Many adults and children take at least one supplement or vitamin a day, largely due to the belief that doing so will have a positive impact on their nutritional health. But how does supplementation compare to whole foods? And is supplementation even necessary in a balanced diet?
Most studies that research the effects of vitamin and mineral supplementation on long-term health outcomes have yet to show clear benefits for prevention of chronic diseases (that aren’t directly related to nutritional deficiencies). In fact, some studies show that some nutritional supplements in excess may have harmful effects. So, before you stop in at your local chemist, let’s look at which is better: food or supplements?
What Are Supplements?
Supplements are products designed to give you nutrients that may be missing from your diet. Classically they come in the form of a tablet, capsules or as a powder or liquid. Supplements are a broad term and can include things such as vitamins and minerals, oil supplements and herbal supplements. People usually take supplements to reduce their risk of chronic diseases, such as osteoporosis or arthritis. Most all dietary supplements can be purchased over the counter and do not require a prescription.
Are Vitamins and Supplements the Same?
So, what’s the difference between a dietary supplement and a vitamin? While all vitamins are technically supplements, not all supplements are vitamins. Supplements are often made up of multiple ingredients. Meanwhile, vitamins are more specific but there can be more than one vitamin present in a product, such as multi-vitamins. Multi-vitamins will have all ingredients clearly labelled on the packaging and should show the exact amount of each ingredient present in the product.
Furthermore, vitamins are naturally occurring in fruit, vegetables, meat and other foods. Our bodies can’t naturally create vitamins and the best way to get these vitamins is through eating a balanced diet.
Federal Regulation of Supplements
In Australia supplements may be regulated as either a food or medicine depending on whether it meets the Food Standards Code or the Therapeutic Goods Act (TGA). Supplements that only contain ingredients appropriate for food, are presented in a ‘traditional form,’ and do not make a therapeutic use claim usually fall under the Food Standards Code. For example, protein powder, bars and energy drinks are all regulated by the Food Standards Code.
Supplements that make therapeutic use claims, such as some herbal blends, vitamins and minerals, are regulated as medicines by the TGA. These supplements go through an assessment process to decide their safety, quality and efficacy before allowing them to be legally supplied in Australia. Any product that is regulated by the TGA will have an ‘AUST’ number on the label.
Supplements When Pregnant or Breastfeeding
There is quality evidence supporting the use of some supplementation during pregnancy. The American College of Obstetricians and Gynaecologists states the following as key vitamins and minerals during pregnancy:
- Calcium
- Iron
- Iodine
- Choline
- Vitamin C
- Vitamin D
- Vitamin B6 & B12
- Folic acid
Women who may become pregnant or are in their first trimester of pregnancy should mainly consider taking adequate amounts of folic acid. Luckily, prenatal vitamins supply this and more essential vitamins and minerals to support the body during pregnancy. If you are breastfeeding and your infant is gaining weight healthily the only supplement that is recommended is Vitamin D. While breast milk contains Vitamin D it is usually not in adequate amounts. Vitamin D can also be obtained through exposure to sunlight (same as in adults) however, the potential risk of sunburn is greater than the potential benefit of sun exposure.
Vitamin A, however, should be avoided because an excess of Vitamin A can cause harm to your unborn child—excessive vitamin A has been shown to cause congenital birth abnormalities. So, if you choose to have a multivitamin during pregnancy opt for a specific prenatal multivitamin. Be sure to check if vitamin A is excluded if you opt for a more generic multivitamin blend.
Which Supplements Should Vegans Take?
For those who practice a vegetarian or vegan diet supplementation can be beneficial in ensuring you have an adequate intake of essential vitamins and minerals. Vegetarians (like vegans) need to ensure they are obtaining enough iron and Vitamin B12. Iron can be found in foods such as beans, lentils, peas and nuts as well as dark green leafy vegetables. However, Vitamin B12 is only naturally found in animal products. Vegetarians can get adequate amounts of B12 through most dairy products and eggs.
Vegans, on the other hand, may find getting adequate amounts of B12 more difficult. Luckily for vegans, plenty of food products these days are fortified with Vitamin B12 such as breakfast cereals or yeast extracts. Vegans also may have trouble getting enough calcium in their diet; however, this again can be sufficiently obtained through fortified foods or other forms of supplementation.
Why Supplements Can’t Replace Food?
Supplementation should never be used in lieu of a healthy and well-balanced diet. In most cases truly little benefit, if any, is provided beyond what is gained by a balanced diet. There are many advantages to obtaining minerals and vitamins from foods instead of supplements. Micronutrients in food are typically better absorbed by the body and are associated with fewer adverse effects. Foods also supply a much wider array of good quality nutritional substances and in more optimal ratios. Research shows that positive health outcomes are more strongly related to dietary patterns and specific food types as opposed to individual micronutrient or nutrient intake.
The Verdict
Are whole foods better than supplementation? Not really. Although there is a place for supplementation, it’s just not generally recommended for healthy adults. People suffering from medical conditions that interfere with nutrient absorption or their metabolism, such as pernicious anaemia, Crohn’s disease and other inflammatory bowel diseases, osteoporosis and other bone health issues, benefit from supplementation of specific micronutrients. Otherwise, it’s almost always better to get the nutrients you need from a well-balanced diet.
So, before you head out to the chemist, have a look in your medicine cabinet and pull out all the vitamins you’re using. Then, head over to Web Md and take this quiz to determine if
1. you need supplementation,
2. which supplements are right for you, and
3. if the supplements you’re currently taking are the ones you need.
Make the necessary adjustments accordingly, just don’t forget to maintain a healthy, well-balanced diet amidst it all.
For more information on the latest evidence-based health and wellness information, keep an eye on our blog Incite Health.
Disclaimer: No content on this platform, regardless of consideration, can be used as a substitute for direct medical advice from your physician or other qualified clinicians. Seek professional advice from your GP or medical doctor prior to making any drastic changes to your diet/supplementation intake.
Lachlan Fisher
BHS/AppSc (chiropractor)
References
(1) Manson, J. E., & Bassuk, S. S. (2018). Vitamin and Mineral Supplements. JAMA, 319(9), 859. doi:10.1001/jama.2017.21012
(2) Guallar, E., Stranges, S., Mulrow, C., Appel, L. J., & Miller, E. R. (2013). Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements. Annals of Internal Medicine, 159(12), 850–851. doi:10.7326/0003-4819-159-12-201312170-00011
(3) https://www.healthdirect.gov.au/food-supplements
(4) https://www.tga.gov.au/media-release/sports-supplements-australia
(5) https://www.tga.gov.au/blogs/tga-topics/how-are-vitamins-regulated-australia
(7) https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/
(8) https://www.nhs.uk/live-well/eat-well/vegetarian-and-vegan-diets-q-and-a/