Great post! Supplement means a supplement and unfortunately its sometimes not treated as a supplement.  
Its the pharma companies pushing sales.
 There are people who feel more comfortable psychologically when taking tablets (placebo effect?). I guess for such people tablets made with plain flour will work just as well, though wholewheat tablets would be better:)  

I think your point about the placebo effect and the psychological effect of taking something labeled “iron” or “calcium” is a really good one. Even with my fish oil habit, whenever I down the pill, I feel that I am doing something good for body and this feeling of goodness is important. So if by taking supplements it makes one feel that they are caring for and loving their bodies then that alone is a huge benefit. If the vitamin comes in place of the “loving” FOOD though, then it may be time to ween yourself from the bottle.

I’m a HUGE fan of eating super nutrient- densely but there are many excellent professional quality supplements which are  just that: supplements- and I am proud to have them on my site http://prasadabeauty.com, a wellness site. Thanks

Thank you Michelle for another enlightening post. When everyone got on the supplements band wagon, something just didn’t seem right to me. Of course now, it’s being found that many nutrients are not properly abosorbed with out the accompanying nutrient, minerals or amino acids in the food. I feel compelled to inform friends taking 1,000s of IUs of vitamin C to ward off a cold that they are just peeing out what they don’t use (and increasing their chances of getting kidney stones). Linus Pauling retracted everything he said about vit C and colds – it’s ineffective. But it’s true that placebos are often as powerful as the “real” thing. it. If I feel something coming on, I just keep telling myself “I am not sick” – and I haven’t been sick for as long as I can remember – no colds, no flu, no nothin’.

I find it hard to swallow a pill everyday but I am religious about adding flax meal to my daily yogurt w/nuts and fresh fruit. And plying as many green and various vegetables I can into my body throughout the day. I love your blog and always learn something great and new – who new spinach is actually better for you when slightly cooked? The way I like it?! Thanks again. Keep them coming!

I agree that the placebo effect and “belief” element is huge. I remember when my Mum years ago told me (after my taking echinacea for colds for years), that it was “useless” – that it could never be an effective remedy for me again…one simple word and it’s powders were gone.

So funny – I have some chives that are starting to blossom and I was going to snip them and get rid of the blossoms. I’m so glad I didn’t! Who knew they were tasty???
And I am totally with you on the topic of this post: if you eat right, you should need few – if any – supplements. Plus it’s a lot more fun to cook (and eat) good food than it is to shop for (and swallow) vitamins!

A supplement seller once told me about all the regulars he has in his department of the health food store and what very expensive pee they have.  That message has stuck with me, and I remain solidly “food first”, as you say.  

And about chive flowers: I took very similar pictures today!  They have been on our plates, in our meals and in bouquets around the house all week.  As a member of the allium family, they are one of those nutrient-dense, eat-’em-instead-of-supplements foods I love to cook with.

I love your approach to food as medicine. I’m off to hunt down the cauliflower soup recipe. 
xo jana 
adore your blog!

I’ve occasionally taken supplements, but only when I know I haven’t been eating properly (or when I’ve been worried about the other life I’ve been forming in my uterus). But I never crave them like I crave the foods that contain their segregated, expensive vitamins. When I’m low on energy, slumping my shoulders, I crave to distraction a medium rare, grassfed steak, but when I’m healthy I never even think about this food. Dark green vegetables take hold of my pysche in similar ways, but when my lurgy is slightly different in quality. I think the answer to supplements is being responsive to cravings like these, and listening out for the more subtle ones as well.

I’m no nutritionist, but I’ve read my fair share of book and articles. I was wondering if you have read any of the literature that says that eating calcium in dairy actually does nothing for bone health. That the US is the highest consumer of dairy and that we also have the highest rate of osteoporosis. These doctors say that bone health is more about retaining the calcium in our bones and avoiding calcium loss than it is about adding calcium. They say that exercise is the best way to strengthen bone and that eating meat and dairy actually speeds up the rate of calcium loss from your bones (Dr. Esselstyn actually says “We are peeing out our calcium when we eat meat). Your thoughts? Have you already written a blog post about this subject? You do such great research, I would love to read your analysis of this!

