Dietary supplements: Well-balanced arguments for your wellbeing

well balanced

Health and diet are inextricably linked: the better the fuel you put into your body, the better it will work. Fatty burgers should be balanced by lean meats, sugary soda by water, chocolate and crisps by fresh fruit and vegetables. But how many of us can maintain this balance? Of all the choices in our lives, the choice of what we eat isn’t one to make lightly, but it’s one we have to make every day. Choose well and feel more confident about your health — fuelled by nutritious, vitamin and mineral rich foods; choose poorly and risk developing a range of diseases and ailments.

But what if we had a third choice? The choice to eat a balanced diet, mostly good, a little not so good, while avoiding any nutritional hiccups along the way? Dietary supplements offer exactly that: the ability to ensure baseline nutrition, avoid deficiencies, and a springboard to a better informed, more active, and more health-conscious life.

Your healthy diet may not be as healthy as you think

It’s easy to say that if you eat a healthy diet, you don’t need dietary supplements, but how many of us manage to get one?

Unfortunately, despite what you might think, there is an immense disconnect between what people think they eat and what they actually do. A survey of 1,234 American adults by Consumer Reports found that while 89.7% of Americans described their diet as “somewhat” (52.6%), “very” (31.5%), or “extremely” (5.6%) healthy, 79% rarely or never count calories and only a slim 8% keep track on a daily basis.

It’s little surprise then, that contrary to how healthy we think we are, the rates of obesity, heart disease, diabetes, and other diet-related ailments in America are at an all-time high. Our eating habits are mostly to blame.

What are we eating?

Up to a quarter of Americans chow down on fast food every day, gaining up to 16% of their calories from sugar alone, while 90% of children are getting far too much salt in their diet. Even worse, 40% of that salt comes from just 10 common food items, such as bread, cheese, processed meats, and spaghetti sauce, and will give one in six kids unhealthily elevated blood pressure.

According to Fast Food Nation author, Eric Schlosser, in 1978, the average American teenage boy drank seven ounces of soda a day; today, he drinks nearly three times as much. Americans also eat substantially more meat than they should — often made more unhealthy by processing and frying — ranking second in the world only to Luxembourg.

In fact, American diets are horribly out of whack across the board. The US Department of Agriculture (USDA) estimates that the top five sources of daily calories among American adults are grain-based desserts (138 kcal), yeast-based breads (134 kcal), chicken and chicken mixed dishes (123 kcal), soda/energy/sports beverages (112 kcal), and alcoholic beverages (106 kcal).

Notice a pattern? Each of these foods, excepting perhaps chicken (but likely not its cooking method), include few nutrients other than refined grains and sugars; fruit and vegetables don’t even make the list. Worryingly, no fruits or vegetables are among the list of the top 25 foods consumed daily by American adults or children, unless you count french fries.

So what are Americans eating? According to a 2010 USDA study, the answer is:

  • meats, eggs and nuts (21%)
  • dairy (9%)
  • flour and cereal (24%)
  • added fats and oils (23%)
  • caloric sweeteners (14%)

Essentially, about 61% of our diet is nothing but refined carbohydrates, added fats, and added sugars.

The situation in the UK is not much better. The National Diet and Nutrition Survey (NDNS) data taken between 2008 and 2012 showed the average intake food trends:

  • sugar: exceeded daily recommendations (11%) for all age groups, most notably for children between 4–10 and 11–18 (14.7% and 15.6% respectively)
  • saturated fat: exceeded daily recommendations (11 percent) for all age groups, most notably in adults aged 19–64 (12.6%)
  • sodium: exceeded daily recommendations (6g/day) in all age groups except for children aged 7–10 years, but particularly in adults aged 65 and over (7.2g/day)
  • fruits and vegetables: only 30% of adults, 40% of older adults, 10% of male children, and 7% of female children received the recommended “5-a-day”
  • oily fish: lower than recommended (140g or one serving per week) in all age groups.

In addition, results showed:

  • Vitamin D levels: 23% of adults aged 19–64, and 22% of children aged 11–18 showed evidence of inadequate vitamin D in blood analysis, increasing to 40% for both groups during winter
  • Iron levels: 46% of female children and 23% of women had lower than adequate iron intake.

