Diet supplements: Which should I take?

First of all; What are dietary supplements?

Dietary supplements are foodstuffs containing concentrated sources of nutrients which strive to supplement the normal diet. Their design often recommends for them to be taken in measured small amounts. They can contain nutrients on their own or in combination with others, and are found in a variety of forms including tablets, capsules, sachets and liquids. Some common examples of dietary supplements include multivitamin tablets, capsules of fish oils and effervescent vitamin C drinks.

What groups in our population are most likely to take diet supplements?

Firstly, a general multivitamin is the most popular dietary supplement on the market, with up to two thirds of our population taking one at some point in their lives. Vitamin C and fish oils are next in line, followed by vitamin D supplements.  People in the older age groups are more likely to take supplements when compared to younger age groups, and women take more supplements than men. And one statistic that stands out to me is that the often high cost of the supplements means that people in the higher socioeconomic groups are more likely to take supplements. Yet they are the least likely to need them seeing that they tend to have better dietary habits.

Why do people take dietary supplements?

Well the use of vitamin and mineral supplements started in the 1940’s and rose in popularity over the course of the 20th century, especially when buzz words such as “anti-oxidants” and “anti-inflammatory” started emerging in the 90’s. The most common reasons people give for taking a dietary supplement are to maintain or improve their health. Others then take supplements because they feel it may improve their immune systems, energy levels or metabolism. Many see dietary supplements as an “insurance” policy. They hope that their small investment will help them to stay healthy alongside (or instead of) a healthy balanced diet.

Are there any diet supplements that I should be taking?

Surprisingly, there is very little evidence to suggest that a dietary supplement can live up to these claims of building immune systems or improving our health. In fact, a large review of all the research available on this topic in 2013 found no clear benefit at all from taking dietary supplements.

To be honest, research stands by the idea that a healthy balanced diet will meet all our nutrient needs -except two. Current policies in Ireland recommend that only three population groups should be taking a dietary supplement. These are vitamin D for children under the age of 1 and adults over the age of 65years, and folic acid for women of childbearing age. So let’s take a closer look at these two supplements.

The reasons to take a vitamin D dietary supplement:

Vitamin D is an important vitamin that is needed to regulate the amount of calcium and phosphorous in our bodies. This in turn helps us to keep our bones, immune systems, muscles and teeth healthy. We often find some vitamin D in foods such as milk, eggs and oily fish. And we can also produce some vitamin D in our skin during summer. However, vitamin D deficiency in Ireland is relatively common, especially in young children and older adults. And so it is recommended that all children under the age of 1 should take 5 micrograms of vitamin D every day. However, this policy was recently updated to include only babies who are breastfed or receive less than 300mls of infant formula (1). And adults over the age of 65 are now recommended to take 15 micrograms of vitamin D daily for the full year. But for other population groups, there is no standard recommendation to take vitamin D supplements as of yet.

The reasons to take a folic acid dietary supplement:

Folic acid is the name for Vitamin B9 and has many functions in our body. These include tissue growth, red blood cell formation and creating new proteins. Folic acid is especially important during pregnancy, when it plays a role in the development of the spinal cord of the unborn baby. Research has shown that up to 70% of cases of neural tube defects in unborn babies can be prevented if the mother takes a folic acid supplement daily. Hence there is a national recommendation for women to take 400 micrograms daily of folic acid from a supplement in the 3 months before becoming pregnant and throughout the entirety of pregnancy.

But what about all the other diet supplements out there?

Well, other than the vitamin D and folic acid supplements, there are no other dietary supplements that are recommended for the general population. However, your GP or dietitian may recommend additional vitamin or mineral supplements specific to your condition, blood results and diet. For example, many people with osteopenia or osteoporosis may be recommended by their GP to take vitamin D and calcium tablets. And people with a very small appetite, or who are eating a very limited diet or who are simply unable to eat enough, may be recommended by their dietitian to take a multivitamin, or more specific vitamin/mineral supplements. Some athletes may also benefit from more sport-specific supplements, however these must always be discussed with their sports dietitian to make sure that it will not interfere with their anti-doping testing.

Would you eat the sprinkles without the cake?

So when it comes to supplements, a question I like asking is, would you eat the sprinkles without the cake? A brilliant sports dietitian in Ireland used this analogy not long ago during a presentation on dietary supplements, and I thought it really helped highlight what role a supplement can play in our diet!

I want you to see these dietary supplements as sprinkles on a cake. Imagine that you were to bake a birthday cake for a friend’s birthday, but instead of baking a cake, you just placed the empty cake tin on the table at the party and sprinkled some hundreds and thousands on the empty base of the tin… You would have really missed the point of how to use the sprinkles right?

The same counts for our diet. Let’s get those basics right first, lets perfect that cake! Include plenty of fruit and veg, some wholegrain carbs, moderate amounts of dairy/meat/fish and only occasional high fat/sugar treats. Once we have perfected that diet, then we could potentially turn our eye to the supplements.

But then again, do we really need those sprinkles if that cake is perfect as is?

I hope this post has helped you see through the fog that surrounds the many dietary supplements that we see on our pharmacy and supermarket shelves! Remember guys, in my next post I will be answering your very own questions on the topic of fad diets and dietary supplements! 

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