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One (not really vitamin) Supplement to Consider

To supplement or not-this is a question I get often.

My short answer-it depends. Before I get into whether you should or shouldn’t supplement, I have two important rules about supplements:

Rule #1: Supplements never replace food.

After all, whole food is medicine-so why supplement?

Sorry Juice Plus fans, but a pill you wash down with your fast-food meal isn’t really the same as eating a plate of roasted vegetables. Fruits and vegetables are more than the vitamins your pill is giving you. There is nothing in a pill that can mimic the feeling of fullness you get from eating produce. This is because food that is chewed takes up some space in your stomach while also triggering digestive hormones that let you know when you’ve had enough. Furthermore, pills that allegedly contain all of the nutrients you would get from eating apples, carrots, broccoli and greens are missing both fiber and phytochemicals.

Fiber helps with fullness-which is great for weight management. Fiber also “makes you regular”, which is not only important for overall digestive health, but also helps rid your body of environmental toxins and other by-products of metabolism that your body needs to excrete. It turns out there are lots of other reasons to get plenty of fiber throughout the day, and this isn't going to happen with a pill.

Phytochemicals are plant compounds that protect plants from environmental damage and protect humans from disease. Examples of phytochemicals you may have heard of include lycopene, found in tomatoes, watermelon, and red grapefruit, or lutein found in some green leafy vegetables.

The thing about phytochemicals-we don’t know how much you need to prevent disease. In other words, there is no such thing as a lycopene deficiency. However, we do know that getting phytochemicals from food, in the way provided by nature, can promote health and prevent chronic diseases such as cancer and heart disease.

It's important to understand the idea of getting food in the way nature intended, because supplements can sometimes give you much more than you can get from nature, and this can be dangerous, as I discuss below.

Rule #2: Supplements, if taken, are…supplements.

Supplements are meant to boost intake of something you are having difficulty in meeting requirements from the food you eat. This may be due to a host of factors, including a medical condition that makes it difficult to absorb certain nutrients from food as well as other conditions, such as pregnancy, that require higher amounts of certain nutrients to aid in fetal health.

More is not better, and can even be harmful to your health. For example, a Vitamin E supplement trial was stopped early when it was discovered that supplementation increased the risk of cancer, the very disease researchers hoped to show the supplement could prevent!

This was not the first supplement trial to stop early for such findings.

This underscores the importance of consulting with your doctor or other medical professional about whether supplements are right for you. Ideally, the person you consult does not sell supplements, so there is no bias in their recommendation.

Having given you my two big rules related to supplements, here is the one supplement that many people should consider (drum roll please…..):

Calciferol….Also Known as Vitamin D

Vitamin D has been in and out of the headlines for the past several years. Most recently, deficiency of this vitamin has been linked to Covid positive status. However, no causal role in preventing Covid has been identified, so this alone would not be a reason to take Vitamin D.

Vitamin D is not technically a vitamin-it is considered a prehormone. Some of it is used to synthesize a steroid hormone called calcitriol. Conversion to calcitriol has several powerful and positive health implications. In a nutshell, it appears that calcitriol made from Vitamin D helps the body regulate other hormones needed by the body through genomic mechanisms. For example, according to Dr. John Cannell, founder of the Vitamin D Council (now Society), if your body is making too much of another hormone linked to high blood pressure, calcitriol made from Vitamin D can step in and reduce the amount of the blood pressure raising hormone so blood pressure goes back into normal range.

That’s really amazing when you think about it!

Food Sources of Vitamin D

Vitamin D is naturally found in egg yolks and oily fish such as salmon, mackerel, and sardines. The fact that these foods are not very common in amounts necessary to maintain adequate Vitamin D levels combined with the government’s push for Americans to get plenty of dairy in their diets is one of the reasons why cow’s milk is a more likely source of Vitamin D for many Americans. The Vitamin D found in cow’s milk as well as many plant-based milks is not natural-it is added (just take a look at the ingredients on the label and you will see for yourself).

The last time I checked, the food sources listed above were not high on the list of most people I work with.

Where does this leave you?

Food Alternatives-Sunshine!

There’s a reason Vitamin D is also known as the “sunshine vitamin.” It turns out the best way to get your Vitamin D is through sunlight exposure. Ultraviolet light helps convert one of the body’s Vitamin D precursors into active Vitamin D. Once you don’t need any more Vitamin D, this mechanism will stop, so there is no danger of getting too much Vitamin D. However, we all know the dangers of too much sun, and for this reason we tend to lather our skin with lots of sunscreen, which interferes with Vitamin D therapy at the beach (something I'm personally having wild fantasies about as I look out my window during the midst of a winter snow storm)!

Applying the Supplement Rules

So, back to my rules about supplements-they shouldn’t replace food and they should be used to supplement if you can’t get enough.

Unfortunately, it’s nearly impossible for most of us to get enough Vitamin D from food, so this is a supplement to consider. However, before making the decision, ask your doctor to check your Vitamin D levels so you know your baseline. Depending on your results as well as other personal health and medical factors, your doctor may recommend anywhere from 2,000- 4,000 international units (IU’s) of over the counter Vitamin D, or in some cases, much higher levels as a prescription.

The tricky thing about vitamin supplements-they are not regulated. This means manufacturers use the honor system in telling you what’s really in their product. Unfortunately, not all manufacturers are so honest. The best way to feel good about the supplement you are taking is to find a brand that has the USP symbol. This indicates the supplement has been verified to contain the amounts of vitamin indicated on the label and does not contain any harmful ingredients not listed on the label.

When shopping for Vitamin D supplements, look for Vitamin D3 (not D2). Vitamin D3 supplements are less expensive, more commonly available, and more effective than Vitamin D2 supplements.

If you do start using Vitamin D supplements, continue to have your blood levels monitored and make sure to continue to notify your health care provider that you are using supplements.

And remember-whole food is medicine-so only supplement if and when necessary!

Dr. Amy Knoblock-Hahn is a registered dietitian nutritionist and health behavior expert.


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