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Food is the Best Medicine

shutterstock_108352955By Ben Kligler, MD 
We are a culture that believes that there is a pill for everything. And this doesn’t just apply to prescription pills—we believe this about natural medicines and supplements as well. Over half the adults in America take vitamins or supplements on a regular basis, and there is lots of advertising aimed at us to convince us that we should be taking even more! As it turns out, although there is good evidence that certain nutritional supplements can be very helpful to people with certain specific health conditions, like osteoarthritis or depression, all the vitamins, minerals and supplements we as a country take for general health and well-being might not really be doing us much good at all. In fact what really works for overall health is making sure we are getting the vitamins and minerals we need from our food, rather than from a pill.

The evidence that food as medicine is best for overall health rather than nutritional supplements got stronger recently with the publication of a recent article in the Annals of Internal Medicine.[i]Using survey data from an NIH-funded national study conducted over a six-year long period in over 27,000 people, the authors of this study found that although having proper levels of key nutrients was important to health, the overall risk of dying over that time period was not decreased in people taking nutritional supplements. And for several specific nutrients-- vitamin A, vitamin K, magnesium, zinc, and copper—the health benefit was only associated with people who got those nutrients from food rather than supplements. In fact, some supplements seem to be associated with an increased mortality risk: those who took more than 1000 milligrams of calcium supplements per day were more likely to die of cancer than those who did not. But there was no risk of increased cancer with high levels of calcium in people’s diet—only if that calcium was taken in supplement form.

This information matches up well with lots of other evidence that has emerged over the past few years on the food vs. pills battlefront. For example, because of the cardiovascular health benefits that were found to be associated—initially in indigenous Arctic populations—with eating fish regularly, a huge industry boomed of omega-three essential fatty acid supplements made from fish oil. And many of us in the medical profession were happily recommending those “natural medicines,” thinking that of course the same benefit in terms of lowered risk of heart disease and stroke would come from these as comes from eating fish. But as it turns out, according to a review in the Journal of the American Medical Association which looked at results from 20 studies of over 68,000 total patients, taking fish oil supplements did not lead to a reduction in risk of stroke or heart attack.[ii] Fortunately, similar reviews in large numbers of patients still find that eating 1-4 servings per week of fish does effectively reduce cardiovascular risk.[iii]

So all of this is not to say that taking nutritional supplements doesn’t make sense for some people—it does. But it should be for a specific reason. For the most part, though, the evidence shows that getting our vitamins and nutrients from a diverse and healthy diet rather than from a pill is the right choice.

 

Dr._KliglerDr. Kligler is the Medical Advisor for The Deirdre Imus Environmental Health Center®. He is also the National Director of the Integrative Health Coordinating Center for the Veterans Health Administration and Research Director for the Center Institute for Research and Education in Integrative Medicine. He is Co-Director of the Beth Israel Fellowship Program in Integrative Medicine, and teaches in the Beth Israel Residency Program in Urban Family Practice. Dr. Kligler is the author of Curriculum in Complementary Therapies: A Guide for the Medical Educator, and co-editor of Integrative Medicine: Principles for Practice, a textbook published by McGraw-Hill. He is also Co-Editor-in-Chief of the peer-reviewed journal Explore: The Journal of Science and Healing.

 



[i]Chen F, Du M, Blumberg JB, Ho Chui KK, Ruan M, Rogers G, et al. Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study. Ann Intern Med. 2019;170:604–613. doi: 10.7326/M18-2478

[ii]Rizos ECNtzani EEBika EKostapanos MSElisaf MS. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis.JAMA. 2012 Sep 12;308(10):1024-33.

[iii]Zheng JHuang TYu YHu XYang BLi D. Fish consumption and CHD mortality: an updated meta-analysis of seventeen cohort studies. PublicHealth Nutr. 2012 Apr;15(4):725-37

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