Are we missing the point of nutritional supplements?

July 26, 2018
/ Aged Care, Nutrition, Research, Supplements

Addressing claims that nutritional supplements can enhance overall health and longevity, a recent review investigated their impact on heart health, stroke and mortality. The researchers report that most supplements did not show evidence of benefit or harm.

They investigated 179 randomised controlled trials of vitamins and minerals. Folic acid and B complex vitamins reduced risk of stroke.

Multivitamins, vitamins A, 6, D and E, beta carotene, zinc, iron, calcium, magnesium and selenium were not linked to heart disease or mortality. Large dose B3 and antioxidant vitamins had small links with greater risk of all-cause mortality.

Limitations of the review include exclusion of cohort studies which are conducted over longer time frames and are more characteristic of the population at large. The researchers also note that antioxidants were lumped together but in reality have different modes of action.

What does it mean?

Available evidence suggests that B vitamins – possibly through their homocysteine-lowering properties – may be a good choice for reducing stroke risk. Other research has shown they might also help prevent dementia.

Other nutritional supplements may not impact heart health or lengthen lifespans – which is not to say they don’t have other benefits, for instance to boost immunity when stressed, avoid the flu or address nutritional deficiencies.

But the overarching take-home message – that most agree on – is that supplements do not replace a healthy diet.

First and foremost, a diet rich in plant foods like fruit, vegetables, legumes, nuts, seeds, wholegrains and healthy fats (e.g. extra virgin olive oil) delivers a kaleidoscope of vitamins, minerals, antioxidants and fibre, with interactive health benefits that supersede supplements alone.

Basically, you may eat your cake, but taking a tablet won’t make it healthier for you.

Supplements and older adults

Australians are amongst the world’s highest supplement users per capita. Older Australians – particularly females – are the cohort most likely to take nutrition supplements, according to the latest national survey.

Supplement users were also more likely to eat healthier diets, so are likely to be more health conscious. Researchers caution that this combination could result in exceeding recommended daily intakes.

In this case fat soluble vitamins like Vitamins D and E are ones to be most aware of because excesses are retained in the body. If water soluble vitamins like the Bs exceed requirements, they are safely excreted.

In aged care, a survey revealed that expenditure on nutritional supplements and food replacements had increased by 128 percent. In this scenario older adults may suffer malnutrition, in some cases requiring supplements like concentrated protein powder if appetite is low.

For instance, a study in convalescing patients with disabilities found that nutritional supplements combined with resistance training improved muscle mass and activities of daily living.

Other nutrients that may be at particular risk in aging, and therefore benefit from supplementation, include B12 and Vitamin D. It is recommended to advise your health care provider of all supplements and medications so they can be aware of potential adverse interactions.

And where possible, a healthy diet comes first. Attention to aged care menus, presentation and palatability in aged care can go a long way to support this.