What do you want from an all-in-one vitamin and mineral nutritional health supplement?
To make sure you are not deficient in any important vitamin or mineral? A one-a-day A-Z supplement pill at 100% of the RDAs will do that. On the other hand deficiency diseases like scurvy and rickets are rare.
Or do you want to reduce the risk of long term health problems – age related diseases like heart disease, stroke, diabetes, arthritis and even cancer? Unfortunately extensive research shows that the one-a-day vitamin pills are unlikely to have this effect. That’s why you see headlines like ‘Vitamin pills are a waste of money’.
So I suggest the real question is “What all-in-one supplements can create an environment in your body that reduces the risk of long term health problems?”
Can you really get all the nutrition you need from a “balanced diet”?
We still often hear this claim. It might have been true 50 or 60 years ago. But 50 years ago we were far more physically active and ate more. More food means more nutrients.
In contrast, today’s low energy, sedentary, and largely indoor lifestyles mean that most people have had to cut their average daily food intake to about 2,000 – 2,500 calories a day if they are not to put on weight. Even if you choose and mix your foods scrupulously, you cannot get a full range and amount of the most important health-protective nutrients at today’s calorie intakes.
Take just vitamins C and D. According to the US National Health and Nutrition Examination Survey (NHANES) 25% of people do not reach the RDA of Vitamin C and 70% do not reach the RDA for Vitamin D. The situation is almost the same in the UK.
But these are just nutrients for which there ARE RDAs. We now know that some of the most important nutrients for long term health have not yet had RDAs established for them; such as the omega 3 fatty acids and the polyphenols, two classes of nutrient that have critically important anti-inflammatory properties.
Why do we need these anti-inflammatory nutrients in an all-in-one supplement? Because they protect us against called ‘chronic sub-clinical inflammation’, an insidious and invisible process that develops in our tissues and which is now known as a driver of all the degenerative diseases, from cancer to Alzheimer’s to heart disease, diabetes, arthritis and osteoporosis; not to mention sexual dysfunction, ageing of the skin, and indeed the bulk of the ageing process.
There is overwhelming evidence that Omega 3 fish oil is heart-protective, helps to protect brain function and has a role to play in reducing the risk of cancer. But few people have sufficient Omega 3 in their normal diet. You would need to eat 3-4 portions of oily fish such as herring, mackerel, sardines or wild salmon (not farmed) a week.
There is equally good evidence to support the importance of polyphenols, a group of phyto-nutrients found in fruits and vegetables, to our long-term health. So much so that the American Cancer Society and many other authorities now recommend 9 portions of fruit and vegetables a day!
Preventing deficiency is not enough
It now becomes much clearer why the best and most effective all-in-one supplements need to go beyond a simple vitamin and mineral pill.
Up to the age of about 50, the aim of a well-designed supplement should be to ensure you have a full spectrum of vitamins and minerals, plus adequate Omega 3 fish oil, plus polyphenols including flavonoids.
To recap, Omega 3s and polyphenols are important because they are anti-inflammatory nutrients which protect us from the silent danger of chronic sub-clinical inflammation. As Scientific American confirmed in a major review:
“Inflammation is an underlying contributor to virtually every chronic disease … rheumatoid arthritis, Crohn’s disease, diabetes and depression, along with major killers such as heart disease and stroke. The connection between inflammation and cancer has now moved to center stage in the research arena.”
We now know, however, that these dangers can be lessened by taking two simple steps. Firstly, we must reduce pro-inflammatory factors in our lifestyle, like high temperature cooking and fast foods which a mostly cooked at high temperatures.
Secondly, we should increase the level of anti-inflammatory nutrients in our diet. That’s why increasing the amount of fruits, vegetables and oily fish – which provide the key anti-inflammatory nutrients – is so important.
And that’s why I recommend Omega 3 and polyphenol supplements – such as derived from curcumin, green tea and grapeseed extract. They are powerful anti-inflammatory ingredients.
You need these elements even in your 30s and 40s, because over time, inflammation causes slowly progressive damage in the tissues leading up to the emergence of clinical symptoms will have been gradually accumulating for decades.
Over 50, add more nutrients to your all-in-one supplement
Over the age of 50, when the powers of healing and regeneration are no longer as effective as they were in youth, there are further protective steps you can take.
