As a society we have been bombarded by advice and clever marketing surrounding supplements. It is an industry worth some £700 million in the UK and an incredible $30 billion in the USA. This alone is a flag to me except, of course, if I was a shareholder in the companies I'd be rubbing my hands together at the thought of all my dividend payments!
Have we all, though, come to see vitamins and nutrients as entities separate from their original food sources?
Our bodies have evolved over millions of years to be perfectly adapted to extracting nutrients and vitamins from a healthy varied diet (rich in fruit and vegetables and moderate intakes of other food groups), synthesizing metabolites as well as actually producing many vitamins in our intestines. We have the most incredible mechanisms for adjustment and regulation based on our requirements at any one time.
Scientists have told us what they believe are the important components in our food but do synthetic versions or extracts have the same effect as obtaining the nutrient or vitamin from food?
One study in 2012 looked at this question and found that in a clinical trial which compared natural broccoli to the equivalent broccoli extract; the natural product produced four times the amounts of the healthy polyphenols in the blood and urine compared to the artificial product. This suggests that the interplay between our food and the bio-availability of vitamins and nutrients is a complex one, more complex than science can currently explain. Our intestines are designed to gradually extract vitamins and nutrients from our food; but what of the sudden chemical surge that a handful or two of pills and capsules has on our stomach?
For some vitamins there is proven medical evidence of the benefit for supplementation, for example, folate for pre-conception and pregnancy. But outside of this group folate overdose is increasing, especially in countries that regularly add folate to manufactured food products such as bread. Many other vitamins and nutrients can be positively dangerous - in excess, in combination with each other or with over-the-counter and prescribed medicines. A degree in pharmacology is needed to navigate the potential rocks in this choppy sea!
I am not anti-supplementation, it has its purpose. Many people - many of us - have proven deficiency diseases or have poor diets because our diseases make it difficult to shop for and prepare meals from fresh ingredients or even stand in front of the heat of a cooker. My message here is one of safety; self-medication has the potential to endanger our already fragile health.
We all want to get better, feel better, reduce our symptoms BUT we need to exercise caution and common sense before trying something we have read about. The last thing any one of us needs is to (inadvertently) be making ourselves sicker.
So how do we do this? Here are my thoughts:
- Investigate whether gold-standard randomised controlled trials have been done and what were the results. Be aware that observational studies are not reliable as they can be biased.
- Remember one person's experience or outcome with a supplement may not be another's.
- Discuss with your doctor(s) but be aware they may not know every detail of every drug or supplement or every possible reaction or contra-indication between them.
- Read carefully all of the the Patient Information Leaflets for your medications and supplements to identify warnings relating to other medicines, supplements and herbs etc.
- Use reputable web resources to research reactions between your medications and proposed supplements.
- Ask your pharmacist. They do have degrees in pharmacology and are excellent information resources. Many (certainly in the UK) now offer full medication reviews.
- Make a full list of all your medications and actual/proposed supplements. Be prepared to leave it with the doctor(s) or a pharmacist to be properly checked.
And in the meantime, think about whether you can boost any particular vitamin or nutrient intake with an extra portion of food just as nature intended us to have it.