Where did the “healthy diet” myth come from?

If these statistics are true, how then do people still have this idea that they’re getting at least a partly healthy diet?

Essential to the myth of the “healthy diet” is the government-sponsored daily dietary goal of 2000 calories: this figure is the average that people should consume in a day. While a comforting, easy-to-follow guide number is potentially helpful, even ideal in theory, the reality is that such a number is arbitrary at best and potentially damaging at worst.

In an article for The Atlantic, Marion Nestle, professor in the Department of Nutrition, Food Studies, and Public Health at New York, explains the source of this dietary fallacy.

“The FDA wanted consumers to be able to compare the amounts of saturated fat and sodium to the maximum amounts recommended for a day's intake--the Daily Values. Because the allowable limits would vary according to the number of calories consumed, the FDA needed benchmarks for average calorie consumption, even though calorie requirements vary according to body size and other individual characteristics.”

Working from the assumption that women typically consume 1600–2200 calories a day, men, 2000–3000, and children, 1800–2500, the FDA settled on 2000 calories — a figure lower than standard consumption for adult men or women, but designed to limit the potential for any endorsement of overeating.

Even if this number were accurate, it would still be helpful only in the loosest sense. Calorie counting ignores the nutritional value of foods — there is a world of difference between 2000 calories of nuts, fruit and vegetables and 2000 calories of cake — and simplifies dietary health to a numbers game, rather than a lifestyle decision. Consider a standard fast food burger meal for instance; served with a medium fries and soda, they clock in at around 1,015 calories — more than half the recommended daily intake. But does such a meal provide half a day’s worth of vitamins and minerals? A handful of nuts on the other hand, while rich in nutrients, might contribute less than 10% of your daily requirement. Nutrition is always more than a numbers game.

How did our diets end up like this?

A recent survey showed 52% of Americans were happier doing their tax than counting calories. That’s a big deal when you consider how many calories we’re ingesting. Average American diets have grown by around 304 calories since the late 1970s, which might not sound like that much, but could represent up to 31 pounds of packed-on weight each year.

While it’s true that in the 1970s Americans couldn’t access the same range of foods we can now, people also ate dramatically less, were more likely to have a job that required some form of physical labour, and cooked more home-made meals. Increases in portion sizes are largely to blame, but it’s not just the plates that were smaller: the people were too. According to the USDA, in the late 1970s, 15% of adults were obese, a figure which more than doubled to 34% by 2008.

Decreasing quality of produce is more than apples and oranges

But it’s not just how much we eat that’s changing. It’s what we eat too. The nutritional quality of fruits, vegetables, and nuts have all declined since the advent of industrial farming, particularly in the last three decades. While many have blamed falling soil micronutrient availability, the answer has more to do with the crops themselves. High-yield, quick-growth crops may be an answer to growing demand for quantity of produce, but they fall sadly short when it comes to the quality stakes. Prioritising bigger, juicier produce that matures faster does not mean it’s better for you; in fact, the faster and bigger produce grows, the less nutritious it is.

A 2004 study, conducted by a University of Texas team headed by biochemist Donald Davis, Ph.D., analysed 43 common garden fruits and vegetables and found that almost half had significantly lower nutrient quantity than they would have had 60 years earlier. While not analysing individual produce types but instead focusing on nutrient content, Davis did find that “six out of 13 nutrients showed apparently reliable declines between 1950 and 1999.” These six were protein, calcium, phosphorus, iron, riboflavin, and ascorbic acid, and declines ranged from 6% for protein and 38% for riboflavin.

Looking at nationwide statistics for dietary intakes, America seems to have a much bigger problem than it realises. USDA research from the early 2000s showed only 30.9% of the US population is receiving the recommended daily intake for calcium, 43% for magnesium, and, most worryingly, 8% for fibre, and 7.6% for potassium.

