Thursday, August 12, 2010

Supplements: Pros & Cons Brainstorm

By Christian Wernstedt

As paleos we know that a diverse whole-foods based diet really is the most powerful and comprehensive foundation of a healthy lifestyle, but sometimes we may feel the itch to supplement with that vitamin X, nutrient Y, or mineral Z that the new hot study touts as the key to health, longevity or sports performance, or because we feel that our diet may not be up to par in all areas of nutrition.

Certainly the issue is not black and white.
Are there any broad principles to apply when considering supplementation?
My aim is to write something more structured on this subject, but for now I'd like to just submit a few of my one paragraph notes on the subject. I'd be happy to hear readers' thoughts about these points, and if I have missed some important aspect.

So, in a relatively random order here goes:

1) Taking a supplement is often easier behaviorally than changing one's diet towards a more appropriate one, but even when a supplement works well in the short term the practice of relying on supplements may induce a psychological attachment to an unsustainable approach in the long run.

2) Supplements can be used appropriately as diagnostic tools (for instance to determine dietary deficiencies) or as training wheels (think for instance acetyl-L-carnitine to aid in becoming fat-adapted in the early stage of low carb dieting).

3) Is your supplement really bioactive? A lot of substances just can't be effectively delivered orally in a pill.

4) Supplementing with a "pre-formed" desired end product may bypass the body's own checks and balances. Examples: Taking pre-formed vitamin A versus the precursor beta carotene can induce toxicity. Vitamin D from supplements bypasses the negative feedback that ensures appropriate serum levels when getting vitamin D from sunshine.

5) Dosage is difficult when taking supplements. Does a thin woman need as much of nutrient X as the 400 pound wrestler?

6) Interactions abound, and not all are known. Calcium + Vitamin D can induce toxicity, but on the other hand D + Calcium can be synergistic for fat loss. If you supplement with both, how do you determine the sweet spot?

7) Well considered supplementation can indeed be an insurance policy against a less than optimal diet. Vitamin D, magnesium, iodine... Most people are probably deficient.

8) Nutrient X may be beneficial for one health aspect, but detrimental for another. Vitamin C (@ 1000 mg/day) and E (@400 IUs/day) while suppressing oxidative stress have been found to blunt some of the positive effects from exercise. Resveratrol hinders some cancers but may promote others.

9) Supplements derived from naturally occurring substances are indeed generally less prone to harmful side effects than pharmaceutical drugs. This is because the body typically has evolved pathways to deal with them (including getting rid of excesses). Sometimes the body is so darn good at getting rid of the "natural" stuff you supplement with that all you get in the process is "expensive urine".

10) Binder/filler material in supplements: Problematic for absorption or may contain downright harmful material (toxins, gluten).

11) Sometimes a supplement restore the body's production of a desired substance by creating a positive feedback loop. Example: HCl supplementation. However there are also examples of where supplementing may shut down the body's own production. (For instance, some hormone related herbals such as testosterone boosters can have this effect.)

12) How to scale into and out of a supplementation regimen may have to be considered carefully. Example: Rapid withdrawal from a high dose Vitamin C regimen can induce scurvy like symptoms.

That's all for now! I hope I didn't just make your life more difficult.

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