By Cliff Harvey
You read a lot nowadays about supplements being worthless… On the other hand, there are just as many people telling you to buy supplement ‘X’ because it will help you to lose fat, gain muscle or be as funny as me.
Now you know that no supplement can help you do that (be as funny as me…) but as for the rest… How do you cut through the BS and figure out the most effective supplements?
That’s why at Nutrition Store we’re putting together this series (with the help of the Holistic Performance Institute) to help you figure out what to take. In a nutshell, we’re giving you the ‘all killer, no filler’ intro to the most effective supplements.
Take a Quality Multi
Estimates from the New Zealand Ministry of Health ‘NZ Adult Nutrition Survey’ of 2008/2009 suggest that many New Zealanders are not getting the recommended amounts of many of the vitamins and minerals from their diets.1
Some of the key findings included:
- Around 20% of people fail to get sufficient vitamins A, B1 and B6.
- 8% of people fail to get sufficient B12.
- Nearly 10% of women don’t get enough iron.
- Around 25% of people don’t consume enough zinc. Interestingly nearly 40% of males do not get adequate zinc from their diet.
- 45% of people don’t get enough Selenium (a mineral lacking in New Zealand soils).
It’s important to remember that food always comes first. We should always focus on trying, over time, to eat better. But a quality multi-nutrient helps to “fill in the gaps”.
Some of the evidence-backed benefits of multi's include:
- A 9% drop in overall mortality has been observed in those taking multinutrients2
- A protective benefit overall for cancer and heart disease3
- Multinutrients may reduce weight gain, breast tenderness, nausea and mood disturbance in those taking oral contraceptives4
- Reduced perceived stress (in healthy, older people)5
- Improved sleep6
- Memory performance significantly improved following multivitamin supplementation (p < 0.05). Performance on other cognitive tasks did not change. Levels of vitamin B12 and folate were significantly increased7
- Benefits appear to be greatest in those most undernourished and as age increases8
- Increased fertility and reduced rates of neural tube defects9
- Multinutrients help to ensure a healthy nutritional intake and are safe for long-term use10
- Reduced risk of age-related cataracts11
So, given that there is commonly a lack of nutrients in the modern diet, and we see some pretty compelling reasons to take one… it’s a good idea to supplement with a daily multi-nutrient.
What to look for in a multi
A multi should contain all the essential micronutrients—with the possible exception of iron because up to 20% or more of people may experience some type of sub-clinical iron overload. It should also be based, where possible on whole-food ingredients and extracts and use the safest ingredients and the most effective forms of the vitamins and minerals. Finally, it shouldn't contain ingredients simply because they are ‘trending’, or popular if they don’t have solid evidence to support safety and efficacy.
Whole Food Ingredients
Whole-foods including herbs, berries, vegetables (and their respective extracts) help to provide ‘secondary nutrients’. These nutrients are antioxidant (and other) compounds that help to support health in addition to the essential micro-nutrients. Conventionally farmed produce is often lacking in secondary nutrients produce and they are not typically found in appreciable amounts in highly processed and refined food items.
Safest and Most Effective Forms to Look for:
Preformed vitamin A plus mixed carotenoids
The most commonly used carotenoid in supplements is beta-carotene, a vegetable-derived carotenoid that is converted into active Vitamin A. However, conversion rates of beta-carotene to usable Vitamin A differ by a factor of nine-fold12 and beta-carotene is required in amounts at least four times higher than pre-formed Vitamin A.13, 14
Both pre-formed Vitamin A (for example from retinyl palmitate) along with sufficient beta-carotene (pro-vitamin A) and other naturally occurring carotenoids help to ensure optimal Vitamin A levels to get the full range of its health effects.
Note: Some care should be taken with pre-formed Vitamin A is it can be toxic in high doses. Multi-nutrient formulas, taken according to label directions should not be any risk though.
