Supplements-ADA - EFR 6-17

Nutrient supplementation continues to be a big moneymaker, but is still considered the least desirable way to achieve a sound nutritional lifestyle. The following summary of the American Dietetic Association's recent position paper on supplementation provides a way to help raise public awareness of the need to make good food choices, not good pill choices.

(Submitted by Mary Cheatham, Extension graduate assistant)

The best nutritional strategy, even with all the vitamin and mineral supplements available today, is to eat a variety of foods to obtain the nutrients needed. There are numerous compounds in foods that are not essential nutrients but have antioxidant and anticarcinogenic activity. Research is discovering more of these substances even now.

Besides added benefits that come from getting nutrients from foods, nutrient toxicities are less likely to occur when nutrients are derived from foods. Toxic doses are as low as 5 times the recommended intake for selenium and as high as 25 to 50 times the recommended intake for folic acid and vitamins C and E.

Even though high doses of vitamin E are not toxic, they can interfere with vitamin K action and enhance the effect of anticoagulant drugs (given to decrease blood clotting - result is increased bleeding). 10,000 IU/day of vitamin A is considered a potential cause of birth defects and women of child-bearing age should avoid these amounts of vitamin A. High amounts of calcium can inhibit iron absorption when taken at the same meal or same time. Zinc supplementation can decrease copper absorption and decrease HDL cholesterol (the good cholesterol). The previous are given as examples and are not a complete list of nutrient interactions.

In certain circumstances supplements are indicated. The strict vegetarian will need a vitamin B12 supplement, women of child- bearing age need extra folate with increased fortification of foods with folate coming in 1998. Vitamin D is needed for those with limited milk intake and little sunlight exposure, while a multivitamin and mineral supplement for those following a severely restricted weight-loss diet is recommended. Iron supplementation during pregnancy is routinely practiced in the U.S. A Food and Nutrition Board committee has specified supplements of iron, zinc, copper, vitamin B6, folate, vitamin C and vitamin D for pregnant women in high risk groups or with inadequate diets.

In summary, more is not always better and sometimes is dangerous or harmful. Avoid excesses and deficiencies by eating a wide variety of foods. If you think that you need a nutrition supplement, be sure to discuss this with your physician or a registered dietitian. Recommendations on use of supplements should come from a registered dietitian or physician after assessment of an individual's diet. These recommendations should be based on scientific research of requirements.

Source:
Position of The American Dietetic Association: Vitamin and Mineral Supplementation, Journal of the American Dietetic Association. 1996; 96:73-77.