What are the healthiest supplements to take?

Healthiest Supplements: Evidence-Based Recommendations

There is no clear evidence that dietary supplements provide health benefits for most people, and they are generally not recommended unless you have a documented deficiency or specific medical need.

Current Evidence on Supplements

General Recommendations

The evidence on dietary supplements is quite clear from multiple authoritative guidelines:

• There is no convincing evidence that dietary supplements reduce cancer risk or provide health benefits in people without underlying deficiencies 1
• Routine supplementation with vitamins, minerals, herbs, or spices is not generally recommended for people with diabetes who don't have underlying deficiencies 1
• The U.S. Preventive Services Task Force found insufficient evidence to recommend for or against use of supplements of vitamins A, C, or E; multivitamins with folic acid; or antioxidant combinations for prevention of cardiovascular disease or cancer 1
• Beta-carotene supplements are specifically not recommended and may cause harm, particularly in smokers 1

Supplement Quality and Safety Concerns

Several important safety issues exist with supplements:

• Dietary supplements are not regulated like medications and don't require pre-market approval by the FDA 2
• Independent evaluations have identified products that are poorly manufactured, contaminated, or mislabeled 3
• There are documented risks including absence of active ingredients, presence of harmful substances, toxic agents, and even dangerous prescription pharmaceuticals 4
• Despite widespread marketing claims, high-quality published studies show little or no weight loss benefits from supplements marketed for this purpose 1

When Supplements May Be Appropriate

While most people don't need supplements, they may be beneficial in specific situations:

• Pregnant women and women of childbearing age (particularly folic acid) 1
• People with restricted dietary intakes 1
• Cases of documented vitamin/mineral deficiency (e.g., iron, vitamin B12, vitamin D) 1
• Protein supplements may be indicated as adjuncts to medically supervised weight loss therapies 1

Evidence-Based Approach to Supplements

For General Health

1. Focus on whole foods first

   • Emphasize vegetables, fruits, legumes, whole grains, and dairy products 1
   • Food is the best source of vitamins and minerals 1
   • Many healthful compounds in vegetables and fruits work synergistically in ways supplements cannot replicate 1

2. If considering a supplement

   • Discuss with a healthcare provider before starting any supplement
   • Choose a balanced multivitamin/mineral containing no more than 100% of the daily value of most nutrients 1
   • Adhere to dosages recommended in the Dietary Reference Intakes of the Institute of Medicine 1
   • Be aware that some vitamins (like A and D) may be harmful in higher dosages 1
   • Look for products with quality assurance seals (such as U.S. Pharmacopeia) 4

Special Considerations

• Diabetes management: Despite widespread marketing, there is no clear evidence that supplements like herbs, botanicals, high-dose vitamins/minerals, amino acids, enzymes, or antioxidants are effective for diabetes management 1

• Weight management: Numerous studies show that supplements marketed for weight loss generally provide little to no benefit 1

• Cancer prevention: The American Cancer Society notes that a diet rich in vegetables and fruits may reduce cancer risk, but supplements have not been proven to reduce cancer risk 1

Common Pitfalls to Avoid

1. Assuming "natural" means "safe"

   • Natural products can have side effects and interact with medications 3, 2

2. Believing marketing claims without evidence

   • Many supplements make exorbitant claims not supported by research 1

3. Taking high doses without medical supervision

   • Some vitamins and minerals can be harmful at high doses 1

4. Substituting supplements for medical care

   • Supplements should complement, not replace, conventional medical care

5. Not disclosing supplement use to healthcare providers

   • Always inform your healthcare team about all supplements you take

Remember that the regulatory framework for supplements is much less stringent than for medications. The best approach is to obtain nutrients from a balanced diet rich in vegetables, fruits, whole grains, and lean proteins, and to only use supplements when specifically recommended by a healthcare provider for a documented deficiency or medical need.