Are dietary supplements necessary?

30/06/2022   Aliments et Santé   Régime   1033   Nikki Kovac

Vitamin D and fish oil supplements may offer protection against disease

Are dietary supplements necessary?


The dietary supplement industry is a multibillion-dollar business. It’s no wonder supplements are so popular. With claims such as “lowers inflammation” and “improves heart health”, who wouldn’t want to simply pop a pill that promises to boost health and lower the risk of disease?
In many countries, supplements do not fall under the same guidelines and regulations as do medications, meaning that the claims on the labels aren’t necessarily substantiated by evidence, nor even truth.
The scientific research on supplements is confusing and often contradictory. Few, if any, conclusive studies exist on the subject. So, who needs dietary supplements, and can dietary supplements really prevent disease and improve health?

Who Needs Dietary Supplements?

Since dietary supplements lack important components present in food, such as fibre and phytonutrients, they are not a replacement for a healthy, balanced diet. You should aim to get all your daily nutrients from diet alone.1 There is no added benefit to exceeding the recommend daily allowance (RDA) of vitamins and minerals.2 If you have a good diet and are absent of disease, you can most likely save your money and skip the supplements. In addition, studies have found that some supplements negatively interact with each other. For example, one study found that supplements that contained both vitamin D and calcium decreased health. This health risk did not exist for individuals who took separate vitamin D and calcium supplements.3 Since these findings have not been universally reproduced, no conclusive statements can be made. The bottom-line is that these negative interactions do not exist in food.4 Furthermore, overdoing certain vitamins/minerals can be harmful to your health. It is especially important not to overdose on fat-soluble vitamins, like vitamin A, D, E, and K. Excess amounts of fat-soluble vitamins are stored in your fat tissue and can accumulate to toxic levels.5 For example, surpassing the RDA of vitamin A has been linked increasing a smoker’s risk of lung cancer6 and overdosing on one form of vitamin A (retinal) while pregnant causes a greater risk of birth defects.7
However, dietary supplements may be necessary to treat or prevent deficiencies in individuals who are unable to reach the RDA of certain vitamins/minerals. Deficiencies may result from diet, age, illness, etc. Blood tests can be used to detect deficiencies. It is also important to note that supplements can have negative interactions with certain medications. Consult a healthcare provider to determine if taking supplements is right for you.

Common Vitamin and Mineral Deficiencies

Vitamins and minerals are micronutrients. As their name suggests, micronutrients are needed in micro or small amounts by the body. Despite the small amount, micronutrients play a crucial role in the proper functioning of the body. Deficiencies in micronutrients can have devastating effects and can lead to disease. Pregnant women and children as well as those living in lower income areas are at higher risks for micronutrient deficiencies. According to the WHO, the most common deficiencies worldwide are iron, iodine, and vitamin A.8 Deficiencies in B12 and vitamin D are also common in some parts of the world. See below the role that each of these five vitamins/minerals have on the body and the possible symptoms of a deficiency.

Iron

What is its function in the body?

  • Component of hemoglobin (a protein found in red blood cells that transports oxygen)
  • Essential for the production of certain hormones and other proteins9

Major Food Sources

  • Fortified grain products
  • Beans
  • Lean meats
  • Spinach
  • Nuts9

Who is most at Risk for Deficiency?

  • Children
  • Pregnant Women
  • Women with heavy periods
  • Individuals with gastrointestinal problems9

Symptoms of a Deficiency

  • Fatigue and weakness
  • Chest pain or shortness of breath
  • Pale or yellow skin
  • Abnormal heartbeat
  • Headache and light-headedness
  • Cognitive impairment
  • Gastrointestinal problems
  • Higher susceptibility to infections
  • Decreased ability to moderate body temperature9,10

Supplement Tips

  • Choose an iron supplement that contains ferrous iron over one that contains ferric iron as ferrous iron is more easily and better utilized by the body
  • Avoid taking calcium with iron supplements as calcium may inhibit iron absorption9


Iodine

What is its function in the body?

  • Needed to make certain thyroid hormones
  • A deficiency can lead to nervous system disorders and mental impairment during child development11

Major Food Sources

  • Seaweed
  • Seafood
  • Eggs
  • Dairy products
  • Iodized salt11

Who is most at Risk for Deficiency?

  • Pregnant women
  • Infants11

Symptoms of a Deficiency

  • Hypersensitivity to cold temperatures
  • Fatigue
  • Weight Gain12

What is its function in the body?

