Category: Nutrition

What vitamin or mineral supplement do we need and which should be avoided?

Over half of the U.S. population take dietary supplements including vitamins, minerals, and herbs.

In 2021, Americans alone spent 50 billion dollars on dietary supplements.

For years many thought that supplements including vitamins and minerals were important for a healthy lifestyle, but what if this is not true and supplements can’t fill the nutritional gaps in our diet?

A review of 84 studies reveals that supplements are often a waste of money and some of them can be harmful to individuals.

The result is surprising as the case for supplements seems strong since foods such as nuts, fish, wholegrains, pulses, eggs, dairy, fruits, and vegetables are rich in nutrients with antioxidative and anti-inflammatory effects.

These nutritious foods have been shown to lower the risk of cardiovascular disease and cancer.

So, the idea that supplements can mimic the effect of vitamins and minerals in foods seems convincing.

However, micronutrients such as phytochemicals, vitamins, minerals, fibre in fruits and vegetables work together along with other nutrients to give the body what it needs.

Whereas these nutrients when extracted and used in isolation won’t have the same health effect as natural foods.

Dr Jeffrey Linder, the study’s senior author, said:

“Patients ask all the time, ‘What supplements should I be taking?’

They’re wasting money and focus thinking there has to be a magic set of pills that will keep them healthy when we should all be following the evidence-based practices of eating healthy and exercising.”

According to Northwestern Medicine scientists, there is not enough evidence for non-pregnant, otherwise healthy adults to take multivitamins or single or paired supplements.

In addition, the United States Preventive Services Task Force (USPSTF) guidelines recommend avoiding beta-carotene supplements as these may increase the odds of cancer.

They also advise against taking vitamin E as the supplement doesn’t reduce cardiovascular disease, cancer, or death from any cause.

Dr Linder said:

“The task force is not saying ‘don’t take multivitamins,’ but there’s this idea that if these were really good for you, we’d know by now.

The harm is that talking with patients about supplements during the very limited time we get to see them, we’re missing out on counseling about how to really reduce cardiovascular risks, like through exercise or smoking cessation.”

However, Dr Linder noted that dietary supplements such as vitamin D and calcium can help people with deficiency, for example, preventing bone loss in the elderly.

Or certain vitamins, such as folic acid (vitamin B₉) are vital during early pregnancy to prevent birth defects.

Dr Natalie Cameron, study co-author, said:

“Certain vitamins, such as folic acid, are essential for pregnant women to support healthy fetal development.

The most common way to meet these needs is to take a prenatal vitamin.

More data is needed to understand how specific vitamin supplementation may modify risk of adverse pregnancy outcomes and cardiovascular complications during pregnancy.”

The study was published in the JAMA (Jia et al., 2022).

Modern lifestyles mean many people do not get enough of this vitamin.

Taking a daily vitamin D supplement could reduce the risk of dying from cancer by 13 percent, research finds.

Vitamin D is produced by the body when the skin is exposed to sunshine.

Vitamin D may work to protect the body against cancer through the production of an enzyme that attacks acids linked to cancer.

Modern lifestyles mean many people do not get outside enough.

Up to half of the world’s population is deficient in vitamin D.

Depression symptoms like energy loss, concentration problems and lack of pleasure can be signs of vitamin D deficiency.

Vitamin D is found in oily fish, egg yolks, fortified cereals and some margarine spreads.

The conclusions come from three new separate studies presented at the American Society of Clinical Oncology conference in Chicago.

One study found that vitamin D deficiency is linked to double the risk of pancreatic cancer and a higher risk of bowel cancer.

Dr. Shifeng Mao, study author, said:

“We are living in a modern society with a fast-paced lifestyle.

People spend significant amount of time at work in a concrete building and have much less time for leisure, let alone being exposed to nature and sunlight, so Vitamin D deficiency is prevalent.”

A second study including 79,000 people found that taking a vitamin D supplement reduced the risk of cancer by 13 percent.

Dr Tarek Haykal, that studies author, said:

“I would like to see more oncologists and primary care doctors consider prescribing vitamin D for their patients as it carries many benefits with minimal side effects.”

A third study involving 2,280 men found that those given vitamin D, along with statins, were at a 38 percent lower risk of dying of prostate cancer.

Other studies presented at the same conference found that exercise helps cancer patients to survive for longer.

The studies were presented at American Society of Clinical Oncology conference in Chicago in 2019.

Good sources of vitamin B12 include fish, poultry, eggs and low-fat milk.

Memory problems can be a sign of vitamin B12 deficiency, research finds.

