Introduction

Common dietary supplements (DS) include :

1. Vitamins and minerals (such as vitamin C or multivitamin)
2. Botanicals (herbs and plant products, such as ginseng)
3. Substances that come from natural sources (such as omega-3 fatty acids in fish oils).

They can be in pill, capsule, tablet, or liquid forms.

Dietary supplements are widely available in Malaysia in health food stores, supermarkets, pharmacies, on the Internet, and by mail. Supplements are commonly taken for health-related reasons.

According to the Malaysian Adult Nutrition Survey (2003), vitamin and mineral supplements (VMS) are the most frequently used dietary supplements. It is estimated that 1 in 4 adult Malaysians consumes VMS.

Vitamins and minerals are organic compounds that our bodies use in very small amounts for a variety of metabolic processes.

Most people can get all the vitamins and minerals they need by eating a balanced and varied diet.

The Malaysian Dietary Guidelines (MDG) make it clear that your nutritional needs should be met primarily through your diet.

Health authorities around the world recommend that we eat a wide variety of foods for good nutrition and only use supplements IF advised or prescribed by a healthcare professional. Unless you have been diagnosed with a vitamin or mineral deficiency and need to replenish that nutrient immediately, it is always better to get nutrients from foods.

Why are whole foods better than supplements (VMS) ?

VMS are not intended to substitute food because they CANNOT replicate all of the nutrients and benefits of whole foods, such as fruit and vegetables.

Whole foods offer 3 main benefits over supplements :

1) Better nutrition

Whole foods are complex, containing a variety of the micronutrients your body needs.

An orange, for example, provides :

• vitamin C plus some beta carotene,
• calcium, and
• other nutrients.

A vitamin C supplement LACKS these other micronutrients.

2) Essential fibre

Whole foods, such as whole grains, fruits, vegetables and legumes provide dietary fibre. Most high-fibre foods also contain other essential nutrients.

Fibre, as part of a healthy diet, can help prevent certain diseases, such as :

• type 2 diabetes mellitus
• heart disease.

It can also help manage constipation.

3) Protective substances

Whole foods contain other substances besides vitamins and minerals that are important for good health.

Fruit and vegetables, for example, contain naturally-occurring substances called phytochemicals (such as lycopene in tomatoes and carotenoids in carrots), which may help PROTECT you against :

• cancer
• heart disease
• diabetes
• high blood pressure.

Many fruit and vegetables are also good sources of antioxidants – substances that slow down oxidation, a natural process that leads to cell and tissue damage.

Antioxidants such as flavonoids are present in fruit and vegetables such as in :

• mangosteen
• grapes
• mangoes
• brinjal
• broccoli
• cabbage.

Remember “More is not always better”.

When a nutrient is isolated in tablet form, it is much easier to OVERDOSE, which can be dangerous, whereas it is generally difficult to have too much of most vitamins and minerals from foods.

HIGH DOSES of single nutrients not only FAIL to improve health but also can make things worse, as has been shown in some clinical trials of the effects of beta-carotene, vitamin E and folic acid, for example, on heart disease or cancer.

Who needs VMS ?

Generally, if you are healthy and eat a wide variety of foods, including ;

• fruits
• vegetables
• whole grains
• legumes
• low-fat dairy products
• lean meats
• fish,

you likely do not need VMS.

A diet rich in a variety of whole plant foods as minimally processed as possible will provide all the vitamins and minerals needed for good health.

However, there are some instances where VMS may be useful to meet recommended levels of nutrients, such as :

1. Women of child-bearing age who are planning a pregnancy who may need a folic acid supplement (folate) to reduce the risk of neural tube defect.
2. Pregnant women needing iron supplements.
3. People following strict vegetarian or vegan diets (who do include fish, egg and milk in their diet) who may need a vitamin B12 supplement.
4. People who are recovering from serious illness, whose eating habits have changed as a result.
5. People who cannot afford healthy foods.
6. The elderly who may have poor ability to taste and smell and increased requirement for certain vitamins due to chronic diseases.
7. People with chronic use of a medication that lower nutrient absorption or increase metabolism or excretion of nutrients.

It is important to consult a doctor or a nutritionist or if you think you may need to supplement your diet.

 

Choosing and using VMS

There are a few factors to consider if you decide to take a vitamin or mineral supplement :

1. Check the label.

• Read labels carefully.
• Product labels can tell you what the active ingredient or ingredients are, which nutrients are included, the serving size – for example, 1 tablet, capsule, packet or teaspoonful, and the amount of nutrients in each serving.

2. Avoid megadoses.

   In general, choose a multivitamin-mineral supplement that provides about 100% of the Daily Value (DV) of all the vitamins and minerals, rather than one which has, for example, 500% of the DV for one vitamin and only 20% of the DV for another.

3. Check expiry dates.

• Dietary supplements can lose potency over time, especially in hot and humid climates.

• Do not buy if a supplement does not have an expiry date.

• If your supplements have expired, discard them.

4. Watch what you eat.

• More and more food products are being enriched with vitamins and minerals, including breakfast cereals and beverages.

• If you are also taking supplements, you may be getting more of certain nutrients than you realise.

• Taking more than you need is expensive can raise your risk of side effects.

• For example, too much iron can cause nausea and vomiting, and may damage the liver and other organs.

 

Conclusion

Most of the time, VMS are not required for achieving or maintaining good health.

Instead, AIM for a diet based on whole plant foods as minimally processed as possible, including :

• 2 servings of fruit, and
• 3 servings of vegetables every day,

as well as a range of ;

• nuts,
• seeds,
• legumes, and
• wholegrain cereals.

References

1. Duyff RL. American Dietetic Association Complete Food and Nutrition Guide. 3rd ed. Hoboken, N.J. : John Wiley & Sons, 2006;134.
2. Practice Paper of the American Dietetic Association : Fortification and nutritional supplements. Journal of the American Dietetic Association. 2005; 105 :1300.
3. Tips for the savvy supplement user: Making informed decisions and evaluating information. U.S. Food and Drug Administration. http://www.fda.gov/Food/DietarySupplements/ConsumerInformation/ucm110567.
4. Malaysian Dietary Guidelines. Ministry of Health 2010.

Last reviewed	:	04 October 2014
Writer	:	Pn. Fatimah Salim