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Simplifying supplements

A user’s guide to vitamins and minerals, from calcium to omega-3s.

“The consequence of not getting enough [micronutrients] is that your body cuts back on certain functions that affect long-term health. … When you’re short of micronutrients, there’s a lot of hidden damage going on” —Nutrition researcher Bruce Ames, Children’s Hospital Oakland Research Institute

Photograph: Jim Block

Natto, a brown, gluey mass of fermented soybeans that emits an ammoniac stench, is served oozing over a bed of rice. In some regions of Japan, natto is a breakfast staple. To most non-Japanese, however, it's an acquired taste at best. Yet the dish is more than a culinary curiosity. It may be a key to understanding the importance of vitamins and minerals to health.

Natto is rich in micronutrients, especially vitamin K, which means regular natto eaters take in more vitamin K than most other people. The fact that natto isn't, shall we say, universally savored has allowed nutrition researchers to conduct population studies in Japan showing that natto aficionados have lower incidences of heart disease and bone fractures. Bruce Ames and Joyce McCann, nutrition researchers at the Children's Hospital Oakland Research Institute in California, have reviewed research into natto, along with a body of other evidence. They conclude that vitamin K, which has so far only been known to support blood coagulation, could be important for heart health and bones as well.

This vitamin K analysis supports Ames' overall theory that shortfalls of essential micronutrients—minerals, vitamins, fatty acids and other biochemicals—may lead to many of the chronic diseases that afflict us as we age. While emphasizing that healthy eating is key, Ames, along with many other experts in mainstream as well as alternative medicine, argues that nutritional supplements can play a valuable role in health as well.

The modern diet is "energy rich and nutrient poor," Ames says. On average we eat too much processed flour and sugar, poor-quality fats and meats and not enough fruit, vegetables, nuts, beans and whole grains, which have more nutrients per calorie. "If people fill themselves with sugary soft drinks they're going to be full, yet they're starving for micronutrients," says Ames.

Ames and McCann aren't alone in finding a link between chronic disease and lack of micronutrients. It's well established that poor dietary patterns increase the risk of many illnesses. A lot of people turn to supplements in the belief that it will lessen the risk. This has contributed to a dramatic expansion in the supplement industry over the past several decades. At least 50 percent of Americans take a supplement, and 35 percent take a multivitamin. Some $4.2 billion was spent on multivitamins alone in 2005, according to the Council for Responsible Nutrition, a trade organization representing the industry.

Ames says nutrient shortfalls in modern diets are now so widespread, and the increased risk of major chronic disease so likely, that we can't afford to wait for definitive scientific proof of the role of supplements or for our habits at the table to improve. If you aren't sure you're eating a perfect diet (and who among us is certain we eat five to nine servings of fresh produce each day?), supplements can even the score. "My feeling is you try to eat a good balanced diet, cut out sugary soft drinks and empty calories, but take a multivitamin as insurance," says Ames.

Most of us already know we need to eat well to stay healthy. Still, when it comes to diet, a lot of us just aren't able to put our knowledge where our mouths are. "We are inundated with appealing advertisements for fast foods, highly sweetened beverages that provide empty calories, and fad diets," physician and alternative medicine expert Andrew Weil wrote in an e-mail interview. "Compounding the media message to ‘eat more of everything' is the plethora of highly processed and refined foods on the market, easy access to rapidly digestible carbohydrates, busy schedules that preclude cooking at home, and frequent travel."

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