Dietary supplements are intended to supplement, not replace a balanced and healthy diet. Diet plays such an important part in the development and prevention of disease, and no amount of supplements will replace a diet, high in vegetables, fruit and high quality lean protein.
Supplement use plays a small role in maintaining health compared to good sleep, regular exercise, a nutritious diet and effective stress management. There are, however, various supplements that have good evidence in the medical literature that help with prevention of diseases like cardiovascular disease as well as improve mental and physical health overall and are available in various forms including pills, capsules, tablets, liquids, soft gels and powders.
Some common supplements include: vitamins such as vitamin D and biotin; multivitamins and minerals like calcium, iron and magnesium; botanicals or herbs such as ginger and echinacea, and probiotics.
Certain supplements have been well studied and can help or improve overall health. However, there are also those the use of which is not sufficiently backed by scientific evidence and which may even put our health at risk.
Supplement use has boomed over the past two to three decades – they are easily accessible, give individuals a sense that they are doing something beneficial for their health, however are sometimes accompanied by false or exaggerated advertising claims. Despite certain supplements containing potent ingredients, they are not regulated in the same way pharmacological drugs are, therefore it is important to research which manufacturers make good quality supplements.
So which supplements are actually backed by science to improve our healthspan and lifespan?
Supplement use, like healthcare, is highly individual. Different people have different needs at different times in their lives. Take iron supplements for example. Iron is one of the most important minerals in our body, especially with regard to transportation of oxygen throughout our body. It is obtained through our diet.
Low levels of iron may cause numerous problems, but supplementing for no reason may lead to too much iron, which is toxic. Iron deficiency arises from not ingesting enough iron rich foods, not absorbing enough iron and or losing a disproportionate amount of iron (blood loss). In particular populations such as menstruating females, pregnant women, athletes and people with specific gastrointestinal diseases may benefit from iron supplementation when dietary changes alone are unsuccessful.
Some supplements can therefore be beneficial for some but not all and it important to seek medical advice on the appropriate tests and forms of supplements you are taking even if they are freely available without a prescription.
Other supplements tend to be beneficial to a wider part of the population. For example omega 3 and vitamin D are often deficient in a large proportion of adults. Omega 3 fatty-acids from fish oil (which is a combination of EPA and DHA) may be derived from a diet rich in fatty fish, however in order to reap the benefits most individuals would require supplementation.
Some supplements that improve our health based on evidence in the medical literature:
• Omega 3 – most people do not consume enough fatty fish for enough omega 3 and supplements are associated better brain function, cardiovascular health, mood regulation, and pain management. Proven to aid in the lowering of triglycerides and related cardiovascular events and may also have some benefit in treating depression and certain inflammatory diseases. Fish oil supplements, for example, are important supplements during pregnancy particularly for brain development but caution must be taken that there is no risk of elevated mercury levels due to contaminants.
• Vitamin D is important for bone health, immune health as well as normal blood pressure. Testing vitamin D levels is essential to guide appraise dosing. Vitamin D3 works better in combination with Vitamin K2 in liquid or capsule form.
• Senolytics – certain compounds like fisetin, quercetin and curcumin are proven to remove old cells which are harmful and promote ageing and inflammation.
• Folate (vitamin B9) – crucial during early pregnancy to reduce the risk of birth defects of the brain and spine
• Probiotics are important as a supplement to a diet rich in greens. Certain strains of bacteria like Akkermansia Muciniphila have improved metabolic health during along with dietary intervention in obese patients.
One must also consider that certain supplements, even when marketed as natural or herbal, can be very potent nonetheless. One such example is Red Yeast Rice (RYR) which is produced by fermenting rice with edible fungus. Supplementation with RYR has been shown to be effective in reducing cholesterol levels. This is because the main active ingredient is identical to a particular cholesterol-lowering statin medication. Clearly it is a powerful supplement whose consumption must be taken with caution and not in combination with other cholesterol lowering drugs without medical supervision.
Supplements must be considered as a small, yet potentially powerful, portion of our overall lifestyle when aiming to maximise health. The enormous range of products available may be overwhelming and at times confusing, however particular supplements have their use and benefit. Some supplements can therefore be beneficial for some but not others and you should seek medical advice on the appropriate tests and forms of supplements you are taking.
Dr Borg is a longevity medicine specialist as well as a consultant interventional radiologist and leads The Longevity Clinic at St. James Hospital.
