There is no doubt that the supplement industry is a big business and like all consumer goods industries, there are people making plenty of money out of making us believe that we need their products… but do we really need them? There is also a huge spectrum when it comes to price and quality, so does everything on the shelves actually do what it says it’s going to do?
Before I studied nutrition, I was firmly in the camp that supplements were a fad and a waste of money. I mean, isn’t the point of food that it gives us everything we need? And don’t they say that we wee all the good stuff out anyway? Well, as it turns out, it’s not quite that simple…
Do we need supplements to be able achieve good health?
Like in all areas of health, much of the answer to this question depends on your unique body. One of the main issues I see in my clinic is poor digestion. This may not sound like a big deal, but when you think about it, if you aren’t digesting your food properly, you aren’t taking on board enough nutrients, and nutrients are needed for every single biochemical reaction in the body. Over time, nutrient deficiencies can lead to serious health issues, with the potential to affect every system in the body.
But why do so many of us have reduced digestion?
Many of us suffer with low stomach acid due to the oh-so-common long-term use of proton pump inhibitor drugs for acid reflux (1), overgrowth of H-Pylori (2), and age (3) - sadly our stomach acid naturally depletes as we get older. Stomach acid plays an important role in breaking down proteins and liberating B12, iron, zinc, calcium, and magnesium from foods. It is also needed to trigger the release of digestive secretions in the small intestine for complete nutrient absorption. So you can see how when stomach acid is low, it affects the entire digestion process.
We are also exposed to many more inflammatory substances today - in our food, water, air, and the chemicals in many of the household items we buy - which, alongside microbial overgrowths, can create problems for our small intestine. When we suffer with inflammation of the brush border lining of the small intestine, we are less able to absorb nutrients from our food (4).
So, problem number one - many of us have reduced digestive ability which means we are simply not taking on board the nutrition we need from our food. In this case, supplements are often needed in the short term to fill nutrient gaps while digestion issues are repaired.
In addition to poor digestion, the food we eat today is, sadly, much less nutritious than it used to be. That’s because we have been destroying our soils due to intensified farming practices which began in the mid-20th century, and soil is where plants get their nutrients from. Synthetic fertilisers, over-grazing and a move away from crop rotation have all led to lack of diversity and erosion of soil. This directly leads to less nutrients in our food and in just 50 years the decline has been dramatic - data from the US shows that sweetcorn has 78% less calcium and 43% less vitamin C, broccoli has 63% less calcium & 32% less iron and cabbage has 36% less vitamin C! (5)
So, problem number two - our food is less nutritious than it was, so we have to eat a lot more of it to get the nutritional levels we need to function properly. With this in mind, supplements may be helpful as a maintenance strategy or used at the times when our demand outweighs supply - i.e. during illness, times of stress, pregnancy and as we age.
Finally, some of us will carry genes which can hinder proper absorption or transport of nutrients into our cells. For example, an MTHFR gene variant may lead to deficiencies in B12, B9 or B6 (6). Carrying one of these gene variants does not necessarily mean you will struggle, but it can predispose you to challenges and if this is coupled with low intake of these nutrients from your diet, it could lead to deficiencies.
So, problem number three - some of us may have genetic predispositions that set us up for a higher need for certain nutrients. In this case, a targeted approach to supplementation can be helpful.
I hope that this sheds some light on the challenges we are up against when it comes to getting the nutrition we need from our food. Bear in mind also, that our starting point should be a minimum of 7 vegetables and fruits a day - and unfortunately, most of us are not even getting close to this level.
So, with a demand that is likely to outweigh supply, can we and should we trust supplements to fill the gaps?
Are all supplements made equal?
The short answer? Absolutely not.
Again, like most consumer goods industries, there is a wide range when it comes to quality, but this is an area where it really matters. Sadly, there are many mainstream brands putting out highly questionable products, with some of the biggest issues being their use of chemical fillers which enable them to market at a lower price, use of nutrients in poorly absorbed forms, and nutrient levels so low that they would fail to have a therapeutic effect. Perhaps the worst of all - the use of synthetic colours, e-numbers and sugar in supplements marketed for children. A product like this is not going to have a net-positive effect on your child’s health.
The truth is that we have to pay for quality, and we are better off choosing a few, higher quality supplements than lots of cheap ones. My advice is to always check the label of what you are buying - does it have lots of chemical names you've never heard of? Is sugar first on the ingredients list? Does it sound too good to be true for the price?
However, it is also important to seek help from a nutrition professional if you believe you need support with supplements. What we each need is very individual, and sometimes, we can do more harm than good by taking certain supplements or combinations of supplements long term.
With my clients, I always prioritise a food-first approach, but I also use supplements in one of three particular ways:
1. For rapid relief from a symptom while we work on the root causes of ill-health - this might include supplements which relieve joint pain, migraines, or improve sleep.
2. For therapeutic use on a specific disease dynamic - this might include supplements which repair digestion, improve insulin sensitivity or bring down inflammation.
3. For maintenance use, occasionally - this might include situations where someone feels unable to eat foods they need for nutrition, or to support those with genetic predispositions for nutrient challenges.
The goal is not to use supplements long term unless there is a specific need. I work with my clients to ensure that they are eating a balanced diet, and to heal any underlying causes of malnutrition, so that their bodies are able to fully utilise the nutrients in their food.
Remember - you are not what you eat. You are what you eat, digest, absorb and get into cells :).