The 411 on Supplements


Almost seven out of every ten Americans take a supplement. Would we be just as well, or better, off without them, or would everyone benefit from a daily vitamin pill? Even if supplements are a good idea, how do you know what and how much to take, what to avoid, and how to avoid spending too much. How do we know when we’re getting our money’s worth? And, what are the hot topics in supplements these days? Elizabeth Somer, registered dietitian and author of Eat Your Way to Happiness set the record straight.

There are four steps in choosing the best, and least expensive, supplements for you:

1. A Multi: For healthy people, a multiple vitamin and mineral is the place to start. Nutrients are supplied as teams in food, so if your diet is low in one nutrient, it’s a sure bet it’s low in others, too. A multiple is a convenient, inexpensive way to supply a balance of nutrients, while avoiding secondary deficiencies that result when you take too much of one nutrient and crowd out another. For example, many of the minerals compete for absorption, so taking a large dose of one, such as iron, could result in a deficiency of another, such as copper or zinc. Take a good multi and you won’t have to worry about that.

Select a broad-range multiple that supplies as close to 100%, but no more than 300%, of the Daily Value for a wide variety of vitamins and minerals. For quality sake, stick with the major brands, such as Centrum or Nature Made, or with a product with the USP quality seal that guarantees high standards. Most of these are inexpensive.

2. Two Minerals: When it comes to calcium or magnesium, you need so much of these minerals that the multi pill would be the size of a golf ball. Typically, multis give only lip service to these nutrients. You need calcium to keep your bones, skin, nerves, and muscle in tip top shape, while magnesium is critical for coping with stress, maintaining a healthy heartbeat and blood pressure, and improving muscle, nerve, and bones. Unless you include at least three servings daily of calcium-rich milk products or fortified soymilk and lots of magnesium-rich soybeans, nuts, and wheat germ, you should supplement these two minerals.

Calcium and magnesium are best absorbed and used when supplied in a 2:1 ratio of calcium to magnesium. You get some of these minerals in your diet, so you only need to fill in the gaps by taking a supplement with 500 milligrams calcium and 250 milligrams magnesium, if your multiple is low in these minerals. When it comes to magnesium, more is not better. Magnesium is the active ingredient in Milk of Magnesia, which means you could be a bit “looser” than you’d like if you exceed the upper limit.

3. Omega-3s: If you don’t consume at least 2 servings a week of fatty fish, such as salmon, mackerel, or herring, then take an omega-3 supplement. You need at least 220mg of the omega-3 DHA, and possibly up to 900mg/day to lower the risk for heart disease (the #1 killer for both men and women), depression, and possibly even lower Alzheimer’s risk by 70%.

The new news here is that recent research shows the omega-3s in seafood show promise in lowering the risk for much more than just dementia and depression. Children who supplement perform better in school, are less impulsive, anti-social, or aggressive, and might have a lower risk for attention deficit, while adults show possible lower risks for certain cancers, hypertension, and vision loss. DHA is very important during pregnancy and breastfeeding for the development of the brain and vision in babies.

4. Vitamin D: If your multi or calcium does not have at least 1000 IU, then consider a separate supplement here, since you can’t get enough from food and optimal intake is associated with lowered risk for muscle weakness, gum disease, diabetes, insulin resistance, arthritis, multiple sclerosis, hypertension, and certain cancers, including colon, breast, pancreas, and prostate cancers. The hot new news here is that vitamin D shows promise in boosting muscle strength in athletes, improving pregnancy outcomes, and lowering the risk for macular degeneration in seniors.

3. Are there any new supplements that might be beneficial?

In addition to the tried-and-true supplements, consider an NR supplement. Aging results in reduced energy, starting at the very foundation of your body, your cells. A substance in your cells called NAD+ is at the center of that energy and it drops dramatically as you get older. NR, a special form of the B vitamin niacin, revs NAD+ back to youthful levels. Research shows NR also may slow, stop, and even reverse memory loss, as well as strengthen muscles and possibly extend the healthy years. Look for a supplement that contains both NR and curcumin, since a wealth or research shows curcumin is a strong antioxidant and anti-inflammatory agent against aging and disease, thus enhancing the effects of NR.

4. What should we avoid?

Most of the supplements on the market aren’t worth your time or money. Skip the big promises and fancy claims. Look for supplements from reputable companies and preferably with the USP seal, which guarantees quality. Also, a few supplements that we once thought might be good, have recently shown some concerns. For example, red yeast rice, a natural form of statins for lowering cholesterol, was found in a recent study to potentially jeopardize the health of your liver and muscles. Another example, is the probiotic supplements on the market. Many contain little or no live cultures and even more contain only one or two. You need at least five different cultures. Your best bet here is to stick with kefir or nonfat, plain yogurt that promises a blend of cultures.

Also, be very careful of herbal products. Just because something is natural doesn’t mean it’s safe. Keep in mind arsenic is natural, too. In fact, a recent study found there is no evidence herbal supplements benefit or are even safe for the treatment of conditions like heart disease. Serious side effects have been noted for many herbs, from yohimbe to kava kava and comfrey. Check reputable sources, such as Consumer Reports, Consumer Labs, or WebMD.