Are supplements really worth it?
By Cliff Harvey
There have recently been a number of articles like this one:
making the claim that most dietary ‘supplements are worthless. And you know…I might almost be inclined to agree with them that ‘many’ supplements are indeed not worth the money, but this has more to do with the quality of forms and ingredients used, or because certain supplements do offer more hype than substance. Some of the claims made lack credibility though:
“Protein powder: Skip it and eat beans, tofu, nuts, fish or meat instead”
I’ve always said, and continue to say that food comes first. So you might be forgiven for thinking that I agree with this. But I don’t…
Protein powders are no better than food derived proteins, but they are also no worse. They are simply protein. So what someone should use at any given time comes down to two things: convenience and cost.
Sometimes it is difficult to prepare a robust, nutritionally sound meal, but conversely it is easy to whizz up a smoothie that contains a quality protein powder, along with lots of great, whole-foods like berries, nuts and vegetables, making a great meal. Protein powders also compare reasonably with meat, fish and chicken cost-wise and so the added convenience of a protein powder doesn’t need to come at a high cost. Cost and convenience are two of the factors that we see affecting compliance with a good diet, and so, if a protein can help with these, it’s likely to be beneficial.
“Creatine: Skip it – eat meat instead”
While the article suggests that there are moderate benefits to taking creatine (I would say that the effects can be pretty profound actually) they go on to say that you should just eat meat to get your creatine intake. Animal muscle tissue contains approximately 0.5% creatine by weight, and so to get an effective dose of creatine you’d need to eat around 1kg of meat per day in addition to what you’re currently eating! Given the well over 1000 peer-reviewed papers published on creatine and showing overwhelming benefits and the extraordinary amount of meat you’d have to eat to get these same benefits, it’s clear that supplementing is a good idea! And creatine isn’t just for bodybuilders! The muscle-building and strength and power improvements are likely to benefit most gym-goers but more importantly for everyday Joes, emerging evidence suggests that creatine can play a valuable role in improving brain health and function.
Ginseng: Skip it — while some research finds that it can help curb fatigue, scientists say more is needed to prove that it’s safe
Ginseng has a long history of use in traditional medicine and is typically regarded as safe. When we have foods and herbs that have been used for many thousands of years without adverse effects we need to take that into account. In fact, this is one of the criteria for common culinary herbs and foods being Generally Regarded as Safe (GRAS) by the US Food and Drug Administration (FDA). Of course whenever using a herb for a medicinal purpose it is important to get advice from a qualified, registered health practitioner who is trained in the use of herbal medicine (such as a properly qualified naturopath or medical herbalist.)
Fish oil pills: Skip them — you can eat salmon instead
Fish is great, but it can be simply too difficult to ensure that you are getting enough of the beneficial omega 3 oils consistently unless you eat a lot of oily fish. Although there is some debate about the value of fish oil supplements, the evidence shows that fish oil supplementation is cardioprotective (1) and exerts positive effects on markers of cardiovascular health like improving ‘good’ cholesterol, reducing fats in the blood and reducing blood pressure.(2-5) Increased consumption of omega 3s from fish or fish-oil supplements reduces rates of all-cause mortality, cardiac and sudden death, and possibly stroke,(6, 7) and benefits from fish oil supplementation are seen in depression.(8, 9) A modest but consistent benefit from fish oil is also seen for joint swelling and pain, and morning stiffness.(10) Not all fish oil supplements are created equal though. Some reports have shown that fish oil can be oxidised and rancid by the time it reaches the consumer. Make sure you use a reputable brand of fish oil.
What about Multi’s and Greens?
Many of us don’t get all of the micronutrients from diet alone. This is especially true of vitamin A, B1, B6, B12 and iron. And a whopping 25% of us don’t get enough zinc, while nearly one half of us don’t get enough selenium!(11) Without all of these vital nutrients we are unable to do anything well. You can think of vitamins and minerals are like the spark plugs in a car—they may not seem too important, but without them, nothing can happen! So it makes sense that a quality multi can help to fill the gaps in your diet. Quality is key though. Many multi formulas use poorer (cheaper) forms of vitamins like B9 and B12 [natural-folate-vs-synthetic-folic-acid] and others, that are either not as effective, or could even be harmful in the long-term. Always choose a whole-food based, high-quality multinutrient like Good Green Stuff. Likewise, most of us now don’t eat the recommended quantity of veggies every day. A quality Greens / multi helps to stock up your green intake for the day.
Many other supplements have considerable evidence backing their benefits, from magnesium to vitamin C, to zinc, just to name a few. A qualified and registered practitioner can help you to determine which specific supplements you should and shouldn’t take.
While some of the statements circulating on the net have value, it is unwise to become too ‘absolutist’ about a pro vs. con position towards supplements.
Each supplement should be evaluated on its merits including:
- Does it use quality ingredients?
- Does it use the best forms of vitamins, minerals and other nutrients?
- Does it have a sound, evidence-base for its use?
- Does it include ingredients that actually work…or just ones that are trendy?
The evidence clearly shows that some supplements offer tremendous benefits and that many of us don’t get enough of even the essential nutrients from diet alone and so there is a sound AND evidence based rationale for supplementation.
- Delgado-Lista J, Perez-Martinez P, Lopez-Miranda J, Perez-Jimenez F. Long chain omega-3 fatty acids and cardiovascular disease: a systematic review. British Journal of Nutrition. 2012;107(SupplementS2):S201-S13.
- Montori VM, Farmer A, Wollan PC, Dinneen SF. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care. 2000;23(9):1407-15.
- Eslick GD, Howe PRC, Smith C, Priest R, Bensoussan A. Benefits of fish oil supplementation in hyperlipidemia: a systematic review and meta-analysis. International Journal of Cardiology. 2009;136(1):4-16.
- Balk EM, Lichtenstein AH, Chung M, Kupelnick B, Chew P, Lau J. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systematic review. Atherosclerosis. 2006;189(1):19-30.
- Campbell F, Dickinson HO, Critchley JA, Ford GA, Bradburn M. A systematic review of fish-oil supplements for the prevention and treatment of hypertension. European Journal of Preventive Cardiology. 2013;20(1):107-20.
- Wang C, Harris WS, Chung M, Lichtenstein AH, Balk EM, Kupelnick B, et al. n−3 Fatty acids from fish or fish-oil supplements, but not α-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. The American Journal of Clinical Nutrition. 2006;84(1):5-17.
- León H, Shibata MC, Sivakumaran S, Dorgan M, Chatterley T, Tsuyuki RT. Effect of fish oil on arrhythmias and mortality: systematic review. BMJ. 2008;337.
- Appleton KM, Rogers PJ, Ness AR. Updated systematic review and meta-analysis of the effects of n−3 long-chain polyunsaturated fatty acids on depressed mood. The American Journal of Clinical Nutrition. 2010.
- Appleton KM, Hayward RC, Gunnell D, Peters TJ, Rogers PJ, Kessler D, et al. Effects of n–3 long-chain polyunsaturated fatty acids on depressed mood: systematic review of published trials. The American Journal of Clinical Nutrition. 2006;84(6):1308-16.
- Miles EA, Calder PC. Influence of marine n-3 polyunsaturated fatty acids on immune function and a systematic review of their effects on clinical outcomes in rheumatoid arthritis. British Journal of Nutrition. 2012;107(SupplementS2):S171-S84.
- University of Otago and Ministry of Health. A Focus on Nutrition: Key findings of the 2008/09 New Zealand Adult Nutrition Survey. Wellington: 2011.