Choose Nutrient-Rich Foods and Supplement to Fill Nutrition Gaps
The truth of the matter is that most people do not eat a nutritious diet. We try to follow MyPlate recommendations for food groups: fruits, vegetables, grains, protein foods, and dairy . And too often fail. For many reasons – time, cost, food availability (both in the pantry/fridge at home and restaurant choices in proximity outside the home), and individual food preferences. In reality, our bodies need vitamins to function properly. One option to help obtain essential vitamins and minerals is to use dietary supplements but there is always a cohort of experts who worry that this will lead to excessive micronutrient intakes. Is this the case?
No. Not according to new research from Australia. The Western Australian Pregnancy Cohort (Raine) Study recruited pregnant women between 1981 and 1991. From the 2,168 children who were regularly contacted by researchers over the next 17 years, Gallagher and colleagues surveyed 991 adolescents (17y of age) using self-reported semi-quantitative food frequency questionnaires (FFQ) between July 2006 and June 2009. Adolescents were also required to record any dietary supplement use. The most common supplement used was a multivitamin (40% of males and 47% of females). The second most common supplement was vitamin C (26% of males, 41% of females), followed by fish/cod liver oil (25% of males and 37% of females). Only 2 females used a folate supplement (which is very depressing when one considers the risk of neural tube defects). Adolescents had inadequate intakes of calcium, folate, vitamin D and vitamin E. Females were also low in magnesium. Supplement users were less likely to be nutrient inadequate.
The 24% of teenagers using dietary supplements in Australia is higher than ~5% reported by Wu et al (2013) for herbal and dietary supplements and lower than 37% reported by Dwyer et al (2013)for dietary supplements in those <18y in the US. [Note how slight change to question asked changes estimates from the same database]. Gallagher et al (2014) cite studies (references 5, 13, 14) reporting 11-45% of European adolescents use dietary supplements. However, I digress.
My point is that vitamin and mineral intakes are often inadequate. Dietary supplements help fill micronutrient gaps. Too few servings of fruits and vegetables translates to a lack of antioxidant nutrients. Adolescents, and their grandparents, parents, siblings, extended families and friends need to be encouraged to consume more fruits and vegetables. Let’s be fair, foods are tasty. A balanced diet, rich in variety, can provide our bodies with an adequate supply of vitamins and minerals. Choosing fortified foods helps even more. And research shows that people using dietary supplements are more likely to choose foods which are more nutrient dense.
But our concern should not be multivitamin use, it should be nutrient inadequacy. Like Gallagher and colleagues (2013) conclude,“Along with increasing the consumption of nutrient-dense foods, supplement use may help to correct micronutrient imbalances”.
Gallagher CM, Black LJ, Oddy WH. Micronutrient intakes from food and supplements in Australian adolescents. 2014 Nutrients doi:10.3390/nu6010342
Wu C-H, Wang C-C, Kennedy J. The prevalence of herb and dietary supplement use among children and adolescents in the United States: Results from the 2007 National Health Interview Survey. 2013 Complement Therapies Med doi:10.1016/j.ctim.2013.05.001
Dwyer J, Nahnin RL, Rogers GT, Barnes PM, Jacques PM, Sempos CT, Bailey R. Prevalence and predictors of children’s dietary supplement use: the 2007 National Health Interview Survey. 2013 Am J Clin Nutr doi:10.3945/ajcn.112.052373