What do doctors think of dietary supplements?
"UK professor says supplements are a waste of time". That was one of the headlines in a recent edition of NutraIngredients.com (1). The article quotes a Scottish professor of nutrition and dietetics saying that "People who take multivitamin supplements are probably just wasting their money and boosting the profits of vitamin companies".
He isn′t the first to speak out against the use of dietary supplements. Earlier this year NutraIngredients.com commented on a study of supplement use among American children and adolescents participating in the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES) (2). About one third of children and youths between 2 and 17 in that survey took dietary supplements. The investigators suggested that "health care providers in the country should discourage the use of supplements by children with healthy diets" (2).
Last year NutraIngredients.com quoted a member of the Harvard School of Public Health saying that dietary supplements will not provide the nutritional boost a poor diet requires (3). His exact quote, "A supplement is called a supplement because it′s supposed to be supplementing a healthy lifestyle", is actually quite amusing and presumably not what he meant. He is saying in effect that you need supplements even if you follow a healthy lifestyle, which surely includes the proverbial "balanced diet". Proponents of dietary supplementation couldn′t have put it any better!
How widespread is this anti-supplement attitude among doctors? The Council for Responsible Nutrition (CRN), a trade association representing the dietary supplement industry, conducted a couple of surveys among health care professionals to find out. What they discovered was that dietary supplement use was just as common among health care professionals as among the general public.
The first CRN survey, conducted in 2007, questioned 900 physicians and 277 nurses about their thoughts on dietary supplements (4). The survey revealed that 51% of the doctors and 59% of the nurses took dietary supplements regularly, comparable to supplement use in the general population. 79% of the physicians and 82% of the nurses also recommended dietary supplements to their patients, whether they themselved took supplements or not. The list of supplements taken and recommended included things like fish oils, in addition to vitamins and minerals.
The second CRN survey, released in 2008, questioned around 1200 orthopedic specialists, cardiologists and dermatologists (5). Among the orthopedic specialists 73% took supplements themselves; 94% of those who took supplements also recommended them to their patients. For the cardiologists surveyed those figures were 57% and 86%, and for the dermatologists 75% and 79%. Even many of the doctors who did not take dietary supplements still recommended them to their patients.
Are these health care professionals "just as naive and gullible as the general public"? I doubt it. The doctors and nurses surveyed may not be nutrition experts, but they see the extent and consequences of poor eating habits and sedentary lifestyles in their medical practices; they just have to look at their patients′ expanding waistlines. How do you get obese on a "balanced diet"? Given the shear number of the overweight and the obese, how could most people possibly get all the micronutrients they need from the food they eat?
In 2007 investigators from the U.S. Centers for Disease Control and Prevention (CDC) examined the dietary habits of about 100,000 high school students to find out how many ate the recommended two servings of fruits and three servings of vegetables per day. The results of the survey, released just recently (6,7), were sobering. Only 32% got two daily servings of fruit and only 13% the recommended three servings of vegetable. Less than one in ten high school students surveyed ate enough of both. The adults questioned in the same survey didn′t do much better. So much for the balanced diet.
I let the Independent Vitamin Safety Review Panel, a group of physicians, academics and researchers, have the last word on this subject:
"In the past, over-conservative government-sponsored standards have encouraged dietary complacency. People have been led to believe that they can get all the nutrients they need from a 'balanced diet' of processed foods. That is not true. For adequate vitamin and mineral intake, a diet of unprocessed, whole foods, along with the intelligent use of nutritional supplements, is more than just a good idea: it is essential." (8)
Sources:
He isn′t the first to speak out against the use of dietary supplements. Earlier this year NutraIngredients.com commented on a study of supplement use among American children and adolescents participating in the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES) (2). About one third of children and youths between 2 and 17 in that survey took dietary supplements. The investigators suggested that "health care providers in the country should discourage the use of supplements by children with healthy diets" (2).
Last year NutraIngredients.com quoted a member of the Harvard School of Public Health saying that dietary supplements will not provide the nutritional boost a poor diet requires (3). His exact quote, "A supplement is called a supplement because it′s supposed to be supplementing a healthy lifestyle", is actually quite amusing and presumably not what he meant. He is saying in effect that you need supplements even if you follow a healthy lifestyle, which surely includes the proverbial "balanced diet". Proponents of dietary supplementation couldn′t have put it any better!
How widespread is this anti-supplement attitude among doctors? The Council for Responsible Nutrition (CRN), a trade association representing the dietary supplement industry, conducted a couple of surveys among health care professionals to find out. What they discovered was that dietary supplement use was just as common among health care professionals as among the general public.
The first CRN survey, conducted in 2007, questioned 900 physicians and 277 nurses about their thoughts on dietary supplements (4). The survey revealed that 51% of the doctors and 59% of the nurses took dietary supplements regularly, comparable to supplement use in the general population. 79% of the physicians and 82% of the nurses also recommended dietary supplements to their patients, whether they themselved took supplements or not. The list of supplements taken and recommended included things like fish oils, in addition to vitamins and minerals.
