Have you ever wondered where health professionals come down on the food vs. supplements debate? Here, our resident nutritional anthropologist gives you the inside scoop!
By turning to supplements, we morph the beautiful and delicious ritual of eating into a daily task to check off our to-do list.
The supplement industry is massive.
The Nutrition Business Journal reports that, in 2015, sales of dietary supplements in the United States reached $38.8 billion. Of this amount, 31% of sales were vitamins, 18% herbs and botanicals, 14% sport’s supplements, 12% meal supplements, 7% minerals, and 18% other kinds of supplements.
As a nutrition specialist, specifically a food and nutrition anthropologist with a Master’s of Science in Food and Nutrition, I find these trends interesting, but also a bit concerning.
After all, the reason why we eat food is to satisfy our physiological need for vitamins, minerals, and macronutrients and to enjoy our culture.
By turning to supplements, we morph the beautiful and delicious ritual of eating into a daily task to check off our to-do list.
Not to mention the irrefutable fact that supplements aren’t natural, which begs the question: do we even need supplements?
Though the numbers above might make you think everyone is (and, therefore, needs to be) taking supplements, in most cases in the developed world and urban environments, we do not.
We are able to access all of the nutrients our bodies need for our health and well-being. The issue is not really an ability, just a habit.
Despite an abundance of food, our eating patterns have morphed in a way that we eat too much of some nutrients (like fat and carbohydrates) and not enough of others (like Vitamin D and Omega 3s).
I believe that the ultimate solution is to develop more balanced diets, rather than turn to more supplementation. In my book, in the battle between food vs. supplements, food wins (most of the time). Here, I’ll explain why.
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You (Probably) Don’t Need a Supplement
It is important to make something very clear:
Most Americans don’t get enough of the nutrients they need from the food they eat.
No one denies it. Neither those in the food industry (such as the Council for Responsible Nutrition) nor the US government (the USDA) pull any punches when it comes to showing Americans what they really eat and what nutrients they are missing out on.
Bi-yearly reports list the vitamins and minerals that are most commonly lacking in the Standard American Diet:
- vitamin A
- niacin
- vitamin E
- magnesium
- vitamin C
- iron
- vitamin B6
- zinc
- calcium
And research has shown that supplementation does, indeed, help fill in these gaps.
However, whether or not filling in those nutrient gaps by taking supplements improves health outcomes is still unclear. Getting adequate nutrients from healthy foods, on the other hand, almost certainly does.
So, a real solution for me isn’t about finding a good supplement to make up for the nutrient holes in your diet, but shifting your diet so that the nutrients you need are coming from real food.
Good Food Should be the Basis for Good Nutrition
Because the biological functions of vitamins are interrelated, a diet poor in vitamins, carbohydrates, fats, and proteins is not necessarily enhanced by vitamin supplementation.
Kathleen A. Blair
When you take a supplement, you are putting one, or maybe a handful, of isolated, individual nutrients into your body. Even if you take a complex multivitamin with every single essential vitamin and mineral you need, it is still only providing micronutrients. You won’t be consuming even close to enough macronutrients (i.e. calories) to keep you going through the day. (Many vitamin supplements don’t provide any calories at all!)
Whole foods, on the other hand, are gloriously rich in everything your body needs to continue to function properly: vitamins, minerals, antioxidants, and calories. The key here is to eat a variety of foods from different food groups to meet all your needs.
To cite researcher Kathleen A. Blair, “Because the biological functions of vitamins are interrelated, a diet poor in vitamins, carbohydrates, fats, and proteins is not necessarily enhanced by vitamin supplementation.”
In other words, we aren’t necessarily healthier because we take vitamins. Foods we eat often naturally contain the right balance of nutrients so that they complement each other, rather than compete with each other.
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And, like well-known food and nutrition author Michael Pollan discusses in his book Food Rules: An Eater’s Manual, there is still plenty we don’t know about how the food we eat interacts with our bodies.
There are undoubtedly still chemicals and nutrients in food that are essential to our well-being that we don’t even know it yet! And they, of course, won’t be in any vitamin supplement you can buy, anywhere!
Fortified or Enriched Foods Aren’t Necessarily Healthy
To make the case for sticking to whole foods even stronger, a lot of the processed foods we eat have vitamins and minerals artificially added to them, so-called “enriched” and “fortified” foods.
Enriched foods are foods that have nutrients added back in that were lost in processing (basically, trying to make them “whole foods” again).
