Food Supplements and Food Replacements

Current trends also include the use of supplementation to promote health and wellness. Vitamins, minerals, herbal remedies, and supplements of all kinds constitute big business and many of their advertising claims suggest that optimal health and eternal youth are just a pill away. Dietary supplements can be macronutrient (amino acids, proteins, essential fatty acids), micronutrient (vitamins and minerals that promote healthy body functions), probiotic (beneficial bacteria such as the kind found in the intestines), and herbally ( often target a specific body part, such as bones) based.

Some public health officials recommend a daily multivitamin due to the poor diet of most North Americans. The US Preventive Task Force also recommends a level of folate intake which can be easier to achieve with a supplement. In addition, the following people may benefit from taking daily vitamin and mineral supplements:^[1]

• Women who are pregnant or breastfeeding
• Premenopausal women who may need extra calcium and iron
• Older adults
• People with health issues that affect their ability to eat
• Vegetarians, vegans, and others avoiding certain food groups

However, before you begin using dietary supplementation, consider that the word supplement denotes something being added. Vitamins, minerals, and other assorted remedies should be considered as extras. They are add-ons—not replacements—for a healthy diet. As food naturally contains nutrients in its proper package, remember that food should always be your primary source of nutrients. When considering taking supplements, it is important to recognize possible drawbacks that are specific to each kind:^[2]

• Micronutrient Supplements. Some vitamins and minerals are toxic at high doses. Therefore, it is vital to adhere to the Tolerable Upper Intake Levels  (UL) so as not to consume too much of any vitamin. For example, too much vitamin A is toxic to the liver. Symptoms of vitamin A toxicity can include tinnitus (ringing in the ears), blurred vision, hair loss, and skin rash. Too much niacin can cause a peptic ulcer, hyperglycemia, dizziness, and gout.
• Herbal Supplements. Some herbs cause side effects, such as heart palpitations and high blood pressure, and must be taken very carefully. Also, some herbs have contraindications with certain medicines. For example, Valerian and St. John’s Wort negatively interact with certain prescription medications, most notably antidepressants. Additionally, there is a real risk of overdosing on herbs because they do not come with warning labels or package inserts.
• Amino Acid Supplements. Certain amino acid supplements, which are often taken by bodybuilders among others, can increase the risk of consuming too much protein. An occasional amino acid drink in the place of a meal is not a problem. However, problems may arise if you add the supplement to your existing diet. Most Americans receive two to three times the amount of protein required on a daily basis from their existing diets—taking amino acid supplements just adds to the excess. Also, certain amino acids share the same transport systems in the absorption process; therefore, a concentrated excess of one amino acid obtained from a supplement may increase the probability of decreased absorption of another amino acid that uses the same transport system. This could lead to deficiency in the competing amino acid.

Supplement Claims and Restrictions

The Food and Drug Administration (FDA) regulates supplements, but it treats them like food rather than pharmaceuticals. Dietary supplements must meet the FDA’s Good Manufacturing Standards, but are not required to meet the standards for drugs, although some companies do so voluntarily. Also, although supplement manufacturers are allowed to say a particular ingredient may reduce the risk of a disease or disorder, or that it might specifically target certain body systems, these claims are not approved by the FDA. This is why labels that make structural and functional claims are required to carry a disclaimer saying the product is not intended “to diagnose, treat, cure, or prevent any disease.” In addition, in the United States, supplements are taken off the market only after the FDA has proven that they are hazardous.^[3] To revisit the topic of structural and functional claims refer back to Chapter 12 “Nutrition Applications”.

Before Taking Supplements

The phrase caveat emptor means “buyer beware,” and it is important to keep the term in mind when considering supplementation. Just because a product is “natural” does not mean it can’t be harmful or dangerous, particularly if used inappropriately. The following are helpful questions to explore before deciding to take a supplement:

• Does the scientific community understand how this supplement works and are all its effects well known?
• Is there proof that the supplement actually performs in the manner that it claims?
• Does this supplement interact with food or medication?
• Is taking this supplement necessary for my health?
• Is the supplement affordable?
• Is the supplement safe and free from contaminants?

Lastly, please remember that a supplement is only as good as the diet that accompanies it. We cannot overstate the importance of eating a healthy, well-balanced diet designed to provide all of the necessary nutrients. Food contains many more beneficial substances, such as phytochemicals and fiber, that promote good health and cannot be duplicated with a pill or a regimen of supplements. Therefore, vitamins and other dietary supplements should never be a substitute for food. Nutrients should always be derived from food first.

Food: The Best Medicine

According to the Global Burden of Disease Study (The Lancet, 2019), poor diet contributes to 11 million deaths annually worldwide. These deaths are mostly due to heart disease, stroke, diabetes, and cancer linked to unhealthy diets. High intake of sodium (3 million deaths ),low intake of whole grains (3 million deaths) and low intake of fruits (2 million deaths) were the leading dietary risk factors for deaths globally and in many countries.^[4] Poor nutrition causes almost 20 times more deaths globally than gun violence. Globally, gun-related deaths were estimated at roughly 580,000 in 2021.^[5]. This includes homicides, suicides, and accidental shootings.

Good nutrition is important because it provides the essential nutrients your body needs to function properly, stay healthy, and prevent disease. Poor dietary choices and a sedentary lifestyle account for a large share of today’s chronic health conditions, including obesity, heart disease, type 2 diabetes, and certain cancers. These preventable issues highlight the critical role nutrition plays in maintaining overall health and well-being. The concept of “food as medicine” emphasizes that the foods we consume can either support or sabotage our body’s ability to heal, repair, and function optimally. Nutrient-rich diets filled with fruits, vegetables, whole grains, healthy fats, and lean proteins not only help prevent disease but can also play a therapeutic role in managing existing conditions. Recognizing the importance of proper nutrition is essential in shifting from a reactive approach to health to a proactive, preventive one.