Supplements - Am I just wasting my money?

We are constantly bombarded with adverts about 'wonder' vitamins, with promises of glossy hair, strong nails, boosted immune systems and general wellbeing. But are supplements really necessary, or are we just throwing money down the drain?

The essence of life

There's no doubt that vitamins and minerals are important for our health - they were first discovered in the 18th Century by a Scottish naval surgeon who realised that a nutrient in citrus fruits (later found to be Vitamin C) appeared to treat, and prevent, an extremely unpleasant condition known as scurvy. Scurvy was often prevalent amongst sailors who had been at sea for several months with no fresh food. A simple introduction of limes into the diet of the sailors completely cured all cases of scurvy.

Since then hundreds of different vitamins, minerals, trace elements, herbal treatments, antioxidants and many others have been discovered, and reproduced artificially, to give us a plethora of nutritional supplements to choose from.

Vitamins, minerals and trace elements (often known as micronutrients) are essential for life - without an adequate supply our bodies are unable to function normally, and deficiencies in these compounds have been found to have profound effects. Examples of deficiency diseases include:

• Scurvy - Vitamin C
• Night Blindness - Vitamin A
• Anaemia - Iron (+ some B vitamins)
• Pellagra - Niacin

However these conditions tend to be seen in developing countries, where nutrition is poor and there is very limited access to healthcare services. In the UK, deficiency diseases are much less prevalent, yet we do still see some cases amongst some socially deprived communities in the UK.

We should be able to get all the vitamins, minerals and trace elements we need to stay healthy from our diet by eating a wide range of different foods including plenty of fruits and vegetables, complex carbohydrates (from a variety of grains), dairy foods, lean protein sources etc. Although this might sound easy, in practice, some people don't manage to get everything they need from their diet alone. Particular groups of the population are vulnerable, and supplements are often recommended as a back-up to ensure that the right levels are achieved. Vulnerable groups include:

• Babies and young children
• Teenagers
• Pregnant and breastfeeding women
• The elderly

New recommendations came out just last week from the Chief Medical Officer highlighting the need for supplementation in the under 5's to make sure they are getting the right levels of nutrition.

But can I have too much?

For most of the population, a healthy diet should provide enough micronutrients. Taking nutritional supplements is a personal choice, however we should all be cautious about taking too much.

Some supplements deliver 'mega' doses of these micronutrients with the promise of wonder cures, or delayed aging. In reality, a mega dose of anything isn't healthy - this was highlighted in a recent BBC news article which told the story of the plight of a group of explorers trekking to the Antarctic in 1912. Following the tragic loss of several members of the group, the remaining explorers resorted to eating whatever they could find to survive, including the husky dogs. Their symptoms - suffering from severe abdominal pain, peeling skin and hair loss - were thought to be signs of severe starvation, but in fact it has since been shown that this was severe Vitamin A overdose from consuming the husky dogs' livers. This is a gruesome story but highlights that an excess of anything (even a supplement that we might think is doing us good) isn't healthy.

So yes, you can have too much, and this is why if you choose to take a supplement you should always look for one that doesn't give any more than 100% RDA (recommended daily allowance) of the particular micronutrient you're interested in. This is particularly the case for the fat soluble vitamins (Vitamin A, D, E and K) because these are stored by the body, so you can overdose if you have too much.

The water soluble vitamins (Vitamin C and the B vitamins) can't be stored by the body, so you can't overdose - HOWEVER any excess requirements will be disposed by the body through its normal cleansing methods i.e. in your pee. So you are literally flushing your money down the toilet if you take more than you need!

What about when I'm restricting my food intake?

You should be able to get all the nutrients you need from an average calorie intake (so around 2000 calories for women, and 2500 calories for men). If you are restricting your intake of food for any reason, you should consider whether a supplement is required. This could be because you have a limited diet due to being a Vegetarian or Vegan, having a food allergy or intolerance, or if you are on a calorie restricted diet.

If you restrict your calories, you restrict your food intake and therefore your nutrients - at the same time you will probably be changing the types of foods you're eating such as reducing fat intake, cutting back on red meat, increasing your fruit and veg consumption... All of these things will change the balance of nutrition that you're getting.

You may need to consider a nutritional supplement at this point - I think of it as an 'insurance policy'. It's impossible to have the perfect diet every single day of your life, so taking a supplement just gives that reassurance that you're getting the right balance when you need it.

What supplement should I choose?

I don't personally believe that paying lots of money out for an 'all singing all dancing' supplement is necessary. The best option is to find a multivitamin and mineral supplement (supermarket own brands are fine) that includes a wide range of all the things that you might need, but all no more than 100% of your RDA. You might not even need to take a supplement every day, consider taking it every other day - in combination with your healthy diet, this should be enough the stay on the straight and narrow. If you choose to go for a supplement that just contains one, or just a few, of the vitamins and minerals - for example, vitamin B complex, or the ACE vitamins, it is best to avoid taking other supplements with the same nutrients at the same time.

If you are in any doubt, always talk to your GP or practice nurse as they will be able to advise about your own personal situation - especially if you are on medication or have specific medical needs that require specialist advice.

So, am I wasting my money?

If you are spending a lot of money on expensive mega dose micronutrients, and you haven't received any specific advice to take these from your GP, then yes, you probably are. However if you're taking a cheaper multivitamin supplement then there's no harm in continuing. Always remember that any supplement shouldn't be used as a excuse not to still eat a healthy diet - it's just a recognition that we're not perfect (and it's impossible to be!) so just do the best you can.