People with B12 deficiency can experience worse memory for both ideas and events.

The vitamin deficiency has also been linked to Alzheimer’s disease and brain shrinkage by some research.

The good news is that B12 deficiency is relatively easy to correct with a change in diet or supplementation.

Good sources of vitamin B12 include fish, poultry, eggs and low-fat milk.

Fortified breakfast cereals also contain vitamin B12.

People who may have difficulty getting enough vitamin B12 include vegetarians, older people and those with some digestive disorders, such as Crohn’s disease.

The conclusions about the link between Alzheimer’s and B12 come from a study of 271 Finnish people aged 65-79 who were followed for 7 years.

At the start of the study, all were healthy — however, by the end, 17 had developed Alzheimer’s.

Blood tests showed that higher levels of vitamin B12 were associated with a lower risk of developing the disease.

Dr Babak Hooshmand, the study’s first author, said:

“Our findings show the need for further research on the role of vitamin B12 as a marker for identifying people who are at increased risk of Alzheimer’s disease.

Low levels of vitamin B12 are surprisingly common in the elderly.

However, the few studies that have investigated the usefulness of vitamin B12 supplements to reduce the risk of memory loss have had mixed results.”

Dr Hooshmand cautioned that B12 supplements for memory problems are not yet supported unequivocally by the research:

“More research is needed to confirm these findings before vitamin B12 should be used solely as a supplement to help protect memory.”

The study was published in the journal Neurology (Hooshmand et al., 2010).

This facial symptom can be irritating.

A twitching near the eyes can be a sign of vitamin B12 deficiency.

Twitches normally happen in one or the other eye — they can be irritating but they are not normally painful.

Similarly, a tingling sensation in the legs, feet or hands can also signal a vitamin B12 deficiency.

The feeling can start in the legs and then, later, move to the hands.

It can be accompanied by difficulties balancing or walking.

This problem is known as neuropathy and is more common in those over 50-years-old.

Other frequent signs of vitamin B12 deficiency include feeling dizzy and lethargic, being constipated, muscle weakness and jaundice.

Vitamin B12 is used by the body to keep the nervous system healthy and to make red blood cells.

Certain groups have difficulty getting enough vitamin B12, such as older people, vegetarians and people with digestive disorders, like Crohn’s disease.

Fortunately, vitamin B12 deficiency is relatively easy for most to rectify.

Supplements are available, or foods such as fortified cereals, liver, dairy, eggs and salmon are all high in vitamin B12.

Dr John D. England, a neurologist at Louisiana State University Health Sciences Center in New Orleans, said:

“People with suspected nerve problems should talk to their doctors about screening tests, especially blood glucose, vitamin B12 level and serum protein levels, since these tests can often point to common causes of neuropathy.”

Dr England continued:

“There are many people with a neuropathy who have been walking around for years without having been diagnosed and treated.

Both neurologists and people with neuropathy need to know that the appropriate choice of tests is critical to accurate diagnosis.”

Be aware that eye twitching can also be linked to tiredness, stress, allergies and dry eyes, among other causes.

The guidelines were published in the American Academy of Neurology.

Experts have estimated how much vitamin C we need relative to our body weight to boost the immune system.

People who weigh more need more vitamin C for a strong immune system to help fight against respiratory infections including COVID-19 and flu during colder months.

Experts have estimated how much vitamin C we need relative to our body weight to boost the immune system and also reduce the odds of heart disease.

So, it would be wise for heavier people to add to their diet more fruits and vegetables high in vitamin C such as strawberries, oranges, kiwis, and kale.

Past studies suggest that poor vitamin C levels in overweight and obese people could imbalance enzyme functions and so increase the risk of low-grade inflammation, cardiovascular diseases, respiratory infections, and getting frequent colds.

Researchers identified that for every extra 10 kilograms an individual carries they need to take 10 milligrams more vitamin C per day to maximise immune system functioning.

For example, if a 60 kg adult requires 110 mg of vitamin C per day then someone who weights 90 kg needs a 140 mg daily intake to obtain a comparable plasma vitamin C concentration.

Professor Carr, the study’s first author, said:

“Previous studies have already linked higher body weight with lower vitamin C levels.

But this is the first study to estimate how much extra daily vitamin C is actually needed for people, relative to their body weight, to help maximize their health.”

Public health officials should revise the guidance on vitamin C intake levels as the nutrient is important for immune health and helps protect our body against viral infections such as COVID-19 and flu.

Taking the correct amount of vitamin C could protect heavier people from such diseases.

Professor Carr said:

“We know obesity is a risk factor for getting COVID-19 and that obese patients are more likely to struggle to fight it off once infected.