  • Important for cell growth and the development and proper functioning of organs such as the heart and lungs
  • Helps maintain good vision and eye health
  • Helps support a healthy immune system
  • Supports good reproductive health13

Major Food Sources

  • Animal products
  • Green-leafy vegetables
  • Orange and yellow vegetables13

Who is most at Risk for Deficiency?

  • Children
  • Pregnant women
  • Individuals living in under-developed countries13

Symptoms of a Deficiency

  • Vision problems
  • Increased susceptibility to infections
  • Stunted growth14


Vitamin B12

What is its function in the body?

  • Plays a necessary part in the formation of red blood cells and DNA
  • Helps to maintain proper nervous system functioning15

Major Food Sources

  • Animal Products (meat, fish, milk, eggs, etc.)
  • Fortified Foods (cereal, nutritional yeast, etc.)15

Who is most at Risk for Deficiency?

  • Individuals who follow a vegetarian/vegan diet
  • Individuals with pernicious anemia
  • Individuals with gastrointestinal problems
  • Older Individuals15

Symptoms of a Deficiency

  • Swollen/inflamed tongue
  • Fatigue
  • Pale skin
  • Cognitive impairments
  • Mood changes
  • Limb numbness/tingling
  • Weight loss
  • Reproductive problems15


Vitamin D

What is its function in the body?

  • Helps the body absorb and maintain good levels of calcium and phosphate (promotes good bone health)
  • Aids in the body’s immune response
  • Helps lower inflammation16

Major Sources

  • Sunshine
  • Foods that naturally contain vitamin D are limited (oily fish and mushrooms are the notable sources)
  • Fortified foods (milk, orange juice, etc.)16

Who is most at Risk for Deficiency?

  • Older individuals
  • Individuals with darker skin pigmentation
  • Individuals with a high BMI
  • Individuals living in cold, dark climates
  • Individuals who avoid the sun and/or use lots of sunscreens16

Symptoms of a Deficiency

Supplement Tips

  • Chose a supplement that contains vitamin D3, cholecalciferol, over one that contains vitamin D2, ergocalciferol, as it can be better absorbed and utilized by the human body.18 Vitamin D3 is the same by-product that the body creates from absorbing the sun’s rays, while vitamin D2 is the by-product of a plant’s response to UV radiation.19

Can Dietary Supplements Prevent Disease?
Most vitamin and mineral supplements, if taken for preventative measures, show no health risk, and unfortunately, no health benefit.3 However, the results of a randomized controlled trial published on January 26th, 2022, showed promise that Vitamin D and fish oil provide protection against developing autoimmune diseases. Over the five years of the study, Vitamin D supplementation, taken with or without fish oil, reduced autoimmune disease in individuals 50 years of age and over by 22%.20 The cause of autoimmune disorders is currently unknown, and as a result, so are preventative measures. More research is required in this area; however, these findings could help to uncover the acting force behind autoimmune disorders and will likely lead to more research into the possible preventative benefits of supplements.












