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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