Supplement Skepticism and the Key to a Healthy 2017

2017 is now in full swing, and I know many of you are working hard at those resolutions you might have made a couple of weeks ago.  Many people like to use New Years to kick start a plan to be healthy.  Gyms and yoga classes always seem packed with motivated individuals in January, as people begin to invest more time and money into their health.  I see nothing wrong with this.  In fact, I believe there is no better use of time and money than getting healthy, whether it be signing up for a new workout class or buying more produce and less fast food.

Small Changes for a Healthy Life

It is important, however, not to get too swept up in all of the fads that seem to pop up around this time of year.  Every year I notice an upswing in advertisements for cleanses, supplements, and programs that claim drastic changes in physique in a few short weeks. Drastic should be setting off alarms in your head.  Yes, change is possible (I work in weight-loss research after all), but you shouldn’t expect or even desire drastic changes in a month or even two months.  Furthermore, if your motivation is truly health related, and you’re not just squatting for Beyonce’s butt or crunching for Shakira’s abs, than the best thing you can do is make small sustainable changes and be patient.  I would argue that developing healthy habits is the single most important thing you can do in the New Year, whether that be making a conscious effort to get eight hours of sleep a night or starting to walk or bike more to work/school.


What’s up with Supplements?

When getting wrapped up in your health goals this year, I would caution against going overboard on the supplements.  Supplements are generally understood to be vitamins, minerals, fiber, amino acids, fatty acids, herbs, botanicals, or other nutrients intended to provide nutrients or serve some health-related purpose.  Walk into any grocery store or pharmacy and you’ll see that the supplement business is a huge industry.  The other day in Whole Foods, I noticed that there were over ten different brands carrying vitamin c alone.

Before I get into the nitty gritty of the supplement world, I want to state that the research on supplements tends to be quite murky, often leading to confusion for us as consumers.  I also want to state that I understand that there is sometimes a need for supplementation.  In fact, I would advise those with restrictive diets or specific deficiencies (evident from a simple blood test) to take certain supplements after consulting with a physician. It is not, however,  a great idea to drink too much of the supplement Kool Aid.  It’s just too easy to get wrapped up in an expensive, usually unnecessary, and potentially dangerous habit.  Here’s why:

1. Dietary Supplements are not regulated

Supplements are not regulated by the FDA as drugs are.  The Dietary Supplement Health and Education Act of 1994 categorized supplements as a category of food. (NIH)  This means that supplements are not regulated as extensively as drugs are.  Instead, they are considered safe until proven otherwise.  Although manufacturing is overseen by a number of agencies, it does not go through the extensive examination that medications do.  Most importantly, supplements are not proven safe prior to going on the market.  If substantial evidence is provided once a supplement is already on the market, than the FDA will take action against the manufacturer or distributer.  Manufacturers are also not required to prove supplements effective as drug manufacturers are required to do.  As my dad sometimes puts it, you could be consuming expensive dirt pills that don’t do much of anything.


2. Just because it’s “natural” doesn’t mean there are no side effects

Even though supplements are classified as a type of food, you can’t expect your body to react in the same way.  Taking a fish oil pill is different from eating a piece of salmon, and shocker, just because it’s natural man, doesn’t mean it always comes side-effect free.

One example is ginkgo biloba, which is extracted from the leaves of the ginkgo biloba tree, and taken to sharpen memory and increase cognitive function.  Although it is generally regarded as safe, some studies have shown internal bleeding as a potential complication along with changes in blood pressure. (Bent, Stephen)

Just as supplements are not submitted to the rigorous screening that drugs are, there also aren’t many regulations regarding warning labels on supplements.  The moral of the story is, it’s important to do your research.  Like anything new you’re taking, know the risks and side-effects prior to taking.  Just because something comes from a plant or a tree, doesn’t automatically make it safe.

3. Supplements often contain way more than you actually need

Take a look at the back of the label sometime and you will see that many supplements contain greater than 100% DV or daily value.  I’ve even seen pills containing 500%-1,000% DV.  The reason for this is that pills are not the most efficient means for nutrient absorption, and not all will be absorbed.  Even so, I would be wary of consuming more than one pill per day that contains 1,000% DV.

Did you know that taking too many supplements can be dangerous?

Over 60,000 cases of vitamin toxicity are reported to US poison control centers annually. (Rosenbloom, Mark)  I bet you’ve heard that you just pee out excess vitamins, and while that may be partially true for some water-soluble (Bs and C) vitamins, it’s not for fat-soluble vitamins (A, D, E, K).  Fat soluble vitamins are stored in the liver and adipose tissues, and typically aren’t necessary on a daily basis.  Because of this, fat-soluble vitamins have a higher potential for toxicity, and supplementation should be approached with caution.

Vitamin toxicity is rare and almost never caused by diet, but rather by excessive supplementation.  I once met a man in clinic with painful neuropathy caused by vitamin B6 toxicity who had been taking vitamin B6 in addition to eating a diet rich in B6.  Note: even excessive water-soluble vitamin supplementation can result in toxicity.

If you have children, be cautious with iron.  Iron containing supplements tend to be the most toxic and toxicity is relatively common in children.  Symptoms include nausea and blood in vomit.

4. Most people who eat a healthy balanced diet don’t need supplements

Nutrients are best absorbed from foods.  According to Dr. Howard D. Sesso, associate professor of medicine at Harvard Medical School and Medical Editor of the Special Health Report, people ideally should try to meet their micronutrient needs through diet rather than supplements. (Harvard Health Publications) Whole foods contain essential vitamins and minerals in addition to dietary fiber and other compounds, which shocker here, makes whole foods a much better source of health and balance.  Again, unless you have a deficiency or a preexisting condition that affects nutrient absorption, supplementation is not necessary.  In fact, even if you don’t have the healthiest diet, you may still be fine, as our bodies are exceptional at absorbing and holding on to what it needs to function properly.


5. People sometimes use supplements as an excuse to make poor nutrition decisions.

Even if a pill, drink, or powder claims to contain all of your nutrient needs, it’s not an excuse to eat crap.  Eating is not just checking nutrients off an internal checklist, the package that your nutrients comes in does matter.  Just because you had your Soylent for breakfast, doesn’t mean you can eschew fruit and vegetables, and it really doesn’t make it alright to subsist on fries and doughnuts. Also, your body does not register liquids in the same way that it does solids, so drinking your your nutrients may leave you less satisfied than if you were to eat a balanced meal.

The best way to have a healthy diet is to approach meals with balance, variety, and moderation.  Choose good, whole foods to fuel a healthy you.

” Just because you had your Soylent for breakfast, doesn’t mean you can eschew fruit and vegetables, and it really doesn’t make it alright to subsist on fries and doughnuts.”

Exceptions when I would advise supplementation

  1. Prenatal vitamins- Pregnant or planning to get pregnant?  Getting enough vitamins during pregnancy is essential and supplementation may be necessary
  2. Vegan diet- make sure you get your Bs and iron, particularly women
  3. Conditions or medications that mess with absorption of certain nutrients


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