Having seen recent reports regarding the vitamin and supplement industry that state vitamins are a “waste of money,” I feel compelled to respond. I have no stake in this argument because I do not sell any supplements, nor do I represent any supplement companies. But as a functional medicine doctor, I do have a stake in public health, and that’s where I have to take issue with the over-arching premise of the newly released report on supplementation. I find this report detrimental to public health for three primary reasons.
Reason #1: Obesity is a Disease of Malnutrition
Most Americans eat a hypocaloric diet. That means they eat more food than they need for health, and are at the same time malnourished, meaning they don’t get enough nutrition for optimal health. There is an assumption that if you eat a lot, you won’t be malnourished, but we know from the state of obese patients that this isn’t true. In fact, obesity is considered a type of malnutrition, and has been described as “a paradoxical state of malnutrition which, despite excessive energy consumption, is associated with a shortage of individual microelements.”
We are currently experiencing an epidemic of obesity in the U.S.—according to the CDC, 44.3% of adults between 40 and 59 are obese. The notorious Standard American Diet is high in sugar and saturated fat, but low in fiber and micronutrients. While the USPSTF statement was in reference to the prevention of chronic disease, what it doesn’t mention is how supplements could help with the prevention of malnutrition.
Studies on older adults and hospitalized patients who more obviously suffer from malnutrition have supported the use of nutritional supplements and shown that they help combat malnutrition, but nobody (to my knowledge) is looking at how this might help people suffering from metabolic diseases like diabetes and obesity. As a health professional who focuses on prevention, I can’t help thinking that Instead of complaining that nutritional supplements don’t cure disease, perhaps we should be working on demonstrating how they can help to restore health.
Reason #2: Science Shows Benefits
It’s not true that research hasn’t shown the benefits of nutritional supplements. Doctors well know that folic acid decreases the risk of some birth defects, and calcium and vitamin D can improve bone strength and reduce bone loss with age. Research has gone on to shown that nutritional supplements can have a profoundly positive effect on human health, especially when it comes to energy, brain function, and mood.
According to a 2020 research study published in the journal Nutrients, B vitamins, vitamin C, iron, magnesium, and zinc can all play a role in improving energy, fatigue, and cognition. Other studies are more specific. One study showed how B vitamins—critical for energy production in the cell—can help with energy in young women under chronic stress A 2019 study published in Frontiers in Behavioral Neuroscience found that taking a multivitamin improved verbal, visual, and working memory in volunteers between the ages of 21 and 59. The researchers concluded that “sub-optimal micronutrient intake may have a negative effect on cognition across the lifespan.” And a 2019 study published in World Psychiatry showed the benefits of several different supplements, including fatty acids, amino acids, and B vitamins, for improving mood in people with depression or ADHD.
It’s my opinion that benefits like this are well worth taking supplements for, even if nobody has definitively proved they prevent heart disease or cancer.
Reason #3: Disease is More Complex Than Cause-and-Effect
Finally, let’s look at chronic disease a little more closely. The action of a supplement in your body and in disease development or prevention are very far apart. There is not a direct correlation of “take this pill and cure this disease” because disease development is complex and multi-factorial—i.e., there are many factors involved in how a person who is healthy turns into a person with a chronic disease.
But while we can’t prove a direct effect, we already know that supplements can nourish the body and support the systems that are already in place to fight disease (like your immune system and detoxification systems). For instance, a probiotic can help replenish and shore up beneficial gut bacteria. This can in turn strengthen the microbiome’s ability to contribute to a healthy immune response, which in turn could help the body get smarter about what to fight and what to leave alone. And this could mean that somewhere way down the line, your immune system will be able to take down cancer cells before they spread.
Another way to look at this is from the perspective of free radicals and inflammation.
A quick lesson in how this works: Within the body, the process of metabolism (turning food into energy at the cellular level) generates waste products in the form of free radicals. These free radicals can also accumulate due to exposure to pollution and other chemicals, inflammatory foods, a sedentary lifestyle, and even depression. Free radicals damage tissues and cause inflammation, which can, over time, lead to chronic disease.
Supplements, such as vitamin C, vitamin E, selenium, and many phytochemicals like lutein, lycopene, and carotenoids, just to name a few, are antioxidants with anti-inflammatory properties. Taking these supplements can give the body a hand in neutralizing free radicals, calming inflammation, and generally promoting a more stable biochemical environment for the body. This in turn can lead to a body that works better and is better able to avoid developing a chronic disease. Other supplements, like B-vitamins, vitamin D, vitamin K, omega-3 fatty acids, magnesium, calcium, and also herbal supplements, have similar mechanisms for helping the body do what it needs to do by reducing the distracting and destructive influences of a modern diet and lifestyle.
None of these supplements are panaceas that will magically cure you, but they are support staff in the body’s quest to get and stay healthy. That’s important, beneficial, and valuable for health and wellness. I certainly wouldn’t waste my money on supplements if I didn’t know they were helping my body do what it’s already trying to do naturally.
The Bottom Line
Can we get what supplements provide from food? We could theoretically come close, but the truth is, most people don’t eat enough nutrients to match what a supplement can do. In fact, in 2019, only 12.3% of Americans met governmental guidelines for fruit intake, and only 10% met the guidelines for vegetable intake (and the governmental guidelines are pretty low).
Are there problems with supplements? Sure. Regulations for the industry are different than the regulations for prescription drugs. And many cheap supplements don’t contain what they say. Some even contain undeclared ingredients that could be hazardous. But if you look around, do some research, and go with a company you trust that has third-party verification standards for purity and quality control, then yes, supplements are beneficial, even without a disease prevention claim. I will continue to recommend them without reservation.