Dietary supplements cannot replace a healthy diet based on a variety of nutritious foods and they are not a licence to eat poorly.

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1 Dietary supplements Dietary supplements are intended to supply nutrients that are not consumed in adequate quantities from the diet. A dietary supplement is a taken orally and may contain vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes. Dietary supplements can be in the form of extracts or concentrates and are sold in different forms including pills, capsules, softgels, tablets, powder, liquid and bars. The use of dietary supplements appears to be increasing. People may take supplements to improve nutrition, to provide nutrients that are missing from the foods they eat, to decrease the risk of developing a disease, to reduce the severity of a disease, or to increase energy or improve performance. Herbal products and botanical supplements are also used instead of conventional medical therapies. Under certain circumstances, dietary supplements can be appropriate but under other circumstances dietary supplements may be unnecessary and may even create unexpected risks. Food versus supplements? Foods are the best sources of vitamins and minerals. Foods are complex and contain a variety of micronutrient. They also provide dietary fibre, which can help to prevent diseases, such as type 2 diabetes and heart disease, as well as prevent constipation. Foods also contain other health-promoting substances e.g. fruit and vegetables contain phytochemicals, which may help protect you against cancer, heart disease, diabetes and high blood pressure. If you're generally healthy and eat a wide variety of foods, including fruits, vegetables, whole grains, legumes, lean meats and fish, you are not likely to need dietary supplements. Important considerations for supplementing your diet Dietary supplements cannot replace a healthy diet based on a variety of nutritious foods and they are not a licence to eat poorly. While we need enough nutrients, excessive amounts of some nutrients can be harmful.

2 Some supplements contain active ingredients that have potent effects and therefore they aren t safe for everyone. If you are pregnant, breastfeeding, or you have a chronic medical condition, such as, diabetes, hypertension or heart disease, consult your healthcare practitioner before taking a supplement. Taking a combination of supplements or using these products together with medications (whether prescription or OTC drugs) could in some circumstances produce undesirable effects, which could be lifethreatening. For example, taking a combination of substances that thin the blood (e.g. Coumadin (prescription medicine), ginkgo biloba (herbal supplement), aspirin (over-the-counter drug) and vitamin E (vitamin supplement) can increase the risk for internal bleeding. If you want to use a dietary supplement instead of medication, or in combination with a medication, discuss it with your health care provider first. Always tell your health care practitioner about any vitamins, minerals, herbals or any other supplements you are taking, especially before surgery. Some products may need to be discontinued a few weeks before surgery to avoid potentially risky supplement/drug interactions e.g. changes in heart rate, blood pressure and increased bleeding. Be cautious with supplementation All chemicals, including nutrients, plant components, and other biologically active ingredients can be toxic when consumed in high enough quantities, for a long enough period or in combination with certain other substances. So don t assume that just because a product may not be beneficial that it won t be harmful. If something is beneficial in a certain quantity, having more won t necessarily increase its health benefits. For example, fat-soluble vitamins or minerals, which the body stores and excretes more slowly, can build up in your system to levels that could be harmful. To ensure you aren t getting too much, choose a product that does not contain more than 100% of the recommended dietary allowance (RDA) for a particular vitamin or mineral. The RDA is calculated to provide 100% of the dietary needs for most people.

3 Don t be misled by the term natural this does not mean that the product is safe or beneficial or milder than a drug. The ingredients may interact with drugs or may be dangerous for people with certain medical conditions. Be aware that sometimes the "proof" of the claims made by supplement companies may actually not be based on evidence-based research. A reputable company should have information to share about tests it has conducted on the safety or efficacy of the ingredients in the product. It should also have a quality control system to check if the product actually contains what it says on the label and is free of contaminants. It is often difficult to know what information is reliable and what is questionable. You may want to consider contacting the manufacturer or distributor about the product if you need more information. Do you need a dietary supplement? The best way to get the vitamins and minerals your body needs is from the food you eat. However you may need additional vitamins and minerals at certain stages of the lifecycle or under certain circumstances, such as: People who consume a very poor diet or who eat less than kilojoules per day Women who are trying to conceive should take extra folid acid to prevent the baby from developing neural tube defects (serious conditions of the brain or spinal cord). Women who are pregnant or breastfeeding may need to take a prenatal multivitamin and mineral that includes iron (to prevent anaemia), calcium (to maintain strong bones) and folic acid, Women at risk of osteoporosis may need to supplement with extra calcium. Vegetarians and vegans diet may need a vitamin B12 supplement. People who have a medical condition that affects how the body absorbs, uses or excretes nutrients, e.g. diarrhoea, food allergies, food intolerance or a disease of the liver, gallbladder, intestines or pancreas.

