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Supplements: Do we need them?

Nowadays, there seems to be a supplement for absolutely anything. Nutrients that normally come from your diet can be found in a form of pill, powder or gel, including vitamins and minerals, macronutrients and fibre. You just need to walk up a supermarket aisle to find an array of herbal supplements, homeopathic and natural remedies. These supplements promise to help aches, energy levels, digestion, provide eternal beauty and solve problems you didn’t even know you had. Trying to decide which supplements are needed for optimal health can be challenging: with the mixed messages from media, influencers, friends, and family, it can leave you confused about what you actually need. So let’s look at the research.

What are supplements?

The role of a supplement is exactly what the word stands for, to supplement (to complete, possibly to enhance). They can be used for a number of reasons: to add nutrients into a daily diet, to support recovery during injuries and illnesses or to enhance performance.

However, supplements are no substitution for a healthy diet.

So if you are looking for a quick fix to substitute your vegetable intake, unfortunately this is not the answer. Remember that supplements will never give you what a balanced and varied diet will. Food is designed to give us all the nutrients our bodies need.

How do I know if I need to supplement?

There is no general rule. When it comes to diet, we are all unique and have different dietary needs, depending on age, gender, ethnicity, lifestyle, and health conditions. The same applies to taking supplements. They can help support someone’s diet but if not used correctly, they can cause more harm than good. Therefore, before taking any supplement, talk to your GP, registered nutritionist/dietitian who can help you assess your needs and advise you on what is best for you.

Are there any specific recommendations?

Yes, it is recommended in some cases for example to prevent deficiency and here are the most common nutrients you should be aware of:

Vitamin D

Vitamin D is a fat-soluble vitamin important to help build and maintain strong bones and teeth, muscles, immune system and other metabolic functions. It is created in the skin by the action of sunlight which is the most reliable source. We can also get some vitamin D from food, such as oily fish, eggs, mushrooms, fortified cereals and dairy however, not in a sufficient amount.

Because we don’t get enough sunlight between the months October to March, everyone living in the UK is advised to supplement with daily 10ug of vitamin D3. Although we should be able to get enough vitamin D from April to September, it is possible we still may not be getting enough, especially due to restrictions caused by the pandemic therefore there is no harm in taking the supplement all year round.

Folic acid

Women who are pregnant or may become pregnant are advised to take a daily supplement of 400 micrograms of folic acid, until 12 weeks of pregnancy. This is to help baby’s brain, skull and spinal cord develop properly and lower the risk of the baby being born with neural tube defect.

Vitamins A, C and D for children

These are important nutrients, supporting healthy growth and development of immune system. As mentioned, the major source of vitamin D is summer sunlight. However, children should not spend too much time on a direct sunlight as their skin is very sensitive and burns easily. Although vitamins A and C are normally well obtained from a balanced diet, it is often hard with small children to get them eat a varied diet. Therefore, it is recommended that all children aged 6 months to 5 years should be given A,C,D vitamin supplements every day.

Who else may consider dietary supplements?

A well-balanced, varied diet can (theoretically) provide all the nutrients needed, but let’s be honest, it can be harder for some people than others. It may require knowledge and skills, effort, money and time.

Research shows that people who follow a vegan diet are at higher risk of deficiency, particularly of vitamins D and B12, long-chain omega-3 acids, iodine, iron, calcium, and zinc. This is not to say that it is impossible to get all the nutrients without animal-based product however, it requires more knowledge and planning and supplements can be useful or considered here. But before you embark on taking any, make sure to speak with your GP who can measure your nutrient blood levels and check for deficiencies.

Another example are sports athletes who may have specific nutrient needs and supplements offer a valid solution. However, a balanced diet should be always the basis of nutrition intake. Besides, there is only a handful of supplements with robust evidence to back their effectiveness and safety. Protein powder is well researched and can serve as an easy way to top up your protein intake. If your performance involves high-intensity activity, a supplement called creatine may be effective for increasing your strength and power. But many supplements lack research to back up their effectiveness, and some may even contain banned or harmful substances. Therefore, to ensure that any sports supplement is safe and beneficial to use, check the supplement certification and consult with a registered sports nutritionist.

What about natural supplements?

The fact that something comes from nature does not mean you need it, neither that it is safe to use. You may see claims like ‘boosting metabolism’ or ‘delay aging’, but there is generally very little evidence to back up any of these. More often than not, you will pay an awful amount of money for no proven benefits. Whilst you may think that there is at least no harm in taking herbal supplements, you should always check their legitimacy, especially if you are buying from the internet. Supplements from the UK should be well regulated, but anything produced outside may contain harmful ingredients and pose risk to your health.  Also make sure that you are not taking more than the recommended amount on the product label and always consult with you doctor if you take any medication or more products at once, as some supplements can interact with medication and could interfere with their effectiveness.

Take-home message

Most people can get all nutrients they need from a balanced diet and sunshine and supplements should be used only as an extra support, not a replacement. If you’re thinking about taking a supplement please, speak with your GP or a registered nutritionist/dietitian to ensure it is beneficial and safe to use.

 

References

Park, J. E., Pichiah, P. B. T., and Cha, Y.-S., 2018. Vitamin D and Metabolic Diseases: Growing Roles of Vitamin D. Journal of Obesity & Metabolic Syndrome, 27 (4), 223–232. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513299/

Pramono, A., Jocken, J. W. E., and Blaak, E. E., 2019. Vitamin D deficiency in the aetiology of obesity-related insulin resistance. Diabetes/Metabolism Research and Reviews, 35 (5). https://pubmed.ncbi.nlm.nih.gov/30801902/

SACN (2016) Vitamin D and Health [online] available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/537616/SACN_Vitamin_D_and_Health_report.pdf

SACN (2017) Update on folic acid [online] available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/637111/SACN_Update_on_folic_acid.pdf

NHS Choices, 2018. Vitamins for children [online]. Available at: https://www.nhs.uk/conditions/baby/weaning-and-feeding/vitamins-for-children/

UK Herbal Medicines Advisory Committee (2014) Safety, regulation and herbal medicines: a review of the evidence [online]. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/545681/HMAC_-_HerbalsafetyOctober2014Final.pdf

BDA (2019) Supplements: Food Fact Sheet [online]. Available at: https://www.bda.uk.com/resource/supplements.html

Kamangar, F. and Emadi, A. (2012) Vitamin and Mineral Supplements: Do We Really Need Them? International Journal of Preventative Medicine, 3(3): 221–226. Available at:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309636/

British Nutrition Foundation (2019) Factsheet – Food supplements [online]. Available at: https://www.nutrition.org.uk/attachments/article/1259/BNF%20Food%20supplements%20factsheet.pdf

Schüpbach, R., Wegmüller, R., Berguerand, C. et al. Micronutrient status and intake in omnivores, vegetarians and vegans in Switzerland. Eur J Nutr 56, 283–293 (2017). https://doi.org/10.1007/s00394-015-1079-7

Petti, A., Palmieri, B., Vadalà, M. and Laurino, C. (2017) Vegetarianism and veganism: not only benefits but also gaps. A review. Progress in Nutrition, 19(3): 229-242

 

Contribution from Magdalena Slavikova ANutr

 

 

 

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