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PrintMedical guide - Supplements: Are they worth it?
Dieticians provide their take on the vitamins and minerals your diet might be missing.
Opinions are mixed on the necessity of supplements and vitamins. In the United States, the Dietary Supplement Health and Education Act of 1994 defines a dietary supplement.
Under the DSHEA, supplements include vitamins, minerals, herbs and amino acids. The U.S. Food and Drug Administration does not regulate supplements as drugs, but instead as food.
Unlike drugs, a company can market a supplement without studies proving it is safe for consumption. Once the supplement is on the market, if the FDA finds it is unsafe, the manufacturer can be issued a warning or the supplement can then be removed from shelves. Additionally, the manufacturer is not required to prove the supplement is effective. Instead, the manufacturer can say the product helps with nutrient deficiencies, supports health or reduces the risk of developing a health problem.
Jeffrey Galles, medical director at Utica Park Clinic, and Doug Tolbert, an exercise specialist at the Saint Francis Health Zone, agree that in the United States, if people eat a well-balanced diet, supplements are not necessary.
“If you are eating a well-balanced meal, you are probably getting what you need, unless you’re in just a real rigid workout routine,” Tolbert says. “You’re probably getting (the vitamins) if your eating habits are pretty good.”
But Sonja Stolfa, Saint Francis Hospital dietician, says many people don’t have the proper eating habits and could benefit from a multivitamin.
“Because, let’s face it, how many of us are eating our five (recommended servings of fruits and vegetables) a day ... ?” she says. “We try to strive for two to three fruits a day or two to three veggies. Honestly, if you go through your dietary history, how many days do you think you’ve hit that mark? It’s hard to get all that in and we should be trying to eat that way.”
And as people age, René Norman, of Nutrition Consultants of Tulsa, says nutrition needs to increase, while calorie intake should decrease. Around the age of 50 is a good time to start taking a multi-vitamin, such as One A Day or Centrum, she says. Children who are picky eaters can also take a multi-vitamin, such as Flintstones vitamins, she says. But, she notes, too many vitamins can also be harmful.
“Getting too much is a toxicity,” she says. “You can get too much of a good thing as well.”
Calcium supplements are also important for women to protect against osteoporosis, Stolfa says. She recommends that women take a calcium pill that includes vitamin D twice a day. Only so much calcium can be absorbed at once, so it’s best to take them in two different doses, she says.
“Read the label and the instructions because some say with or without food,” she says. “Calcium citrate is preferred because it’s absorbed easier.”
For its part, the Office of Dietary Supplements, part of the National Institutes of Health, reminds consumers on its Web site that dietary supplements are not intended to treat, diagnose, mitigate, prevent or cure disease.
“In some cases, dietary supplements may have unwanted effects, especially if taken before surgery or with other dietary supplements or medicines, or if you have certain health conditions,” the site says.
Without hard data on some supplements such as ginseng, the outcome can be risky, Norman says.
“I’m not going to say they don’t work, but I prefer to use supplements with hard data,” she says, adding that people should understand fully what they are ingesting. “People sometimes start taking them indiscriminately and it can cause blood to thin. When people start taking a handful and don’t know why, then that’s a problem.”
Tolbert cautions against supplements such as creatine, which some athletes use to gain muscle mass.
“They may speed up the metabolism,” he says. “They may allow you to burn a little better, but they dehydrate you fast, too. If you’re taking the supplements, talk to the professionals and find out the precautions you need to take. The dehydration factor really takes a toll on the body.”
However, Stolfa notes that some protein supplements can be used for either weight gain or weight loss.
“Usually healthy people within ideal body weights don’t need supplements unless there is a medical need,” she says. “For some of the weight-loss issues, a lot of times the protein supplements are healthy, and also for the weight-gain issues for people that have an inadequate dietary intake. So there are advantages to it. It can be used for weight gain and weight loss with good guidance.”
