Imagine if there were one pill that could make you smarter, healthier, and more energetic.
In Limitless, Bradley Cooper’s character was given such a pill that gave him superhuman abilities.
Despite what many may think, the multiple vitamins and minerals taken in the form of expensive pills every day will not make you smarter or even healthier, in most cases.
A fairly recent survey has shown that about 68% of Americans use vitamin and mineral supplements with regularity, and believe that they have a beneficial effect…
Science begs to differ. While not all supplements are useless, many are.
If you’re on PaleoHacks, you obviously care about your health and nutrition, which is great. In this article we’ll go over the science behind supplements so that you can stick to any that might actually benefit your health.
Are Any Supplements Really Paleo?
Supplements, in terms of vitamins and minerals, are little pills/capsules with a concentrated dose of that nutrient. For this to be possible, their original sources have to be highly processed as other nutrients are stripped away.
I don’t think that anyone can really argue that supplements are strictly Paleo. However, I know that most people (like me, and probably like you) eat a more modern form of the Paleo diet.
To be honest, eating liver and other organ meats (which are very nutrient-dense) gross me out. And while I’d like to, it’s not always possible to eat the highest-quality cuts of meat. There are many other ways that you could miss out on important nutrients depending on your own food preferences.
I don’t think too many people would argue that getting all nutrients from quality food sources would be ideal, but it’s not always realistic.
Supplements may be an important ingredient for optimal health.
Supplements Can Be Critical to Good Health…In Certain Situations
The good news is that supplements have been studied quite a bit. So let’s dig in to the research and see what impact they really have.
As a general rule, taking supplements for no reason is a waste of money and effort. Many doctors, whether they endorse a Paleo diet or not, have already become vocal against the common use of general supplements and multivitamins.
The Utter Uselessness of Multivitamins
When taking a more long-term view, and studying the effects of multivitamins and mineral supplements on chronic disease and cancers, no definitive benefit or harm could be determined (1). This essentially means that they have an extremely small effect, if any. Similar insignificant effects were found when studying multivitamins and cardiovascular disease (CVD) (2).
Antioxidants are Good, Right?
I’d say it’s been about 10 years since “a great source of antioxidants” started being plastered on just about every packaged food.
The main antioxidants are vitamin C, vitamin E, and beta carotene. In food products, “extra antioxidants” usually just means they added some vitamin C or E.
I’ve gone over the dangers of free radicals before in The Complete Guide to Cooking Oils. In short, free radicals are highly reactive molecules that can react with and damage DNA and other important structures.
Antioxidants have the ability to shut down free radicals before they cause too much harm, which is why they are part of a healthy diet.
But most people get plenty of antioxidants through fruits, nuts, and other sources.
Take a look at the chart below. It shows the results of a comprehensive study that examined the effects of antioxidants on mortality (3).
The results are clear. In all cases, the antioxidant supplement either had no conclusive effect on mortality, or it actually increased it by a small amount in the cases of beta carotene and vitamin E. There are dangers of over-consuming antioxidants, and it can increase your mortality (not a good thing) (4).
What About the Elusive Sunshine Vitamin? Vitamin D
Vitamin D is important for several reasons, primarily to facilitate calcium absorption from the gut and to maintain strong bones. In addition, vitamin D deficiency is linked to mood disorders, like seasonal affective disorder.
In studies of vitamin D and calcium supplementation, no conclusive benefit or harm has been established yet (5).
What Does All This Mean?
It means that in a randomized sample of the population, supplementing with vitamins or minerals has no clear benefit, and could even be harmful.
As we’ll look at next, supplements do have a role in good health in people that are deficient in one or more important nutrients. Since the above research was all done in the general population, that should also tell you that it’s pretty hard to be deficient in most circumstances.
How Effective are Supplements for Correcting Nutritional Deficiencies?
At this point, we know that supplements are useless for the vast majority of the population that already have fairly healthy levels of nutrients.
However, we know that being deficient in essential vitamins or minerals can lead to preventable diseases like rickets and scurvy, and can make people more likely to fracture bones.
There are many ways for deficiencies to arise, but supplements may be an excellent way to treat these deficiencies.
Who’s at Risk for Deficiencies?
Deficiencies typically only arise in special cases, like:
- a highly restrictive diet
- old age (sometimes)
- extreme weather conditions (no sun for long periods)
Technically, the Paleo diet is a restrictive diet. Although we restrict mostly “bad” foods, we should still examine any risks that come with it, and will do so shortly.
Vitamin D Deficiency: A Need for Supplements?
Humans make vitamin D from the sunlight that hits their skin. It is a fat-soluble vitamin, which means that you can store it in relatively large amounts.
In most parts of North America, it is possible to develop a deficiency, but not extremely likely. However, in some places, like Iceland, there are only a few hours of sunlight during the winter. If you don’t have enough vitamin D stored up, you could be at high risk of deficiency.
Since there aren’t really any food sources that are rich in vitamin D, supplements are the natural place to look for a solution. Luckily, the research seems promising (8).
