Simplifying Supplements

By Carmel Wroth, Ode Magazine

Studies have repeatedly shown that the typical Western diet corresponds to higher risks of heart disease, cancer and other chronic conditions, such as diabetes. Bruce Ames, a nutrition researcher at the Children’s Hospital Oakland Research Institute, has a theory about how the diet-disease connection may work. “There are about 40 micronutrients you need to run your metabolism,” says Ames. “If you don’t get any one of them, you die. What we’re learning is the consequence of not getting enough is that your body cuts back on certain functions that affect long-term health. When you’re short of micronutrients, there’s a lot of hidden damage going on.”

The World Health Organization has stated that diet is second only to smoking as a preventable cause of cancer. Indeed, the United States Department of Agriculture (USDA), American Heart Association and American Cancer Society have made dietary recommendations a central part of their disease-prevention messages, suggesting we eat more fruit and vegetables, replace refined carbs with whole grains and cut down on junk food. Yet according to Centers for Disease Control and Prevention (CDC) surveys, only 11 percent of Americans meet the USDA’s guidelines for eating five to nine servings of fresh fruit and vegetables daily. The nutrient shortfalls are dramatic. According to data gathered from 1999 to 2002 and compiled by the CDC, 93 percent of Americans don’t get enough vitamin E, 56 percent don’t get enough magnesium, 31 percent don’t get enough vitamin C and 12 percent don’t get enough zinc. Another CDC survey indicated many people are low on vitamin K, calcium and potassium, and many seniors lack B vitamins.

The first step to fixing nutrient shortfalls is to improve diet, says Yale University nutrition researcher David Katz. The 40 or so isolated micronutrients that scientists study – and supplement companies pack into capsules – are only a fraction of the array of organic compounds found in food. Indeed, many vitamins are not a single “vitamin” but a family of compounds. And our bodies need these complementary nutrients to make use of these vitamins. When you get your vitamin C in a piece of fruit, for example, it comes with a lot of other ingredients – fiber, antioxidants and trace minerals – that might help you more consumed together than if you down vitamin C alone in a supplement. “It may be that the active ingredient in broccoli is broccoli,” says Katz. “People who don’t want to eat broccoli and take a vitamin instead will probably be disappointed. If you want the benefits of nutrients in foods, you need to eat foods rich in nutrients.”

Next: The decline of nutrition in food: are you getting enough vitamins?

The trouble, argues Lynne McTaggart, editor of the monthly U.K. health journal What Doctors Don’t Tell You, is that even if you do eat your broccoli, you may not be getting what you need. “Food isn’t as nutritious as it once was,” she says, pointing to research that shows a decrease in nutrient levels in produce compared with what was harvested a few decades ago. In 2007, Brian Halweil, a researcher at the Worldwatch Institute, reviewed several projects that examined nutrient levels in produce. In a report published by the Organic Center of Boulder, Colorado, he concluded that breeding for high yields has diluted the nutritional quality of the plants we eat. According to data collected by government agencies in the U.S. and U.K., modern harvests are lower in many nutrients than those in the 1940s and 1950s, including magnesium, iron, potassium, calcium, riboflavin and vitamin C.

Halweil also highlighted research suggesting that conventional produce grown in poor soils and bathed in synthetic fertilizers may have lower levels of nutrients than that grown with organic techniques. But even organic food has come in for criticism; a report commissioned by the U.K. Food Standards Agency (FSA) found no substantial difference in nutritional content between organic and conventional food, a finding strongly contested by the Organic Center, the U.K. Soil Association and others.

Still, to many nutrition experts, supplements make a lot of sense. “Even people who consistently eat well can benefit from supplementation,” says Weil. “Optimal intakes of key nutrients, in amounts sufficient to enhance health beyond the prevention of deficiency states, can be difficult to obtain through diet alone.”

At least 50 percent of Americans take a supplement, and 35 percent take a multivitamin. Some 4.2 billion dollars was spent on multivitamins alone in 2005, according to the Council for Responsible Nutrition, a trade organization representing the industry.

Vitamins were first discovered in the early 20th century when researchers observed that certain diseases correlate to dietary patterns. In the 1920s and 1930s, scientists discovered links between scurvy and vitamin C, blindness and vitamin A, and rickets and vitamin D. Though these deficiency diseases have been virtually eliminated in the West, through fortification and greater access to a wide variety of nourishing foods, many people in the developing world still suffer from them.

While most Americans don’t suffer from overt deficiencies, Ames argues many of us may be suffering from less obvious shortfalls that contribute to disease.

“There are many diseases that could be a long-term consequence of being deficient in one or more nutrients,” argues McTaggart. “There’s a lot of evidence that vitamins and minerals protect against illness. Jeffrey Blumberg, a nutrition scientist at the Tufts University Friedman School of Nutrition Science and Policy in Boston, Massachusetts, points out that certain benefits of supplements have been verified. Vitamins A, C and E can help protect against age-related macular degeneration, an eye condition that can lead to blindness, and vitamin E boosts immune response. A combination of vitamin E and selenium looks promising for fending off cancer, he says, and several studies support a potential cancer prevention benefit from vitamin D and calcium. There’s also good research linking omega-3 supplements to reduced risk of heart attack.

