Top Five Supplements

December 7, 2011 Written by JP       [Font too small?]

“Is there a short-list of supplements that everyone should take?”. This may seem like a simple enough question, but it might surprise you to know that if I had to answer strictly ‘yes’ or ‘no’, my reply would be ‘no’. There are simply too many individual considerations and requirements that make blanket recommendations inappropriate and unreliable. Having said that, there is a select group of supplements that tend to fill important nutrient gaps in many diets. These very same nutritional aids also safely promote greater well being.

A natural multivitamin/mineral, fruit and vegetable extracts, magnesium, omega-3 fatty acids and Vitamin D top my list of general, health promoting dietary supplements. Whenever possible, the above mentioned pills should be taken with meals or snacks and on a daily basis. If more than one pill is necessary, such as a “twice daily” multivitamin, spreading out your intake to the morning and evening is ideal. Separating dosages allows for more even nutrient distribution and lightens the digestive load.

Multivitamin/Mineral: I typically recommend encapsulated multivitamin/minerals that emphasize bioavailable forms of essential nutrients such as chelated minerals (ex. chromium picolinate and magnesium citrate) and natural forms of Vitamin E (d-alpha tocopherol and tocotrienols). Whether or not to choose a multi with iron is an important consideration. Unless iron inadequacy is established, most men and postmenopausal women should avoid supplemental iron. Recent studies indicate that taking a daily multivitamin/mineral may enhance stress tolerance, improve cognitive functioning and support positive mood in men and women of all ages.

Concentrated Fruit & Vegetable Extracts: How many of you eat the recommended nine servings of fresh fruits and vegetables daily? Not many people can honestly say that they do on a consistent basis. And, it’s not just minerals and vitamins that you’re missing if you fall short of your fruit and vegetable quota. These foods are your primary source of health promoting antioxidants and phytochemicals which support wellness independent of meeting nutritional requirements. Fortunately, researchers have discovered that concentrated fruit and vegetable extracts are capable of imparting some of the health benefits attributable to a produce-rich diet. Of late, publications such as the British Journal of Nutrition reveal that fruit and vegetable extracts may increase resistance to the common cold and reduce oxidative stress in a real world setting.

Magnesium Citrate: Modern diets are often lacking in this macromineral, which may be contributing to some of the leading causes of morbidity and mortality such as heart disease, osteoporosis and even accelerated aging. A study appearing in the November 2011 issue of the journal Atherosclerosis reports that low serum magnesium is associated with higher all-cause and cardiovascular mortality. Inadequate magnesium has also recently been implicated in lower levels of testosterone in older men and inferior bone density in younger women.

Omega-3 Fatty Acids: If you don’t eat clean sources of fatty fish, including salmon and sardines, on a regular basis, you’d probably do well to supplement with clinically validated forms of omega-3 fatty acids. This is especially important for vegetarians since nut and seed oils do not contain the most important omega-3s (docosahexaenoic acid or DHA and eicosapentaenoic acid or EPA). A current meta-analysis in the Journal of Nutrition informs omnivores and vegetarians alike that algae-derived DHA promotes heart health and beyond by elevating HDL (“good”) cholesterol and lowering serum triglycerides. For non-vegetarians, krill oil and purified fish oil are suitable options. Of the two, concentrated fish oil tends to be less expensive and has more research in its favor than algae or krill oil.

Vitamin D3: The use of a basic multivitamin rarely achieves optimal Vitamin D concentrations in your system. The exact dosage necessary to establish a sufficient Vitamin D status (50-80 ng/mL) varies. Dosages upwards of 6,000 IUs are not uncommon in my experience. Even mainstream medicine is becoming hip to the importance of Vitamin D. In fact, they’re beginning to combine it with fish oil. A study currently underway is assessing the relative merits of a prescriptive form of fish oil (Omacor) and a common form of Vitamin D3. The participants in the study are receiving 1 gram/day of DHA & EPA and 2,000 IUs of Vitamin D3. The research will examine the effects of the fish oil/D3 combination with regard to the prevention of cancer, cardiovascular disease and a broad array of other conditions including autoimmune disorders, cognitive decline and diabetes.

