From The Straits Times    |

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With so much emphasis being placed in recent years on leading a healthy lifestyle, it seems that we now have a need to consume practically anything advertised that tells us we’ll live longer, healthier lives.

Ask around and you’ll probably find that many of your family and friends take health supplements every day.

Health supplements include a range of vitamins and minerals that add to the nutrients that we already get through our diet.

Some are derived from natural sources but some are also created in labs.

Louis Yap, a dietitian at Mount Elizabeth Novena Hospital, advises to do a health check prior to taking any form of supplements as blood tests may show what may be deficient in the body.

Also, a dietitian may pinpoint the potential lack of food groups that links to the deficiency in certain nutrients.

“If one is skipping these steps, then make sure the supplements purchased are from a reliable source, and to check the expiration date of the supplement,” he adds.

Here are the most common supplements and why you should or shouldn’t take them.


1. Vitamin C

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This vitamin works as an antioxidant and reduces the harmful effects of free radicals, which are reactive particles that are generated in the cells from normal bodily processes such as breathing, breaking down food and toxins. Vitamin C is also important for collagen formation, an important part of the connective tissue found in our skin, bones, joints and gums.

Should you take it: Since vitamin C is commonly found in fruits and vegetables, you probably won’t need it if you eat enough of them.

“If an individual does not consume fruits and vegetables, then perhaps the supplement needs to be considered,” says Mr Yap. “Otherwise, it is generally found in most food, to meet the requirement of 105mg for men and 85mg for women. For example, a 3/4 cup of orange juice contains 93mg of vitamin C, while about 100g of broccoli (one serving) would provide 51mg.”

You could also take these supplements in certain situations.

“Supplementation may be useful in the case of excessive stress (e.g. increasing physical training, stressful circumstances to reduce the likelihood of viral infections), and can also be considered at the onset of symptoms of a viral infection to reduce the likelihood of developing a full-blown illness or to reduce the severity of symptoms,” says Dr Julinda Lee, a gynaecologist at Wellness & Gynaecology Centre who also has a Masters of Science in Human Nutrition and Functional Medicine.

What you should note: The good thing about vitamin C is that it’s a soluble vitamin so even if it’s consumed in excess, it’s excreted from the body and unlikely to cause any harm except for some side effects such as abdominal cramp or diarrhoea.


2. Omega-3/fish oil

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Our bodies can’t make omega-3 fatty acids; they can only be obtained from our diet or through supplementation. The most common sources of omega-3 are fatty/oily fish, dark green leafy vegetables, nuts and seeds.

Omega 3 fatty acids are good for brain development and also reduce inflammation in the body.

Should you take it: Dr Lee explains that individuals who have a diet high in vegetables, good quality meats or eggs and fatty fish do not require omega-3-fatty acid supplementation. But those who have increased inflammation – which can manifest as excessive aches and pains, depression, heart disease, diabetes – may need to consider supplementation.

Mr Yap adds that this supplement is required when an individual is a vegan or avoids consumption of oily fishes.

What you should note: However, Mr Yap cautions about the amount to take.

“It was documented that a high dosage of omega-3 (3 g/day) may risk bleeding, abnormal heart rhythm, or cardiovascular disease; a 1 gram dose would be sufficient.” Also, there are also non-fish related omega-3 supplements, for those who prefer plant-based options.


3. Calcium

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This mineral is best known for its role in bone health and dairy products are often heralded for their high calcium content and their importance for reducing the risk of osteoporosis and related fractures. For those with lactose intolerance, non-dairy products that are also sources of calcium include green leafy vegetables, sardines with bones, fortified cereals, almonds, and soy products such as tofu and soy milk.

Should you take it: “Osteoporosis, an increased porousness and fragility of bones, is often thought of as a woman’s disease, as pregnancy, lactation and the drop in oestrogen levels in menopause increases the rate of bone loss,” Dr Lee explains.

“Calcium supplementation is typically seen in women who may start these supplements as early in life as their first pregnancy. Many Asians are lactose intolerant and unable to tolerate milk and this is often the reason for being on calcium supplementation.”

There are many forms of calcium supplements including calcium carbonate, calcium citrate and calcium hydroxyapatite. They are often formulated with vitamin D which is important for its role in regulating the absorption of calcium.