Which supplements should we choose? How many should we take? And in what form should we take them? The key to choosing supplements is to analyze your own dietary patterns, says Yale’s David Katz. “Look at your diet and figure out what nutrient you might be deficient in. Make the supplements match the likely pattern of gaps in your diet.”

Next: Which supplements to choose and which to avoid


Blumberg, like many others, recommends choosing a multivitamin containing moderate dosages of nutrients, between 100 and 200 percent of the U.S. National Academy of Sciences’ Dietary Reference Intake levels. Avoid pills that have high amounts of single nutrients. Irwin Rosenberg, a Tufts University scientist who helped set these levels, cautions against taking too much of vitamins A and D, which can accumulate in the body and become toxic, leading to liver damage. He also says to watch out for excessive minerals, many of which can be harmful in high doses.

In addition, says Victoria Maizes, director of the Arizona Center for Integrative Medicine, avoid any supplement that contains pre-formed vitamin A, which appears only in food from animal sources and can be harmful in high doses. Read labels carefully, she says, and choose a pill that contains mixed carotenoids, compounds found in colorful fruits and vegetables that are formed into vitamin A in the body. Carotenoids have additional antioxidant effects and no risk of toxicity. Also, check what type of vitamin E is in the pill; the best is natural mixed tocopherols, which are absorbed more efficiently. Finally, it’s a good idea to choose a pill designed for your gender and age, as nutrient needs vary. Women of childbearing age, for example, need to make sure they’re getting enough iron, so multivitamins for women typically have more iron. Older people have different requirements as well, and in general need more vitamin D and vitamin B12.

Calcium, vitamin D and magnesium

Since calcium, which helps protect bones, is a bulky molecule, most multivitamins don’t have more than about 10 percent of the daily requirement, says Blumberg, so an additional pill is a good idea. Your body can’t fully assimilate calcium without vitamin D and magnesium, so if you decide to take a supplement, choose one that includes all three.

Bone health is affected by protein-rich foods and excessive sweets, which disrupt the acid/alkaline balance in our bodies. “The body doesn’t want blood to be acidic,” says Amy Lanou, a nutrition scientist at the University of North Carolina at Asheville and author of Building Bone Vitality, “so it pulls calcium compounds from bones to neutralize acidity.” This contributes to the high rate of bone fractures and osteoporosis among the elderly. To protect your bones, Lanou recommends eating more alkalinizing foods beans, whole grains and vegetables.

Taking vitamin D alone, or with calcium, may decrease the risk of some cancers, yet many of us don’t get enough vitamin D. The vitamin doesn’t appear in most foods; the primary way we get it is through our skin when it’s exposed to sunlight. To ensure enough vitamin D, many experts now recommend about 20 minutes a day of sun, without sunblock, or a supplement.

Omega-3 fatty acids

Essential fatty acids found in vegetable and animal fats are important building blocks for cells and regulate many of the body’s functions. Evidence is mounting that the typical modern diet, which is high in animal fats and vegetable oils, overemphasizes omega-6 fatty acids, which can cause inflammation. They also deliver too few of the anti-inflammatory omega-3 fatty acids found in green plants, certain nuts and seeds, fatty fish and fats from animals that graze on grass.

To combat this problem, experts recommend increasing omega-3 intake with a fish oil supplement. David Servan-Schreiber, a physician and professor of psychiatry at the University of Pittsburgh School of Medicine as well as author of Anticancer: A New Way of Life, says having the right balance of essential fatty acids can reduce the body’s inflammatory response and protect against illness. “All the chronic degenerative diseases stem from a high level of inflammation in the body,” he says.

The U.S. National Institutes of Health (NIH) reports that most Americans get about 10 times more omega-6 fatty acids than omega-3s; other estimates suggest that number may be as high as 25 times more. The NIH has determined that adequate consumption of omega-3s can protect against heart disease, and the American Heart Association recommends the supplement for heart disease patients. Other research suggests omega-3s may also protect against cancer, bone disease and mood disorders, including depression, and support brain health as we age.

One reason many of us may have an omega imbalance is that the meat, dairy and eggs we typically consume are from animals raised on corn and soy. Corn and soy are high in omega-6 fatty acids, while grass is rich in omega-3s. Most packaged sweets and snacks contain soy oil high in omega-6s. To get a better omega balance, choose grass-fed sources for animal products and eat fewer packaged snacks, fried foods and cheap vegetable oils, such as salad dressings made with corn or soy oil. And eat more fish, beans, tofu, flax seeds and walnuts.

Yale nutrition researcher Katz recommends taking supplements made from dehydrated whole fruits and vegetables. Whole foods supplements contain more of what you’d find in the plant, so they’re more likely to deliver the best antioxidant benefit, since isolated compounds tend to have fewer antioxidants than whole foods. Experts suggest avoiding ingredients such as dyes, synthetic sweeteners, flavorings and preservatives.