My overall philosophy about dietary supplements is that they ought to be used as supplements, not replacements, for other healthy practices including eating a wholesome diet, getting adequate sleep and regular exercise. I think of my own supplement regimen as providing additional protection against the dietary and environmental insults I experience just by living in the modern world. When supplements are utilized in this way, I’ve seen them work wonders in the lives of myself and many others.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – The Effect of Multivitamin Supplementation on Mood and Stress (link)

Study 2 - Memory Improvements in Elderly Women Following 16 Weeks (link)

Study 3 - The Effect of 90 Day Administration of a High Dose Vitamin B(link)

Study 4 - Low Serum Magnesium Concentrations Predict Cardiovascular (link)

Study 5 - Magnesium and Anabolic Hormones in Older Men (link)

Study 6 - Evaluation of Magnesium Intake and Its Relation with Bone Quality (link)

Study 7 - A Meta-Analysis Shows That Docosahexaenoic Acid from Algal Oil (link)

Study 8 - The VITamin D and OmegA-3 TriaL (VITAL): Rationale and Design (link)

Study 9 - Reduction of Common Cold Symptoms by Encapsulated Juice Powder (link)

Study 10 - Effects of a Fruit/Berry/Vegetable Supplement on Muscle Function (link)

Multivitamins May Improve Cognitive Functioning

Source: Psychopharmacology (Berl). 2011 Oct 18. (link)

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Posted in Alternative Therapies, General Health, Nutritional Supplements

17 Comments & Updates to “Top Five Supplements”

  1. MiaB. Says:

    Hi Healthy Fellow!
    Thank you for the very handy, easy-to-follow breakdown of essential vitamin nutrients…Especially in this Holiday Season, it is easy to slip off good routines or even remember to make the best dietary choices.
    Enjoy the season!!!

  2. Tony Says:

    Good list, I’ve done a post before on my top 3 supplements, and they were a multivitamin, cod liver oil (EFAs), and whey protein. I’d rather buy the supplements my body needs, and use diet and exercise to achieve my wants.

  3. liverock Says:

    JP
    I take Jarrow Green Defence as I dont eat enough greens. Heavy metals elimination by Modified Citrus Pectin (MCP),or some other chelator is essential I think if you eat fish(even sardines) or if you live in a city.

  4. JP Says:

    Thank you, MiaB! :) I wish you a healthy and joyful holiday season as well!

    Be well!

    JP

  5. JP Says:

    Thank you, Tony. I’m a fan of whey protein as well. However, I rarely recommend cod liver oil these days. If a combination of DHA, EPA and Vitamin D are desired, it’s quite easy to find supplements containing all three. That’s what I use and often recommend.

    Be well!

    JP

  6. JP Says:

    Liverock,

    Some of the nutrients contained in my recommendations above (antioxidants, selenium, zinc, etc.) may protect the body from mercury exposure to some degree. If high levels of mercury as suspected, I recommend having tests to verify the suspicion. If the test results indicate unacceptably high concentrations of mercury or other heavy metals, I wouldn’t hesitate to add more specific supplements such as those containing chlorella like Green Defense.

    Be well!

    JP

  7. rob Says:

    Why would you go for 3 seperate supplements when cod liver oil delivers them all?

  8. JP Says:

    Hi, Rob. I probably didn’t explain that very clearly. What I meant was, I take (and generally recommend) a concentrated, purified fish oil supplement containing both DHA & EPA that also includes added Vitamin D3. I find this to be preferable because it allows for higher dosages of the omega-3s and Vitamin D without concerns about excessive Vitamin A intake.

    As an example, let’s compare a popular cod liver oil supplement vs. a fish oil + D supplement like the one I described above:

    (Carlson) Cod liver oil (per each 1,000 mg soft gel): 2,000 IUs of Vitamin A, 250 IUs of Vitamin D, 120 mg of DHA and 90 mg of EPA. Online price per soft gel: about $.10.

    (Natrol) Fish Oil + Vitamin D (per each 1,000 mg soft gel): 1,000 IUs of Vitamin D, 120 mg of DHA and 180 mg of EPA. Online price per soft gel: about $.09.

    Since most diets and/or multivitamins provide adequate Vitamin A, I feel as though the higher omega-3 and D content of the latter supplement is a better deal financially speaking and health-wise.

    Be well!

    JP

  9. Ted Hutchinson Says:

    Readers interested in this thread may also enjoy TEDxIowaCity – Dr. Terry Wahls – Minding Your Mitochondria During the talk there is a slide from Loren Cordain showing which Vitamins/minerals/nutrients the average adult diet fails to meet current RDA levels.