Great post!  I eat yogurt and drink milk with my meals rather than take a calcium pill every day….  Also, thanks for the info on the cardamom pods – I think I would have done the same thing!

Yes, absolutely, but no, not really.

When I came here from Europe 30 years ago I was adamant that one was supposed to get all nutrients from food – in  fact I still am – and would have never questioned that wisdom. Three decades, handicapped and sick children and a chronic disease (which started during my teenage years in Europe) later I swallow plenty of carefully chosen supplements with my mostly home grown food.

Where do you have doctors prescribing vitamins? It is supposed to be illegal here in Canada to even talk about supplements to your patients, a doctor could lose his license for that. (If that isn’t an urban myth and/or just in Quebec?).

In fact a friend with terrible osteoporosis got a prescription for a medicament which would help her body absorb more vitamin D and calcium – without any mention that she’d first need to take these supplements. The doctor unfortunately never talked about her diet either – she is a vegetarian who eats plenty of junk …… (Not that a non-vegetarian junk eater had a better diet)

There is also the fact that you have fresh cauliflower right now when I just planted my little plants in the garden.  Although we have plenty of fallow fields around here the only produce in our local store comes from far, i.e. is not really fresh, from over cropped (depleted) fields.

Today is supposed to be sunny but as of yet not much evidence for that. Even if the sun comes out in force most people will be inside working at a desk during peak sunshine hours, and the season during which we up here can really absorb some vitamin D is barely 6 months long. And we can have days and days of rain (as in no sun at all) during our summer.

There seems to be evidence that vitamin fortified foods did a lot of good for the public health. Of course getting kids outside during the day instead of keeping them inside classrooms would do away with the need for vitamin D in milk, and whole wheat bread wouldn’t need to be enriched…..

Popping vitamins can never be an excuse for a bad diet, but when I look at what friends and neighbors believe to be good food I do wish they’d swallow at least a multivitamin. Especially as we are living so long today…..

As usual good food for thought.

I so want to believe that I can get all my necessary nutrients from good food. When I was anemic after a miscarriage I brought my iron up simply with red meat, molasses, eggs and pinto beans. 
However, I live in the sunny Southwest, where most people who are tested are deficient for Vit D, which is mysterious. I do take Vit D oil in the winter.

I don’t take a specific suppliment, but I do take a daily multi vitamin. I’m a huge believer in getting my nutrients from food, but a multi vitamin can’t hurt, right? I’m a vegetarian and the multi vitamin I take (Trader Joe’s high potency women’s formula) truly helps me with iron absorption. I love to eat spinach, kale, dates, beans and lentils, but I still tend to bruise easily. When I add the multi vitamin to the mix, my bruises heal super fast and I’m less likely to get new ones.

One food that I’m super crazy about it flax seeds. I buy them ground and add them to a meal every single day. Since I’ve added flax seeds to my diet, my cholesterol levels have dropped dramatically (even more then when I became a vegetarian).

I take supplements AND eat lots of fresh, organic fruits & veggies. Since I’m in my 50s now & am told I look like I’m in my 30s, I think I must be doing something right. With all the exposure to toxins & stress these days ( I work w/ kids & need lots of energy & a strong immune system), I feel that supplements do help keep my body strong. 

&  I refuse to choke on ‘horse pills’ ! Vitamins & minerals are made in all kinds of forms these days besides tablets, for example: I buy calcium/magnesium/zinc in a softgel & drink 1000mg C in the form of EmergenC Light w/ MSM every a.m..

