More than half of all Americans take one or more dietary supplements on a regular basis. People take these supplements to make sure they get enough essential nutrients and to maintain or improve their health. Which supplements to take is controversial, even among the healthcare community and among dietitians.
The position of the Academy of Nutrition and Dietetics, the entity that governs dietitians, is that most Americans eat well enough that supplements are only needed in certain situations. With that taken into consideration, I have come to a different conclusion. My conclusion is based largely on the fact that I’ve never had an in-depth nutrient analysis of anyone’s dietary intake show 100% of nutrient needs being met by diet alone.
Here are Some Nutrient Facts
- Dietary supplements are regulated by the U.S. Food and Drug Administration (FDA) as foods, not as drugs. The label may claim certain health benefits, but unlike medicines, supplements can’t claim to cure, treat or prevent a disease. With this in mind, it is important to know that no vitamin or mineral supplement can reverse any chronic disease like diabetes or heart disease.
- Research shows few, if any, of us get enough vitamin B-12, vitamin D, or potassium. Vitamin B-12 is important for nerve cells and blood cells. Potassium helps regulate normal heart rate and vitamin D helps keep our bones strong and our cells protected.
- Too many vitamins and minerals in our bloodstream are unhealthy and can contribute to increased risk of health problems and death. More is not always better, so make it a goal to avoid supplements with more than 100% of the recommended daily intake.
- Vitamins and minerals are best absorbed with food and some vitamins can cause stomach upset if taken on an empty stomach.
My Recommendations, Based on Science
For all of us:
1. Eat your very best. Make nutrient-dense fruits and vegetables the base of your diet, and round out your diet with whole grains, lean proteins and healthy plant-based fats. These whole foods contain high levels of vitamins, minerals, fiber, phytochemicals, anti-inflammatory compounds, and antioxidants that protect and support good health. Consume portions to promote healthy weight and limit empty calories from traditional snack foods like chips and cookies, alcoholic beverages, and deep-fried foods.
2. Take a multivitamin supplement. Even when you eat your very best, there will be gaps in nutrient intake that a multivitamin will help bridge. Multivitamins will contain up to 100% of a wide variety of vitamins and minerals we need for good health, including vitamin B-12 and potassium listed above, while protecting against excessive intake. You can go with a standard “one a day” multivitamin, or tailor to your gender and age.
3. Take a calcium supplement if you consume less than 3 servings of dairy daily. Very few people get 3 cups of milk or yogurt (the main dietary sources of calcium) on a daily basis, and many of us consume no dairy. Substantial evidence shows dairy calcium to be superior to any other source for health benefits, including heart and bone health, but the next best way to ensure those health benefits is with a supplement. For those under the age of 50, calcium carbonate is best absorbed. After age 50, switch to calcium citrate for better absorption. Recommended total intake is 1000-1200 mg, with 1500 mg if osteoporosis (bone thinning) is present. Taking into consideration average dietary intake and the calcium contained in multivitamins, one 500-600 mg calcium supplement daily is appropriate for most.
4. Take a vitamin D3 supplement. You are likely vitamin D deficient, as research shows as much as 90% of the population is. Vitamin D is a potent anti-inflammatory vitamin that protects health at a cellular level. Insufficient levels can contribute to fatigue and diffuse muscle ache. Absorption varies widely, with 1000-2000 iu being a minimum recommendation (in addition to the amount in your multivitamin). If you can, get your vitamin D levels checked by your doctor and adjust your supplement intake until you achieve a blood level of 40-50 ng/ml, with common doses 4000-5000 iu for maintenance.
5. Take a fish oil supplement if you don’t eat 6 ounces or more of salmon weekly. Heart disease is the leading cause of death and fish oil provides heart-protective omega-3 fats. 1000 mg is a minimum dose, with 2000-4000 mg recommended if cholesterol numbers are elevated or heart disease is present.
For advice on the particular brand of vitamin that is best, look for one that has a USP rating or states that it has been sent to an independent lab for testing. This testing ensures it contains the nutrients it claims, in the dose identified, and is in an absorbable form. Become a subscriber to Consumer Labs if you want unbiased research and guidance on specific nutrients, brands of nutrients, dosages and ideal ways to take supplements. And, of course, keep working on your healthy diet.
Karen Fisher, MS, RD, LDN, CDE is a dietitian in Reno, Nevada, happily promoting the benefits of healthy foods at her nutrition consulting firm, Nutrition Connection. Find her website at www.NutritionConnectionNV.com
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