Few modern health controversies are as hot and cold as the supplement debate. In one corner, you have miracle pills touted by TV doctors and infomercials as cutting-edge breakthroughs that can banish belly fat, increase energy and regrow hair lost from male pattern baldness. Some have even started claiming that vitamins can cure cancer.
But in the other corner, you have doctors and other health experts who contend that the safety of most supplements is unknown. The Food and Drug Administration issues dozens of warnings and recalls each year over tainted or toxic supplements.
By the time the warning or recall is issued, however, damage has usually been done. That's because the FDA has no power over the supplement industry until after complaints have been filed, in which case it can investigate a facility or test a product.
Officials in New York recently decided to take matters into their own hands after testing several supplements sold there. The ones tested were store brand herbal supplements from Target, Walgreens, GNC and Wal-Mart. The investigation showed that 80 percent of the supplements tested contained none of the herbs on the labels, and often consisted of nothing but cheap fillers. The New York attorney general has demanded the stores remove the supplements from their shelves or face legal action.
Who Doesn't Need Supplements
Strictly speaking, most of us don't need supplements at all. In a perfect world, you would get all your nutrients from your diet. For many adults, it's possible to receive proper nutrition through diet, but most of us don't. Adhering closely to a diet rich in produce, lean protein, whole grains and good fats is the best way to get all the nutrients your body needs. Perfection isn't necessary -- splurges here and there are OK, according to the Academy of Nutrition and Dietetics.
Unfortunately, most people don't eat that way. Even though the U.S. Department of Agriculture reports that Americans have begun to eat healthier in the past few years, the average diet is still too high in all the wrong things. Those would be sugar, refined grains, saturated fats and processed foods. Most Americans also eat too much sodium and consume too little water.
If that sounds like your diet, your doctor may recommend you take a multivitamin, but that's between you two. Women who menstruate lose iron through that process, and may need a supplement if that iron is not replaced through diet. Some doctors also recommend fish oil supplements to all of their patients because studies indicate that omega-3 fatty acids found in fish oil support long-term brain, bone, heart and metabolism health.
Those in Need of D
Like omega-3 fatty acids, vitamin D has been extensively studied in recent years due to its variety of health applications. Vitamin D is necessary for bone health, but also supports the immune system and may offer protective benefits against chronic diseases. People with dark skin sometimes have vitamin D deficiency, as do some adults over 50.
Specifically, vitamin D -- which is a hormone molecule -- has been linked to autoimmune disorders such as multiple sclerosis, rheumatoid arthritis and lupus. These diseases tend to be more prevalent the farther away from the equator you are, where less sunlight reaches the skin. As you may already know, your body makes vitamin D on its own when sunlight hits your skin.
It's no coincidence that people with autoimmune disorders have a higher incidence of vitamin D deficiency. It might surprise you, however, that autoimmune disease patients with vitamin D deficiency often have more severe illnesses. For example, multiple sclerosis patients with vitamin D deficiency tend to have more relapses, and psoriasis patients tend to have more patchy, itchy skin flare-ups.
The B vitamin folic acid is extremely important for fetal development and cell generation, and babies deficient in folic acid are often born with birth defects -- so a daily dose of folic acid can be instrumental in decreasing costs down the road. For that reason, folic acid supplementation is recommended for all women who are pregnant, breastfeeding or who want to become pregnant. These women are also advised to eat foods rich in folic acid, such as leafy greens, fruit, beans and enriched breads. Folic acid supplements prevent an estimated 1,300 birth defects annually.
In the case of folic acid, it may be possible to have too much of a good thing, according to researchers in Portugal. To see whether there is an upper limit to how much folic acid should be consumed during pregnancy, researchers fed pregnant rats 20 times the recommended amount of folic acid. They compared their offspring with those of a control group of mothers that consumed the recommended amount of folic acid.
The offspring in the high folic acid group were overweight, overeaters and insulin resistant. These are common signs of diabetes, which is similar in rats and humans. No corresponding human trials have been conducted due to ethics concerns, since it can be dangerous to the fetus if its mother participates in medical experiments.
People Over 50
As you age, you may need to supplement with vitamins D and B-12. This is common, since an aging body is less able to absorb these key nutrients from food than a younger one. Doctors often recommend that older people supplement these two vitamins.
Calcium is also more difficult to absorb from food as you age, and it can be worse if you're also low on vitamin D. That's because vitamin D is essential for the proper absorption of calcium, which helps keep bones strong and hard. Without enough calcium, bones become brittle and break easily. Supplementation with calcium and vitamin D is commonly recommended for women especially, since they are less able to absorb and utilize calcium as they age.
Those on a Restricted Diet
If you're lacking a food group due to diet restrictions, you might benefit from supplements.Vegetarians and vegans who don't use supplements are often deficient in more than one key nutrient. Most commonly, people on a plant-based diet lack calcium, vitamin D, iodine and vitamin B-12 -- all of which are obtained from animal products in a normal diet.
Other people might have a restricted diet due to disease, allergies or food intolerance. Since there are a variety of reasons your diet may be restricted, it's important to consult with your doctor or a registered dietitian before starting any supplements.