We also know that vitamin C is essential for good immune function and works by helping white blood cells fight infection.

The results from this study therefore suggest that increasing your vitamin C intake if overweight might be a sensible response.

Pneumonia is a major complication of COVID-19 and patients with pneumonia are known to be low in vitamin C.

International research shows that vitamin C decreases the likelihood of people getting pneumonia and decreases the severity of it, so finding the right levels of vitamin C to take if you are overweight may help to better support your immune system.”

The best way to achieve the optimal levels of vitamin C is eating fruits and vegetables rich in vitamin C rather than taking supplements.

Professor Carr said:

“The old saying of ‘an apple a day keeps the doctor away’ is actually useful advice here.

An average-sized apple contains 10 milligrams of vitamin C, so if you weigh 70 to 80 kilograms, achieving the optimal amount of vitamin C your body needs could be as easy as eating an extra apple or two to give your body the extra 10 to 20 milligrams of daily vitamin C it needs.

If you weigh more than this, then perhaps an orange, which contains 70 milligrams of vitamin C, or a kiwifruit with 100 milligrams, may be the easiest solution.”

The study was published in the journal Nutrients (Carr et al., 2022).

Foods high in vitamin B12 include shellfish, eggs, fish, poultry, meats and milk.

A vitamin B12 deficiency means there is not enough vitamin B12 circulating in the body.

Mentally, prolonged vitamin B12 deficiency has been linked to a range of symptoms.

These include memory issues, confusion, irritability, depression and even psychosis, which is starting to believe things that are not true.

Other physical rather than mental symptoms of a vitamin B12 deficiency include headaches, fatigue, breathlessness and pale skin.

It is thought that up to six percent of people under 60-years-old have a vitamin B12 deficiency.

For those over 60, the figure could be as high as 20 percent.

Vitamin B12 is involved in the function and development of the nervous system and in the formation of red blood cells.

If vitamin B12 deficiency is not treated, it can even lead to vision loss, tingling in the extremities, nerve damage, mouth ulcers and problems with the tongue.

People who suspect they have a B12 deficiency should first get it checked with a test.

People who are particularly susceptible to a vitamin B12 deficiency include vegetarians and vegans as well as older people.

The former can get little B12 in their diet while the latter tend to have difficulties with absorption.

Other people with a higher risk of a B12 deficiency include those with digestive disorders, such as Crohn’s disease and IBD.

In the normal course, though, taking a B12 supplement is one of the easiest ways to combat this problem.

Adults need around 1.5 mcg per day.

For those who have problems with absorption, regular shots may be required.

Usually, symptoms of a vitamin B12 deficiency will clear up with treatment over time.

However, the longer that the condition goes untreated, the more likely it is that permanent damage will be caused.

Foods high in vitamin B12 include shellfish, eggs, fish, poultry, meats and milk.

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Bloating is a frequent symptom of irritable bowel syndrome and is triggered by specific types of diet.

A low-fibre diet can help to reduce the stomach discomfort, pain, bloating, flatulence, and diarrhoea linked to irritable bowel syndrome, research finds.

Typical foods to avoid include:

• garlic,
• artichokes,
• onions,
• Brussels sprouts,
• cabbage,
• peas,
• cereals,
• soy beans,
• celery,
• beans,
• cauliflower,
• leeks,
• bread and pastries made of wheat,
• corn,
• broccoli,
• bananas,
• carrots,
• grapes,
• peaches and figs.

All these foods are known technically as fermentable oligosaccharides, disaccharides, monosaccharides and polyols or FODMAPs.

FODMAPs are resistant to digestion and tend to absorb water.

These fermentable foods are components of what is known as a “flatulogenic” diet.

This tends to increase intestinal gas production due to changes in the microbiota, the microorganisms living in the human body.

FODMAPs are used by gut bacteria as a fuel, resulting in the production of the hydrogen and methane gas responsible for bloating in some people.

They also produce hydrogen sulfide, which produces a similar smell to rotten eggs.

On the other hand, healthy people’s gut microbiota remains unaffected or less disturbed by this type of food.

Professor Giovanni Barbara, one of the microbiota experts who presented this topic at the Gut Microbiota for Health World Summit in Miami, said:

“Recent findings suggest that IBS is linked to clearly detectable gut microbiota alterations.

Additionally, bloating can be related to specific kinds of diet, thus opening up promising paths towards an efficient disease management.”

For many years, conditions such as bloating and IBS were considered a psychological disorder mostly affecting young females with anxiety.

As a result, it seemed to be an imaginary illness and so patients were not treated seriously.

