If there can be a good thing to come out of a deadly pandemic, it is that it has done much to concentrate our minds on improving our health. We might not have gone full Gwyneth Paltrow, but many of us have been exercising that little bit more, making an effort to eat better and have been thinking about taking supplements.
But as the debate about whether we actually need dietary supplements rumbles on – and to figure out whether they are likely to improve our health – we chatted with a range of experts and asked them what supplements actually do and which ones they would recommend.
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What exactly are supplements?
“Generally, they are manufactured products in the form of tablets, capsules, soft gels, gel caps, powders or liquids intended to supplement the diet, often, but not always, with nutrients, to maintain health,” says dietitian Dr Carrie Ruxton from the Health & Food Supplements Information Service. “They may contain micronutrients [ie, vitamins, minerals], amino acids, herbs, botanicals and many other ingredients. In UK and EU law, dietary supplements are not allowed to make claims around disease prevention or disease risk reduction.”
What supplements are not is a substitute for a balanced and varied diet. Thing is, and with the best will in the world, there are all sorts of things standing in the way of us getting that balanced diet – smoking, drinking too much and over-exercising can all deplete our body of vital nutrients. If you are convalescing and/or have a restrictive or low-calorie diet, this can also limit the vitamins and minerals you are getting.
As to the much-debated question of “Do we need them?”, the general consensus is this: at certain times in our lives, yes. But it could be just one, possibly two kinds of vitamin or mineral that are beneficial depending on your individual circumstances. You might then only need them for a matter of months, and not for life. And for the record: necking handfuls of them willy-nilly is probably not only a waste of your hard-earned cash – it is also potentially harmful.
So, which ones should you take for general health?
Unanimously, our experts recommend a multivitamin and mineral. Many talk about it as a health “insurance policy” because it should offer a full spectrum of what your body needs so you get a near-perfect balance of vitamins and minerals daily.
As public health nutritionist Dr Emma Derbyshire from the HSIS says: “The UK National Diet and Nutrition Survey highlights shortfalls in vitamin and mineral intake across the board. This is due to a poor diet. Diets rarely lack one nutrient – it is usually several. It is, therefore, best to take a multivitamin and mineral supplement that contains 100 per cent of the Nutrient Reference Value (NRV) for as many vitamins and minerals as possible.”
And while no supplement can prevent or cure disease, including Covid-19, a review by immunology and nutritional medicine experts Philip C Calder and Margaret P Rayman suggests micronutrient deficiencies could compromise the effectiveness of the Covid-19 vaccines and they propose giving multivitamin and mineral supplements – particularly to the elderly and clinically vulnerable – a few weeks before and after their jabs to help to increase their efficacy.
Multivitamin and mineral supplements come in many forms (pills, drops, sprays, gummies) and are often tailored specifically to certain groups: vegans and vegetarians; men or women; and the over-50s or over-70s (as we age it becomes harder to absorb and/or produce certain vitamins and some people find their appetite decreases making it a problem to get the full spectrum of nutrients needed). It’s best to choose the most appropriate for you.
Dr Sarah Brewer, medical nutritionist and medical director of lifestyle brand Healthspan, also recommends taking your multi with food as it increases your body’s ability to absorb more nutrients – preferably with your evening meal, to get maximum pick-up. “The repair processes your body undergoes are greatest at night when growth hormone is secreted,” she says.
Think of a multivitamin and mineral as your classic, go-to “nutritional peace of mind/safety net” supplement. Pretty much all nutritional bases are covered with just one of these hole pluggers and, taken daily, it will supply you with 100 per cent of your Nutrient Reference Value (NRV) requirements for an impressive 20 vitamins and minerals. Even if you are generally healthy and your diet is good, supplementing with a multi can still be beneficial, as it can pre-empt any shortfalls that might occur at points in your life (when ill or under sustained stress, for example).
Our nutrition experts were also keen to flag up the importance of a multivitamin and mineral supplement for vegans – pointing out a plant-based diet is likely to be low in iron and vitamin B12, as the most potent natural food sources of these are meat. This vegan multi provides both of these crucial nutrients plus another 22 to boot, and comes approved by the Vegan Society.
So, supplements do work then?
“They ‘work’ in the sense they bridge shortfalls in the diet that are common in the UK,” says Dr Emma Derbyshire. While there is currently no evidence to suggest they help you live a longer life or protect you from chronic illness (which isn’t to say they can’t, just that no one really knows yet), even relatively minor shortfalls of some vitamins and minerals can lead to health problems.
Take vitamin D, a vital nutrient that is made in the body on exposure to sunlight. Deficiency can lead to serious bone and muscle problems and low levels can cause muscle weakness, joint pain, tiredness, depression and an increased vulnerability to infections and illness including coughs and colds.