For example, the evidence for the carotenoid supplements such as beta carotene, lutein and lycopene is persuasive. Lutein appears to have a protective effect for eyes and the laboratory research for the anti-cancer effect of lycopene is increasingly convincing.
I would also add the nutrients betaine, Co-enzyme Q10 and soy isoflavones. Soy isoflavones are one of the dietary elements that contribute to the generally better health and life expectancy of the Japanese.
All these nutrients occur in high levels in the diets of those societies that have a long life expectancy and health expectancy – and overall, it’s an all-in-one supplement combination designed to reproduce the elements of that ideal diet.
Although food and supplements cannot treat or cure age-related disease, they can create a climate in the body where disease is less likely to develop or worsen, and where the body’s own ability to heal itself is supported.
Don’t bother with vitamin and mineral supplements labelled as being especially for women or men. These are marketing gimmicks. We’re all human and we all need the almost the same vitamins and minerals.
The only exception is iron. Iron in men and post-menopausal women can potentially accumulate to the point where it becomes pro-inflammatory and pro-oxidative, so I would not include it in an all-purpose supplement. But pre-menopausal women should include it. Some women may also benefit from extra calcium, although if you have regular dairy products and leafy green vegetables you should have adequate calcium.
Don’t bother with specialist supplements either – for eyes or heart or for the brain. Why try to protect one vital organ and leave others undefended? Especially when the secret of brain, eye, heart and indeed sexual health, lies in reducing the tissue damage inflicted by chronic inflammation.
You can now see why simple A-Z vitamin pills have little impact on reducing long term age related illness. They are only designed to avoid deficiency diseases. They have little or no anti-inflammatory effect and so cannot combat the key driver of age-related health decline, namely chronic inflammation.
Only a truly comprehensive all-in-one nutrient support programme can do that. You can see details of NutriShield, which I designed to help cut the risk of age-related illness at www.nutrishield.com.
If you enjoyed this article, please share it with family and friends (see buttons below).
Dr Paul Clayton’s best-selling book Health Defence is available from most good bookstores. See the website www.healthdefence.com for excerpts and links to buy direct from the publisher.
See online here for delicious recipes from the Health Defence Cookbook incorporating healthy foods featuring in a Mediterranean Diet.
1. Clayton P, Rowbotham J. How the mid-Victorians worked, ate and died. Int J Environ Res Public Health. 2009 Mar;6(3):1235-53
2. Ames BN. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage. Proc Natl Acad Sci U S A. 2006 Nov 21;103(47):17589-94
3. Ames BN. Optimal micronutrients delay mitochondrial decay and age-associated diseases. Mech Ageing Dev. 2010 Apr 24. [Epub ahead of print]
4. Schick B. A tea prepared from needles of pine trees against scurvy. Science. 1943 Sep 10;98(2541):241-2
5. Bolland MJ, Avenell A, Baron JA, Grey A, Maclennan GS, Gamble GD, Reid IR. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010 Jul 29;341:c3691. doi: 10.1136/bmj.c3691.
6. IoM Worksop Summary. The Development of DRIs 1994–2004: Lessons Learned and New Challenges. November 30, 2007
7. Jiang Q, Moreland M, Ames BN, Yin X. A combination of aspirin and gamma-tocopherol is superior to that of aspirin and alpha-tocopherol in anti-inflammatory action and attenuation of aspirin-induced adverse effects. J Nutr Biochem. 2009 Nov;20(11):894-900
8. Royer MC, Lemaire-Ewing S, Desrumaux C, Monier S, Pais de Barros JP, Athias A, Néel D, Lagrost L. 7-ketocholesterol incorporation into sphingolipid/cholesterol-enriched (lipid raft) domains is impaired by vitamin E: a specific role for alpha-tocopherol with consequences on cell death. J Biol Chem. 2009 Jun 5;284(23):15826-34
9. Sacha B, Zierler S, Lehnardt S, Weber JR, Kerschbaum HH. Heterogeneous effects of distinct tocopherol analogues on NO release, cell volume, and cell death in microglial cells. J Neurosci Res. 2008 Dec;86(16):3526-35
10. Ren Z, Pae M, Dao MC, Smith D, Meydani SN, Wu D. Dietary supplementation with tocotrienols enhances immune function in C57BL/6 mice. J Nutr. 2010 Jul;140(7):1335-41
11. Sen CK, Khanna S, Roy S. Tocotrienols in health and disease: the other half of the natural vitamin E family. Mol Aspects Med. 2007 Oct-Dec;28(5-6):692-728. Epub 2007 Mar 27. Review.