Safest forms of B12
Cyanocobalamin, is a synthetic form not found naturally in foods. Metabolism of cyanocobalamin leaves behind a cyanide residue that the body must then excrete. This is unlikely to cause problems for most people (the amount of cyanide left is extremely small), however, those with pre-existing kidney problems may have trouble excreting even these small amounts.15 It has been recommended that cyanocobalamin should be replaced with a non-cyanide form of B12 for general safety.16 Naturally occurring cobalamins are absorbed more effectively than synthetic B12 (cyanocobalamin)17, 18 Methylcobalamin has a methyl group and is able to act as a methyl donor for the remethylation of homocysteine to l-methionine and the subsequent formation of S-adenosylmethionine (SAMe).19 (SAMe is essential to most biological methylation reactions including the methylation of myelin, neurotransmitters, and phospholipids). Synthetic (non-methylated) forms need to themselves be methylated in order to do this. This step may be limited in some people and even in healthy people could tax methylation pathways unnecessarily.
Best forms of B9 (folate)
Many people cannot effectively convert synthetic forms (like pteroylmonoglutamate) of folic acid to active folate in the body. These are the most common forms found in supplements but they can lead to high levels of unmetabolised folic acid in the blood20, 21 which interferes with the functions of active folate22, 23 and can be tumor-genic and negatively affect immunity.24
Recommendation: Use a multi that includes a methylated folate form (i.e. L5-MTHF)
Broad spectrum vitamin E
It was once thought that the only active form of Vitamin E in the body was d-alpha-tocopherol. However, all four tocopherols and four tocotrienols demonstrate important health functions, including increased antioxidant activity and reductions in cancer formation. Overloading with alpha-tocopherol alone may reduce levels of the other health-promoting forms of Vitamin E in the body.25
Recommendation: Choose a mixed tocopherol/tocotrienol blend that also has ample amounts of alpha-tocopherol
Includes Vitamin K
Commonly omitted from nutrient formulas, Vitamin K plays an important role in promoting proper coagulation and wound healing. Vitamin K is also involved in regulating immunity and inflammation and in aiding proper bone construction and development.
Note: Vitamin K2, menaquinone-7 (K2-MK7) has demonstrated promise to help reduce arterial calcification and so may offer additional cardiovascular benefits.
Selenium is an important antioxidant mineral. It works with Vitamin E to protect cell membranes and is involved with proper thyroid function—by aiding the conversion of the thyroid hormone thyroxine (T4) to the more active form triiodothyronine (T3). It is extremely low in New Zealand soils and thus nearly half of New Zealanders do not get enough from diet alone.
Our top multi-nutrient picks:
- Good Green Stuff by Nuzest
- Thorne Basic Nutrients lll - (Please Note this is a Practitioner-Only Product - contact us for more information)
- University of Otago and Ministry of Health. A Focus on Nutrition: Key findings of the 2008/09 New Zealand Adult Nutrition Survey. Wellington: 2011.
- Huang H-Y, Caballero B, Chang S, Alberg AJ, Semba RD, Schneyer CR, et al. The Efficacy and Safety of Multivitamin and Mineral Supplement Use To Prevent Cancer and Chronic Disease in Adults: A Systematic Review for a National Institutes of Health State-of-the-Science Conference. Annals of Internal Medicine. 2006;145(5):372-85.
- Alexander DD, Weed DL, Chang ET, Miller PE, Mohamed MA, Elkayam L. A Systematic Review of Multivitamin–Multimineral Use and Cardiovascular Disease and Cancer Incidence and Total Mortality. Journal of the American College of Nutrition. 2013;32(5):339-54.
- Mohammad-Alizadeh-Charandabi S, Mirghafourvand M, Froghy L, Javadzadeh Y, Razmaraii N. The effect of multivitamin supplements on continuation rate and side effects of combined oral contraceptives: A randomised controlled trial. The European Journal of Contraception & Reproductive Health Care. 2015;20(5):361-71.
- Macpherson H, Rowsell R, Cox KHM, Scholey A, Pipingas A. Acute mood but not cognitive improvements following administration of a single multivitamin and mineral supplement in healthy women aged 50 and above: a randomised controlled trial. AGE. 2015;37(3):1-10.
- Sarris J, Cox KHM, Camfield DA, Scholey A, Stough C, Fogg E, et al. Participant experiences from chronic administration of a multivitamin versus placebo on subjective health and wellbeing: a double-blind qualitative analysis of a randomised controlled trial. Nutrition Journal. 2012;11(1):1-10.
