Do you feel lethargic or get tired fast? Most of us automatically pop multi-vitamin tablets or other supplements to pep ourselves up. Well, there’s nothing radically wrong in fortifying oneself once in a while with health supplements when you know your nutritional intake is not as good as it should be. But do it indiscriminately and you are asking for trouble, says Delhi-based retired cardiologist and marathoner Dr Ashish Roy. Overuse not only hurts the pocket, it can hurt the body too, he says.
Seventy-four-year-old Roy, who completed his 75th marathon only last week in the US, follows a simple vegetarian diet of lentils, vegetables and salads. The only neutraceuticals (over- the-counter nutritional supplements) he pops, at his age, are multi-vitamins at lunchtime, he says. “It’s a myth that vegetarians need to take protein supplements,” he says firmly. Delhi-based nutritionist Ishi Khosla agrees that two servings of lentils, some milk and a handful of nuts are adequate protein for the average person, vegetarian or otherwise.
Till some years ago, most Indians belonged to Roy’s and Khosla’s school of thought. But today, in a trend imitative of the West, a growing number of Indians—especially people in their 30s and 40s, who are aware they are not eating right—pop supplements in a bid to keep diseases at bay. This is reflected in the growth of the Indian neutraceuticals market, which notched up Rs1,800 crore in revenues last year and is growing at a rate of 8% annually.
Protein powders, multi-vitamin pills, Omega-3 supplements, calcium tablets, magnesium pills... there is no dearth of micronutrient offerings available at the neighbourhood chemist to boost the body. But the question is: Do we really need all these supplements?
In the US, where nutritional pill popping has led to a multi-billion dollar industry, there has been considerable debate on the issue, with a whole body of scientific research flying across the Internet to show the damage caused by over-supplementation. In India, nobody really wants to stick their neck out on the issue as yet, especially as deficiency diseases are rampant in the country. However, aware of the growing negative press worldwide on the issue of supplementation, the industry has its argument pat. “In the Indian context, where one cannot be sure about the quality of vegetables and fruit, it makes sense to take supplements,” says Arvind Junagade, senior vice-president (technical), Amway, the direct-selling company, which sells the Nutrilite range of health supplements.
Besides, as he questions, how many helpings of fruit and vegetables is the average individual able to consume daily to get the requisite recommended dietary allowance of nutrients?
Given that both sides sound convincing, what should you do? For a start, check with your doctor or nutritionist before taking supplements. Says Dr Sandeep Budhiraja, head of department, internal medicine, Max Healthcare, New Delhi: “The scientific evidence, so far, is that multi-vitamin formulations serve no purpose in normal, healthy people.” But, he clarifies: “If a person has been found to suffer from certain deficiencies, it is important to prescribe supplements to correct it.”
According to Dr Budhiraja, even if a particular deficiency is identified, a blanket multi-vitamin formulation will not be able to rectify the problem because such a formulation will have all the minerals in low quantities, and will not be able to make up the deficiency.
More effective, he suggests, will be tests to find out which vitamin is lacking and take the specific formulation required.
So, what’s the rule of thumb for smart supplementation for a normal healthy individual?
You can take them, but the verdict is that they serve no useful purpose. At the same time, they won’t do any harm either. According to doctors, they probably work like a placebo, giving you a psychological feeling of well-being just because you know you have popped one. Cheap or expensive does not matter—the effect is all the same.
Vitamins B, C
Again, no harm in taking these since these are water-soluble and excess quantities will be eliminated in urine.
Vitamins A, D, K
According to Dr Budhiraja, vitamins A, D and K are fat-soluble and if consumed in excess quantities, tend to accumulate in the body, leading to toxicity and other side effects. Of these, he says, vitamin D is most wrongly used in India. In the natural course, the skin produces this when exposed to sunlight. However, it’s true that a large number of Indians are deficient in Vitamin D and in need of supplementation. But, given the dangers of over-consumption, it’s best to take these under a doctor’s or nutritionist’s advice and after proper tests.
A routine calcium supplementation for every post-menopausal woman is a must, advises Dr Budhiraja. That’s because most post-menopausal women develop oestrogen deficiency, due to which bones progressively lose minerals. At this stage, you need at least 1,500mg of calcium in your diet, equivalent to five glasses of milk or a similar proportion of dairy products. Rather impractical, hence going in for supplements is a must.
Nutritionist Ishi Khosla advocates “these food fats” supplementation as this is one nutrient lacking in ‘fishless’ Indian diets. Dr Budhiraja endorses it as well.
A normal person needs 1gm of protein per kg weight. So, if your weight is 60kg, you will require 60gm of protein per day. Your dietician can help you with this. However, athletes and those wanting to build muscle mass need extra protein, says Dr Budhiraja, with the requirement shooting to 2gm per kg weight. In this case, protein supplements may be necessary. Protein supplements are also advised for elderly people, or those recovering from an illness or a surgery. In the case of protein, Khosla cautions that oversupplementation can lead to problems as it can cause renal overload since the kidneys will need to work overtime.
Indian women tend to be anaemic. However, it’s best to get tests done to find out the extent of deficiency and take supplements under medical advice...