FWIW, the USDA also has .pdf lists of foods sorted by specific nutrient content (& it’s linked on their food search page):

http://www.ars.usda.gov/Services/docs.htm?docid=20958

In the US, Rx for supplements is not uncommmon since there is a max dosage that is allowed to be sold over the counter (ie. on the shelf) so if a doc thinks you need more, you need an Rx. For example, pre-natal vitamins are often given with an Rx (in the US anyway) since the levels of several vits and minerals is higher than you could ever find on a shelf.

Will look into it … stay tuned.

thank you! you are the best!

Dr. Joel Fuhrman writes about this in his book “Eat to Live.” It starts on page 102 (I’m in the middle of reading it and it was sitting right next to me ).

Thanks for that post, very interessting! 
When I lived in the States I was really surprised how many people take vitamines every day. Here in Germany I hardly know anybody who takes vitamins (only people who are sick) on a daily base. I eat normal, meat, veggies, fruit but also sometimes sweets and fast food. I never took any food supplement not have I ever needed, my blood doesn’t show any signs that I’m low on anything. As far as I now all my friends and family here are the same. I think if you eat relativly healthy you don’t need any supplements.

Excellent take on real life food!  Just to reiterate what I mentioned @ your last article, taking supplements can actually cause the natural functions of our bodies in providing us with “real”, healthy substances to become lazy and lethargic (and thus ineffective over time) if these nutrients are conveniently provided by a supplement….especially if synthetic,

My take on the issue is that calcium is important but taking massive doses will likely do little to help if you’re not also excercizing and in particular doing weight and resistance excercizes that “strain” the bones (in a good way).  Vitamin D is also equally important to bone health as calcium.

In terms of meat and dairy being a detriment, the only thing I’ve read about that is that excessive amounts of protein (100 grams/day for a prolonged period of time) can cause the bones to be depleted as the digestion of protein does requires some calcium in the bloodstream, which is drawn from the bones. But the protein levels would have to be very high for this to be a concern.

Harvard’s Pub. Health side has a good piece on this … http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-full-story/index.html

If you are deficient in Vitamin D3 then you cannot absorb the calcium you need. 

As a physician in the US, I agree that everyone needs to do a better job with eating appropriate foods.  However, there is a role for vitamin D and other selected vitamin supplements.  If someone is vitamin D deficient, it is next to impossible to get the “loading doses” needed to rebuild the body’s stores without the high dose vitamin supplements required for the first few weeks of treatment.

As always, before we go ahead and blame the MEDICAL ESTABLISHMENT, take a minute to think about what my clinic days tend to look like: overweight, obese, and morbidly obese patients who want magic bullets for every ache, pain, and sleepless night but never seem to listen to my advice to change their diet, exercise more (or at all, and walking a couple blocks to the bus or running after your 2 year old actually doesn’t count in my book), and generally LIVE more healthfully.  So forgive us if occasionally we tire of preaching healthy diets to echoing rooms filled with closed ears and instead write a prescription for a multivitamin.  We’re only humans.

Joanna, I certainly did not mean to malign docs in anyway – so apologies! And I can well imagine the frustration that must come when you as a doc feel like a patient is simply not taking personal responsibility for their own health. There is only so much you can do to influence them.

So I applaud you for taking on the herculeal task on of caring for people that don’t always do such a great job of caring of themselves. I also have to remind myself that just b/c someone (a doc, a blogger) might tell you that food x is great for you, if you’re not in the habit of eating it, cooking it, or knowing others that do so, then it may simply be too “foreign” to ever be embraced. Unfortunate, but I think very often true.

Hi. I just started taking the same mulit-vitamin fromTJj and I was wondering if you take all 5 caps at the same time or do you divide it up through the day? It doesn’t really specify so I was sure. Thanks for any info.

Hi. I just started taking the same mulit-vitamin fromTJj and I was wondering if you take all 5 caps at the same time or do you divide it up through the day? It doesn’t really specify so I was sure. Thanks for any info.

lol Sorry. I meant to post that to the link above yours.