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Supplements

1. What are supplements?

As the name implies, supplements (dietary / nutritional / food / nutraceuticals) are products designed to give you micronutrients that could potentially be missing from your diet, maintain or support your health and wellbeing. These include individual or a combination of vitamins, minerals, herbs, and other botanicals (a plant or plant part valued for its medicinal or therapeutic properties), fatty acids, enzymes, probiotics, prebiotics or amino acids or other ingestible preparation added to the diet to benefit health.

2. Why use supplements?

Supplementing or complementing your diet is the actual purpose for supplements when your nutrient needs cannot be met through diet alone for various reasons.  Even if you go out of your way to eat a healthy, variety, or balanced diet, there may be some essential multivitamins and other micronutrients that are slipping through the cracks, and because not all nutrient deficiencies cause symptoms, you might not even know it. Moreover, with so many multivitamins and other micronutrients to check off in a day, it can be difficult to gauge which ones you need to work on the most, particularly without any professional screening tests or bloodwork done.

3. Why can it be difficult to get enough of certain nutrients?

Nowadays, it can be difficult to ensure that you are getting enough, or the right combination of vitamins, minerals and nutrients as nutrition and healthy living may be the last thing on your mind or busy to-do list. Some nutrients are either only found in high amounts in few foods (that you may not typically eat), or it is a nutrient that’s not easily absorbed by the body (because of your age, health issues or medications). Others may be required in big quantities or bulky like calcium, omega-3, magnesium, iodine, vitamin C, K, B-complex, herbals, or botanicals, and as a result need to be consumed regularly, in large quantities.

Although multivitamins, minerals, amino acids, essential fatty acids, enzymes, coenzymes, and herbals are all considered micronutrients, they differ in basic ways. For example, they can be broken down and destroyed by heat, air, or acid. So why does this matter? It means the micronutrients, in the soil and water can easily find their way into your body through the plants, fish, animals, food, and drinks you consume however, the cooking, storage, and simple exposure to sunlight or air, and processing from pre-set to microwave cooking programs and defrost functions can inactivate these more fragile compounds

In tough times, food, alcohol, stimulant overdose, substance abuse and late-night partying provides fun, pleasure, and escape from reality. Moreover, the common barriers to healthy eating and lifestyle habits are time constraints, loadshedding, extended screen time due to blurring boundaries between work, family, and social commitments, rising food prices, shrinking wallets, convenience, and easy access to junk meals or snacks.

4. Who needs supplements?

Most people can benefit from regular supplementation due to increased nutritional needs due to:

  • Lifestyle e.g., diet, stress, smoking, excess alcohol or caffeine intake, and poor sleep.
  • Change in routine e.g., season, or weather changes, loadshedding, shiftwork, travel, jetlag, deadlines, strain from work or family.
  • Frailty before, during and after an illness e.g., infections, injury, surgery, and hospitalisation.
  • Individuals with special needs e.g., adults aged 40 and above, elderly, kids, women of childbearing age, trying to get pregnant, being pregnant, or breastfeeding.
  • Going through life stages or hormonal changes e.g., menstruation, menopause, or being elderly.
  • People who follow a restricted diet e.g., vegans, vegetarians, individuals with allergies, and weight watchers.
  • Living with pre-existing medical conditions e.g., diabetes, hypertension, cardiovascular disease.
  • Those taking certain medications e.g., antibiotics, painkillers, contraceptives.
  • If you have been diagnosed with a deficiency or a malabsorption syndrome e.g., iron deficiency anaemia, calcium deficiency osteoporosis, lactose intolerance, short bowel syndrome.
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5. When to use supplements

  • Timing for taking supplements is mostly flexible, as different supplements work in different ways. This means that some have special considerations on how to take them to improve absorption, bioavailability or avoid side effects. For example, whether to take them in the morning, before bedtime, on an empty stomach as well as with a large meal of the day or after meals.

    In general, it is better to take them consistently. Try taking your vitamins at the same time you finish an already established habit or routine, such as eating a meal, brushing your teeth, bathing, praying, or setting an alarm clock. Pairing vitamins with another daily task with the time of day you take them can also help you remember and stay consistent. Routine drives effectiveness and consistent results, too. Supplements do not stick around in the body, so they must be taken consistently to always keep nutrients at a steady state.

    Supplements are usually well-absorbed with food, so you can take them with breakfast, lunch, or dinner. Just avoid taking them on an empty stomach to prevent irritating and upsetting your stomach.

