Farmer or Pharma: Supplements debate
In this video, a number of nutrition experts from Monash University share their views on how we should obtain nutrients we require to stay healthy.
HELEN TRUBY: All governments around the world make recommendations about what their population should eat, in terms of servings of fruit and vegetables, and dairy products, and meat groups, et cetera. But what we know from dietary surveys is that the majority of people don’t actually follow those guidelines. They have been made to ensure that the population gets enough micronutrients as well as their macronutrients, and to support a healthy diet. But a lot of people these days rely on supplements, and it’s become a multimillion dollar industry. So I’ve got a panel of experts here with me today, who are going to discuss some of these things.
And we’re going to think about, why do people use those supplements, where are they useful, are there particular population groups that we should be using supplements? And just think about how we can get best value for our money from supplements or food.
CATE LOMBARD: Groups that I would be most concerned about are those that are thinking about becoming pregnant, or are pregnant, and those are probably reaching mid-age and older, where their intake, it is important to get a very good, healthy, lots of nutrients in their diet. The other time is for those women at around the time of menopause where the calcium requirement goes up quite a bit. If they haven’t been great milk drinkers all their lives, they may need to consider a calcium supplement depending on their bone density and family history.
JANEANE DART: And I think certainly encouraging people to be conscious of the amounts, or the labels of different nutrients, or rather, to supplements. So I think people generally being aware of what recommended daily intakes are for different nutrients, so they can actually make informed choices, and trying to ensure that the supplements that they’re taking, somewhere between 50% to 150% of the recommended daily intake, rather than overdosing, because toxicity can be an issue in some circumstances.
CATE LOMBARD: I think it’s extraordinarily difficult for people to understand the complexities of nutrition today. We have so much information, we have access to information. We also have access to misinformation. And I think that’s where the general population has to be very careful about where they seek their information, and who they seek it from.
DAVID KANNAR: Maybe I can just add to that. I’m not opposed to supplements, but I guess the thing that supplements versus food– the argument for food for me is that there’s a lot of known and unknown substances in foods that we just can’t account for in supplements. And so I think, to add to what Kate said, obviously that’s the first part is to actually make sure dietary invention is as effective as possible.
LIZA BARBOUR: I’ve worked as a community dietitian, and predominantly with people who are experiencing hardship of various kinds. And unfortunately, I’ve seen a lot of situations where people are subjected to really convincing marketing saying that they need to have certain supplements to maintain a healthy life, and I just have to spend this amount of money to get– whether it’s protein, whether it’s iron, calcium, things that we can actually get from food.
TRACY MCCAFFREY: I think that’s a really good point, Liza, and one supplement that’s a good example of that are like, lutein and zeaxanthin. They’re forms of vitamin A, and they’re sold for helping promoting vision. And in some clinical trials that does work, but it’s mainly for developing countries that have high levels of deficiency, and particularly in children where they can become deficient very quickly. In adults it takes, perhaps, one to two years. But in the Western population, we have a problem with age-related macular degeneration.
And some of the studies have really shown that for those people with advanced age-related macular degeneration supplements are useful, but really in the early stages of the disease, or in disease prevention, supplementations– the evidence isn’t really there as yet. But if we eat a healthy diet, that will really help us and to try and prevent those diseases in the first place. But as we get older, we do experience more incidence of disease anyway.
LIZA BARBOUR: We know that fish oils have some really beneficial long-chain fatty acids, and they can help prevent coronary heart disease, stroke, amongst a range of other health benefits. The problem is that here in Australia, we’re recommending at least three servings of fish a week to the adult population. And this is being promoted globally, that we should be eating more and more fish to get those beneficial fatty acids. And from an environmental perspective, devastatingly, our fish stocks are plummeting. And so we’ve overfished, and marine ecologists have predicted that in the next 40 years, we’ll see the fish stocks absolutely collapse.
So, while there’s benefit from a health perspective to have the fish oils, I think that it’s worth, definitely from a nutrition practitioner perspective, we should be open to the idea of recommending supplementation to replace that whole fish.
