Revisiting Supplementation

23 09 2013

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Earlier this year I started up a short series on vitamin supplementation. Since this time I’ve read numerous additional articles and studies and thought it would be a good idea to post my latest thoughts on vitamin supplementation.

As I said in my first post, vitamin supplementation is not absolutely necessary for everyone and most vitamins and minerals should be achieved through eating a well-balanced diet of whole foods. Take the term supplementation literally; you should really only supplement with something if you cannot get adequate amounts from your diet. With this in mind, let’s start with the most commonly used supplement out there: multivitamins.

Multivitamins

Earlier this year, my general stance on multivitamins was that they were a good way to ensure intake of all vitamins and the benefits surely outweighed the risks. Even the Harvard School of Public Health agreed: “Looking at all the evidence, the potential health benefits of taking a standard daily multivitamin seem to outweigh the potential risks for most people.” However, the more I read, the more I become skeptical of effectiveness of multivitamin products. The major issues?:

  • Most multivitamins provide levels around the recommended daily allowance (RDA), which accounts for a minimum level of health, not an optimal level.
  • Most multivitamins contain a majority of micronutrients that are readily met through even the poorest of diets. You end up getting very little of what you actually need, and too much of what is unnecessary.
  • Multivitamins lack the other compounds of real food which are necessary for absorption and that contribute to optimal health.
  • Too much focus on including a plethora of vitamins and minerals, not enough focus on the necessary vitamins and minerals, nor optimal dosing.

I have multivitamins in the house, but I stopped taking them earlier this summer. When I stopped, there was no noticeable change in my energy levels, general well-being, or overall health. Instead, I began to concentrate on individual vitamins and minerals that are difficult to get through a balanced diet, which is now the recommendation that I would make for others. Multivitamins are great in concept, but their effectiveness has not been proven. Due to this, most people will be much better off spending their money on only the vitamins and minerals that are the most difficult to get, which include…

Vitamin D

The RDA for vitamin D is roughly 400-800 IU, but the optimal level is, at minimum, 2000 IU; as I mentioned in my post on Vitamin D earlier in the year, daily intake of closer to 4000 IU is recommended. The only people who do not need to concern themselves with vitamin D are those that live within the tropics and have frequent sun exposure with bare skin (wearing a t-shirt and shorts is not enough). For the majority of my readers, those of us in the northern hemisphere, vitamin D supplementation is absolutely necessary for optimal health, especially in the winter. Don’t overlook this important vitamin!!!

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Vitamin K

The RDA for vitamin K is roughly 60-120 mcg, and the optimal level is roughly 1000 mcg. The problem with getting enough vitamin K is that most foods containing the vitamin have very poor bioavailability, or in other words, the human body is simply unable to extract the full amount from the food. Due to this, supplementing with vitamin K might be necessary.However, if you eat a diet that contains a lot of leafy greens (kale, spinach, collards, broccoli, brussels sprouts, etc.) and lean animal protein (especially whole eggs), you likely needn’t worry about additional supplementation.

Iron

A friend of mine recently told me that she was thinking about getting an iron supplement. My reaction: Why? Her answer: Because a friend of mine said it helped with her premenstrual cramps. Okie dokie. Here’s the thing about iron: yes, it is a common deficiency (especially among women) in our society, but you shouldn’t start taking an iron supplement on a whim. I suffered from an iron deficiency for years, supplemented with over-the-counter pills and liquids for a few years, and since my levels returned to normal I have been able to maintain healthy levels of iron through my diet. The cause of my deficiency remains a mystery, but those typically at risk include children and pre-menopausal women, most notably those with diets restrictive of animal sources (vegans and vegetarians). If you suffer from the symptoms below, please consult your physician to see if iron supplementation is right for you:

  • fatigue
  • dizziness
  • pallor
  • hair loss
  • twitches
  • weakness

Calcium

Deficiency is common in older people and those with low dairy intake. If you do not consume dairy and do not eat a lot of kale, collard greens, broccoli, or other greens, you will almost surely be calcium-deficient. These whole foods contain far more bioavailable calcium than their supplemental counterparts, so increasing these foods in the diet should be option #1, but supplementing with a high quality calcium supplement could be a secondary option. My first suggestion would be to start with a whey protein supplement, as whey contains 20% of the RDA for calcium and also provides additional protein- something that will only benefit the body. If you are considering a calcium supplement, please first consult your physician; multiple studies have linked calcium supplementation with an increased risk of cardiovascular disease and several forms of cancer, so proceed with caution. Again, whole foods are the best choice.

