The supplement industry is booming, offering an array of pills that promise to boost your health and improve your wellbeing. But does the evidence support these claims? In this article we ask do supplements work, and are there better ways to get the nutrients you need.
January 16, 2023 11:58 am January 16, 2023 11:58 amMiracle pills or misleading marketing?
Supplements are a lucrative business. Surveys indicate that around half of adults in the UK regularly take some form of dietary supplement.(1) Meanwhile, the global market for such products was worth an estimated 151.9 billion US dollars in 2021.(2) Predictions suggest this figure is only going to grow.
But do supplements work? With so many people taking them and so much money being spent, it’s an important question to ask. Are they the miracle pills companies claim them to be, or are we being misled by clever marketing?
Perhaps unsurprisingly, there isn’t a simple answer. That’s partly because there are countless types of supplements on the market, each offering its own supposed benefits. The efficacy of one has no bearing on the efficacy of others. Likewise, we as individuals are all unique, with different health concerns and requirements. What’s right for one person might not be right for another. Plus, to determine whether a supplement is effective, you need to know what you’re hoping to gain by taking it.
However, there is one thing we’re able to say with confidence. Although some supplements may be helpful, you shouldn’t use them as a replacement for eating a healthy and balanced diet. The belief that we can get all the nutrients we need by popping a pill every day is simply untrue. A multivitamin will not compensate for a poor diet, nor can it boost longevity or prevent chronic diseases.
What about more modest claims, though? Do supplements work to address deficiencies, reduce the risk of certain medical conditions, improve cognitive functions, or boost overall health? Let’s take a closer look.
Making sense of multivitamins
Firstly, how do supplements work? The general idea is that they provide us with specific key nutrients that the body needs. This could be one single vitamin or mineral, such as vitamin C or iron, or a combination of several. The latter are called multivitamins and minerals, and they are among the most popular supplements. Many people take them for an overall health boost. But are they effective?
Unfortunately, the evidence is mixed. For example, some studies have found that multivitamins may correlate with a decreased risk of heart attacks.(3) However, others suggest they have no such effect.(4)
Likewise, the research on multivitamins and cancer risk is also conflicting. There are studies which link such supplements with a reduced risk of particular cancers, whereas others have found no effect.(5)(6) More worryingly, some evidence suggests that taking supplements could actually increase the risk of developing certain forms of cancer.(7)
Overall, there is little scientific evidence to support the claim that multivitamins can significantly improve your health. Many of the positive correlations found may actually be because people who take supplements tend to live healthier lifestyles generally.
Yet taking multivitamins isn’t the only approach. So, do supplements work when they’re targeted at specific deficiencies?
Do vitamin D supplements work?
One of the most common supplements we are recommended to take is vitamin D. Nicknamed ‘the sunshine vitamin’, our bodies produce vitamin D when we expose our skin to sunlight.
However, many of us spend much of our time inside, and/or live in areas that get limited sunshine in winter. This can lead to deficiencies, especially because we only naturally find vitamin D in a small range of foods. This makes it more difficult to obtain from diet alone. In fact, studies suggest that around 13% of Europeans are severely deficient in vitamin D.(8) So, do supplements work as a way to counter this? Once again, the science is split.
Evidence suggests that vitamin D supplementation can help to improve the bone health of people who are deficient in it.(9) Indeed, the advice from the UK government is that everyone should take vitamin D supplements during winter.(10) However, this may not be necessary for those who get enough vitamin D from sunshine and their diet.
It’s also important to note that taking too many vitamin D supplements could be toxic. This is because it results in a build-up of calcium, which can weaken your bones and damage your heart and kidneys.(11)
Consequently, it’s preferable to get your vitamin D from more natural sources. This means spending time out in the sun (wearing sun cream!) and obtaining it through your diet. When it comes to the latter, fatty fish, fortified plant milks and hemp seed oil are all fantastic choices.
Do vitamin B12 supplements work?
If you follow a plant-based diet, someone will almost certainly have warned you about getting enough vitamin B12. It’s naturally found in many animal products, but is more difficult to obtain if you’re vegetarian or vegan. However, it’s not impossible to do so, and there are several plant-based sources of B12 out there. But do supplements work as an alternative?
