These food-sourced nutrients beat supplements for longer, healthier life

By Naveed Saleh, MD, MS
Published April 6, 2020

Key Takeaways

  • Research has shown that food-based vitamins and minerals are superior to supplement-based ones due to their biologically active compounds. While most Americans get enough major vitamins and nutrients, certain populations at increased risk for inadequate intake.

  • Chronic health situations associated with suboptimal vitamin intake, as well as food-based sources that can reduce risk for increased longevity, include heart health, cancer prevention, bone health, and hematologic health.

  • Physicians should consider familiarizing themselves with these conditions and their potential remedies that can be found in these food-based sources, as well as advising their patients to try these foods to help with their respective conditions.

Getting the recommended dietary allowance of vitamins and nutrients from foods—rather than supplements—is more effective in promoting good health and greater longevity. While supplements can help address nutritional deficiencies, researchers have shown that food-based vitamins and minerals are superior to their supplement-based counterparts due to their biologically active compounds.

Fortunately, most Americans get enough of the major vitamins and nutrients.

Certain populations, however, are at increased risk for inadequate intake—including the elderly, vegans, alcohol-dependent individuals, and patients with absorption issues. Insufficient vitamin status has been linked to some serious chronic illnesses and, consequently, premature death. To that end, here are some chronic health conditions associated with suboptimal vitamin intake, as well as food-based sources that can reduce risk for increased longevity:

Heart health

Increased risk of coronary heart disease or ischemic stroke has been linked to lower folate (vitamin B9) intake in various studies. Folate, vitamin B6, and B12 are needed for homocysteine metabolism. Some researchers have shown that higher homocysteine levels may predict heart disease. Research on whether B vitamins actually help prevent heart disease is mixed, but supplementation could be beneficial.

"There is clear evidence that, in the general population, people with lower homocysteine levels have a lower risk of cardiovascular disease."

Council for Responsible Nutrition

It is known that giving B vitamins will lower homocysteine levels if they are high, and it was reasoned that lowering these levels would also lower heart disease risk in the population,” the authors of a chapter in The Benefits of Nutritional Supplements added.[]

Luckily, there are plenty of foods rich in the B vitamins to choose from. Natural sources of Vitamin B6 include fish, poultry, meat, nuts, legumes, potatoes, and whole grains. Vitamin B12 is found in animal products, such as meat, milk, poultry, fish, and eggs. Folate is found in animal products, dark-green leafy vegetables, whole-grain cereals, and fortified grains.

But, folate and other B vitamins aren’t the only nutrients that could benefit heart health and longevity. In a 2019 study published in the Annals of Internal Medicine, researchers examined the association of nutritional intake from foods and supplements with mortality among nearly 31,000 US adults aged ≥ 20 years.[] After a median follow-up of 6.1 years, they found that vitamins A and K, magnesium, zinc, and copper were all associated with reduced all-cause or cardiovascular mortality, and these associations were restricted to nutrient intake from foods.

“Our results support the idea that, while supplement use contributes to an increased level of total nutrient intake, there are beneficial associations with nutrients from foods that aren’t seen with supplements,” said senior author Fang Fang Zhang, MD, PhD, associate professor, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA.

"This study also confirms the importance of identifying the nutrient source when evaluating mortality outcomes."

Fang Fang Zhang, MD, PhD

Vitamin A is naturally present in orange and yellow fruits and vegetables like carrots, in dark greens such as spinach, and in eggs. The most common foods that are high in vitamin K include green, leafy vegetables such as kale, collard greens, and spinach. Like vitamins A and K, magnesium-rich foods include dark, leafy greens, but avocados and nuts are also great natural sources. According to the NIH, the richest dietary sources of copper include shellfish, seeds, and nuts, while those for zinc include oysters, crab, lobster, poultry, beans, and nuts.

Cancer prevention

Carotenoids (provitamin A) have various anticancer properties including inhibition of angiogenesis, free-radical scavenging, mitigation of cell propagation, and induction of apoptosis in the lungs, breasts, prostate, and colon, according to an article published in Cancer Chemoprevention by Natural Carotenoids as an Efficient Strategy.[]

Although results from clinical trials on the anticancer effects of vitamin A have been inconclusive, some researchers have shown that dietary intake of foods rich in provitamin A may be chemoprotective.

“[E]vidence for a protective role of whole fruits and vegetables rich in provitamin A carotenoids (β-carotene, α-carotene, and β-cryptoxanthin) in the prevention of certain cancers and other chronic diseases (eg, atherosclerosis, diabetes, age-related macular degeneration, UV damage in skin) continues to be reported in human epidemiological studies and small intervention trials, as well as in mechanistic studies using cell culture and animal models,” wrote the authors of a chapter in Carotenoids and Human Health.[]

Provitamin A carotenoids naturally occur in orange, yellow, and red plants. The richest dietary sources include carrots, cantaloupe, and squash.

Bone health

When it comes to bone health, vitamin D is essential. Various factors combine to increase the risk of hypovitaminosis D and osteomalacia in the elderly, including changes in vitamin D exposure, cutaneous vitamin D synthesis, and changes in calcium and vitamin D pathophysiology (ie, increased parathyroid hormone, changes in calcium absorption, decreased 25-OH vitamin D hydroxylation, and lower renal fractional calcium reabsorption). Behavioral components also play a role, such as decreased physical activity, sun exposure, and dietary intake.

“When considering osteoporosis, fracture risk is our main concern, but vitamin D therapy has no consistent fracture-prevention effect, except in studies where calcium is coprescribed (particularly in frail populations living in care homes),” wrote authors of a review article published in Therapeutic Advances in Musculoskeletal Disease.[]

They continued: “As a J-shaped effect on falls and fracture risk is becoming evident with vitamin D interventions, we should target those at greatest risk who may benefit from vitamin D supplementation to decrease falls and fractures, although the optimum dose is still unclear.”

Vitamin D is mostly synthesized in the body from sunlight, but it is also naturally present in fatty fish, liver, beef, egg yolks, and even some mushrooms.

Hematologic health

The body needs vitamin K to produce prothrombin, a protein vital to blood clotting as well as bone metabolism. People with poor vitamin K intake are at risk of bleeding dyscrasias or hemorrhage—particularly after taking antibiotics, which kill off the intestinal bacteria that produce vitamin D. Hemorrhage—a leading cause of potentially preventable death—can quickly lead to stroke, causing brain damage or death.

Other comorbidities that heighten the risk of vitamin K deficiency include renal disease, hepatic disease, and malabsorption. (Remember to carefully monitor dietary vitamin K intake in patients on warfarin as it may counteract warfarin’s anticoagulative effects, as well as in patients receiving dialysis treatments due to kidney disease.) As mentioned, the richest dietary sources of vitamin K are dark-green vegetables like spinach.

What this means for you

Physicians should consider familiarizing themselves with these conditions and their potential remedies that can be found in these food-based sources. Follow the research on such food-based approaches, and consider advising your patients to try these foods for help with their respective conditions.

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