Doctors actually think you should take supplements

DDietary supplements are a booming business. More than half of U.S. adults take at least one, and the supplement industry is worth billions of dollars.

However, many experts say that it is better to save money. Industry regulations are so lax that supplement makers don’t have to prove their products are safe and effective before they hit stores – something studies show many would find difficult to do. Numerous studies have shown that dietary supplements are not particularly beneficial to the average person and in some cases can even be harmful or expose the user to dangerous substances.

Studies show that the vitamins and minerals in supplements cannot match those in real food. “Food contains countless other components that ultimately benefit you as well,” says Dr. Joel Mason, professor of medicine and nutrition at Tufts University. “In the long run, it is better for us to maintain our health through a consciously healthy diet rather than trying to fill the gaps” with nutritional supplements. And yet many people do exactly that.

Dr. David Seres, a professor of medicine in the Institute of Human Nutrition at Columbia University Irving Medical Center, wishes they wouldn’t. “Supplementation is generally completely unnecessary in the U.S. population,” says Seres. “I would recommend that [users] Think about stopping because it’s a waste of money.”

Although Seres doesn’t advocate the widespread use of supplements, he and other experts say there are some products that may be helpful in individual cases. Here’s what you should know about supplements that may be beneficial for some people.

Vitamin B12

Vitamin B12, which occurs naturally in fish, meat, eggs and dairy products, plays a number of important roles in the body, including supporting nerve cells and aiding DNA production. The body’s ability to absorb B12 often declines with age, and some medications commonly taken later in life—including proton pump inhibitors and the diabetes drug metformin—can further impair absorption. This puts older adults at risk of B12 deficiency, which has been linked in some studies to an increased risk of dementia, among other things.

For this reason, Mason says it’s appropriate for older adults, and especially those taking medications that interfere with B12 absorption, to consider using a supplement. (Even the shy Seres takes one, a decision he made because he has a B12 deficiency.)

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People who follow a vegan diet and therefore don’t eat animal products that contain B12 are also likely to benefit from a B12 supplement, says Mason. But aside from those who eat animal-free diets or have health conditions that affect nutrient absorption, most younger adults get plenty of B12 from their diet. “I don’t think there’s any evidence of that [supplementation] at any age,” says Dr. JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital and regular supplement researcher.

calcium

Calcium’s best-known function is to promote bone health, but it also supports muscles, nerves, blood vessels, and more. It is found in dairy products and some fish, vegetable and grain products.

Older adults, and especially postmenopausal women, often do not absorb or store enough calcium from food – especially because lactose intolerance can develop later in life, causing some seniors to avoid dairy products. Some older adults get enough calcium through their diet, says Mason, but those who don’t may want to consider taking a supplement.

And that also applies to men, he says. “Older men are also susceptible to osteoporosis,” a condition that results in weak, fracture-prone bones and is common in older women, Mason says. “It’s not as common in men, but it definitely exists.”

However, according to the US National Institutes of Health (NIH), older adults should not exceed 2,000 milligrams of total calcium per day because too much of the mineral can increase the risk of kidney problems, heart disease and even prostate cancer. .

Vitamin D (maybe)

Vitamin D works with calcium to keep bones strong and healthy. It is also involved in immune and brain function. Only a few foods – including egg yolks, fatty fish, mushrooms and beef liver – naturally contain vitamin D, but some others, such as milk, are fortified with it. The skin can also produce vitamin D through sun exposure.

However, skin loses some of this ability as we age, leaving older adults at particular risk of vitamin D deficiency – a situation exacerbated by the fact that many seniors do not and may not spend much time outdoors Eat lots of foods containing vitamin D. says Mason. Starting around age 60, Mason says, some adults may benefit from taking a vitamin D supplement.

This is not a universal opinion. Some experts recommend avoiding taking vitamin D supplements because research on their health benefits is mixed and inconclusive. The United States Preventive Services Task Force (USPSTF), which makes recommendations on screenings and health habits that can improve well-being, recently released a draft recommendation that generally healthy older adults should not take vitamin D, either alone or in combination Combination with calcium – to prevent falls or fractures, as there is not enough evidence to support this practice.

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How about using vitamin D to combat seasonal affective disorder? Although not all experts agree, Manson says this is a “very sensible” move if you don’t get much sun during the dark winter months. But “no one should ever view these supplements as a panacea,” warns Manson. “Regular physical activity is a much greater panacea than taking a pill.”

If you decide to take vitamin D, be sure not to overdo it. The NIH recommends that most adults consume no more than 100 micrograms of vitamin D total per day. In very high doses, vitamin D can cause a number of side effects and complications, including serious ones such as kidney failure and irregular heartbeat. Vitamin D supplements may also have problematic interactions with certain common prescription medications, including statins.

Folic acid and prenatal vitamins

Folate, found in fruits, vegetables, legumes and beef liver, is crucial for cell function and DNA production. According to the U.S. Centers for Disease Control and Prevention, women who are pregnant or considering pregnancy should consume at least 400 micrograms per day because the vitamin supports fetal development. To reach this threshold, people who are pregnant or trying to become pregnant can take a prenatal vitamin that contains folic acid along with other micronutrients, says Manson.

Just don’t exceed 1,000 micrograms of folic acid per day, according to the NIH, because high doses can mask or worsen B12 deficiency and potentially increase the risk of colon cancer.

Multivitamins (maybe)

Manson’s research on multivitamins, which contain a cocktail of vitamins and minerals, suggests that these popular pills could have significant benefits for older adults. She has published studies suggesting that multivitamins may be linked to a lower risk of cancer and slower cognitive aging, at least in middle-aged and late-life adults. “That’s pretty good,” she says, especially for something that’s “safe and doesn’t have all these side effects.”

However, not all researchers agree. Other studies have found that multivitamins are not associated with a reduction in the risk of cancer, heart disease, or mental decline.

Seres says he is “interested” but not “compelled” by the data on the benefits of multivitamins. He is nutrition editor at UpToDate, a widely used decision support tool for healthcare providers, and notes that the database advises healthy people against taking multivitamins. The USPSTF also concluded that there is insufficient evidence to assess the risks and benefits of using multivitamins – or other dietary supplements – to prevent cancer or heart disease.

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The bottom line, says Seres, is that most generally healthy people don’t need supplements, especially at a young age. If you have a documented nutrient deficiency or a health problem that could affect your ability to get enough nutrition, talk to your doctor about what supplements, if any, are right for you, he says.

But in most cases, your health – and your wallet – will benefit from eating a varied diet that includes plenty of fruits, vegetables, whole grains, legumes, and proteins, rather than stuffing yourself with pills and capsules.