The dangers of taking nutritional supplements without medical justification, as many do

A survey by the Israeli Ministry of Health revealed a figure that may surprise: about 71% of the population in Israel take nutritional supplements. What are the reasons? Most of them stem from a need to supplement nutritional deficiencies or from the perception of nutritional supplements as health enhancers and as part of a healthy lifestyle. But is this actually what is happening? A position paper recently published by the Israel Medical Association presents important findings: many consume supplements without proven nutritional or medical justification, and thus may actually endanger their health. In times of war, when the routine is disrupted, anxiety and stress increase and emotional eating becomes more common, the temptation to rely on a capsule or powder as a “quick fix” becomes stronger. And right now, it’s more important than ever to go back to the basics – to real food.

In recent years there has been a fundamental change in global nutrition research. Dietary recommendations have shifted from focusing on individual nutrients to focusing on overall dietary patterns. The first reason is that in Western countries the common diseases are chronic diseases such as cardiovascular diseases, cancer and diabetes. Unlike specific nutritional deficiencies, these chronic diseases are more influenced by dietary patterns than a single nutrient.

And there is another reason. Foods consist of a combination of a variety of nutrients, some of which are not even well known, that work together and complement each other within the food itself and in combination with other foods. Reference to the dietary pattern allows one to examine the interrelationships between the foods and the nutritional components, and their combined effect on health.

The third reason is related to the microbiome, the population of bacteria that lives mainly in the intestines. Studies show that the intestinal bacteria use components that come from the food we eat to produce substances that affect central systems in the body, including the immune system, the hormonal system and the nervous system. Therefore, the food itself has a significant effect on the activity of the microbiome and on health.

Even when nutritional supplements are consumed in an appropriate dose, there is not always proof of their effectiveness, and sometimes relying on them may reduce the consumption of healthy and varied food. But this is not the only risk. Taking dietary supplements increases the risk of excess consumption of various nutrients above the recommended daily allowance and even above the safe upper threshold. This is especially important in nutritional components, an excess of which may endanger health, such as iron and fat-soluble vitamins – A, D, E, K.

There may also be an unwanted and even dangerous interaction between certain supplements and different medications. Due to low regulatory oversight, the use of dietary supplements increases the risk of the presence of various pollutants and heavy metals. For example, laboratory tests conducted on 66 supplements from 21 different companies in the Netherlands revealed that between 33% and 40% of the supplements designed to improve athletes’ performance contained prohibited substances – substances that were not declared on the label.

In the case of protein supplements, the tests are even more worrying. The Clean Label organization in the United States found high levels of heavy metals in 77% of plant-based protein supplements and in 28% of whey protein supplements, levels that are above California state standards. In addition, there may be a gap between the information shown on the label and the actual content of the supplement.

In cases of nutritional deficiency according to a professional nutritional assessment, which cannot be supplemented through nutrition, it is worth considering supplements. For example, a recommendation for a vitamin B12 supplement in populations that avoid consumption of animal food, or a recommendation for a calcium supplement in situations of low nutritional intake. Medical conditions that require the use of supplements, such as conditions of hypoabsorption in the digestive system due to illness, also require supplements. When this is possible, it is desirable that the consumption of the various nutrients come from whole foods and not from the consumption of isolated food components or nutritional supplements. Even in cases where nutritional supplements are combined, emphasis should be placed on a balanced and varied diet as much as possible and maintaining a combination of nutritional supplements in the minimum required dose. Attention must be paid to different nutritional requirements in different populations – infancy, pregnancy, the elderly – and compliance with recommendations adapted to them.