TRACY MCCAFFREY: So one argument against taking supplements would be the fact that our body does regulate our intake of nutrients very well. For example, if we take our fat-soluble vitamins, such as vitamin A, D, E, and K, they’re typically stored in the liver. And it takes about one to two years for those vitamins to actually deplete out of the liver if we didn’t consume anything within our diet. Whereas B vitamins, C vitamins, they are water-soluble vitamins, and they are excreted daily. So really, if you do happen to take supplements that are B vitamin complexes, or vitamin C really you end up with very expensive urine.
So I think it’s actually better to consume our vitamins from our whole food diet rather than targeted supplements such as B and C vitamins.
DAVID KANNAR: Good point, Tracy. The only other thing to add to that is the protein, just to make sure we don’t take too much protein because there’s a propensity with weight gain, muscle bulk, increased to then put pressure on the other organs, particularly in the kidneys. So that would be the only other caution.
HELEN TRUBY: So one way that people can try and make sense of the information that’s available to them is to have a look at the label on the side of the supplement. It should give you information on how much is in that supplement and the dosage for an adult. And again, as we’ve talked about, the amount of the percentage recommended daily intake. So that gives you a sense of whether it’s reasonable, has it given you all your daily intake, or is it giving you a megadose? And generally, people don’t require those megadoses unless they’ve been recommended by a health practitioner.
CATE LOMBARD: It’s extraordinary, the number of supplements that are out there, and it shows how effective marketing can be in this case. You just have to go into the supermarket aisle, and you can see a wall of supplements. Someone is buying them, it’s a multi-million dollar industry. So I think supplement use is becoming normalised, and it’s not necessary.
DAVID KANNAR: There may not be a whole lot more benefit through megadoses, if you’ve got a good fundamental dietary intake of some of these nutrients. But again, it’s very specific, so it needs to be handled with a professional.
JANEANE DART: My view is that supplements fall way short of providing everything that we need.
I have a preference in most instances, that we aim to get our nutrients through food, as we’ve said already that there are certain circumstances and subgroups where we need to get specific supplements. But food offers so much more than taking a pill, and it’s for all the social and convivial reasons. And I guess sharing a meal is one of life’s greatest joys, and I guess one of culture’s longest traditions. And it connects us not only to food but, to people,to our family and our friends. So I think food offers so much more than supplements, and I guess, for example, even stimulating the gastrointestinal tract, when we’re eating and chewing.
So there are physiological benefits, as well as those social and emotional and personal benefits that eating offers.
HELEN TRUBY: I think Janine is absolutely right, in terms of being able to have a wide variety of food’s really important. And we know that early childhood’s a very incredibly important time when our food choices are going to be influenced. So children are influenced by what their parents eat. But also, we know that young children who aren’t very good at eating fruit and vegetables, they actually have to be exposed to one food eight or nine times before they might find it acceptable. So, just giving you child one teaspoon of peas and they spit it out doesn’t mean they don’t like peas. It just means that they haven’t gotten used to that taste yet.
So, introducing a wide variety of fruit and vegetables in that first year of life in those early years is very important in terms of being able to influence the sorts of foods that your child is going to be able to eat, and is going to accept later on. So perhaps some key messages to people to think about if you’re going to go on to supplement, is really considering why you’re actually going to take the supplement. Do you actually need it? If you can afford to buy that particular supplement, can you actually get what you need from food? And are there any reasons why you shouldn’t be able to absorb those nutrients from foods?
So, I think we are very much taking a view on food first, but with the recognition that the supplements are useful, and there are numerous reasons why humans eat, why we have food, the complexity of food, and just how it comes, how we cook food, are all very important as to what happens to the micronutrients. And that’s what makes nutrition so interesting.
At a time when nutrient supplements are popular, many people ask the question: should we obtain the nutrients we require to be healthy from supplements or from foods?
Watch a number of nutrition experts from the Department of Nutrition and Dietetics at Monash University (who are experts in different areas of nutrition spanning public health, to nutrition science) share their thoughts on obtaining nutrients from food and supplements.
Talking point
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- Should it be from food or supplements, or a combination of both?
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