There are plenty of people ready to tell you that their new supplement is the answer to your prayers
The world of supplements can be confusing. On the one hand, you have brands and influencers claiming a supplement has radically changed their life. On the other hand, you have experts and sceptics dismissing most supplements as unscientific or misleading. The truth is more nuanced.
Nichola Ludlam-Raine, specialist dietitian and author of How Not To Eat Ultra-Processed, confirms that “there are very few supplements you actually need”. “Other than for specific circumstances or times of life, you can get all your nutrition from food,” she says. “It’s actually absorbed better and you’re getting other nutrients from that food”.
However, that doesn’t mean that none of the supplements on the market work – just that they need to be taken in specific contexts or by specific people. Ludlam-Raine adds: “I’m a big believer that if something’s not going to confer harm, may confer benefit, it’s not going to break the bank, and you’re doing the basics right, then you can give it a go for a number of weeks. If you notice an improvement, great; if you don’t, stop.”
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While the best solution for you will remain, ultimately, personal, we spoke to the experts and looked at the studies to establish the few supplements that are actually recommended by medical experts, and break down who they work for and how to take them.
The advice, always, Ludlam-Raine adds, is to speak to a healthcare professional before making any changes. But if you do opt to trial a new supplement, Ludlam-Raine says the key is “to buy from a reputable company, have a short ingredient list, and to be third-party tested. This will ensure you’re getting what you’re paying for.”
Magnesium
What does it do?
Magnesium is a key nutrient involved in hundreds of biochemical processes in the body: it regulates muscle and nerve function, blood sugar levels, and blood pressure and makes protein, bone and DNA. The body does not produce magnesium, but sources it from our intake.
“There is some evidence around magnesium helping sleep and a bit around migraine prevention, muscle relaxation, and constipation as it can have a laxative effect,” Ludlam-Raine says. “But most people don’t need to supplement as they are getting enough from their food.”
Who needs to take it?
In order to see positive effects of any kind from taking magnesium, you need to be deficient in the first place. The last National Diet and Nutrition Survey in the UK, which looked at magnesium status (in 2018), found that around 10 per cent of men and 20 per cent of women are not getting the daily recommended intake. Those most likely to be getting too little include people with gastrointestinal diseases, people with type 2 diabetes, people with long-term alcoholism, and older people.
But in general, it is recommended to focus on dietary sources before opting for supplements, Ludlam-Raine says. “If you are deficient in magnesium, then [a supplement] will benefit you, but if you are not deficient, I don’t think the evidence is there to support taking [it] unless you need help with something like constipation.”
For everyone else, she says to focus on dark leafy greens, nuts and seeds like almonds and pumpkin seeds, black beans, edamame, even whole grains and dark chocolate. “If you’ve got a lot of those in your diet, then you probably don’t need a supplement, especially as there can be side effects like nausea and diarrhoea.”
Who should avoid it?
There are also groups who should avoid taking magnesium supplements without medical supervision, as there can be a risk. “If you are pregnant, breastfeeding, taking prescription meds, or dealing with diarrhoea, you must discuss it with your doctor or pharmacy”, she adds.
For those with kidney disease, taking magnesium supplements can even be dangerous and can cause hypermagnesemia – a potentially life-threatening condition that can leave someone with paralysis or in a coma.
What’s the best way to take it?
The daily recommended dose is 300mg for men and 270mg for women, though the supplement should skew lower as you will likely have dietary sources. Other than eating your magnesium, the two types of supplements are magnesium citrate (which is well absorbed and helpful for constipation) and magnesium oxide (which is not very well absorbed and has a really strong laxative effect), Ludlam-Raine explains.
Creatine
What does it do?
Creatine is a natural compound found in every cell in your body. We make about half of what we need from the amino acids in our liver and kidneys – though the rest comes from our food. The main job of creatine is to supply energy to the muscles, which helps them produce quick bursts of energy.
“Creatine is one of the most widely studied supplements, especially in the bodybuilding community,” Ludlam-Raine says. “But research is also expanding into brain and joint health. Benefits of creatine include muscle strength, muscle mass maintenance, cognition and potentially healthy ageing.”
Who needs to take it?
