Eat Well to Be Well: Vitamin supplements – friend or foe?

The best way to get enough vitamins is to eat a balanced diet with a variety of foods. You can usually get all your vitamins from the foods you eat. Photos: CDC/ Debora Cartagena

Vitamin supplements – are they worth it or not? Vitamins are our ally as they are essential for good health and to keep us alive, yet they can be our adversary, turning into toxic chemicals that cause significant damage when taken in excess. Chances are all of us have ingested a vitamin supplement at some point in our lives, and nearly half of U.S. adults continue to do so today. But why? Is our food supply deficient in vitamins? What are the real health benefits of taking these supplements and how much do we really know about vitamins?

I was inspired to write this article after reading the book “Vitamania: Our Obsessive Quest for Nutritional Perfection” by journalist Catherine Price. This research-based publication takes the reader on an educational journey starting from the history of these vital micronutrients to the reasons behind why so many of us put more faith in popping a pill or downing a vitamin-charged drink than eating real food. To understand if vitamins taken in a supplement form is a good idea, let’s first focus on the questions that will aid in a well-informed decision.

What are vitamins? Vitamins are organic compounds, meaning they come from living substances (plants and animals) and contain carbon. They are vital to life and indispensable to body functions, needed only in tiny amounts and they contain no calories. Their main role is to facilitate chemical reactions in our bodies to keep us alive. There are a total of 13 vitamins necessary for human health.

How long have we known about vitamins? Not very long! The first vitamin was identified in 1897, just a little more than a century ago. Compared to the sciences of astronomy and physics, nutrition is still a young science. Since 1900 is when most nutrition research has been conducted. Vitamins were originally called “growth factors” than were labeled “vitamines” in 1912. The “e” of “vitamine” was dropped when it was discovered not all vitamins were amines or contained nitrogen.

041015-vitamins3What is a dietary supplement? According to the definition by the Food and Drug Administration, a dietary supplement is a product intended for ingestion that contains a “dietary ingredient” intended to add further nutritional value to (supplement) the diet. A “dietary ingredient” may be one or any combination, of the following substances: a vitamin, a mineral, an herb or other botanical, an amino acid, or a concentrate, metabolite, constituent, or extract. Dietary supplements may be found in many forms such as tablets, capsules, softgels, liquids or powders.

Can dietary supplements replace food? Thankfully no! Taking pill forms of vitamins will only provide what is stated on the label of the bottle. Dietary supplements were never intended to replace food. But there were two important discoveries made in the early 20th century that has propelled the vitamin supplement industry into the billion dollar business it is today. One, as vitamins were being discovered, the realization was made that many diseases people suffered from were actually vitamin deficiency diseases and now they could be treated and prevented entirely. Second, by the 1930s, scientists were able to synthesize vitamins in labs and put them in a pill form. Once this happened, consumers rushed to buy them not only to prevent nutritional deficiencies but also in hopes of better health.

Who may need to take a dietary supplement? There are certain situations where a person may need to rely on a supplement. Here is a list of people who may, and I emphasize may, need a supplement: People with nutritional deficiencies, women in their childbearing years, pregnant and breast-feeding women, infants, habitual dieters, the elderly, people addicted to drugs and alcohol, people recovering from a prolonged illness or injury, strict vegetarians, anyone with a disease where they don’t absorb nutrients properly, and anyone taking medications that interfere with the body’s use of nutrients. It is very likely that people who do not fall into the categories listed above can forgo supplements. In all cases, it is important to have an open dialogue with your physician about your current use of supplements and future personal considerations.

Are dietary supplements regulated by the FDA? Yes and no. Supplements are treated differently than prescription or over-the-counter drugs by the FDA. Dietary supplements do not require premarket review or approval by the FDA like drugs do. They do, however, need evidence stating their products are safe and the label claims are truthful and not misleading. But, the supplement can be marketed to the public without providing evidence of safety to the FDA beforehand. They are permitted to have health-related claims on their label, such as “supports heart health” but such a claim must be followed by the words, “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.” If a supplement is found to be unsafe or if supplement companies are making false or deceptive statements or promoting their product as treatments or cures for diseases, the FDA can take legal action to remove the product from the marketplace.

How effective are vitamin supplements? It depends. If you do have a vitamin deficiency, a vitamin supplement, in addition to eating rich food sources, will help you to correct the deficiency. They can also be useful in managing some health conditions such as taking folic acid to reduce the risk of birth defects or vitamin D in reducing bone loss. For most people who eat a nutritious diet, adding a supplement is not necessary. In fact, many food companies either enrich or fortify their products with vitamins and minerals, so most of us are already being supplemented without our own doing. Vitamins A and D added to milk and the B vitamins added to numerous bread products or breakfast cereals are just a few that come to mind. Given such widespread use of vitamin supplements, several studies have begun to question their effectiveness.

Researchers from John Hopkins University in Baltimore reported in the Annals of Internal Medicine that “most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided.”

Are there safety risks in taking a supplement? Definitely. One of the problems is the more-is-better philosophy. We all have a tendency to want to dose ourselves with just a little more in hopes that we’ll be healthier in the long run. Taking a vitamin supplement at or around 100 percent of the Recommended Dietary Allowance (RDA) should be fine. But taking above and beyond what the RDA states could have unexpected side effects. For example, taking vitamins E and C while being treated with chemotherapy can reduce the effectiveness of the treatment. Taking a high dose vitamin A supplement while pregnant can increase the likelihood of birth defects along with causing headaches and liver damage.

041015-vitamins2What are the demographics of people who take vitamin supplements? In a Gallup poll conducted in 2013, there were some eye-opening data collected to see who regularly takes vitamin supplements. Older Americans lead the pack. More than 50 percent of 50-64-year-olds and a solid 68 percent of seniors take a daily supplement. Only one-third of 18-29-year-olds buy supplements. Education and income play a role in determining supplement use. The more college education you have, the more likely you take a supplement. Fifty-six percent of people with household incomes of $90,000 or more per year have an increased usage of supplements. Who is more likely to use supplements, men or women? Women, with 54 percent taking a supplement compared to 46 percent of men.

In conclusion

Bottom line, vitamin supplements can be useful and necessary in certain situations. However, the vast majority of healthy people do not need to add these complements to their daily routine. Taking a vitamin supplement won’t make up for a poor diet. Our bodies want us to eat food and it will always absorb the nutrients from food much better than it will from a supplement. Eating a variety of healthy food will provide all the vitamins humans require in addition to other important substances such as phytochemicals that vitamin supplements don’t contain. Besides, I’ve never tasted a vitamin supplement that tasted anywhere near as good as food.

Sources: National Institutes of Health; “What Vitamin and Mineral Supplements Can and Can’t Do – WebMD; Nutrition and Diet Therapy, 6th edition. F.A. Davis Company; Food and Drug Administration; Nutrition Concepts and Controversies, 12th edition. Wadsworth.

Cheryl_Mussatto_pictureCheryl Mussatto MS, RD, LD, is a registered dietitian who is an adjunct professor at Allen Community College, Burlingame, where she teaches Basic Nutrition, and at Butler County Community College, Council Grove, where she teaches Therapeutic Nutrition. She is also a certified health and wellness coach. She writes Eat Well to Be Well, a column about health and nutrition, and may be contacted at [email protected].

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