WHEN IT COMES TO over-the-counter nutritional supplements, there are the good, the bad, and—if not exactly the ugly—the tricky. The “trick” is to know the difference between what your body needs and what’s right for it.
Or, as Marilee Clemons said, “Food first, supplement second.”
Over-the-counter nutritional supplements have their place, said Clemons, ambulatory care pharmacist at the University of Toledo General Internal Medicine and clinical associate lecturer at UT’s College of Pharmacy and Pharmaceutical Sciences. They’re to supplement the diet of those who can’t absorb the proper amount of nutrients, who follow a less-diverse diet, who are on a restricted diet, or who routinely eat highly processed foods.
Clemons issued a disclaimer: over-the-counter supplements aren’t regulated by the federal Food and Drug Administration. “There is no common body or organization that is certifying that what the product says it contains is really in the product,” she said. “You want to make sure that it has been tested by a third party—one is the United States Pharmacoepia—certifying that it has the right ingredients in the right amount and that nothing that shouldn’t be in there is in there.”
With all that being said, Clemons suggested a few supplements that are worthwhile in the right conditions:
• Multivitamins. These cover all the gaps, depending on your diet,' she said. 'It won't fix it if you have a chronic disease, but if someone doesn’t eat nutrient-dense food or eats a lot of processed food,” taking a multivitamin daily is wise. Clemons added, “Patients who are pregnant should take prenatal vitamins to be sure the mother gets all the nutrients the fetus needs.”
• Vitamin D. This is what the body gets from exposure to sunlight, but for those who don’t get outside much or who use sunscreen regularly, taking vitamin D is important to maintain healthy bones, she said.
• Omega 3. This is a fish oil that is an essential fatty acid—”a good fat, a very good fat,” Clemons said. “It helps with the structural fat in our bodies. An example is the outer layer of fat on the nerve cells. It helps ensure the nerve cells do what they’re supposed to do.” Omega 3 occurs naturally in salmon, mackerel, sardines, walnuts, and other nuts.
Omega 3 also contains eicosapentaenoic acid—EPA—which is important for brain health, affecting mood and well-being, and heart health. “Not all fish oils are created equal,” she said. “Not all have enough EPA. When taking an Omega 3 product, make sure it has high enough EPA—at least 1,000 milligrams, or 1 gram, per day. That’s the minimum.”
• Magnesium. Clemons said this is a nutrient we historically get from food, but through changes in farming, “soil tends to be less-nutrient-dense in magnesium.” This nutrient is important for healthy muscles and bones. Magnesium is available in dark chocolate, dark leafy greens, nuts, and some seeds, she said.
Magnesium combined with the amino acid glycine is a supplement— magnesium glycinate—that aids in sleep and can induce a calming effect. Magnesium glycinate is easily absorbed by the body and has fewer gastrointestinal side effects compared to other magnesium products.
• Protein powders. Protein is important for muscle health, mass, and longevity. “Having healthy muscles allows us to continue to do the things we want to do,” Clemons said. “Where it gets tricky,” she said, “is what it has in it. You need a clean source of the supplement, whey or plant-based protein.” Some protein powders contain chemicals like artificial sweeteners or caffeine, she said, which are to be avoided.
Pure protein powder is to be mixed with water or, for additional calories, milk.
There are some supplements that should be skipped. The main category is weight loss. Clemons’s rule of thumb: “If it’s too good to be true, it probably is.” If a supplement claims that it’ll help the patient lose 30 pounds in a month, “that’s too good to be true. You have to be really careful with over-the-counter weight-loss supplements. They often do not contain what they say they do, and they include stimulants that can be dangerous.”
She advises patients to steer clear of erectile dysfunction and testosterone- boosting supplements because they often are mislabeled. She said the FDA has a specific division focusing on counterfeit drugs and supplements, mainly in the weight loss, erectile dysfunction, and testosterone- boosting categories.
When it comes to supplements claiming to improve memory, “that’s really tricky,” she said. Researchers aren’t sure what the exact underlying cause of memory loss is, Clemons said. “Instead of using supplements, eat well and do stimulating things to keep the brain healthy.”
That advice circles back to her main point: “Food and physical activity for overall well-being. Eat nutrient-dense food—vegetables, fruits, brown rice, whole-wheat bread, lean meat, olive oil, seafood, eggs, nuts, seeds, avocadoes, beans. Supplements are synthetic. They’re meant to mimic something from nature.” She added that supplements sometimes can interact adversely with prescriptions the patient takes for health reasons.
“If you’re going to take a supplement,” Clemons advised, “work with a dietitian, physician, or pharmacist— someone who knows how to interpret literature on the supplement. Don’t just assume that an over-the-counter supplement is safe.”
Dennis Bova is a freelance writer and editor. ✲
