Do you really need dietary supplements?

Is your diet as healthy as you think?

One of the most frequently asked questions in my work as a naturopathic physician is “I eat pretty well, doesn’t my diet give me the nutrition I need?”  The answer is, it all depends:  is your diet really as healthy as you think it is?  What standard are you using to gauge the quality of your food intake?  We now have ample evidence confirming that a nutrient dense, low glycemic burden (blood-sugar stabilizing) diet, rich in plant nutrients, healthy fats and fiber, supports good nutritional status, health and vitality; in contrast, the standard American diet (the so-called SAD diet of refined, adulterated foods which have journeyed from distant processing facilities to reach your table, losing nutrient value along the way) is more and more associated in medical research with the chronic health issues which have unfortunately come to be accepted as part of the aging process.

To the extent that your otherwise good diet contains elements that require your body to make withdrawals from its nutrient supply to metabolize them (the white-flour bagel you grabbed on the way to work this morning, the mid-afternoon cookie to lift your energy, that glass of wine with dinner), nutrient deficits can develop over time. No matter how your diet would measure up on close examination, even the most health-conscious among us has difficulty maintaining dietary perfection 100% of the time (and the pursuit of perfection carries health risks of its own!) – so supplementation to cover our nutritional bases has value from this point of view.

Toxins and Nutrition

Another consideration is the additional burden of toxins we encounter daily in modern times, a nutrient-depleting phenomenon of proportions for which we humans were never physiologically designed.  From the phthalates in  body lotion to the lead in lipstick to the styrene packaging beneath (even organic) chicken breasts and the acetaminophen we may take for aches and pains, each chemical requires a constellation of vitamins, minerals, amino acids and nutrient cofactors to complete its journey through and out of our bodies.  When we lack the nutrient support to make these detoxifying pathways run well, we store toxins in our body tissues, where they can impact health now and over the entire course of our lives.  Supplemental nutrients can support better toxin temoval from the body, providing proactive protection from our brave new toxic world.

How’s your digestion?

Our digestive tracts are beautifully designed to transform your breakfast, lunch and dinner from macronutrients (proteins, carbohydrates and fats) into micronutrients (such as vitamins, minerals, amino acids, and essential fatty acids), and to convey them by elegant mechanisms from your intestines into your blood stream and lymph channels.  “White foods” such as refined sugars and flours, alcohol, food allergens, inflammation, and stress compromise the effectiveness of digestion.  If you belch, or experience odorous flatulence and/ or abdominal bloating, one reason may be maldigestion, or ineffective breakdown of foods into usable nutrients.  If you have had your gall bladder removed, whose function is to store bile for fat digestion, you may not thoroughly digest fat-soluble vitamins (vitamins A, D, E and K),  important fatty acids and other fat-containing nutrients such as phospholipids, essential for healthy brain neuron and cell membrane receptor function.  If like many, your stomach acid production has declined over the decades, if you take antacids or a proton-pump inhibitor, the reduction in gastric acid changes the pH (acid-base balance) not only in the stomach, but throughout the “downstream” digestive tract, interfering with normal activation of digestive enzymes and the breakdown of foods.  Any of these digestion-compromising factors can create significant, multiple nutrient deficiencies.

How’s your absorption?

You may have heard the saying, “You are what you eat.”  This is true, but equally as important, we are what we digest – and what we absorb.

Part of the elegant design of the digestive tract is the refinement of the absorbtive processes for specific nutrients.  An example is the narrow range of acidity required for absorbtion of minerals such as calcium and magnesium, and amino acids such as tryptophan, which in the body is used to make the anti-depressant neurotransmitter serotonin.  Health issues or medications which reduce stomach acid levels (as discussed above) affect not only digestion, but also absorbtion of these and other nutrients.

