Are Supplements Necessary?
By Kelsey Chadwick, MS RDN
November 3rd, 2023
This is a question I get several times a week. It is a topic that comes up frequently in the news, at medical appointments, in conversations with friends and in the latest magazine headline. In the United States, approximately 57.6% of adults over the age of 20 have used a supplement in the last 30 days. So, are they necessary?
Every dietitian may approach supplements differently, so here I am sharing my personal thoughts and how I approach supplements in my work as a dietitian. I do not recommend supplements to everyone! In fact, I seldom recommend supplements for several reasons including:
Supplements are not regulated by the FDA - they are not required by federal law to be tested or “approved” for safety and effectiveness before they are marketed
Supplements can be contaminated by pesticides, lead and bacteria
The FDA has to prove that a supplement is not safe in order to restrict its use or remove it from the market, once a dietary supplement is marketed
The supplement industry was estimated to be worth $137 billion in 2021 and this number continues to grow
A supplement can have one of three types of claims listed on its label. These include:
A nutrient content claim
A structure/function claim
A health claim
A nutrient content claim “describes the relative amount of a nutrient or dietary substance in a product.”
A structure/function claim is a statement “describing how a product may affect the organs or systems of the body and it can not mention any specific disease,” and they do not require FDA approval. However, the manufacturer must send the FDA text of the claim within 30 days of putting the product on the market.
Lastly, a health claim describes “a relationship between a food, food component, or dietary supplement ingredient, and reducing risk of a disease or health-related condition.”
All products containing any of these claims must include the disclaimer “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”
Despite not being regulated, there are still ways to ensure your supplements are safe and the best choice for you. Independent companies do testing for safety and accuracy of nutrient claims, which can help you and your dietitian find the right supplement for you.
Scenarios where I might recommend a multivitamin or individual supplement(s), include someone with an eating disorder, malabsorption condition, someone who follows a vegan diet, pregnant and nursing women, someone who has had bariatric surgery and anyone taking medication that causes a deficiency. Most times individual supplements such as vitamin D can be taken individually if needed, while obtaining all other vitamins and minerals that a multivitamin would contain through a balanced diet.
The bottom line is that most individuals can get all necessary vitamins and minerals from an overall balanced diet. What we do overtime is important and a few days of missing fruits or vegetables is not going to cause a deficiency. To help you eat and enjoy foods with a variety of nutrients check out the table below. It can be surprising how many foods contain different vitamins and minerals, not just fruits and vegetables!
Additionally, before you grab that vitamin C supplement, you might want to consider that a single bell pepper has enough vitamin C to reach the recommended daily value!
In future blog posts I will talk more specifically about individual supplements.
Vitamins
Biotin | Avocado, cauliflower, eggs, raspberries, liver, pork, salmon, whole grains
Choline | Beans, peas, egg yolks, cod, salmon, liver, milk, nuts, soy foods, broccoli, spinach
Folate/Folic Acid | Asparagus, avocado, beans, peas, enriched grain products, spinach, oranges and orange juice
Niacin | Beans, beef, enriched grains, nuts, pork, poultry, seafood
Pantothenic Acid | Avocado, beans, peas, broccoli, eggs, milk, mushrooms, poultry, seafood, sweet potatoes, whole grains, yogurt
Riboflavin | Spinach, mushrooms, meat, enriched grain products, eggs
Thiamin | Beans, peas, pork, sunflower seeds, whole grains
Vitamin A | Cantaloupe, carrots, dairy products, sweet potatoes, red peppers, spinach, broccoli, pumpkin
Vitamin B6 | Chickpeas, potatoes, salmon, tuna
Vitamin B12 | Clams, trout, salmon, haddock, tuna, meat and poultry, eggs, dairy products, fortified cereals
Vitamin C | Cantaloupe, kiwifruit, citrus fruits, strawberries, broccoli, peppers, tomatoes, Brussel sprouts, citrus juices
Vitamin D | Eggs, herring, mackerel, salmon, trout, tuna, fish oil and cod liver oil, mushrooms, pork, fortified plant based beverages, fortified dairy products, fortified cereals
Vitamin E | Nuts, seeds, vegetable oils, peanut butter, spinach, broccoli, fortified cereals and juices
Vitamin K | Green vegetables including kale, spinach, turnip greens, broccoli, collard greens, Swiss chard, mustard greens
Minerals
Calcium | Canned seafood with bones, dairy products, fortified OJ, fortified plant based beverages, kale, broccoli, collard greens, tofu (made with calcium sulfate)
Chloride | Olives, rye, seaweeds (kelp and dulse), table and sea salt, celery, lettuce, tomatoes
Chromium | Apples, bananas, meat, garlic, basil, turkey, whole grains, broccoli
Copper | Lentils, whole grains, liver, nuts, seeds, shellfish, chocolate and cocoa
Iodine | Breads and cereals, dairy products, iodized salt, potatoes, seafood, seaweed, turkey
Iron | Beans, eggs, raisins, prunes, spinach, kale, broccoli, collard greens, meat, nuts, liver, peas, poultry, tuna, sardines, haddock, shrimp, oysters, seeds, tofu, whole grains
Magnesium | Dairy products, bananas, raisins, spinach, nuts, pumpkin seeds, beans, peas, avocado, potatoes, whole grains
Manganese | Beans, nuts, pineapple, sweet potatoes, spinach
Molybdenum | Beans, peas, nuts, whole grains
Phosphorus | Dairy products, meat and poultry, seafood, nuts and seeds, beans, peas, whole grains
Potassium | Milk, yogurt, bananas, dried apricots, clams, salmon, tomato products, potatoes, sweet potatoes, spinach, beans
Selenium | Eggs, seafood, poultry, meat, enriched pasta and rice, nuts and seeds
Sodium | Breads, rolls, soups, snack foods, sandwiches, cold cuts, cured meats, cheese
Zinc | Beef, beans, peas, fortified cereals, nuts, whole grains, shellfish, dairy products
Sources
“Background Information: Dietary Supplements.” Centers for Disease Control and Prevention, 19 Feb. 2021, www.cdc.gov/nchs/products/databriefs/db399.htm#:~:text=Among%20U.S.%20adults%20aged%2020,60%20and%20over%20(80.2%25).
“Dietary Supplement Use Among Adults: United States, 2017–2018.” NIH Office of Dietary Supplements, Feb. 2021, ods.od.nih.gov/factsheets/DietarySupplements-Consumer/#.
Statista and Adroit Market Research, “Global Dietary Supplements Market 2018-2028,” 2021, https://www.statista.com/statistics/1263458/global-dietary-supplements-market/.
“Fooddata Central.” FoodData Central, 1 Apr. 2019, fdc.nal.usda.gov/fdc-app.html#/food-details/169383/nutrients.