actual papers and Advances Magazine.

 

Doug Cook:

Yeah. Those are amazing. I’ve been looking at those for a really long time. They’re very, very detailed. They’re very research-based. In my mind, if somebody were to read any of these, I’m just looking at one here on cognitive health, it would leave little doubt in their mind of the role that natural health products, good quality natural health products could play in supporting people’s health for sure. So, yeah, it’s all under the website there, under learn and under blog. So, it’s laid out really, really well. I guess just wrapping up, is there maybe that we’ve already talked about it but I’m just wondered if there’s anything you wish people knew about the natural health products or what you’d like listeners to know about AOR and its products just as a bit of a summary I guess? I mean you’ve said it already.

 

Dr. Nibber:

Yeah. I would say these are exciting times for nutrition. There are challenges ahead but there is a lot of research. AOR in the last 30 years since its existence has collaborated with over 60 different academic research institutions all over the world, not just Canada and we continue to do that. We’re a firm believer that only through research with academia, with researchers can we come up with novel ingredients as well as give credibility to supplementation so that the regulators and the medical community, the pharmaceutical community can feel confident that this is another industry that is on the right path. Now we’re not making unsubstantiated claims and AOR, that’s part of AOR’s core strength is innovation. We know we cannot exist. I mean there’s a saying that from our academic world is you publish or you die. AOR has to continue innovative, innovation and it’s exciting for that. There are challenges. We don’t dispute that but I believe we’re on the right path. When I first came into this industry as a pharmacist, my goal was natural health products, why can’t we make them as effective as pharmaceuticals in a short period of time without the side effects? Why does ibuprofen work within an hour or so? Why can’t natural health products work without the side effects? It’s a goal but it’s a doable goal. We can achieve it.

 

Doug Cook:

Yeah. No, that’s an amazing summary and it summarizes why I think AOR is such an industry leader and why people need to know more about it if only to be patriotic I guess. So, where can people learn more about AOR and your amazing work? There’s the website for sure. Anything else?

 

Dr. Nibber:

Yeah. I think the website is the primary portal way they can get information. I mean we are based out of Calgary, Alberta and we have a 95,000 square foot state-of-the-art facility. But there are other social blogs and there are social media other parts like—I don’t know them off the top of my head but I’m sure they can be passed onto your listeners to learn about AOR.

 

Doug Cook:

Yeah. For sure, there’s Instagram and Twitter and the usual suspects. So, I just want to thank you for taking time out of your busy day. I know you’re all over the place fighting the good fight and promoting these amazing high quality products. I think people will be really, really pleased to hear what you’ve spoken today which will do nothing but instill confidence both in your product line but also in the industry. So, again, I just wanted to thank you for your time and to say keep up the good work.

 

Dr. Nibber:

You’re very kind and thank you for interviewing me. I really enjoyed it.

 

Doug Cook:

Me too. Thank you.

 

Dr. Nibber:

Thank you. Bye, bye.

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Doug Cook RDN is a Toronto based integrative and functional nutritionist and dietitian with a focus on digestive, gut, mental health.  Follow me on FacebookInstagram and Twitter.

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