What this article covers:
- What are supplements?
- Multivitamins, Iron
- Creatine Monohydrate
- Which are beneficial/ not useful
To begin, lets clarify the definition of a supplement.
Google defines a supplement as: “a thing added to something else in order to complete or enhance it.”
So whenever we think about if a supplement is necessary, it is worth considering the above and asking whether taking the thing will have a net benefit above what you are already doing, not instead of what you are already doing.
Supplements are not designed to replace good quality nutrition (or they shouldn’t be) – eating a balanced diet to support your goal should always be your priority.
We then come to the issue surrounding the sheer volume of supplements available on the market currently. A large issue here is that supplements aren’t regulated in the same way as drugs/medicines. They only have to comply with food regulations i.e. are safe to consume and don’t claim to treat, prevent or cure any illness or medical condition.
The result of this is that we have lots of supplements that are available, which are safe to consume (so they comply with regulation) but may not actually provide any tangible benefit upon consumption. Whilst the placebo effect can be marked, I’m sure you’d rather be spending your hard earned cash on something that is actually beneficial.
With this in mind, below I have evaluated the most commonly used supplements as well as a brief discussion on the benefits/ lack thereof of each.
- Multivitamin/mineral products
These are the most commonly used supplement in the world, and are often recommended by many. These products often contain 50-100% of your recommended daily intake of a wide range of vitamins and minerals. All of these should be obtainable through your nutrition in sufficient quantities provided that you are eating a well-balanced, varied diet.
A recent study1 looked at the effects of supplemental Multivitamins, Vitamin D, C and calcium on the prevention of cardiovascular incidents and all-cause mortality.
The results of this study indicated that ‘the data on the popular supplements show no consistent benefit for the prevention of CVD, MI, or stroke, nor was there a benefit for all cause mortality to support their continued use.’
The paper also notes that ‘in the absence of further studies, the current data on supplement use reinforce advice to focus on healthy dietary patterns, with an increased proportion of plant foods in which many of these required vitamins and minerals can be found’
In essence, Multivitamins probably don’t have much, if any benefit in reducing your risk of health issues if you are eating well. Overall, the current research doesn’t convincingly show that multivitamin use is beneficial for the majority of people.
In reality, if you believe that you are deficient in one of these micronutrients, it’s worth finding out if this is the case, and taking a specific, effective supplement to correct this. Supplementation is more likely to be required if you are dieting or eating a restrictive diet such as vegan, vegetarian and any other diet involving food group restriction, where it’s easy to become deficient if you aren’t careful about the range of foods you consume. Many products today are fortified with extra vitamins to help with this, but often, organic versions aren’t – which is something worth bearing in mind.
However, taking a multivitamin is very unlikely to cause you harm, so don’t panic if you are taking one currently or feel that you want to ‘cover your bases’ by taking one.
- Vitamin D
Especially if you live in the UK, spend most of your time indoors, or have darker skin, there is a high chance that you will be deficient in Vitamin D.
Vitamin D can be obtained from the diet (oily fish, eggs etc), but the majority is produced via sun exposure, hence why working indoors and living far from the equator is likely to have a negative impact here.
It’s worth getting your level checked by the GP, and supplementing with the appropriate amount (the GP will be able to advise how much you need individually) to bring your levels back up to normal.
Having appropriate levels of Vitamin D is important for brain and immune function, improved bone health, mental health benefits, amongst others.
Many people will not have an issue with their iron levels, as diet will often provide sufficient quantities, especially if you consume meat regularly.
Commonly at risk populations include women (higher risk due to menstrual blood loss), vegetarians and vegans (iron is obtainable from a range of plant sources, but at much lower concentrations than meats)
Common symptoms of deficiency include: fatigue, pale skin, dizziness, and shortness of breath.
If you feel that you may be deficient, a quick blood test at the GP’s will be able to tell you, and they can prescribe an appropriate dose of supplemental iron to restore your levels.
- Vitamin B12
Also known as Cobalamin, this is an essential vitamin for DNA and blood cell production.
Deficiency often presents with similar symptoms to Iron deficiency (pale, fatigue, pins and needles etc.) and can sometimes be confused for a folate deficiency as low B12 levels will cause folate levels to drop.
Susceptible populations include: elderly, vegans, and people taking metformin, those with gastric bands/gastric surgery or bowel removal.
