Opinion on the use of supplements is divided. And if everyday supplements weren’t enough, unscrupulous opportunists have now jumped on the ‘Bant wagon’ in an attempt to make money from people trying to lose weight or reclaim their health. The claims on some of these products are extraordinary and defy belief.
So, are supplements safe? And if so, which are recommended?
The main argument for using supplements is that we do not get enough vitamins and minerals from our food. Proponents claim that our food lacks nutrients due to intensive farming and processing, and the absence of key minerals in the soil. Studies have shown varying results, but the bottom line is that supplements are no substitute for a healthy diet and exercise when it comes to warding off disease. Modern medicine has become obsessed with isolated synthetic nutrients and has spawned a massive dietary supplement industry that advocates synthetic nutrients over real, wholesome food, even when clinical trials of these synthetic supplements have revealed that many do not actually work and some even have adverse effects.
The researchers of one brilliant study in the American Journal of Clinical Nutrition1 do not buy into the synthetic supplement idea, and propose that more effective nutrition can be found in eating whole foods. They have found that nutrients in foods, delivered from their biological environment, have effects that are different from, and far better than, those that are synthetically manufactured. This makes sense when you think that whole-food-based vitamins are uniquely bioavailable (the extent to which a nutrient or medication can be used by the body) and occur naturally, whereas synthetic vitamins are created in laboratories.
The same study found that nutrients can affect one another’s absorption. Where interdependent nutrients (nutrients that need to work together to be of benefit) tend to appear together in foods, it is not necessarily so in supplements. How the nutrients are produced is also important. For example, trans fats found in highly processed seed oils are toxic, whereas trans fats produced in ruminant animals, such as conjugated linoleic acids in dairy products, are beneficial to health.
While the supplement debate rages,2 reliable studies have shown that there is some benefit to supplementing in certain situations. While calcium has caused a fair bit of controversy, calcium combined with vitamin D has been shown to increase bone mineral density in post-menopausal women. There is some evidence that vitamin E may decrease the incidence of prostate cancer in male smokers and cardiovascular disease in women. Vitamin D has been shown to have some cardiovascular benefits and there is mounting evidence linking low levels of vitamin D to an increased risk of type 2 diabetes, muscle and bone pain and, perhaps more serious, cancers of the breast, colon, prostate, ovaries, oesophagus and lymphatic system.
But for every supplement shown to have some benefit, there are myriad others that seemingly have no effect. There is little or no evidence, for example, that multivitamins enhance health.3 Similarly, the joint support supplements glucosamine and chondroitin, which racked up massive sales after initial trials looked promising, have been shown in a meta-analysis of 10 research studies covering 3 803 patients to have no benefit.4 One meta-analysis even concluded that ‘Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.’ In other words, taking these antioxidant supplements could increase our risk of premature death.5
Where does this leave us? We recommend that you discuss supplementation with your health-care provider (rather than the sales assistant in the supplement aisle) and bear in mind the following when buying supplements:
Keep in mind that although the South African government is trying to regulate the complementary medicines industry, it has met with strong resistance. This means that there are hundreds of natural medicines on the market that have not been evaluated by the Medicines Control Council.
If you are going to take supplements, do your homework. Some supplements react with others as well as with some foods. Foods and other vitamins that assist supplement absorption are called promoters. Those that prevent the absorption of supplements are called adversaries.
Make sure you understand which doses are necessary to be beneficial and in which forms the supplements are best absorbed. Remember that not all supplements are safe and many in excess can cause unwanted side effects.
It is always better to get nutrients from whole foods, but we understand that this is not always possible. We therefore highlight here only those supplements that may be beneficial for optimal health and weight loss. If you feel that you are lacking certain vitamins or minerals, chat to your doctor or nutritionist for supplement recommendations.
Fish oil supplements are the primary contributors of two types of omega-3 fatty acids, EPA and DHA. The human body does not produce its own omega-3 fatty acids, so fish oil is one of the most studied supplements and has been shown to be the most beneficial. Fish oil supplements are usually made from mackerel, herring, tuna, halibut, salmon, cod liver, whale blubber or seal blubber.
Mackerel
Tuna
Salmon
Sardines
Swordfish
Marlin
Lowers triglycerides
Some reduction in total cholesterol, but not a significant clinical reduction as is seen in triglycerides
Decreases blood pressure in people with hypertension
Decreases risk of heart disease
Reduces inflammation
Decreases symptoms of lupus erythematosus
Decreases cortisol levels
Notable decrease in major depression
Effective in reducing symptoms of ADHD in children
Doses vary depending on individual requirements. The American Heart Association recommends 1 gram per day. However, depending on the treatment goal, doses can be increased to 6 grams per day spread over the course of the day.
