We chatted with Dr. Tieraona Low Dog, MD, Fellowship Director for the Academy of Integrative Health and Medicine about why it’s hard to get proper nutrition through food alone—and how to find the best supplements for you.
I eat a very healthy diet. Why do I need additional supplements?
Even those of us who eat a “healthy” diet may be at risk for certain nutritional gaps. According to the CDC, 90 million Americans are low in vitamin D, 30 million of us are deficient in B6, 18 million in B12, ~16 million in vitamin C and, for the first time, women between the ages of 20 and 39 are borderline iodine insufficient.
Here’s more about the reasons behind these insufficiencies—and the risks that come along with them.
Vitamin D can be hard to get in your diet, as it was intended to be produced in our body after exposure to the sun. The fact that we spend less time outdoors as a population—coupled with widespread use of sunscreen—dramatically inhibits our ability to make vitamin D. It’s important to note that the consequences of low vitamin D extend beyond our bones, as this nutrient interacts with more than 1,000 genes.
Roughly 1 in 10 Americans have low vitamin B6 levels—low enough to negatively impact their mental health. In addition, many healthy women take oral contraceptives, which lowers B6. Another interesting fact: Women are twice as likely to be deficient in B6 as men, and are also twice as likely to be treated for depression.
Vitamin B12 is essential for physical energy, mental clarity and emotional wellbeing. But B12 levels are often negatively impacted by prescription medications, such as Metformin, used to treat type 2 diabetes, and proton pump inhibitors (PPIs), used to treat acid reflux. Among the 18 million Americans deficient in B12, two-thirds are over age 40, as it becomes harder to absorb B12 from our food with age. The Institute of Medicine recommends that people over the age of 50 get their B12 from eating fortified foods or taking a supplement.
Today, warnings about sodium’s hazards have caused us to cut back on table salt—and in turn iodine (which was added to salt by the Morton Salt Company to help eradicate goiter in the early 20th century). Although high in sodium, processed and fast foods do not contain iodized salt, and specialty salts like Himalayan are naturally low in iodine. But as a group, women ages 20 to 39 (prime reproductive age!) have borderline iodine insufficiency. Goiter aside, this is troubling given that low iodine during pregnancy can reduce IQ and increase the risk for impaired cognitive development in babies. Sadly, iodine is not a nutrient required in prenatal vitamins.
Even plant-based foods—which we need an abundance of in our diet because of their importance to our health—have changed when compared to those grown just a century ago. Breeding plants for size and quick growth has made our veggies and fruits less nutritious. Studies show that there has been a statistically significant decline in five important nutrients in our produce—calcium, iron, riboflavin, phosphorous and vitamin C—when comparing garden crops from 1950 to 1999.
And now more than ever, we need the antioxidants and other protective compounds in plants to protect our cells from the damaging effects of environmental pollutants. For instance, vitamin E has been shown to be protective against a number of pesticides, but studies consistently show that most Americans do not meet the recommended daily allowance (RDA) for vitamin E from their diet alone.
The reality is that nutrient deficiencies are far more prevalent than most people realize, and suboptimal levels of key nutrients not only increase our risk for disease but also can negatively impact our mood, focus and energy.
How do I know which supplements I should be taking?
It can be overwhelming trying to figure out what nutrients you specifically need. That’s why I included whole sections on how to customize a supplement regimen in my most recent book, National Geographic’s Fortify Your Life: Your Guide to Vitamins, Minerals and More.
If I had to boil it down to the most important ones, I’d start with these three: A basic multivitamin that is appropriate for your age and gender. Consider taking additional magnesium and vitamin D, and possibly calcium if your diet is low in these nutrients. These are often found in one single supplement. And given the state of the human microbiome, taking a probiotic is probably wise. This can be in the form of a probiotic drink, probiotic-rich yogurts or a supplement.
Can supplements really provide the same quality nutrition I would get through food?
There is no substitute for a healthy diet. None. But the evidence is clear that many of us are not getting all the nutrients we need in our diet. That’s because the nutritional quality of our food has changed over the past 60 years, and many of us are taking medications that can rob us of key nutrients. And with the growing number of food allergies and food sensitivities, many people now eat an increasingly restricted diet, putting them at even greater risk for nutrient gaps. While food is best, it just may not be enough.
How do I make sure I’m buying the highest quality supplements?
Not all multivitamins are created equal. I recommend looking for those that deliver nutrients in a food matrix. Do not take supplements that contain synthetic fat-soluble vitamins (A, D, E and K), as these are inferior to their natural counterparts. Look carefully at the “other ingredients” section on the label. If you see artificial colors and flavors, look for another vitamin.
Why did you choose to partner with MegaFood on their new line of multis?
I love MegaFood and have long been impressed by their commitment to quality and their use of organic produce in the production of their supplements. But I wasn’t taking their multivitamin, as I need the active forms of folate and B12 due to a genetic impairment that makes it difficult for my body to methylate/activate these B vitamins. I am not alone in this. And as a physician who specializes in women’s health, I had trouble finding a prenatal vitamin that I could recommend that contained adequate iodine and choline. So when MegaFood asked if I would like to help develop a line of food-based multivitamins in accordance to my specifications, I felt deeply honored and excited.
By taking out the calcium and magnesium and putting them in a separate supplement with additional vitamin D, we were able to deliver the key nutrients most of us need in a matrix of whole food in just two tablets—not an easy task when you are making food-based multis! I am very proud.