Dietary Supplements – Navigating the Unknown

Kimberly Andreola, Dietetic Intern at Bay Pines Veterans Administration
Health Care System


Every day we are being bombarded by messages from the media telling us what foods and supplements we need to stay healthy. It may be a “new miracle cure for cancer” or that essential ingredient that we need to “fight infections and boost the immune system”. The information can be confusing and leave you with lots of unanswered questions. To help you sort out the confusion and find helpful resources on the topic, read on.


What is a supplement?
Supplements contain one or more dietary ingredients such as vitamins, minerals, herbs or botanicals and are found in many different forms (usually pill, capsule, tablet or liquid form).  Supplements are not foods and are not food replacements – they are intended to “supplement” a healthy diet.


Dietary supplements are not intended to treat, diagnose, prevent or cure disease.   In some cases, supplements can even interact with your normal prescription medications, decreasing or altering the desired effects and rendering your medications ineffective or unsafe.  For example, the herbal supplement St. John’s Wort can speed the breakdown of many drugs including birth control pills, and antidepressants thereby reducing the drugs’ effectiveness.


In addition to these interactions, supplements may negatively interact with each other or cause undesired effects if consumed in excess of what your body needs.  Many foods are fortified with extra nutrients these days.  Supplementation beyond what is required along with intake of a normal diet and consumption of fortified foods could be overloading your body on certain nutrients. 


Should I consider using a supplement?
If you consume a varied diet rich in vegetables, fruit, whole grains, and lean proteins, you probably do not need to add supplements to your diet.  People who might consider supplementation include those who have been diagnosed with a deficiency disease or those for whom vitamin and mineral intake may be inadequate.  People at risk for inadequate intake of vitamins, minerals, carbohydrate, protein, or fat include: pregnant women, people who lack access to healthy foods, alcohol-dependent individuals, strict vegetarians and those with increased or altered nutritional needs related to a health condition (such as those people who have a medical condition that alters how their body absorbs or uses nutrients).


If you are currently using supplements or are considering adding one to your diet, discuss the following with your doctor or dietitian first:

1. What are the potential health benefits of the product for me? What works for your best friend or family member, may not work for you and could even be harmful to your health. Eating a variety of nutritious foods is the best way to maintain health and prevent chronic disease.  
2. How does this supplement fit into my total diet? If you don’t eat a nutritious variety of foods, some supplements might help you get adequate amounts of essential nutrients.  Supplements cannot take the place of a varied diet, though.  
3. Does this product have any safety risks? Always know your supplement and its risks, including interactions with medications, before adding it to your diet.  The National Institute of Health (NIH) provides fact sheets on many of the common supplements summarizing benefits and risks.  The Food and Drug Association (FDA) also posts reports of adverse events as they occur and makes recommendations for certain products.  
4. What is the proper dose to take?  The FDA monitors supplements once they have been placed on the market.  It is the manufacturers’ responsibility to recommend serving sizes and doses based on research. Discuss your need for each supplement with your doctor to determine what dose may be appropriate for you.
5. How, when, and for how long should I take it?  Each of these questions should be discussed with your doctor.  The answers will vary by individual and by supplement.  
6. Does this product seem too good to be true?  More than likely the answer is yes. Read your label, research the product on the NIH and FDA websites and talk to your doctor before initiating any supplement regimen.

It is important to keep in mind that no supplement will replace the benefits of eating real food.  To decrease your risk of disease and stay healthy, your best bet is to consume a diet rich in fruits, vegetables and whole grains as well as lean protein and low fat dairy foods.  If you find it difficult to consume everything your body needs or think you may need more of a certain nutrient for medical reasons, consult your doctor before purchasing and using a supplement.  Your doctor or dietitian can help you navigate the supplement aisles of the grocery store and determine what your individual needs might be. 


References:


National Institute of Health.  Dietary supplements: What you need to know. (2011, June 17). 

Federal Trade Commission. (2011, November). Dietary supplements.  


USFDA. (2011, October 06). Dietary supplements.


ADA (2009). Position of the american dietetic association: Nutrient supplementation. Journal of the American Dietetic Association, 109, 2073-2085.


National Center for Complementary and Alternative Medicine. (2011, November). St. john's wort.