Without much sun for around half of the year in this country – and with few potent food sources – we can easily become low in it, which is why Public Health England (PHE) recommendsall of us sun-starved Brits take a 10mg supplement in the winter. And during the pandemic – with some people barely going outdoors for up to a year – there is more reason than ever to suppose people might be struggling to get enough. PHE offered over 2.5 million over-70s and clinically vulnerable people in England free vitamin D for four months from January 2021.
More research is needed to determine what role, if any, vitamin D and vitamin D deficiency might play in the prevention and treatment of the virus. As things stand, research suggests that while being deficient in vitamin D doesn’t appear to make you more susceptible to catching Covid-19, it can make the outcome of it more problematic if you do. Other studies have found no such links. We also know deficiency is more common in people who are 50 and above and those who are obese or have darker skin – these factors increase the risk of severe Covid symptoms. A clinical trial at Queen Mary, University of London is currently underway to establish further evidence.
Boots vitamin D, 90 tablets: £2.30, Boots.com
This is a supplement the government recommends we take for half of the year. Long before we’d even heard of Covid-19, PHE recommended we all take a 10mcg dose of “the sunshine vitamin” (so-called because we create it in the body on exposure to UV light) from October to March because, hold onto your hats here, we tend not to get much sunshine in the UK then. One of these tablets gives the PHE-recommended daily 10mcg dose during those sun-starved times.
Which ones should I take for hair and skin health?
As most of us can testify, skin is generally a pretty good barometer of your general health. Getting plenty of antioxidant-rich fruit and vegetables as part of a balanced, varied diet with healthy fats is essential to keep it looking good – but are there specific supplements that can also help?
Consultant dermatologist Dr Justine Hextall says the most important thing to keep your skin in optimum health is to protect it from the sun, saying “around 80 per cent of skin damage is caused by UV damage”. She adds that anything that can help mitigate against UV damage, like antioxidants that help reduce free radical damage (including so-called ACE vitamins A, C and E), anthocyanins (compounds with antioxidant effects found naturally in foods with blue, red and purple pigments like blueberries, bilberries, blackcurrants and cherries) and lycopene (the naturally occurring chemical that gives fruit and vegetables like tomatoes and watermelon their red colouring) can all be helpful.
Supplements should, however, be an adjunct to a balanced diet and topical skincare like wearing a daily sunscreen of at least SPF30.
Can lycopene help protect your skin from the ravages of UV damage? Kind of. In one small trial, those given 16mg of lycopene daily for five weeks (in the form of five tablespoons of tomato paste) were found to have the equivalent of an in-built 1.3 SPF and were better protected against sunburn and sun-induced ageing.
This doesn’t make it a substitute for sun cream, but it is potentially another tool in your anti-ageing and skincare arsenal. You could, of course, get your lycopene by eating a lot of pizza/ketchup/tomato sauce for weeks, but the beauty of these tablets is they give you 15mg daily (sourced from tomatoes), which could prove a useful summer skincare supplement.
Solgar bilberry berry extract with blueberry vegetable capsules, 60 tablets: £23.75, Solgar.co.uk
This dynamic duo of anthocyanin-rich berries should have skin-protecting effects to help reduce UV-induced damage and potentially premature signs of ageing. Both high in antioxidants, these natural compounds help fight cell-damaging free radicals.
As we age our ability to fight off free radicals declines and sun exposure, smoking, environmental pollution and poor diet can all weaken collagen and elastin in the skin, leading to wrinkles and sagging. Is this Botox in pill form? No. But increasing your antioxidant intake might go some way to stopping you from looking old before your time.
When your hair becomes undernourished, this is also a pretty good gauge of where you are at health-wise. The further away from Jennifer Aniston’s you can get – dry, thin, brittle and possibly falling out – the more likely it is you could benefit from supplementation.
As always, a balance of nutrients is needed to give you a healthy head of hair, but one nutrient that is key, as consultant dermatologist Dr Martin Wade points out, is iron. He says: “We need good levels of iron to grow healthy hair and as more people move to plant-based diets it can become harder to get the amount you need. In the clinic I recommend Ferrous sulphate tablets – these seem to be the most effective iron tablets available.”
For hair that is fine and thinning he points to Viviscal, as it has “good clinical data showing it supplies the follicle with all the nutrients it requires including biotin and zinc for healthy hair growth”. Dr Hextall also recommends this product.
Iron is key to healthy hair because without enough of it your body can’t produce the haemoglobin (the red substance in blood that combines with oxygen and transports it around the body) for the growth and repair of cells, including the ones that stimulate hair growth.
Hair follicles can be particularly sensitive to decreasing levels of iron and might not be able to grow new cells, effectively leading to thinning or shedding hair. To help, Dr Wade recommends taking ferrous sulphate on an empty stomach with a little orange juice (which contains vitamin C), to help the body “absorb the iron”. Be patient though: it can take over three months for the regrowth process to fully kick in.