B12 is obtained naturally in the diet from meat, dairy and eggs, and many products are now fortified with B12 as well (organic products often aren’t), so that’s worth checking if you’re vegan and like to choose organic options.
If you are vegan/ think you may be at risk, as for Iron above, get a blood test at the GP, and the deficiency can easily be rectified with B12 supplementation/ dietary improvements.
- Creatine Monohydrate
Originally popularised by the bodybuilding community due to its well-researched benefits from a muscle and strength building capacity, further research is now beginning to support its use in all populations (so everyone from your vegan friend to your grandma is likely to benefit from supplementation)
It has been shown to positively impact cognitive function, muscle retention in aging populations (important to maintain strength and reduce fall risk in the elderly) and improvements in immune function.
Whilst creatine is naturally obtained from food, supplementation is an effective way of maximizing the muscle concentration and thus the availability for use within the body especially if you choose to eat a plant only diet.
How much should you take?
5g/day is optimal, it will take a few weeks – a month to reach peak concentration within the muscle, but you can keep taking this every day without issue.
It is worth mentioning that supplementing with creatine will increase the excretion of a substance called creatinine (this is what the body produces from creatine as it is used). So if you have a blood test, let the GP know that you supplement so they don’t see the elevation as out of the ordinary, as creatinine levels are used as a marker for kidney function testing.
- Protein Shakes
More of a performance food than a supplement, but it falls into this category. Again, the bodybuilding community has massively popularized this. Whilst you can definitely get sufficient protein from your diet without the need for a protein shake, for many, it can be a great addition.
The minimum RDA is currently 0.8g/kg bodyweight, however research suggests that a more optimal level for general health is probably closer to 1g/kg.
From a muscle gain/retention point of view, a higher level would be recommended, of 1.2-2.0g/kg with 1.6-2.0g/kg being more optimal for muscle growth/ retention during a dieting phase.
Some benefits of whey protein (and other protein powders) include:
Convenience and quality – no cooking is involved, and provided that you buy a reputable brand, it’s a great way of getting a good amount of high quality protein in.
It’s low calorie as you don’t have the associated fat content of meat, so really useful if you are dieting or want to keep protein high whist keeping to your calorie targets.
If you happen to be lactose intolerant, opt for whey isolate to reduce/avoid the associated lactose related issues.
(Vegan options are also available now that don’t derive from milk if you’ve chosen to go meat-free.)
Probiotics are basically bacteria that are intended to provide a positive impact on health. Especially gut health. This is an emerging area of research currently, and at present there isn’t a huge amount of data on the microbiome (gut bacteria), and the effects that this has on health (other than it is probably fairly significant for a range of health outcomes)
Given this, I would only recommend a probiotic if advised by the GP with a view to helping with symptom control (IBS symptoms can sometimes be improved) and post antibiotic treatment they can sometimes be beneficial. In this instance, it is still often a trial and error process, as you will need to ingest the appropriate bacterial strain to have the required effect. There are many different strains, so sometimes you will have to test a few to see if there is a benefit.
Overall, the best way to maintain a healthy gut is to eat a wide variety of foods, and pay attention to/avoid foods that seem to adversely affect your gut (cause bloating, flatulence etc.)
Other supplements that are well researched and beneficial from a performance point of view include:
This has been shown repeatedly to enhance exercise performance. Start with a dose of 2mg/kg bodyweight, taken 45-60mins before exercise and see how you feel, increase as able/ needed up to 6mg/kg.
Some people suffer from undesirable gastric effects from caffeine (bloating etc), so if you are unsure how well you tolerate this, work up slowly to find your maximum tolerated dose.
Bear in mind that if you utilize caffeine regularly, tolerance will build as can dependence.
This is potentially useful if you are training for endurance.
It has been shown to increase muscular endurance in bouts of training >90s (time under tension)
There is a potential side effect of skin tingling, which is dose dependent.
If you have any further questions regarding any of the above, please feel free to get in touch and ask, or check out my Instagram where i will be covering each of these and more in greater detail.
1. Supplemental Vitamins and Minerals for CVD Prevention and Treatment
David J.A. Jenkins, et al
J Am Coll Cardiol. 2018 Jun, 71 (22) 2570-2584.