References:

  1. Allessandra Durazzo, Massimo Lucarini and Michael Heinrich (12 January 2023). Frontiers in Pharmacology: Dietary Supplements, Botanicals and Herbs at The Interface of Food and Medicine. Accessed 6 December 2023 Available from: https://www.frontiersin.org/research-topics/18013/dietary-supplements-botanicals-and-herbs-at-the-interface-of-food-and-medicine

  2. Restore Mason JB, Booth SL. Vitamins, trace minerals, and other micronutrients. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 205.

  3. Markell M, Siddiqi HA. Vitamins and trace elements. In: McPherson RA, Pincus MR, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 27.

  4. MedlinePlus [Internet]. Bethesda (MD): National Library of Medicine (US); [updated 2023 Jan 19]. Vitamins. Accessed 8 December 2023 Available from: https://medlineplus.gov/ency/article/002399.html

  5. Kangsen Mai, M. Xue, G. He, S.Q. Xie, Sadasivam J. Kaushik, (2022). Chapter 4: Protein and amino acids, Fish Nutrition, 4th edition (pages 181-302). Accessed 6 December 2023 Available from: https://doi.org/10.1016/B978-0-12-819587-1.00012-4

  6. Reichrath J, Lehmann B, Carlberg C, Varani J, Zouboulis CC. Vitamins as hormones. Horm Metab Res. 2020 Feb;39(2):71-84. doi: 10.1055/s-2020-958715. PMID: 17326003. Accessed 8 December 2023 Available from: https://pubmed.ncbi.nlm.nih.gov/17326003/

  7. Kevin Martinez and Jennifer Huizen (24 June 2021). Medical News Today: Natural hormone replacement therapy: How it works. Accessed 8 December 2023 Available from: https://www.medicalnewstoday.com/articles/natural-hormone-replacements

  8. Brett White (15 August 2021) Dietary Fatty Acids: Am Fam Physician. 2021;80(4):345-350 Accessed 8 December 2023 Available from: https://www.aafp.org/pubs/afp/issues/2021/0815/p345.html

  9. Christine Mikstas and Wendy C Fries (3 February 2023). WebMD: Top Foods High in Fatty Acids. Accessed 8 December 2023 Available from: https://www.webmd.com/diet/foods-high-in-fatty-acids

  10. Salminen S, Collado MC, Endo A, Hill C, Lebeer S, Quigley EMM, Sanders ME, Shamir R, Swann JR, Szajewska H, Vinderola G. The International Scientific Association of Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of postbiotics. Nat Rev Gastroenterol Hepatol. 2021 Sep;18(9):649-667. doi: 10.1038/s41575-021-00440-6. Epub 2021 May 4. Erratum in: Nat Rev Gastroenterol Hepatol. 2021 Jun 15; Erratum in: Nat Rev Gastroenterol Hepatol. 2022 Aug;19(8):551. PMID: 33948025; PMCID: PMC8387231

  11. Debbie Steinbock (d30 March 2023) Mindful Family Medicine: The “Biotic” Trio: Prebiotics, Probiotics & Postbiotics Accessed 8 December 2023 Available from:  https://mindfulfamilymedicine.com/the-biotic-trio-prebiotics-probiotics-postbiotics/

  12. Lambeau KV, McRorie JW Jr. Fiber supplements and clinically proven health benefits: How to recognize and recommend an effective fiber therapy. J Am Assoc Nurse Pract. 2020 Apr;29(4):216-223. doi: 10.1002/2327-6924.12447. Epub 2020 Mar 2. PMID: 28252255; PMCID: PMC5413815. Accessed 8 December 2023 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5413815/

  13. Kara Rogers (25 July 2023). Encyclopedia Britannica: Coenzymes. Accessed 8 December 2023 Available from: https://www.britannica.com/science/coenzyme.

  14. Jeremy R. Townsend, Trevor O Kirby, Philip A. Sapp, Adam M. Gonzalez, Tess M. Marshall, Ralph Esposito (12 October 2023). Nutrient synergy: definition, evidence, and future directions. Frontiers in Nutrition: Volume 10. Accessed 8 December 2023 Available from: https://doi.org/10.3389/fnut.2023.1279925

  15. Expert Group on Vitamins and Minerals (2003). Safe Upper Levels for Vitamins and Minerals Available online: https://cot.food.gov.uk/sites/default/files/vitmin2003.pdf

  16. Rohini Radhakrishnan and Shaziya Allarakha (je;a). MedicineNet: 16 Essential Minerals. Accessed 8 December 2023 Available from: https://www.medicinenet.com/16_essential_minerals/article.htm

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