Do we really need supplements? A skeptic’s guide to micronutrients

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Pixie Turner
Pixie Turnerhttp://pixieturnernutrition.com/
Pixie Turner is a Registered Nutritionist (RNutr), author and public speaker.

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Every Sunday I do a Q&A on my Instagram, which is always an enlightening process as it provides me with regular insight into the misconceptions and curiosities people have around food and health. Over time, I’ve noticed that there are a few topics that appear without fail every single week, and one of them is supplements.

The entire narrative around supplements is a strange one. These little pills seem to hover on a tightrope between natural and artificial, wellness and pharma. Ask someone what supplements they take, and you’ll tend to either hear an enthusiastically long list of everything they’re taking, or a scoff that they’re totally unnecessary and a money-making scheme. There doesn’t tend to be much in-between, and I’d like a little more of the in-between please. So here is my (very general) guide to what supplements humans actually need for health. All of this is general guidance, and not a substitute for personalised advice from a healthcare professional.

Multivitamins

Multivitamins are a mix of nearly every essential micronutrient humans need, all neatly packaged into a single pill. These supplements are largely unnecessary for most of the population, especially if you’re eating a wide variety of foods, eating enough, and plenty of fruits and vegetables within that.

There are exceptions though, as always. If you’re pregnant or trying to become pregnant, then taking a pregnancy or pre-pregnancy multivitamin is useful. It gives your body what it needs at that stage in life, and it takes the pressure off food during a time where additional stress is the last thing you need.

Speaking of stress, in my clinical experience I’ve found that sometimes a daily multivitamin can really help and reassure someone who is very stressed or anxious around food and health. It’s not an ideal long-term solution, but it can allay their concerns gently, to allow us to do the more important work on what’s going on for them.

Finally, if someone is only able to eat a really narrow range of foods, for example, due to nausea, illness, or sensory issues with food if they’re on the autism spectrum, a multivitamin can provide some reassurance and cover all bases.

Vegans and vegetarians

If you don’t eat any animal products you need a B12 supplement. For me, that’s non-negotiable. Yes I know there are fortified foods, but are you really drinking 250ml of fortified almond milk every day? I doubt it. A supplement is the only sure-fire way to ensure you’re getting enough of this essential nutrient. You may also potentially need to consider other supplements like iodine or iron, for example, but that’s for you to determine.

A plate of cooked sardines

If you’re someone who doesn’t eat fish, then an omega-3 supplement is also worth adding. Omega-3 is classified as an essential nutrient, an essential fat, meaning it is required in the diet for normal physiological functioning, and particularly for brain function. The NHS recommendation is one portion of oily fish per week, which is equivalent to a daily supplement containing around 500mg of DHA and/or EPA. Of the main types of omega-3 fats that we humans need, ALA is the version typically found in plant foods, while DHA and EPA are found in oily fish. While you could decide to rely on plant foods like flaxseed and walnuts, the reason I tend to recommend supplements is simply because the conversion rate in our bodies from ALA to the more beneficial DHA and EPA is low.

Vegans rejoice, because algae-based supplements mean you can still obtain enough DHA and/or EPA, without the fishy burps.

Vitamin D

If you’re in the UK, you need a vitamin D supplement in winter. In summer months, the UV rays from the sun hit our skin, and start the process of converting 7-Dehydrocholesterol into functional vitamin D. Unfortunately, due to our shitty winter weather, general lack of sunlight, and the low positioning of the sun in the sky, from around October to March every year those UV rays struggle to get to us. So, it’s recommended that everyone in the UK take around 10-25µg (that’s micrograms, not milligrams) or 400-1000 IU of vitamin D daily.

No, it’s not going to prevent or cure Covid, that’s just a myth, but it will hopefully prevent a deficiency which has been linked to reduced immune function and potentially seasonal affective disorder.

Again, taking vitamin D isn’t a ‘boost’ to your immune system, it’s simply a matter of taking enough to avoid deficiency, so your body has the basic building blocks it needs.

The weird and wonderful

Supplements are an incredibly lucrative industry, and you can find almost anything in supplement form now: collagen for anti-ageing (no evidence), ketones for energy (or you could just eat food), carb-blockers (an unauthorised health claim), and so much more. The vast majority of them are completely unnecessary, a solution the company is trying to sell you to a problem they likely invented in the first place. Many are substances we can easily and cheaply obtain from food (unless you’re following the carnivore diet, in which case… good luck), many are made by our bodies, and many don’t even make it past our digestive system. Skepticism is certainly required when reading about this subject, although that doesn’t mean we should dismiss them entirely.

It’s not correct to suggest humans never need supplements, or that they aren’t worth considering. As a nutrition professional, I see supplements as simply another choice humans can make about where we obtain our nutrients from. You can eat animal products of you can take a B12 supplement – either way, you’re still getting what you need.

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