Research indicates that B12 supplementation can be helpful for vegetarians and vegans.(12) This is especially because levels of the vitamin in plant-based foods are not always consistent. However, it is also possible to get sufficient B12 as a vegan without turning to supplements. You can do this by ensuring you include fortified foods in your diet. For example, many plant milks have added B12. Other good sources are nori seaweed and chlorella.
Alternative ways to get the nutrients you need
Let’s return to our original enquiry: do supplements work? It seems the answer is both yes and no, depending on the supplement in question and reason for taking it. While they won’t provide you with a miracle cure, they can help to counter specific deficiencies in certain people.
This brings us to another issue – are supplements the most effective way to achieve this? In the majority of cases, they don’t appear to be.
For most of us, getting the nutrients we need from our diet rather than supplements is preferable. There are many reasons for this. Firstly, it’s not always clear exactly what’s in a supplement. This is partly due to insufficient regulation and the inclusion of extra ingredients like binding agents and fillers. In addition, it’s difficult to judge the quality of any individual supplement.
Moreover, supplements tend to isolate one specific vitamin or mineral (or a collection of them in a multivitamin). With whole foods, on the other hand, you consume a multitude of nutrients and other natural substances all together. This enables them to work synergistically, resulting in greater health benefits.(13)
There are also certain key differences between natural nutrients, like those in food, and the synthetic ones found in supplements. This can affect the ease with which your body absorbs them. For example, studies suggest that we can absorb natural vitamin E twice as easily as synthetic vitamin E.(14)
Finally, you may be at greater risk of overdosing on vitamins and minerals if you get them via supplements. This is particularly true for fat-soluble vitamins like A and K, which can accumulate in the body to high levels.
"The science is clear that lifestyle changes and a healthy diet are far more effective than supplements at improving our wellbeing."
Do collagen supplements work?
Vitamins and minerals aren’t the only things our bodies require to stay healthy. So, do supplements work for other types of nutrients?
An increasingly popular choice of supplement is collagen, one of the most abundant proteins in the body. People take it to improve the health of their hair, skin and nails, plus support their joints, muscles and bones. Research indicates that collagen supplements can have some benefit on skin hydration and elasticity.(15) They could also help with building muscle mass and alleviating the symptoms of osteoarthritis.(16)
However, it’s worth bearing in mind that there is a lack of human studies into the effectiveness of collagen supplements. Further, much of the research is at least partially funded by industries with a vested interest in proving their efficacy.
Fortunately, there are plenty of foods you can include in your diet as an alternative to supplements. For example, walnut oil is rich in ellagic acid, which may help to protect your body’s collagen.
Do testosterone supplements work?
Another type of pill that’s become more prevalent in recent years is testosterone supplements. They’re marketed as a way to boost your levels of the hormone and increase everything from energy to muscle mass. But do supplements work in this instance?
Like with most other examples, the evidence is unclear.(17) Prescribed medical treatments may help to raise levels of the hormone and ease the symptoms of testosterone deficiency. However, experts generally believe that testosterone supplements don’t live up to the hype.
Some studies suggest they could boost testosterone levels, whereas others have found no effect or even a reduction in testosterone. The latter occurs when the body believes it no longer needs to produce the hormone itself thanks to the supplement.
Fortunately, there are simple lifestyle changes you can make to help increase your levels of testosterone naturally. These include doing more exercise (in particular weightlifting), getting plenty of good quality sleep, and eating a healthy, balanced diet.
Do brain supplements work?
Nootropics – drugs intended to enhance your cognitive functions – are a profitable business these days. And it’s easy to see why. Who hasn’t wished they could improve their recall and focus by simply taking a pill? So, the big question is: do memory supplements work?
Sadly, once again, things are inconclusive. Research in this area is still in its infancy. However, the results so far have not proven brain supplements to be effective.(18) This is true for enhancing cognition in both healthy people and those suffering from conditions such as dementia. Alarmingly, studies have also found many such products to be marketed in a misleading fashion.(19)
When it comes to brain health, changes to your diet and lifestyle are far more effective than supplements. For instance, staying hydrated, getting lots of high quality sleep, keeping physically active and minimising stress can all help. It’s also a great idea to keep your mind active. As an example, you could do this by learning a new language or how to play a musical instrument. Even socialising has a positive impact on the health of our brains!(20)
Are there any risks to taking supplements?
