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Vitamin Supplements vs. Food

What’s best for packing a nutritional punch?

Supplements sandwiched between two slices of white bread.
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It happens to the best of us. You’re concerned that your steady stream of takeout Chinese, Cheetos, and Diet Coke isn’t doing your body good, so you take vitamin supplements—maybe a multivitamin so you can get everything in one dose or a plethora of supplements to cover your bases. Nutrition mission accomplished, right?

Unfortunately, no. You aren’t really making up for missed nutrients by taking supplements for two major reasons. First, certain nutrients that are essential for good health can only be found in actual food. Second, supplements are not regulated by the U.S. Food and Drug Administration (FDA) the way drugs are, so there’s no guarantee that what it says on the bottle is what you’re actually ingesting.

What’s in a pill?

More than half of America’s adults take supplements, either individual nutrients or multivitamins, spending $12 billion annually. But supplements just don’t hit you with the nutritional punch of plain old food. For example, nutrients such as carotenoids (a type of antioxidant—the much-heralded nutrients that help prevent cell damage that can lead to cancer) can be found in supplements, but they are not designed to work alone, explains Alissa Rumsey, a registered dietitian. To get the full benefit of carotenoids, they must be consumed with fat in order for the body to absorb them. Further, a new study in the Annals of Internal Medicine shows that diets rich in foods containing certain nutrients can reduce the risk of heart disease and cancer, but consuming the same nutrients in supplement form does not have the same health benefits.

“Whole foods are complex and contain nutrients that work together in a variety of ways,” Rumsey says. “Supplements can't always mimic the way that these nutrients from whole foods work together. That’s why food should always be your first option for getting everything you need.”

Have you ever seen a label saying a single pill contains 1,000% of the recommended daily intake of a certain vitamin? First of all, what does that even mean? But more to the point: It isn’t necessarily true. “The FDA doesn't regulate or oversee supplement content or claims to the same degree it does with prescription medications, so what you see on the label might not be what’s actually in there,” Rumsey cautions.

And why would anybody want “1,000%” of anything? Is that even safe?

No, it’s often not. For example, fat-soluble vitamins, including A, D, and E, can be stored in the body, but very high levels of these vitamins can be toxic. (Very high levels of vitamin E, for example, can increase your risk of internal bleeding.) On the other hand, the water-soluble vitamins, notably vitamin C and the B vitamins, cannot be stored in the body. So if you have enough at any given time, any excess will simply be eliminated in the urine (aka, you’ll pee it out). If you’re eating a varied, healthy diet, you’re more likely to already be getting the amounts you need.

Who needs supplements?

The right vitamin supplements can be useful for specific groups. Women trying to conceive or who are already pregnant need prenatal vitamins, especially folic acid, a B vitamin that has been shown to reduce the risk of life-threatening birth defects in a developing baby's brain and spinal cord.

People who are preparing for bariatric surgery, or who have already had it, are often counseled to take supplements because they tend not to eat enough food to meet the daily recommended amounts of certain nutrients. Further, it may be more difficult for them to maintain necessary levels of fat-soluble vitamins, those stored in fat cells, because of rapid weight loss.

Rumsey also recommends that older adults consider supplements, as our bodies are less efficient at extracting nutrients from food as we age. Specifically, older adults tend to be deficient in vitamin B12, which is necessary for healthy blood cells and nerves.

People of any age who don’t eat entire categories of food, such as strict vegans and vegetarians, may also want to consider B12 supplementation, Rumsey suggests, because the vitamin is only found naturally in animal foods such as meat, milk and milk products, and eggs.

Like B12, vitamin D only naturally occurs in animal products—liver, butter, fatty fish (such as salmon), and egg yolks. Your body, however, creates vitamin D when your skin is exposed to sunlight. It doesn’t take much if you’re fair skinned—just 10 to 15 minutes on a small area of exposed skin, three times a week—but if you’re dark skinned or live in places with less sun exposure, it will take longer in the sun, with more skin surface area exposed to get what you need (which comes with its own set of concerns). In those cases, vitamin D supplements could help.

If you use supplements, it pays to be choosy. Look for a third-party label review, such as those done by ConsumerLab.com, which indicates that the supplement was reviewed to ensure it contains the amount of nutrient the label claims it does. Those reviews do not, however, evaluate whether the supplement actually does what it claims to do.

Variety is key

When it comes to getting all essential nutrients in your diet, Rumsey has good news—you needn’t worry about eating a rainbow at every meal to ensure you’re checking off your nutrient checklist. “Look at your diet over the course of a week, not every day or every meal,” Rumsey advises. “If you meal prep and eat the same thing a few times a week, just change it up the following week to incorporate foods you might not have gotten the previous week.”

And do your homework. You might be surprised what foods contain certain vitamins. Yes, citrus fruits deliver vitamin C, for example, but so do vegetables including broccoli, cauliflower, leafy greens, and sweet potatoes. You can get calcium from dark leafy greens—chard, collards, kale, and spinach—and from some fish, including sardines and salmon. Knowing what’s in the foods you eat will help confirm you’re getting what you need (without making you stressed that you have to eat everything from arugula to zucchini).

“There’s room to eat a lot of different things,” Rumsey continues. “You don’t need to have an all-or-nothing attitude about diets to ensure you get all your vitamins.”

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Published September 30th, 2019
A young woman with dark curly hair is using mobile phone. Female is smiling while holding smart phone. She is lying on sofa at home.

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