Do We Need Supplements?

It is a bit of a paradox that in this world of plenty, most of us are deficient in vitamins and minerals. The question is why we became deficient and what to eat or take in order to overcome these deficiencies. Many people has the mistaken belief that a bad diet will be rebalanced by taking supplements.

First and foremost, I would like to highlight that the most important supply of vitamins and minerals comes from actual food. Throughout our history on this planet, we've been eating "food". Supplements appeared only very recently, maybe about 50 years ago. It's reasonable to assume that genetically we are not adapted to process and absorb nutrients from pills. The supplement industry is growing every year, there are more and more people relying on these pills to overcome deficiencies, prevent and cure diseases. However, the statistics show that the number of patients with chronic diseases is also increasing, suggesting that supplements might not be the best answer to prevent and treat these conditions.

Today, there are no requirements for companies manufacturing supplements to list all their ingredients.
When we take pills we don't really know what we put in our body. It is true that the same applies to food, who knows what kind of pesticide is sprinkled on the vegetables, or who knows what the animals ate. When we buy food, we still have the option to choose from organic, non-organic produce, or we have the option to opt for healthier choices, and avoid processed food, even though we might not know exactly what kind of harmful chemicals it contains.

To see if supplements lead to a healthier life, a number of studies had been published. However, they could not demonstrate the beneficial effects of vitamin pills. If there is only conflicting evidence available, then further tests should be done in order to establish the validity of the theory, or the theory is simply wrong. Here are two articles:

Health supplements 'could cause cancer': Study finds some products may increase chance of getting disease

The Vitamin Myth: Why We Think We Need Supplements

To this day, there are no comparative clinical trials to see which company produces the most efficient supplements. These supplements are examined and classified according to different qualities, for example bioavailability or if the ingredients come from organic sources, etc. Each company claims that their supplements are the best, however, it does not really help the confused customer in his/her choice.

Here are two interesting articles by Chris Kresser's articles discussing why supplements might not be the best option.

Calcium Supplements: Why You Should Think Twice

Throw away your multivitamins and antioxidants!

"It’s crazy to me that so many health care practitioners – both conventional and alternative – tell their patients to take multivitamins and antioxidants when their is little support for that position in the medical literature."
                                                      - Chris Kresser

When people read "high-bioavailability" on supplement labels, they think that they will absorb everything from the pills. However, bioavailability is not equal to absorbability. A few examples:

1. In order to absorb vitamin A (retinol and carotenoids) and other fat soluble vitamins, we need to eat fat. No matter, how bioavailable those vitamins are, in the absence of fat in the diet, the vitamins will not be absorbed. Retinol is an animal for of vitamin A, carotenoids, on the other hand, are present in vegetables. Animal food contains enough fat for our body to absorb the vitamin A it contains. In the case of plants however, the addition of fat to the diet is required for better assimilation. Vegetables do taste better with olive oil or butter.

"Carotenoid bioavailability ranges between 1/5 to 1/10 of retinol's. Carotenoids are better absorbed when ingested as part of a fatty meal. Also, the carotenoids in vegetables, especially those with tough cell walls (e.g. carrots), are better absorbed when these cell walls are broken up by cooking or mincing."
                                                - (from Wikipedia)

According to Wikipedia, retinol (from animal origin) is much better absorbed than Carotenoids. Therefore, it is important to check the label on the supplements if the vitamin A is derived from animal or plant origin. You can make an experiment yourself: drinking a lot of carrot juice every day, will turn your skin orange, a sign that your body is unable to deal with the high amounts of carotenoids. This will not happen when ingesting large amounts of butter from grass fed animal.

2. Vitamin B12 is absorbed through the lining of the stomach and small intestine. However, if the lining is damaged, B12 absorption will be impaired, no matter how bioavailable the supplement is. For more on B12, here is another article by Chris Kresser: 

B12 deficiency: a silent epidemic with serious consequences

When overcoming deficiencies, food should be our first choice. If problems persist, I recommend everyone to see a health care professional to perform the required tests and determine the type and amount of supplement needed. A regular follow-up is necessary to ascertain the effectiveness of the treatment. I would call hazardous taking supplements without knowing exactly our deficiencies.

I came to the conclusion that we are not vitamin and mineral-deficient because we do not have enough of these nutrients in our diet, but because our diet contains a new type of food (sugar and refined carbohydrates), totally absent from our diet for most of our history. 

"If the primary change in traditional diets with Westernization was the addition of sugar, flour, and white rice, and this in turn occurred shortly before the appearance of chronic disease, then the most likely explanation was that those processed, refined carbohydrates were the cause of the disease. Maybe if these carbohydrates were added to any diet, no matter how replete with essential protein, vitamins, minerals, and fatty acids, it would lead to chronic diseases of civilization."
                          - Gary Taubes (Good Calories, Bad Calories) about Peter Cleave's theory

In a few words: we are not sick because of the 1. absence of vitamins and minerals, but because of 2. the presence of sugar and refined carbohydrates in our diet. These two theories are different, and depending on which one you consider true, the solution to overcome deficiencies is also different.

According to the first theory, we eat whatever we want, and as long as we take our supplements we have a higher chance to avoid chronic diseases and extend our lifespan. If this is true, then why the existing studies show conflicting results? And why despite increasing sales of vitamin pills, the population is becoming sicker every year?

The second theory is about the presence of something in our diet that is causing disease, rather than the absence of nutrients. We just have to look at the how chronic diseases spread around the world with the adoption of a western lifestyle. The addition of sugar and refined carbohydrates to any traditional diet seems to be the fundamental problem.

Of course, we could discuss at length about what else might cause deficiencies, for example soil depletion and harmful chemicals in our environment. However, at the beginning of the 20th century when obesity, with its related conditions, became a problem among local populations living on reservations (America, Australia, New-Zealand), soil depletion could not have happened in a short period of time, and chemicals (plastics, detergents, smoke from factories, etc.) were yet non-existent.

There might be a multitude other causes contributing to the development of chronic diseases. But no nutritionist or physician would argue today, that the majority of us would benefit from the reduction of sugar and refined carbohydrates in our diet.