Around half of British adults take a regular supplement in the hope of covering our nutritional bases. But do we need it?
Many experts say they have their place. Others say they are expensive and unnecessary. It’s certainly true that supplement brands are raking in the profits. This year, the revenue generated by the industry reached £610m in the UK and the market is forecast to grow by 6.53 per cent annually over the next five years.
The benefits promised by these brands cover everything from improving immunity and general well-being, to addressing specific concerns such as gut problems or brain health. It’s easy to see why they’re so popular – who wouldn’t want to pop a pill to fix our ailments? But could taking unnecessary supplements do more harm than good? Let’s find out.
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A comprehensive usually includes vitamins A, C, D, E and B vitamins, as well as minerals such as iron, calcium, magnesium and zinc. The difference is that vitamins are produced by animals or plants, while minerals come from the soil and environment. Plants absorb the minerals, which are then eaten by animals and humans.
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As much as we’d like a yes or no answer to that, the truth is more complicated. “If you’re generally well and have a healthy diet, you don’t need a multivitamin,” says Dr Emily Leeming, a registered dietitian, food scientist at King’s College London and author of Genius Gut: The Life-Changing Science of Eating for Your Second Brain. “Meta-analyses of randomized controlled trials find that you won’t live longer by taking multivitamins and there is no benefit in terms of cardiovascular disease. But there are certain groups of people for whom supplements may be beneficial.”
“Changes in agriculture and soil practices have significantly reduced the mineral content of our food over the past few decades,” says Aidan Goggins, a pharmacist, nutritionist and independent consultant to the supplement industry. “The judicious use of a high-quality multivitamin can be beneficial given the challenges facing modern diets,” he argues.
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Fat-soluble vitamins, such as A and E, can build up in the liver and become toxic because your body is unable to clear them. “Too much vitamin A can cause headaches, liver damage and affect the strength of your bones,” explains Dr Leeming. “Water-soluble vitamins, such as C and B vitamins, will pass through your urine, but can still be a problem in excessive doses over a long period of time.”
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Everyone agrees on vitamin D, which is absorbed through our skin from the sun. In the UK, we don’t get enough sunlight in the winter months, so supplements are advised for everyone, but especially children and the elderly. Vitamin C is the second most popular individual nutritional supplement in the UK, although it’s actually quite easy to get from food, so unnecessary as long as you eat enough fruit and vegetables. Good sources are citrus fruits, berries, peppers, broccoli, kale, parsley, and even plain potatoes.
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Yes: an omega-3 algae supplement. “Plant sources of omega-3, like ALA, have poor utilization in the body,” says Goggins. “We need superior DHA, which can only be obtained from microalgae if we don’t eat fish.” He adds that plant sources of iron may be less well absorbed because of other compounds in the plant, such as lectins and tannins, so that’s another to consider.
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“Vegans should definitely supplement with B12,” advises Dr Leeming. “It is found in meat and animal products and is important for neurological processes, including mood.” A vegetarian who eats dairy and eggs will not necessarily need a B12 supplement. But if they don’t have it that often, it might be worth checking their levels.
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The advice here is clear: yes, and ideally start before conception. It will contain folic acid, which is important for helping the neural tubes stay healthy, as well as iron and iodine. Be sure to choose a pregnancy-specific supplement, as it won’t contain vitamin A, high levels of which have been shown to contribute to birth defects.
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Yes, pregnancy is not the only time when women may need a supplement. Many premenopausal women are iron deficient, especially if they have heavy periods, which can cause debilitating fatigue. You can increase your iron through diet, but often women need this boost from a supplement, especially if they don’t eat meat.
After menopause, iron levels can return to the same as men, but there are different considerations. “Some women are advised to take calcium supplements because of concerns about osteoporosis,” says Dr Leeming. Many of us can get all the calcium we need from food, but if you don’t eat dairy, then it’s worth considering a supplement.
Similarly, B12, a brain nutrient, can be low after menopause. “But to be honest, we don’t really know because there hasn’t been enough research on it,” sighs Dr Leeming. “It’s scary how little research we have because it’s always been so male-focused. About 50 percent of the population will go through menopause, and yet we have a great lack of information and opportunities to improve their quality of life.
Not as much as women, but we all need more protein later in life to maintain muscle mass. And we’re less able to absorb nutrients as efficiently as we grow, so we have to pay more attention to getting everything we need.
In general, which is better: a multivitamin or an individual nutritional supplement?
“A multivitamin is a compromise designed to cover as many bases as possible, but with some compromises,” explains Goggins. “For example, water-soluble vitamins are better absorbed on an empty stomach, while fat-soluble vitamins and minerals are better absorbed with food. Nutrients often compete with each other: copper is inhibited by zinc, while vitamin E inhibits the absorption of vitamin D. And minerals like magnesium, iron, and zinc compete to cross the intestinal wall into the bloodstream.”
While multivitamins are quick and convenient to take, the nutrients in whole foods are designed to work together, not against each other—which is impossible to replicate in a pill. If you’re going to supplement, then ideally you’ll get a specific nutrient after identifying a deficiency. “If you have symptoms, your GP can arrange blood tests to check your iron and B12 levels, but there are many nutrients we can’t test through blood,” says Dr Leeming. “For most people, really focusing on their diet will be much more impactful for their health.”
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“Again, if you’re generally healthy, don’t worry,” says Dr Leeming. “Most of those on the market don’t contain enough live microbes to have any health effects.” And fermented foods are rich in good bacteria that will keep your gut happy. She cites kefir, in particular, as powerful research on its benefits for brain health. If you’re not a fan of kefir (or its fermented friends: sauerkraut, kimchi, and kombucha) the good news is that more foods are fermented than you might think, including cheese, olives, sourdough bread, and natural yogurt. The other thing that will keep your gut microbiome happy is fiber, otherwise known as raw plant food. It’s in all plants, so fill up on fruits, vegetables, nuts, seeds, beans, legumes and whole grains.
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