The lining of the small and large intestine is the interface across which nutrients must travel to be used by the body to nourish cells, manufacture molecules, build muscle, bone and tissue, and help us live our lives energetically and healthfully. If the lining of the intestine becomes damaged or chronically irritated by inflammatory effects of toxic foods (an example of this is gluten intolerance or celiac disease, but any food has the potential to exert inflammatory effects on the membranes of the digestive tract); by immoderate alcohol consumption; stress; medications (such as non-steroidal anti-inflammatory medications and aspirin; or steroid drugs); microbe imbalance in the form of unhealthy bacterial, fungal, or parasite overgrowth; or any combination of these – nutrient malabsorbtion and nutrient deficiency are common effects.  It should be noted that malabsorbtion and the causes for it often exist below the level of our awareness, unless and until the process of inflammation becomes well advanced.

Biochemical individuality and nutrient needs

The biochemist Roger J. Williams, Ph.D. used the term “Biochemical Individuality” in his 1956 book of the same title to describe the uniqueness of each person’s nutrient requirements, based on genetics and other influences.   In contrast to the concept of RDA (Recommended Daily Allowance), which uses a generic calculation based on a review of currently available scientific literature to determine nutrient needs for “most people”, the principle underlying biochemical individuality disputes the idea of an average person, and says that biological diversity even between people who seem physically similar would dictate an individualized approach to determining and meeting nutritional needs.

Even within a given individual’s lifetime, nutrient needs vary widely as circumstances change.   Acute and chronic illness, stress, medications, injury or surgery, dietary changes, and environmental exposure present different nutritional requirements for healthy body function.  If you are fighting a cold or flu, or if you burned your hand making dinner last night, your nutrient requirements increase.  If you have been working longer hours, have been taking a cholesterol-lowering agent, are worried about finances or your child heading off to college, have undergone chemotherapy or radiation, your nutrient requirements are altered.  If in the past there was an extended period of time when your nutritional status was compromised – let’s say in college years when poor diet may combine with “recreational” drug and/or alcohol use – you may have created a “pothole” of ongoing nutritional deficit in the road of your life.  It can be difficult to repair such damage to nutrient status without intensive, “super-dietary” nutrient intake from supplements.

Nutritional Supplements as Therapeutic Tools

Using nutritional supplements in these ways, to repair the effects of present or past deficiency, or to protect against negative health consequences of current dietary insufficiency, digestive incompetence, environmental stressors, or medications, is part of my role as a naturopathic physician.  Beyond prevention and repair, though, is the realm of using nutrients with therapeutic intent, to improve health outcomes in acute illness and chronic disease.  Evaluating current nutritional status using physical signs and symptoms and laboratory testing, identifies of areas of need and appropriate supplementation.

Most of my work with nutritional supplements is in this area, grounded in the extensive and growing body of scientific evidence for the clinical benefits of such use, and the deep awareness that as humans, our physiology is based on biochemistry, not chemistry.  Nutritional approaches to treatment work in alignment with our biology and honor our human nature as biochemical beings.

How healthy do you want to be?

This may seem like a silly question with an obvious answer, but years of working with people and their health concerns has taught me that not everyone has the goal of “optimal health”.  Some seem fairly content with the assortment of illnesses, aches and pains, medications and procedures, and limited “vitality expectancy” which have come to be part of our cultural health standard.  If we define health as “the absence of disease”, nutritional supplements may seem expensive and unnecessary.  If the World Health Organization’s description of health as “a state of complete physical, mental and social well-being” is more compatible with our beliefs, we are more likely to consider nutrient supplementation as one way to preserve and increase our well-being.  For some, the idea of taking supplements feels too much like taking medication, and they prefer to focus on optimizing diet to create wellness.  Certainly, to eat and drink well, exercise, and develop strategies for healing from the stresses and toxic influences of our lives today – these are essential elements to create health and well-being, and supplements alone will not replace them.   However, to use supplements in conjunction with a healthy lifestyle can provide the benefits of each and the synergy of all for greater wellness.

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