When did healthy diets become so confusing? One of the most pervasive, if not entirely malicious, problems in nutrition education is the prevalence of biased science:

  • “white hat” researchers and policy makers who distort the interpretation of research data to further what they consider to be the greater good
  • less scrupulous, more commercially motivated scientists who promote diets based on corporate agenda
  • single-nutrient-focused self-help gurus that argue for one compound as a miracle cure for all ailments.

Take the war against dietary fat as an example. Once nutritional public enemy one, fats and cholesterol are now recommended — what happened? Essentially, science triumphed over hysteria.

Established in the 1980s, saturated fat and cholesterol guidelines emerged from a number of highly flawed studies which mostly focused on already unhealthy male participants. Tenuous results, promulgated in part by public concern, and, certainly to some extent, pressure from sugar industry lobbyists, led to a witch hunt against saturated fats that would only abate in the last few years. That the anti-fats hysteria may have led to an increase in obesity is a grim irony for those who saw through it: replacing fats in products like butter and confectionaries with highly-processed oils, and encouraging consumers to avoid meat and indulge on carbohydrates may have caused a great deal more damage than they have prevented. More than that, almost constant reinforcement of the dangers of fat have led to the popular opinion that anything “reduced fat” is good for you. On the contrary, many of these products are loaded with sugars that may contribute more to weight gain than fat itself.

Eggs, demonised for years as cholesterol-loaded mortality bombs have only recently been cleared of this poor reputation and are once again recognised as a healthy, nutritious and convenient food that should not be associated with limited intake. Sadly, during the years that eggs fell from favour, particularly as a breakfast food, they were replaced in many diets by sugary breakfast cereals.

Speaking of sugar, how much is too much?

Less than you’d think. It wasn’t until February 2015 that the US Government released guidelines recommending sugars make up only 10% of daily caloric intake, a figure that some would still call too high. Legislators are only now mustering the courage to force manufacturers to include nutritional labels based on realistic serving sizes: showing the sugar content of 100ml of a 750ml beverage is disingenuous to say the least when you consider that these drinks are generally sold as a single-serve item.

Nutritional labels hide unhealthy secrets

Even when guidelines are right, how can we even be sure what’s in what we eat? Joanna Blythman’s book, Swallow This: Serving Up The Food Industry, reveals an alarming number of insider tricks employed by industrial food producers to cover their chemical tracks.

Increased interest in nutritional labelling has predominantly led to what’s known as “clean-label” protocol, a whitewashing of potentially harmful additives into much more benign sounding ingredients. Rosemary extract for instance, commonly found in cured meats, is food scientist code for a range of E numbered preservatives, derived from rosemary through chemical solvents not too dissimilar from petroleum. Lovely.

Many desserts include what are known as “co-texturisers”, a cost-effective means of creating a thick and creamy texture without anything remotely creamy. Based on highly processed, altered starches, these additives drastically modify the consistency, nutrition, and composition of foods but need only be labelled as “starch”.

This heavy, chemical-based processing of food may often result in tasty flavours and consistent presentation, but its main purpose is to lower costs and make the few organic ingredients stretch further. Just as supermarket sausages are often cheaper than those at the butcher but contain less lean meat and more filler, industrially produced fruit and vegetable products typically contain less nutrients per calorie and those calories are predominantly sugar.

British researchers recorded the prices of 94 key food and drink items between 2002 and 2012, finding that healthy foods cost consistently more than less healthy alternatives. Worse, the problem only grew with time. In 2002, 1000 kcal of healthy food cost an average of £5.65, compared to £1.77 for junk food; by 2012, the disparity had increased to £7.49 against £2.50. Another global study reported that healthy diets cost on average $1.50 per day more than unhealthy ones.

How can dietary supplements improve health and nutrition?

From the statistics and evidence, it seems clear that most of us aren’t eating anywhere near as healthily as we should. But given the immense amount of misinformation and confusion that surrounds nutrition, it can be easy to feel like you don’t have much choice. Spend big and eat better, or sacrifice health for money and convenience.

It doesn’t have to be like that. By doing your research, shopping around, and taking the time to think about what you eat, supplements such as high-grade minerals and vitamins can provide the nutrients you need to fill the gaps in your diet simply and easily, letting you get on with your life and continue making positive health choices.

