Wednesday, August 10, 2016

On supplements

I am often asked what, as an holistic nutritionist, my position on supplements is.

The topic is quite complex and I cannot reply with a simple “yes their good”, “no their not”. What makes nutrition a very fascinating science is that the answer is always “it depends”.

This is not what people want to hear so chances are that half of the readers will stop reading NOW and look for another blogger who dispenses a more manicheistic opinion. But if you made it to this sentence thanks for your confidence, let me explain.

The correct way to supplement

Supplements are indeed useful in certain circumstances, Even I myself prescribe supplements to resolve some important deficiencies. Some fundamental things to consider are:
  • nobody has the same needs. The recommendation to swallow multivitamin pills like candies is based on the desperate need to sell medicaments to people that wouldn’t otherwise fund Big Pharma
  • supplements are meant to unlock tricky situations where diet alone cannot help. These cases must be identified correctly with the help of a registered dietician or nutritionist (and not by the pharmacist whose main interest is to sell you something)
  • supplements are a temporary solution, not a daily habit to keep all your life in the hope to make to 100yo

Let’s take for example the group of vitamins B:
  • some people may need more vitamins B of this group: (B1, B4, B6, B12)
  • others may require a second group of vitamins B, formerly called vitamins G (B2, B3, B8, B9, choline betaine, lipotropic factors)
The typical multivitamin just tries to provide a good amount of all the vitamins based on the daily recommended values, this obviously cannot work for everybody and to some people this unbalance may even exacerbate their issues. Would you walk in somebody else's shoes? Of course you can give it a try but I am pretty sure it won’t feel good.

Properly prescribed supplements, on the other hand, can be helpful to unlock tricky situations. One typical example I mention is the condition related to low gastric juices' acidity, with all the cascade of issues that this represents:
  • GERD (yes: Gastroesophageal Reflux is caused by lack of acids, not excess of them)
  • bloating
  • SIBO (Small Intestine Bacterial Overgrowth)
  • leaky gut (and so allergies and food sensitivities)
  • and last but not least, impaired nutrients absorption

The last one is important: in order to produce stomach acids the body needs a number of nutrients, one of these is zinc. The irony is that to be able to absorb zinc you need stomach acids. It is a vicious circle and clearly diet alone cannot fix this, supplementation with zinc, digestive enzymes and additional acids is required. And that’s just ONE example, it should start to be clear why do-it-yourself diets don't work.

Then, why not taking supplements all our life anyway?

A-ha… I see where you come from: you want skip the boring healthy food and try to make up for the missing nutrients with pills and fortified snacks. Nutrients need cofactors to be properly absorbed and used in metabolic processes. Some are more famous than others (Vit-C and iron, Vit-A-D3-K2 and calcium, …). Others are less obvious, one example for all.

Ascorbic Acid is a molecule that the FDA decided to call Vitamin C. It is a very important nutrient for our body and although everybody thinks its role is just to calm the symptoms of a flu, its deficiency causes much worse conditions: bleeding gums, epistaxis, poor collagen health (and so weak cartilages, wrinkles…), poor adrenal glands function, etc. It was therefore decided a minimum quantity, called RDA, that everybody should take in order to avoid health complications, and so far so good.

Small problem now: ascorbic acid needs co-factors to be used in metabolic processes. These cofactors are a countless plethora of phytonutrients contained in the plants that naturally contain ascorbic acid itself and are definitely not found in a supplement. If you overdo with isolated ascorbic acid, and especially in the ambit of a poor diet, you can deplete your body’s stores of cofactors, with the consequence that, even in presence of ascorbic acid, you can show symptoms of Vit-C deficiency. How cool's that?

Reality check: the true Vitamin C is not ascorbic acid, but instead ascorbic acid with all its co-factors.

To conclude, the perfect supplement for Vitamin C (ascorbic acid and co-factors) are fresh fruits and vegetables. This holds true for most other nutrients:
  • Vit-A (it needs carotenoids to be used in metabolic processes)
  • Vit-B12 (like zinc, it needs good levels of stomach acids to be absorbed later in the small intestine)
  • Vit-D3 (must be in balance with Vit-A and Vit-K2), never take isolated D3 supplements, take fish oil instead
  • Vit-E (l-alpha-tocopherol is one molecule among many others with similar and complementary functions, most multivitamins contain only this one)

Quality of the supplements

Another issue with supplements is the quality of nutrients contained. I’ll go quick on this paragraph:
  • Vit-D3 (cholecalciferol) is often replaced by Vit-D2 (ergocalciferol)
  • Vit-B12 (methil-cobalamine) is almost always replaced by ciano-cobalamine
  • Vit-K2 (menaquinone) is rarely found in supplements, what you'll find instead is Vit-K1 (phylloquinone). Both are important, but are not interchangeable
  • And finally, vitamins produced per synthesis may present the rests of the solvents used in the production process (yummy...) 

Good supplements exist indeed, they are extracted from plants or from the organs of animals (glandular therapy). They contain the good vitamins and possibly even some cofactors, however they are more expensive: wouldn’t it be a better idea to invest that money in organic food?

Not only micronutrients

Protein powders, BCAA and multivitamins are the heritage of a “gym diet” that was very popular in the 80ies and 90ies. Bodybuilders supplemented for various reasons:
  • because of the wrong idea that the more proteins one eats, the bulkier they will get
  • because their low-fat diet, rich in refined carbs and lean meat (white rice, eggs white, chicken breast), left them seriously deficient in most vitamins and minerals

The “gym diet” recently lost some terrain thanks to the growing awareness of people on the importance of seasonal local produce and nutrient-dense food. Unfortunately some experts are trying to reintroduce them back, often for personal gain: either they have their own gamma of supplemental products or are planning to release it soon. I won’t point the finger: I’ll let you, the reader, the pleasure to rethink the claims of nutrition experts in this new optic.


Another trend are the superfoods, at least these are natural. Every year a new product is launched onto the market with a list of alleged health benefits. I’ll go quick on this one because I consider it the least of the problems: I myself enjoy goji berries sometimes, but not because I believe they have some magical properties. It's because I like them, and blueberries are not available all year long.

Typical characteristics of superfoods are:
  • they are newly discovered, often coming from some exotic location
  • consequently, none of your ancestors ever heard about them but in spite of this they did pretty fine (if you are here...)
  • sometimes they have some intriguing story behind: the monk who lived of goji for example, or the grain found in a hidden chamber inside a pyramid which had been planted and miraculously sprouted… c’mon give me a break!
  • it is cheap to produce but overly expensive for you to buy. Ah, the power of marketing!
  • for some reasons I never understood, they can grow at any latitude and altitude but you still have to import them
  • you are likely to forget about it after some years (mangosteen juice anyone?)


To be clear, I don’t think I walk on waters, but I am pretty sure I can swim better than many experts out there.

These days, with the help of internet and social platforms, the trend is the promotion of quick solutions to achieve health or higher performances (weight loss, clear skin, immune system strengthening, athletic performances, mental clarity, etc).

People don’t want to be sick and I can definitely understand it, that’s why I am so strict on my diet of nutrient-dense properly grown and prepared whole food. Eating liver is not very popular and most people would prefer a combo hotdog/multivitamin instead. The second option may still be better than hotdog alone, but in the optic of what we discussed this would limit your ability to fully express your genetic potential so… why?

In health, stay tuned!

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