With cold and flu season in full swing, it’s the season for many Americans to forego one or more dietary supplements in the hopes of warding off illness. And it’s not just a winter habit; for many they have become routine, with nearly 58% of people aged 20 and over reporting using at least one dietary supplement.
But do all those little pills – which together form a billion-dollar industry – really do anything?
Supplements vs. nutrition
Experts say that food trumps supplements as the best source of nutrients. Dr. Marilyn Tan, a clinical associate professor of medicine at Stanford University, explained the benefits of getting a nutrient gradually throughout the day instead of getting “a large chunk all at once” via the pill.
“I think if you can take it throughout the day — say, in nutrients through food — it just gets absorbed better. Because there’s a maximum amount that your body can absorb at one time,” she said. “For calcium, for example, if you take more than 500 to 1,000 milligrams, your body is just going to pee it out, and many vitamins are like that, where you just can’t absorb that much at once.”
Tan said most Americans get the nutrients they need from food alone.
“Most people on the standard American diet, unless they follow a very restrictive diet, get enough nutrients through their diet,” she said. “Vitamin deficiency can occur with certain conditions, such as malabsorption or pernicious anemia, but for the average, otherwise healthy American, they get enough nutrients through the diet.”
Lisa Moskovitz, a registered dietitian, CEO of NY Nutrition Group and author of “The Core 3 Healthy Eating Plan,” told Yahoo News that for someone already following a relatively healthy diet, supplements probably won’t make much of a difference and “could be a waste of money and just really expensive urine,” as your body expels all those excess nutrients. For people who already get enough nutrients through their diet, adding a vitamin supplement won’t necessarily give them the extra boost they might be hoping for.
“If you already have adequate levels in your body and you take supplements of B12, for example, you won’t feel more energy from taking B12 if you already had enough B12 in your system to begin with,” she said. .
When are supplements a good idea?
Experts emphasize a “food-first” approach to nutrients, meaning that supplements should do just that: complement, but not compensate for, bad eating habits. They can help fill nutritional gaps in certain cases, such as if you are restricting your food intake to lose weight or if you follow a vegan diet, have limited access to healthy foods, or have a certain vitamin deficiency, which can be diagnosed. by your doctor with a blood test.
For example, an iron deficiency is not uncommon, especially in menstruating women or people who have bleeding. Iron can also sometimes be harder to get through food alone if you’re a vegetarian.
And for many people, vitamin D can also be difficult to get through diet alone. We get vitamin D mainly from sunlight, but if you wear a thick layer of sunscreen while out in the sun or if you don’t get enough outside, you may not absorb much. How dark or fair your skin is can also affect vitamin D absorption.
“Vitamin D is very difficult to get enough from the diet. There aren’t that many dietary sources of it,” Tan said. “But for most other vitamins, we can get them in food.”
Vitamin B12 is another example, she said, for which a doctor may recommend an oral supplement if you’re mildly deficient, which becomes more common as people age.
And folic acid, a B vitamin, is a supplement that enjoys widespread support from public health experts, even among supplement skeptics. It has been proven to prevent serious birth defects of a baby’s brain and spine, and since the benefits of folic acid are most crucial in the early days and weeks of a fetus’s development – before many women even know they are pregnant – the CDC recommends that “all women of childbearing age should get 400 micrograms (mcg) of folic acid each day, in addition to consuming foods containing folic acid from a varied diet.
“The risk is too great to take on a woman who thinks she is getting enough folic acid [through their diet] but they’re not,” Moskovitz said. “It’s just because the research is so, so strong.”
So do supplements really work?
While folic acid supplements have proven benefits, the jury is still out on the merits of most other supplements.
In 2013, researchers at Johns Hopkins University published an editorial titled “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” with one of the authors of the editorial saying that he did not recommend supplements other than folic acid for women who may become pregnant.
Earlier this year, the US Preventive Services Task Force issued updated guidelines stating that vitamin, mineral and multivitamin supplements are unlikely to prevent cancer or heart disease or affect overall mortality.
“It normally doesn’t hurt to take a multivitamin, but a lot of studies have looked at whether a multivitamin can help improve mortality or quality of life or sense of well-being or things like that, and nothing has been very conclusive said Tan. . “There is no large randomized control trial showing significant health benefits from taking a multivitamin.”
Tan said if you have a diagnosed deficiency that affects your health — such as a B12 deficiency that affects memory, for example — supplementing it can help. But taking supplements simply in the hope of reaping health benefits later may not do much.
“Many studies have tried to explore, for example, whether vitamin D can help with heart disease or with infections like COVID,” Tan said. “Studies are mixed, but nothing has definitively proven that a specific supplement of a vitamin will help you with longevity.”
When it comes to using supplements to treat illnesses like the common cold or shorten their duration, the results are also mixed. Zinc is a mineral touted by some for its ability to potentially reduce the duration of a cold if taken in the form of a lozenge within the first 24 hours of the onset of symptoms, but nothing has been definitively proven. While some studies have shown that zinc can shorten a cold by several days, other studies have concluded that zinc had no effect on the duration or severity of the cold.
Most over-the-counter vitamin supplements are safe in limited amounts, so if they make you feel better, it probably won’t hurt to take them. But they’re unlikely to cure your ailments, Tan said.
“Are they necessarily going to cure or reverse an infection? No, probably not,’ she said. Nor are they a substitute for recommended treatment [from your doctor]. For example, if you have the flu and your doctor recommends taking Tamiflu because you are at high risk, taking vitamin C may help or taking zinc may help, but it is not a substitute for what your doctor recommends.
Too much of a good thing?
It’s also possible to have too much of a good thing, experts say. Excess water-soluble vitamins are usually excreted in the urine, but excess fat-soluble vitamins can remain in your body and have adverse effects.
For example, long-term use of zinc in high doses can cause a copper deficiency; high doses of vitamin A should not be taken during pregnancy, as it may harm the fetus; and excess vitamin D can lead to high, unhealthy calcium levels.
Some supplements can also interfere with medications.
“If you’re on certain medications, you still want to be careful, especially with herbal supplements like ashwagandha [or] herbal supplements like St. John’s wort,” Moskovitz said. “They can influence psychotropic drugs, so antidepressants [or] anti-anxiety medication. Some can even interfere with heart medications [or] blood thinners. That is why it is also very important to check with a professional.”
How can you be sure you’re taking the right supplement?
Supplements are not regulated by the US Food and Drug Administration the way medications are; they are considered a subcategory of food, not medicine, so anything the manufacturer believes to be safe can be marketed without prior FDA approval.
One way to be sure that the supplement you are taking lives up to its claims is to look for ConsumerLab or United States Pharmacopeia seals on the label, which indicate that the product has been quality tested and verified. And if a product makes “wonderful claims” that it can improve your health, take that with a grain of salt, Tan said.
You should check with your health care provider before taking any supplements, Tan and Moskovitz said, because chances are you may not need them.
“For someone who wants to add more supplements to their diet, who wants to explore that and see if it could benefit them, it always helps to talk to a professional doctor and dietitian first, especially one who can order blood work,” Moskovitz said. “Test your levels before you spend your hard-earned cash on something you may not need and are just excreting anyway.”