Do I need vitamins and supplements to be healthy?

28 June 2021

There’s a supplement out there for just about every aspect of health you can imagine… for inflammation, weight loss, immunity, gut health, ageing…

You name it. There’s a supplement for it. But do you really need them?

– Vitamins and minerals are essential for many processes in our body

– They are required in very small amounts, for a variety of metabolic processes

– The supplement industry generates approximately $1.5 billion in Australian sales a year

– About 70% of Australians take some form of vitamin or mineral supplement

It is commonly believed that taking mega-doses of certain vitamins will act like medicine to cure or prevent certain ailments.

For instance, vitamin C is suggested as a cure for the common cold, and vitamin E is widely promoted as a beneficial antioxidant to help prevent heart disease.
After extensive research, however, neither of these claims has been shown to be true.
Large-scale studies have consistently shown little benefit in taking mega-doses of supplements.
In fact, there is good evidence that taking high-dose supplements to prevent or cure major chronic diseases, such as heart disease and cancer, may be harmful to your health.

Vitamin supplements are sometimes taken to help manage stress.

Feeling under pressure doesn’t automatically lead to a vitamin deficiency, so taking a vitamin supplement won’t necessarily make the stressful feelings go away.
If you are feeling run down, it is more likely to be due to stress, depression, insufficient sleep or other factors, rather than a deficiency of a particular vitamin.

Taking higher than recommended doses of some vitamins may cause problems.

Over-consumption of certain vitamins or minerals can be dangerous.

Vitamins A, D, E and K are fat soluble, which means they are stored in the body. High doses of these vitamins can be toxic.
There’s increasing evidence that large doses of vitamin A increase the risk of lung cancer.
Large folate intakes can hide vitamin B12 deficiencies.
At just five times the recommended intake, zinc, iron, chromium and selenium can be raised to toxic levels in the body.
High doses of iron supplements may decrease zinc absorption.
Very large doses of fish oil can lead to decreased blood clotting.
High doses of vitamin A may cause birth defects, as well as central nervous system, liver, bone and skin disorders.

When should someone consider taking a vitamin or mineral supplement? You sometimes hear that we should all be taking a multivitamin as an insurance policy.

Aside from a few specific situations or groups of people, most people who have a balanced diet have no need for supplementation.
Vulnerable groups: There are some groups in the community who are not meeting their nutrient requirements and are at higher risk of vitamin deficiency due to inadequate intake or individuals with increased nutrient requirements (such as pregnant or lactating women)

Most people can fulfil their vitamin and mineral requirements by eating a healthy, balanced diet. However, there are a few groups that may need a supplement.

Pregnant women and those trying to conceive (one month prior to conception and three months after): Folate. It is well established that folate supplements reduce the risk of neural tube defects.
People on a strict vegan diet and the frail aged who may be eating poorly and/or absorbing less from their food: Vitamin B12
People on restrictive diets (including those with eating disorders, food allergies or intolerances): the type of supplement depends on the foods missing from the diet.

While it’s tempting to take multivitamins as a nutritional insurance policy, it’s far more beneficial to your health to improve your diet.

While taking a vitamin and mineral supplement ‘just in case’ poses little health risk, and may benefit a person whose diet is restricted and lacks variety, taking vitamin and mineral supplements instead of eating a nutritious diet is not recommended.

The best way to meet your targets for vitamins and minerals is by eating a variety of healthy unprocessed foods.

Real food has several big advantages over supplements.

Food is a complex source of vitamins, minerals and other components which all work together.

Supplements tend to work in isolation. Research has shown that a food component that has a particular effect on the body may not have the same effect when it is isolated and taken as a supplement. This could be because the vitamins and minerals in foods are also influenced by other components of the food, not just the ‘active ingredient’.
Unlike supplements, whole foods contain a number of substances that help vitamins and minerals be absorbed by the body and do their job inside cells. Additional components, such as fibre and antioxidants, can help protect against conditions such as cancer, diabetes and heart disease.
Whole foods often contain vitamins and minerals in different forms, all of which range in their ability to be absorbed by the body (known as their bioavailability). Vitamin E occurs in nature in eight different forms, for example, but supplements usually contain just one.

High-dose supplements should not be taken unless recommended under medical advice.

If you’re taking vitamin or mineral supplements or natural or herbal remedies along with prescribed medicine, it’s important to be aware of possible interactions with other nutrients and with medication.
In extreme cases, for example, where people take many times the recommended dietary intake (RDI), this can stop the work of anticonvulsant drugs, such as those used in epilepsy.

For children, it’s particularly important for parents to provide a healthy selection of foods rather than give a multivitamin to cover up for possible nutritional shortfalls.

A recent study of Australian preschoolers found that 31% were overweight or obese, and their diets lacked fibre and had too much saturated fat – problems that a multivitamin won’t fix.
Don’t offer something that will distract from the consumption of real food. Children need to be assisted to develop healthy eating habits and this is a skill that will last them throughout life.

If you’ve got any questions about this blog, or you’d like to have your diet analysed to see if you’re meeting your dietary requirements for vitamins, minerals, macronutrients and energy balance, please contact us for an appointment with an Accredited Practising Dietitian.

Sources:

https://www.bmj.com/content/369/bmj.m2511

https://www.betterhealth.vic.gov.au/health/healthyliving/vitamins-common-misconceptions

https://bmjopen.bmj.com/content/10/11/e039119

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3309636/