The Supplement Myth

‘There is no need to take dietary supplements, as we get all the nutrients we need in food’. I hear this all the time, usually from overpaid health care professionals in the mainstream media, who generally have no clue what they are talking about. Their unsubstantiated claims are not however supported by the huge number of studies in the research literature that show many people around the World do not get anywhere near the nutrients they need from food. If you think about it, why do around half a million children in developing countries develop vitamin A deficiencies and go blind, if we ‘get all the nutrients we need in food’? Clearly, we do not, unless childhood blindness is not classed as important these days. Oh, and most of these children then die within a year, something that could be prevented with a simple, cheap vitamin A tablet costing a few pence. Add in pellagra, scurvy and beriberi and you have a serious need for dietary supplements in the developing World.

There is also a huge body of research that shows that developed nations have a massive epidemic of disease caused by insufficient nutrient intakes. The abundance of food ensures that the classical nutrient deficiencies are rare. But much of the typical Western diet is overly processed and devoid of any meaningful nutritional value. Consumption of this food produces subtle, sub-clinical deficiencies that take decades to manifest in degenerative diseases such as diabetes, cardiovascular disease, cancer and arthritis. A paper published in the American Journal of Clinical Nutrition in 19901 measured the mineral content of foods consumed by ten males in the United States and found that the percentage of diets containing less than the RDA for the various minerals were manganese 50%, copper 40%, zinc 87%, iron 37%, magnesium 37% and calcium 47%. Obviously these men were ‘not getting the nutrients they needed from food’.

Then there is the selenium deficient soil that results in increased risk of various types of cancer in certain provinces in China. Research has shown that those with the highest intakes of selenium have the lowest risk of cancer2. And guess what? The cancer rates fall when the people living in those areas take selenium tablets3. The true scale of the selenium deficiency problem in the West was demonstrated by research4 which showed that supplementing people with 200µg of selenium resulted in a 50% fall in morbidity and mortality from cancer. Can you argue that the people who died from cancer because they did not receive selenium supplements did not need supplements because ‘they got all the nutrients they need in food’? Apparently some people do, illogical as it may seem. What about the population of New Zealand who have low selenium intakes because of selenium deficient soils5? Again, supplements raise their selenium levels from below the recommended level, to above it.

In a typical Western diet the chromium intake per 1000 calories has been reported to be 15µg6. This means that to get the recommended chromium intake we would need to eat at least 3000 calories per day. So yes we can get the chromium we need from food, but it is  going to make us fat getting there. Researchers7 looking at children with haematological problems caused by vitamin B12 deficiency tried to elevate their levels with plant based foods. The plant based foods were completely unable to prevent further decline in the children’s vitamin status, and they deteriorated during the study. However, one child was given a supplement of vitamin B12 and guess what? Yes, this child improved dramatically. But I guess vegans ‘get all the vitamin B12 they need in their food’, despite the fact that plant sources of vitamin B12 are limited and likely not bioavailable. So yes we can ‘get all the nutrients we need in food’ as long as we are prepared to get fat and do not want to be a vegan.

More than half of the 3055 postmenopausal women sampled8 in one study were deficient in vitamin D, with 57.1% showing plasma levels of 25(OH)D of less than 50 nmol/L. Around 13% of the subjects had severe deficiencies of less than 25 nmol/L and were therefore at risk of developing osteomalacea, the classic vitamin D deficiency disease. But I am sure they were ‘getting enough vitamin D in their food, right’? Or what about the study that investigated the vitamin D status of children in New Zealand and found 80% of the children sampled in the winter had 25(OH)D3 levels below 50 nmol/L9. With 40 nmol/L the level below which serious ill health can manifest, these children were in severe danger of degeneration and disease. Ideally vitamin D levels should be at around 100 nmol/L. In another paper10 38% of residents in a nursing home and 54% in sheltered accommodation had vitamin D levels below 25 nmol/L. In Massachusetts general hospital, 57 % of patients had vitamin D levels below 40 nmol/L with 27 % of these below 20 nmol/L.

Nutrient losses in food processing are substantial and have been extensively reported in research11. The milling of whole grains to make refined four results in the loss of 72% of the vitamin B6, 86.3% of the α-tocopherol and 66.6% of the folate. Estimates for the total loss of minerals in refined flour are between 40.0 to 88.5%. White bread compared to whole grain bread had 40% less magnesium, 71.4% less chromium, 69.4% less cobalt, 69.8% less copper and 77.4% less zinc. Yes we can eat wholegrain bread, but the point is that most people do not. The nutrient removal from white bread is so extreme that in Britain, white bread is fortified with calcium, iron, thiamine niacin and riboflavin and folic acid to replace some of the nutrients removed. Removal of the nutrients from the production of white rice was how the vitamin thiamine was discovered, because the rice gave the people that ate it the disease beriberi. Studies on food poverty show that many cannot afford the extra cost of high quality foods required for health12.

