To Supplement or Not to Supplement?

By Paulette Lambert, RD, CDE,  California Health & Longevity Institute, located within Four Seasons Hotel Westlake Village (chli.com). 

A glance at the vitamin and supplement aisle in any grocery or drug store is proof: the nutritional supplement market is booming. More than half the American population takes supplements in some form,1 and we are spending $27 billion annually on a wide array of products that includes everything from mineral and vitamin capsules to herbal remedies and protein powders.2

So why the rush to supplement? Many people believe that supplements can improve health, protect against disease, and, at worst, do no harm. But many of the claims made by manufacturers cannot be supported by science, and consumers are often unaware of drug interactions and other potential risks of using these products without a physician’s supervision.

Food First

What many people seeking to improve their health with nutritional supplements may not know is that a balanced diet is adequate to provide most of us with the nutritional support we need. Supplements are not the same as food; they cannot replace a well-rounded diet made up of real food that includes a large volume of fruits and vegetables. And while many of us pop supplements to counter poor food choices, the fact is that no supplement has all the properties found in real food; there are more than 8,000 known bioactive compounds in fruits and vegetables alone, offering a treasure trove of protective benefits.

More Is Not Always Better

While it may seem like a good idea to boost our health by adding more of a beneficial nutrient, problems, including cellular toxicity or poor absorption of other nutrients, can arise when you take a higher concentration of a particular nutrient in supplement form. A nutritional compound that may be beneficial as one component of a food can have a potentially negative impact in a higher, concentrated dose. It is a double-edged sword: a supplement we take in an effort to do our bodies good may actually interfere with protective processes that occur naturally. More is not always better.

Questionable Science

When a supplement is recommended, a specific scientific study will often be cited that describes the purported benefits of the supplement. But the studies referred to are not always based on sound science. For example, if we were to examine the fact that Japanese men have a much lower rate of prostate cancer and assume that it is because they consume a large amount of soy, that may not be correct. They also consume large amounts of fish, vegetables, and fruit—all which may be factors in the lower prostate cancer risk.

One reason for the jump to attribute scientific studies to various supplements is the potential financial returns on supplements in the lucrative US market; manufacturers want to cite studies to help market the supplements, so they push the results of studies that are sometimes incomplete, lack outcome data, and are not based on the rigorous human studies needed. For studies to be valid in nutritional science, they need to be complete and conducted over a sufficiently long period to offer results that can actually make a valid claim as to benefit or harm. Even the rather prolific research on multivitamins does not show a direct correlation to greater longevity. The bottom line: don’t assume that the studies used to market supplements are reputable or rigorous; think critically about any scientific claims made, and always discuss supplements with your physician.

Be a Savvy Consumer

As with claims about scientific studies related to various supplements, other marketing approaches should also be evaluated with a critical eye. When you see a claim on a package that states something like “supports breast health,” ask yourself, What does that actually mean? In all likelihood, at this time, there is no good evidence that it can lower the risk of breast cancer.

The nutritional supplement market has our attention, but research does not necessarily support the marketing claims about these products. Until we have more sound scientific proof that taking supplements provides real benefit, it may behoove us to focus more on the most optimal diet possible. Using real food instead of searching for a “magic pill” will likely provide more long-term benefit for our overall well-being.

Moderation and variety in the diet give us the nutrition we need. If you do feel the need for a supplement, consult your physician to avoid harmful interactions with other drugs you may be taking. If your physician approves, keep supplementation to a level that is found in food, avoid the “mega” levels often seen in nutritional supplements, and stay within the bounds of the daily recommended intake. Do not base your decisions on retailers; even more importantly, focus on what we do know about nutrition: a lifestyle that includes a high intake of fruits and vegetables and regular exercise to maintain a healthy weight is generally the best choice.

REFERENCES
1. NCHS Data Brief. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/nchs/data/databriefs/db61.htm. Accessed October 1, 2013.

2. 10 Surprising Dangers of Vitamins and Supplements. Consumer Reports website. Available at: http://www.consumerreports.org/cro/magazine/2012/09/10-surprising-dangers-of-vitamins-and-supplements/index.htm. Accessed October 1, 2013.

Nutrition through Real Food

Look to the garden for foods that offer vital nutrients easily absorbed by the body—and great taste. Eating a large volume of a variety of vegetables and fruits ensures adequate intake, promoting health and longevity.

Farmers’ Market Salad with Butternut Squash

Arugula is a leafy green that provides many powerful nutrients. Approximately 3 cups of arugula (three small handfuls) offers 16 percent of the recommended daily intake of calcium, 79 percent of vitamin A, 25 percent of vitamin C, 90 percent of vitamin K, and 24 percent of folate.

Dressing
2 tablespoons orange juice
2 tablespoons pomegranate juice
1 tablespoon walnut oil or olive oil
1 tablespoon water
½ teaspoon sea salt
½ teaspoon freshly ground black pepper

Salad
4 cups butternut squash, cut into ½-inch cubes and roasted
1 tablespoon olive oil
Pinch of red pepper flakes
½ teaspoon sea salt
1 bag arugula salad mix
½ cup feta or goat cheese, crumbled
¼ cup walnuts, chopped and toasted
½ cup pomegranate seeds (dried cranberries are an alternative)
3 tablespoons pomegranate molasses

Preheat oven to 400°. Toss squash cubes with olive oil, red pepper flakes, and salt. Spread squash in a single layer on a baking sheet and roast for 30 to 40 minutes, until tender and golden. Set aside to cool. (Squash can be prepared a day in advance.)

Whisk juices, oil, water, salt, and pepper in a small bowl. Set aside.

When ready to serve, toss arugula with dressing, place on platter, and arrange squash on top. Sprinkle with cheese, walnuts, and pomegranate seeds, then drizzle with pomegranate molasses.

Note: If pomegranate molasses is unavailable in your area, place one cup pomegranate juice in a saucepan and reduce over low heat for 20 minutes until thick and syrupy. Watch carefully to avoid burning.

Nutritional information:
Yield: 6 servings
Nutritional information per serving: calories 195; calorie equivalent: 1 carbohydrate, 2 fats, 2 vegetables

When Supplements Make Sense

While most of us can get the nutrients we need by eating a balanced diet that includes a high volume of fruits and vegetables, the following individuals may benefit from nutritional supplements:

  • Those who have a medical condition that restricts the intake of a healthy diet or that interferes with the absorption of nutrients, such as food allergies, gastrointestinal disease, or liver disease
  • Those on calorie-restricted diets, generally below 1,500 calories per day
  • Women who are pregnant or planning to become pregnant—a prenatal vitamin ensures adequate intake of certain nutrients
  • Those with very little exposure to the sun who may need vitamin D
  • Those over 50 who may need a Vitamin B 12 supplement due to reduced absorption with age.