With cold and flu season in full swing, it’s the season for many Americans to turn to one or more dietary supplements in hopes of fending off illness. And it’s not just a winter habit; for many they have become routine, with almost 58% of people aged 20 and over relationship with at least one dietary supplement.
But do all those little pills – what do they make up a multi-billion dollar industry – really do something?
Supplements versus food
Experts say that food trumps supplements as the best source of nutrients. Dr. Marilyn Tan, an associate clinical professor of medicine at Stanford University, explained the benefits of getting a nutrient gradually throughout the day instead of getting “a big chunk of everything at once” via pill.
“I think that if you can take it throughout the day – for example, in nutrients through food – it is simply absorbed better. Because there is a maximum amount that your body can absorb at one time,” he said. “For example, for calcium, if you take more than 500 to 1,000 milligrams, your body is just going to pee. And many vitamins are like that, where you can’t absorb such a large amount at once.”
Tan said most Americans already get the nutrients they need from food alone.
“Most people on the standard American diet, unless they’re on very restrictive diets, are getting adequate nutrients through their diet,” he said. “Vitamin deficiency can occur with certain conditions such as malabsorption or pernicious anemia, for example, but for the average, otherwise healthy American, they get a lot of nutrients through the diet.”
Lisa Moskovitz, registered dietitian, CEO of NY Nutrition Group and author of “The Core 3 Healthy Eating Plan”, told Yahoo News that for someone who already eats a relatively healthy diet, supplements probably won’t make much of a difference and “could be a waste of money and just really expensive urine,” since your body is excreting all those excess nutrients. For people who already have enough nutrients through their diet, adding a vitamin supplement will not necessarily give them the extra boost they may be hoping for.
“If you already have enough levels in your body and you take B12 supplements, for example, you won’t feel more energy from taking B12 if you already had enough B12 in your system to begin with,” he said. .
When can supplements be a good idea?
Experts emphasize a “food first” approach to nutrients, which means that supplements should do just that – supplement, but not compensate for bad eating habits. They can help fill nutritional gaps in some cases, such as if you restrict your food intake for weight loss or if you adhere to a vegan diet, have limited access to healthy foods or have a certain vitamin deficiency, which can be diagnosed. by your doctor with a blood test.
An iron deficiency, for example, is not uncommon, especially in menstruating women or people who have sources of blood loss. Iron can also be more difficult to get through food alone if you are a vegetarian.
And for many people, vitamin D can also be difficult to get through diet alone. We get vitamin D mostly from sunlight, but if you wear a thick layer of sunscreen in the sun or if you don’t get outside enough, it may not be absorbing much. How dark or fair your skin is can also affect vitamin D absorption.
“Vitamin D is very difficult to get well from food. There are not many dietary sources,” said Tan. “But for most of the other vitamins, we are able to get them in food.”
Vitamin B12 is another example, he said, for which a doctor can recommend an oral supplement if you have a slight deficiency, which becomes more common with age.
And folic acid, a B vitamin, is a supplement that has broad support from public health experts, even among supplement skeptics. It has been shown to prevent serious birth defects of the baby’s brain and spine, and since the benefits of folic acid are most important in the first days and weeks of fetal development – before many women they know they are pregnant – the CDC recommends that “all women of reproductive age should get 400 micrograms (mcg) of folic acid every day, in addition to consuming foods with folate from a varied diet.”
“The risk is too great to take the chance of a woman who thinks she is getting enough folic acid [through their diet] but I don’t know,” Moskovitz said. “That’s just because the research is so, so strong.”
So do supplements really work?
While folic acid supplements have proven benefits, the jury is still out on the merits of most other supplements.
In 2013, researchers at Johns Hopkins University published an editorial titled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” with one of the editorial’s authors saying he did not recommend any supplements other than folic acid for women who may be pregnant.
Earlier this year, the US Preventive Services Task Force has published an updated guide saying that vitamin, mineral and multivitamin supplements are unlikely to prevent cancer or heart disease, or to impact overall mortality.
“Usually it’s not bad to take a multivitamin, but many studies have looked at whether a multivitamin can help improve mortality or quality of life or sense of well-being or things like that, and nothing has been very conclusive,” said Tan. . “There is no large randomized control trial that shows significant health benefits from taking a multivitamin.”
Tan said that if you have a diagnosed deficiency that affects your health – such as a B12 deficiency that affects memory, for example – the supplement can help. But taking supplements only in the hope of reaping health benefits down the road may not do much.
“Many studies have tried to examine, for example, whether vitamin D can help with heart disease, or help with infections like COVID,” said Tan. “Studies have been mixed, but there is nothing that has been definitively proven that a specific vitamin supplement will help with longevity.”
When it comes to using supplements to treat or shorten the duration of illnesses such as the common cold, the results are also mixed. Zinc is a mineral that has been praised by some for its ability possibly shorten the duration of a cold if it is taken in pill form within the first 24 hours of the onset of symptoms, but nothing has been definitively shown. While some studies have indicated that zinc can shorten a cold by a few days, other studies have concluded that zinc has no effect on the duration or severity of the cold.
Most vitamin supplements for sale are safe in limited amounts, so if they make you feel better, it’s probably not bad to take them. But it is unlikely to cure your patients, said Tan.
“Are they necessarily going to cure or reverse an infection? No, probably not,” he said. “They are also not a substitute for any recommended treatment [from your doctor]. For example, if you have the flu and your doctor recommends taking Tamiflu because you’re at high risk, taking vitamin C can help or taking zinc can help, but it’s not a substitute for what your doctor recommends.”
Too much of a good thing?
It’s also possible to have too much of a good thing, experts say. Excess water-soluble vitamins are usually excreted through the urine, but excess fat-soluble vitamins can remain in your body and have adverse effects.
Long-term use of zinc in high doses, for example, can cause a copper deficiency; high doses of vitamin A should not be taken during pregnancy because it can harm the fetus; and excess vitamin D can lead to high and unhealthy calcium levels.
Some supplements can also interfere with medications.
“If you take certain medications, you want to be careful, especially with herbal supplements like ashwagandha. [or] Herbal supplements like St. John’s wort,” said Moskovitz. “These can affect psychotropic medications, such as antidepressants [or] anti-anxiety medication. Some can actually interfere with heart medications [or] blood thinners. That’s why it’s also very important to check with a professional.”
How can you be sure you are taking the right supplement?
Supplements are not regulated by the US Food and Drug Administration in the way that medications are; i am considered a subcategory of foodnot drugs, so anything the manufacturer feels is safe can hit the market without prior FDA approval.
One way to get some assurance that the supplement you are taking lives up to its claims is to look for the ConsumerLab or US Pharmacopoeia seals on the label, which indicate that the product has been tested and quality checked. . And if a product makes “miraculous claims” that it can improve your health, take it with a grain of salt, Tan said.
You should consult with your doctor before taking any supplements, Tan and Moskovitz said, because chances are, you may not need it.
“For anyone who is looking to add more supplements to their diet, who wants to discover this and see if it can be beneficial, it always helps first to talk to a professional doctor and dietitian, especially a doctor who can order blood work “, Moskovitz. he said. “Test your levels before spending your hard earned money on something you might not need and might just throw away anyway.”