Do We Need Supplements, And Do They Work?

The article discusses the results of a survey on supplements and presents conflicting viewpoints on the effectiveness of supplements and the nutritional value of food.
Title: Are Supplements Worth the Investment?

Description: Explore the efficacy and benefits of incorporating supplements into your daily regimen. Discover if these dietary additions truly deliver results that work.

Does our diet need a little help?

We asked you for your take on supplements, and got the above-illustrated, below-described set of results.

  • The largest minority of respondents (a little over a third) voted for “I just take something very specific”
  • The next most respondents voted for “I take so many supplements; every little helps!”
  • Almost as many voted for “I just take a vitamin or two / a multivitamin”
  • Fewest, about 8%, voted for “I get everything I need from my diet”

But what does the science say?

Food is less nutritious now than it used to be: True or False?

True or False depending on how you measure it.

An apple today and an apple from a hundred years ago are likely to contain the same amounts of micronutrients per apple, but a lower percentage of micronutrients per 100g of apple.

The reason for this is that apples (and many other food products; apples are just an arbitrary example) have been selectively bred (and in some cases, modified) for size, and because the soil mineral density has remained the same, the micronutrients per apple have not increased commensurate to the increase in carbohydrate weight and/or water weight. Thus, the resultant percentage will be lower, despite the quantity remaining the same.

We’re going to share some science on this, and/but would like to forewarn readers that the language of this paper is a bit biased, as it looks to “debunk” claims of nutritional values dropping while skimming over “yes, they really have dropped percentage-wise” in favor of “but look, the discrete mass values are still the same, so that’s just a mathematical illusion”.

The reality is, it’s no more a mathematical illusion than is the converse standpoint of saying the nutritional value is the same, despite the per-100g values dropping. After all, sometimes we eat an apple as-is; sometimes we buy a bag of frozen chopped fruit. That 500g bag of chopped fruit is going to contain less copper (for example) than one from decades past.

Here’s the paper, and you’ll see what we mean:

Mineral nutrient composition of vegetables, fruits and grains: The context of reports of apparent historical declines

Supplements aren’t absorbed properly and thus are a waste of money: True or False?

True or False depending on the supplement (and your body, and the rest of your diet)

Many people are suffering from dietary deficiencies of vitamins and minerals, that could be easily correctable by supplementation:

However, as this study by Dr. Fang Fang Zhang shows, a lot of vitamin and mineral supplementation does not appear to have much of an effect on actual health outcomes, vis-à-vis specific diseases. She looks at:

  • Cardiovascular disease
  • Cancer
  • Type 2 diabetes
  • Osteoporosis

Her key take-aways from this study were:

  • Randomised trial evidence does not support use of vitamin, mineral, and fish oil supplements to reduce the risk of non-communicable diseases
  • People using supplements tend to be older, female, and have higher education, income, and healthier lifestyles than people who do not use them
  • Use of supplements appreciably reduces the prevalence of inadequate intake for most nutrients but also increases the prevalence of excess intake for some nutrients
  • Further research is needed to assess the long term effects of supplements on the health of the general population and in individuals with specific nutritional needs, including those from low and middle income countries

Read her damning report: Health effects of vitamin and mineral supplements

On the other hand…

This is almost entirely about blanket vitamin-and-mineral supplementation. With regard to fish oil supplementation, many commercial fish oil supplements break down in the stomach rather than the intestines, and don’t get absorbed well. Additionally, many people take them in forms that aren’t pleasant, and thus result in low adherence (i.e., they nominally take them, but in fact they just sit on the kitchen counter for a year).

One thing we can conclude from this is that it’s good to check the science for any given supplement before taking it, and know what it will and won’t help for. Our “Monday Research Review” editions of 10almonds do this a lot, although we tend to focus on herbal supplements rather than vitamins and minerals.

We can get everything we need from our diet: True or False?

Contingently True (but here be caveats)

In principle, if we eat the recommended guideline amounts of various macro- and micro-nutrients, we will indeed get all that we are generally considered to need. Obviously.

However, this may come with:

  • Make sure to get enough protein… Without too much meat, and also without too much carbohydrate, such as from most plant sources of protein
  • Make sure to get enough carbohydrates… But only the right kinds, and not too much, nor at the wrong time, and without eating things in the wrong order
  • Make sure to get enough healthy fats… Without too much of the unhealthy fats that often exist in the same foods
  • Make sure to get the right amount of vitamins and minerals… We hope you have your calculators out to get the delicate balance of calcium, magnesium, potassium, phosphorus, and vitamin D right.

That last one’s a real pain, by the way. Too much or too little of one or another and the whole set start causing problems, and several of them interact with several others, and/or compete for resources, and/or are needed for the others to do their job.

And, that’s hard enough to balance when you’re taking supplements with the mg/µg amount written on them, never mind when you’re juggling cabbages and sardines.

On the topic of those sardines, don’t forget to carefully balance your omega-3, -6, and -9, and even within omega-3, balancing ALA, EPA, and DHA, and we hope you’re juggling those HDL and LDL levels too.