- Harris E, Macpherson H, Vitetta L, Kirk J, Sali A, Pipingas A. Effects of a multivitamin, mineral and herbal supplement on cognition and blood biomarkers in older men: a randomised, placebo-controlled trial. Human Psychopharmacology: Clinical and Experimental. 2012;27(4):370-7.
- McNeill G, Avenell A, Campbell MK, Cook JA, Hannaford PC, Kilonzo MM, et al. Effect of multivitamin and multimineral supplementation on cognitive function in men and women aged 65 years and over: a randomised controlled trial. Nutrition Journal. 2007;6(1):1-5.
- Czeizel AE, Dudás I, Métneki J. Pregnancy outcomes in a randomised controlled trial of periconceptional multivitamin supplementation. Archives of Gynecology and Obstetrics. 1994;255(3):131-9.
- Biesalski HK, Tinz J. Multivitamin/mineral supplements: rationale and safety – A systematic review. Nutrition.
- Zhao L-Q, Li L-M, Zhu H. The effect of multivitamin/mineral supplements on age-related cataracts: a systematic review and meta-analysis. Nutrients. 2014;6(3):931-49.
- Tang G, Qin J, Dolnikowski GG, Russell RM. Short-term (intestinal) and long-term (postintestinal) conversion of β-carotene to retinol in adults as assessed by a stable-isotope reference method. The American Journal of Clinical Nutrition. 2003;78(2):259-66.
- Wang J, Wang Y, Wang Z, Li L, Qin J, Lai W, et al. Vitamin A equivalence of spirulina β-carotene in Chinese adults as assessed by using a stable-isotope reference method. The American Journal of Clinical Nutrition. 2008;87(6):1730-7.
- Tang G, Qin J, Dolnikowski GG, Russell RM, Grusak MA. Golden Rice is an effective source of vitamin A. The American Journal of Clinical Nutrition. 2009;89(6):1776-83.
- Vitamin B12 Deficiency. New England Journal of Medicine. 2013;368(21):2040-2.
- Freeman AG. Cyanocobalamin--a case for withdrawal: discussion paper. Journal of the Royal Society of Medicine. 1992;85(11):686-7.
- Matte JJ, Guay F, Girard CL. Bioavailability of vitamin B12 in cows' milk. British Journal of Nutrition. 2012;107(01):61-6.
- Koyama K, Usami T, Takeuchi O, Morozumi K, Kimura G. Efficacy of methylcobalamin on lowering total homocysteine plasma concentrations in haemodialysis patients receiving high‐dose folic acid supplementation. Nephrology Dialysis Transplantation. 2002;17(5):916-22.
- Pfohl-Leszkowicz A, Keith G, Dirheimer G. Effect of cobalamin derivatives on in vitro enzymic DNA methylation: methylcobalamin can act as a methyl donor. Biochemistry. 1991;30(32):8045-51.
- Ashokkumar B, Mohammed ZM, Vaziri ND, Said HM. Effect of folate oversupplementation on folate uptake by human intestinal and renal epithelial cells. The American Journal of Clinical Nutrition. 2007;86(1):159-66.
- Kelly P, McPartlin J, Goggins M, Weir DG, Scott JM. Unmetabolized folic acid in serum: acute studies in subjects consuming fortified food and supplements. The American Journal of Clinical Nutrition. 1997;65(6):1790-5.
- Smith AD, Kim Y-I, Refsum H. Is folic acid good for everyone? The American Journal of Clinical Nutrition. 2008;87(3):517-33.
- Wright AJ, Dainty JR, Finglas PM. Folic acid metabolism in human subjects revisited: potential implications for proposed mandatory folic acid fortification in the UK. British Journal of Nutrition. 2007;98(04):667-75.
- Troen AM, Mitchell B, Sorensen B, Wener MH, Johnston A, Wood B, et al. Unmetabolized folic acid in plasma is associated with reduced natural killer cell cytotoxicity among postmenopausal women. The Journal of Nutrition. 2006;136(1):189-94.
- Huang H-Y, Appel LJ. Supplementation of Diets with α-Tocopherol Reduces Serum Concentrations of γ- and δ-Tocopherol in Humans. The Journal of Nutrition. 2003;133(10):3137-40.