We see many articles in the newspapers or on television in which, even with abundant evidence to the contrary,‘experts’ insist that there are no nutritional deficiencies in the UK, that everybody gets enough nutrients from their diet and so there′s no need to take supplements.

Other ‘experts’ point to scientific studies which show that taking supplements can help towards ensuring a long and healthy life. Whom are we to believe? And to whom can we turn for impartial advice? Fortunately, there are now many studies published in the scientific and medical literature to help us understand the ways in which sound nutrition truly supports good health.

DOES THE DIET PROVIDE?

In the last two decades, the groundbreaking National Diet and Nutrition Survey¹ has been introduced by the UK Government as a ‘tool’ to measure nutrient consumption. About 2,000 people are selected for each survey to reflect the general population. Respondents are asked to record and weigh everything they eat for a week and then their daily intakes of nutrients are calculated. While averages intakes of nutrients were, with a few notable exceptions, found to be above the target set by the government², it was also revealed that a large number of individuals failed to reach it. In particular, women showed lower intakes than men and many older folk were found not to reach their target for a wide range of micronutrients, including zinc, vitamin D, calcium, selenium, folic acid and vitamin B12. Teenagers were the worst nourished of all the age groups. In short, although a ‘healthy’ diet is theoretically capable of providing adequate amounts of all the nutrients we need, in reality, many people fail to meet the ideal.

ENSURING NUTRIENT TARGETS ARE MET

Even if you are eating a ‘healthy’ diet, you are still on the ‘knife edge’ as far as sound nutrition is concerned, particularly if your energy expenditure is low due to a sedentary occupation and lack of exercise. If such expenditure is low, to avoid becoming overweight you must lower your food intake and this jeopardises your intake of micronutrients and risks failure to meet recommended targets. And the less you eat, the more critical this becomes. This is where long-term supplementation should be considered alongside a healthy diet. There is no doubt that nutrient deficiencies can lead to symptoms of ill health and that to rectify deficits of long standing by simply changing over to a healthy diet can take a long time. Supplements can help to speed nutrient repletion, but even so, their full value may not be evident for about three months - the time-frame necessary for nutrient exchange in many body tissues. When advising my patients, I first consider whether he/she would benefit from one or more of these four ‘building block’ supplements which can be safely taken long-term on a daily basis.

THE SUPPLEMENTS

1. A-Z multivitamins are the foundation ‘building block’ for providing basic micronutrients to ensure adequate nutrition. Most adults, and particularly women and the elderly, would benefit from such a supplement³.
2. Calcium supplements may be necessary at any time of life if fewer than three portions of dairy products are eaten per day. Many young women are chronically short of calcium and do not realise that this increases the risk of premenstrual syndrome as well as osteoporosis in later life. Soya products, fortified with calcium to the same extent as dairy products, are acceptable alternatives to the latter, but vegetables, such as broccoli, are not, as their content of calcium is too low. When supplementing with calcium, I recommend choosing a ‘bone formula’ containing magnesium as well as calcium to overcome the difficulty of high doses of one of these minerals interfering with the absorption of the other. Vitamin D, also required for bone metabolism, should be present too.
3. Antioxidants. A supplement of vitamin C (500mg per day or more) is helpful if intake of fruit and vegetables is low or when suffering symptoms of inflammation (e.g. skin inflammation, asthma, viral infection, catarrh, headaches, hayfever, joint problems). Vitamin E can also be taken alongside vitamin C to help increase the antioxidant status of the body.
4. Omega 3 fatty acids. The two families of essential fatty acids (omega 3 and omega 6) are unbalanced in modern diets and this is largely responsible for the high incidence of inflammatory conditions such as hayfever, eczema and asthma among the population. The recommended average intake of the omega 3 fatty acids (DHA and EPA) is about 500mg per day. However, I normally advise a daily intake of 1,000mg as maintenance dose for healthy people and 2,000mg per day if a person is suffering from an inflammatory condition.

COMPLEMENTARY SUPPLEMENTS

To complement the ‘building block’ supplements, supplementation with non-essential nutrients can be helpful for alleviating specific ailments. A typical example is glucosamine which, although not an essential nutrient, has been found in clinical trials to be helpful for maintaining joint health. Not surprisingly, therefore, many people find that taking it regularly prevents reoccurrence of joint problems. Other examples include valerian for sleep problems, saw palmetto for prostate health, soya isoflavones for menopausal problems and St John’s Wort for low mood.

CONCLUSION

National surveys have found that a large proportion of the population fail to reach their targets for all nutrients. The less people eat or the more inadequate the diet, the more helpful dietary supplementation becomes. And people who get the best results from supplements are those who take them regularly as part of their daily routine and remember to re-order them when they run out.

¹ National Diet and Nutrition Survey, people aged 65 and over. Young people 4 to 18. Adults 19 to 64. 1998, 2000, 2003, UK Department of Health.
² Department of Health, dietary reference values for food energy and nutrients for the UK. Report on Health and Social Subjects No 41, 1991, HMSO, London.
³ Fairfield KM, Fletcher RH, (2002). Vitamins for Chronic Disease Prevention in Adults: Scientific Review. Journal of the American Medical Association 287, 3116-3126.

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