One in three of us take supplements regularly. But are you popping the right ones?
Look into almost any woman's medicine cabinet and you're likely to find vitamins and supplements of some sort to make up for a less-than-perfect diet, as well as help us feel more energetic, ward off infections, as a preventive measure to keep hearts healthy and joints moving and to help resolve specific health problems.
But do supplements really work? Absolutely, as long as you are taking the right one, for the right reason and in the right dose. We've put together your one-stop top-ten guide to essential nutritional supplements, along with advice on how to take them to see the most benefits.
On buying vitamins and minerals
Go into any health food shop and you'll probably be overwhelmed by the sheer volume of nutritional supplements on sale, with so many brands, different formulations and varied potencies. In addition to using this list, don't be shy about asking staff at any health food shop. They should be trained to advise you on different formulas or refer you to a nutritionist, herbalist or your GP as necessary.
Supplement safety is obviously essential - it is always advisable to check with your GP if there are any conflicts between supplements and medicines you may be taking. You should also not take supplements when pregnant or breastfeeding unless you know they are safe.
Match your needs to a supplement Match up your health needs with the right vitamin, mineral or supplement. Then go to What you need and why you need it to find out the specifics of each, what they need to work best and issues to watch out for.
Depression, moods, brain health: B-vitamins, Omega-3s, Zinc
Digestive health: Bowel bacteria and FOS/Inulin
Energy levels: B-vitamins, iron
Eye health: Antioxidants, berry extracts
Fertility: Folic acid/B-vitamins, Zinc
Healing Antioxidants: Zinc
Immune health: Bowel bacteria and FOS/Inulin, antioxidants, Zinc
Heart Health: Folic acid/B-vitamins, Omega-3s
Inflammation: Antioxidants, Omega-3s
Lung health: Antioxidants, Berry extracts
Pregnancy: Calcium/magnesium, Folic acid, Iron, Omega-3s, Zinc
Premenstrual health: B-vitamins, Calcium
Skin, hair and nails: Hair and nail formulas, Omega-3s, Zinc
Stress: B-vitamins, calcium/magnesium, zinc
What you need and why you need it
What Omega-3s
Why you need it
These fatty acids are linked to many health benefits because they are a fundamental human need. The diet on which we evolved consisted of about equal 1:1 or 2:1 ratios of omega-6s to omega-3s, but the ratio now stands at about 18:1. Not surprisingly this means that a number of metabolic imbalances are causing health problems. Omega-3 deficiency, or imbalance with omega-6s, is linked to depression, heart disease, some cancers such as breast and prostate cancers, and stroke. Omega-3s are also essential for a baby's development in the womb as they make up important structural elements of the brain and other nervous tissues. They also help protect against skin problems such as eczema and inflammation such as joint problems.
What you need to know
Supplements feature EPA, a vital fatty acid which is useful for depression (affecting nerve cell signalling) and thinning blood. DHA, another vital fatty acid found in supplements, is used structurally in the brain and is particularly important for pregnant women and small children. For omega-3 supplements to work well, you should reduce intakes of hydrogenated omega-6 fats in the diet - these are fats that come from fast foods, packaged foods, margarines and cooking oils. There are no major risks associated with supplements, though people on blood-thinning medication should consult their doctors to ensure that the blood-thinning properties do not cause problems. Pregnant women should ensure their fish oils do not come from cod liver oil, which is too high in vitamin A and could be damaging to the foetus.
What Bowel bacteria and FOS/inulin
Why you need it
Improving the health of bowel bacteria is critical for digestive and immune health. Lactobacillus and bifidobacteria are two groups of bacteria found in supplements, though they may come as different 'subspecies'. A good quality supplement will also include FOS, also called inulin, which acts as food for the beneficial bacteria to thrive and take hold more effectively. The link to digestive health - for problems such as bloating, wind, constipation and irritable bowel syndrome is fairly obvious, but immune health is also improved. This is because the digestive system is the largest immune organ in the body and bacterial balance is vital for this function. 'Good' bacteria helps fight off 'bad' bacteria.
What you need to know
Make sure the supplement has sufficient live bacteria by checking that it's within its sell-by date and kept refrigerated. Alternatively buy a supplement with micro-encapsulated or freeze-dried bacteria. There are no real risks attached to taking probiotics and prebiotics (as these supplements are called) as long as they are from reputable companies. There have been cases of contamination with potentially pathogenic bacteria, but these are few and far between and have not occurred with reputable supplement companies.
What Folic acid
Why you need it
All women of child-bearing age who might become pregnant should ensure they are getting 400 micrograms of folic acid daily in supplement form (taking their total daily intake to 600 mcg with 200 mcg coming from food). Folic acid has been unequivocally linked to reduced incidence of spina bifida and other neural tube defects (where the foetus' spine does not form and close up correctly). It is not possible to get this amount from food alone and the synthetic form used in supplements is more effective than the natural form found in foods. For this reason there is a strong lobby to add folic acid to flour in the same way that has been done in the USA.
