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Home / The Listener / Health

Pills and ills: How the evidence stacks up for our top-selling supplements

By Niki Bezzant
New Zealand Listener·
12 Nov, 2023 04:00 PM5 mins to read

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Supplementary evidence: New Zealand consumers should find out whether manufacturers belong to a local industry body. Photo / Getty Images

Supplementary evidence: New Zealand consumers should find out whether manufacturers belong to a local industry body. Photo / Getty Images

Vitamin C

Having enough vitamin C in our bodies is important for overall immune function and general health; it plays a role in many bodily functions. It is often promoted for prevention of, and quicker recovery from, colds and flu. The evidence for this, though, is still patchy. Large reviews show taking vitamin C doesn’t prevent a cold, but taking it regularly might shorten the amount of time you’ll be sick. Sport dietitian Conrad Goodhew says our recommended intake is easily met with a diet of colourful vegetables and fruit. “If you’re going to use it [in pill form], use it in high dose during illness.”

Magnesium

Another important nutrient central to many body processes, including regulating muscle and nerve function and making proteins and bone. Magnesium is often marketed for sleep, muscle relaxation and mood improvement, but the evidence for these benefits is mixed.

The Australian Institute of Sport puts it in Group C of its Sports Supplement Framework, meaning there’s little current evidence of any benefit to athletes in taking it. Local medical information website Healthify says there’s no evidence it helps with sleep, though it may be useful for people who suffer from migraines and those with type 2 diabetes.

Probiotics

Probiotics are designed to introduce “good” bacteria into the gut, aiming to boost gut health and potentially treat a range of conditions. There’s growing evidence for potential benefits for irritable bowel syndrome and other gut disorders, allergies, immunity and help during or after antibiotics. However, there’s a wide range of probiotic strains, with different products marketed for different benefits. “You need to use particular strains to target a particular issue,” says Vavasour. She warns taking a probiotic “for some people can actually worsen symptoms and can cause gastrointestinal discomfort, upset, constipation and diarrhoea”. But the Nutrition Foundation says generally speaking, probiotics are safe for most people.

Vitamin B

B vitamins as a group include eight micronutrients that perform different functions in the body. They’re water-soluble, meaning we need a consistent supply. But the good news, says Goodhew, is that most of us will get all we need from food. “There’s ample amounts in fresh fruit and veges or even frozen fruit and veges.” Popping a B complex is unlikely to do much, although there are situations where certain B vitamins are recommended. Vitamin B9, known as folate or folic acid, is recommended for anyone planning to become pregnant and in the first three months of pregnancy. Vitamin B12 is essential for those on a strict vegan diet, since it is found only in animal foods.

Vavasour says she never recommends a general B complex. “I encourage people, if they’re struggling with energy – which is why they’ve taking a B complex – to incorporate more whole grains into their diet, which are a great natural source of B vitamins.” She warns of toxicity with vitamin B6 in particular. “You can get toxicity even on very low levels of supplementation. That could cause neuropathy. So, if you have any symptoms of tingling or numbness in your extremities, then you need to see GP and stop any B vitamin supplements immediately.”

Immunity products

Dozens of different products are promoted for immunity, and it seems many of us are keen to give ourselves a boost by popping everything from zinc and olive leaf extract to colostrum. Products have different levels of evidence, and some are promising, Vavasour says. “There’s been a lot [of research] with Covid around things like n-acetylcysteine, zinc, vitamin D and vitamin C, and I think all of these things do have a role. So many people are deficient in vitamin D, yet we don’t know about it and it’s an unfunded blood test.”

Again, she recommends focusing on diet as the first line of defence. Goodhew agrees, but adds, “We’re seeing now that high-dose zinc can be really valuable during times of infection, especially with our athletes and when it comes to travel.”

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Sleep products

From homeopathic drops to valerian and tart cherry extract, sleep aids are big business. Evidence is extremely mixed on most, and sleep experts are generally wary of anything we may come to rely on to get us to sleep. There’s a quick-fix factor in play, says Vavasour. “With sleep, too often, we reach for a pill or a product to buy, as opposed to addressing things like sleep hygiene and the practicalities.” Instead, she suggests looking at issues such as the amount of time spent on devices, how much exercise we’re getting, caffeine intake and sleep routines. “Nine times out of 10, the issue resolves itself.”

Fish oil

Omega-3s are important components of the membranes that surround cells, and they’re some of the most researched dietary substances around. There’s good evidence to show potential benefits of these fats in the diet, including to heart health. The Heart Foundation recommends 2-3 portions of fish (including oily fish) a week to supply the omega-3s we need. If we don’t eat fish regularly, though, supplements might be a good idea, says Vavasour. “By and large, the general population doesn’t eat enough oily fish and doesn’t get enough DHA and EPA in their diets.” Vegans and vegetarians could also consider a supplement.

* Based on Circana MarketEdge data.


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