As you probably know, nutritional supplements are a large part of both our mainstream and alternative cultures today. These supplements provide concentrated amounts of one or more vitamins, minerals, or macro-nutrients in pill, powdered, or liquid form. Billions of dollars in nutritional supplements are sold each year around the world, and there are many passionate advocates and followers of various supplement regimes. But are supplements effective and health-promoting, are they a wise use of our time and resources, and are they safe?
Photo Courtesy of Supplement Tablets
To answer these important questions based on reliable science, we need to consider two crucial factors. First is the background diet and health of a person. After all, modern-day diets and health levels can vary widely, influencing an individual’s nutrient intake, uptake, outtake – the amount of nutrients entering, being absorbed by, and exiting the body, in other words.
A second essential consideration is how any supplement’s dosage compares with daily recommended amounts, for example U.S. Daily Reference Intakes, for the nutrient(s) it contains. Popular multivitamin pills generally contain concentrations of vitamins and minerals at or near DRI levels. On the other hand, single nutrient and other specialty supplements can provide one-dose concentrations far in excess of DRI or equivalent recommended daily values.
The Scientific Evidence
Though the use of supplements is widespread today, with vast amounts of promotional information available from supplement advocates and manufacturers, these societal facts exist in sharp contrast to the actual science of supplementation. Simply put, for people in average health and following typical government eating guidelines in the developed world, there is strong evidence – for example cataloged here and summarized here – that nutritional supplementation is unnecessary (though two potential exceptions are discussed below).
This broad body of evidence, even if counter-intuitive for many people or actively discounted by some, explains why many national governments prohibit ascribing therapeutic value to supplements intended for non-medical use (creating fodder for conspiratorial theories rationalizing supplement practices). Indeed, it is instructive that the prestigious U.S. Institute of Medicine’s focus on supplements almost exclusively involves safety considerations and regulation of industry excesses, rather than investigation of the health benefits of supplementation regimes.
But what about people who are not in average health or following typical government nutritional standards? In the case of people in above average health and adhering to daily health practices superior to common governmental standards – including those of us following HumanaNatura’s Personal Health Program and OurPlate eating guidelines – the empirical case for supplementation further weakens. Here, we have good reason to expect that more than adequate daily intake and uptake of nutrients will occur from eating alone, and that the risk of unusual physiological losses of nutrients will be low.
On the other hand, when considering people in below average health or regularly not meeting governmental eating guidelines, the case for supplementation grows stronger but is still quite nuanced. Potential reasons for people being in either or both categories are of course numerous. They include personal or community poverty, malnourishment due to social insecurity or disruption, any number of chronic or acute diseases, health-indifference and failure to consume a natural diet rich in fruits and vegetables, and strict vegetarianism or veganism (where little or no animal foods are consumed).
As a class, these many and varied situations can lead to different conclusions regarding the desirability of supplement use, including the advisable amounts and types of supplements that should be considered. But overall, at least some amount of dietary supplementation is likely to be beneficial in these cases. But which amounts and what types of supplements? While we will touch on this question in a moment, ultimately this is a question for a treating or consulting physician or registered dietitian, especially since the needed approach may involve supplement levels that exceed daily recommended values for a particular nutrient (and thus should be medically or professionally supervised for safety reasons, as we will discuss next).
Balancing Freedom & Safety
As part of our overview of nutritional supplements, we would like to focus for a moment on the important and instructive issue of supplement safety. As suggested before, the safety of supplements is a notable concern of national regulatory and health research agencies.
In practice, however, this concern is often significantly tempered by common legislative frameworks in the developed world, which generally permit freedom of choice in the absence of clear threats in many areas of modern life. For this reason, supplements are often regulated as foods rather than drugs, even as people may take or be advised to use supplements for health promotion reasons. In other words, without obvious patterns of widespread harm, ineffectual supplementation practices can be left largely unregulated and tolerated, and thus implicitly encouraged and sanctioned, by national governments. In our view, this uneasy balance of safety and freedom of choice considerations aptly describes our general context for supplement use today.
As evidenced in the research summary above, a common compromise among health agencies in our time permits but recommends against the use of high-concentration supplements (those exceeding recommended daily nutrient levels or including unusual active compounds), unless contrary evidence is available. Similarly, widespread science-based advice today typically and correctly involves treating daily multivitamins (those that do not exceed recommended nutrient amounts per dose) as a generally unnecessary but acceptable practice, and supplement amounts above this level as undesirable, absent the advice of a treating or consulting physician or registered dietitian.
Building on a large and well-established body of scientific research, this pattern of regulatory and professional accommodation of low concentration supplements on personal freedom grounds underscores the weak scientific support for and marginal health benefits of supplementation practices by healthy people eating recommended national diets in the developed world.
Nutrients In The HumanaNatura Approach
Let’s next review our major macro-nutrients, vitamins, and dietary minerals – to explain and highlight their place in a healthy modern diet, and to demonstrate why supplementation practices are often of low value or needed in selected areas only.
Below is a list of common nutrients, links to info sources about them, comments regarding their intake adequacy and key sources in a natural human diet, and special points on specific nutrients we want to highlight. Overall, this information reflects and supports the idea that supplements are generally unnecessary for healthy people eating a reasonable modern diet.
