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Should you take a supplement?

COMMENT

Many people assume that if they take a multivitamin their nutrient needs are covered and they can just eat whatever they like. Doritos and ranch dip are totally fine for dinner if you wash a multivitamin down with beer first…right?

While I am sure I am not the only one who has occasionally resorted to having popcorn and a glass of red wine for dinner – I call it my Olivia Pope dinner – I do this knowing that a well-balanced diet cannot be replaced with a pill or two.

Olivia-Pope popcorn

Photo source: Eliots Eats

The scientific community does not even fully understanding all the components of the huge variety of foods we eat. Let alone how these components interact. Our diets are a complex mix of many micro (vitamins and minerals) and macro (protein, fats, and carbohydrates) nutrients, phytochemicals, fibres, and more. Even how certain nutrients are digested and absorbed depends on a number of factors, including what specific foods are eaten together. We could not possibly have the knowledge to manufacture a suitable replacement for a healthful diet in pill form. Not yet anyway. We might catch up to The Jetsons one day.

Taking a multivitamin as a “backup” seems to be a popular approach as well and probably won’t harm you … but it is likely a waste of money if you’re eating well. An editorial titled, “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” in the Annals of Internal Medicine went so far as to conclude that: “…we believe that the case is closed— supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful.” Other studies have reported no cognitive benefits in older men (physicians), insufficient evidence for cancer or chronic disease prevention, and even potentially harmful effects of supplementing with beta-carotene, vitamin E, and higher doses of vitamin A.

If you are not eating well, try to focus on small, sustainable changes to add more nutrient-dense foods to your diet (check out this link for great examples). Spend your money on more convenient pre-cut and washed fruits and vegetables, if convenience is key for you (which it is for most people), instead of a bottle of multivitamins. This investment is much more likely to pay off!

I am a “food first” dietitian and strongly believe that, in general, you should not rely on a supplement to improve your health. However, there are some cases when a supplement may be necessary. Here are some situations when you should evaluate the need for a supplement with your doctor or dietitian:

upbeet food over supplements

 

You eat a very low calorie diet

 

In this case, it may be hard to get the amount of vitamins and minerals that you need. Ideally, you should be eating enough calories to meet your micro and marco nutrient needs. If you think you might not be, see a dietitian or your physician to assess your potential need for supplementation.

 

 

You are a women of childbearing age

 

Women of childbearing age should take a 0.4 mg folic acid supplement every day. This helps to prevent neural tube defects during the early stages of pregnancy. It is often too late to start taking a supplement once you find out that you are pregnant.

 

 

You are over 50 years old

 

As you age, you may not be able to absorb vitamin B12 as efficiently. Talk to your doctor or dietitian about a supplement. You should also take 400 IU of vitamin D daily (up to 1000 IU daily in the winter).

 

 

You eat a vegan diet

 

While a vegan (or vegetarian) diet can meet all your nutrient needs and be very healthful, economical, and sustainable, it needs to be well thought out to ensure certain nutrients are covered. It can be especially hard to get enough vitamin B12. Nutritional yeast is a good source (and delicious on popcorn). Fortified foods or a supplement are options, too.

You may also need an iron supplement as your needs will be higher with only plant-based sources. Consider getting a blood test to check for adequacy of iron and B12 intake. Follow up with your doctor to discuss the results. Other nutrients to ensure you have a good food or supplement source of are: omega-3’s fats, zinc, calcium, and vitamin D.

 

 

You live in Canada

 

The right amount of sunlight is needed to make sufficient vitamin D. In Canada from about October to March, we make very little, if any, vitamin D from sunlight. During this time, consider taking 1000 IU per day as our food sources are also limited. However, there are food-based options! Check them out here.

 

 

You have a specific medical condition or are pregnant

 

Certain conditions may increase your need for a specific nutrient or indicate that you need to take a supplement, anemia and osteoporosis for example. People with diabetes who are taking metformin long term may also be at increased risk for a vitamin B12 deficiency. Recovering from surgery can also increase your need for certain nutrients.

If you are pregnant, the key nutrients to ensure you are getting enough of are iron, folate, calcium, vitamin D, and omega-3 fats. Ample fibre, protein, and fluids are also important!Talk to your doctor or dietitian if you think your nutrient needs are increased. Assess your intake and take a food first approach if possible.

 

If you want to be certain that your diet, on average, is meeting your nutrient needs you can use eaTracker.ca. It was developed by Dietitians of Canada and can be a very helpful tool. You can use eaTracker to track your food and activity choices, analyze your recipes, and plan your meals.

Once you have entered in your food choices (aim for about one week’s worth or more), use eaTracker to generate a report showing you if your diet is low in any vitamins and minerals. If so, aim to include good food sources of the missing nutrients and repeat the process again in a couple months. Once you are on track, this is a great process to do every year or so to check in and see how you’re doing.

Do you take supplements? If so, why? Do you agree or disagree with my approach? I would love to hear your thoughts in the comments section below.

Share your thoughts + comments with Melissa (upbeet, RD)!



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