Pills for every day of the week.
Filling your hand so to speak.
Pretty colors, round, oval, big, and small.
Gels, tablets, powders, liquids, bars line the wall.
Overwhelming choices to "improve" health.
How to choose one over another as I observe the shelf.
He said "this one", she said "that one", maybe all of them?
But alas, no fretting, this trend should be stemmed.
What are the upsides to this I ask?
Do I feel better or should I pass?
Do the results measure up to the hype?
Or do I continue to gripe?
But aha, no need to exhaust my wealth.
To reach maximum health.
Just pick the fruit and veggies over the junk food.
Mix em up, try new things, lots from which to choose.
Before long the produce replaces the supps.
Tastes delicious, makes me well, requires no more big bucks!
What's wrong with the picture below?
This is yet another installment of basic food knowledge and maybe the most confusing and least understood of all.
Vitamins and Minerals are key regulators of many bodily functions. They are micronutrients as opposed to macronutrients like protein and carbohydrates because the body needs them in smaller concentrations. Vitamins are organic compounds found in food and act as catalysts for biological processes we need to live.
According to the National Center for Complementary and Integrative Health (NCCIH), "Vitamins and minerals are essential substances that our bodies need to develop and function normally". The known vitamins include A, C, D, E, and K, and the B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxal (B6), cobalamin (B12), biotin, and folate/folic acid. Vitamins A, D, E and K are fat soluble; C and B vitamins are water soluble. Fat soluble vitamins can be stored by the body for months but water soluble vitamins are excreted and therefore do not remain in the body for long. If you have ever heard people talking about taking large doses of vitamin C it is because too much is just excreted and won't hurt you. This is not the case for the fat soluble vitamins. The dosage is important since they accumulate in fat tissue as they are consumed (1) .
Minerals are inorganic substances that help enzymes structurally rather than catalytically. A number of minerals are also essential for health, namely calcium, phosphorus, potassium, sodium, chloride, magnesium, iron, zinc, iodine, sulfur, cobalt, copper, fluoride, manganese, and selenium. The Dietary Guidelines for Americans 2015–2020 recommends that "people aim to meet their nutrient requirements through a healthy eating pattern that includes nutrient-dense forms of foods."(1).
According to Bloomberg (2), the supplements market (nutraceuticals) is projected to reach 71.4 billion dollars by 2028. This is a lot of money Americans spend, mostly unnecessarily, to supplement their diets. What did people do before vitamins were manufactured? Surprise surprise - they got their vitamins, minerals and fiber from the foods they hunted, gathered and ate.
"Awareness among consumers regarding health and wellness is shifting the trend toward the "Prevention better than cure" ideology. This has resulted in more consumers relying on nutraceuticals, functional foods, and dietary and vitamin supplements to lead a healthy and disease-free life". Some examples include:
💊 spices used for medicinal purposes, e.e., ginger, turmeric and mushrooms in pill form or to add to your coffee
💊probiotics and prebiotics
We want a quick fix. Why bother worrying about the food we eat when we can pop a pill or take a powder and be done with it?
Our lifestyles are dramatically different from those of the hunters/gatherers but we can't evolve to embrace our current food practices as fast as our lifestyles have changed. So there is a disconnect between what our bodies need and expect from what we give them.
There are supplements for everything:
💊busting free radicals floating around our bodies
💊depression and anxiety
💊cancer prevention and treatment
We face difficult choices when deciding what supplements to take.
Note: this segment does not address prescription or over-the-counter medications.
You could spend a good chunk of your life researching which supplements you should be taking. Walk into any "health" store and the shelves are FULL! If you read the literature you will be more confused than ever. Supplements are often advertised as having amazing results and if you believe each claim, you will be taking a myriad of additives a day. How will you ever measure the benefit or harm of each? At the very least do not start taking many supplements at once.
One thing to note is that if a supplement makes claims about results you can expect, such as a cure for an illness, or to lose 10 pounds in a week, the company must be able to back up the claim (3).
Here's the rub (4). Vitamins and minerals are not absorbed by the body in the same way from a supplement as they are from food. Absorption will vary depending on a host of factors so no claim is going to apply to everyone or even a majority of people. Vitamins and minerals are also not regulated like prescription medications. It is very difficult to provide accurate advice about which supplements would benefit you, which could be harmful, and the outcomes you should expect.
There was a period when I spent an inordinate amount of time researching supplements and determining which ones I should take. Every time I heard of a new one and "what it could do for me" I would say - "oh yes, I definitely need that one". Before I knew it I was taking 6 different supplements, it was very expensive, and I had no idea which were making a difference. Finally I hit 🛑! The manufacturers are getting very rich and I was getting poorer.
Food also provides more than just vitamins and minerals. Fruits, veggies and whole grains provide natural fibers that cannot be replicated by drinks, pills, and powders. Fiber is a very important component of our diet. There are claims that Americans don't get enough fiber but that indicates that they are not eating a healthy well-rounded and varied diet.
There are a couple of important things to know.
