By: Erin Kukura, MS, RD
UCSD Recreation Dietitian

What are supplements?

Dietary supplements can include a variety of components such as vitamins, minerals, herbs, amino acids, enzymes and other ingredients taken in various forms such as a pill, gel, capsule, gummy, powder, drink or food. Most common examples include multivitamins, herbal supplements, probiotics and yes, protein powders and weight loss supplements fall under this category as well.

The purpose of a supplement is to “supplement” your overall diet, helping to bridge the gap between your usual dietary intake and nutrient needs. Supplements, especially vitamin and minerals can be useful in situations when the demand for nutrients is higher. For example, during pregnancy, there is an increased need for nutrients, vitamins, minerals, and in particular folic acid to prevent birth defects. Other individuals may be deficient in certain vitamins or minerals such as Iron or Vit D and unable to meet these requirements with food alone or have malabsorption issues.

However, numerous supplements exist and often claim unfounded health benefits.  Although these seem harmless there are actually a few things to consider before buying and using a supplement.

1. There is little oversight and regulation when it comes to supplements and they are regulated differently than food and medications. They are not required to prove their safety prior to coming onto market. And only once they reach the market can the FDA take action.
2. Although good manufacturing practices exist there are numerous incidents of contamination with toxins, metals, and wide variances in amounts of active ingredients that are claimed compared what is actually in the product.
3. Additionally, no scientific data is needed to support claims regarding health and structure/function when it comes to supplements.
4. Supplements can interfere with other medications and some have the potential to accumulate in toxic amounts leading to medical concerns in some cases.

What does the research say?

It’s common to see claims out there how certain supplements can “enhance immunity, protect heart health, improve digestion…” However, for the majority of supplements there is a lack of strong evidence supporting these claims or it has very limited indications. For example, fish oil supplements containing omega-3 fatty acids has mixed results when it comes to benefits on heart health. Some populations or those who don’t consume any fatty fish may offer some benefit from supplementation while others do not (1). And the studies become even more inconclusive when evaluating fish oil supplementation with other medical conditions.

Overall, the studies we have are far and few in between for the majority of supplements and oftentimes positive data is seen when studying a specific food component but no benefit is found once it is taken in supplement form.

What’s the bottom line:

It’s ultimately best to get the majority of our nutrients from food. However, there is a time and a place for supplement use such as for a deficiency, certain disease states or with research to support the positive benefits

If you do add in a supplement, take one at a time and monitor for any side effects. Also, independent third-party testing resources exist that review the purity of supplements, such as Consumer Labs (https://www.consumerlab.com/). You can also select brands with the USP label (a non-profit that evaluates supplements for quality and potency on a voluntary basis) which indicates consistent quality and accuracy with what’s in the product is on the label. However, these do not make any claims towards the safety or efficacy of supplements.

While supplements seem safe and are often touted as “natural” there is minimal oversight and regulation. It’s best to work with your doctor or a dietitian to determine when and where a supplement is needed. Keep in mind that for supplements, less is usually more.

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References:

1. “Should you be taking an Omega-3 supplement?” Harvard.Edu. Harvard Health Publishing. Published April 2019. Accessed May 26, 2020.
2. “Dietary Supplements What You Need to Know.” NIH.com. Office of Dietary Supplements. Reviewed April 7,2020. Accessed May 26, 2020.
3. “Using Dietary Supplements Wisely.” NIH.com. Office of Dietary Supplements. Last Updated January 2019. Accessed May 26,2020.
4. “Omega-3 Supplements: In Depth” NIH.com. Office of Dietary Supplements. Last Updated May 2018. Accessed May 26, 2020.