By Carol Witte, RDN, Director of Nutrition Services and Senior Centers
Good nutrition and a healthy diet are important for good health. But walk through your favorite grocery store, pharmacy or health food store and you will see a variety of vitamins, minerals and other supplements that are advertised as something you “need” to keep you healthy. But are they truly 
needed? I guess it depends on who you talk to. Advertisements, commercials and stores are trying to sell those supplements so of course they will say you need them. But how much money should you spend and can you get the nutrients you need from the food you eat?
According to the 2015 Dietary Guidelines for Americans, “Nutritional needs should be met primarily from food. Individuals should aim to meet their nutrient needs through healthy eating patterns that include nutrient-dense food which contain essential vitamins, minerals and also dietary fiber and other naturally occurring substances that may have positive health effects.” While there may be a need to supplement our diet at certain times in our lives, the safety of taking a supplement also needs to be considered. Too much of some vitamins and minerals can cause health issues and therefore, recommended levels should not be exceeded.
Who Really Needs Supplements?
A varied, colorful diet is the best way to obtain the nutrients you need. Nutrient deficiencies are not common among Americans, but there are different times in our lives where extra vitamins, minerals and supplements may be needed or have additional health benefits. Individuals who have allergies, those on a vegetarian diet, people with special medical conditions, those who have had a surgery that affects the absorption of nutrients, pregnant women, and children or adults who do not get enough food or calories in their diet, may need specific supplements. In addition, if you are eating less than 1,600 calories each day because you are trying to lose weight, have a poor appetite or have trouble eating due to the use of alcohol or drugs, discuss the need for supplements with your doctor or registered dietitian nutritionist.
Vitamin B12 Older adults with acute gastritis, pernicious anemia, who have had surgeries which change nutrient absorption and strict vegetarians need a Vitamin B12 supplement. B12 is a water-soluble vitamin that is naturally present in some foods, added to others, and available as a dietary supplement and a prescription medication.
Vitamin B12 is required for proper red blood cell formation, neurological function, and DNA synthesis. This vitamin, bound to protein in food, is released by the activity of hydrochloric acid and gastric enzymes in the stomach. It is naturally found in animal products including fish, meat, poultry, eggs, milk, and dairy products. Vitamin B12 is generally not present in plant foods, but fortified breakfast cereals are a readily available source with high bioavailability for vegetarians. Some nutritional yeast products also contain vitamin B12.
Calcium and Vitamin D: Together with calcium, vitamin D helps protect older adults from osteoporosis. Your body can make its own vitamin D with enough sun exposure. Vitamin D is found in cells throughout the body. Muscles need it to move, nerves need it to carry messages between the brain and every body part, and the immune system needs it to fight off invading bacteria and viruses. Very few foods naturally contain vitamin D. Fatty fish such as salmon, tuna and mackerel are the best sources while beef liver, cheese and egg yolks provide vitamin D in small amounts. Mushrooms also contain some of this vitamin which is boosted by exposing them to ultraviolet light. Almost all milk is fortified with 400IU of vitamin D per quart and is also added to many breakfast cereals and some brands of orange juice, yogurt, margarine and soy beverages. (Check ingredient lists and nutrition labels.)
Dairy products are a rich source of calcium. Calcium is also found in fortified cereals and juices, broccoli and some green leafy vegetables but is not always available for absorption in the same way that it is absorbed from dairy foods. Calcium not only helps your bone strength but is also required for muscle function, nerve transmission, hormonal secretions and metabolic functions.
Food should be your primary source of nutrition and having a balanced diet is the best way to get the nutrients your body needs, including protein, vitamins and minerals. Real food contains healthy vitamins and minerals a pill can’t duplicate. When we take a nutrient out of a food and concentrate it in a pill, it’s not quite the same thing. Be sure to consider your individual situation and consult a doctor or a registered dietitian nutritionist before considering supplements.
While dietary supplements fall under the review of the Food and Drug Administration, they are regulated differently from conventional foods and drugs. Manufacturers do not have to prove a supplement is safe or even that it works before it is sold. The FDA can take action to remove or restrict the sale of a supplement only after it has been on the market and been proven unsafe. So be cautious!
