Sunday, June 24, 2018
Health

Nutrition in a pill? Better to get it on a plate, experts say

Wouldn't it be great if you could take just one pill a day to get all the nutrients your body needs? All the vitamins, minerals, protein, antioxidants, healthy fats and fiber that help fight disease and ensure a healthy body.

No checkout lines, no washing, no peeling, no chopping, no storing, no juicing, no mixing. Just pop one pill and you're done. And, best of all, NO CALORIES! Or you could use all your calories for fun stuff, with no worry about nourishment.

You could even close your kitchen.

Sorry, but no such pill exists. Even if you work with what's available, it would take handfuls of pills every day to even attempt to meet all your nutritional needs without food. Still, you'd come up short.

"Fruits and vegetables have hundreds of different phytochemicals that you simply can't get in a pill," said Advanced Nutrition Concepts registered dietitian Christine Miller. "You get a bigger nutritional punch from fresh foods than you do from supplements."

Another problem with popping pills in place of food: cravings and hunger pangs. Just ask anyone who has had to give up food and receive nutrition through a tube. It isn't fun, delicious or satisfying.

"You are not only missing out on all the nutrients of whole foods, but there's the sensory aspects. What's better than biting into a crisp apple or a sweet ear of corn?" asks Morton Plant Hospital outpatient registered dietitian Nadine Pazder.

Even if a manufacturer claims its pills are made from natural foods, the food still has to be dehydrated, sometimes heated, pulverized and turned into a pill, which can alter its nutritional content. "It's ironic that people who complain about how processed our foods are will turn to pills for nutrients," Pazder said. "Pills are highly processed products."

• • •

Americans have turned supplements into a $12 billion-a-year industry — at a time when several studies have cast doubt on their benefits.

A report this month from the U.S. Preventive Services Task Force says vitamins and minerals don't seem to be effective at preventing heart disease or cancer and recommended that Americans instead spend their money on a well-balanced diet. A 2012 study in the Journal of the American Medical Association found that omega-3 supplements, thought to be powerful protectors against heart disease, didn't reduce the risk of heart attacks or stroke, or death from heart disease or other causes.

How can something that seems so healthy perhaps not have such healthful benefits?

Some nutrients in foods may change when processed into pills. Compounds the body needs to absorb nutrients may be stripped away in the manufacturing process. Pazder points to a popular supplement advertised heavily online that claims to supply all the nutrients of more than a dozen fruits, vegetables and grains in one capsule.

"Well, taking the pill is not the same as eating the foods," she said. "The phytonutrients and antioxidants and fiber and water that you would get in these very low-calorie foods you don't get in a capsule. And we need all of that."

• • •

So who should take vitamin supplements? If you eat a variety of foods from all the major food groups you are not very likely to need supplementation. But that simple prescription is more complicated than it sounds for people who think the lonely lettuce leaf on their burger counts as a vegetable. How many of us consistently eat at least five servings a day of fruits and vegetables, including dark green leafy veggies like spinach and kale?

Not surprisingly, most Americans come up short on a few key vitamins and minerals — notably vitamin D, calcium, vitamin B-12, magnesium — and fiber.

"I do nutrient testing on many of my clients and it is rare to find one who isn't deficient in vitamin D, Miller said. "It's also common to come up low in the others, as well as omega-3 fatty acids, which are essential nutrients and can't be manufactured by the body."

Supplementing with commercial vitamins and minerals makes sense when you try to eat a balanced diet and still can't meet the USRDA, the federally established Recommended Dietary Allowance, for essential nutrients. "They (supplements) help fill in the gaps," she said.

For example, most healthy adults need 1,000 to 1,200 milligrams of calcium a day. It takes several servings of fortified dairy products, juices and other calcium-rich foods daily. A calcium pill can help take up the slack. Vitamin D can also be difficult to get from the diet or sunshine alone, especially if you're avoiding the sun due to skin cancer concerns. Yet, without D, calcium can't do its job in the body, strengthening bones and teeth and preventing osteoporosis. So you may need a supplement to get the 600 to 800 international units of D recommended for healthy adults every day.

• • •

Other factors that could determine whether you need a supplement include:

• Age (women of child-bearing years need folic acid to prevent birth defects; children may need more or less of particular nutrients than adults, the elderly may need more or less than adolescents and teens).

• Health status: Some diseases or disorders increase the need for some nutrients.

• Lifestyle or life stage: Serious athletic training, breast-feeding, pregnancy, menopause, being a vegetarian, smoking cigarettes, dieting or having had bariatric surgery may mean you need extra nutrients.

• Medications: Antibiotics and acid reflux drugs can interfere with nutrient absorption.

"All of these things can affect how nutrients are used by the body,'' said Yashwant Pathak, a professor and associate dean for faculty affairs at the USF College of Pharmacy. "Also, as you get older, usually starting after age 40, your body changes and may not absorb nutrients as well, that's when you might need supplements."

But Pathak, who has written four books on supplements and so-called nutraceuticals, cautions against taking doses higher than the USRDA. "Most of the time, your body selects out what you need and the rest is eliminated as waste. So, for example, when you are sick or have a cold, it may be a good idea to get 1,000 milligrams of vitamin C to support your immune system, but only while you are sick, not every day. And, it's much better to get it from fruits and juices than from pills."

• • •

Talk with your doctor, pharmacist or a licensed registered dietitian for help in deciding whether you need supplements and which product will best meet your needs. For most generally healthy adults over 40, Pathak says a multivitamin with calcium and vitamin D is a good choice.

Unlike drugs, dietary supplements do not need FDA approval to be sold. So, how do you find good supplements? Miller suggests looking for a brand that has been certified or given a "seal of approval" from a nationally recognized independent lab, such as the U.S. Pharmacopeial Convention, the Natural Products Association and NSF International, which test for purity and potency.

But even the best supplements, Pazder, Miller and Pathak all agree, aren't as good for you as fresh, healthy food.

Irene Maher can be reached at [email protected]

   
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