12. Comitato R, Leoni G, Canali R, Ambra R, Nesaretnam K, Virgili F. Tocotrienols activity in MCF-7 breast cancer cells: involvement of ERbeta signal transduction. Mol Nutr Food Res. 2010 May;54(5):669-7
13. Pierpaoli E, Viola V, Pilolli F, Piroddi M, Galli F, Provinciali M. Gamma- and delta-tocotrienols exert a more potent anticancer effect than alpha-tocopheryl succinate on breast cancer cell lines irrespective of HER-2/neu expression. Life Sci. 2010 Apr 24;86(17-18):668-75
14. Grant WB, Schwalfenberg GK, Genuis SJ, Whiting SJ. An estimate of the economic burden and premature deaths due to vitamin D deficiency in Canada. Molecular Nutrition & Food Research 2010 March 29th.Published online ahead of print, doi: 10.1002/mnfr.200900420
15. Hanley DA, Cranney A, Jones G, Whiting SJ, Leslie WD, Cole DE, Atkinson SA, Josse RG, Feldman S, Kline GA, Rosen C. Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada. CMAJ. 2010 Jul 19
16. “Dietary Supplement Fact Sheet: Vitamin D” Ods.od.nih.gov. Retrieved 2010-03-25
17. Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999; 69(5):842-56.
18. Vieth R, Chan P-C, MacFarlane GD: Efficacy and safety of vitamin D3 intake exceeding the lowest observed adverse effect level. Am J Clin Nutr 2001;73:288–94.
19. Adams JS, Clemens TL, Parrish JA, Holick MF. Vitamin-D synthesis and metabolism after ultraviolet irradiation of normal and vitamin-D-deficient subjects. N Engl J Med.1982 Mar 25;306(12):722-5
20. Munro I, Derivation of tolerable upper intake levels of nutrients, Letter, Am J Clin Nutr 2001; 74:865
21. Woodhead JS, Ghose RR, Gupta SK. Severe hypophosphataemic osteomalacia with primary hyperparathyroidism. Br Med J 1980; 281:647-648.
22. Eguchi M, Kaibara N. Treatment of hypophosphataemic vitamin D-resistant rickets and adult presenting hypophosphataemic vitamin D-resistant osteomalacia. Int Orthop 1980; 3:257-264.
23. Schurgers LJ, Vermeer C. Differential lipoprotein transport pathways of K-vitamins in healthy subjects. Biochim Biophys Acta. Feb 15 2002;1570(1):27-32.
24. Schurgers LJ, Cranenburg EC, Vermeer C. Matrix Gla-protein: the calcification inhibitor in need of vitamin K. Thromb Haemost. 2008 Oct;100(4):593-603. Review.
25. Knapen MH, Schurgers LJ, Vermeer C. Vitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal women. Osteoporos Int. 2007 Jul;18(7):963-72
26. Kim KH, Choi WS, Lee JH, Lee H, Yang DH, Chae SC. Relationship between dietary vitamin K intake and the stability of anticoagulation effect in patients taking long-term warfarin. Thromb Haemost. 2010 Jul 20;104(4)
27. Kaneki M, Hodges SJ, Hosoi T, Fujiwara S, Lyons A, Crean SJ, Ishida N, Nakagawa M, Takechi M, Sano Y, Mizuno Y, Hoshino S, Miyao M, Inoue S, Horiki K, Shiraki M, Ouchi Y, Orimo H. Japanese fermented soybean food as the major determinant of the large geographic difference in circulating levels of vitamin K2: possible implications for hip-fracture risk. Nutrition. 2001 Apr;17(4):315-21
28. Bolland MJ, Grey A, Avenell A, Gamble GD, Reid IR. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ 2011 Apr 19;342:d2040.
29. Krebs-Smith SM, Guenther PM, Subar AF, Kirkpatrick SI, Dodd KW. Americans do not meet federal dietary recommendations. J Nutr. 2010 Oct;140(10):1832-8.
30. Troesch B, Hoeft B, McBurney M, Eggersdorfer M, Weber P. Dietary surveys indicate vitamin intakes below recommendations are common in representative Western countries. Br J Nutr. 2012 Aug;108(4):692-8.
31. Fulgoni VL 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011 Oct;141(10):1847-54