Are Dietary Supplements Needed for Health?

The question often arises whether dietary supplements are needed to stay healthy.

While our bodies require a variety of nutrients to maintain health, the source of these nutrients is important.  As the name suggests, supplements are meant to complement a healthy diet not replace it.  Food should be our starting point because it contains a host of biologically active compounds (beyond isolated nutrients) that work together synergistically to build health, protect us from disease and enhance the absorption capacity of nutrients and phytonutrients. We don’t yet understand the full complexity of this interactive environment but we do know that it’s very difficult to replicate in a pill.

With this in mind, there are certainly instances in which dietary supplements may be both warranted and supportive of health. For instance, you may not be able to obtain sufficient amounts of a nutrient from your diet because both dietary sources of that nutrient are very scarce (for example: vitamin D) or because you are not eating sufficient amounts of the food source (for example: omega-3 fatty acids) or because your blood work reveals that you are deficient in a particular nutrient (for example: iron or vitamin B12).

Here’s a closer look at some of the more common scenarios:

• Vitamin D — in addition to its potential role in disease prevention, vitamin D is crucial for absorbing calcium (needed for healthy bones/teeth). Very few foods contain vitamin D naturally (salmon, tuna & egg yolks are among the few – milk & alternate milk beverages are fortified with vitamin D). Our best source of this mighty nutrient comes from the sun. During the non-summer months, when the northern latitude sun is not sufficiently strong, supplementation becomes necessary for most individuals to maintain sufficient levels. Required amounts will vary depending on a number of factors, including: age, weight, skin colour, geographic location and the amount of time spent outdoors.  Speak with your health care practitioner regarding appropriate supplementation and keep in mind that vitamin D levels can be easily tested through blood work.

• Omega-3 fatty acids — omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) have been shown to exert an anti-inflammatory effect on the body that are protective of heart and brain health. Several neuronal and cognitive functions depend on these fats to keep the lining of the brain cells flexible and communication fluid. The best sources of omega-3 fatty acids come from cold water fish — salmon, mackerel, herring, sardines, anchovies.  Plant-based omega-3 fatty acids (alpha-linolenic acid or ALA) can be found in flaxseed, flaxseed oil, walnuts and canola oil but they are less beneficial than those from fish because our body has to convert ALA into EPA/DHA, something it does not do very efficiently.  If you don’t eat fish (or eat very little of it), you may wish to consider a fish oil supplement (or algae-derived supplement sources of DHA for vegans). Like all things, individual supplementation levels will vary depending on health goals and needs (maintenance vs. therapeutic doses), so be sure to discuss appropriate levels with your health care practitioner.

• Iron – The most common deficiency implicated in fatigue is iron especially for menstruating women (with vegetarians and vegans being at higher risk).  Iron deficiency, even in the absence of anemia, can cause fatigue, lethargy and difficulty concentrating.  Iron occurs in both animal and plant foods (notably leafy greens and legumes) however plant-based sources are not as well absorbed due to compounds that bind the iron. To enhance absorption from plants consider cooked, soaked, sprouted and fermented sources which help release some of the oxalic/phytatic acids. Vitamin C is also an excellent way to enhance absorption of plant-based iron while calcium inhibits it so you can enjoy some sautéed spinach for example with sliced strawberry, red bell pepper and/or orange segments while avoiding cheese/milk at that particular time.  Iron levels can easily be tested through routine blood work.

• B12 — vitamin B12 occurs naturally in animal foods.  The two most common classes of B12 deficiency occur among vegans and individuals who have difficulty absorbing vitamin B12, including those over age 50. Certain medications also interfere with B12 absorption. Vitamin B12 deficiency puts individuals at a higher risk of developing B12 deficiency anemia a condition associated with symptoms that include: weakness, fatigue, confusion, depression and other neurological symptoms.  Due to poor absorption issues, B12 is commonly taken sublingually or in spray form.  If you are in a high risk class or suspect absorption issues due to symptoms, a history of intestinal disorders/medical conditions affecting the intestines (including bypass surgery) and/or family history, be sure to ask your health care practitioner to test your B12 levels through blood work. 

• Calcium — calcium is important for building strong bones/teeth in childhood and maintaining as we age.  Our bodies cannot make calcium, it must be acquired through our diet.  If we are not consuming sufficient amounts or our bodies are not absorbing enough (recall the vitamin D connection), we put ourselves at risk of developing conditions such as osteoporosis. Calcium rich dietary sources include dairy, fish (canned salmon & sardines with bones) and plants (notably dark leafy greens).  Alternate milk beverages are also generally calcium fortified. If you suspect dietary insufficiency, you may wish to discuss with your health care practitioner to determine whether calcium supplementation is right for you – this is particularly so given recent studies suggesting that calcium supplementation may have potential heart risks (more on this in the comment section below). Information on dietary sources, requirements by age category and concentration by food type here.

• Multivitamins – multivitamins are often viewed as an insurance policy to cover off on nutrients that may be missing from our diets (or depleted from our soils or diminished due to the long distances food has to travel to get to us).  The broad coverage offered in a multivitamin may also be supportive of those who lack appetite, are recovering from illness or are on a restricted diet. Seniors may also benefit from multivitamins as their ability to absorb nutrients from food often decreases with age.  Multivitamins may also be helpful during times of stress when our nutrient needs increase – this is particularly the case with B vitamins which are supportive of the nervous system and vitamin C which supports our adrenal glands (the glands that release stress hormones).

The information in this post is provided for educational purposes only and is not intended as a substitute for the advice of your physician. Dietary supplements can interact with some medications and taking any nutrient in excess amount can potentially lead to adverse effects, always consult your physician or other health care professional directly before beginning or changing a course of health treatment.