Do we need supplements?
Dietary supplements are a hot topic in health and wellness! According to the NHANES 2003-2006, about 53% of adults reported using a dietary supplement and the most frequently reported supplement is a multivitamin. I believe that a certain population of people can benefit from taking multi-vitamin and mineral supplements to meet micronutrient requirements and maintain global and cellular health and function. However, I am still not fully certain there is enough evidence to support that nutritional supplements can prevent chronic illnesses and infections. After reading and watching the assigned videos, my personal opinion is that most people can benefit from supplements, provided that the usage and administration falls within the description of “intelligent allopathy.” This is a term I learned in the FDN program, which means refers to “targeted therapy”that will facilitate healing and restoration of normal cell function, organ function and system function. This type of supplementation is preferably conducted using data from lab testing to identify deficiencies and needs. With intelligent allopathy, a supplement fills a specific role to enhance an individual’s health by substituting for something an individual is lacking or supporting the function of their cells/organs/system.
The first questions I have often asked myself, how effective are the supplements? Bailey et. al (2012) examined vitamin intakes from food sources by dietary supplement use and assessed how dietary supplements contributed to meeting or exceeding the Dietary Reference Intakes for selected vitamins in the National Health and Nutrition Examination Survey (NHANES) 2003–2006. This study demonstrated that there were differences between men and women and the vitamin and mineral gaps varied. For example in the men studied, “the mean intakes of folate, vitamin A, vitamin E, and vitamin K from food sources were significantly higher among those who used dietary supplements.”(Bailey, Fulgoni, Keast, & Dwyer, 2012) However among the women studied, the micronutrient deficiencies included folate and vitamins A, C, D, and E. It can be inferred from the data from this study that women need an additional source of vitamin C and D compared to men, but both showed deficiencies in folate, vitamin A, vitamin E and vitamin K. These simple discrepancies in gender demonstrate that not all supplement users are equal, and therefore a one-size-fits all approach may not be suitable.
Interestingly, Bailey et al (2012) also noted that women aged 19 to 30 years exceeded the upper limit for folic acid, as a result of recommendations that women of reproductive age should supplement. However, this recommendation could be leading to a B-12 deficiency as excessive folic acid may mask hematological signs of a B-12 deficiency. “Thus, the use of dietary supplements has the potential to lower the prevalence of inadequate dietary intakes among adults for many micronutrients. Detary supplement use also has to potential to increase the risk of intakes above the tolerable upper intake level (UL).”(Bailey et al., 2012). Also, according to Barringer et al (2003), the extent to which deficiencies of micronutrients contribute to infections is not really clear. “Several studies indicate that vitamin supplementation may improve various immunologic factors. However, other trials demonstrated impaired immunologic response in participants who consumed larger than recommended quantities of certain nutrient supplements.” (Barringer, Kirk, Santaniello, Foley, & Michielutte, 2003). In their study, 73% of the placebo group experience one of more infection-related illnesses compared to 43% of the treatment group. This implies that supplements can prevent infections. On the contrary, Guallar et. al (2013) concluded “there was no clear evidence of a beneﬁcial effect of supplements on all-cause mortality, cardiovascular disease, or cancer.”(Guallar, Stranges, Mulrow, Appel, & Miller, 2013) In his bold and unforgettable statement, Guallar et. al (2013) stated:
The message is simple: Most supplements do not prevent chronic disease or death, their use is not justiﬁed, and they should be avoided. This message is especially true for the general population with no clear evidence of micronutrient deﬁciencies, who represent most supplement users in the United States and in other countries.
As a result, I am still on the fence as to the role supplements have in chronic illnesses. I believe that epigenetically –triggered illnesses are often related to micronutrient deficiencies, but my personal and limited experience has not yet given me enough confidence to conclude that dietary supplements have a significant role in prevention and management of infections and chronic illness.
In the video, Blumberg (2015) was able to indicate that regardless of the opinions against taking supplements, there are significant shortfalls where health adults are falling below the EAR, such in numerous micronutrients such as vitamin A, vitamin C, Magnesium, Vitamin D, Vitamin E, and Vitamin K. When the supplements users were compared to the non-supplement users, the supplement users showed a much less prevalence of falling below EAR, and according to Blumberg, “they are better off.” “We need to get more people using appropriate dietary supplements.” (Blumberg, 2015). The key word is “appropriate”, which from my perspective refers to “intelligent allopathy.” The main hazard of taking supplements, according to Blumberg, is that people continue their unhealthy lifestyle, but continue to take supplements in the hope that the supplements alone will keep them healthy. This is a valid point and definitely worth further investigation.
Finally, who can benefit from supplements? What population would benefit most? There seems to be two categories in the dietary supplement world: those who need them and those who probably do not. Barringer et. al demonstrated that elderly people, particularly those with diabetes, have impaired immune function and a higher prevalence of micronutrient deficiency. In their study, 93% of the diabetic participants in the placebo group experienced an infectious illness versus only 17% of the diabetics in the treatment group. Their trial did demonstrate a benefit in incidence of infection, but only among diabetics. “Our ﬁndings suggest that in certain diabetic samples, perhaps those with a high prevalence of micronutrient deﬁciency, daily use of a multivitamin and mineral supplement can decrease infection frequency.”(Barringer et al., 2003) Another older study conducted by Chandra (1992) showed a statistically signiﬁcant difference in the mean number of days with an infection-related illness in favor of the group that received the vitamin and mineral supplement. “In addition, participants in the treatment group had statistically signiﬁcant improvement in several reliable indices of immune function.”(Chandra, 1993) Therefore, there may be a population of individuals who can benefit from supplements.
In conclusion, I believe that supplements can be very useful. However, I do think they are often misused and can be exploited as a way to make profits. Evidence is demonstrating that many people around the world are deficient in many key micronutrients, despite a healthy whole foods diet. In today’s world and due to the resources of our food chain, it is almost impossible to obtain all the nutrients from food alone. Supplements can provide the missing link between what is necessary for optimal health and what is missing from our food supply, as long as it is done intelligently with a purpose to promote optimal health and healing.
Bailey, R. L., Fulgoni, V. L., 3rd, Keast, D. R., & Dwyer, J. T. (2012). Examination of vitamin intakes among US adults by dietary supplement use. J Acad Nutr Diet, 112(5), 657-663.e654. doi:10.1016/j.jand.2012.01.026
Barringer, T. A., Kirk, J. K., Santaniello, A. C., Foley, K. L., & Michielutte, R. (2003). Effect of a multivitamin and mineral supplement on infection and quality of life. A randomized, double-blind, placebo-controlled trial. Ann Intern Med, 138(5), 365-371.
Blumberg, J. (2015) Multivitamins in the Promotion of Optimal Health & Wellness. Nutrition Pro Series, Board for Certification of Nutrition Specialists. Retrieved: https://www.youtube.com/watch?v=tfTkO7MCVA0 (Links to an external site.)Links to an external site. (Links to an external site.)Links to an external site.
Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet. 1992;340:1124-7. [PMID: 1359211] 12.ChandraR.Nutritionandimmunityintheelderly:clinicalsigniﬁcance.Nutr Rev. 1995;53(4 Pt 2):S80-5. [PMID: 7644160]
Guallar, E., Stranges, S., Mulrow, C., Appel, L. J., & Miller, E. R., 3rd. (2013). Enough is enough: Stop wasting money on vitamin and mineral supplements. Ann Intern Med, 159(12), 850-851. doi:10.7326/0003-4819-159-12-201312170-000111