Weighing the Pros and Cons of Vitamins and Supplements
Nowadays, it seems every time you turn around, someone’s slapping a health claim on a box of Triscuits. Picking out a box of cereal now involves a moral dilemma, as you contemplate boxed breakfasts that claim to turn your ticker up a notch by promoting heart health while others offer to boost your cancer-fighting potential with a dose of much-hyped antioxidants. Will you suffer heart failure if you forgo an oat-based cereal in favor of puffed rice? Or will you find salvation in the cracker and chip aisle, where you can choose potato chips “proven” to lower your cholesterol? Not even water is immune, as you know if you’ve found yourself lost amid shelves of vitamin water or electrolyte-infused water claiming to increase your energy, improve bone density, boost immunity, and scavenge free radicals.
Welcome to the world of nutraceuticals and qualified health claims.
Nutraceuticals (a portmanteau of the words “nutrition” and “pharmaceutical”) are bioactive chemicals derived from food, but consumed at concentrations much higher than you could achieve through diet alone. Think alpha-linoleic acid supplements (originally found in greens, seeds, and animals that eat grass), isolated lycopene (derived from red fruits), or allicin tablets (from garlic). Qualified health claims are the little blurbs on packages something along the lines of this: “Some research suggests the specific type of oil in this deep-fried product could possibly reduce the risk of certain bad stuff like maybe heart disease, if the oil is replacing saturated fat, ground glass, or battery acid in the diet, and if this product isn’t increasing the number of calories you currently consume, and if you’re not standing in the middle of a busy street when you eat it.” If you live in the U.S., you may have noticed that qualified health claims are on a whole lot of things right now, from plain oatmeal to junk food to cooking oils to frozen foods. And while oatmeal is still just oatmeal for the most part, food giants are monkeying with a lot of their products in the interest of increasing their profit margins by marketing them to health-conscious Americans and those looking for quick fixes. Medicines masquerading as foods are running rampant, and still, vitamin supplements are ubiquitous. Taking a daily multivitamin is a matter of course for many people of all ages—a full third of all adults take a supplement of some type, according to the National Health Interview Survey. Unfortunately, the press on vitamins has not been so positive lately. While supplements can be vital for a nutrient-deficient diet, most Americans frankly do not have such deficiencies, and overdosing on some micronutrients can be dangerous, even deadly.
Recently, I saw a New York Times article by Tara Parker-Pope that mentions several recent studies on vitamins. The findings range from the benign (no reduction in cancer results in those taking vitamins C and E for a decade, no reduction in heart disease with those supplements either, no reduction of heart attacks with vitamin B supplements, no difference in infection rates among the elderly taking a multivitamin) to the severe. Among the most concerning:
- In October, a major trial studying whether vitamin E and selenium could lower a man’s risk for prostate cancer ended amidst worries that the treatments may do more harm than good.
- Recently, doctors at Memorial Sloan-Kettering Cancer Center in New York warned that vitamin C seems to protect not just healthy cells but cancer cells, too.
- A Johns Hopkins School of Medicine review of 19 vitamin E clinical trials of more than 135,000 people showed high doses of vitamin E (greater than 400 IUs) increased a person’s risk for dying during the study period by 4 percent. Taking vitamin E with other vitamins and minerals resulted in a 6 percent higher risk of dying. Another study of daily vitamin E showed vitamin E takers had a 13 percent higher risk for heart failure.
- A 1994 Finland study of smokers taking 20 milligrams a day of beta carotene showed an 18 percent higher incidence of lung cancer among beta carotene users. In 1996, a study called Caret looked at beta carotene and vitamin A use among smokers and workers exposed to asbestos, but the study was stopped when the vitamin users showed a 28 percent higher risk for lung cancer and a 26 percent higher risk of dying from heart disease.
- A 2002 Harvard study of more than 72,000 nurses showed that those who consumed high levels of vitamin A from foods, multivitamins and supplements had a 48 percent higher risk for hip fractures than nurses who had the lowest intake of vitamin A.
Here’s the Simple Spoonful version. We need vitamins and minerals. They are critical for a variety of normal body functions. However, most people here can get adequate levels of micronutrients from foods; vitamin deficiency is rare in the United States, particularly if you make sure to eat a variety of fresh fruits, vegetables, and whole grains grown in healthy soils. Furthermore, as Marion Nestle points out, getting micronutrients from food is generally superior to getting them from supplements due to the variety and balance of nutrients found in whole foods, which encourage optimal digestion, absorption, and metabolism, not to mention the fact that the possibility of harm from overdose is next to nonexistent. Supplements are best reserved for those with specific health issues, such as severe anemia, or those with special needs (like folic acid for expectant mothers, or B12 for vegans who aren’t consuming nutritional yeast, fermented, or fortified foods). Megadoses of vitamins, however, are increasingly shown to be a questionable approach to good health. If you look at the nutrition information on the supplements in the store, prepare to be shocked. When I went window-shopping recently, micronutrient levels in supplements were routinely 200-5000% more than the USDA recommended daily allowance. Call me crazy, but taking 5000% of what you supposedly need for good health doesn’t seem like a good idea. More isn’t always better.
Keep it Simple. Eat a variety of whole, fresh foods. Stay active. If you are concerned about a deficiency, get evaluated by a doctor instead of just tossing back a possible excess of an isolated nutrient. Choose the source of your supplements carefully if supplements seem to be the best choice for you. Do the research to know what form of the micronutrient you should be taking, as well as what to take or avoid when taking it to aid absorption. Got it?
And for anyone without a specific diet deficiency or concern: Put down the vitamin C-fortified gummi bears and pick up a tangerine.
Got it?
Good.
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Agreed. Though on my more vegan-heavy kicks I wonder about a B12 supplement. I think I eat meat/fish often enough to cover that though. It’s really all about variety and moderation!
Absolutely. I’ve taken B12 supplements in the past during vegan stints, but I prefer to be supplement-free. B12 is one of the ones vegans do need to keep an eye on, as deficiencies can cause an impressive list of complications including reduced cognitive function, anemia, fatigue, weakness, constipation, loss of appetite, weight loss, numbness and tingling in the hands and feet, difficulty in maintaining balance, depression, confusion, dementia, and soreness of the mouth or tongue (according to the National Institute of Health).
However, B12 can be found in dairy products, eggs, some nutritional yeast, and some fortified foods. It’s something to pay attention to, but not anything for most people to lose sleep over. B12 is one of the reasons I haven’t switched to veganism–I don’t really want to get B12 through processed, fortified foods, and data about fermented foods and seaweeds as sources of B12 don’t look good, despite some vegetarians’ beliefs to the contrary. For the time being, I try to stick with pastured dairy and eggs.