Supplements aren’t nonsense — here’s why they make a difference after 50

The global supplement market is expected to reach a value of US$185.1 billion ($296b), with a significant boost from the pandemic. Photo / 123rf

The supplement business is booming, with the global market forecast to reach a value of US$185.1 billion ($296b) within the next couple of years. The pandemic has rocket-fuelled the industry — a survey of more than 10,000 adults found the number of supplement users ros 19 per cent between 2019 and 2021, with one in three citing the pandemic as the catalyst.

But do they make a difference? Most of us start January with the best intentions for a healthier lifestyle. Adding in a pill or two is easy enough — much easier than changing diet or taking up exercise — but can they really make us healthier in midlife and beyond? Many will answer “no”. Microbiome expert and co-founder of the Zoe app Professor Tim Spector has claimed supplements are a waste of money and people should buy “real food” instead. Former Australian Medical Association president Dr Michael Gannon once famously said supplements just make “very expensive urine”.

Despite this, an increasing number of doctors recommend them, and the UK government now advises all adults to consider taking a daily Vitamin D supplement during the autumn and winter. So what else — if anything — should we be taking and why?

Do we really need to take supplements?

“That really depends on your age, diet, state of health and where you live in the world — if you’re in Africa, you should get enough vitamin D from the sun. In the UK, in winter, you won’t,” says Dr Anna Moore, GP and specialist in nutritional medicine at Moore Medical Practice. Few would disagree that a rich, varied diet is more important — but how many of us eat the perfectly balanced combination of plants in five colours, oily fish, fermented foods, meat and dairy, week in, week out? Many factors can prevent this — busy lifestyles, living alone, not prioritising regular meals and, if mobility issues set in, shopping and cooking becoming more challenging.

Age, too, makes our bodies less efficient at absorbing certain vitamins. “The nutritional markers of a 25-year-old will rarely show deficiencies in B12, folate, vitamin D and magnesium because at that age, body function is pretty good,” says Dr Geoffrey Mullan, chief medical officer of longevity specialist healthcare providers Humanpeople. “As we get older, those deficiencies become far more likely. The diet may not have changed, but the body’s functioning has.”

Can supplements really work?

Yes — with the correct approach, says Dr Melaney Angelova, who specialises in functional medicine at Optimise Health. Buying a selection of multivitamins in the hope they cover everything might not address your own deficiencies and health needs. At worst, it could even be harmful. “Indiscriminate and excessive use of supplements without a clear understanding of your nutritional status can have adverse effects and lead to imbalances and potential health issues,” says Angelova. Vitamin A is one example. Some research suggests taking too much can make your bones more likely to fracture as you age. Blood tests and specialist consultations are the best way to determine the supplements that could enhance your health — and if this isn’t possible, look carefully at your diet, health concerns and potential deficiencies in order to develop more personal solutions. “Of course, you can exist without supplements. People do. That’s not the point,” says Moore. “The point is that you can have a longer, healthier life if you take them.”

What are we most deficient in?

“Omega-3 is the most likely deficiency,” says Mullan. “We’ve run thousands of tests at our clinic and 96 per cent have shown omega-3 is below optimal levels.” Humans evolved on the edges of land masses, living mainly on fish, and most of us no longer have enough oily fish in our diet. Vitamin D is another candidate. A US study found 42 per cent of people were vitamin D deficient. “Even in summer, many of us struggle to make enough vitamin D,” says Moore, “for example, those who are obese or dark skinned”. What’s more, “older people are often short on B vitamins too. As we age, our bodies are less able to absorb B12,” Moore explains.

Common deficiencies include omega-3, vitamin D, B vitamins, and iron, especially among older individuals. Photo / 123rf

Can supplements help with losing weight?

There’s no substitute for diet and exercise, and supplements won’t provide magic solutions. However, some carefully targeted supplements can make a difference, says Mullan. “Weight is massively complex and depends on many factors — including our genes and how effective the body is at absorbing and storing fat. Berberine, for example, reduces the absorption of fatty acids and has been found to stabilise blood sugars and reduce insulin resistance, which are both linked to weight gain.” Supplements can also help mitigate some of the harms caused by being overweight. Berberine and psyllium husk can help reduce cholesterol. Omega-3 can reduce levels of inflammation and harmful free radicals. Levels of omega-3 tend to be lower in overweight people and studies suggest taking it can have a positive impact on managing obesity.

Can you take supplements if you’re pregnant?

Yes, you can and you should. When you’re growing another human being, your nutrient needs increase significantly.

“Supplementation during pregnancy is crucial for the wellbeing of both mother and baby,” says Angelova. “Essential supplements commonly recommended include folic acid, which helps prevent neural tube defects, and fish oil, which provides omega-3 fatty acids important for the baby’s brain and eye development. Probiotics can also be beneficial for maintaining a healthy gut microbiome.” These can be taken in powdered form, mixed with water, ensuring the preservation of the maximum nutrient content but also facilitating quicker absorption by the body.