Another point to consider, particularly regarding multivitamins, is whether you have the discipline to take more than one pill a day. One-a-day pills usually contain isolated nutrients. Some supplements are formulated with extra food-based ingredients and these need to be taken several times a day to get the suggested amount of nutrients. But they may also have added benefits. “The food-grown stuff is closer to food and lower in potency and is very well absorbed,” says Don Summerfield, co-founder of Pharmaca Integrative Pharmacies, a chain of natural medicine stores based in Boulder, Colorado.

Supplements can come in either tablet or capsule form or as a liquid. There’s no real difference, according to Katz, unless the tablet is poorly formulated and doesn’t break down well in the digestive tract. If you’re not sure about quality, ConsumerLab independently tests supplements to verify that they contain the alleged ingredients and are free of toxins.

But all experts agree good health isn’t simply a matter of popping pills. “The basic principle is that supplements are not substitutes,” says Tuft University’s Blumberg. “You can’t eat a terrible diet and take supplements and think you are okay.”

“While it is possible to obtain sufficient amounts of important nutrients through a healthy diet, it is nonetheless difficult,” concludes Weil. “Improving your diet will certainly contribute to your health, but getting a consistent level of nutrient intake through diet alone is a challenge, one best met through appropriate supplementation.”

Carmel Wroth has sworn to give up junk food, but can still sometimes be found nervously clutching a soft drink.

Ode, the magazine for Intelligent Optimists, is an international independent journal that publishes positive news, about the people and ideas that are changing our world for the better. Click here for your FREE issue.

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Jo S.
Jo S.7 months ago

Thanks for the info Megan.

Linda Testerman
Linda Testerman5 years ago

PLEASE be very careful with the supplements- 25 years ago I took a supplement(L-tryptophane) to help my migraines. Little did I know that they were contaminated. I am now left with a disease that is totally dibilitating- some have even died. Be sure you know where your supplements are manufactured and if they are pure.

Jane L.5 years ago


megan m.
megan m.6 years ago

"To get a better omega balance, choose grass-fed sources for animal products and eat fewer packaged snacks, fried foods and cheap vegetable oils, such as salad dressings made with corn or SOY oil. And eat more fish, beans, TOFU, flax seeds and walnuts."

um, tofu is soy.... otherwise good article.

Tim L.
Tim L.6 years ago

It is really good information, however I think one reason people don't eat enough fruit is cost, with things like apples that cost 50 to 75 cents each it could cost 25$ a day to feed 9 servings of fruit to a family of 4....

Ax R.
Vicky L.6 years ago

This all sounds anything but simple!

I've been avoiding supplements so far, but now being anemic I need to take high dose iron (far exceeding normal daily recommendation).

I think eating good quality animal products and large amounts of vegetables (even if they're not as nutritious as they once were) should provide most nutrition you need. That's of course if you don't have to exclude some type of food (for whatever reason), then you should look at what you're missing out on and supplement your diet.
The section on Omega3 FA is especially well written here, and again historic records show that people eating diverse and unprocessed foods used to consume well balanced FA composition long before NIH guidelines or any other official documentation

Kimberly Dunn
Kim Donavan6 years ago

If you feel the need to add supplements, make sure it's a whole food supplement. It makes all the difference in the world!

Elvira S.
Elvira S.6 years ago

Very good information, Megan, thanks so much. Also thanks to Alex for mentioning "other Ingredients", we really must be careful. It appears to me that so many foods have been altered due to human manipulation for profit, mainly in the dairy and large scale meat industry. How can industry produced meat be healthy when the animals lived confined under extreme stress eating only a certain type of food such as corn?

Cindy M.
Cindy M.6 years ago

A few things to note: If you take supplements, do so after you eat something with that same thing in it. Yes, you may be getting it in the food first, but why are you taking the supplement? This is because you can't always get enough from the food, especially, and unfortunately, today. But eat the food first!!! Otherwise, your body will become lazy and only take it from the pill, since it's easier to obtain. Therefore, it's not only not as healthy, but your body won't get the exercise it needs in order to break up the food properly/digest, and then you'll always be dependent on supplements and also have other problems.
Second, be sure your supplements break up properly. There are tons of elderly people whose insides are laden with capsules which never broke down, causing them all kinds of problems. To check yours, put it in a glass of water and wait a while. It's not wasted, you can still drink it. Some take longer to break down, yes, and even a day later, it's still broken down. But if it doesn't break down, QUIT taking it!!!
Also, organics are GREAT! But people have still gotten E-coli (at least the last thing traced to) things like spinach. Makes NO sense. But it was cross contaminated somehow, so still wash unless you really know your source. Otherwise, with great soil & care etc., a strawberry can be a complete food to survive solely on, if NOT washed. In that case, it's actually healthier NOT to wash it, because we wash off nutrients.

Antonio S.
Antonio M.6 years ago

Thanks for this good information!