Magnesium

I covered this in-depth in its own piece a few months ago, but long story short:magnesium supplementation can be quite beneficial for athletes. For the general population, if you don’t consume a diet that contains ample amounts of nuts, seeds, beans and/or leafy greens, you may very well be magnesium-deficient.

Fish oil/Omega-3

Yep, fish oil is important. Do it.

Yep, fish oil is important. Do it.

Essential fatty acids (EFAs) omega-6 and omega-3 are essential to human health and must be consumed in the diet. The North American diet contains a plethora of omega-6 foods, but very few omega-3s. An optimal ratio of the two EFAs is 1:1, so everyone should make an effort to eat fatty fish a few times a week or to supplement with a fish oil supplement. I covered this supplement here.

Creatine

Often thought of as a supplement for bodybuilders and gym junkies, creatine has gotten a weird reputation. Creatine is naturally produced in the human body and is a major component in supplying energy to cells, namely muscle. Yes, creatine has demonstrated reliability when it comes to things like overall power output and strength, but it is also very beneficial for people who do not frequent the gym. Non-meat eaters are a population that should surely be supplementing with creatine. As roughly half the creatine stored in the human body comes from the diet (which can only be derived from animal sources), vegetarians and vegans have significantly lower levels in their bodies. This can result in poor energy levels and decreased cognition. Creatine supplementation studies have shown a significant increase in cognition/intelligence, as well as the ability to ward off the symptoms of depression, most notably in vegetarian/female populations. If you are a meat-eater, you may not need creatine supplementation (unless you have personal strength goals at the gym, in which case you should definitely be supplementing), but for non-meat eaters, creatine supplementation should be seriously considered.

Aside from these supplements listed above, there really aren’t many other that I would advise looking into. One of my favourite online images will serve to give you a very good idea of which supplements can be trusted for what:

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The graphic isn’t perfect- for example there have been reliable studies conducted on magnesium demonstrating an increase in serum magnesium in the body, a decrease in blood pressure and an increase in aerobic capacity and muscle oxygenation- but it’s a nice overview with fairly accurate indication of what you should and should not spend your money on. In the end there are tons of supplements on the market claiming to do many things, but the reality of the matter is that most are good in theory, but poor in practice. Eat whole foods, do your homework, and if you are taking a supplement, be honest with yourself and listen to your body- are you actually getting any benefit from the supplement? If not, save your money and improve your diet!

For more information on nutritional supplementation, or for questions related to specific supplements, please feel free to post a comment below!

Happy Monday!

DW

 

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Supplements 101: Fish Oil

20 02 2013

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What is fish oil?

Fish oil (otherwise known as oil that comes from fish) is rich in two omega-3 essential fatty acids: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Much like omega-6 fatty acids, we cannot make omega-3 in our bodies, so we need to get them from our diet.

To refresh your memory (you’ve obviously already read my post on dietary fat), it is very easy for us to get omega-6 fatty acids in our diets as these are found in plant oils and corn-fed factory-raised animals (ie, most of the meat consumed but the average North American). Unfortunately, it is much more difficult for us to get omega-3 fats from dietary sources as we eat a lot more processed foods and a lot less wild game and plants than we did centuries ago. We evolved with an omega fat ratio of about 1:1; now it is closer to 1:20, in favour of the inflammatory omega-6 fatty acids. Due to the fact that omega-3 and omega-6 fatty acids compete with each other for space in cell membranes, and also for the attention of enzymes, this ratio matters far more than the absolute amount of omega fatty acid consumption.

NOTE: Eating a healthy diet of whole foods is more important than supplementation, but many whole fish sources are contaminated with environmental pollutions and offer lower-quality omega-3 fatty acids. Eating fish once or twice a week is still a good idea, but additional fish oil supplementation is recommended.

What are the benefits of taking fish oil?

DHA and EPA are very important for overall health, improving the functionality of the cardiovascular and nervous systems, as well as the brain. Omega-3 fatty acids have also shown to improve overall immune health. Low DHA consumption has been associated with memory loss, lack of concentrating, Alzheimer’s disease and other mood disorders.

Fish oil can help.

Fish oil can help.

