“I’m pretty healthy and eat a good diet. Do I still need to take vitamins?” This is a commonly asked question, but one that has been hotly debated in recent years. On the one hand, statistics tell us that 40% of Americans take a daily multi-vitamin and a whopping 75% of the world’s population takes some form of dietary supplement. There are more and more supplements to choose from these days and many healthcare and nutrition professionals recommend them as part of their treatment plans. On the other hand, some experts say that even a daily multi-vitamin is not needed (or even harmful) for those who are generally health and eat a balanced diet. Still others say supplements aren’t worth the risk altogether because they aren’t regulated by the Food and Drug Administration.

While it is true that certain nutrients, such as iron and preformed vitamin A (retinol), can be toxic in large amounts and that some people may be taking supplements they don’t really need, it is simply not true that supplements are unregulated. Dietary supplements are regulated under the Dietary Supplement Health and Education Act. Supplement manufacturers are required to follow good manufacturing practices (GMPs). Additionally, there is a good deal of evidence to suggest that targeted supplementation can play an important role in overall wellness for much of the population. Here are 3 evidence-based ways that nutritional supplements may add to a healthy life.

Multivitamins: Nutritional Insurance

Unfortunately, many of the studies cited to make the case against taking a daily multi-vitamin have major design flaws, as discussed in an article by Harvard School of Public Health. When these flawed studies are taken out of the equation, there is very little evidence to suggest that a basic multi-vitamin (containing no more than Recommended Daily Allowances for nutrients) causes more harm than good. In fact, there is mounting evidence for the opposite – that micronutrient deficiencies can cause damage to DNA, leading to a host of chronic diseases, and that many individuals who take a daily multi-vitamin are healthier than those who don’t.

Even those who think they eat healthy should take a closer look. Research suggests that 90% of Americans do not get enough vitamin D or vitamin E and that older individuals (even generally healthy ones!) do not absorb B12 very well after the age of 50. Let’s say you are in the small percentage of people under the age of 50 that meets daily nutritional requirements through food. You may still benefit from taking a daily multi-vitamin. A landmark study published in the Journal of the American College of Nutrition showed that the nutritional content of foods is steadily declining with each passing decade, due to soil depletion from modern agricultural practices used to improve crop yield. Other studies have been consistent with this finding. Nutrients such as protein, calcium, phosphorus, iron, B2 and vitamin C have shown “reliable declines” since the 1950s.

Nutritional Support for Athletes

Athletes and those who exercise on a regular basis are a healthier subset of the general population and yet they have increased nutritional needs. In 2010, an extensive review was published in the Journal of the International Sports Society. The article summarized nutritional needs of athletes and evaluated the level of evidence supporting various dietary supplements marketed for athletes. Not all the supplements lived up to their claims and some showed promise, but need more research. But there were several supplements that were reported to be safe and effective for helping support athletes in the following categories – overall wellness (basic nutritional needs), immune support, joint protection, recovery, antioxidant support in case of over-training, protein synthesis, and energy availability.

Some of the supplements that received a good review were a daily multi-vitamin, omega-3 fatty acids, glucosamine and chondroitin, vitamin C, zinc, Echinacea, supplemental carbohydrates and protein, essential amino acids, creatine, and electrolytes. While some of these needs can be met through food, it is important to note between the increased need and the importance of the timing of nutrient intake, it is often difficult for athletes to achieve this solely through diet. Since nutritional requirements vary based on the type and intensity of the activity, active individuals should seek out the advice of a sports nutrition specialist or other knowledgeable professional for individualized recommendations.

Drug-Induced Nutrient Depletions

It is estimated that at least 50% of Americans (some sources say up to 70%) are taking at least one daily prescription drug. Many of these individuals would still consider themselves generally healthy. And even those who don’t take a daily medication may still take antibiotics or use over-the-counter medications from time to time. What many people do not take into consideration (including many doctors) is the potential for certain medications to deplete nutrients. Nutrient depletions can often explain side effects associated with certain drugs or at best can cause sub-optimal nutritional status, which may have negative health effects over time. After all, nutrients are needed to carry out metabolic processes in every cell of our body! Targeted supplementation to help counteract the effects of medications on nutritional status is another way dietary supplements can add to a healthy life.

Here are a few specific examples. Many people are aware that antibiotics can deplete “good” bacteria such as lactobacillus acidophilus and bifidobacterium bifido. Supplementation with probiotics (taken a few hours away from antibiotic doses) can help replace what is lost and minimize digestive distress. But antibiotics can also deplete B vitamins and vitamin K. Acid-reducing medications like proton-pump inhibitors and H2 blockers are also extremely common and may seem relatively harmless. However, these drugs can drastically reduce the absorption of certain nutrients such as B12, folic acid, iron, and zinc, due to the reduction of stomach acid. Older individuals are already at risk for B12 deficiency, so this can be particularly dangerous for this population. Other medications that are likely to cause nutrient depletions include statins, anti-hypertensives, beta-blockers, oral hypoglycemic, psychotropic meds, and hormone replacement therapy (different from bioidentical hormone replacement therapy). Even over-the-counter Tylenol can deplete glutathione, the body’s major endogenous antioxidant.

Other Considerations

There is more and more research being conducted on how various nutrients and other types of dietary supplements could play a role in preventing disease. For example, medium chain triglycerides may help ward off Alzheimer’s and omega-3 fatty acids may help prevent a wide range of inflammatory disorders. As our society becomes more educated about the negative effects of the “Standard American Diet” on health and the modern agricultural practices on nutrient values of food, supplementation may become less necessary. But as it stands currently, there are very few people who would not benefit from taking at least a basic multi-vitamin daily. Those who are active or use medications have additional reasons to consider supplementing their diet. If you do decide to begin a nutritional supplement regimen, make sure to check with your doctor or pharmacist on possible interactions with medications. Also keep in mind that supplements vary widely in quality. We also have a how-to guide on finding quality supplements.

References

1. https://www.scientificamerican.com/article/soil-depletion-and-nutrition-loss/

2. https://www.hsph.harvard.edu/nutritionsource/multivitamin/

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202787/

4. http://www.lifeextension.com/Magazine/2016/4/Fortify-Your-Life/Page-01

5. http://jissn.biomedcentral.com/articles/10.1186/1550-2783-7-7

6. https://nutritionreview.org/2016/12/practical-guide-avoiding-drug-induced-nutrient-depletion/

7. http://newsnetwork.mayoclinic.org/discussion/nearly-7-in-10-americans-take-prescription-drugs-mayo-clinic-olmsted-medical-center-find/

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