There is a wealth of research highlighting symptoms and diseases linked to poor nutritional status, and hence, supplementation is increasingly becoming a practical solution to supporting our health and delivering micronutrients that are diminishing from our food. Supplement recommendations are widespread and can become a minefield, and it can be difficult to know sometimes which supplement is right for you, if it is of good quality and what you should be looking for on the label.
In this weeks’ blog we have put together information to help you understand what to look for in a supplement, the best forms and levels of nutrients and tips to tell if it has been well-formulated or not. We hope this helps you to make an informed choice.
In short, a well-formulated supplement is one that:
- Provides the nutrients a person needs to make up for shortfalls,
- at the correct (safe) levels
- and importantly, in a bio-effective form.
- Minimal or no excipients are ideal.
Levels of Nutrients
Nutrient shortfalls are caused by many factors, and this means that most people are not getting the daily level of essential nutrients needed for health and protection.
The term “Nutrition Gap” is the difference between the levels of nutrients the average person, eating a reasonable Western diet is obtaining from food and those nutrient levels identified by research as being needed for optimal health. A safe and effective level of nutrients to look for in supplements for general use is therefore the level needed to elevate the intake from average, to optimum. We call this ‘bridging the nutrition gap.’ Many supplements on the market do not satisfy this criterion.
A note on NRV’s
Formulations that have levels of nutrients that are above the Nutrient Reference Intake (NRV) but lower than the upper safe limit are recommended. NRV’s were never intended as any more than a ‘safety net’ with the specific purpose of preventing diseases of overt deficiency. The typical dose sufficient to prevent overt deficiency-states is always short of the amount needed for optimum health. It also does not consider the needs of individuals. Irrespective of this, so many people mistakenly believe NRV’s are levels of intake that will give rise to optimum health.
When we state ‘bio-effective form’, we mean supplements that provide nutrients that are in the same form as those nutrients occur in food, wherever possible. If this is not possible, then a compound which has good bioavailability and efficacy. The best products are those that fit into normal food metabolic pathways and thus are constructively helpful to the everyday healthy working, function, repair and regeneration of tissue and organs.
Food State and Wholefood
Food State and other Wholefood nutrients are the most bio-effective food supplements, where the nutrients are in a food form. These contain vitamins and minerals complete with the associated food factors and other phyto-nutrients with which they occur in whole foods. This total food complex ensures these products are recognisable as food by the human body and optimally utilised. Often it is the associated food components in the complex that are responsible for the retention and utilisation of the primary nutrient, and this ensures a beneficial metabolic use.
Food State Nutrients
Food State nutrients are combined with a variety of natural food bases that naturally carry significant levels of the required nutrient. The food base grows in an indoor process that mimics perfect growing conditions in nature, and uptakes the nutrients into its cellular matrix. This ensures they come complete with phytonutrients that are necessary for optimal absorption, utilisation, and retention in the body. The resulting product is a fully food complexed nutrient fortified food. Examples of appropriate food bases include citrus pulp for vitamin C, carrot concentrate for beta carotene and sunflower oil for vitamin E.
There are nutrients that have been extracted from wholefoods or have been grown into edible plants (usually brassica species). These plants have a great ability to uptake nutrients at higher levels than normal plants and when used for the purpose of mineral accumulation, are grown in a clean/controlled environment (such as a hydroponic environment) and in a mineral-rich water containing the level of nutrients required in the finished product. These are then taken up into the root systems of the plants and are transported into the leaf vacuoles, which become tissue metabolised into the plant leaf tissue. This is the natural process that also occurs during normal plant growth from soil.
The advantage of using a hydroponic growth medium is that the mineral levels can be controlled, the growing environment can be kept consistent, and the nutrition, temperature and light can be kept at optimum for growth, allowing a consistent and mineral-rich product to be grown all year round.
The other great advantage of natural plant minerals is that they contain thousands of other phytonutrients which have complementary and beneficial action in the human body. They contain all the bio-actives that our bodies expect to obtain from fresh vegetables – our greatest protectors, and the component most absent from 21st Century diets.
There are also other wholefood nutrients available on the market – Vitamin C from acerola and Amla, beta carotene from carrots, calcium from calcified seaweed, iodine from kelp, vitamin D from lichen, omega 3 from algae – the list is ever evolving. Usually, these nutrients will be listed on the label to make it clear that the nutrient is from an edible plant or other food source.
Conversely, many supplements on the market contain isolated nutrients which, as the name suggests, are without the other food factors that ensure recognition by the body. This is witnessed particularly in the metabolic difference between Food Vitamin C and ‘isolated’ ascorbic acid. The former is absorbed, retained and used optimally – the latter, whilst still acting as an antioxidant, is excreted more rapidly.
It is important to mention that all substances will (eventually) get into the body through a concentration gradient – but this does not mean that they will be beneficially utilised. This is, of course, why one often sees very high doses of isolated nutrients being sold – simply because a huge dose is necessary to get the nutrients into the body. The body does not have mechanisms in place to easily uptake these substances. In contrast, this is also the reason why, when using a nutrient in a form that fits into normal metabolic pathways, small (physiological) levels will be sufficient for bio-efficacy.
Products which use nutrients from food will appear as Brassica juncea providing zinc, or kelp providing Iodine, for example. These are self-explanatory. Many nutrients in supplements are however chemical form and you will see a chemical compound name on the label. It is important to check whether the nutrients within are from approved sources and to do a little homework on the biological activity of each. On the whole, the less bioavailable nutrient sources are cheaper forms.
