More than half of American adults take multivitamins or another supplement, according to the NHANES data, perhaps in part because of what they are—or aren’t—already eating. It’s no secret that many Americans don’t follow a healthy diet; for example, about 90 percent of people don’t eat the daily recommended 1½ to 2 cups of fruit and 2 to 3 cups of vegetables, according to the Centers for Disease Control and Prevention.
But can supplements make up for those shortfalls? Supplement proponents argue that it can be challenging for Americans to stick to dietary guidelines. “The majority of U.S. adults do not get the recommended amount of nutrients,” says Andrew Shao, interim senior vice president for scientific and regulatory affairs at the Center for Responsible Nutrition (CRN), a trade association for the supplement industry. “It is a health benefit to get the nutrients you need.”
Still, experts say that eating healthfully is a preferred way to stay healthy. “Using dietary supplements shouldn’t be a substitute for a healthy, balanced diet,” Zhang says. What’s more, when you get nutrients from food, you are also getting a variety of other compounds, such as phytochemicals, that interact with one another in myriad ways, some of which scientists may not even understand yet.
“It’s possible that these particular benefits we’ve seen here could reflect the complex interaction among multiple nutrients from food,” Zhang says. “We don’t eat isolated nutrients.”
Another concern with supplements is that the Food and Drug Administration classifies them differently from drugs. So the companies that make and sell them aren’t required to prove that they’re safe for their intended use, that they work as advertised, or even that their packages contain what the labels say they do, according to Chuck Bell, programs director at Consumer Reports, who is involved in CR’s advocacy work on supplement safety.
There are times when supplements are recommended, such as if a patient is deficient in a certain nutrient due to a health issue, Zhang says. In some cases, a doctor might also suggest taking prescription supplements, which are subject to FDA regulations for drugs.
People who may need supplements include:
Women planning to become pregnant within a month. Folic acid supplements are recommended to reduce the risk of brain and spinal-cord abnormalities (called neural tube defects) that can occur in the first months of pregnancy.
Pregnant women. Folic acid is needed to protect against neural tube defects, and vitamin D is needed to help prevent pre-eclampsia.
Strict vegans who consume no meat, fish, eggs, or dairy. A daily vitamin B12 supplement can be recommended; B12 is found only in animal foods.
People over age 60. At this age, you may need vitamin B12, because with age, some people lose the ability to absorb vitamin B12 from food.
A person who rarely gets out in the sun. He/she may need vitamin D3. Our bodies make vitamin D from sunlight.
Those taking certain drugs. Vitamin B12 and magnesium supplements may be needed for people taking diabetes medication such as metformin (Glucophage and generic) and long-term users of heartburn drugs, such as lansoprazole (Prevacid and generic) or famotidine (Pepcid and generic).
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