A few weeks ago, Explain It to Me — Vox’s weekly call-in podcast — went on a field trip to our local Whole Foods supplement aisle, where there were powders and pills and tinctures galore. These supplements promised to do everything from reducing wrinkles, to maintaining focus, to keeping your gut biome intact. But how much of that is true?
According to Anahad O’Conner, health columnist at the Washington Post, supplements can be a mixed bag. But despite the dubious evidence behind some of them, a lot of us are taking these pills and potions. “The best statistics we have show that at least 60 percent of people in the United States alone use dietary supplements,” he said. “And that’s just one supplement or more. I know one doctor who had told a story of a patient who was taking 121 supplements in a day.”
How do we navigate the dizzying world of supplements? And what actually works as advertised? Below is an excerpt of our conversation with O’Connor, edited for length and clarity. You can listen to the full episode on Apple Podcasts, Spotify, or wherever you get podcasts. If you’d like to submit a question, send an email to [email protected] or call 1-800-618-8545.
We’re taking these products to feel better, but are they actually making us feel better?
There could be the placebo effect where people take supplements and think they’re getting benefits.
There have been studies showing that selenium is really good for your health and essential, and vitamin E is really good for your health, and it’s essential. And scientists will say, “Okaym we need to figure out what doses we should be telling people to take and how often to take these supplements.” They’ve then found people who take these supplements actually develop side effects and are more likely to develop cancer or heart disease, prostate cancer, things like that, and have been shocked. In fact, what we know is that it’s the dose that makes the poison. We need some level of vitamins and nutrients, of course, but taking more and more and more is often not good for your health and can cause a lot of side effects.
So, why are we allowed to take them? How come the FDA isn’t stepping in?
To put it mildly, dietary supplements are very loosely regulated in this country. They’re treated almost like they’re just food, because they are nutrients that come from food, but then they’re purified and concentrated.
Decades ago, the supplement industry pushed for this law called the Dietary Supplement Health and Education Act, which basically created what many critics call the Wild West of the supplement industry. Supplement makers can make all sorts of health claims. They can say that their supplement or their vitamin supports immune health, cardiovascular health, skin health — all these sorts of vague claims. They don’t have to undergo clinical trials where they’re tested to find out what doses are safe, what the side effects are, if they actually work or not for what’s claimed. And the FDA really can’t do anything once they’re on the market, unless there are reports of severe side effects. Right now, there are an estimated 90,000 different dietary supplements.
These companies don’t have to register their products at all with the FDA. The FDA has no idea what most of the products are unless there are many reports of people getting sick from a particular supplement.
And, in fact, you and I can easily create our own supplement company in five minutes. You can just create a website, get some powder, put it in a capsule, and start marketing your supplement. You don’t have to do any studies or notify any agency. You can just start marketing it.
I think we should talk about a few of these supplements. Should we be taking those daily multivitamins?
If you are eating a healthy diet, then it’s very unlikely that you actually need a multivitamin. Although there have been some studies showing benefits. For example, in older adults, it’s been shown that taking a daily multivitamin could potentially help with memory loss, for example.
Another thing everyone talks about is gut health. People say it can impact more than just your stomach. Should we be taking probiotics?
Probiotics are basically any bacteria or microbe that confers health benefits. You want a diverse community of gut microbes. You want a healthy ecosystem. But if you take a probiotic in capsule or pill form, what happens is that oftentimes they contain a limited number of species of bacteria in very concentrated mega-doses that can throw off the balance of your gut microbial ecosystem.
Probiotics are good for you, and you can get them from fermented foods. So, you think about things like sauerkraut, kimchi, Greek yogurt, for example. Humans have been consuming fermented foods for thousands of years, and they contain these healthy live microbes. If you’re just taking the probiotics in capsule or pill form, there can be side effects, and you can actually reduce the diversity of your gut microbiome rather than enhance it.
I have a couple of more supplements to ask you about. One is collagen. I admit that I bought some back when my favorite influencer at the time was putting it in her macha lattes, and now it’s sitting there gathering dust on my coffee bar. Should we be taking it?
No, I don’t think so. I haven’t seen any convincing studies that show any benefits of taking collagen supplements. That is something that I would not particularly waste money on.
What about creatine? Who should be taking this beyond your gym bros who are trying to get buff?
Creatine has been around for a while, and there have been a lot of studies on its benefits. It’s something that you can obtain naturally from food, particularly meat. And there have been studies showing that when you take a creatine supplement in combination with resistance training, then you can get some benefits from that. Particularly, it’ll help you grow bigger and stronger, but the benefits are not extraordinary. It might help you gain a few extra reps out of your bench press or your squat, for example. What they have also shown is that if you’re just taking creatine and not lifting weights, then you’re not going to see any benefits from it.
There’s been a lot of health claims that it can improve your cognitive health, help with dementia. There haven’t been any real good studies demonstrating that. That’s not to say that it’s not true, just that it hasn’t really been shown conclusively.
Any final thoughts on supplements? Should we be as invested in them as we are?
I am not anti-supplement. I still take some supplements here and there. Protein powder, for example, is something I’ll add to my smoothies.
Just be cognizant that there is a multibillion-dollar industry that wants the profit off of you by selling you their products, and they’re allowed to make all sorts of health claims and there are a lot of potential side effects. I always tell people, unless you have a documented demonstrated deficiency, you should be focusing on getting your nutrients and vitamins from your diet just by eating a lot of healthy whole foods, which is what human beings have been doing for millennia and has always worked. If you’re going to take supplements, be really careful about which ones you’re taking, make sure that you actually need it, that you’re actually getting benefits, and don’t just believe what the industry wants you to believe.
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