Viviscal maximum strength hair supplement, 30 tablets: £29.99, Boots.com
This supplement comes highly recommended by not just one, but two dermatologists, who both allude to the 25 years of research and persuasive clinical data behind it. That Dr Hextall takes it herself and says it has made her hair thicker, her nails stronger and her skin less dry (adding that many of her clients have noted the same improvements) is some endorsement. It’s not cheap but there is evidence – both anecdotal and scientific – that it works.
What supplements should vegans take?
A well-planned balanced vegan diet should, theoretically, provide you with all the nutrients you need – including plenty of fresh fruit and vegetables, whole grains, soy, pulses and healthy fats like olive oil or rapeseed oil.
But as Dr Ruxton points out: “Animal source foods are important sources of several nutrients including vitamin B12, iron, zinc, calcium and iodine and omega 3 fatty acids from oily fish. Simply cutting out animal foods and fish in a vegan and vegetarian diet increases the risk of shortfalls in all the above nutrients. As well as benefitting from a multivitamin and mineral supplement, vegans should always supplement with B12 as animal-source food is the most reliable way of getting it. For anyone not eating oily fish, taking a plant-based omega 3 supplement is a sensible choice.”
Boots vegan omega 3 oil, 60 tablets: £8, Boots.com
We all need good fats in our diet like omega 3, an essential fatty acid, classed as such because it is vital to good health and our body does not make it so we have to get it from food or supplements. Vegans can find omega 3 in walnuts, chia seeds and ground flaxseed, but might find it hard to get the amounts they need. Taking a daily supplement like this one containing flaxseeds – nutritional powerhouses which are a rich source of plant-based omega 3 – should resolve any shortfall.
BioCare vitamin B12 veg capsules, 30 tablets: £12.59, Biocare.co.uk
Our nutrition experts recommended a vitamin B12 supplement for vegans with good reason: the only reliable vegan dietary sources are foods that are fortified with it (like some plant milks or soy products) and if these are not part of your diet you will need a daily 10mcg supplement to compensate. If you are low in B12, over time this can lead to extreme fatigue, memory problems, blurred vision and anaemia, so this is a supplement well worth shelling out for.
Do collagen supplements work and how long do they take to work?
That collagen supplements are having a moment right now is perhaps unsurprising given they are marketed as wrinkle-fighting elixirs of youth that tantalisingly promise to make skin appear more youthful while also minimising joint pain and stiffness.
A major building block of the cells, tissues and organs, collagen is an essential naturally occurring protein in the body, needed for healthy bones, joints and skin. Think of it as the scaffolding that holds the body together and, while we might produce it naturally, this process slows down from our mid-20s onwards.
You can increase collagen production very effectively through your diet – eggs, beans, meat, shellfish, nuts, vitamin C-rich citrus fruits, berries, peppers and bone broth (when simmering bones in water, collagen and other minerals seep into it) are all excellent sources.
Do collagen supplements offer the same benefits? Mmm, maybe. Maybe not. Dr Hextall points out that “not all collagen supplements are created equal” and says those containing “hydrolysed collagen, which is the more absorbable form, do seem to help”.
She adds that stimulating and protecting collagen should come from your diet, safeguarding your skin from UV damage using a high-factor sunscreen (UV rays cause collagen degradation) and possibly facial treatments like intense pulse light therapy and micro-needling, which help stimulate new collagen.
If you do go down the supplement route, how long is it before you see results? Well, sadly, you might not get your Benjamin Button moment for a while – Dr Hextall says it can take around three months to notice improvements in your skin and/or joint health. It should also be pointed out that collagen is mostly derived from animals and fish. Plant-based vegan and vegetarian versions might claim to encourage collagen production via amino acids that are said to mimic the composition of animal collagen but, as things stand, there is little evidence to support this.
Nature’s Plus collagen peptides, 28 servings: £27.99, Amazon.com
Our experts were cautious but optimistic about the effects of collagen supplements. Dr Derbyshire said the evidence for their use was “promising” and Dr Hextall said that “some do seem to help”. It should also be said that many of the clinical trials on them have been small and funded by companies that make collagen products.
That said, supplements containing “hydrolysed collagen” in a powder base, like this Nature’s Plus product, were singled out as the more helpful kind. It is a more absorbable form of collagen as it is broken down into smaller, more easily digestible particles or peptides which, in theory, your body can then pick up and use in areas where it is most needed.
For vegans looking for a collagen fix, sadly as yet there’s no real reliable evidence that the “vegan amino acid collagen blend” like in this protein powder can speed up the process by which the body creates collagen. That said, this product does contain a range of nutrients that can make you look and feel better – including vitamin C, which is essential for collagen production (although it is rare anyone in this country is deficient in vitamin C), hyaluronic acid (a natural substance that holds water and helps to keep skin springy and plumped up) and biotin (part of the B vitamin family which has been shown to improve hair health, including thickness and shine).
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