It shows that vitamin D supplementation is effective at preventing rickets in infants and children (9).
In a meta-study (a study reviewing 29 other studies), it was found that vitamin D with calcium supplementation leads to higher bone density and a lower fracture rate in people over 50, who are most at risk for deficiency (10).
One of the challenges of this type of research is having subjects who are deficient in the vitamin. While studies identify high-risk populations, this can still muddle results, which is why large meta-studies can be useful for gaining an overall view.
One Caveat: Dose Matters
To make things a bit more complicated, the dose of the supplement can have a significant effect on the results.
For example, trials using 400 IU (international units) of vitamin D per day had no significant effect on fracture risk, but trials using 700-800 IU did result in a lower fracture risk, regardless of whether calcium was or wasn’t supplemented (11).
Vitamin and mineral daily intake recommendations are typically on the safe side. While there is a risk of having too much of certain vitamins (mainly fat-soluble ones), the recommended intake is just a guideline, and may not be ideal for you.
For vitamin D, Canadian professor Dr. David Hanley is pushing for a higher minimum intake of vitamin D, from the current recommendation of 400 to 1000 IU, to a minimum of 800 IU. He also notes, “Canadians can safely take daily vitamin D supplements up to the current definition of tolerable upper intake level (50 mcg [2000 IU]), but doses above that require medical supervision.”
Not all countries have the same recommendations for daily intake, but you get the point.
What About Other Vitamins and Minerals?
Vitamin D deficiency appears to be the most thoroughly studied deficiency, because it’s also the most likely. However, deficiency in any essential vitamin or mineral can cause many significant health defects.
When you are deficient in vitamin K, uncarboxylated MGP (an important protein) is made, which appears to contribute to CVD through vascular calcification (basically calcium deposits in your veins/arteries). People on hemodialysis, a treatment for advanced kidney failure, are likely to develop severe vascular calcification because of poor vitamin K utilization. Supplementing with vitamin K has been successful for decreasing vascular calcification in these patients – a very good thing (12).
Another demographic with high risk of deficiency is pregnant women. Folic acid (folate/vitamin B9) deficiency causes neural tube defects (NTD), which causes many formation issues for the fetus. In addition, a vitamin B12 deficiency can also cause NTD issues, along with infertility or recurrent spontaneous abortion. Supplements have been shown to be effective at preventing these common deficiencies (13).
The research is far from complete enough to make any definite conclusions, but the research does tend to point towards supplements having a positive effect overall when taken by individuals with a high risk of deficiency.
Are Multivitamins a Good Solution?
While specific supplements should be taken if you are at high risk for a deficiency, that doesn’t address multivitamins.
In general, it’s rare to be deficient in a wide variety of nutrients. Even if you are, it’s unlikely that a multivitamin has a nutrient profile that matches your deficiencies.
While a multivitamin is better than nothing if you know that you have a high risk of deficiency, supplementing for that specific vitamin or mineral is a much better solution.
The Most Common Deficiencies When on a Modern Paleo Diet
We know that supplements should really only be taken if a deficiency is suspected. That leads us to the final issue of determining which deficiencies you might be at risk for on a Paleo diet.
Since all diets are highly variable, the best I can do is provide some general nutrient information for common areas of Paleo foods. From there, you’ll have to assess your diet and see if anything is missing.
I created a table that looks at some of the more common staples of Paleo across different types of foods.
Note: This is not an exhaustive list by any means. There are a ton of vitamins and minerals; I only included the most common ones that people typically take supplements for.
(click to enlarge)
You’re free to view a copy of the sheet and download it for personal use in any way.
What we can see from the chart is that if you’re eating a wide variety of foods (and food types), you’ll have no problem getting a good amount of all vitamins and minerals. The hardest nutrients to get are:
- Vitamin D
- Vitamin E
Vitamin D has been the focus of a lot of the research I went over earlier. It’s overall one of the most common vitamins that people are deficient in. Evaluate how much sun you get to determine whether you’re at risk of deficiency. If you don’t get a lot of sun, supplementing with vitamin D (try to get the D3 form) is a good idea.
Paleo foods high in vitamin E include almonds, red bell peppers, eggs, avocados, and some seeds. If you don’t like these foods or don’t eat them consistently, it would make sense to supplement your vitamin E intake with vitamin E pills.
When you’re eating a typical Western diet, having too little sodium is the last thing you should be worried about. But when a lot of people switch to a Paleo diet or even a Keto diet, they often forget to get enough sodium. No supplement is needed, just add a bit of salt to your food when appropriate.
Should You Take Any Other Supplements?
I can’t tell you if you do or don’t need supplements, but you can use the sheet above to get an idea if there are any big gaps in your diet. If you think you are at a high risk of being deficient, experiment with supplementing the specific vitamin(s) or mineral(s) that you might be lacking and see if you notice a difference.
Supplements are an amazing scientific advancement, but that doesn’t mean that they’re necessary for everyone. Make sure that you have a reason for buying any before doing so — otherwise, you’re probably just wasting your money.
Let me know if you’ve had any experience with supplements – good or bad – in the comments below.