What Kind of Supplements Are Actually Recommended To Take?

You will often hear mixed messages about supplements and whether or not you should be utilizing them to complete your diet. Hopefully we can offer you some clarity so you know exactly what you should be doing in this season of life to offer you optimal health. 

Supplements Can’t Replace The Real Thing

Supplements were originally designed to do just merely what it's called-to add to your current diet rather than replacing or substituting entire food groups from your diet. Supplements have become a multi-billion dollar industry and you can understand why–they’re convenient and can be a “quick fix” to fill huge deficits found in the typical American diet as only 1 in ten adults consume the recommended daily servings of fruits and vegetables. There is tremendous pressure in the industry to develop individual chemical substances to market and sell. While supplements have potential short-term benefits and prevent deficiencies, long-term research shows that supplements don't prevent heart disease or cancer. Supplements can’t replace the synergy that whole foods offer us when we consume them in its entirety. Focusing wherever you can first on whole foods will provide you with many more benefits than isolating nutrients that are found in supplements.

Things To Consider When Purchasing Supplements

Supplements are as potent and powerful as prescription drugs. It is always recommended to consult with a trusted medical professional when you are adding a new supplement to your dietary regimen. Multivitamins often contain too much of everything you don’t really need, and too little of the nutrients you do need. With limited regulation and oversight, it's also difficult to know for certain that the supplement contains the ingredients on the label and is free of contaminants. It is wise to invest in high quality supplementation.

Additionally, supplements are not regulated by the Food and Drug Administration (FDA), supplements can appear on the shelf without having to prove they offer any benefits or even contain the purported ingredients listed. Some ways to ensure they truly contain what is listed on the label is to look for third-party verification, such as USP Verified, NSF International, Consumerlab.com, Informed Choice and NSF Certified for Sport. 

Maintain the quality of your supplements by following the storage instructions as stated by the label. Keeping supplements in extreme temperatures can compromise their quality and efficacy. Typically, liquid supplements and some probiotics require refrigeration. 

Despite what labels may tout, they can never replace the nutrients found in real foods. Whole food supplements are often not as high in nutrient content as other counterparts and can be contaminated with lead. Organic supplements have not been found to be nutritionally superior to conventional ones and are often pricier. Methylated supplements can be appealing as they can be considered more effective to certain populations with genetic mutations; however, they may not necessarily be safer due to a likelihood to over consume the nutrient creating unpleasant side effects such as insomnia, rash, mood swings and anxiety.

PlantWhys Recommendations for Supplementation

General Recommendations 

We recommend that everyone (regardless of diet) take vitamin D and omega-3 supplements

Vitamin D

Vitamin D is known as the sunshine vitamin because it is produced in the skin by ultraviolet rays from the sun. Sunscreen use, the latitude of your location and an indoor lifestyle mean that most of us are lacking in this essential vitamin. Adequate vitamin D is central to a strong skeleton. With time, even slight shortfalls in vitamin D may impact bone strength, as insufficient vitamin D forces your body to withdraw calcium from bones in order to maintain balance in the body. Two of the largest studies studying micronutrient intakes in people consuming a variety of diets (EPIC-Oxford and Adventist Health Study-2) found that all dietary groups were low in vitamin D. It was concluded that vitamin D status is more influenced by supplementation, sun exposure and skin pigmentation than diet. For most people, it is wise to take a Vitamin D supplement. When looking for a supplement you will find two forms of vitamin available: D3 (animal source) and D2 (plant source). There is some debate on the superior form but studies are not conclusive. Choose a reliable, third-party verified supplement that offers sufficient IUs to meet the needs for your current season of life.

Omega-3 

For most people, supplementing with ALA sources of Omega-3 (i.e. chia seeds, flaxseeds) would be sufficiently utilized in their bodies. Others who may not be able to efficiently convert ALA to DHA/EPA in their bodies due to genetic variability, smoking, advancing age, hypertension, metabolic syndrome, diabetes, pregnancy and lactation (in this case, they simply require more). Rich non-plant sources of DHA/EPA can include: omega-3 fortified eggs and fish. Most EPA and DHA are made by plants in the ocean, which are then consumed by fish. Omega-3 containing microalgae can be cultured and extract their DHA and EPA content to be used in foods and supplements. You will find certain foods being fortified with microalgae-based DHA such as infant formulas, soy milks, cold-pressed oils, juices, cereals, etc. A 2019 scientific review highlights the importance of algae supplementation for plant-based eaters to achieve desired DHA and EPA omega-3 levels. Some other ways to optimize omega-3 consumption is to avoid foods that can reduce ALA conversion capacity such as alcohol, caffeine and foods high in trans fatty acids. One of the best ways to know your omega-3 status is to obtain the omega-3 index to measure the EPA and DHA content in your red cell membranes.