Dry skin and hair
Eczema
Excessive thirst
Poor memory
Inflammatory health problems such as arthritis
Magnesium is an essential dietary mineral. It is responsible for over 300 enzyme reactions and is found in all of the body’s tissues. Although found in many foods, a ‘good’ source of magnesium only supplies about 10 per cent of our daily recommended intake. A large percentage of people are therefore magnesium deficient. This is also largely due to the Western diet, as grains and processed foods are a poor source of magnesium. Prominent sources of magnesium are not eaten regularly enough or in sufficient quantities and therefore supplementation may be required.
There are not many side effects associated with taking magnesium, as absorption depends on how much the body requires. In other words, the body will only absorb as much as it needs. Excessive doses may cause diarrhoea.6
Almonds
Spinach
Avocado
Pecan nuts
Brewer’s yeast
Decreases blood pressure
Reduces symptoms of asthma
Reduces blood glucose
Increases insulin sensitivity
Contributes to cardiovascular health
May help insomnia
RDA for adults is 300–400 milligrams per day. It is important to note that not all forms of magnesium are well absorbed, and a large amount of calcium found in dairy products may inhibit absorption. Magnesium citrate or chelated magnesium are recommended forms.
Muscle tremors
Muscle weakness
Irregular heartbeat
High blood pressure
Irritability
Insomnia
Anxiety
Chronic fatigue
Palpitations
Depression
Constipation
Vitamin D is involved in a variety of bodily functions. The metabolism of vitamin D produces hormones with a number of important roles. Vitamin D also helps the body to absorb calcium and phosphorus from the food we eat. It is an important vitamin for nerve function, muscle function and bone health. It also plays a role in immunity. The body produces vitamin D from cholesterol, provided there is an adequate amount of ultraviolet light from sun exposure. However, the majority of people these days do not spend adequate time in the sun, with the result that vitamin D deficiency is no longer exclusive to people in the northern hemisphere. Although most people are not considered deficient in vitamin D, they do not have high enough levels in their bodies for optimal health. Vitamin D is available in very few foods and not in sufficient quantities.
Although vitamin D is a supplement that is highly recommended, it can be toxic if amounts in the blood become too high. It is therefore recommended to check blood levels from time to time.
Cod liver oil
Swordfish
Salmon
Tuna
Promotes calcium absorption
Promotes bone health and decreases risk of fractures
Decreases risk of falls in the elderly
Decreases risk of colorectal cancer
Decreases risk of cardiovascular disease
Decreases blood pressure
Increases insulin sensitivity
RDA for vitamin D is between 400 and 800 IU (international unit) per day – however, this is considered too low for adults. Research has shown that this is only about one-tenth of what’s needed to cut incidence of diseases related to vitamin D deficiency. The suggested true safe upper limit is more like 10 000 IU per day.8 Between 1 000 and 2 000 IU is recommended for moderate supplementation, although higher doses may be prescribed by your health-care practitioner.
Vitamin D3 supplementation (cholecalciferol) is recommended over D2 supplementation (ergocalciferol), as D3 is used more effectively in the body. Vitamin D is a fat-soluble vitamin and should be taken daily with meals or a source of fat.
Joint pain
Stiffness
Backache
Tooth decay
Muscle cramps
Hair loss
Vitamin C is a water-soluble nutrient found abundantly in some foods. Vitamin C plays an important role in immune function and is involved in collagen production. It acts as an antioxidant helping to protect cells from damage caused by free radicals from the environment (such as cigarette smoke and air pollution) and from those made in our body in food-to-energy conversion. Vitamin C also improves iron absorption and may help to shorten the duration of a cold by about 10 per cent. Despite the many claims about vitamin C, research is not convincing and studies show mixed results.
Broccoli
Cauliflower
Cabbage
Watercress
Green and red peppers
Brussels sprouts
Strengthens immune system
Makes collagen
May protect against heart disease
Helps convert food to energy
RDA of vitamin C is 60 milligrams. Smokers require approximately 30 milligrams per day more. Given that is it abundant in foods, it should not be necessary to supplement on a healthy diet. For example, 100 grams of broccoli contains 110 milligrams of vitamin C.
Frequent colds
Lack of energy
Frequent infections
Bleeding or tender gums
Easy bruising
Slow wound healing
Nosebleeds
Zinc is one of the essential nutrients needed for survival. It is found in cells throughout the body and plays a role in immunity, wound healing, and the synthesis of protein and genetic material in all cells. Zinc is also required for a proper sense of taste and smell. It is available in many foods and the majority of people eating a healthy diet will not require supplementation.
