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Walk into any drugstore in America and you will find at least An entire aisle is devoted to supplements that claim to support better health. Hear every claim associated with those supplements and you might have a Stanley Cup full of pills to take every morning.
But of all the supplements out there, are there any that are really worth taking? According to nutritionists, the answer is simpler than you might think.
Does anyone need supplements?
According to Joan Manson, professor of medicine at Harvard Medical School and chief of the division of preventive medicine at Brigham and Women's Hospital, most healthy people can get all the essential vitamins and minerals from their diet. “Dietary supplements will never be a substitute for a healthy diet and healthy lifestyle,” explains Manson. In Verse.
In fact, David Serres, a professor of medicine at the Institute of Human Nutrition at Columbia University Medical Center, takes this claim one step further: “Almost no one needs to take supplements,” he explains. In Verse, He says the exceptions to the rule are people who are deficient or those with a disease that leads to a deficiency, both of whom should seek advice from their doctors about supplements.
According to Ceres, no trials have demonstrated that any supplement is significantly and consistently beneficial. In the worst case, supplements can be harmful. He cites a 2011 study of more than 35,000 people that found those taking high doses of vitamin E had an increased risk of prostate cancer. Manson says it's important to consult your doctor before taking supplements because they may interact with medications in undesirable ways.
In addition to all this, in the United States, the more than 90,000 available alternatives are not regulated by the Food and Drug Administration, so they are not subject to the same rigor as prescription drugs. It is also difficult to evaluate how well they work because reliable randomized controlled trials are time- and money-intensive, while observational studies yield nothing more than concrete cause and effect.
the two complement It is possible worth taking
In 2018, Manson led a large randomized controlled trial called VITAL, which analyzed more than 25,000 healthy participants who took vitamin D supplements, omega-3 supplements, or placebo for an average of 5.3 years. The trial results showed that daily vitamin D was associated with a reduced risk of death from cancer. VITAL is the largest and longest randomized trial investigating whether high doses of vitamin D and omega-3 can reduce the risk of cancer, heart disease and stroke over time.
Vitamin D helps absorb calcium from our intestines, making it important for bone health. We get most of our vitamin D from the sun, and some from oily fish and fortified dairy. This vitamin has received a lot of attention as a multitasking supplement that can improve everything from osteoporosis prevention to weight control, some of which VITAL addresses. For example, findings suggest that 2,000 IU daily does not reduce the risk of cancer or heart disease, nor does it prevent bone fractures. Still, for Manson, vitamin D is a supplement whose positive aspects may outweigh any negatives.
“Vitamin D is essential for good health, but we only need small amounts to get those benefits,” says Manson. “More is not necessarily better.” Regarding dosage, the National Institutes of Health's Office of Dietary Supplements recommends that we get 600 to 800 international units (IU) of vitamin D daily. 2,000 IU of VITAL is “fine,” Manson says, though consumers should stay away from “mega-doses” approaching 10,000 IU, which can be toxic.
A meta-analysis published in 2019 British Medical Journal The vitamin D study also found that supplementation was associated with a 16 percent reduction in the risk of cancer death. Another review of 159 trials in 2014 found that vitamin D “appears to reduce mortality in elderly people living independently or in institutional care.” Both papers also called for further research.
Another great supplement to consider, according to Manson, are omega-3 fatty acids, which are found in products like fish oil capsules. These are the building blocks of fats that come from oily fish as well as flaxseed, Brussels sprouts and walnuts.
The VITAL study found that one gram of omega-3 daily was associated with a 28 percent reduction in heart attacks and a nearly 20 percent reduction in the incidence of autoimmune diseases. Manson believes the benefits are most pronounced in people whose diets don't already include fish, so they get the most benefit from these supplements. Additionally, a review published in 2017 identified the importance of omega-3s for gut microbiota and immunity, but also called for more research. Another review concluded that omega-3 supplementation reduces the risk of chronic heart disease and death from chronic heart disease.
Still, Ceres isn't convinced. He says the VITAL results are not consistent with other “albeit small” studies, and the long-term effects are still unknown. Even though these vitamins may seem to be associated with some benefits, he points out that they do not prevent more common diseases like heart disease. Ultimately, “the results are not compelling in combination with all other research.” Furthermore, he would not support “a blanket statement that people who want to prevent autoimmune disease should consider taking vitamin D.”
As for meta-analyses, Serres observes that his calls for further research indicate inconclusiveness. “When you come to the conclusion after a meta-analysis that more studies are needed, it means, 'We don't know. There's not enough data, not strength of data, enough to say anything conclusively. Not a big difference,” Serres says.
In line with Serres, Manson advocates “precision nutrition”, arranging supplemental nutrition based on each individual's needs. Also consistent with VITAL's findings, she says that people who eat little or no fish and suffer from autoimmune diseases benefit from omega-3s, while people who don't get much sun exposure have less. eat dairy, and have high levels of cancer risk “they may want to hedge their bets and supplement with moderate doses of vitamin D”.
Some studies may praise supplements too highly for what the research does or doesn't tell us, but randomized studies like VITAL keep expectations in check. “I think the evidence is more rigorous in randomized trials,” says Manson. “But, it is limited to certain health outcomes.”
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