In addition to bread, margarine is also nutrient stripped during processing and so it is fortified with vitamins A and D by manufacturers. Both the US and Canada currently fortify milk with vitamin D. The fact that food is fortified at all means that the ‘health authorities’ know perfectly well that there is a serious concern over low mineral and vitamin intakes when certain foods are consumed regularly. Think about it for a minute. Why would authorities fortify commonly eaten foods with nutrients if they were already present in foods? In Britain, breakfast cereal is fortified with B vitamins and certain minerals, after many of the original nutrients are stripped from the grain during processing. Often the nutrient dense bran is fed to farm animals because the vitamins and minerals it contains makes them healthy. The manufactures then sprinkle on a fraction of the nutrients they removed so they can write the names of the vitamins on the box. This insanity passes as acceptable practice of course to the men in expensive shiny suits.

Those who argue against dietary supplementation conveniently forget that white bread, milk, breakfast cereal and infant formulas are quietly fortified by government without any public consultation. What is the difference between taking supplemental vitamin D via a tablet or taking it via some margarine? Both are admission of inadequate food intake and an action to correct that deficiency. Personally I do not want to get fat chasing some dietician’s chromium pipe dreams, and I do not like the idea of being less healthy than a farmyard cow by eating refined grains. Taking a multi-vitamin and mineral as insurance against disease therefore makes perfect sense to me. It guarantees an adequate intake of nutrients that ensures that if I happen to eat an apple from the wrong side of the tree, my health is not affected. Of course we ‘don’t need dietary supplements as we get all the nutrients we need in foods’. So should I stick the tablet in my apple and pretend I fortified it just like the government does?

Just why anyone would want to convince others that ‘we get all the nutrients we need in food’ is a good question, and perhaps one that deserves at least a little consideration. This viewpoint certainly has not come from the research literature, because the amount of evidence arguing against it is insurmountable in any rational discussion. Given the excellent safety record of dietary supplements recorded in the medical literature, I can only imagine that it boils down to greed and money, as most things do. Of course, many of the people that make this argument do so in a forum where open debate and discussion is not permitted and so only one side of the argument is ever endorsed. Often the individual will hold a position of ‘authority’ in the mainstream health industry and will exaggerate the dangers of supplements without providing any evidence to support their accusations. Perhaps the 50% reduction in cancer rates from a safe and cheap 200µg selenium tablet would eat to far into their paymasters drug profits?


1Greger, J. L., Davis, C. D., Suttie, J. W. and Lyle, B. J. Intake, serum concentrations, and urinary excretion of manganese in adult males. American Journal of Clinical Nutrition. 3: 457-461
2Wei, W., Abnet, C. C., Qiao, Y., Dawsey, S. M., Dong, Z., Sun, X. and Fan, J. 2004. Prospective study of serum selenium concentrations and oesophageal and gastric cardia cancer, heart disease, stroke, and total death. Journal of Clinical Nutrition. 79: 80-85
3Blot, W.J., Li, J.Y., Taylor, P.R., Guo, W., Dawsey, S., Wang, G. Q., Yang, C. S., Zheng, S. F., Gail, M. and Li, G. Y. 1993. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. Journal of the National Cancer Institute. 85: 1483-1492
4Clark, L. C., Combs, G. F., Turnbull, B. W., Slate, E. H., Chalker, D. K., Chow, J., Davis, L. S., Glover, R. A., Graham, G. F., Gross, E. G., Krongrad, A., Lesher, J. L., Park, K., Sanders, B. B., Smith, C. L., Taylor, R. 1996. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. Journal of the American Medical Association. 276: 19571985
5Thomson, C. D., Chisholm, A., McLachlan, S. K. and Campbell, J. M. 2008. Brazil nuts: an effective way to improve selenium status. American Journal of Clinical Nutrition. 87: 379-384
6Anderson, R. A. and Kovlozsky, A. S. 1985. Chromium intake, absorption and excretion of subjects consuming self-selected diets. American Journal of Clinical Nutrition. 41: 1177-1183
7Dagnelie, P. C., van Staveren, W. A. and van den berg, H. 1991. Vitamin B-12 from algae appears not to be bioavailable. American Journal of Clinical Nutrition. 53: 695-697
8Millen, A. E., Wactawski-Wende, J., Pettinger, M., Melamed, M. L., Tylavsky, F. A., Liu, S., Robbins, J., LaCroix, A. Z., LeBoff, M. S. and Jackson, R. D. 2010. Predictors of serum 25-hydroxyvitamin D concentrations among postmenopausal women: the Women’s Health Initiative Calcium plus Vitamin D Clinical Trial. American Journal of Clinical Nutrition. 91: 1324-1335
9Houghton, L. A., Szymlek-Gay, E. A., Gray, A. R., Ferguson, E. L., Deng, X. and Heath, A. m. 2010. Predictors of vitamin D status and its association with parathyroid hormone in young New Zealand children. American Journal of Clinical Nutrition. 92: 69-76
10Hanley, D. A. and Davidson, K. S. 2005. Vitamin D insufficiency in North America. Journal of Nutrition. 135: 332-337
11Schroeder, H. A. 1971. Losses of vitamin and trace minerals resulting from processing and preservation of foods. American Journal of Clinical Nutrition. 24: 562-573

12Rehm, C. D., Monsivais, P. and Drewnowski, A. 2011. The quality and monetary value of diets consumed by adults in the United States. American Journal of Clinical Nutrition. 94: 1333-1339