Unless derived from wholefoods, minerals will always be present in a complex, as they are not bioavailable as pure mineral forms. Minerals are inorganic elements and are difficult for the body to absorb without being attached to an organic compound or other substrate or carrier. The combining of inorganic minerals with organic compounds happens through a process called chelation. Chelated minerals are usually joined to either organic acids or amino acids so that the two do not disassociate in the digestive system, essentially protecting the mineral so it can be absorbed. The effect of chelating agents generally depends on the stability of the chelates in the intestine and their solubility.
Inorganic Mineral Forms
Inorganic mineral forms are generally cheaper but are not always as efficiently absorbed by the body as organic forms are. Moreover, often minerals with the highest label claim (percentage of mineral in the complex) are the least bio-effective, and those with the lowest label claim (i.e. threonates) are the most bio-effective, as the base more readily donates the mineral into the body. Examples of inorganic forms include sulphates, oxides and carbonates.
In general, the more bio-available a mineral becomes, the lower the dietary concentration needs to be to obtain the daily requirement. Additionally, the more absorbable the mineral, less mineral is excreted.
In our booklet A Comprehensive Guide to Choosing a Good Supplement we look at some of the commonly used approved sources of vitamins and minerals, the level of the nutrient (in respect of minerals) in a complex, a little about the biological activity of each (in essence if it is well absorbed and used in the body or not), indications, and whether we recommend or not. This will help you identify which are the best forms of nutrients to look for on the label of a product – the good and the not-so-good.
Reduced or Methylated Forms
Over the past decade, following the rise in genetic testing and greater awareness of nutrigenomics, there are times when reduced or methylated forms of nutrients are most bio-effective in individuals. Usually, these forms are more bio-effective in everyone, so where these forms exist, they are usually the choice for supplements. For example, methylfolate has greater activity in the body than folic acid – it is also safer in the elderly and the only form of folate that is bio-effective in people carrying a genetic flaw. The genetic flaw does not permit proper use of folate from food or folic acid in supplements and is most significant for women of childbearing age. 40% of the population are adversely affected by this genetic error.
Some nutrients such as the B vitamins and magnesium are not found in high levels in plants and other foods. So, where higher levels are needed to meet population needs, augmentation of the food level with a supplement in a nature identical form is a practical solution.
Products that contain minimum or no excipients are always recommended. Excipients are materials that facilitate the making of the ingredients into a finished product. They are usually inactive and do not contribute any form of nutritional value to the supplement. They can, however, play an important role in ensuring that supplements are of a consistent and reproducible quality. The type of excipient used is determined by the objective. Although many people nowadays prefer to avoid wherever possible, they are not all bad. If you are only taking one or two supplements with low levels, this is probably not an issue at all but if you are taking a large number then the total ingested can escalate. There are a various types of excipients used in the manufacture of supplements and you can find further information in our Comprehensive Guide to Choosing a Good Supplement. Here we outline which excipients in our opinion are safe to include, and those that are not.
Bridging the ‘Nutrition Gap’ is a safe and effective population approach, and in most healthy people this will ensure they are achieving above nutritional adequacy. It needs to be recognised however that there are many instances where people will require individualised extra support to meet nutritional needs. This can be by virtue of many different factors including stress, smoking, medications, pregnancy, ageing, disease, genetic susceptibility, and so on. Normally, we would recommend that needs over and above the Nutrition Gap are assessed professionally.
On the Label
Always check the label for:
- Well-utilised forms of nutrients
- Safe and effective levels of nutrients
- Recommended intakes
- Allergy warnings (if the product contains any of the main 14 allergens it must be included on the label)
- Contraindications (are you taking medications? Check no medication contraindications are listed)
- Who the product is suitable for (i.e. adults/children/vegetarians/vegans etc.)
- Excipients used
- The % of the NRV should be clearly displayed.
If you are taking more than one supplement do always cross reference the levels of the same nutrients in both, to make sure you are not tipping balances into excess. If you are looking for a supplement for a therapeutic purpose, it is advisable to seek the help of a health professional or qualified Nutritional Therapist.
It is wise to check out if the company supplying the product have nutritional therapists and medical doctors on board to help with product formulations. This will ensure that formulations are researched properly and put together professionally. Also, look for any mention on the website or literature that the products are manufactured in a GMP accredited facility. This is important as you can then be confident that the products are well made and what they say they are. If the product is organic and soil association registered this is further evidence that the product is of high quality and that the ingredients have had a high level of scrutiny and testing.
- Supplementation is increasingly becoming a practical solution to supporting health and delivering micronutrients that are diminishing from food.
- A well-formulated supplement is one that provides the nutrients a person needs to make up for shortfalls, at the correct levels and in a bio-effective form.
- A safe and effective level of nutrient to look for in supplements for general use, is the level needed to elevate the intake from average, to optimum.
- Nutrient reference intakes (NRV’s) were never intended as any more than a ‘safety net’, with the specific purpose of preventing diseases of overt deficiency.
- Bio-effective form’ means supplements that provide nutrients that are in the same form as those nutrients occur in food.
- Food State and Wholefood are the most bio-effective food supplements, where the nutrients are in a food form.
- Isolated nutrients are without the other food factors that ensure recognition as beneficial by the body.
- Unless derived from wholefoods, minerals will always be present in a complex, as they are not bioavailable as pure mineral forms.
- There are times when reduced or methylated forms of nutrients are most bio-effective in individuals.
- Products that contain minimum or no excipients are always recommended.
- Many instances where people will require extra support to meet nutritional needs (stress, smoking, medications, poor sleep, disease, genetic susceptibility etc.)
- Always look on the label for recommended intakes, allergy warnings, contraindications, who the product is suitable for and its strength/potency.
- Check out if the company supplying the product have nutritional therapists and medical doctors on board to help with product formulations.
If you have questions regarding the topics that have been raised, or any other health matters, please do contact our team of Nutritional Therapists.