Food First, Supplement Second

FOOD FIRST, SUPPLEMENT SECOND

A recent survey shows that Americans spend approximately $30 billion per year on dietary supplements, and 45 percent of supplement users do so “to improve overall health.”¹ While improving your health is always an excellent goal, it turns out you may not need to spend your hard-earned money to get the benefits of many common supplements. Making smart food choices every day and including all five food groups in your diet is just as effective as taking supplements, in many cases even better for you!

What is a dietary supplement?

Dietary supplements include any product taken by mouth that contains a “dietary ingredient” intended to supplement the diet. These ingredients may include macronutrients (carbohydrates, proteins, and fats), vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, and hormones.²

Do I need dietary supplements?

Maybe not! Some dietary supplements have been shown to be beneficial to overall health, such as various multi-vitamins and omega-3 fatty acids³, but almost all of the substances sought in supplement form are found in nature, i.e., the food and beverages you consume on a regular basis. Not only are food and beverages typically less expensive than supplements, they also come packaged in a form that tastes good! Below are some examples of components people commonly seek out in dietary supplements to improve their health. Included in the list are foods and beverages that also contain the components:

• BCAA (Branched-Chain Amino Acids). Claim – BCAAs enhance exercise performance, prevent fatigue, reduce muscle breakdown, and improve recovery. 16 oz. of skim milk or 3.5 oz. of tuna will provide the same amount of BCAAs as 6 capsules (one dose) of BCAA supplements.


• Quercetin. Claim – Quercetin acts as an antioxidant and anti-inflammatory, prevents cancer, and improves heart health. Quercetin is one of the most abundant flavonoids found in nature, primarily in fruits, vegetables, nuts, and some spices.


• Omega-3 Fatty Acids. Claim – omega-3 fatty acids improve heart health, and new research indicates they may reduce the risk of some cancers, depression, and neurological disorders. Omega-3s are found in cold water, oily fish such as salmon, herring, mackerel, and sardines. They are also found in walnuts, and canola, olive, flaxseed, and soybean oils.


• Creatine. Claim – creatine can enhance muscle building and increase “bulk;” it is primarily used for enhancement of explosive movements such as those required in power lifting events. Creatine can be obtained through consumption of meat, poultry, or fish; the body can also make creatine in the liver, kidneys, and pancreas.


• Whey. Claim – Whey is high in BCAA, is quickly absorbed and decreases muscle break down. Whey is a milk-based protein; therefore you can get the same amount of BCAA from 16 oz. of milk as you can with one scoop of whey.

Things to consider

If you are taking a dietary supplement or are thinking about starting, here are a few things to consider:

1. Be aware of potential medication interactions. Even common vitamins can impact the effectiveness of medications. Always talk with your healthcare provider before taking a new supplement.
2. Know the dosing recommendations. Review the recommended dose/amount; exceeding this amount or “stacking” multiple supplements can lead to adverse health outcomes.
3. Ensure the mandatory information is available on the packaging. Per federal regulations, the label must contain the following components:
   1. Statement indicating it is a “supplement” and name of the supplement
   2. Name/place of business of manufacturer, packer, or distributor
   3. Complete list of ingredients
   4. Content (# of pills)
   5. Supplement facts panel
4. Watch for false or misleading claims. Many times you will see the terms “natural” or “herbal” giving the impression of a healthy or healthful product. The packaging must have the following Food and Drug Administration (FDA) disclaimer: “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”
5. Know the risks. There is no guarantee of quality, purity, composition, safety, or effectiveness of dietary supplements and therefore the possibility exists that it contains banned or harmful substances that are not declared on the label.
6. Choose wisely. The Navy and Marine Corps Public Health Center strongly recommends that if you are choosing a dietary supplement, you look for products with third-party verification programs as they validate quality/safe manufacturing practices:
   • United States Pharmacopeia (USP)         
   • NSF International                                     
   • Informed-Choice                                      
   • Banned Substances Control Group       
   • ConsumerLab.com                                  


7. Be informed. Just because a product is sold on a military installation does not mean it is a DoD approved supplement. If the product has not been banned/recalled by the FDA, Federal Trade Commission or Drug Enforcement Agency, it is not banned by DoD at large. However, each base, command, and even unit has the authority to issue guidance on dietary supplements for their service members. Check with your chain of command to determine if there is a local-level policy that impacts you.

Supplementation may be necessary if you have a specific nutritional deficiency. Talk to your healthcare provider to determine if a vitamin or mineral supplement is right for you. When it comes down to it, a diet consisting of five to six small meals per day with a variety of foods, preferably fresh and unprocessed (in their natural state), contains the highest concentration of vitamins, minerals, and fiber. The quality sources of protein (which are made up of amino acids), complex carbohydrates (the body’s primary fuel source), and fat (focus on the healthy fats) will give your body what it needs for energy, tissue repair, healthy skin and hair, anti-oxidants for disease prevention, and weight control.

Learn more

Check out the following resources to determine the safety and/or efficacy of the supplement you are taking or considering taking:

• The Navy and Marine Corps Public Health Center Healthy Eating page
• Human Performance Resource Center’s Operation Supplement Safety
• The Natural Medicine’s Comprehensive Database

References:

1. Bailey R, Gahche J, Miller P, et al. Why US Adults Use Dietary Supplements. JAMA Intern Med. 2013;173(5):355-361. http://archinte.jamanetwork.com/article.aspx?articleid=1568520. Accessed June 18, 2013.
2. U.S. Food and Drug Administration. Q&A on dietary supplements. http://www.fda.gov/Food/DietarySupplements/QADietarySupplements/default.htm#what_is. Updated May 21, 2013. Accessed June 17, 2013.
3. National Institute of Health: Office of Dietary Supplements. Dietary supplements: What you need to know. http://ods.od.nih.gov/pubs/DS_WhatYouNeedToKnow.pdf. Reviewed June 17, 2011. Accessed June 19, 2013