Better Health & Living: Article: Get Smart About Supplements

Issue: October 2007

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Get Smart About Supplements

Is that vitamin pill you pop every day making you healthy?

by Elizabeth Somer, RD

Published in food+nutrition •eating_right •METRO •METRO Story | 0 Comments, Talk about this article »

I just know that if I miss my daily supplements, I’m destined for some unknown health disaster; I just don’t feel completely safe without them.

I’m not alone in that feeling. The Council for Responsible Nutrition (the professional branch of the supplement industry) estimates that 150 million Americans take one or more supplements daily. And given that new research suggests that some supplements, such as vitamin E, may be harmful, how do we know whether the $15 billion worth of supplements sold in this country every year are doing us any good? Here’s my take on this important issue.

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Do We Really Need Them?

Most experts agree that the best delivery method for nutrients is food. “Food is a complex package of vitamins, minerals, fiber, and thousands of phytochemicals that are important for health. With rare exceptions, there just isn’t the evidence to support supplements over food in optimizing health or preventing disease,” says Alice H. Lichtenstein, DSc, director of the Cardiovascular Nutrition Laboratory at the Jean Mayer USDA Human Nutrition Research Center at Tufts University in Boston.

Her colleague, Jeffrey Blumberg, PhD, agrees that food comes first. “That’s why they are called supplements, not substitutes.” But, he adds, there’s plenty of evidence that supplements help with not-so-perfect diets and may even lower risks for some health conditions, such as neural tube birth defects, macular degeneration, and osteoporosis.

The truth, according to every national nutrition survey, is that our diets are less than perfect. Most are sorely lacking in many nutrients, especially vitamins A, C, D, and E; the minerals calcium, magnesium, and potassium; and fiber. Studies have shown that only 3 percent of Americans follow four of the five Dietary Guidelines for Americans, which include recommendations for daily servings of fruit, vegetables, dairy foods, and protein.

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Take calcium, for example. The latest recommendations for women are easy enough to achieve if you drink three or four glasses of milk daily. For women who shun milk—and that’s many of us—the daily quota could be met by consuming 6 ounces of tofu, a can of salmon with bones, and 2 cups of black bean soup every day. In your dreams!

Folate (called folic acid in supplement form) is another case in point. “This B vitamin is of particular concern, since the average woman consumes only half the optimal dose,” warns Walter Willett, MD, DrPH, nutrition professor at the Harvard School of Public Health. Low folate intake increases the risk of neural tube defects (such as spina bifida), cancer, and heart disease. Dr. Willett recommends that all women take a multivitamin/mineral supplement, if for no other reason than to ensure they get enough of this important vitamin.

On the other hand, some supplements fall short on their promises. Researchers once believed that vitamin E could lower heart disease risk by up to 40 percent and possibly boost immunity and reduce risks for other diseases, such as cancer. More recent studies suggest that E’s health effects are probably modest at best, and some studies even suggest that taking more than 400 IU of vitamin E a day may increase your risk of disease and premature death.

The Bottom Line

Here are four rules for getting the most from your supplements at the lowest cost.

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Rule #1
Choose a multi. The best ones are balanced, moderate-dose multiple vitamin and mineral supplements that contain about 100 percent of the Daily Value—as listed on the label—of a wide variety of nutrients. Your age and gender may influence these recommendations.

Women: Studies show that one in every two pregnancies is unplanned, so all women of childbearing age should take a multi containing 400 micrograms of folic acid to prevent birth defects. Also, iron is the leading nutrient deficiency in premenopausal women; choose a multi with 18 milligrams.

Seniors: With each passing decade, you need more vitamins B12 and D, since the body becomes increasingly less efficient at making or absorbing these nutrients. In contrast, postmenopausal women and men need less iron than menstruating women and children; choose a multi that contains 10 milligrams or less.

Northerners: Our bodies make vitamin D when skin is exposed to sunlight. However, people living north of the latitude line running (generally) through Los Angeles and Atlanta typically are sun-deprived and are consequently low in vitamin D, especially during fall and winter. These low levels are associated with elevated risk of a variety of diseases, including osteoporosis, muscle weakness, gum disease, diabetes, insulin resistance, arthritis, multiple sclerosis, and certain cancers—including colon, breast, pancreatic, and prostate cancers. Current daily recommendations of 400 to 600 IU may not be adequate. “Some women require up to 1,200 IU to maintain optimal blood levels,” says calcium expert Robert Heaney, MD, of Creighton University in Omaha.

Rule #2
Take calcium and magnesium. All single-dose multiples are short on calcium and magnesium, so consider taking a separate calcium-magnesium supplement if you don’t drink three glasses of milk or eat several servings of magnesium-rich soybeans, wheat germ, and leafy dark green vegetables daily. You need 1,000 to 1,200 milligrams of calcium a day and 350 milligrams of magnesium from a combination of food and supplements.

Rule #3
Consider fish oil. The omega-3 fats in fish protect against heart disease, and preliminary research suggests they may also aid in preventing depression, osteoporosis, and arthritis. If you don’t eat two weekly servings of fatty fish, such as salmon or sardines, consider taking a supplement that contains the most potent of the omega-3s—DHA and EPA—at a dose of 500 to 1,000 milligrams

Rule #4
Contain costs and stay safe. Steer clear of supplements that contain “extra” ingredients such as lipoic acid, enzymes, primrose oil, or inositol, to name a few. Avoid timed-release vitamins and chelated or colloidal minerals. These extras add cost, not value, since they are either useless or typically supplied in amounts too low to be of use. Also, skip most “natural” products; they’re costly and usually provide no added benefit. Exceptions are vitamin E, selenium, and chromium; their natural forms appear to be slightly more potent than the synthetic versions. Play it safe and stick with nationally known, reputable brands, since they’re most likely to contain the amounts of nutrients listed on the label and least likely to be contaminated by harmful metals such as lead, according to a recent report from Consumer Labs.