    IMO it’s probable Dr Wahls is right mitochondrial dysfunction underlies most chronic diseases of western culture. I agree with her that we can and should improve the creation of new healthy mitochondria. But I think we still have a lot to learn about the mechanisms by which this happens. Think about the amount of vegetables/fruit Dr Wahls consumes daily and consider what effect the physical BULK of FIBRE from those vegetables/fruits is going to have on her gut flora. We should appreciate simply providing the nutrients (from supplements) may not have the same impact on our gut flora without the influence of those gut microbes that process micronutrients and make them available to us.

  10. JP Says:

    Thank you, Ted! What a stunning video! I’m so happy and thankful that you shared it here. I highly recommend that anyone reading this thread view the video.

    I agree with your closing thought. There are many components in whole foods which are often missing in supplements. That’s why a combined approach is probably best for most people. Practically speaking, I don’t know how many people would fully embrace this style of eating on a consistent basis. For those who can’t/won’t, supplements are all the more important. However, they’re no replacement for a nutrient dense, whole food based diet. And, I’m very much in favor of the style of eating that Dr. Wahls advocates. The possible addition of alternate day fasting to the mix might make it even more therapeutic, IMO.

    Be well!

    JP

  11. JP Says:

    Important Study: Taking fish oil with a multivitamin improves omega 3 absorption: http://www.mdpi.com/2072-6643/6/5/1956

    Nutrients. 2014 May 14;6(5):1956-70. doi: 10.3390/nu6051956.

    Randomized Controlled Trial Examining the Effects of Fish Oil and Multivitamin Supplementation on the Incorporation of n-3 and n-6 Fatty Acids into Red Blood Cells.

    The present randomized, placebo-controlled, double-blind, parallel-groups clinical trial examined the effects of fish oil and multivitamin supplementation on the incorporation of n-3 and n-6 fatty acids into red blood cells. Healthy adult humans (n = 160) were randomized to receive 6 g of fish oil, 6 g of fish oil plus a multivitamin, 3 g of fish oil plus a multivitamin or a placebo daily for 16 weeks. Treatment with 6 g of fish oil, with or without a daily multivitamin, led to higher eicosapentaenoic acid (EPA) composition at endpoint. Docosahexaenoic acid (DHA) composition was unchanged following treatment. The long chain LC n-3 PUFA index was only higher, compared to placebo, in the group receiving the combination of 6 g of fish oil and the multivitamin. Analysis by gender revealed that all treatments increased EPA incorporation in females while, in males, EPA was only significantly increased by the 6 g fish oil multivitamin combination. There was considerable individual variability in the red blood cell incorporation of EPA and DHA at endpoint. Gender contributed to a large proportion of this variability with females generally showing higher LC n-3 PUFA composition at endpoint. In conclusion, the incorporation of LC n-3 PUFA into red blood cells was influenced by dosage, the concurrent intake of vitamin/minerals and gender.

    Be we11!

    JP

  12. JP Says:

    Update: Juice supplements benefit pulmonary function and health in smokers …

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996529/

    J Am Coll Nutr. 2013;32(1):18-25. doi: 10.1080/07315724.2013.767652.

    An encapsulated juice powder concentrate improves markers of pulmonary function and cardiovascular risk factors in heavy smokers.

    OBJECTIVE: Cigarette smoking is associated with reduced pulmonary function and increased risk factors for cardiovascular disease. This randomized placebo-controlled double-blind study evaluated the effects of two different combinations of mixed fruit and vegetable juice powder concentrate (Juice Plus+, NSA, Collierville, TN) on heavy smokers.

    METHODS: At baseline (T 0) and after 3 months’ supplementation (T 1), pulmonary function parameters and cardiovascular risk factors-that is, plasma total homocysteine (tHcy) with related B vitamins and cysteine (tCys) concentrations-were assessed in 75 apparently healthy smokers (aged 49.2 ± 10.6 years, >20 cigarettes/d, duration ≥10 years) randomized into 3 groups: placebo (P), fruit/vegetable (FV) and fruit/vegetable/berry (FVB).