Oysters
Ginger root
Lamb
Pecan nuts
Seafood
Egg yolks
Almonds
RDA for zinc varies with age and sex: 8 milligrams for an adult female, 11 milligrams for an adult male.
Delayed sexual development in adolescents
Impotence in men
Hair loss
Poor sense of taste or smell
Skin ulcers
Chromium is a mineral that humans require in trace amounts. It plays a role in how insulin helps the body to regulate blood sugar levels. It is a popular supplement that for years has been touted to aid weight loss, lower blood sugar and control carbohydrate cravings.9 It is also alleged to increase insulin sensitivity, reduce LDL cholesterol, lower triglycerides and build muscle.
For years researchers have studied the effects of chromium supplements on type 2 diabetes and insulin resistance. The studies in general have been highly unreliable, with some showing possible slight benefits and others showing none at all. It appears that in people with normal levels of chromium a reliable effect is not achieved. There does appear to be a slight reduction of fasting blood glucose in some subjects, but with no apparent change in insulin sensitivity. Studies on insulin sensitivity have been very unreliable, with some showing a slight increase in insulin sensitivity and others showing none at all.
So far chromium has not been shown to have a significant influence on weight loss. The three studies done on the effects of chromium on appetite showed a possible minor effect in reducing carbohydrate cravings, specifically in subjects who admitted to inappropriate eating patterns. With regards to cholesterol, chromium does not appear to play a role in reducing triglycerides. There is also no evidence to support the claim that chromium lowers LDL cholesterol. Reports of actual chromium deficiency in humans are rare.
Brewer’s yeast
Broccoli
Green beans
Eggs
Chicken
Butter
Swiss cheese
RDA is 25 micrograms for women and 35 micrograms for men.
Excessive cold sweats
Need for frequent meals
Cold hands
Excessive thirst
The human gastrointestinal tract is one of the most complex microbial ecosystems on earth. You may know that gut microbes are hugely important in digestion, but their influence extends far beyond the gut. Advancing science is revealing that these organisms play a significant role in both mental and physical health.
Healthy gut microbiota can not only lead to weight loss, but can also fix a number of digestive problems as well as boost energy and beat cravings.
Bacteria in the colon break down the fibre that we get from plant sources, but with our poor Western diet, many of us are not getting enough fibre. We’ve also been wiping out our bacteria with antibiotics and sugar-rich foods.
If we want to lose weight optimally, we need to take care of our gut microbiota and repair the damage we’ve already done. Apart from cutting out processed foods, we can help to regenerate healthy gut bacteria by eating real whole foods, but we may need to use prebiotic and probiotic supplements to help this process along.
Prebiotics are carbohydrates that humans are unable to digest. These fibrous carbs reach the colon undigested where they stimulate the growth or activity of beneficial gut bacteria. Prebiotic fibre is found in many fruits and vegetables. Unfortunately, the minute amounts of fibre in each make ingesting enough fibre extremely difficult. Most people should consume at least 30 grams of fibre per day, but it is nearly impossible to eat sufficient quantities of the foods highest in prebiotic fibre every day. Let’s take a quick look at some of the top prebiotic foods:
Jerusalem artichoke: 1.6 grams of fibre per 100 grams
Raw onion: 1.7 grams per 100 grams
Asparagus: 2.1 grams per 100 grams
Leeks: 1.8 grams per 100 grams
Cabbage: 2.6 grams per 100 grams
Because it can be so difficult to get enough fibre in our diet, a prebiotic supplement is a fast and simple solution. Of course, eating real food is always first choice.
Probiotics are live bacteria and yeasts similar to the beneficial micro-organisms found naturally in the human gut. They are essential to basic human nutrition.
Fermented foods like kefir, kimchi, kombucha and sauerkraut are a great source of probiotics. Traditional yoghurt was also a good source of beneficial bacteria, but most of today’s yoghurts are pasteurised and do not have the same benefits.
Probiotics may be useful in treating a number of conditions, such as inflammatory bowel disease, constipation, IBS and diarrhoea. Our gut microbiota have a vast influence on our health and scientists are now linking dysbiosis (an unhealthy gut microbiota) to a multitude of illnesses, including diabetes, immune problems, generalised inflammatory conditions and mental illness.
When buying a probiotic supplement, it is important to look for a good-quality product. Here are a few pointers for buying an optimal brand:
Different strains of probiotics have different functions and are concentrated in different places along the digestive tract. Probiotics that contain multiple strains therefore tend to be more effective than those containing very high concentrations of just one or two strains.