When I was in medical school and learning how to perform basic tasks, like reading an ECG or a chest x-ray, I was taught very specific protocols for each process. For example, reading an ECG was RRABEIIM – rate, rhythm, axis, bundles, enlargements, intervals, ischemia, morphology. The goal was to make sure nothing was missed, nothing was inadvertently overlooked.
In other words, taking shortcuts – such as jumping to the evidence of a heart attack occurring – might mean missing a long QT interval, which could lead to serious problems if medication choice did not take this into account.
Pilots, auto mechanics, chefs, and in fact almost every profession uses checklists or SOP’s in some form to make sure a vital process does not get short-circuited.
Supplements – Do They Work?
I have to admit, it seems logical to assume that if a substance is found to have health benefit in nature, it should have similar benefit if taken in the form of a supplement. But is this true?
It turns out that we have very little evidence this is true. In fact, studies have been disappointing when it comes to benefits of supplements.
1. First, in a fascinating study, researchers looked at muscle building after exercise in weightlifters given whole eggs vs. egg-whites after exercise. While the protein content was identical, the muscle building effect was greater after whole egg consumption. Adding fat to the protein source protein source to make the energy (calorie) load the same did not restore the protein building effect. There is something about eating the whole egg that confers benefit not seen when eating isolated components.
2. An observational study of more than 30,000 US adults found that dietary supplement use was not associated with reduced risk of mortality, cardiovascular disease, or cancer.
3. While vitamin E, folic acid, beta-carotene and niacin might be expected to reduce cardiovascular risk, none had benefit in studies when given as a supplement.
We are meant to eat real food
My take on this is that there are no shortcuts when it comes to nutrition. It appears the best way to get all the nutrients needed to be at your best is to eat a variety of healthy foods that have high quality and are nutrient dense. For most people, the basis for this will be vegetables and possible fruits and whole grains for those who choose to eat these.
Are any supplements worthwhile?
There may be a couple exceptions worth considering for adults:
- Vitamin D. It may be hard to maintain adequate vitamin D levels through sun exposure for most people in the US, especially in the winter.
- Omega-3 fatty acids. Fish consumption has been associated with reduced risk of vascular disease, with two servings of fatty fish weekly as a recommended amount. A prescription version of EPA was recently shown to reduce heart attacks in people who have high triglycerides. For healthy people, it has not been shown that taking fish oil supplements is beneficial. I would consider supplementation for people who choose not to eat fish, especially if at risk for heart disease.
- Medicinal spices. Various spices, such as turmeric and cinnamon, may have benefit for certain conditions.
If you’re curious, my current supplement regimen consists of a multivitamin daily (no clear benefit from studies but I consider it protection against anything I might miss in my diet), 15,000 units of vitamin D3 once per week, and occasional turmeric if I feel especially stiff or achy in my joints.
Take home message
I believe for most of us, we are better off taking the money we invest in supplements and instead using this to increase the quality of the food we eat.
Dr. Topher Fox