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Dietary supplements is a broad term that includes macronutrient supplements (protein, carbohydrates, fat), vitamins and minerals and plant extracts.

Let’s take a further look at dietary supplements and how to determine if we need them.

 

Do you need supplements?

As the name suggests, supplements help complement our diet with additional nutrients when required. They are not a substitute for a healthy, balanced diet which should always be a priority. Supplements are not for everyone; it depends on individual need.

A diet that includes plenty of fruits, vegetables, whole grains, adequate protein, and healthy fats should normally provide all the nutrients needed for good health. However, hectic work schedules, erratic meal timings, an increased access to processed foods and specific dietary restrictions may limit the nutrients available through one’s diet.

 

Major factors determining the need to supplement –

  • Deficiencies – The prime factor, deficiencies can be identified through a blood test, a dietitian or through symptoms such as fatigue. Also, certain groups are more susceptible to specific deficiencies. For example, studies have shown that vegan diets may be deficient in vitamin B12 and D3. Ketogenic diets, on the other hand, may be deficient in fibre, B vitamins and magnesium.
  • Stage of life – Nutrient requirements keep changing. For example, for pregnancy (and while planning pregnancy), folic acid is crucial as it helps prevent birth defects. Older adults need calcium and vitamin D for bone health because bone density reduces with age.
  • Fitness and health goals– Adequate nutrition and hydration are essential components of any fitness routine and increasing intensity may increase nutritional needs. Research has also shown that increasing protein intake optimizes performance, muscle-building and post-workout recovery.
  • Clinical conditions and Medication – Many illnesses improve with targeted nutrient therapy. For example, fibre for constipation or other digestive issues and a combination of calcium, magnesium vitamin D and vitamin K for osteoporosis. Certain chronic medications impact our body’s ability to produce and utilize specific nutrients. For example, Statins, a common drug for cholesterol management, can reduce coenzyme Q10 that is an antioxidant essential for good health.
  • Severe stress – Keep in mind that stress can impact nutrient absorption and increase inflammation so many people with severe stress end up supplementing with guidance from a medical professional. For example, vitamin B complex and omega-3 can help boost mood and reduce inflammation.
  • Lifestyle choices: Certain lifestyle choices can increase nutrient requirements. With smoking, our body needs antioxidants to process and remove the chemicals introduced by this habit. Individuals spending a lot of time in the sun can benefit from supplementing with nutrients that protect against sun damage.

 

Understanding how much to take –

  • Recommended Dietary Allowance (RDA): the minimum daily requirement for most healthy individuals.
  • Adequate Intake (AI): The level that is assumed to ensure nutritional adequacy; established when evidence is insufficient to develop an RDA.
  • Tolerable Upper Intake Level (TUL): Maximum daily intake unlikely to cause adverse health effects.
  • Toxic Level: The level beyond which we will start seeing some negative health effects, which can increase as the level continues to rise beyond the toxic level.

Optimum intake is usually between AI and TUL. For example, vitamin D RDA: 400 IU, AI: 600 IU, TUL: 4,000 IU and toxicity: beyond 50,000 IU per day. So optimum intake would be between 600 and 4,000 IU per day depending on our vitamin D levels and sun exposure. Toxicity beyond 50,000 IU can lead to many illnesses including hypercalcemia and hyperphosphatemia.

 

Keep in mind that high dose nutrients are used for certain diseases under medical guidance. Additionally, when using nutritional supplements, it’s important to carefully read labels including those of enriched foods to avoid taking multiple doses of the same nutrient. Another key point to know is that RDA and AI are generally established for nutrients that are essential to good health (vitamins, minerals, proteins, fats and carbohydrates) and may not be established for antioxidants and botanical extracts. However, TUL levels are generally established for all nutrients approved for use in dietary supplements and its best to supplement under this level unless under medical guidance.

 

The verdict: Eat a balanced healthy diet, and learn more about your nutrient needs which will be specific to your lifestyle and goals. Only supplement when required!

 

References –

  1. Incze M. Vitamins and Nutritional Supplements: What Do I Need to Know? JAMA Intern Med. 2019;179(3):460. Available from https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2720139
  2. Manson JE, Bassuk SS. Vitamin and Mineral Supplements: What Clinicians Need to Know. JAMA. 2018;319(9):859–860. Available from https://jamanetwork.com/journals/jama/article-abstract/2672264
  3. What are Food Supplements and Who Needs Them? The European Food Information Council: 12 April 2013 Available from https://www.eufic.org/en/healthy-living/article/food-supplements-who-needs-them-and-when
  4. Ritchie H. Front. Sustain. Food Syst., 30 April 2018
  5. Long SJ. Psychosom Med. 2013 Feb;75(2):144-53.
  6. Dietary Supplements for Exercise and Athletic Performance. National Institutes of Health:Office of Dietary Supplements (ODS). Available from https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-HealthProfessional/

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