Is it better to get nutrients from food or supplements?

Researchers have found that nutrients from food may be linked to lower risks of death, while excess intake of certain supplements may have the opposite effect.

Taking supplements leads to an increased level of total nutrient intake. Dietary supplements include vitamins, minerals, herbs, amino acids, and enzymes. Suppliers sell them in different forms, including tablets, capsules, powders, and liquids. Common dietary supplements include calcium, fish oil, and vitamin D.

According to the 2018 consumer survey conducted by the Council for Responsible Nutrition (CRN), consumer confidence in products and trust in the dietary supplement industry is strong among people in the U.S. The survey found that 75 percent of U.S. individuals take dietary supplements, as opposed to just 65 percent in 2009. "This year's data provide further evidence that dietary supplements are mainstays in modern day health and wellness regimens," explains Brian Wommack, the senior vice president of communications at the CRN. Vitamin and mineral supplements such as vitamin D and calcium remain the most popular types. However, the use of herbals and botanicals — especially turmeric — has significantly increased during the past 5 years.

The main reason that U.S. individuals take dietary supplements is overall health and wellness, according to the survey. Although many people use dietary supplements, a recent study found that multivitamins, vitamin D, calcium, and vitamin C showed no advantage or added risk in the prevention of cardiovascular disease or premature death. However, folic acid alone and B vitamins with folic acid may reduce the risk of heart disease. The team, from the Friedman School of Nutrition Science and Policy at Tufts University in Medford, MA, conducted a study to evaluate the association between dietary supplement use and all-cause mortality. The researchers have published their results in the journal Annals of Internal Medicine.



For each nutrient, the scientists calculated the daily supplement dose by combining the frequency with the product information for ingredient, the amount of ingredient per serving, and ingredient unit. They assessed the participants' dietary intake of nutrients from foods using 24-hour dietary recalls and mortality outcomes through the National Death Index through December 31, 2011.

Adequate intakes of vitamin A, K, zinc, and magnesium — from food, not supplements — were linked to a lower risk of death. Adequate intakes of vitamin A, vitamin K, and zinc — from foods, not supplements — were associated with a lower risk of death from cardiovascular disease. Excess intake of calcium was associated with a higher risk of dying from cancer. Excess intake of calcium from supplements (at least 1,000 milligrams per day) was associated with an increased risk of death from cancer.

In addition to the harmful effects of excess calcium intake from supplements, the researchers found that people with no sign of vitamin D deficiency who use vitamin D supplements may have an increased risk of all-cause mortality. Further research on this potential connection is necessary.

Our results support the idea that, while supplement use contributes to an increased level of total nutrient intake, there are beneficial associations with nutrients from foods that aren't seen with supplements."

My Take:
The article also notes some limitations in the study, including the duration of dietary supplement use studied and the fact that dietary supplement use was subject to recall bias. I agree that getting your nutrition from food is ideal and that the synergistic effects of all the nutrients in food surpasses the benefit of supplementation. However, this is a poorly designed study and no conclusions should be drawn for the outcome.

Supplementation is not a replacement for a good diet. As the name implies, it is a “supplement” to the diet. Few, if any of us, are getting enough omega-3 fatty acids in our diet. When 95% of the U.S. population is deficient in vitamin D do you have to exhibit symptoms of vitamin D deficiency to understand the need for supplementation?

Standard Process, one of my main supplement providers, shares this whole food philosophy. All their products are made from organically grown whole food. I prefer to use this product line whenever possible. However, some deficiencies, like genetic impairment of folic acid or vitamin B12 methylation, require the use of bioavailable supplements not derived from whole food.

Bottom Line:
Our food quality and SAD (standard American diet), require supplementation to meet the needs of the human body. This study appears to be contrived to undermine this simple fact.

Source: April 12, 2019 NIH