The question ‘do supplements work’ is not the only one we need to be asking. We also have to consider whether there are any risks to taking them. And there are a few issues to keep in mind in that respect.
First, if you’re on any medication, it’s wise to consult with a doctor before you start taking any supplements. This will help to prevent you from experiencing any unwanted interactions. Likewise, if you’re pregnant, you should seek medical advice prior to adding any kind of supplements to your diet.
It’s also important for everyone to be careful not to overdose on supplements, as excessive levels may be toxic.
Another potential concern is that by taking a supplement, you’re giving yourself an excuse not to be healthy. It’s much easier to take a pill than to overhaul your diet or start up an exercise regime. However, the science is clear that lifestyle changes are far more effective than supplements at improving our wellbeing.
This doesn’t mean you can’t use supplements to counter a specific nutritional deficiency or help with a diagnosed medical condition. Just make sure that they’re only one part of your health strategy – not your entire solution!
Do supplements work: the bottom line
The world of supplements can be a tricky one to navigate. There’s a lot of conflicting information out there, as well as dubious marketing strategies being used by some companies. However, there are a few key points we can use to guide us.
Do supplements work? For some people, in certain circumstances, yes. With medical guidance, they may help to counter deficiencies or treat specific health conditions. Yet for most of us, they are ineffective or unnecessary.
Instead, a better option is to use whole foods as our source of dietary nutrients. We should combine this with lifestyle factors such as taking regular exercise, prioritising sleep, and looking after our mental wellbeing. Such an approach will allow us to optimise our health in a sustainable and effective way.
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References
- Food Supplements Consumer Research Food Standards Agency, 2018.
- Dietary Supplements Market Size, Share & Trends Analysis Report Grand View Research, 2021.
- Multivitamin use and the risk of myocardial infarction: a population-based cohort of Swedish women The American Journal of Clinical Nutrition, 2010.
- Multivitamins in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial Journal of the American Medical Association, 2012.
- Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial Journal of the American Medical Association, 2012.
- Multivitamin use and risk of cancer and cardiovascular disease in the Women’s Health Initiative cohorts Archives of Internal Medicine, 2009.
- Health effects of vitamin and mineral supplements The British Medical Journal, 2020.
- Vitamin D deficiency 2.0: an update on the current status worldwide European Journal of Clinical Nutrition, 2020.
- The health effects of vitamin D supplementation: evidence from human studies Nature Reviews Endocrinology, 2021.
- Statement from PHE and NICE on vitamin D supplementation during winter Public Health England, 2020.
- Taking too much vitamin D can cloud its benefits and create health risks Harvard Health Publishing, 2022.
- Vitamin B12 among Vegetarians: Status, Assessment and Supplementation Nutrients, 2016.
- Health benefits of fruit and vegetables are from additive and synergistic combinations of phytochemicals The American Journal of Clinical Nutrition, 2003.
- Human plasma and tissue alpha-tocopherol concentrations in response to supplementation with deuterated natural and synthetic vitamin E The American Journal of Clinical Nutrition, 1998.
- Oral Intake of Low-Molecular-Weight Collagen Peptide Improves Hydration, Elasticity, and Wrinkling in Human Skin: A Randomized, Double-Blind, Placebo-Controlled Study Nutrients, 2018.
- Effect of collagen supplementation on osteoarthritis symptoms: a meta-analysis of randomized placebo-controlled trials International Orthopaedics, 2019.
- The putative effects of D-Aspartic acid on blood testosterone levels: A systematic review International Journal of Reproductive BioMedicine, 2017.
- The Real Deal on Brain Health Supplements Global Council on Brain Health, 2019.
- A Public Health Issue: Dietary Supplements Promoted for Brain Health and Cognitive Performance Journal of Alternative and Complementary Medicine, 2020.
- Greater Social Engagement and Greater Gray Matter Microstructural Integrity in Brain Regions Relevant to Dementia The Journals of Gerontology, 2021.
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