Do dietary supplements work and are they worth the cost? What to know
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- Research on dietary supplements is limited due to the inability to patent natural substances, hindering investment in large-scale studies.
- The FDA’s attempts to regulate supplements faced public resistance over concerns about restricted access.
- While some experts are skeptical, others support supplement use to address potential dietary gaps and promote specific health benefits.
I have written several columns about dietary supplements, but confusion still reigns and I received more questions about this recently. In thinking about it, I was reminded of a conversation with a friend from years ago. His wife was having some health problems and had become convinced that the $350 a month she was spending on exotic supplements was helping and well worth the money. He was highly skeptical, of course, but he supported her and hoped they were doing some good.
Although this is an extreme example, supplements are popular and gaining popularity, especially among older folks. Is it money well spent? That depends on who you ask.
When it comes to supplements, there is no end to controversy. Some experts are “all in” while others scoff at the notion. For example, many physicians are skeptical and probably would rather you didn’t take supplements. Why not? Let’s examine their major objection.
Why isn’t there more research on dietary supplements?
At present, a few large-scale medical research studies have found that taking a multivitamin does not reduce the risk of heart disease, cancer, or mental decline. Unfortunately, this limited research has been applied to all supplements, in general, discrediting the entire group.
Why is there so little research evidence? Supplements are naturally occurring substances such as vitamins, minerals, herbs, and botanicals. A botanical is a plant used for medicinal properties, and examples are saw palmetto, echinacea, St. John’s wort, gingko, etc.
Since supplements are natural, research findings cannot be patented. This means if I spent millions of dollars on a large-scale sophisticated research project to determine the effects of a given vitamin or mineral, and found very positive effects, the lack of a patent would allow anyone to grab my results, tout them to the public and cash in on my investment. Unfortunately, and erroneously, the lack of scientific research evidence is often misinterpreted as a negative, a reason to avoid supplements.
Is this ever going to change? Probably not. Years ago, the FDA stepped up and decided it was time to regulate supplements to protect consumers. For example, without FDA oversight, a label may claim that each pill in the bottle contains 500 mg of Vitamin C. However, when samples of various brands were tested, there was a huge range of values in each pill, and some contained no Vitamin C at all. When the FDA attempted to move forward with oversight, there was a huge backlash. Why? Folks believed if the FDA got involved and seized control of the situation, eventually, you might need a doctor’s prescription to get a vitamin pill, and no one wanted that.
Another question is assurance of potency. Is there evidence the contents of a pill, if accurate as advertised, will get through the digestive process and make it to the cells intact and provide the desired effect? Hard to say, and therefore, much about taking supplements depends on faith and belief.
Health risks of taking a dietary supplements
If you take large amounts of some vitamins that are fat soluble (A, D, E, and K), they can accumulate in your body fat. This can lead to toxicity when taken in large doses, especially for Vitamins A and D. Several minerals also are fat soluble and should not be taken in excess.
There is the potential for adverse side effects that can interfere with prescription medications. In addition, taking some supplements prior to surgery could complicate things like blood clotting, etc. That’s why your doctor asks what supplements you take and may discourage you from doing so.
Supplements can provide a false sense that they patch the holes in a bad diet, like a lack of fruits and vegetables. If you are a typical American, chances are good that you eat a higher amount of processed food that provides limited nutritional value, but lots of saturated fat and sugar, and you hope that swallowing vitamin pills will compensate and keep you healthy. While a pill may cover some of what you are missing, supplements in no way cancel out effects of a bad diet.
What are the benefits of dietary supplements?
Many medical and nutritional experts strongly support dietary supplements. First, although you can get all the vitamins and minerals you need from a good diet, taking a supplement may ― just in case ― help fill in gaps. Second, the healthful benefits of supplements should not be judged only on a handful of medical research studies that showed no positive effects of a multivitamin on heart disease, cancer, and mental functioning.
Despite the lack of large-scale sophisticated research, there is supporting evidence for many supplements. For example, pregnant women often need iron supplements and folic acid (a B vitamin). Vitamin D as a supplement is important for the absorption of calcium in bones. Vitamin B12 is found only in animal products, which means vegans may need a supplement to promote the health of nerve and blood cells. Vitamins C and E are antioxidants, as is coenzyme Q 10 (CoQ10), which protect cells from damage. In addition, there is a vast array of botanicals and herbs like echinacea believed to bolster immune health, and turmeric, a spice that acts as an anti-inflammatory. The list of supplements of all kinds and their potential effects goes on and on.
Taking everything into consideration, the pros and cons, my view is that supplements may provide healthful benefits. For example, as a vegetarian who avoids animal products, I take a vitamin B12 supplement. I also take several other supplements daily, viewing them as “just in case” insurance to hopefully cover any other inadequacies in my diet.
Reach Bryant Stamford, Emeritus Professor of Kinesiology & Integrative Physiology at Hanover College, at [email protected].
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