When it comes to folic acid, it’s worth knowing that some of us are unable to metabolise it. For this reason, many experts now suggest taking methlytetrahydrofolate (5-MTHF) instead, the most bioeffective form of folate.

Pregnant women are advised to take supplements such as folic acid, fish oil for omega-3, and probiotics for a healthy gut microbiome to support both their own and the baby's wellbeing. Photo / 123rf

How can you tell supplements are being absorbed?

“It’s possible to have blood tests to track and monitor nutrient levels, but this is expensive so the practical answer is that you often can’t,” says Moore. Some supplements are easy to measure through simple blood tests — like vitamin D or iron levels. More often, it’s a case of whether you feel better a few months after taking them. Do you have more energy? Are you sleeping better? Have you noticed improvements in the areas you were hoping to target? Certain supplements, such as vitamin C, can cause diarrhoea when taken excessively. If this happens, cut back or stop taking it.

The supplements you might need

Experts weigh in with the supplements you should consider investing in.

Omega-3 for heart and brain

“It’s an obvious win,” says Mullan. Omega-3 are unsaturated fats that we need to get from our diet. Human beings evolved living mainly on fish — and oily fish are high in omega-3 — but now we’ve switched to a more seed-based diet. “The list of pros for omega-3 is pretty long,” says Mullan. It’s important for brain health, including learning and memory. We need it to build cells throughout the body, it helps regulate blood clotting, contraction and relaxation of artery walls and inflammation, so it helps prevent heart disease and stroke. “There’s plenty of research that shows the benefits of omega-3 throughout life.”

Vitamin D with K2 for bones and immunity

“We need vitamin D for a variety of reasons,” says Moore. It regulates the amount of calcium and phosphate in the body so it’s important for our bones, teeth and muscles. Vitamin D deficiency is associated with osteoporosis, falls and fractures in older people. It also plays a role in our immune responses — vitamin D deficiencies have been associated with increased autoimmunity and susceptibility to infection.

It may also affect mood — with many studies finding that vitamin D supplementation can be effective in reducing depression. Many benefit from a supplement all year round. “Older people might not get outside enough, especially those with mobility issues,” says Moore. Many experts now recommend combining vitamin D supplements with K2 because this helps maximise calcium absorption

B vitamins to beat cognitive decline

“The B vitamins — such as B6, B12 and folate — are essential for converting food into energy, maintaining healthy skin and supporting neurological function,” says Angelova. B vitamins play an important role in controlling levels of the chemical homocysteine in our blood — raised levels of homocysteine are commonly linked to age-related cognitive decline and dementia. Many will benefit from this supplement because the capacity to absorb vitamin B12 from food reduces as we get older. Vegetarians, and most especially vegans, should also supplement because it’s found mainly in meat, eggs and dairy products.

As people age, their bodies become less efficient at absorbing certain vitamins, making deficiencies more likely. Photo / 123rf

Magnesium to improve sleep and energy

Magnesium plays a pivotal role in various bodily functions, including muscle and nerve function, blood sugar regulation, and energy production. Magnesium-rich foods include spinach, avocado, banana and beans, but agronomic and environmental factors have meant magnesium content in fruit and vegetables has dropped in the past 50 years, and about 80 per cent is lost during food processing. One US study found nearly half the population didn’t ingest enough.

“Magnesium supplements can really help in later life when we tend to get short of it,” says Moore. “If you’re suffering muscle cramps at night or poor sleep, or if you’re feeling more fatigue, that can be a magnesium deficiency and it’s always a good idea to supplement.” Older people can be particularly susceptible because of diet, multiple drug use and a less-efficient digestive system, which leaves them less able to absorb it.

NMN for youthful vigour

For flagging energy that comes to us all as the years pass, there’s a relatively new solution on the scene — NMN, the much-lauded star supplement of the anti-ageing movement. Derived from ribose, nicotinamide, nicotinamide riboside and niacin, NMN is a potent precursor for NAD+, a key molecule that gives us our energy.

“From our mid-20s, our levels of NAD naturally decline. By the time we reach middle age, they’re about 50 per cent of what they were,” says Mullan. Growing research has suggested boosting NAD+ levels with NMN capsules can improve insulin sensitivity and boost energy production. Though found in foods such as broccoli, cucumber and avocado, you’d need to consume an awful lot — a kilo of broccoli every day — to get the quantity from one daily 500mg capsule.

“Does a 25-year-old need to take it? No. Would a 49-year-old like me benefit from an NMN supplement to stave off physical and mental fatigue? Absolutely,” says Mullan. However, it’s worth noting that published reports about NMN’s long-term safety in humans are scarce.