Nutrition Meets Food Science

Diet Sometimes Needs Supplements to Make it Healthy

Various nutrients are needed every day in order to complete the diet in all respect, making it nutritious and healthy. It is never possible to have exact requirements day after day with each nutrient contributing 1 RDA, not more or less. People don’t eat like they take medicines which are taken as doses. Food is not consumed as doses of nutrients so there will always be variations, with some nutrients being more than necessary, others being less. There are sometimes conditions develop such as pregnancy, ailment or old age, when the requirements differ and many times it is not easily possible to compensate for these changes by food alone. This is when supplements are necessary.

Supplements may come in many forms like tablets, capsules, gummies, powders and even food formats like teas, candies, energy drinks and nutrition bars. This makes it convenient to take them at any place at any time.

Why are supplements necessary?

There are some instances which necessitate use of supplements other than just variation of daily diet.

Indians consume less proteins. Vast number of them are vegetarian, thus not only the diet contains ingredients that are lower in protein compared to animal foods. Although, choosing legumes and seeds in diet can increase the quantity, the quality of vegetarian protein combination is normally not as high as milk and egg proteins. So protein supplementation helps bridge the gap of proteins.

Vegetarian diet also provides less of iron and some B-vitamins especially B12. Anemia can result from deficiency of either. Children and pregnant women need them more urgently. Pregnant women also may be prescribed folate to prevent problems in fetal development. Iron absorption is also low in presence of some antinutritional factors such as oxalate and phytate which are high in vegetarian foods. So vegetarians have multiple difficulties getting iron, which is plentily available in meats in the easily absorbable form namely heme iron. Calcium also inhibits its absorption.

Calcium is another important nutrient sometimes lacking in diet. Although milk has plenty of it, Indians don’t drink milk as such except children and seniors and sometime pregnant and lactating women. Lack of calcium not only affects growth but may cause problems such as osteoporosis. Calcium absorption also requires vitamin D, which although is generated freely when exposed to sunlight. However, people have reduced their exposure to sunlight as they are either mostly indoors or moving about in enclosed vehicles.

Another nutrient that needs mention is omega 3 fatty acids. These have many health benefits. They help brain development, promote heart health, reduce inflammation and provide protection against many chronic conditions. Out of three common ones, alpha-linolenic acid (ALA) is present in many plant foods including flax seeds and soya bean oil. Eicosa-pentaenoic acid (EPA) and docosa-hexaenoic acid (DHA) are commonly present in animal foods, mostly in fish.

ALA consumed is converted in body to EPA and to DHA. These latter ones are more active for health benefits. Since the conversion from ALA is very low, it is better to consume EPA and DHA either in foods like fish or from supplements. Even the conversion becomes less efficient in old age, so those who consume these higher omega 3 fatty acids from diet or supplements would have better eyesight, memory and brain function, heart health etc.

These are some of the reasons for taking the supplements.

Validation & Safety

Many substances have been considered to have health benefits but before these are approved for use as supplements, they must be tested rigorously before regulatory bodies may consider their use. Since supplements have less controls over their consumptions, many do not need any prescriptions, their safety and efficacy must be thoroughly investigated.

Normally their investigative journey starts with scientific research in educational or research institutions. The research tries to evaluate their effectiveness in promoting health or tackling specific health issues. Although initial study may be carried out in animals, the real test involves human studies.

Clinical trials may follow the research. These are necessary for the validation of efficacy as well as the safety of these substances. Randomised controlled trials (RCT) under strict guidelines and protocols are performed to ensure their effectiveness and to rule out any chance occurrence.

The regulatory agencies then scrutinise all the data of both efficacy and safety and decide on the dose of the supplements. They may consider the fact that some of these nutrients and botanicals may already be coming from the normal diet. There may also be considerations of quality that may also affect safety of supplements. Many are purified and isolated from natural materials such as herbs and medicinal plants, that may also contain some undesirable substances that need to be removed. This gives rise to quality control of the supplements that include testing for purity, potency and proper labelling with respect to ingredients and directions for usage etc.

Adverse effects

Dietary supplements can help get adequate amounts of essential nutrients if the diet does not contain good amounts of these nutrients. Some supplements may cause side effects if taken at high doses. Some supplements can even cause some problems. Vitamin K can reduce the ability of blood thinners prescribed to heart patients. St. John’s wort can reduce the effectiveness of some medicines. Antioxidants including vitamins C and E may reduce effectiveness of some types of cancer chemotherapy.

It is always better to consult health professionals when taking dietary supplements especially when taking high doses. Some may be wasteful but some can cause adverse effects.

Finally, the supplements should not be considered as a regular part of diet unless these are prescribed to prevent some chronic issues. Most supplements should be short term solutions for inadequate diet due to some conditions. Nutrients should preferably come from foods. However, in the event of some shortfall, dietary supplements are very cost effective solutions to correct them.


Dr Jagadish Pai

Editor, PFNDAI

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