The Era of Supplements

‘Boost your brain health!’ ‘Elevate your wellness journey today!’

‘For younger skin!’

Do these sound familiar?

These are some of the many eye-catching phrases of supplements that we often see, be it in advertisements, the local pharmacy nearby, and even on the glossy boxes they come in.

Approximately 55% of Malaysians take dietary supplements regularly.

In 2022, Malaysia witnessed a whopping RM 7.48 billion made in sales from supplements alone, a remarkable jump from the RM 940 million recorded in 2005.

After the recent COVID-19 pandemic, we have become more health-conscious. Health is a luxury we cannot afford to lose.

It is a good thing though, considering the staggering rates of obesity and diabetes among Malaysians.

This simple realisation brings us to the next question, ‘How do I become healthier?’

Enter supplements.

What does this mean?

From the substantial rise in sales made, it is evident that Malaysians perceive supplements as essential for improving health.

Vitamin C stands out as the most frequently sought-after supplement in Malaysia. It is followed closely by fish oil and multivitamins.

But…do they actually make us healthier?

The National Institute of Health in the UK has spent a whopping $2.4 billion since 1999 to study the benefits and need for minerals and vitamins.

However, scientific evidence still remains unclear with limited clarity as to whether dietary supplements actually provide any health benefits.

In fact, surprisingly, research has revealed that the majority of dietary supplements do not

slow down cognitive decline (memory loss, trouble concentrating, brain fog)
prevent cancer
reduce our risk of developing diabetes and/or heart disease.
make us live longer

Research done in the United States found that around 80,000 supplements for sale have not undergone scientific trials. That is a lot!

This can be concerning, as some supplements may not be approved by the National Pharmaceutical Regulatory Agency (NPRA) and may contain contaminants like heavy metals or pesticides.

Manufacturing companies often market supplements with glossy terms like

‘This supplement improves your brain power and focus’, ‘This supplement will enhance your beauty and keep you staying young’, ‘This will boost your heart health and immunity!’.

However, if you are a regular healthy person, dietary supplements do not ‘revitalise’, ‘fuel’ or ‘boost’ your health.

These statements often mislead customers into purchasing them.

A study found that only 17% of regular dietary supplement consumers buy them as per their doctor’s recommendations. The others buy them out of their own initiative.

Contrary to popular belief, the majority of the population does not require dietary supplements. Eating a regular and healthy diet is sufficient to meet our nutritional needs.

When (and which) are supplements necessary?

Old age

Malnutrition is common amongst the elderly, especially due to reduced appetite and reduced food intake.

As we age, our bodies cannot absorb nutrients as readily as before. Therefore, dietary supplements like vitamin D, calcium and vitamin B12 may be recommended by your doctor.

Your doctor may require you to undergo a blood test prior to screen for any vitamin or mineral deficiencies.

It is important to talk to your doctor about the medications you are currently on, as dietary supplements can interact with them, potentially causing severe side effects.

There are other factors as to why malnutrition and nutritional deficiencies are common among the elderly population.

These include dental problems, physiological changes to taste and smell, psychosocial issues (social isolation) or even financial issues.

Some of the elderly also struggle with swallowing diseases and cognitive impairment like dementia and Alzheimer’s disease.

Osteoporosis

Osteoporosis is a condition of reduced bone mass. It may occur as a result of old age, smoking, long-term use of glucocorticoids, osteomyelitis (bone infections) and more.

It commonly affects the elderly, especially postmenopausal women. Osteoporosis is insidious and silent, often diagnosed after a fracture from a simple fall. It is often diagnosed with DEXA scans or bone mineral density scans.

Then, calcium and vitamin D are required to treat osteoporosis and prevent further progression of the disease.

Post-surgery

People who have undergone surgeries like stomach or intestine removal (be it permanent or temporary) will require adequate nutrients. Hence, our doctors may recommend we take dietary supplements during the recovery period.

Chronic health conditions

People with chronic disease may suffer from nutritional deficiencies and thus require dietary supplements too.