References
  • Chen F, Du M, Blumberg JB, Ho Chui KK, Ruan M, Rogers G, et al. Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study. Ann Intern Med [Internet]. 2019 May 7 [cited 2022 Jun 15];170(9):604-613. Available from https://pubmed.ncbi.nlm.nih.gov/30959527/ DOI: 10.7326/M18-2478.
  • Institute of Medicine (US) Food and Nutrition Board. What are Dietary Reference Intakes?. Dietary Reference Intakes: A Risk Assessment Model for Establishing Upper Intake Levels for Nutrients [Internet]. Washington (DC): National Academies Press (US); 1998 [cited 2022 Jun 15]. Chapter 1. Available from: https://www.ncbi.nlm.nih.gov/books/NBK45182/ DOI: 10.17226/6432
  • Safi U. Khan, Muhammad U. Khan, Haris Riaz, Shahul Valavoor, Di Zhao, Lauren Vaughan, et al. Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes. Ann Intern Med [Internet], 2019 Aug 6 [cited 2022 Jun 15];171(3):190-198. Available from: https://www.acpjournals.org/doi/10.7326/M19-0341
  • Heravi AS, Michos ED. Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk? Methodist Debakey Cardiovasc J [Internet]. 2019 Jul-Sep [cited 2022 Jun 22];15(3):207-213. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822648/ DOI: 10.14797/mdcj-15-3-207
  • National Research Council (US) Committee on Diet and Health. Fat-Soluble Vitamins. Diet and Health: Implications for Reducing Chronic Disease Risk [Internet]. Washington (DC): National Academies Press (US); 1989 [cited 2022 Jun 15]. Chapter 11. Available from: https://www.ncbi.nlm.nih.gov/books/NBK218749/ DOI: https://doi.org/10.17226/1222
  • Satia JA, Littman A, Slatore CG, Galanko JA, White E. Long-term use of beta-carotene, retinol, lycopene, and lutein supplements and lung cancer risk: results from the VITamins And Lifestyle (VITAL) study. Am J Epidemiol [Internet]. 2009 Apr 1 [cited 2022 Jun 22];169(7):815-28. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842198/ DOI: 10.1093/aje/kwn409
  • Bastos Maia S, Rolland Souza AS, Costa Caminha MF, Lins da Silva S, Callou Cruz RSBL, Carvalho Dos Santos C, et al. Vitamin A and Pregnancy: A Narrative Review. Nutrients [Internet]. 2019 Mar 22 [cited 2022 Jun 22];11(3):681. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6470929/#:~:text=The%20main%20adverse%20effects%20associated,abortion%20%5B12%2C13%5D. DOI: 10.3390/nu11030681
  • World Health Organization (WHO). Micronutrients [Internet]. Geneva (CH): WHO; 2022 [cited 2022 Jun 22]. Available from: https://www.who.int/health-topics/micronutrients#tab=tab_1
  • National Institutes of Health (NIH). Iron: Fact Sheet for Health Professionals [Internet]. Bethesda MD: NIH; 2022 Apr 5 [cited 2022 Jun 22]. Available from: https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
  • Freeman AM, Rai M, Morando DW. Anemia Screening [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jul 31 [cited 2022 Jun 22]. Available from https://pubmed.ncbi.nlm.nih.gov/29763080/
  • National Institutes of Health (NIH). Iodine: Fact Sheet for Health Professionals [Internet]. Bethesda MD: NIH; 2022 Apr 28 [cited 2022 Jun 22]. Available from: https://ods.od.nih.gov/factsheets/Iodine-HealthProfessional/
  • Wilson SA, Stem LA, Bruehlman RD. Hypothyroidism: Diagnosis and Treatment. Am Fam Physician [Internet]. 2021 May 15 [cited 2022 Jun 22];103(10):605-613. Available from: https://pubmed.ncbi.nlm.nih.gov/33983002/#affiliation-1
  • National Institutes of Health (NIH). Vitamin A and Carotenoids: Fact Sheet for Health Professionals [Internet]. Bethesda MD: NIH; 2022 Jun 15 [cited 2022 Jun 22]. Available from: https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/
  • Sommer A. Vitamin a deficiency and clinical disease: an historical overview. J Nutr [Internet]. 2008 Oct [cited 2022 Jun 22];138(10):1835-9. Available from: https://pubmed.ncbi.nlm.nih.gov/18806089/ DOI: 10.1093/jn/138.10.1835
  • National Institutes of Health (NIH). Vitamin B12: Fact Sheet for Health Professionals [Internet]. Bethesda MD: NIH; 2022 Mar 9 [cited 2022 Jun 22]. Available from: https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
  • National Institutes of Health (NIH). Vitamin D: Fact Sheet for Health Professionals [Internet]. Bethesda MD: NIH; 2022 Jun 2 [cited 2022 Jun 22]. Available from: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
  • Anglin RE, Samaan Z, Walter SD, McDonald SD. Vitamin D deficiency and depression in adults: systematic review and meta-analysis. Br J Psychiatry [Internet]. 2013 Feb [cited 2022 Jun 22];202:100-7. Available from: https://pubmed.ncbi.nlm.nih.gov/23377209/ DOI: 10.1192/bjp.bp.111.106666
  • Tripkovic L, Lambert H, Hart K, Smith CP, Bucca G, Penson S, et al. Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: a systematic review and meta-analysis. Am J Clin Nutr [Internet]. 2012 Jun [cited 2022 Jun 22];95(6):1357-64. Available from https://pubmed.ncbi.nlm.nih.gov/22552031/ DOI: 10.3945/ajcn.111.031070
  • Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol [Internet]. 2013 Jan 1[cited 2022 Jun 22];5(1):51-108. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897598/ DOI: 10.4161/derm.24494
  • Hahn J, Cook NR, Alexander EK, Friedman S, Walter J, Bubes V, et al. Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial. BMJ [Internet]. 2022 Jan 26 [cited 2022 Jun 15];376:e066452 Available from: https://www.bmj.com/content/376/bmj-2021-066452 DOI: https://doi.org/10.1136/bmj-2021-066452


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