Are Supplements Necessary?
We live in a world of instant gratification where there is an expectation that we can hack our way into fitness, health, performance, or success. We want to find the easy way to do something without having to put in the work. It should be no surprise that Americans spent $21 billion on vitamin and herbal supplements in 2015, yet most Americans fail to get the recommended 5-9 servings of daily fruits and vegetables.
The definition of supplement is essentially "something added." They are not meant to replace a healthy diet. So why are so many people spending so much money on them? Supplement companies do a good job of appealing to the quick fix mentality with their marketing and fancy labels. There are also practitioners out there that have convinced people that they need to take several hundreds of dollars worth of supplements every month just to be "healthy." These same practitioners may make a good profit on selling supplements. Unfortunately, many of the supplements on the market are a waste of money and will not get you the results you desire.
I am not against supplements. I think they can be beneficial and in some cases they are necessary. I take supplements. In fact, I take more than one, but I am not going to discuss what I am taking on this blog. Why? Because it does not matter which supplements I am taking. That is irrelevant to you. I have my own unique needs and my own unique situation. I do want to make it clear that I am not taking them because I am trying to avoid healthy eating. The supplements I am taking are strategic. They are based on blood work and genetic testing along with a personal analysis of my current activity level, health and fitness goals, and dietary intake. I take some daily, some every other day, and some only as needed.
When I am working with a client I may talk with them about supplements. However, that is not my main focus. The main focus is their nutrition and diet. How are they fueling? Are they eating enough? Are they getting the right proportion of carbohydrates, proteins, and fats to help them reach their goals? Are they eating nutrient dense foods? Are they trying to follow a particular dietary protocol, such as ketogenic, or are they vegan? I often encourage many of my clients to get blood work if they have not done so already. I analyze their current intake to address any nutrient inadequacies. If they are able to fill these inadequacies by adding certain foods, that is the first approach. If not, then I recommend a supplement.
Taking supplements in the absence of the evaluation of a skilled and educated practitioner can cause harm. Supplements are not benign and some herbal supplements can have toxic effects. Just because it comes naturally from a plant does not make it safe. For instance, the notorious hemlock plant was used by the ancient Greeks to kill off prisoners, and cyanide is a deadly natural substance found in apple seeds and apricot kernels. Even minerals can cause harm and often it is important to know how much to recommend to optimize health, but not overload the system. For instance, iron is critical for red blood cells to carry oxygen to tissues in the body. Too much iron can be toxic and can potentially cause damage to the liver. Some nutrients interact with other nutrients or medications. One common example is Saint John's Wort, which can interact with coumadin, birth control, and benzodiazepines (among others). When there is a nutrient and drug interaction, the nutrient can either increase or decrease the effect on the drug.
The form of the vitamin and mineral can also make a huge difference in how well the nutrient is absorbed and utilized in the body. Let's take magnesium, for example. Here are some of the different forms of magnesium available: magnesium oxide, magnesium chelate, magnesium citrate, magnesium carbonate, magnesium sulfate, and magnesium malate. These different forms can have different effects on the body. If you are looking to optimize your magnesium levels, magnesium oxide might not be the best choice because it is often used as a laxative. Magnesium chloride is often used in manufacturing and it used as a road de-icer. It can also be used in supplements. Magnesium carbonate and magnesium sulfate are less effective as there is only have about a 10-30% absorption rate. The best forms of magnesium are magnesium citrate, magnesium malate or glycinate, and magnesium orotate.
It can be confusing! Not to mention that different supplement manufacturers will make different claims about which form is best. Often, cheaper supplements will have less absorbable forms of vitamins and minerals because those are the less expensive (and less bioavailable) forms. This is often the case when people shop in their local supermarket and buy whatever looks the most appealing or whichever is the cheapest. If you are only absorbing 10-30% of that nutrient, I would argue that it is actually a waste of money. Or worse, it has a side effect such as diarrhea, constipation, or even causing liver/kidney problems.
What should you do? Consider working with a practitioner that has the educational background and experience to help you. Be cautious with practitioners that have a "nutrition certification," as often this has no real value. A certification can mean that they have taken a weekend certification course or maybe an 8-week online program in nutrition. My background in both exercise science as well as nutrition science means that I have completed coursework in biochemistry, organic chemistry, anatomy, both human physiology and exercise physiology, and advanced nutrition science (among many other classes). This is several years worth of education, not to mention the intensive year-long internship, and all the experience I have gained and continue to gain now that I am out of school and working with people every day. I have an advanced understanding of how the human body works and how nutrients are absorbed, utilized, stored, interact with other nutrients, and eliminated from the body.
As a registered dietitian, my expertise is nutrition and diet, and I am also skilled at analyzing diet, blood work, and other factors to help determine if a supplement is necessary (including dose, form and for how long). I do this often with my clients. I am not a supplement pusher and I will not work with someone who is not willing to take a deeper look into their diet before turning to supplements. I believe in integrity and honesty with my clients, and for this reason I make sure that I am not recommending anything that my client does not need. I recommend high quality supplements and provide recommendations from a few high quality (often pharmaceutical grade) supplement companies. In the end, they have the choice about if they want to take the supplement and where they purchase them. My goal is to educate and guide my clients about nutrition and supplements so that they can feel empowered to improve their health and reach their fitness/nutrition goals.