Creatine, Ludlam-Raine says, “is one of the few [compounds] where even if you have a healthy, balanced diet, you can top it up – adding creatine could help you above and beyond.” It’s found in all our protein sources, but there is evidence to suggest that the supplementary form gives you more bang for your buck. One study found that 5g of a creatine supplement corresponds to the same creatine content as found in 1.1kg of uncooked steak.
The best food sources of creatine are meat and fish, and it is also found in dairy and eggs and in smaller amounts in legumes, nuts, seeds and soya. “You could argue that those following a plant-based diet or a vegan diet may benefit a bit more from taking it,” she adds. Again, the most impactful benefits are for older adults, women, and vegetarians and vegans, as they naturally start with lower creatine levels.
Who should avoid it?
Creatine is a relatively safe supplement, but Ludlam-Raine cautions that “you need to stay hydrated if you are taking it because you need enough fluid to help with kidney function.” By the same metric, “it might be unsafe for people with pre-existing kidney problems.”
What’s the best way to take it?
“Creatine monohydrate is the gold standard: it’s the best absorbed, most studied and also the cheapest,” Ludlam-Raine says. “The usual dose is between three and five grams”.
Vitamin D
What does it do?
Vitamin D helps regulate the amount of calcium and phosphate in the body and is a key nutrient for maintaining the healthiness of our bones, teeth and muscles. “Vitamin D is found in eggs, oily fish, some mushrooms and fortified foods like breakfast cereals,” Ludlam-Raine says, “but the majority of our body makes during the summer months when our skin synthesises the sun’s rays. In winter months, those rays aren’t strong enough and you generally can’t guarantee how much vitamin D a) is in your food or b) that you’re getting enough every single day.”
Who needs to take it?
“We have a lot of evidence around how a lack of vitamin D will impact you – your bone health is going to suffer, as will your immune system and muscle function,” Ludlam-Raine says. It can lead to bone deformities like rickets in children and bone pain caused by a condition called osteomalacia in adults. “So the advice is all around preventing deficiency.”
The NHS recommends a vitamin D supplement in the UK during the autumn and winter months, though there are groups who will need it all year round. Those include if you’re pregnant, breastfeeding, elderly, you don’t go out much, you’ve got dark skin, you spend a lot of time inside or covered up, or if you’ve got a BMI of above 30.
Who should avoid it?
Vitamin D is generally safe in supplement form as long as you stick to the recommended dose.
Taking too many vitamin D supplements over a long period of time can cause too much calcium to build up in the body (hypercalcaemia). This can weaken the bones and damage the kidneys and heart.
What’s the best way to take it?
The recommendation is 10 micrograms of Vitamin D per day during autumn and winter months, and to not take more than 100 micrograms (4,000 IU) a day, as it could be harmful.
“[When it comes to formulation], D3 is better than D2 and you should take it with a meal containing olive oil, or a handful of nuts, so it will be better absorbed”, Ludlam-Raine says, adding that it is worth adding in calcium as vitamin D helps you absorb that better.
Omega-3
What does it do?
Omega-3 fatty acids are essential amino acids that support brain function, have anti-inflammatory effects and have positive health effects on the brain, eyes and joints. The body cannot make enough on its own. They are found in abundance in oily fish and can also be found in some nuts and seeds (including walnuts and chia seeds), as well as olive oil and fortified foods like eggs and milk.
Who needs to take it?
Omega-3 in supplement form is not recommended for the UK general population, according to the British Dietetics Association, “because the evidence of benefits is inconclusive”. The benefits are much more impactful through food sources, particularly oily fish (like mackerel, salmon, sardines, pilchards), as you have additional benefits of vitamin D and protein.
“However, if you don’t have oily fish (maybe you don’t like it), you should choose a type of Omega-3 that’s based on fish,” Ludlam-Raine says. “If you’re vegan, choose an algae-based Omega-3 because that is where the fish get their Omega-3 from.”
Who needs to avoid it?
It is advised that people on blood thinners, with bleeding disorders, or those scheduled for surgery seek GP advice before taking omega-3 supplements, as omega-3s reduce clotting.
What’s the best way to take it?
Ludlam-Raine recommends, if you do take a supplement, to check “it’s got at least 500 mg of EPA and DHA. You need both of those for heart health, brain health and inflammation.” That, taken daily, is the equivalent of two portions of oily fish a week.