While dietary supplements are now part of many peoples’ lives — the Centre for Disease Control and Prevention (CDC) estimates over half of adult Americans take one — some are still sceptical about their benefits. Let’s take a moment to examine some popular common reservations about supplement use.

Money not flushed down the toilet

One criticism frequently levelled at supplements is that the only thing they provide is expensive urine; the body can only store so much of any nutrient and any excess is simply excreted. For a start, this assumes that many people are likely to be in excess of any nutrient; this is clearly false, judging by USDA statistics showing that vast proportions of Americans are deficient in at least one essential mineral or vitamin.

Secondly, if ingested vitamins are evident in urine, this suggests nothing more than your body having absorbed the nutrients it needs. That’s why we test athletes’ urine for drug traces; nobody would argue that an athlete caught with steroids in his urine had simply paid for an expensive trip to the bathroom.

Thirdly, this argument against supplements ignores the fact that they are simply that: supplements. Vitamin and mineral supplements are not designed to replace nutrient intake through diet, but rather to fill the gaps that might prevent optimal health. While serious deficiencies don’t happen often, suboptimal intake of nutrients is a real issue for most of the population.

Where’s the scientific evidence for dietary supplements?

While it’s true that there is a dearth of quality research about vitamin and mineral supplements, there is good evidence to suggest they are still beneficial, particularly as part of a move to a healthier lifestyle.

Evidence from a range of surveys shows that users of dietary supplements are more likely than non-users to adopt a range of positive health-related habits. These include better diet, more regular exercise, weight management and avoidance of tobacco, with users well represented across age, race, and gender groups. Surveys also indicate that those who regularly take supplements do so consistently, indicating a strategic and committed outlook toward beneficial health outcomes. Just some of the positive lifestyle choices associated with supplement use include:

Weight management Normal-weight individuals (56%) and overweight individuals (57%) were more likely to take dietary supplements than obese individuals (48%).

Regular exercise Research reveals 59% of participants who engaged in regular physical exercise took a dietary supplement. Only 43% of those who engaged in little or no exercise took dietary supplements.

Good quality diet Surveys have shown that those who consume high-fat and low-fibre diets are less likely to take dietary supplements, while in people over 50, consuming a healthy diet was found to be a significant predictor of supplement use.

Not smoking People who have never smoked or are former smokers (52% and 61% respectively) are more likely to use dietary supplements than current smokers (43%).

Though none of these factors directly relate to dietary supplement use, they do show a positive correlation between thinking about your health, what you eat, and how you live, and making the effort to ensure you’re getting the vitamins and minerals your body needs. If taking a multivitamin in the morning inspires you to eat better and do more exercise, then perhaps that alone is worth the price of admission.

That’s not to say there is no genuine evidence of health benefits being associated with dietary supplements. A 2013 systematic review of literature found that multivitamin supplementation was not attributed with any additional risk of mortality and in many cases provided a “modest protective benefit”.

When you consider that doctors once prescribed cigarettes and cocaine and that more people die every year from prescription painkillers than illicit drug overdoses, arguments about the medical safety of vitamins and minerals, essential for the body’s function, seem totally ridiculous.

With the prevalence of nutrient deficiencies, even in developed nations such as America and the UK, it seems clear that dietary supplements could provide positive health benefits for a large proportion of the population.

Key dietary supplements for better everyday health

So you know that our diets aren’t up to scratch and that dietary supplements can help, but what should you be taking? Let’s examine some of the more common compounds and how they can help.

Selenium Of particular importance to those with gastrointestinal orders (which can affect absorption), and people who have spent long periods being fed intravenously, selenium strengthens the immune system, detoxifies the body, and is essential to normal growth and development.

Zinc Despite its importance, up to 17.3% of the world’s population isn’t getting enough zinc; vegetarians and vegans particularly. Zinc is necessary for cell division and growth, wound healing, growth, and even the senses of taste and smell.

