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The appeal of vitamins and supplements is strong. But do they actually help improve your health? Here’s what the science has to say.
Older adults know their supplements. Or do they?
Roughly 70% of older adults now take multivitamins, herbal remedies, antioxidants, fish oil, probiotics, fiber, individual vitamins or minerals and other supplements, according to a 2017 National Institutes of Health (NIH) study.
And yet, a recent Harris Poll for the American Osteopathic Association found that half of older adults who take supplements didn’t know if what they took could interact with their prescription drugs. And 76% used supplements without knowing if they needed it due to a nutritional deficiency.
What’s more, recent research suggests that multivitamins and other supplements don’t seem to reduce the risk for major chronic diseases.
Before you buy another supplement, here are eight things to know.
Fact #1: Healthy Foods Beat Supplements
Supplements can’t take the place of nutrition-packed foods like fruits, vegetables, whole grains, lean protein, dairy products and good fats.
“Natural food should be the first choice to provide the building blocks of the human body,” says Julie Stefanski, R.D.N., a spokesperson for the Academy of Nutrition and Dietetics. “Taking a close look at your normal go-to foods and how they add up to meet your vitamin and mineral needs is a good place to start.”
In a 2019 study from Tufts University of nearly 31,000 adults, dietary supplements didn’t protect against fatal heart disease or cancer — but getting the same nutrients from food did.
“Foods provide more than vitamins and minerals,” says Regan Bailey, Ph.D., a professor of nutrition at Purdue University. Whole foods also contain fiber, protein and other nutrients that you need for good health. Plus, Bailey points out that actual food helps you feel satisfied and provides the energy you need for the day.
Fact #2: Your Provider Needs to Know What You’re Taking
The U.S. Food and Drug Administration (FDA) recommends that consumers go over all the dietary supplements they’re taking with their primary care provider (PCP) once a year. That includes mentioning:
- Supplements that contain just one nutrient (vitamin C, for example)
- Combination formulas (such as a calcium plus vitamin D supplement)
- Herbal remedies
It’s also wise to check with your PCP before starting a new supplement, Bailey says. They can help you avoid any that are ineffective — and help you steer clear of false claims. Most important, your PCP can flag potential interactions with medications you take and help you dodge unwanted side effects. In other instances, your PCP can recommend supplements to address your personal health needs.
Other health care practitioners can help, too, Stefanski says. Your pharmacist can also tell you if a specific supplement will interact with medications you use. And a registered dietitian can take a close look at your diet and recommend supplements to fill in the gaps.
Fact #3: Supplements Don’t Have Protective Superpowers
Don’t assume you need a multivitamin or antioxidant supplement. Taking a multivitamin did not protect against heart attacks or strokes in a 2018 University of Alabama at Birmingham review of studies involving more than two million people. Nutrients in multivitamins also didn’t reduce cancer risk in a 2017 German research review, either.
A 2016 report in JAMA shows that 2% to 19% of adults age 65-plus take supplements of antioxidants like selenium and vitamins C and E. Yet there’s no evidence that getting these as supplements protects against chronic health conditions like heart disease and diabetes, according to the National Institute on Aging (NIA) and the American Heart Association.
Fact #4: Supplements Come With Risks
Taking too much of some supplements can cause health problems. High doses of vitamin B6 can lead to coordination problems and nausea, for instance. Some supplements may also make prescription medications you take less effective or trigger interactions, Bailey explains.
For example, vitamin K can interfere with blood thinners, notes the NIH’s Office of Dietary Supplements. Calcium can hamper some antibiotics and thyroid medications, reports the National Library of Medicine. Antioxidant supplements, like vitamins C and E, can make chemotherapy drugs less effective, says the NIH. And high-dose niacin supplements can increase the risk of muscle pain in people taking cholesterol-lowering statin drugs, according to the Mayo Clinic.
Fact #5: Supplements and Surgery Don’t Mix
Make sure your PCP knows about vitamins, minerals, herbs and other supplements you’re taking if there’s a planned surgery in your future. You may be asked to stop taking them several weeks beforehand to avoid interactions with drugs that could affect your blood pressure, heart rate or risk for bleeding, according to the FDA.
Fact #6: Some Supplements May Be Helpful
Your PCP may recommend specific supplements to help address your individual health needs or nutritional shortfalls. These may include the following:
Vitamin B12. B12 is important for red blood cell formation and healthy brain function. It’s found in seafood, beef and dairy products. Some older adults have a harder time absorbing naturally occurring B12, Bailey explains.
In fact, up to 15% of older adults may be short on the nutrient and could benefit from a supplement, according to the NIH’s Office of Dietary Supplements. In that case, your doctor may recommend a supplement or a fortified food, like breakfast cereal.
Calcium plus vitamin D. For healthy bones, women need 1,200 milligrams (mg) of daily calcium after age 50; men need 1,000 mg, with 1,200 mg after age 70. In addition, older adults need 800 to 1,000 IU of vitamin D daily to aid in calcium absorption. If you aren’t getting that much from the foods you eat, adding a supplement can help, according to the National Osteoporosis Foundation.
AREDS AND AREDS2 formulas. These research-tested combinations of vitamins C and E, plus beta-carotene, copper, lutein, zeaxanthin and zinc can help lower the risk for advanced age-related macular degeneration. This eye health condition is a major cause of vision loss in older adults, according to the National Eye Institute.
Omega-3 fatty acids (fish oil). The American Heart Association recommends all adults eat fish containing these good fats twice a week. People with diagnosed heart disease should talk with their doctor about substituting a supplement if they don’t eat fish that often.
Fact #7: Labels Are Often Misleading
Over-the-counter supplements can’t take the place of medical care for health conditions you may have. Don’t be fooled into thinking that words like “natural” and “herbal” mean a supplement is safe, the FDA warns.
And if something sounds too good to be true — for example, claiming it can cure or prevent diseases — it probably is, the FDA warns older adults.
Fact #8: Knowing What to Look for on a Label Is Important
When you’re ready to buy a supplement suggested by your PCP or a registered dietitian, stick with recommended doses. “For most individuals there is little benefit in going beyond 100% of the DRI,” Stefanski says. DRI stands for daily reference intake, which is the amount most people need per day.
And since the FDA does not test the content of supplements for purity or strength, check the label for a seal of approval or verification from a third-party organization, such as ConsumerLab.com, NSF International, U.S. Pharmacopeia (USP) or UL. That seal means the supplement has passed one of these organization’s checks for content, strength and contaminants, notes the NIA.
“Supplements can vary significantly in the quality of the ingredients they contain,” Stefanski says. “Because of risks of contamination with both heavy metals and even prescription drugs, it’s best to purchase supplements from a reputable company manufactured in the U.S. or Canada.”
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