Essential fatty acids also have an integral role in promoting cell health. Cell membranes in the human body are composed of a semi-permeable layer of fat (meaning it allows certain things into the cell but not others). If the ratio of omega-3 to other fatty acids is skewed in the direction of trans and saturated fats, the fluidity of cell membranes will be compromised. Neurochemicals like serotonin (which makes us happy) will therefore have a much more difficult time being properly transmitted. Sad face.

Cells also require omega-3 fats for optimal repair and regeneration (a continual and constant process in the human body), and DHA and EPA have also shown to increase metabolism by raising the levels of enzymes that boost calorie-burning ability and also to increase the insulin sensitivity of muscle cells (theoretically allowing the body to divert more nutrients to muscle tissue instead of fat cells, which also decrease in the presence of omega-3 fatty acids).

When should we be taking fish oil?

Fish oil can be taken in either liquid or capsule form. I prefer capsules, because the taste of the liquid can be rather overpowering- although there are some liquids on the market that taste less offensive than others.

The timing of when to take fish oils is irrelevant. Some people find it easiest to take a few capsules with every meal. I prefer to take mine exclusively after work, as I’ve found that they can sometimes leave a bit of a fishy smell on my breath.

How much fish oil should we consume?

It appears that even 1 g per day can be beneficial, but the generally recommended amount is 2-3 g per day- this is the amount I would recommend to the average person. However, I try to get 5-10 g daily and my friends over at Precision Nutrition recommend aiming for 6-12 g daily (about 3-6 grams of both EPA + DHA). These recommendations are more in line with people who are obese or severely overweight, or for people who are extremely active and put more strain on their body than most people (ie, athletes).

NOTE: Until quite recently I thought that 1 fish oil capsule (which contains 1 g of oil) equated to 1 g of EPA + DHA. This is incorrect. 1 capsule actually contains 180 mg of EPA and 120 g of DHA, or 300 mg of active omega-3 fish oil per capsule- which is standard. I was therefore only getting 1-3 g of fish oil per day until I made this realization. I am now taking strides to consume 20+ capsules per day to try to get the dosage I desire. 

The only time Arnold has ever been wrong.

The only time Arnold has ever been wrong.

Who should be taking a fish oil supplement?

Fish oil is one of only a handful of supplements that can literally benefit everyone. Again, we all typically consume too much trans fat, saturated fat and omega-6 fatty acids, so taking fish oil will help us balance out our dietary fat ratio and lead to an improvement in overall health, both physical and mental. I honestly recommend fish oil supplementation to everyone.

Aside from the benefit to the general population:

– People with coronary heart disease can benefit greatly from taking a fish oil supplement (please first consult your physician, especially if you are already taking heart medication)

– Athletes can benefit from the advantages in body composition and muscle synthesis provided by fish oil

– People suffering from arthritis should be taking fish oil for joint lubrication

How do I find a high-quality fish oil?

Here are some things to look for when shopping for fish oil:

– Make sure the oil comes from small-fish-based formulations (e.g. herring, mackerel). Small fish are lower on the food chain and less likely to accumulate environmental toxins. Another option is to choose krill oil or algae oil (these are the true source of omega-3, as they make up the diet of these small fish).

– Add up the amounts of EPA & DHA listed on the back of the product and make sure the total is at least 300 mg per 1000 mg capsule (30%)

– Choose a supplement company that doesn’t contribute directly to the depletion of fish (ie, they use primarily fish discards).

Other considerations

Find a liquid fish oil supplement that you can tolerate the taste of, otherwise you won’t use it. Capsules are another way to go, but you have to be prepared to take 10+ capsules a day to get the recommended dosage (or 20+ if you want the dose recommended by some nutrition experts).

Fish oil is one of the safest supplements on the market (people on blood-thinning medications should consult with a physician before use; fish oil toxicity can lead to severe bleeding).

You can also improve your omega-3:omega-6 ratio by doing the following:

– Avoid trans fats; they have nothing but detrimental effects on the body and can interfere with EPA & DHA, compromising cellular function and overall health.

– Use fewer omega-6 rich vegetable oils, which will negatively alter your fatty acid ratio.

– Eat less corn-fed factory-raised animals (buy local!)

That’s it and that’s all! For additional questions on omega-3 fish oil supplementation, don’t hesitate to post a comment below or contact me personally!

DW