Hippocrates once said, “Let food be thy medicine, and medicine be thy food.” But like any other quote from history, its interpretation has evolved over more than two millennia. My favorite interpretation, however—and basing it on the oath of medical practice that was penned onto papyrus scrolls by the same philosopher—is that the human body heals itself, if just provided with everything it needs to complete such a task. And that it is this same nourishment that should be maintained if the same human body is to remain healthy.
This again begs the question, “What diet is best for the human body?” and, “Given the appropriate diet, do we need to take supplements to remain healthy?”
More than half of Western civilization takes one or more dietary supplements daily or on occasion. Supplements are available without a prescription and usually come in pill, powder or liquid form. Common supplements include vitamins, minerals, amino acids, and herbal products, also known as botanicals. Do we really need to take these supplements? Carol Haggans, registered dietitian and consultant to the United States’ National Institutes of Health (NIH), claims that, “It’s possible to get all of the nutrients you need by eating a variety of healthy foods in a well-balanced diet.” But the crux of the matter is, who in this day and age is eating a “well-balanced diet”? Ms. Haggans answers the query indirectly: “But supplements can be useful for filling gaps in your diet.” In other words, we cannot get everything our body needs from our diet no matter how well-balanced we think it is. Now that we’ve got ourselves into the proper mindset of this discussion, the concept of a well-balanced diet becomes cloudier and cloudier; but that is another topic best left for another discussion.
To Supplement or Not to Supplement:
Is That Even the Question?
Benedict Francis D. Valdecanas, MD | February 21, 2016
There is no one left to blame in this whole “to supplement or not” conundrum but us doctors; yes, myself included. We used to discourage our patients from taking vitamins, telling them it was just a waste of money—“Just eat a balanced diet and exercise!” Or as one medical sitcom quipped, taking supplements is “a good way to make expensive urine.” But as I mentioned early on in this article, even the practice of medicine evolves. And now that medical research has refocused ever deeper into the cell and has reopened genetics and biochemistry as the basis for all disease, it is these very same biochemical processes that provide a good argument for the taking of supplements; the vitamins and minerals that we see bottled on the shelves of our favourite health stores are the very fuel and ingredients to see these cellular processes through. In other words, the very basic ingredients that push life itself.
Then why is there still controversy with this very subject? The confusion for most of us is that we see and hear so much contradictory advice from the Internet, from print media, from nutrition documentaries, and even from medical publications. This just goes to show that scientists still have much to learn even about common vitamins. One recent study found unexpected evidence about vitamin E, for example. Earlier research suggested that men who took vitamin E supplements might have a lower risk of developing prostate cancer. “But much to our surprise, a large NIH-funded clinical trial [Selenium and vitamin E Cancer Prevention Trial or SELECT; talk about a forced acronym!] of more than 29,000 men found that taking supplements of vitamin E actually raised, not reduced, their risk of this disease,” says Dr. Paul M. Coates, director of NIH’s Office of Dietary Supplements. The more recent results in 2011 contradicted the initial results of the same study in 2008, which claimed that there was no significant difference. However, this inconsistency in their results prompted deeper investigation into the actual design of the study itself; it was ultimately found in 2012 that the study design was statistically flawed. That’s why it is not only important to keep abreast of clinical studies of supplements to confirm their effects; we need to keep in mind that these clinical studies should themselves be studied to confirm their credibility.
It is not only vitamin E that earned the ire of the public due to flip-flopping evidence. Vitamin C, specifically its high-dose use in specific diseases, was very recently questioned as well. I’ll leave the reason for this back-and-forth exchange of clinical claims to conspiracy theorists. Now that we’ve gotten that existential question on supplements out of the way, the next question is, “What kind of supplements do I need to take and at what dose?” Well, make that two questions.
Supplements, as I’ve mentioned, can fall into four general groups; each of which I will further discuss now.
Vitamins. The most popular nutrient supplement are vitamins, often compounded together empirically as multivitamins. These are composed of the more common ones that have been identified through observing the different chemical processes in the cell itself and the basic biochemical process common to all cells, the so-called Kreb’s Cycle; something that nerds are all too familiar with and yet try to forget. All identified vitamins in the market now have been found to be vital parts of the cell’s processes, and thus providing what the cell needs should propel these processes forward and with ease. That is the basic logic behind supplementing. Examples of vitamins are of course not all too new to us; all the letters of the alphabet, vitamin A, B and its subtypes, C, D, E and its different forms, and so on and so forth.
Elemental Minerals. These are like supporting actors in a play. In fact, most minerals involved in the cellular processes are called co-factors. In other words, a segment of a chemical reaction will proceed only if the specific mineral is present. Examples are magnesium, zinc, selenium, chromium… yes, the periodic table of elements.
Amino Acids. Imagine the human body and how it looks in anatomy books. Each and every element of that picture, the muscles for example, is made up of molecules called proteins. Each of these protein molecules are chains, and the links in these chains are what we call amino acids. Therefore, amino acids are smaller molecules that make up the larger molecules that are the proteins. Still with me? Therefore, there wouldn’t be proteins and tissue in that picture of a human body in your mind now without the basic building blocks that we call amino acids. In addition to structural tissue, hormones and neurotransmitters are chemicals in the body by which its different parts communicate; these, too, are proteins and hence made up of amino acids. (We will discuss hormones and neurotransmitters in another discussion.) There are generally two types of amino acids, the essential amino acids which cannot be synthesized by the human body, and the nonessential amino acids which can be synthesized by the human body. So where do we get our essential amino acids if they cannot be produced by the body itself? From our diet, which again is not always adequate, hence the need to supplement.
And lastly, Botanicals. These popular herbal products have anecdotal properties proven to either maintain a certain bodily function, enhance it, or both. The main problem with the botanicals is that until recently, their active ingredients had not been identified and hence could not be isolated for potency testing. What adds to the complication is that each of the ingredients acting alone does not carry the same effect as in combination with their inherently combined ingredients. Thus, despite the advances in molecular biology, botanicals will remain to be botanicals. Examples are St. John’s Wort, given for anxiety, maca root for hormonal imbalance, and astragalus for cardiovascular health, not to mention the fact that it has been studied for breast cancer, hepatitis and even the common cold.
The NIH has a website that can objectively guide you in getting to know your supplements very well. “Deciding whether to take dietary supplements and which ones to take is a serious matter,” says Coates. “Learn about their potential benefits and any risks they may pose first. Speak to your health care providers about products of interest and decide together what might be best for you to take, if anything, for your overall health.”
We at Aegle Wellness Center are here for you to guide you as to which supplements to take, how much, and when in the course of your day. But even before that, we administer tests to determine which particular supplements, from vitamins to elemental minerals to amino acids, and even botanicals, your body needs based on your unique profile: your current state of health and with your ultimate health goals in mind. Visit us at the 6th floor of The City Club at Alphaland Makati Place for a consult with your doctor on the matter.