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What to know about dietary supplements

If a product sounds to good to be true, it probably is

Pam Stuppy
January 31, 2018
Pills in a spoon.

Supplement companies are reaping billions of dollars a year. They spend a fortune marketing their products to consumers, each touted as the answer to prevention and/or treatment of a wide range of health concerns. In a culture averse to aging, supplements sometimes appear to be the path to everlasting life. Should everyone, then, join the masses and head out to the nearest supplement store?

Dietitians strongly encourage consumers to prioritize a healthy diet made up a wide variety of less processed "real foods." When people feel they are not able to achieve this goal, however, they often turn towards supplements as a solution. Unfortunately, it is not that simple. A poor diet with added supplements is still a poor diet providing insufficient amounts of nutrients and fiber.  

Consumers also have the mistaken idea that more is better when it comes to nutrients. For most nutrients there is a "Tolerable Upper Intake Level" (UL) established by the National Institutes of Health. Above this amount of the particular supplement, research has indicated that there is some negative side effect. In addition, since nutrients tend to operate as team players in the body, consuming excesses can actually create nutrient imbalances.  

If you choose to take a supplement such as a multiple vitamin, look for one that has close to the Daily Value (DV) of most nutrients listed on the label. The Dietary Guidelines for Americans suggests getting most of the antioxidant nutrients we need from foods (think plant-based foods) rather than high-dose supplements.  

In some cases, a supplement may be used appropriately to address a specific medical concern, such as temporarily adding an iron supplement to improve anemia. Vegans may also benefit from the intake of certain supplemental nutrients that are potentially low in their diet. For persons living in the northern latitudes, adding a vitamin D supplement from about September through April might be a good idea. This is because the ultraviolet light from the sun is not strong enough to create vitamin D in the skin and food sources are few. So, there are other conditions that may truly benefit from the use if one or more supplements, and a registered dietitian is a good resource for supplement questions. 

Note that some nutrients can be depleted by the use of certain medications. Also, be aware that some supplements should not be used when taking certain medications (such as vitamin A with Accutane). A pharmacist can provide guidance here. 

Many consumers also believe that if it is for sale, it is safe to use and effective. Although this is true in the pharmaceutical world, this is not the case when it comes to supplements. The supplement market is not tightly regulated. Supplements also have the potential for containing hazardous ingredients like heavy metals, pesticides, etc., especially in herbal products. Although there may be some evidence of a supplement being "safe", once it is combined with other supplements or medications, it has the potential to cause a problem. 

In the world of athletics, some supplements may contain unlabeled substances actually banned by athletic organizations. There is also concern regarding the use of supplements containing one or more stimulants, especially when consumed prior to physical activity or with the concurrent use of alcohol or certain drugs. 

The bottom line is to be thoughtful about the use of any supplements. If a supplemental product sounds too good to be true, it probably is. Instead, focus on getting a wide range of nutrients from a variety of foods consumed throughout the day. Use supplements cautiously and only as truly needed in appropriate doses that you purchase from reputable companies.   

Pam Stuppy, MS, RD, CSSD, LD is the nutritionist at Phillips Exeter Academy. She is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth, New Hampshire, and is board certified as a specialist in sports dietetics.