Be supplement savvy
To make sense of the many conflicting ‘reports’ about the benefits and dangers of nutritional supplements, GP and nutritionist Dr Sarah Brewer and Rob Hobson, Healthspan’s head of nutrition, talk with Abi Jackson
DOES EVERYBODY ‘NEED’ TO TAKE SUPPLEMENTS?
Supplements, as the name suggests, are there to help supplement a diet that may be lacking in certain nutrients, and of course food should always come first.
In an ideal world, we’d all get all the vitamins and minerals we need from our diets. But in reality, few achieve this, and our diet can change from one week to the next depending on many different lifestyle factors, including cutting back meals to lose weight.
he National Diet and Nutrition Surveys show that significant numbers of people do not get the reference nutrient intake (RNI) for many micronutrients. Even for those who consciously eat healthily, the nutritional content of many foods is depleted compared with how it was even a few decades ago (there’s concern intensive farming methods may play a part in this).
For example, selenium intake has dropped by 50% in the last 20 years due to the sourcing of wheat from low selenium areas; the beneficial fatty acid content of meat and eggs is significantly lower in animals that have been intensively reared; fish consumption’s dropped by 50% in 60 years which is having dramatic consequences on the intake of omega 3 fatty acids. An increase in refined grains has also seen a drop in B vitamins, magnesium, calcium, chromium, iron and zinc.
DOES A MULTI-VITAMIN TICK ALL THE BOXES, OR SHOULD PEOPLE CHOOSE SPECIFIC SUPPLEMENTS?
A broad spectrum multi-vitamin and mineral will provide a cost-effective ‘back-up’ to cover most needs, but some people may benefit from additional supplements if they choose to exclude certain food groups from their diet. Examples include vegans, who will benefit from taking a vegan omega 3 supplement as, without oily fish, it’s difficult to obtain sufficient essential fatty acids. Vegans also benefit from a vitamin D supplement (normally found in dairy, oily fish and eggs) and a vegetarian source of vitamin B12.
Over-50s may benefit from eating more foods fortified with Vitamin B12 or taking a multi-vitamin that contains B12.
People who don’t consume enough calories and enough fruit and vegetables could benefit from a multi-vitamin and mineral, and people with a medical condition that affects how their body absorbs nutrients may need additional supplements. Plus, women who experience heavy periods may need an iron supplement.
DO DOCTORS ADVOCATE PEOPLE TAKING SUPPLEMENTS?
Most health professionals understand the benefit of using supplements sensibly and when necessary. For example, folic acid during pregnancy, vitamins A, C and D for children aged under five, iron to treat iron-deficiency anaemia and calcium for those at risk of osteoporosis. Different GPs have different special interests, and a growing number are studying for a diploma, or even a Master’s degree, in nutritional medicine. There’s still a ‘knowledge gap’ on nutritional supplements in everyday general practice among GPs, practice nurses and health visitors. Supplements are only there to supplement the diet, not replace food source, but some health professionals are opposed to their use as they’ve either not researched their benefits or don’t have the necessary knowledge to know which doses are safe.
ARE ALL SUPPLEMENTS PROVEN TO BE BENEFICIAL AND HOW DO YOU KNOW YOU’RE BUYING FROM A RELIABLE SOURCE?
When required, supplements are of proven benefit for treating nutritional deficiency diseases. The most famous is vitamin C and the prevention of scurvy but this condition is rarely seen in the UK.
We do however have growing numbers of children being diagnosed with rickets, which is associated with lack of vitamin D, and osteoporosis which can be associated with poor calcium intakes. Nutritional supplements are then used as part of conventional medical treatment.
When buying supplements, choose a long-standing reputable retailer – it’s important to check they are made to a pharmaceutical standard known as GMP (Good Manufacturing Practice) as this confirms they contain exactly what’s stated on the label. Similarly, when buying a traditional herbal medicine, it’s important to look for the THR (Traditional Herbal Registration) certification sign. A licensed traditional herbal medicine will also contain a Patient Information Leaflet detailing how to take them, possible side-effects, known interactions and advice about who should not use them.
Mostly supplements are taken as an insurance policy to safeguard future health, so don’t expect to suddenly experience radical changes in your health and wellbeing, rather gradual changes over time.
SHOULD PEOPLE ALREADY ON MEDICATION SEEK ADVICE FROM THEIR DOCTOR BEFORE TAKING SUPPLEMENTS?
Yes, you should always seek advice when taking medicines and consult your GP to check for drug-nutrient interactions.
CAN SUPPLEMENTS CURE DISEASES?
Supplements can only cure a deficiency disease – for example, vitamin C can cure scurvy. Supplements cannot ‘cure’ other health problems such as high blood pressure or heart disease, but they can complement the conventional medical treatment. For example, supplements containing potassium and magnesium may help to lower blood pressure if used alongside diet and lifestyle changes, but medication may still be needed.
DO SUPPLEMENTS ONLY WORK IF YOU TAKE THEM AT THE SAME TIME EVERY DAY?
This is another common myth. Regularity is important when taking supplements, mainly to ensure that you DO take them each day! There are also better times of the day to take certain supplements. Many people like to take them in the morning, so that it becomes part of their breakfast routine. Vitamins and minerals should be taken with meals, when digestion’s most active, for maximum absorption. Stimulating supplements, such as ginseng, are best taken in the early part of the day, not before bedtime. B vitamins and vitamin C are water-soluble and are the more ‘stimulating’ members of the vitamin group, so avoid taking these at night too.
Disclaimer
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