For Exclusive or Predominantly Plant-Based Eaters

Vitamin B12

Plant foods are not a reliable source of  B12 and for this reason there is the highest increased risk of deficiency in exclusive or predominantly plant-based eaters. The only reliable way to achieve this is by eating fortified foods or taking a vitamin B12 supplement. Deficiencies in this vitamin can be irreparable especially amongst infants, who have minimal B12 stores compared to adults, and when not caught early on can lead to permanent brain damage. In adults, it can take years to manifest a deficiency and can not be easily reversed when left unchecked. A B12 deficiency can present as anemia with weakness, fatigue, irritability, shortness of breath and paleness. There can also be signs of nerve damage with numbness and tingling as it continues on. Due to the absorption rate, it is recommended to take double the recommended dietary allowance (RDA) for B12 and to take a supplement and not solely rely on fortified foods. The best case scenario is to supplement daily or twice weekly. B12 is a water-soluble vitamin so any excess is excreted in your urine (it’s what gives it the neon yellow color) and side effects from excess intake are rare and infrequent (some say they have acne or rosacea). 

Additional nutrients to consider

Iodine and Selenium

Iodine and selenium help regulate your thyroid and metabolism. When insufficient iodine occurs, it can trigger thyroid issues, especially in combination with goitrogen-containing foods like raw cruciferous vegetables. Vegans who do not want to consume brazil nuts, iodized salt or eat seaweed should consider taking an iodine and selenium supplement. 

Calcium

Supplementation may be needed for plant-based eaters and young children who do not regularly consume fortified foods that contain adequate amounts of calcium. Dairy is not required for optimal bone health, despite the public health messaging that is touted in the American media. It is very possible to meet calcium needs without relying solely on cow’s milk (moose’s milk is actually twice as concentrated in calcium). Calcium absorption can be impacted by the oxalate content found in plants as well as can be excreted more readily with higher sodium intake. Focusing on low-oxalate foods that are higher in calcium can help. Such foods include: dark leafy greens (broccoli, bok choy, kale, Napa cabbage, turnip greens), sweet potatoes, tahini, beans, and fortified foods like plant milks, tofu, nuts and blackstrap molasses. The absorption of calcium in plant milks and tofu is comparable to cow’s milk (about 30 to 32 percent). Calcium is important for children who have higher needs while they are growing and getting optimal bone health is more than just having adequate calcium levels. Care is needed to not over supplement on calcium as excess levels can lead to constipation and compromised iron and zinc absorption. Having a reliable source of vitamin D, adequate physical movement and protein, vegetable and fruit intake all play a part in the overall picture. 

Iron

Lower iron levels is quite common in all dietary groups, however it has been shown to be slightly lower for those on a plant-based diet and a risk factor for pre-menopausal women. Plant-based eaters should aim to eat iron-rich foods, despite the lower bioavailability of iron in plant foods, such as cruciferous vegetables, beans, peas, dried fruit, nuts, and seeds, and enhance iron absorption by pairing it with vitamin C-rich foods. Some other ways to mitigate the inhibited absorption is to consume iron-rich foods and drink teas separate from meals.

There is some benefit to being lower than having higher iron stores as it has been associated with increased risk of developing metabolic syndrome, diabetes, cardiovascular diseases and some forms of cancer. Unnecessary intake of supplements like iron can do more harm than good by damaging cells or blocking the absorption of other minerals. The best way to determine whether iron supplements are necessary is to get your hemoglobin and ferritin levels checked by your health practitioner.

Zinc

Daily intake of zinc is essential as we have limited stores of it in our body. For plant-based eaters, it has been indicated that they are on the lower end of typical serum zinc concentrations. A systematic review done in 2021, found that zinc is poorly bioavailable for plant-based eaters when compared to omnivores. One culprit is that zinc absorption from some plant foods is limited due to their phytate content. This can be combated in several ways: food preparation methods, consuming one and half times more zinc-rich foods or supplementing with a multivitamin that contains zinc for those who are pregnant, lactating or selective eaters.

These are suggested daily intakes for typical male or female adults:

• Omega-3: ALA-based (seeds) 2.2 g (females) 3.2 g (males) or EPA/DHA-based (microalgae) 160 mg (males) 110 mg (females)
• Vitamin D:  D3 (animal source) and D2 (plant source) 600 to upwards of 2,000 IU depending on current vitamin D status
• B12: 100 mcg (daily); 1,000 mcg (2x a week) 2,000 mcg (weekly)
• Zinc: 11-12 mcg in individuals who are pregnant or lactating; best to consume in a prenatal with other essential nutrients.

