Supplements - do we need them?

One of the most common questions I get asked is whether supplements are needed for our health or whether they are a waste of time and money, or perhaps even harmful. The short answer is probably all of the above is correct – just in different circumstances.

Of course it’s not natural to take supplements – this is only a very new addition to our health regime in the scheme of our evolutionary history. However, the changes in our diet and food in general, particularly in the last few decades has meant that the level of nutrition we are receiving is not always enough. Consider this - the main types of disease in the developed world are chronic diseases such as obesity, cardiovascular diseases (high cholesterol, hypertension, atherosclerosis, stroke), metabolic diseases (insulin resistance, metabolic syndrome and diabetes), and cancer.  These are at least in part due to faulty diet and lifestyle.

The faster pace of modern living has seen an increased reliance on premade, takeaway and junk foods has resulted in some of us consistently making poorer food choices than previous generations. The results from the most recent Australian Health Survey (2011-13) confirm what we suspected - we are not eating what we should be. Less than 10% of people eat enough vegetables, less than 50% enough fruit and a whooping third of our energy intake (kilojoules) is likely to come from poor choices such as biscuits, cakes, lollies, fried foods and alcohol. These chronic levels of poor nourishment coupled with excessive intake of potentially harmful substances, conspire to diminish our resilience to disease and our ability to repair. 

Add to this that changes in agricultural practice in the last 50 years or so have also resulted in poorer nutrient levels are available in food than consumed by previous generations. Excessive farming as well as a greater emphasis of crops which are commercially more viable (eg grow faster or bigger) has depleted key nutrients from the soil. Plants derive their nutrients from the soil and of course this nutrition is then consumed by the animals or people eating them. If the soil is depleted, then obviously this will eventually affect our nutritional levels. In a landmark study by Davis et al (2004) published in the Journal of American College of Nutrition, as well as several subsequent studies the level of key nutrients in fruit and vegetables such as protein, calcium, iron, vitamin B2 and vitamin C were found to be lower than those grown 50 years earlier.

Our own individual genetic makeup is also believed to influence how much of any one nutrient we may require for optimal function. Folate is a great example of this. Up to a third of us are believed to have a subtle genetic change (called a single nucleotide polymorphism) which means we require a greater amount of folate to have the same effect as someone without the genetic quirk.

And we haven’t yet even started talking about the many other reasons why it may not be possible to get everything you need from your diet:

  • Drinking tea, coffee, or alcohol on a regular basis
  • Taking medication daily eg the oral contraceptive pill or aspirin
  • Eating on the run
  •  High stress levels – emotional or poor work / life balance
  • Poor digestion – things like bloating, reflux, burping, flatulence and irregular bowels can indicate poor breakdown and absorption of nutrients
  • Being unwell or having a disease

So, if it’s difficult for us to get everything we need from the diet, supplements seem like a good idea right? Well maybe.

Researchers attempting to see if the benefits of eating fruit and vegetables in preventing cardiovascular disease can be replicated or even improved upon found that suppling antioxidant supplements does not work. One of the key reasons for this is simply that whilst fruit and vegetables contain the nutrients used in the supplements, they also contain many other valuable nutrients and plant-based chemicals which are not. The effect of all of these components are disease protective and the same results cannot be achieved by only having a few.

So, what is basically comes down to is this – you need a healthy diet – at least most of the time and this cannot be replaced by supplements. But many of us will also benefit from some supplements, some of the time.