    RESULTS: T 0: most smokers showed abnormalities in tHcy and tCys concentrations. T 1: respiratory function was unchanged in P and slightly, but not significantly, improved in FV, whereas FVB showed a significant improvement in forced expiratory flow at 25% (FEF25; p < 0.0001 vs P and FV) and significant improvement in CO diffusion lung/alveolar volume (DLCO/VA). FV and FVB (50%) showed significant reduction in tHcy and tCys compared to T 0 ( p < 0.0001) and P ( p < 0.0001).

    CONCLUSIONS: At T 1, both supplemented groups, but to a greater extent the FVB group, showed improvements in some pulmonary parameters, cardiovascular risk factors, and folate status. The beneficial effects of Juice Plus+ supplementation could potentially help smokers, even if smoking cessation is advisable.

    Be well!

    JP

  13. JP Says:

    Update: Magnesium citrate protects against potentially dangerous elevations in blood pressure during pregnancy …

    http://link.springer.com/article/10.1007%2Fs00404-013-2900-2

    Arch Gynecol Obstet. 2013 Dec;288(6):1269-74.

    Magnesium supplementation to prevent high blood pressure in pregnancy: a randomised placebo control trial.

    PURPOSE: To assess if hypertension during the last part of pregnancy could be prevented by magnesium supplementation.

    METHODS: Pregnant primagravida women from a local antenatal care unit were given an oral supply of 300 mg magnesium as citrate or placebo from pregnancy week 25 in a randomised double-blind setup. Blood pressure was recorded during pregnancy as well as pregnancy outcome.

    RESULTS: In the magnesium-supplemented group, the average diastolic blood pressure at week 37 was significantly lower than in the placebo group (72/1.4 mean/SEM vs 77/1.4, p = 0.031). The number of women with an increase in diastolic blood pressure of ≥15 mmHg was significantly lower in the magnesium group compared with the women who received placebo (p = 0.011). There was an inverse relation between the urinary excretion of magnesium during pregnancy and the diastolic blood pressure (p = 0.005).

    CONCLUSIONS: Magnesium supplementation prevented an increase in diastolic blood pressure during the last weeks of pregnancy. The relation between diastolic blood pressure and urinary excretion of magnesium suggests that magnesium is involved in the regulation of blood pressure and that the increase in diastolic blood pressure in pregnancy could be due to a lack of magnesium.

    Be well!

    JP

  14. JP Says:

    Update 05/03/15:

    http://link.springer.com/article/10.1007%2Fs11357-015-9782-0

    Age (Dordr). 2015 Jun;37(3):9782.

    Acute mood but not cognitive improvements following administration of a single multivitamin and mineral supplement in healthy women aged 50 and above: a randomised controlled trial.

    A number of randomised controlled trials have indicated that multivitamin/mineral supplementation for a period of 4 weeks or greater can enhance mood and cognition. To date, no studies have investigated whether a single multivitamin dose can benefit mental function in older adults. This study investigated the acute effects of a single multivitamin and mineral and herbal (MVMH) supplement versus placebo on self ratings of mood and the performance of an effortful computerised cognitive battery in a sample of 76 healthy women aged 50-75 years. Mood was assessed using the depression anxiety stress scale (DASS), state trait anxiety inventory-state anxiety scale and visual analogue scales (VAS). Mood was rated at 1 h post supplementation and again after the competition of the cognitive assessments at 2 h post supplementation. It was demonstrated that the MVMH supplement improved overall DASS mood ratings; however, the most prominent effects appeared to be a reduction in ratings of perceived mental stress. These findings were confirmed using visual analogue scales, with these measures also demonstrating MVMH-related increased ratings of calmness. There were no benefits of the MVMH to mood ratings of depression and performance was not enhanced on the cognitive battery. Supplementation with a single multivitamin, mineral and herbal supplement reduces stress several hours after intake in healthy older people.

    Be well!

    JP

  15. JP Says:

    Update 05/03/15:

    http://stroke.ahajournals.org/content/46/5/1167.abstract

    Stroke. 2015 May;46(5):1167-72.

    Multivitamin use and risk of stroke mortality: the Japan collaborative cohort study.

    BACKGROUND AND PURPOSE: An effect of multivitamin supplement on stroke risk is uncertain. We aimed to examine the association between multivitamin use and risk of death from stroke and its subtypes.

