In my role as a nutritional therapist, clients often ask me about which supplements they should take, whether they should include a daily multivitamin or pop a probiotic. And while we'd all like a clear "yes" or "no" to the question, "What supplements should I take?" The answer is often far less clear.
Your body is unlike anyone else's, and its needs are complex and unique. Your diet, lifestyle, microbiome status, and your genetic profile can all influence your nutritional needs. So, keeping the bio-individuality of your body's needs in mind, there is no one-size-fits-all approach to diet or nutritional supplementation. For this reason, it's wise to work with a nutritionist or health care provider who is well-versed in supporting clients through an individualized nutritional approach.
In addition to deciding which supplements to take (or whether to take them at all), it's wise to be mindful of quality, production standards, and potential efficacy.
Probiotics, Prebiotics and Synbiotics
From a technical perspective, probiotics are live microorganisms which, when administered in the proper amounts, convey a benefit to the host. In simpler terms, probiotics are good bacteria that, when you take them in the right amounts, support your health. It also means that, in order for bacteria to qualify as probiotic, scientific research must support the health benefits of that particular strain.
We know that probiotics help support systemic health (1), by supporting digestion (2), blood sugar regulation (3), and even the production of vitamins (4) and important neurotransmitters that support brain health (5). But, these probiotics are also fragile, and the probiotics in many supplements may not survive the highly acidic environment of the stomach (6). And that means, you're not getting much benefit, so look for supplements designed to withstand digestion.
Ideally, you should get your vitamins and other nutrients from food, not supplements. But, supplements can be helpful for a few reasons. Sometimes, particularly those on restricted dietary protocols, might find that their diets consistently lack certain vitamins. Accordingly, it makes sense to supplement the diet with those vitamins. Alternatively, other people might take supplementary vitamins for specific therapeutic purposes as recommended by a health care provider or nutritionist.
Taking vitamin supplements regularly is only questionably effective (7), and the efficacy of vitamin supplements depends largely on the individual supplement, the need, and the quality of the supplement. So, be strategic, and work with your health care provider or nutritionist.
When consuming vitamin supplements, choose food-based supplements and supplements with high-bioavailability wherever possible. Further, choose supplements with minimal additives, fillers and excipients. So, always look closely at the ingredient list, and buy high-quality supplements.
Like vitamins, sometimes our diets lack a certain mineral in sufficient quantities for health. And while it's optimal to consume all your micronutrients from a whole foods diet, sometimes diet isn't sufficient. For example, about half of Americans consume less than the RDA for magnesium (8), and the same goes for calcium, too (9).
Or, sometimes, due to genetics, health history or lifestyle, your individual nutrient needs might be higher than what you typically consume in your regular diet.
Essential Fatty Acids
A well-planned diet includes a wide variety of healthy fats from a wide variety of sources, but many people struggle to make that happen. In addition to aiming for a variety of fats and oils, you should also aim for balance between omega-3 fatty acids and omega-6 fatty acids.
To that end, most Americans eat too many omega-6 fatty acids and too few omega-3 fatty acids for the proper balance. And that imbalance leads to inflammation and chronic disease (9).
You can find omega-3 fatty acids in fish, flaxseeds and other foods. And you can find omega-6 fatty acids in many seeds, nuts and other foods; however, much of the omega-6 fatty acids in the American diet comes from heavily processed and refined vegetable oils.
Some people, owing to their genetic background or other factors, have an increased need for omega-3s, so high-quality cod liver oil or similar supplements might be particularly valuable for them. While others, might benefit from a more well-rounded variety of supplementary EFAs.
In addition to vitamins, minerals, EFAs and probiotics, many people benefit from additional support. For some people, this means taking herbs and others might benefit from digestive enzymes or even amino acids. The list of additional support you can take is extensive, but as with other supplements, it's wise to do so strategically, judiciously and with the guidance of a nutritionist or health care provider who can pinpoint what's likely to be effective and beneficial for you on an individual level.
1) Probiotics: What You Need to Know. National Center for Complementary and Integrative Health (2019).
1) Rowland, et al. (2018) Gut microbiota functions: metabolism of nutrients and other food components. European Journal of Nutrition.
2) Kasińska, M. A., Drzewoski J. (2015) Effectiveness of probiotics in type 2 diabetes: a meta-analysis. Pol Arch Med Wewn.
3) Le Blanc, J. G., et al. (2013) Bacteria as vitamin suppliers to their host: a gut microbiota perspective. Current Opinion in Biotechnology.
4) Yano, J. M.,et al. (2015). Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell.
7) Fortman, S.P. (2013) Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: An updated systematic evidence review for the U.S. Preventive Services Task Force. Annals of Internal Medicine.
8) Rosanoff, A., et al. (2012) Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutrition Reviews.
9) Environmental Working Group. (2014) HOW MUCH IS TOO MUCH? : APPENDIX B: VITAMIN AND MINERAL DEFICIENCIES IN THE U.S.
10) Simopoulus, A.P. (2002) The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomedicine & Pharmocotherapy.
1) Rocha, T., et al. (2015) Adulteration of Dietary Supplements by the Illegal Addition of Synthetic Drugs: A Review. Comprehensive Reviews in Food Science and Safety.
2) National Center for Complementary and Integrative Health. (2019) Using Dietary Supplements Wisely.