What you need to know
This level of intake does not represent a risk for most people. In the elderly there is concern that it could mask a vitamin B12 deficiency but the chances are small. Folic acid is probably best taken with a B-complex supplement (see below) and all prenatal formulas will include the required amount.
What Calcium/magnesium
Why you need it
Calcium is the most abundant mineral in the body, mostly stored in bones. Bone is a live tissue, and is not static as some imagine, so calcium is being turned over all the time. Boosting calcium intake is linked to improved bone health and reduced premenstrual symptoms. Calcium is excreted at times of stress.
What you need to know
Absorption of calcium is greatly improved by taking a supplement which also contains vitamin D and magnesium at a ratio of 2:1 (so 500mg calcium to 250mg magnesium). The most absorbable form of calcium is calcium citrate. There are no particular problems with calcium supplementation at levels of around 500mg-1000mg.
What Zinc
Why you need it
Zinc is needed for each and every growth and healing process. This makes it essential for skin health, immune health, wound healing, fertility and pregnancy. Daily amounts of 7-9 milligrams are recommended from the diet, however those whose diets have been deficient, who are experiencing long-term stress or illness, or who have impaired fertility could benefit from 15-20 mg daily. Depression is also often improved with zinc supplementation.
What you need to know
Zinc is safe to take at the levels described, even in pregnancy. However taking zinc at doses of 15mg or more over a prolonged period could result in a reduction of copper levels, so good quality supplements will include 1mg copper for every 10mg zinc. As zinc works particularly with vitamin B6, it's best to take it with a B-complex or to make sure a multi includes B-vitamins.
What Iron
Why you need it
Ninety per cent of women do not consume enough iron. Iron is needed for red blood cells to transport oxygen around the body and is found in meat, eggs, cheese, pulses and fortified cereals. The most likely symptoms of iron deficiency are low energy and pale skin. A doctor can run a test for anaemia. Women who menstruate heavily, who have just given birth or who have quick successive pregnancies are most at risk of anaemia.
What you need to know
Best forms of iron supplementation are iron citrate or liquid iron (iron-rich water sources for instance) and the worst, least absorbable and most constipating form is ferric iron so it is best to buy ferrous iron. While most multi-supplements include iron because so many people consume insufficient amounts, it is equally important not to take too much iron if it is not needed. As it is a 'pro-oxidant' (as opposed to antioxidant) it has been suspected of playing a part in heart disease if excess levels are in the blood, particularly in men who don't have any means of eliminating iron unless they donate blood.
What B-vitamins
Why you need it
Anyone who is suffering from low energy levels, a stressful period in their life, or depression (that is, almost everyone), might consider taking a B-complex supplement or boosting their diet with brewer's yeast or wheatgerm. This is because B-vitamins are essential for most aspects of energy production, for stress hormone regulation and for nerve health. Drinking alcohol and taking antibiotics also depletes vitamin B levels. B-vitamins are also important for cardiovascular health as B2, B6, B12 and folic acid all work together to lower homycysteine, a compound that significant numbers of people make too much of and which increases the risk of heart disease.
What you need to know
B-vitamins are mostly water soluble (elimated from the body, and not stored in fat) and so are very safe. Upper limits of 25mg for vitamin B6 have been set, though previously many women took much higher amounts as an effective way of controlling premenstrual problems.
What Antioxidant formulas
Why you need it The antioxidant mineral selenium and the antioxidant vitamins A, C and E are often found together in different formulations. They are grouped together because they complement each other in nature. Antioxidants are important for supporting immune health, for healing and for skin health. Anyone who smokes should take extra vitamin C in particular to compensate for vitamin C depletion.
What you need to know
Vitamin A should not be taken by women who are pregnant (or who think they may become pregnant) because of its potential toxic effects on the baby in the first 12 weeks of pregnancy. Prenatal formulas use beta-carotene instead, which can be safely converted in the body to vitamin A as needed. It is easy to overdo vitamin A if taking, for instance, a multi-formula, an antioxidant formula and cod liver oil at the same time.
What Hair and nail formulas
Why you need it A glossy head of hair and strong nails are a sign of good health. Zinc is important and will be found in most formulas. An herb that is often found in hair and nail formulas is horsetail because it is rich in the mineral silica which is needed for hair and nails.
What you need to know
There are no risks attached to this but check that zinc levels when combined with other formulas do not make your daily intake level too high (see zinc above).
What Berry extracts
Why you need it Berries, such as blueberry (bilberry), cranberry and elderberry are rich in very powerful antioxidants called anthocyanins. They have been linked to improved eyesight, skin health and lung health (making them excellent for asthma sufferers). Some supplements will be described as flavonoid extracts and will have a high amount of berry extracts.
What you need to know
There are no contraindications to taking berry extracts. Some supplements, aimed at eye health, also include lutein and zeaxanthin in addition to the berry extracts. They are extracted from spinach and ideally both should be included rather than just one or the other - this is because just including one might imbalance levels of the other.
Suzannah Olivier is a nutritionist and the author of many nutrition books. Her latest is Food Medicine (Robinson). You can find out more about her on her website www.healthandnutriton.co.uk
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