Suggested daily intakes for typical children (recommendations may vary for certain ages)

• Omega-3: ALA-based (seeds) 1.8-3.2 g or EPA/DHA-based (microalgae) 90-160 mg
• Vitamin D:  D3 (animal source) and D2 (plant source) 400 IU 
• B12: 10-50 mcg (daily); 250-750 mcg (2x a week) 1,000-1,500 mcg (weekly)
• Calcium: Starting at 4 years aim for 1,000 mg daily total. Adjust supplements to account for dietary intake and not exceed 2,500 to 3,000 mg
• Iron: Consult with your pediatrician about an iron supplement for pre-term or exclusively breast-fed infants. Between ages 1 to 5 limit cow’s milk to <3 cups daily and light on other dairy products.
• Zinc: For selective eaters, opt for a supplement that contains between 2-8 mcg

PlantWhys Brand Favorites 

Like mentioned earlier, there are many supplements that are most likely acceptable to use, just make sure they have third-party testing due to lack of federal regulations. Remember that first and foremost, it is recommended to get your nutrients from whole foods first and that these are merely minor additions to your overall diet. It can be easy to get carried away with all the offerings, but stick to the basic nutrient recommendations shared above and you’ll save money in the long run focusing on whole foods.  However, we know sometimes it helps to get some personal recommendations, so here are our favorites:

• Dr. Fuhrman’s has an assessment you can take to determine your personalized supplementation program. Otherwise there are an assortment of supplements you can order that are specifically tailored for vegans/plant-based eating.
• Wholier has a specific line as well for plant-based eating that can be ideal for those who don’t need an individualized supplement regimen or not quite sure which specific nutrients are lacking.The link has a discount of $15 for first-time purchases.
• Complement is also catered to plant-based eaters and has a quiz that can be filled out to find out a personalized supplement regimen.  

Sources:

Foster M, Chu A, Petocz P, Samman S. Effect of vegetarian diets on zinc status: a systematic review and meta-analysis of studies in humans. J Sci Food Agric. 2013 Aug 15;93(10):2362-71. doi: 10.1002/jsfa.6179. Epub 2013 May 29. PMID: 23595983.

Burns-Whitmore, B., Froyen, E., Heskey, C., Parker, T., & San Pablo, G. (2019). Alpha-Linolenic and Linoleic Fatty Acids in the Vegan Diet: Do They Require Dietary Reference Intake/Adequate Intake Special Consideration?. Nutrients, 11(10), 2365. https://doi.org/10.3390/nu11102365

Guo, Wanli, et al. (2016). Magnesium deficiency in plants: An urgent problem. The Crop Journal 4(2). P. 83-91. https://www.sciencedirect.com/science/article/pii/S221451411500121X

Harvard Health Newsletter. (2021). Do you need a daily supplement? Harvard Health Publishing. Accessed June 21, 2022.  https://www.health.harvard.edu/staying-healthy/do-you-need-a-daily-supplement

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262608/

Pineda Ochoa, Sofia. (2017). Vitamin B12: Your Questions Answered.   Forks Over Knives Newsfeed: Wellness. Accessed: June 23, 2022. https://www.forksoverknives.com/wellness/vitamin-b12-questions-answered-2/

Amidor, Toby. (2019). Ask the Expert: Supplement Savvy. Today’s Dietitian. Accessed June 16, 2022. https://www.todaysdietitian.com/newarchives/0719p8.shtml

Shah, Rehsma and Brenda Davis. (2020). Nourish: the definitive plant-based nutrition guide for families. Health Communications, Inc. 

Bakaloudi, D. R., Halloran, A., Rippin, H. L., Oikonomidou, A. C., Dardavesis, T. I., Williams, J., Wickramasinghe, K., Breda, J., & Chourdakis, M. (2021). Intake and adequacy of the vegan diet. A systematic review of the evidence. Clinical nutrition (Edinburgh, Scotland), 40(5), 3503–3521. https://doi.org/10.1016/j.clnu.2020.11.035

Dunne, Stephanie and Jenna A. Bell. (2014). Vitamin D’s Role in Health-Deterministic or Indeterminate? Today’s Dietitian. 16 (7), 48. Accessed: June 29, 2022. https://www.todaysdietitian.com/newarchives/070114p48.shtml#:~:text=Vitamin%20D%20comes%20in%20two,manufactured%20supplements%20contain%20either%20form