Health in a bottle has become a booming business - Americans shell out around $35 billion on dietary supplements each year, according to the National Institutes of Health (NIH).
But is it money well spent?
In some cases, supplements can fill in the nutritional gaps that can crop up even in a healthy diet, says Brianna Elliott, R.D., a coach at nutrition counselling service EvolutionEat. But there are some nutrients that you likely to get enough of in your regular diet, which makes supplements of them just plain unnecessary.
The trick is knowing which supplements can actually help you stay healthy - and which are likely doing nothing at all. Here’s your quick cheat sheet.
SUPPLEMENT TO TAKE: VITAMIN D
Vitamin D - known as the sunshine vitamin, since you can get it from its rays - aids your body in absorbing calcium. It also helps reduce inflammation, improve mood, and boost immune function.
Many people are lacking in D, though. In particular, those in the northern part of the U.S. don’t get enough sunlight for their bodies to produce enough vitamin D naturally, says Elliott.
And that’s a problem, since vitamin D is incredibly difficult to get from food sources, she says. Vitamin D deficiency has been linked to a number of serious health issues, including depression, dementia, and heart disease.
In fact, people with low levels of vitamin D were about 20 percent more likely to experience a major cardiac event like a heart attack or heart failure, a new study presented at the American College of Cardiology Scientific Sessions found.
“The effects of low vitamin D could be cumulative,” says study author Heidi May, Ph.D., a cardiovascular epidemiologist with the Intermountain Medical Center Heart Institute. “The longer you maintain low levels, the more you might be increasing health risks.”
There’s some debate on how much you should aim to get, though. The NIH recommends 600 IU, while the Endocrine Society suggests much higher levels of up to 2,000 IU daily.
“This would be a good conversation to have with your doctor,” says May. “It’s easy to test for vitamin D levels, and then you can get a recommendation based on your situation.”
SUPPLEMENT TO TAKE: MAGNESIUM
Magnesium is very important for a range of functions, from proper digestion to blood sugar control.
But most American diets provide less than the NIH’s recommended amount of 400 to 420 milligrams (mg).
One reason? Poor soil health compared to past centuries of agriculture, as one recent study in The Crop Journal noted. That’s because vegetables are drawing in less magnesium from the soil now, so we’d have to eat more of them to get the same amount of the mineral than before.
So even though you may be eating foods that should contain lots of magnesium - think leafy green vegetables, beans, nuts, brown rice, and whole wheat - you may not be getting as much of it as you may think, says Elliot.
Aim for about 350 mg daily in a supplement, but start low - like about 150 mg - and build up from there over a few weeks to give your digestive system time to adjust, says Elliott. Otherwise, you could risk digestive upsets like diarrhoea.
And just be sure you’re taking the right kind, says Men’s Health nutrition advisor Mike Roussell, Ph.D.
Look for chelated magnesium - which means the minerals have been combined with amino acids for better absorption - rather than magnesium oxide. Magnesium oxide may have more magnesium per gram, but your body doesn’t absorb it as well.
SUPPLEMENT TO TAKE: PROBIOTICS
Probiotics - “good” bacteria that live in your gut - can improve digestion, which makes it easier for your body to absorb vitamins and minerals in your diet, says food scientist Joy Dubost, Ph.D., R.D.
“Research is still emerging on the benefits of probiotics,” she says. “But we do know that they can enhance immune function.”
You can get probiotics in some food products like cultured dairy, fermented sauerkraut and kimchi, but daily supplementation can help make sure you’re getting enough - and the right kinds.
Dubost suggests choosing a brand with at least 3 or more different strains of bacteria. Each strain has unique functions, and they’ll complement each other to better improve your digestive health.
Look for ones that contain lactobacillus and bifidobacterium, which the World Gastroenterology Organization (WGO) Handbook on Gut Microbes reports have been shown to reduce respiratory infections and improve digestion.
SUPPLEMENT TO SKIP: VITAMIN C
Popular belief dictates that you reach for vitamin C tablets - or foods rich in the vitamin, like oranges - to ward off a cold.
But research hasn’t actually proven it can prevent colds, though other studies have shown it can reduce the duration of cold symptoms, according to the Mayo Clinic.
Still, it’s easy to get recommended amounts without popping it in pill form.
According to the NIH, adult males need just 90 mg daily - you get three times that amount in just one cup of chopped, raw yellow pepper.
“Most of the time, vitamin C supplements contain an excess amount of the vitamin,” says Elliott. “That means your body will end up excreting it through urine, since it’s water-soluble.”
SUPPLEMENT TO SKIP: B-COMPLEX VITAMINS
Given the breadth of benefits of B-complex vitamins - stronger metabolism, healthy skin, better conversion of food into fuel for energy - it seems logical that popping a supplement with all 8 of them would be the way to go.
How much you need of each B-complex vitamin - including B-12, folate, pantothenic acid, riboflavin, niacin, and biotin - varies. For example, you need 1.3 mg of vitamin B6, and 2.4 mg of vitamin B12 per day.
But adding them to you supplement could be a waste, says Roussell.
That’s because B-vitamins are ubiquitous in fruits, vegetables, nuts and grains, he points out. A can of tuna will get you 0.87 mg of B6 and 2.5 mg of B12, for example.
“They are everywhere, and there are no documented benefits of taking additional B-vitamins in healthy individuals,” Roussell says.
Plus, the marketing claims about B-complex vitamins giving you a boost through energy drinks is just hype, he says. It’s likely the caffeine and sugar providing the energy uptick instead.
In fact, taking too much certain B vitamins like niacin can be harmful. A recent case study in BMJ Case Reports highlighted a healthy, 50-year-old construction worker who was diagnosed with a severe case of acute hepatitis.
Doctors believe it was caused by a B-vitamin overdose brought on by overconsumption of energy drinks.
Also, much like vitamin C, these vitamins are water-soluble.
So, getting excess means no additional benefits - you’d just be peeing it out, Elliott says. But that doesn’t mean it’s not harmful. Like the construction worker patient, your liver could get taxed by trying to clear those excess vitamins.
SUPPLEMENT TO SKIP: CALCIUM
Calcium is a vital mineral for bone strength and nervous system function. But should the supplement be in your shopping cart?
Only if you’re avoiding calcium-rich foods for some reason - say, if you’re vegan or lactose intolerant - or have a bone condition like osteoporosis or osteopenia, says Elliott.
“Calcium is important,” she says. “But it’s very easy to get through food.”
In addition to dairy products like milk and yogurt, you can get calcium in spinach, kale, bok choy, sardines, broccoli, almonds, chia seeds and salmon.
For men ages 19 to 50, the recommended daily amount is 1,000 mg per day, the Mayo Clinic notes. You’ll hit that if you eat an 240ml container of nonfat yogurt, a cup of cooked spinach, and an ounce of Swiss cheese in the same day.
Another reason to aim for food-based sources over supplements is that studies on calcium supplementation been mixed.
In fact, research from the NIH suggests that men may have increased risk of heart attack, stroke or other cardiovascular diseases from calcium supplements. But that correlation needs further study, the researchers noted.