These include

Autoimmune diseases like systemic lupus erythematosus (a disease where the immune system attacks the body cells) or rheumatoid arthritis (a disease that causes inflammation of joints of the body).
Chronic lung diseases like chronic obstructive pulmonary disease, which is most commonly caused by chronic smoking and excessive air pollution.
Malabsorption diseases like inflammatory bowel disease or ulcerative colitis, where the intestines cannot absorb nutrients.

For example, a person receiving treatment for tuberculosis may be given vitamin B6 supplements to prevent side effects from the medication.

Folic acid

Pregnant women are encouraged to consume around 400 mcg of folic acid daily. It prevents birth defects like neural tube defects in babies.

The potential harms of supplements

In some cases, taking supplements may actually cause more harm than good.

Interaction with medications

Certain supplements may increase the effects of medications!

Vitamin K, vitamin E and glucosamine interfere with the anti-clotting effects of blood thinners like warfarin or heparin, increasing the risk of bleeding.

Ashwagandha, often used for insomnia and stress, can increase the sedative effect when taken together with benzodiazepines like Valium and anti-anxiety medication like Xanax.

On the flip side, some supplements may also reduce the effect of medications.

St John’s Wort, an ingredient in certain supplements can reduce the effect of antidepressants, birth control pills, warfarin and even certain cancer medications.

Vitamin B6 reduces the effectiveness of levodopa – a medication for Parkinson’s disease.

Iron and calcium can reduce the effects of levothyroxine, a medication for hypothyroidism (a condition of low thyroid hormone levels in the body).

Eliminating Excess Waste

Taking an excess of minerals will cause a buildup of excess waste in our bodies. This will mean that our bodies may need to work harder to eliminate the excess vitamins.

This can in turn injure our organs like our liver and kidneys.

An excess of calcium, vitamin C and D can increase one’s risk of kidney stones.

Toxic Doses

There is something called a therapeutic window for medications. This applies to supplements too. An excess amount of certain minerals and vitamins may also have detrimental effects on one’s health.

The risk of lung cancer in smokers may escalate with high doses of beta-carotene.

Too much vitamin C can cause nosebleeds and seizures.

What then, should we be focusing on?

A healthy diet.

Yes, you got that right! It is as simple as that.

Instead of worrying about which supplements to take, we ought to focus more on what food we put in our bodies.

For most of us, our diet actually provides us with sufficient minerals and vitamins.

Whole foods

Cut out processed foods and fast foods. Reduce your intake of food rich in saturated or trans fat.

French fries and fried chicken are delicious no doubt, but they are also high in sodium and trans fat.

Local fried foods like you tiao, keropok lekor and murukku are dangerously addictive (once you start eating, you cannot stop!), but can also add additional inches to our waistlines.

Instead, opt for fruits, vegetables and whole grains like brown rice instead of empty calories.

An apple a day, keeps the doctor away

Instead of foods that are rich in sodium and refined sugar, opt for fruits and vegetables. They are rich in antioxidants, vitamins and minerals.

Kiwi, lemon, mango, pineapple and oranges are rich in vitamin C.

Fish, soy milk, oatmeal, eggs and fish oil are rich in vitamin D.

Broccoli, tomatoes, eggs, avocado and spinach are packed with vitamin E.

Dietary fibre also prevents constipation and reduces the risk of haemorrhoids.

Protein

Animal protein, soybean and pea protein contain all 9 essential amino acids that help in building healthy muscles. They also strengthen our immune function.

An average person ought to eat 0.8 grams of protein per kg of body weight. So for example, if Mr Abu is 70 kg, he ought to aim to eat around 56 grams of protein a day.

Steer clear of red and processed meat!

If you are a vegetarian, talk to your doctor and make sure you are eating enough protein to meet your dietary needs.

Beyond the Hype: Do You Really Require Supplements?

We do not need to splurge a few hundred ringgit every month for dietary supplements!

The basis is this: if you do not have a nutritional deficiency, you do not need to take dietary supplements.

Instead, we ought to focus on maintaining a healthy and balanced diet, regular exercise and effective stress management.

Consult your doctor before starting on any supplements.

Reference

https://www.verywellhealth.com/these-supplements-can-interfere-with-your-medications-7501468

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