So, when it comes to getting everything we need from our diet, for most of us (who aren’t living in food deserts and/or experiencing food poverty, or having a medical condition that restricts our diet), the biggest task is not “getting enough”, it’s “getting enough of the right things without simultaneously overdoing it on the others”.

With supplements, it’s a lot easier to control what we’re putting in our bodies.

And of course, unless our diet includes things that usually can’t be bought in supermarkets, we’re not going to get the benefits of taking, as a supplement, such things as:

Etc.

So, there definitely are supplements with strong science-backed benefits, that probably can’t be found on your plate!

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  • Stop Cancer 20 Years Ago

    Dr. Jenn Simmons shares vital tips on preventing cancer and inflammation, advocating for lifestyle changes and proactive health management at any age.

    Get Abreast And Keep Abreast

    This is Dr. Jenn Simmons. Her specialization is integrative oncology, as she—then a breast cancer surgeon—got breast cancer, decided the system wasn’t nearly as good from the patients’ side of things as from the doctors’ side, and took to educate herself, and now others, on how things can be better.

    What does she want us to know?

    Start now

    If you have breast cancer, the best time to start adjusting your lifestyle might be 20 years ago, but the second-best time is now. We realize our readers with breast cancer (or a history thereof) probably have indeed started already—all strength to you.

    What this means for those of us without breast cancer (or a history therof) is: start now

    Even if you don’t have a genetic risk factor, even if there’s no history of it in your family, there’s just no reason not to start now.

    Start what, you ask? Taking away its roots. And how?

    Inflammation as the root of cancer

    To oversimplify: cancer occurs because an accidentally immortal cell replicates and replicates and replicates and takes any nearby resources to keep on going. While science doesn’t know all the details of how this happens, it is a factor of genetic mutation (itself a normal process, without which evolution would be impossible), something which in turn is accelerated by damage to the DNA. The damage to the DNA? That occurs (often as not) as a result of cellular oxidation. Cellular oxidation is far from the only genotoxic thing out there, and a lot of non-food “this thing causes cancer” warnings are usually about other kinds of genotoxicity. But cellular oxidation is a big one, and it’s one that we can fight vigorously with our lifestyle.

    Because cellular oxidation and inflammation go hand-in-hand, reducing one tends to reduce the other. That’s why so often you’ll see in our Research Review Monday features, a line that goes something like:

    “and now for those things that usually come together: antioxidant, anti-inflammatory, anticancer, and anti-aging”

    So, fight inflammation now, and have a reduced risk of a lot of other woes later.

    See: How to Prevent (or Reduce) Inflammation

    Don’t settle for “normal”

    People are told, correctly but not always helpfully, such things as:

    • It’s normal to have less energy at your age
    • It’s normal to have a weaker immune system at your age
    • It’s normal to be at a higher risk of diabetes, heart disease, etc

    …and many more. And these things are true! But that doesn’t mean we have to settle for them.

    We can be all the way over on the healthy end of the distribution curve. We can do that!

    (so can everyone else, given sufficient opportunity and resources, because health is not a zero-sum game)

    If we’re going to get a cancer diagnosis, then our 60s are the decade where we’re most likely to get it. Earlier than that and the risk is extant but lower; later than that and technically the risk increases, but we probably got it already in our 60s.

    So, if we be younger than 60, then now’s a good time to prepare to hit the ground running when we get there. And if we missed that chance, then again, the second-best time is now:

    See: Focusing On Health In Our Sixties

    Fast to live

    Of course, anything can happen to anyone at any age (alas), but this is about the benefits of living a fasting lifestyle—that is to say, not just fasting for a 4-week health kick or something, but making it one’s “new normal” and just continuing it for life.

    This doesn’t mean “never eat”, of course, but it does mean “practice intermittent fasting, if you can”—something that Dr. Simmons strongly advocates.

    See: Intermittent Fasting: We Sort The Science From The Hype

    While this calls back to the previous “fight inflammation”, it deserves its own mention here as a very specific way of fighting it.

    It’s never too late

    All of the advices that go before a cancer diagnosis, continue to stand afterwards too. There is no point of “well, I already have cancer, so what’s the harm in…?”

    The harm in it after a diagnosis will be the same as the harm before. When it comes to lifestyle, preventing a cancer and preventing it from spreading are very much the same thing, which is also the same as shrinking it. Basically, if it’s anticancer, it’s anticancer, no matter whether it’s before, during, or after.

    Dr. Simmons has seen too many patients get a diagnosis, and place their lives squarely in the hands of doctors, when doctors can only do so much.

    Instead, Dr. Simmons recommends taking charge of your health as best you are able, today and onwards, no matter what. And that means two things:

    1. Knowing stuff
    2. Doing stuff

    So it becomes our responsibility (and our lifeline) to educate ourselves, and take action accordingly.

    Want to know more?

    We recently reviewed her book, and heartily recommend it:

    The Smart Woman’s Guide to Breast Cancer – by Dr. Jenn Simmons

    Enjoy!