    METHODS: A total of 72 180 Japanese men and women free from cardiovascular diseases and cancers at baseline in 1988 to 1990 were followed up until December 31, 2009. Lifestyles including multivitamin use were collected using self-administered questionnaires. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of total stroke and its subtypes in relation to multivitamin use.

    RESULTS: During a median follow-up of 19.1 years, we identified 2087 deaths from stroke, including 1148 ischemic strokes and 877 hemorrhagic strokes. After adjustment for potential confounders, multivitamin use was associated with lower but borderline significant risk of death from total stroke (HR, 0.87; 95% confidence interval, 0.76-1.01), primarily ischemic stroke (HR, 0.80; 95% confidence interval, 0.63-1.01), but not hemorrhagic stroke (HR, 0.96; 95% confidence interval, 0.78-1.18). In a subgroup analysis, there was a significant association between multivitamin use and lower risk of mortality from total stroke among people with fruit and vegetable intake <3 times/d (HR, 0.80; 95% confidence interval, 0.65-0.98). That association seemed to be more evident among regular users than casual users. Similar results were found for ischemic stroke.

    CONCLUSIONS: Multivitamin use, particularly frequent use, was associated with reduced risk of total and ischemic stroke mortality among Japanese people with lower intake of fruits and vegetables.

    Be well!

    JP

  16. JP Says:

    Update 05/27/15:

    http://www.mdpi.com/2072-6643/7/5/3796/htm

    Nutrients. 2015 May 19;7(5):3796-812.

    Improved blood biomarkers but no cognitive effects from 16 weeks of multivitamin supplementation in healthy older adults.

    Supplementation with vitamins, minerals and phytonutrients may be beneficial for cognition, especially in older adults. The aim of this study was to assess the effects of multivitamin supplementation in older adults on cognitive function and associated blood biomarkers. In a randomised, double blind, placebo-controlled trial, healthy women (n = 68) and men (n = 48) aged 55-65 years were supplemented daily for 16 weeks with women’s and men’s formula multivitamin supplements. Assessments at baseline and post-supplementation included computerised cognitive tasks and blood biomarkers relevant to cognitive aging. No cognitive improvements were observed after supplementation with either formula; however, several significant improvements were observed in blood biomarkers including increased levels of vitamins B6 and B12 in women and men; reduced C-reactive protein in women; reduced homocysteine and marginally reduced oxidative stress in men; as well as improvements to the lipid profile in men. In healthy older people, multivitamin supplementation improved a number of blood biomarkers that are relevant to cognition, but these biomarker changes were not accompanied by improved cognitive function.

    Be well!

    JP

  17. JP Says:

    Updated 02/22/16:

    http://onlinelibrary.wiley.com/doi/10.1111/jnu.12201/abstract

    J Nurs Scholarsh. 2016 Feb 15.

    Effects of Multivitamin Supplements on Cognitive Function, Serum Homocysteine Level, and Depression of Korean With Mild Cognitive Impairment in Care Facilities.

    PURPOSE: To examine effects of multivitamin supplements on cognitive function, serum homocysteine level, and depression of Korean older adults with mild cognitive impairment (MCI) in care facilities.

    DESIGN: A quasi-experimental pretest-posttest control group design was employed.

    METHODS: Forty-eight adults 65 years of age and older with MCI (experimental, n = 24; control, n = 24) who were living in care facilities in Gyeong-gi-do, Korea, were recruited. Multivitamin supplements as experimental treatment consisted of vitamin B6, B12, and folic acid. Multivitamin supplements were taken at a dosage of one pill every day for 12 weeks through the oral route. Measures were Mini Mental State Examination-Korean, serum homocysteine level, and Geriatric Depression Scale Short Form Korea Version. Collected data were analyzed using SPSS version 21.0 statistical software (SPSS Inc., Chicago, IL, USA).

    FINDINGS: There were significant effects of multivitamin supplements on cognitive function (F = 3.624, p = .021), serum homocysteine level (F = 6.974, p = .001), and depression (F = 10.849, p = .001).

    CONCLUSIONS: Multivitamin supplements increased cognitive function, and decreased serum homocysteine level and depression of Korean older adults with MCI in care facilities.

    CLINICAL RELEVANCE: Multivitamin supplements can be utilized for improving cognitive ability and for decreasing depression of Korean older adults with MCI in care facilities.

    Be well!

    JP

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