To Supplement Or Not To Supplement? A Billion Dollar Question!
It’s amazing what people will eat.
That pig’s blood pudding on a traditional English breakfast plate or the deep-fried butter served at American state fairs?
I rest my case!
But how about the chemical somethings that have never been anywhere near a field, a ranch, or an ocean - the billions of dollars of multivitamins and other supplements we swallow annually in the hopes of everything from gaining extra energy to producing superior sperm, better bones or a terrific thyroid.
I say “we” because it really is most of us - last year around 75% of us diagnosed ourselves with a particular vitamin or mineral deficiency before we self-prescribed an over-the-counter (OTC) aid that truthfully, we knew very little about.
That’s more than the two-thirds of us who annually put our trust in a prescribed medication - a remedy selected for us individually, by our highly educated and experienced health care professionals after consideration of every aspect of our health history. We can be confident that our prescribed pill will contain only rigorously tested, active ingredients (and typically just one) that have been packaged into a tablet or capsule via a highly regulated, quality-controlled manufacturing process.
Contrast that with the supposed brain-supporting or probiotic supplement three-quarters of us threw into our supermarket basket. That OTC supplement will have had a fraction of the testing of our prescribed drug, may well contain more than twenty different and possibly interacting elements, and will have been manufactured in a much less regulated process than any pharmacy-only medication.
(I can’t help but note here the weirdness of people’s thinking – currently in the US only around 50% of adults have had sufficient confidence in the safety and effectiveness of the highly tested Coronavirus vaccines to be fully vaccinated whereas 75% of adults appear to have no such worries when it comes to using the very much less-tested and regulated OTC’s!!)
Back to the matter in hand.
What does science have to say about the need for these vitamins and minerals (micronutrients) and consequently, the wisdom of taking supplements?
Not as much as we might imagine.
Because it’s incredibly challenging to create the right experiments to help us find the answers.
For example:
· How feasible is it to have human guinea pigs (subjects) following completely identical diets, except for the single vitamin/mineral we want to study?
· How similar do experimental humans need to be? Whereas strains of lab rats are so genetically alike that they’re almost clones, human subjects are much more genetically diverse from each other and in addition, vary greatly with respect to body composition, activity levels, sleep habits etc – all aspects of our biological make up that could mean differing micronutrient requirements.
· How old should the experimental subjects be? For instance, the brain’s micronutrient needs might be very different in a questioning toddler compared with a moody adolescent or an exhausted parent, but I don’t see any ethics board agreeing to scientists deliberately manipulating the diet of babies!
· When humans are aiming for decades of va-va-voom, is a month-long experiment, even if carried out under perfect conditions, useful in predicting lifetime consequences?
· Finally, as most of these “experiments” don’t house their human subjects in a laboratory for days, let alone years, can we trust one of the major methods of collecting dietary data – asking the human guinea pigs to honestly complete surveys about what they ate?????????
So, about those RDA (recommended dietary allowance) values on the back of the multivitamin jar?
They’re guestimates.
Using the limited data from those imperfect experiments, a first number is calculated to which, just for good measure, a little extra is added and et voila, an RDA value is born. This guestimate value means it’s entirely possible that even if we’re not hitting the RDA value specified for a particular micronutrient, we may still be getting enough for our needs.
But, okay, let’s say we’ve been monitoring our diet and we’re confident that we’re not getting enough of a particular micronutrient, is a supplement the best way to improve our intake of the vitamin or mineral we’re lacking?
Probably not.
Take, for example, vitamins, A and K.
Both appear to reduce the development of heart disease, but this health-sustaining benefit was only seen in people eating foods rich in these vitamins, adding them via a supplement did not have the same disease-reducing benefit.
What if, rather than just no effect, there might actually be unhelpful interactions between different elements within these multi-nutrient containing supplements.
Take, for example, the minerals, zinc and iron.
The more zinc we swallow and move into our gut, the less iron that can move from our gut into our blood. A supplement containing both (which is almost every multi-vitamin!) could see us upping already acceptable zinc levels at the expense of our ability to absorb iron.
And for women of reproductive age? That could be absolutely the wrong way round!
Calcium supplements are widely used in an attempt to reduce our chance of developing osteoporosis and all its consequent problems; however, studies suggest that men taking large-dose calcium supplements may be more likely to develop and/or die from prostate cancer. Interestingly though, this increase in cancer was not seen in men who were supporting their inner framework with ……. a calcium-rich diet!
A conversation about supplements would not be complete with mentioning melatonin, not a vitamin or a mineral but a hormone produced by our brain’s pineal gland. Americans spend more than 800 million dollars annually to have more of this naturally occurring sleep aid and, to give it its due, melatonin does have a proven effect - on average, melatonin users get to sleep around seven minutes quicker and sleep for an extra eight minutes over the entire night.
I didn’t say it was a large effect!
For the one in three of us struggling to get a good night’s sleep, even that small benefit might be worth the pennies but disappointingly, there’s no guarantee of those additional zzz’s with every bottle – an analysis of more than thirty different OTC melatonin supplements found some tablets containing as little as one-eighth of the stated dose, whilst others were stuffed with almost five times as much as the supposed dose!
Perhaps even more concerning was the more than one-quarter of the melatonin supplements contaminated with serotonin, a worry as our brain produces and uses serotonin to manage various functions within our nervous system. Our serotonin brain levels are carefully managed as excess serotonin is linked to many types of ill health, including migraines and seizures - this really shouldn’t be something we are unknowingly dosing ourselves with.
Problems like the above melatonin-related issues have been found in other supplements like the several brands of echinacea and turmeric that not only didn’t match the stated dose, but worse, contained lead and bacteria, yeuch.
This will keep happening until OTC supplements are subject to the same level of scrutiny as medicines – that means better testing for both the effectiveness and side effects of these supplements as well greater oversight and quality control of their manufacturing processes.
As things stand today, the science points to eating as good a diet as possible as the best, lowest risk route to health.
And if we’re worried we might be short of a nutrient or two, we should adopt the same thinking for over-the-counter supplements as we do with prescribed medicines ….. discuss our concerns with a trusted health care professional!
Stay curious,