Fortified foods are foods that have nutrients added in that aren’t naturally found in them (at least not at the same doses).
Fortifying and enriching foods is a very important public health strategy, especially in countries with pervasive malnutrition and undernutrition. It is likely you are already consuming foods that contain added vitamins and minerals.
Commonly fortified and/or enriched foods include:
- Flour (corn, wheat, or rice)
- Pasta
- Rice
- Dry milk
- Fluid (liquid) milk
- Cocoa products
- Salt
- Sugar
- Soy sauce, fish sauce
- Juice, soft drinks
- Bouillon cubes
- Cereal-based complementary foods
- Breakfast cereals
While enriched and/or fortified foods may be healthier than their non-supplemented counterparts, the addition of extra vitamins and minerals can be used to mislead you. For example, a breakfast cereal marketed to kids might have plenty of iron, calcium, and vitamin B6 added through fortification. But, it almost certainly also contains tons of added sugar, artificial sweeteners, flavors, and dyes.
Adding nutrients to the formula doesn’t make your sugary cereal a health food, no matter what the label makes you think. Another point for food in the food vs. supplements battle.
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It’s Easy to Overdo It with Supplements
Many supplements contain mega-doses (multiple times the RDA dose recommended by the government) of vitamins, minerals, herbs, or other components.
At these amounts, supplements no longer function as vitamins or minerals, but as drugs. There are certain conditions for which doctors may recommend mega-doses, but these are generally not recommended for otherwise healthy people. In fact, they may be harmful to your health if your doctor hasn’t prescribed them for you.
For decades, researchers have documented the potential health hazards of mega-doses through supplements. Some common potential side effects of over-supplementation (depending on the supplement) could include nausea, loss of appetite, slowed growth, impotence, dizziness, and many more.
Situations Where You Likely Do Need to Supplement
Don’t get me wrong. I am aware that there are times where it’s a lot harder to get the vitamins and minerals you need from food.
This can be the case if you have a special or restricted diet, if you are taking certain medications, or if you have certain medical conditions.
In these cases, the when (when should I be taking a supplement?) and the what (what supplement do I need to be taking?) can be hard to pick out of the flood of marketing selling unnecessary supplements out there.
While this information shouldn’t replace the advice given to you by your doctor or registered dietician, below I’ve summarized a list of conditions or situations where the scientific community (specifically the Food and Nutrition Board and the American Dietetic Association) has expressed consensus on the need for supplementation.
Health specialists recommend supplements when there is:
- Increased need that is very difficult to satisfy only with diet
- Decreased absorption of vitamins, minerals or other nutrients in your gut
- A nutrient is completely missing from the diet
| Conditions and Situations | Supplements recommended |
| Pregnancy | Folic acid (and four months before pregnancy) Iron Omega 3 (DHA+EPA) Some OBGYNs may also recommend calcium and vitamin D. |
| Vegetarianism and veganism | Vitamin B12 |
| Living in a country with limited sunlight | Calcium Vitamin D (which is needed for the absorption of calcium) |
| People with lactose intolerance or low dairy intake (especially adolescents) | Calcium Vitamin D |
| Heavy menstrual flow | Iron |
| Nutrient-specific deficiencies | Depends on nutrient |
If You Feel Better Taking Supplements…
Some people think of taking nutrient supplements as a sort of “health insurance”.
If you feel better about your health by taking supplements, evidence shows that multivitamin and mineral supplements are better tolerated than single-vitamin supplements. And it seems that the benefits may outweigh the risks when it comes to multivitamin and mineral supplements, especially for older people.
However, let’s not forget the importance of diet first. Feel free to take a multivitamin if it makes you feel better, but always strive to consume a wide variety of real foods, especially fruits, vegetables, healthy fats, and lean meats to meet your nutrient needs.
Take Home Message
Here is a summary as to why I prefer eating foods vs. supplements to achieve my health goals:
- With supplements, you miss out on the pleasure and fun of eating
- Most people in developed countries have access to all the foods they need for balanced nutrition
- Supplements cannot effectively replace foods to maintain health
- There are likely plenty of elements in food that we need but don’t yet know what they are
- It’s easy to overdo it with supplements
Of course, I recognize that there are several situations in which supplementation is highly recommended and sometimes even necessary because it would otherwise be very difficult to get all of the nutrients you need through food. In these cases, it is essential that you consult with your doctor before self-administering vitamins and minerals.
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