Calcium can also be deposited in soft tissues instead of the boney tissues, hence calcium supplementation should also include magnesium as well as vitamin K2 which help ensure that the calcium absorbed is directed to boney tissues.

What you should note: Mr Yap mentioned that a high dosage of calcium that hits the upper limit of 2500 mg/day may risk developing soft tissue calcification, kidney stones, cardiovascular disease and constipation. It’s also important to keep calcium and iron supplements at least two hours apart (if you’re taking both) as they compete for absorption.


4. Iron

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The main function of iron is to transport oxygen in the red blood cells throughout our body. It also has a role in the production of some tissues such as keratin in hair and nails. You can get iron from red meat and dark green leafy vegetables, although it may be more poorly absorbed from the latter.

Should you take it: Women are at a greater risk of iron deficiency and can develop anaemia (a reduction in haemoglobin in the blood), which commonly presents as pallor and tiredness, says Dr Lee.

This is due to monthly menstrual blood loss so women with heavy menstrual blood loss often supplement with iron. Women who are vegan or vegetarian may also find it hard to have sufficient dietary iron, she adds.

What you should note: Iron supplements are notorious for its effect on the gastrointestinal system, especially constipation. Iron in excess can accumulate within tissues in the body and result in damage to these tissues through the generation of free radicals. It is therefore important to supplement with iron only when blood tests confirm a deficiency, says Dr Lee.


5. Protein

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A favourite go-to drink with gym goers, protein facilitates muscle recovery from the wear and tear during exercise. You can also get protein from meat including fish, chicken, beef and pork, and plant-based protein comes from soy, beans and lentils. Milk is also a good option.

Should you take it: “General non-athletic adults who exercise regularly for one hour, four to five times a week, do not need to take extra protein supplements,” says Mr Yap.

“I would only say top-performing athletes, who train for two hours or more, twice a day, every day, would benefit from taking this supplement, as training hours often affect meal times, which directly affects meeting nutritional requirements.”

What you should note: Overconsumption of protein supplements may lead to excessive calorie intake or weight gain. Generally, a healthy adult needs 0.8-1 g of protein per kilogram of body weight.


6. Vitamin D

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This helps to absorb calcium in our body, promote bone growth, and is also essential in cognitive functions and for our immune system. You can get a good dose of vitamin D from the sun so Mr Yap advises to stand under the sun for 15 minutes a day, exposing the arms and face – this should give you an adequate amount of vitamin D. However, you may need a longer time under sunlight if you have a darker skin tone or wear more to cover your body due to religious reasons. Alternatively, take foods such as egg yolk, oily fish, cod liver oil, milk and milk products such as cheese and yoghurt.

Should you take it: Vitamin D supplements are only required for people living in countries with limited sunlight, or who have a vitamin D deficiency.

What you should note: A too-high dosage (upper limit of 50,000 IU daily for several months) of vitamin D may lead to high uptake of calcium, leading to constipation, nausea and loss of appetite.


7. Multi-vitamins

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Multi-vitamins are a combination of many different vitamins that are normally found in foods and other natural sources. They are used to supplement your daily needs if one is not taking in enough through your diet.

Should you take it: Dr Lee explains that because a multi-vitamin typically contains a combination of nutrients close to what is recommended for the average adult, the benefit of this is that there is a lower likelihood of developing a nutrient insufficiency as a result of taking a large amount of another nutrient. However, in a patient who presents with illness or symptoms related to nutrient deficiency e. g. bone loss or osteoporosis, taking a multivitamin will not provide sufficient calcium or vitamin D, and supplementing these nutrients with a separate supplement will be needed.

What you should note: Multi-vitamins do not contain important nutrients that may be found in real food, including fibre and plant chemicals such as polyphenols which have important benefits on our health. Multi-vitamins are sufficient “only if that individual is already eating well and occasionally may have forgotten to take that vegetable or fruit”, Mr Yap says.

Lastly, is there such a thing as taking too many supplements?

The question you should ask yourself before taking any supplement is – “Is it necessary?”. “Spending so much money just to take supplements when one can enjoy real food is not worth the comforts and satisfaction,” Mr Yap says.