1.Supplements do not replace the vitamins and minerals in food. The best way to get what you need is through eating a healthy, balanced, and varied diet rich in color - red, green, yellow, purple, etc. For example, if you dislike all green vegetables and you think you can take supplements to mimic the effects of eating the spinach, broccoli, kale etc. you are mistaken. Habits can be changed but you have to give them a chance. If you are willing to experiment with food preparation, you may find one for a green leafy vegetable that you can enjoy and gradually even crave. That may sound crazy right now but those foods are truly the only ones that I crave now.
2. MVMs stand for multivitamins/multiminerals. "Taking an MVM increases overall nutrient intake and helps some people get the recommended amounts of vitamins and minerals when they can’t or don’t get them from food alone. But taking an MVM can also raise the chances of getting too much of some nutrients, like iron, vitamin A, zinc, niacin, and folate/folic acid, especially when a person takes more than a basic, once-daily product that provides 100 percent of the daily value (DV) of nutrients."There’s no standard or regulatory definition for MVMs, or any dietary supplement, as to what nutrients they must contain or at what levels. Manufacturers choose which vitamins, minerals, and other ingredients, as well as their amounts and fillers, to include in their products. Simply stated, dietary supplements aren’t required to be standardized in the United States. However, they are required to bear a Supplement Facts label and ingredient list describing what’s in the product. (3)
Here are just a few of the many questions you should ask a trustworthy source to glean information before taking anything.
What complementary food (s) are required for maximum absorption? When should you eat that food? Should you take the supplement on an empty or full stomach? Morning, afternoon, evening?
What medications and other supplements are you taking that might interact or interfere ?
What dosage should you take?
What are the side effects of the supplement(s)?
Is there a limit to how many unique supplements you should be taking and if so, how do you choose?
Based on your reason for taking the supplement, how will you judge its efficacy?
What brand is best? Do you trust the manufacturer?
What additives are used for consistency, color, complementary effects, etc.?
Is there a risk to suddenly stop taking the supplement?
Why are you taking this supplement?
Many food labels and marketing campaigns tout fortification of their foods with vitamins, minerals and fiber. For example, most commercially available cereals are fortified with vitamins, minerals and even protein. Eating unprocessed grains do not require fortification as all nutrients remain in the food, rather than being stripped out and then added back in supplement form. Taking an MVM a day is probably not harmful but you have to evaluate it in light of your diet, and other supplements and medications you are taking.
Some additional considerations include (5,6):
1. Most research shows that taking multivitamins doesn’t result in living longer, slowing cognitive decline, or lowering the chance of getting cancer, heart disease, or diabetes.(4)
2. What’s on the label may not be what’s in the product. For example, the FDA has found prescription drugs, including anticoagulants (e.g., warfarin), anticonvulsants (e.g., phenytoin), and others, in products being sold as dietary supplements.(4)
3. Advertising/marketing is misleading. Statements such as " provides 50% of your daily iron requirement" is an attempt to make you believe that a handful of pills can replace the nutrients in food. Unless you are willing to find out exactly how that company arrived at the claim and duplicate it exactly, which is nearly impossible, you can't apply the claim to yourself. Natural does not mean safe. Health claims provided on packaging is regulated by the FDA but the problem is that the supplements they test are different than the ones you may be taking and they are tested in isolation so don't include other supplements or foods that may impact effectiveness, dosage, and safety.
4. There are so many other factors that contribute to your health. How can you possibly know how the supplements figure into your health quotient?
A note about RDAs (Recommended Daily Allowances) (7).
Recommended Dietary Allowances (RDAs) are the levels of intake of essential nutrients that, on the basis of scientific knowledge, are judged by the Food and Nutrition Board to be adequate to meet the known nutrient needs of practically all healthy persons.
The first edition of the Recommended Dietary Allowances (RDAs) was published in 1943 during World War II with the objective of “providing standards to serve as a goal for good nutrition.” It defined the recommended daily allowances for the various dietary essentials for people of different ages” (NRC, 1943)
From their original application as a guide for advising “on nutrition problems in connection with national defense,” RDAs have come to serve other purposes; for planning and procuring food supplies for population subgroups, for interpreting food consumption records of individuals and populations, for establishing standards for food assistance programs, for evaluating the adequacy of food supplies in meeting national nutritional needs, for designing nutrition education programs, for developing new products in industry, and for establishing guidelines for nutrition labeling of foods. In most cases, there are only limited data on which estimates of nutrient requirements can be based.
It is not possible to set RDAs for all the known nutrients. However, the RDAs can serve as a guide such that a varied diet meeting RDAs will probably be adequate in all other nutrients. Diets should be composed of a variety of foods that are derived from diverse food groups rather than by supplementation or fortification and that losses of nutrients during the processing and preparation of food should be taken into consideration in planning diets.
Buyer beware. RDAs are complex calculations. They have become buzz words in the drug and food industries. Be wary of RDA claims for any supplement.
Are you more confused than ever?? Use the confusion opportunity to change your dietary habits. I am not suggesting that all supplements are bad and that there are no times when a supplement may really help. It is critical however, to do your homework, work with a knowledgeable professional and don't start taking something without questioning and subsequently measuring its effectiveness. Most importantly, you should not be taking supplements to compensate for a poor or deficient diet. They may be pretty but they aren't harmless.
(3). Larson-Meyer, D.Ennette, PhD, RDN and Ruscigno, Matt, Plant-Based Sports Nutrition, Human Kinetics, 2020, chapter 8.