Sunday, May 30, 2010

My year of not taking supplements

We took the children to the circus last weekend. When it came to the Flying Sandros, a terrifying trapeze act, I was on the edge of my seat. For during the third jump, a daring reverse triple salto, the catcher’s and the flyer’s hands missed each other by a nanosecond and the flyer came crashing down into the net. Thank goodness for safety nets!

For the last 12 years, I have had my own dietary safety net: nutritional supplements. When I stopped taking them 79 days ago for my Anti-Cancer Challenge (in line with the World Cancer Research Fund’s recommendations, upon which the Challenge is based) I felt like a trapeze artist working without a net, for this is the first time in over ten years that I am supplement-free.

Over the past ten years I have swallowed approximately 50,000 supplements pills. At my peak intake nine years ago, my husband would joke that if you shook me, I’d rattle. For a while, my daily regimen included a high-dose multi-vitamin and mineral supplement, extra vitamin C to boost my immune system, a herbal combo to support my liver, a formulation to stabilize my blood-sugar, probiotics to aid my gut flora, magnesium to help me relax at night and digestive enzymes and hydrochloric acid capsules to assist me in digesting and assimilating my food.

After moving to France from the UK nine years ago I scaled back my supplement intake. When I ran out of my British supplements and couldn’t find easy replacements (in France there aren't entire shops dedicated to the sale of supplements as there are in the US and the UK) I noticed that I felt no worse-off, even after several months of supplement-deprivation. Moreover, as I discovered irresistible fresh, locally-grown food at greengrocers’, farmers’ markets and bistros I quickly lost interest in the encapsulated astronaut fare I had leaned on for years. I was happy to invest the $4-5 a day I was saving on supplements in delicious, fresh and healthy food.

According to the WCRF, some 35% of Britons and 50% of Americans regularly take supplements. In France, that number stands at a modest 20% but it is rising. Many of us see supplements as a sort of top-up health insurance, a safety net for when we don’t get around to eating well. Let’s be honest: isn’t it reassuring to think that if we take multivitamins and minerals, probiotics and omega-3 fatty acids in capsule form, it’s OK to give the real foods that contain these – fruits, vegetables, yogurt, nuts, oily fish – a miss occasionally?

Sporadic dietary transgressions are fine, of course. The problem is, ‘occasionally’ often becomes ‘regularly’ and before we know it, we rely increasingly on supplements to provide our nutrients. For instance, many people who do not eat fish (alas, there are many!) will struggle to obtain enough omega-3's or selenium from their diet.

In terms of cancer prevention – the remit of this blog – supplementation does not appear to deliver great benefits; in fact, in some cases, for instance in smokers taking beta-carotene supplements, they may actually increase risks. That’s why the WCRF concluded in its 2007 Expert Report: “For otherwise healthy people, inadequacy of intake of nutrients is best resolved by nutrient-dense diets and not by supplements.”

“Nutritional supplements contain forms and concentrations of nutrients that don’t occur in nature,” says Dr Rachel Thompson, science programme manager in charge of nutrition at the WCRF, adding that “supplements don’t contain fibre or the many bioactive components found in food and which are important for health.”  Indeed, it is increasingly understood that the different vitamins, minerals, proteins, fats and plant chemicals bound up together in natural foods reinforce each other’s actions in synergistic ways that supplements cannot replicate.

To be sure, many nutrients have been found to offer cancer-protection, but these should ideally come from food, not pills. For instance, according to the WCRF the mineral selenium (found in Brazil nuts, whole grains, fish, crustaceans and meat) probably protects against prostate cancer, calcium (from kale, spinach and other green, leafy vegetables, nuts & seeds, canned whole sardines, tofu and dairy products) is thought to act against colon cancer and vitamin E (from plant oils, seeds, nuts & whole grains, berries and green leafy vegetables) may cut prostate-cancer risk.

Granted, swallowing a pill takes a lot less time than preparing a healthy meal. However, healthy, nutritious food is a lot tastier and need not be time-consuming, as my previous post shows. So let’s prioritise real food over laboratory nutrients. For optimal nutrition, the food we eat should be as fresh as possible (ideally, locally grown in rich, healthy soil and eaten as soon as possible after harvesting), highly varied and carefully prepared. Long-distance transportation, long-term storage and overcooking can significantly reduce nutrient levels in foods.

There are exceptions where supplements are advisable. In people who have marked nutrient deficiencies or heightened nutritional needs, or who have trouble eating, digesting and absorbing food, supplementation is important. People over 50 who have difficulty absorbing vitamin B12 should supplement this. Moreover, women planning to conceive should take folic acid. Vitamin D is recommended for people who are not exposed to sufficient sunlight or those (such as the elderly or people with dark skin) who do not synthesise adequate vitamin D from sunlight. However, do not self-administer supplements; if you think you need extra nutrients or have difficulty digesting and absorbing the nutrients in your food, consult a doctor or nutritionist.

I will report over the next few months on my year without supplements. For now, anyway, I’m feeling fine without my nuritional safety net - indeed, last week I was the only member of my family to escape a spring cold that was doing the rounds.

Picture credit: Five female trapeze artists performing at the circus. Published by Calvert Litho Co., Detroit, Michigan; obtained from the Library of Congress.

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