4 People who have had surgery on their digestive tract and can t digest and absorb nutrients efficiently. If you are concerned about your nutrient intake, consult a registered dietitian who can assess your current intake and make recommendations for overcoming any potential deficiencies. A dietitian can also design an individualised eating plan for you based on your specific medical and nutritional profile. Multivitamins: Do young children need them? Experts disagree on whether daily multivitamins are necessary for all children. Many young children are picky eaters, but that doesn't necessarily mean they will develop nutritional deficiencies. Children do not need large amounts of vitamins and minerals, and in addition, many common foods are fortified with these important nutrients, so they may be getting more vitamins and minerals than you think. If you do choose to supplement your child s diet, select multivitamins designed specifically for children. Follow the recommended dose, and remind your children that multivitamins are not sweets. Make sure an adult dispenses the multivitamins, even if your child seems responsible enough to do so him or herself. And remember, multivitamins don't replace proper nutrition - continue to offer your children healthy meals and snacks. Vitamin C: Can too much be harmful? Vitamin C (ascorbic acid) is a water-soluble vitamin that supports normal growth and development. Vitamin C also helps your body absorb iron. Because your body doesn't produce or store vitamin C, it's important to include vitamin C in your diet. For most people, a small glass of orange juice and a cup of strawberries, a medium orange, or a serving of broccoli provide enough vitamin C for the day. Any extra vitamin C will simply be flushed out of your body in your urine. Still, it's possible to have too much of a good thing. Although too much vitamin C from your diet is unlikely to harm you, megadoses of vitamin C supplements can cause nausea, diarrhoea, kidney stones and inflammation of the stomach lining (gastritis). Rarely, too much vitamin C can cause faintness, dizziness and fatigue.

5 Can taking vitamins help prevent heart disease or a heart attack? Researchers aren't sure whether taking vitamins can reduce your risk of developing heart disease or having a heart attack. Certain vitamins, such as vitamins C and E, may reduce your heart disease risk by preventing low-density lipoprotein (LDL, or "bad") cholesterol from producing plaques that can narrow your heart's arteries. Some research studies on these vitamins have shown that taking vitamins can reduce your heart disease risk, but most haven't shown a difference in heart disease risk between people who take vitamins and those who don't. Another vitamin that might improve your heart health is Vitamin D. There's some evidence that Vitamin D improves the health of your blood vessels, but nothing conclusive yet. Many people don't get enough vitamin D, so talk to your doctor if you're concerned about your vitamin D level. No matter what type of vitamins you take, vitamins won't prevent the development of heart disease if you don't control your other risk factors, such as diet, lack of physical activity, smoking, high cholesterol and diabetes. Prenatal vitamins are they necessary during pregnancy? Most prenatal vitamins contain more folic acid, calcium and iron than do standard adult multivitamins. It's still important to eat nutritious foods, but prenatal vitamins can help ensure you're getting enough of these essential nutrients during pregnancy: Folic acid helps prevent neural tube defects serious abnormalities of the brain and spinal cord. Folic acid may also decrease the risk of preterm delivery and low birth weight. Calcium promotes strong bones and teeth for both mother and baby. Calcium also helps your circulatory, muscular and nervous systems run normally. Iron supports the development of blood and muscle cells for both mother and baby. Iron helps prevent anaemia, a condition in which blood lacks adequate healthy red blood cells. Iron may also decrease the risk of preterm delivery and low birth weight.

6 Keep in mind that standard prenatal vitamins don't include omega-3 fatty acids, which help promote a baby's brain development. If you're unable to eat fish or other foods high in omega-3 fatty acids or choose not to, your health care provider may recommend omega-3 fatty acid supplements in addition to prenatal vitamins. It's best to start taking prenatal vitamins three months before conception. This is because the baby's neural tube which becomes the brain and spinal cord develops during the first month of pregnancy, perhaps before you even know that you're pregnant. Taking prenatal vitamins before conception is the best way to help prevent neural tube defects.

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