In reviewing this list, please note that our comments assume use of HumanaNatura’s Personal Health Program and OurPlate healthy eating guidelines – including regular daily exercise and sun exposure – and that a person has no symptoms of reduced health, limited nutrient uptake, or unnatural nutrient outtake.
> Protein – a natural human diet provides all essential amino acids in adequate amounts via animal foods, nuts and seeds.
> Fat – diet correctly reduces intake of saturated fats and hydrogenated oils via restrictions on foods containing them, including fatty meats, eggs, and dairy. Simultaneously provides adequate mono-saturated and unsaturated fats via emphasis of olive oil, lean meats and fish, and tree nuts and seeds. Provides adequate fatty acids (especially Omega-3 acids) via emphasis on fish consumption.
> Carbohydrate – diet provides adequate but not excessive carbohydrates, while emphasizing natural fructose consumption via fruits and de-emphasizing unnatural dietary sugars via restrictions on grain, beans, starches, and industrial foods.
> Vitamin A – adequate amounts via orange and yellow fruits, leafy vegetables including spinach, carrots
> Vitamin B1 – adequate amounts via meats, eggs, vegetables
> Vitamin B2 – adequate amounts via fruits and vegetables
> Vitamin B3 – adequate amounts via meats, fish, eggs, vegetables, tree nuts
> Vitamin B5 – adequate amounts via meats, broccoli, avocados
> Vitamin B6 – adequate amounts via meats, vegetables, tree nuts
> Vitamin B7 – adequate amounts via eggs, meats, vegetables
> Vitamin B9 – adequate amounts via leafy vegetables
> Vitamin B12 – adequate amounts via meats and fish (note that vitamin B12 supplementation is required for vegans, since no vegetable sources of this vitamin are available to us and humans are not evolved to manufacture it)
> Vitamin C – adequate amounts via fruits and vegetables
> Vitamin D – adequate amounts via sunlight, fish, eggs (note that HumanaNatura recommends having individual circulating vitamin D amounts checked and either increased sun exposure or targeted supplementation if amounts are low)
> Vitamin E – adequate amounts via fruits and vegetables, nuts and seeds
> Vitamin K – adequate amounts via leafy green vegetables egg yolks
> Calcium – adequate amounts via eggs, fish with bones (salmon, sardines), shellfish, green leafy vegetables, nuts, seeds, thyme, oregano, dill, cinnamon
> Chlorine – adequate amounts via a variety of plant and animal foods
> Copper – adequate amounts via leafy greens, tree nuts and seeds
> Iodine – adequate amounts via eggs, fish and shellfish, strawberries
> Iron – adequate amounts via eggs, meats, fish, dark leafy greens
> Magnesium – adequate amounts via fish, tree nuts, spinach, tomatoes, ginger, cumin
> Manganese – adequate amounts via fruits, spinach, thyme, cinnamon, turmeric
> Molybdenum – adequate amounts via tomatoes, onions, carrots
> Phosphorus – adequate amounts via meats, fish
> Potassium – adequate amounts via fish, fruits, tomatoes, avocados, dark leafy greens, turmeric
> Selenium – adequate amounts via wild fish, meats, tree nuts and seeds
> Sodium – adequate but not excessive amounts via a variety of plant and animal foods, and restriction on use of added salt
> Zinc – adequate amounts via meats, fish, dark leafy greens, tree nuts and seeds (note that zinc lozenges have been shown in research to reduce the severity and length of colds, if used at the onset of symptoms)
Aspirin – though not traditionally considered a nutritional supplement, daily low-dose aspirin use has been increasingly shown to have significant health benefits and HumanaNatura recommends a coated 81-milligram daily supplement for all adults, subject to physician approval.
Our Natural Truth Rating
Given this pattern of evidence, HumanaNatura rates the proposal that nutritional supplements are advisable for healthy people following a typical government recommended diet a 3/10 (Weak Evidence) in our Natural Truth rating system.
We base our rating on the broad body of reliable evidence failing to support the idea that nutritional supplements provide benefits to healthy people following a diet with adequate animal foods, vegetables, and fruit.
However, we would temper this conclusion by noting:
1. There is growing evidence to recommend that circulating vitamin D levels be checked and steps taken to ensure adequate amounts – either via additional daily sunlight and outdoor exercise, dietary changes, or a daily vitamin D supplement. Please note that the potential for a vitamin D shortfall may be greater in people with darker skin living in higher latitudes.
2. HumanaNatura recommends, subject to a physician’s approval, a coated 81-milligram daily aspirin supplement for all adults, due to increasing science indicating significant potential benefits from this low-cost health promotion practice.
3. People who have limited or no animal foods in their diet will at least need a vitamin B12 supplement, and a daily multivitamin (not exceeding DRI or comparable values) may be advisable.
4. People not eating adequate (5+ servings) of fruits and vegetables each day, and either unwilling or unable to move to a more natural diet that is rich in these foods, should consider a daily multivitamin (but not ones exceeding DRI or comparable values).
5. People with health-related symptoms of any kind should seek medical assistance and follow any supplement instructions given to them by a treating physician or medical professional.
We hope this discussion of nutritional supplements is valuable to you, and that it helps you to make more informed and optimal decisions about how and where you focus your health-promotion efforts and resources.
You can click to learn more about our Natural Truth health information campaign and evidence-based 1-10 rating system. And we always welcome your comments and input on this or any other HumanaNatura Natural Truth review.
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