Today around 20 percent of the population in Western countries suffer from IBS, with the most common complaint being bloating.

Diarrhoea, sudden urges to have bowel movements, discomfort and abdominal pain are symptoms of gastrointestinal disorders such as IBS (irritable bowel syndrome).

Professor Barbara said:

“We now know for sure that diets containing low fiber content improve these symptoms significantly.

Recent research results suggest that, compared to a normal Western diet, a diet low in so-called FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) reduces symptoms of IBS, including bloating, pain and passage of wind.”

The study was published in the journal PLoS One (Sloan et al., 2019).

Two vitamin Ds share a very similar structure, but only one of them is important for human health and could fight infections.

While the importance of vitamin D on human health is undeniable, experts question if vitamin D2 (ergocalciferol) has any beneficial effect, but are sure about vitamin D3 (cholecalciferol).

This pro-hormone is involved in a wide range of activities such as helping the body to use calcium for bone health and preventing osteoporosis, reducing depression, heart disease and some cancers, and boosting the immune system.

A study suggests there is a big difference between the two vitamin Ds, with vitamin D3 strengthening the immune system against infections such as COVID-19 but vitamin D2  having no effect on human health.

The study examined the effect of vitamin D2 and vitamin D3 supplementation on women aged between 20 to 64 for 3 months in winter.

One group received none (placebo), the second a daily dosage of 15 μg vitamin D2, and the third 15 μg vitamin D3 per day, within fortified orange juice and biscuits.

The results showed that vitamin D3 could activate the immune system by making it stronger against bacterial and viral diseases whereas vitamin D2 didn’t show any impact on human health.

Professor Colin Smith, the study’s senior author, said:

“We have shown that vitamin D3 appears to stimulate the type I interferon signaling system in the body—a key part of the immune system that provides a first line of defense against bacteria and viruses.

Thus, a healthy vitamin D3 status may help prevent viruses and bacteria from gaining a foothold in the body.

Our study suggests that it is important that people take a vitamin D3 supplement, or suitably fortified foods, especially in the winter months.”

Vitamin D2 is found in some plants and fungi like mushrooms, while some animal sources contain vitamin D3.

Although both forms of the vitamin are sold as food supplements or found in some fortified foods such as bread, yogurts, juices, breakfast cereals, most vitamin D3 comes from exposure to sunlight and is produced in the skin.

Many people are vitamin D3 deficient due to living in poor climates like the UK where sunlight is insufficient, especially in the winter.

Moreover, in the past few years, due to the pandemic, exposure to the sun has been reduced dramatically as many people were in lockdown or working from home.

Professor Susan Lanham-New, study co-author, said:

“While we found that vitamin D2 and vitamin D3 do not have the same effect on gene activity within humans, the lack of impact we found when looking at vitamin D2 means that a larger study is urgently required to clarify the differences in the effects.

However, these results show that vitamin D3 should be the favored form for fortified foods and supplements.”

The study was published in the journal Frontiers in Immunology (Durrant et al., 2022).

In the winter months, when less sunlight hours are available, it can be difficult to get the requisite amount of vitamin D.

Sadness can be one of the consequences of a vitamin D deficiency.

When people are low in this vitamin they sometimes feel a loss of interest in activities that they used to be motivated to perform, such as work and exercise.

Low levels of vitamin D have also been linked to anxiety disorders.

Indeed, people diagnosed with anxiety disorders often have low levels of the vitamin in their bloodstream.

A vitamin D deficiency has also been linked to severe fatigue and poor sleep quality — both of which are clearly associated.

Most people get enough vitamin D during the summer months from their exposure to sunlight.

The body produces vitamin D when sunlight hits the skin.

However, in the winter months, when less sunlight hours are available, it can be difficult to get the requisite amount.

Around one-in-five people are thought to have a vitamin D deficiency.

A deficiency in this vitamin is particularly prevalent among people with darker skin, who do not leave the house or who are pregnant or have problems with absorption.

Vitamin D supplementation is one option for correcting the problem.

Around 10 mcg per day is the dose often recommended.

A change of diet can also help the problem.

Vitamin D is particularly abundant in foods like milk, liver, fatty fish, and egg yolks.

Avoid too much vitamin D

At the other end of the scale, some people take too much vitamin D supplementation.

Signs of very high levels of vitamin D include excessive urination, vomiting, muscle weakness and dehydration.

Too much vitamin D can even lead to kidney stones, loss of appetite, pain and confusion.

It is not possible to get too much vitamin D from sun exposure, so it is almost always taking too many supplements that is to blame.

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