Dietary Supplements — Wait, supplements to WHAT?
I’m one of the nearly 3/4 of adults in the US taking at least one dietary supplement. Dietary supplements include vitamins, botanicals, herbals, and other substances that are extracted from food sources or made synthetically to mimic chemicals contained in foods, and are intended to increase the quantity consumed in the diet.
So, does that mean that if we all ate a well-balanced diet, we wouldn’t need to use supplements? Well, yes. And no.
We know that lifestyle has a huge impact on health. In fact, for many of the common health concerns that prompt consumers to purchase dietary supplements, the main method of prevention and even initial treatment is often lifestyle change. A balanced diet that takes caloric intake into account is a large part of a healthy lifestyle. But physical activity that keeps the heart and muscles strong, keeps joints flexible, and burns calories goes right along with it. And don’t forget social engagement, which is known to keep the brain active. Research shows that we can prevent or lessen the effect of many chronic health problems such as diabetes, high blood pressure, and memory loss by engaging in a healthy lifestyle.
Of course, that’s easier said that done. But when it comes to dietary supplements, many of which don’t have good research backing up their effectiveness, it’s safe to say that including important nutrients in a well-balanced diet is more likely to improve health, especially when combined with physical and social activity. So it’s important to talk about what nutrients we can easily get from the diet and which ones we can’t.
Let’s talk about calcium.
It keeps bones and teeth strong and healthy, among other things. Most adults should get at least 1000mg every day, and women over about 50 along with men over 70 should try to take in about 1200mg daily. Does that mean that everyone should be taking a calcium supplement? Not necessarily. Many people eat a fair amount of calcium.
You can get almost a third of your requirement by drinking a glass of milk every day, drinking a glass of fortified orange juice or (yes, really!) hot chocolate. Cheese has between 10 and 25% of the daily requirement in every serving. Yogurt, cottage cheese, soy or almond milk, all contain a significant amount of calcium in each serving. Take a look at the nutritional labels on the foods you eat, and you might find that you eat plenty of calcium in your diet. If you only get a portion of your requirements on average, you can use supplements to make up for the portion not in your diet. Here’s a link for more information about foods that contain calcium.
Vitamin D, though, is a different story.
It’s harder to find in the diet, at least in amounts high enough to be meaningful. Our skin makes vitamin D from sunshine, but that requires us to live in areas that have lots of sunshine, and regularly expose our skin to the sun without sunscreen for a period of time, which carries its own health risks.
Official recommendations for daily vitamin D intake are 400-800 units (10-20 mcg). But many experts have been suggesting for some time now that most people should take in 1000-2000 units daily (25-50 mcg) to keep blood levels of vitamin D sufficiently high. Research continues and we’ll be hearing more about the optimal daily intake of vitamin D. For now, people wanting to maintain adequate levels of vitamin D without exposing skin to damaging UV rays will have a tough time finding enough in the diet. Take a look at this chart to find out what foods are highest in vitamin D.
How about fish oil?
Fish oil is a dietary supplement that is used by many people for a variety of reasons. Fish oil contains omega-3 fatty acids, including EPA and DHA. Another omega-3 fatty acid, ALA, is found in some nuts and seeds.
Research has shown that eating two 3-4 ounce servings of tuna or salmon weekly provides the necessary amount of fish oil for adults. Other types of fish, including mackerel, sardines, trout, mussels, oysters, and crab, and some other foods also contain significant amounts of omega-3 fatty acids. Here’s a chart showing the omega-3 content of various foods. For those who enjoy eating fish, supplements may be redundant. Interestingly, some of the foods that are highest in fish oil are also those that are highest in vitamin D!
Nutrients in the diet are more efficiently used by the body
In general, a healthy lifestyle including balanced diet, physical activity, and social engagement is the most reliable way to stay healthy. Knowing what our diet contains in the way of nutrients, though, will help us decide what, if any, dietary supplements we should take.
Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.