supplements: should you take them?
Supplements are widely used not just in the fitness community, but among people who are looking for ways to get healthier. I think certain supplements have their place, but we have to be very careful about choosing them, using them, or suggesting them. At a time when people are looking for fast ways to get healthy or lose weight, it's more important than ever that we stick to the facts and do our due diligence to make sure we don't consume something that at best is useless, and at worst progresses disease.
First, I believe that the components of food act synergistically. A whole food is a powerful package that is beneficial because it's a package, not just because of one or two components. Consuming a Fiber One Brownie may promise you 20% of your daily value of fiber, but can we treat it as a health food because it contains fiber? (Incidentally, their Why Fiber? page recommends only whole foods for adding more fiber to your diet!) The evidence that associates high fiber intake with lower risk of disease pertains to whole foods only, not extracts. This is just an example of why we can't isolate the "active compound" of a food and consume it in pill form, and expect to see the same health benefits. In studies done comparing supplements to their nutrient-containing whole food counterparts, whole foods consistently do better, and in fact, supplements in many cases are harmful. For example, in a 19-year study following ~2k men with lung cancer, beta-carotene supplements actually increased mortality. In the Harvard Nurses’ Health Study, women who took vitamin E supplements saw no benefit, but those who had high vitamin E levels from a nut-rich diet saw their asthma risk cut in half. So there isn’t any convincing, comprehensive evidence that supplementation is a replacement for real food.
Second, supplements are poorly regulated. In the US, the onus is on the supplement manufacturer to determine whether a supplement is safe or effective before it is marketed, and research studies to prove it aren't required! Can we really be comfortable trusting the salesman, not an objective third party, to guarantee their product's safety? If a supplement is found to be unsafe after it is on the market, only then does the FDA step in to issue a warning or remove it. What does this mean? It means that at best, a supplement could be useless but do no harm, and remain for sale undetected. At worst, damage could be done to one's health before meaningful action is taken to protect consumers.
Finally, as tempting as it is to use our own experiences to defend or deride usage of supplements, we have to cultivate a meaningful balance between listening to our bodies, and understanding scientific literature. This is not to be dismissive of people's personal experiences using supplements, but to challenge one to treat them as a last resort adopted under medical supervision or recommendation, not as a trusted go-to. Our perspective on nutrition should be holistic and nuanced, not compartmentalized or reductionist.
Not all circumstances or supplements are the same, of course. If you have a severe deficiency, are recovering from surgery, are pregnant or trying to get pregnant, eat a 100% vegan diet, don't get enough sunlight, etc, then on recommendation by a practitioner only:
1. Make sure the components of the supplement have been studied, and that the company is trustworthy.
2. Adhere to the recommended dosage, and only take them for the recommended length of time.
3. Choose single-ingredient supplements - they're less likely to be contaminated.
4. Immediately report adverse effects and cease taking the offending supplement.
As someone who consumes almost no animal products, I do supplement vitamin b12 on recommendation and consensus by well-known doctors I have met and trust, such as Dr. Michael Greger and Dr. Michelle McMacken. Vitamin b12 is found in soil, but is typically taken in via animal products because it is in the feed animals consume. I also supplement vitamin D on occasion - many, if not most of us, have chronically low vitamin D levels due to lack of exposure to sunlight for a significant portion of the year. As someone who wears the hijab and covers my arms and legs when outdoors, I can't achieve sufficient vitamin D absorption from the sun. If I do get an opportunity to get this sun exposure, I don't take the supplement.
In my opinion, it's not necessary to overzealously fill gaps in nutrition by taking a variety of supplements or a multivitamin under normal circumstances. It is up to us to make sure our diet is colorful and varied enough that we can protect ourselves from experiencing severe deficiencies. Many of us have the luxury of access to a diverse array of produce, even when they're not in season, so take advantage. If you don't, frozen and canned foods are an option. Stay aware and in conversation with your doctor, but also keep in mind that most doctors undergo little to no training in nutrition, so it's also important to take strong ownership of understanding nutrition and your dietary needs. Check my resources page for books, practitioners to follow and other goodies that have helped shape my stances and perspectives. You don't need to be a doctor yourself! Making the investment to learn can literally be life-saving and enrich your life, and the lives of those around you.
Finally, a word on "miracle" supplements or those purported to enhance your athleticism, memory, physique or anything else: this is most likely garbage. Steer clear. I know we so badly want to believe there's a miracle bullet, but the likelihood is that these supplements are either totally useless or unsafe. It disheartens me to see influencers on social media recommend them. If some fitness or nutrition specialist includes an array of supplements as part of their diet program, be skeptical. This preys on people's desire for a fast, easy cure, isn't ethical, and likely isn't scientifically supported. Remember: one's usage of them should be dependent on having a specific reason, a recommendation, and evidence for safety.
Food is the sum of its parts. In our pursuit of good health, it's important to make well-informed decisions. We can't know everything, but we can tune in to the strongest research we have and determine what is best for us based on it. As reliable new science arises, we can adjust our understanding accordingly, and couple this with a very careful appreciation for the messages our body sends us. You are important, so treat yourself and your health with love and respect.