Iodine Essential for thyroid and metabolic function and linked to the absorption of other minerals such as calcium and selenium, a good source of dietary iodine is paramount for good health. Taking notice of iodine intake is particularly important as we now tend to consume less table salt — often enriched with this precious mineral.

Magnesium Required for a number of biochemical processes involving the immune system, heart, bones, blood, muscles, and metabolism. Magnesium, and the dark leafy greens that are rich in it, are often neglected in modern diets. It’s important if you suffer from digestive issues or are recovering from surgery.

Potassium Potassium affects a wide range of mechanisms around the body, including building protein and muscle, maintaining growth, controlling electrical impulses in the heart, and regulating blood pressure. Even a minor deficiency can lead to fatigue and muscle weakness.

B12 Particularly important for vegetarians, pregnant women, and those taking the contraceptive pill, B12 can improve mental agility, protects the nervous system, stabilizes mood, and eases the symptoms of PMT.

Vitamin D Essential for bone growth, calcium absorption, and strengthening the immune system. Highly recommended for older individuals and those who live in climates with limited sunlight during winter months.

Vitamin B6 A crucial antiaging vitamin left out of many low-quality supplements, vitamin B6 prevents the build-up of cross-linked proteins which can lead to conditions such as cataracts, hardened skin, diabetes, and even cancer.

Dietary supplements — Justified, safe, and effective

In today’s world of processed foods, hidden ingredients, busy schedules, and confusing and contradicting nutritional advice, getting a healthy diet is not always straightforward. But a well-informed dietary supplement plan can provide a safe and effective means of making sure you’re not missing out on the essential, quality-of-life improving compounds your body needs.

While there are many things in our lives we can’t control, our nutrition shouldn’t be one of them. As Hippocrates once said, “let food be thy medicine and medicine be thy food”: listen to your body, fulfill its needs, and start reaping the health benefits.

References

Alexander, DD. Weed, DL. Chang, ET. Miller, PE. Mohamed, MA. Elkayam, L. A systematic review of multivitamin-multimineral use and cardiovascular disease and cancer incidence and total mortality. J Am Coll Nutr. 2013;32 (5) :339-54. Web. 26 Feb 2015.

Americans falsely believe their diet is healthy. Discovery News. Discovery, 4 Jan 2011. Web. 27 Feb 2015.

Avena, Nicole. The American Diet. Psychology Today, 19 Aug 2013. Web. 20 Feb 2015.

Blythman, Joanna. Inside the food industry: the surprising truth about what you eat. The Guardian. The Guardian, 21 Feb 2015. Web. 22 Feb 2015.

Community Nutrition Mapping Project. USDA. USDA Agricultural Research Service, 30 March 2010. Web. 20 Feb 2015.

Dickinson, Annette. MacKay, Douglas. Health habits and other characteristics of dietary supplement users: a review. Nutrition Journal. (13) 14. 2014. Web. 25 Feb 2015.

Dietary guidelines for Americans 2010. USDA, December 2010. Web. 25 Feb 2015.

Donnelly, Laura. Healthy diet costs three times that of junk food. The Telegraph. 8 Oct 2014. Web. 25 Feb 2015.

Nestle, Marion. Why does the FDA recommend 2000 calories per day. The Atlantic, 4 Aug 2011. Web. 24 Feb 2015.

New National Diet and Nutrition Survey shows UK population is eating too much sugar, saturated fat and salt. Gov.co.uk. Public Health England, 14 May 2014. Web. 22 Feb 2015.

Reducing sodium in children's’ diets. Vital signs. CDC, Sep 2014. Web. 26 Feb 2015.

Schlosser, Eric. The bitter truth about fast food. The Guardian. The Guardian, 7 April 2001. Web. 27 Feb 2015.

Study suggests nutrient decline in garden crops over past 50 years. University of Texas, 1 Dec 2004. Web. 26 Feb 2015.

Taylor, Marisa. New dietary guidelines put strict limits on added sugar. Al Jazeera America, 20 Feb 2015. Web. 25 Feb 2015.

Woolston, Chris. What’s wrong with the American diet. HealthDay, 11 March 2014. Web. 25 Feb 2015.