What dietary supplements are recommended for overall health?

Dietary Supplements for Overall Health: Evidence-Based Recommendations

For most healthy adults, routine supplementation with multivitamins or individual nutrients is not recommended for overall health, as there is insufficient evidence that supplements prevent chronic diseases or improve mortality outcomes. 1, 2

General Principles for Supplement Use

Who Should Consider Supplements

• Individuals with documented nutritional deficiencies
• Those with medical conditions affecting nutrient absorption
• People with restricted diets that limit food variety
• Specific populations with increased needs:
  • Pregnant women (folic acid)
  • Older adults at risk for falls (vitamin D)

Evidence on Common Supplements

Multivitamins

• Current evidence is insufficient to assess the balance of benefits and harms for preventing cardiovascular disease or cancer 1, 2
• May help fill small nutritional gaps but should not replace healthy dietary habits 3, 4
• If choosing a multivitamin, select one containing amounts close to Recommended Dietary Allowances rather than megadoses 5

Individual Nutrients

• Vitamin D: May be recommended at 800 IU daily or equivalent intermittent dosing for those at risk of deficiency 6, 7
• Beta-carotene: Recommended AGAINST supplementation, especially in smokers (increased risk of lung cancer) 1
• Vitamin E: Recommended AGAINST supplementation for disease prevention (no benefit shown) 1, 2
• Folic acid: Recommended for women who are planning pregnancy or capable of becoming pregnant 1

Dietary Approach vs. Supplementation

The strongest evidence supports obtaining nutrients through food rather than supplements:

• Focus on a diet rich in:

  • Fruits and vegetables
  • Whole grains
  • Legumes
  • Lean proteins
  • Healthy fats (especially monounsaturated and polyunsaturated)

• Specific dietary recommendations:

  • Limit sodium to <2,300 mg/day 1
  • Avoid sugar-sweetened beverages 1
  • If consuming alcohol, limit to moderate amounts (≤1 drink/day for women, ≤2 drinks/day for men) 1

Common Pitfalls and Caveats

1. Supplement quality varies: The FDA does not strictly regulate supplements; look for USP verification seal for quality assurance 1

2. Risk of excessive intake: Fat-soluble vitamins (A, D, E, K) can accumulate to toxic levels; water-soluble vitamins generally have lower risk 1

3. Supplement-medication interactions: Always inform healthcare providers about supplements being taken 1

4. False sense of security: Supplements should not replace healthy lifestyle choices 4

5. Cost consideration: Americans spend billions annually on supplements with uncertain benefits 1

For those who choose to take supplements despite limited evidence, it's important to stay within recommended dosages and avoid duplication of nutrients across multiple products 6.