The second CRN survey, released in 2008, questioned around 1200 orthopedic specialists, cardiologists and dermatologists (5). Among the orthopedic specialists 73% took supplements themselves; 94% of those who took supplements also recommended them to their patients. For the cardiologists surveyed those figures were 57% and 86%, and for the dermatologists 75% and 79%. Even many of the doctors who did not take dietary supplements still recommended them to their patients.
Are these health care professionals "just as naive and gullible as the general public"? I doubt it. The doctors and nurses surveyed may not be nutrition experts, but they see the extent and consequences of poor eating habits and sedentary lifestyles in their medical practices; they just have to look at their patients′ expanding waistlines. How do you get obese on a "balanced diet"? Given the shear number of the overweight and the obese, how could most people possibly get all the micronutrients they need from the food they eat?
In 2007 investigators from the U.S. Centers for Disease Control and Prevention (CDC) examined the dietary habits of about 100,000 high school students to find out how many ate the recommended two servings of fruits and three servings of vegetables per day. The results of the survey, released just recently (6,7), were sobering. Only 32% got two daily servings of fruit and only 13% the recommended three servings of vegetable. Less than one in ten high school students surveyed ate enough of both. The adults questioned in the same survey didn′t do much better. So much for the balanced diet.
I let the Independent Vitamin Safety Review Panel, a group of physicians, academics and researchers, have the last word on this subject:
"In the past, over-conservative government-sponsored standards have encouraged dietary complacency. People have been led to believe that they can get all the nutrients they need from a 'balanced diet' of processed foods. That is not true. For adequate vitamin and mineral intake, a diet of unprocessed, whole foods, along with the intelligent use of nutritional supplements, is more than just a good idea: it is essential." (8)
Sources:
- Shane Starling. UK professor says supplements are a waste of time. NutraIngredients.com Sept. 10, 2009.
http://www.nutraingredients.com/content/view/print/259495 - Lorraine Heller. Most children don′t need supplements, says study. NutraIngredients.com Feb. 4, 2009.
http://www.nutraingredients-usa.com/content/view/print/235056 - Shane Starling. Harvard professor slams supplements. NutraIngredients.com Jul. 7, 2008.
http://www.nutraingredients-usa.com/content/view/print/173318 - Dickinson A, Boyon N, Shao A. Physicians and nurses use and recommend dietary supplements: report of a survey. Nutr J 2009;8:29
http://www.nutritionj.com/content/8/1/29 - Lorraine Heller. Doctors reveal supplement recommendations. NutraIngredients.com Dec. 11, 2008.
http://www.nutraingredients-usa.com/content/view/print/229798 - 9 in 10 teens fall short on fruits and veggies. Associated Press Sep. 29, 2009.
http://www.msnbc.msn.com/id/33071814/ns/health-diet_and_nutrition/ - State indicator report on fruits and vegetables. Department of Health and Human Services, Centers for Disease Control and Prevention.
http://www.fruitsandveggiesmatter.gov/downloads/StateIndicatorReport2009.pdf - Doctors say, raise the RDAs now. Orthomolecular Medicine News Service Oct. 30, 2007.
http://orthomolecular.org/resources/omns/v03n10.shtml
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Dietary Supplements and Today’s Lifestyle
Many articles by nutritionists and physicians blithely assume that we all eat five fruits and vegetables per day that we never skip breakfast, and religiously consume whole grains rather than processed grains. They seem to ignore the fact that the average person does eat fast food and that salt, carbohydrates, and sugar are a regular part of millions of people’s diets. These are the people who say that dietary supplements are not necessary, because a balanced diet takes care of all that for you.
The Reality of Today’s Lifestyle
Reality dictates otherwise. Our schedules are packed, and many of us are worried about finances, making ends meet, and the general stresses of raising a family where everyone seems to have a different schedule. Even for those who make nutrition a priority, perfect eating habits sometimes go by the wayside. As a result, it’s hard to be sure whether we are consuming enough fiber, minerals, vitamins, essential fatty acids, and amino acids to ensure optimum health.
The Role of Dietary Supplements d
Keeping our bodies properly nourished even when we can’t take the time or effort to ensure we eat properly is what dietary supplements are all about. Most people take them in the form of tablets or capsules, but they also can be had in the form of extracts, liquids, and powders. They are generally shelf-stable, relatively inexpensive, and serve as a good backstop to the typical diet and lifestyle of today.The most popular supplements are multivitamin and mineral supplements because they ensure we meet our baseline needs and are relatively inexpensive. Calcium supplements are also important for women, and for men who may not get enough calcium, because osteoporosis affects both sexes. Fish oil supplements are becoming widely used because of their benefits on cardiac health. Glucosamine is another supplement that is becoming popular for the health of the body’s joints.
Dietary Supplements d
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