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Comment by weavie | Hacker News Reader

I guess the argument would be that you don't know for sure whether your diet does provide all the nutrients your body needs, so supplements could be used to fill in any gaps. The assumption being that your body will just dispose of any excess safely.

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That's the sales pitch for multivitamins and the like; they talk you into a problem but they provide the solution.

Certain vitamins your body will dispose of safely (like vitamin C), but there's others that just build up until they kill you; there's the case of Xavier Mertz [0] who was theorized to have died from an excess of vitamin A after eating his sled dogs' livers.

But the basic rule is: just eat normally / "a balanced diet"; you likely don't need supplements unless you have absorption issues or stick to a specific diet (e.g. vegetarianism / veganism, soylent / diet shakes, or the same thing every day, like the 14 year old who only ate chips and ended up (partially) blind due to a vitamin deficiency [1])

[0] https://en.wikipedia.org/wiki/Xavier_Mertz

[1] https://www.acpjournals.org/doi/10.7326/L19-0361, https://www.cbsnews.com/news/british-teenager-went-blind-fro...

Even that balanced diet will consist of less and less minerals and vitamins as time goes on and growers optimize for vegetable, fruit VOLUME instead of vitamin/mineral contents.

>>>

The level of decline varied depending on the specific nutrients and the type of fruit or vegetable, but it generally ranged from 6 percent for protein to 38 percent for riboflavin. In particular, calcium dropped most dramatically in broccoli, kale, and mustard greens, while the iron content took a substantial hit in chard, cucumbers, and turnip greens. Asparagus, collard greens, mustard greens, and turnip greens lost considerable amounts of vitamin C.

Further studies since then have backed up the case that nutrient levels are dissipating. Research in the January 2022 issue of the journal Foods found that while most vegetables grown in Australia had relatively similar iron content between 1980 and 2010, there were noteworthy drops in certain veggies. Declines in iron content, ranging from 30 to 50 percent, occurred for sweet corn, red-skinned potatoes, cauliflower, green beans, green peas, and chickpeas. By contrast, Hass avocados, mushrooms, and silverbeet (another name for chard) actually gained in iron.

Grains have also experienced declines, experts say. A study in a 2020 issue of Scientific Reports found that protein content in wheat decreased by 23 percent from 1955 to 2016, and there were notable reductions in manganese, iron, zinc, and magnesium, as well.

<<<

https://www.nationalgeographic.co.uk/environment-and-conserv...

Food storage and preservation also has a lot to do with it as well. Oxidation makes a lot of nutrients mostly unavailable, and degradation can happen quickly. Minerals in vegetables aren’t chelated, so while they sit in refrigerated storage, they are still rapidly losing nutrition.

The question is one of optimization. There are arguably optimal doses of particular nutrients (i.e. Vitamin D) that would be extremely hard to achieve through "a balanced diet". Also most people do not and many can not eat a "balanced diet", as that requires a ton of effort to maintain.

To put it another way, if the benefits of exercise were available in pill form on grocery store shelves, everyone would be taking that pill. Saying "you could save some money by just exercising normally!" is making a lot of assumptions about what people are willing and able to do, and frankly you'd be a fool to waste time exercising if the benefits were achievable through a magic pill.

Supplements aren't quite that magical, but they make optimal, hard-to-achieve doses achievable, even on a bad diet. Granted they can also be misused, or doses can be so low/ingredients not bio-available such that they have no impact. They're a tool like anything else, and can be used correctly or incorrectly. Part of what bugs me about the meta-analysis saying "supplements don't reduce all-cause mortality!" is that they lump wildly different supplements with different make-ups, taken in different doses on different schedules from different starting diets with different amounts of discipline/regularity. Of course at a population level the number of people using them wrong probably outnumber the people who do their research and maintain a disciplined approach. Your average person has issues getting their car's oil changed and understanding the difference between synthetic and conventional oil. A skilled individual could properly apply and see benefits from supplements, just as a skilled individual could successfully change their own oil.

And what is a balanced diet? Is it the 1990s food pyramid that I was taught by my doctor to follow?

No, I'd say there's high consensus it's one that satisfies all of your vitamin and mineral RDA's. Also very high consensus it at least includes vegetable staples like broccoli, cucumbers, onions, tomatoes, and green salads with some way of obtaining proteins like meats or beans.

If you spend enough time looking into what micronutrients you need, you eventually figure out that it is actually pretty hard to get them all through diet. But there is essentially no end to the scientifically backed list of beneficial supplements you might choose to take, so if you want to start, there’s not really a rational place to stop, and it can spiral out of control quite quickly. I think the better approach is just to eat a varied diet.

The assumption being that your body will just dispose of any excess safely.

Well worded. From my personal experience, this assumption is dangerous.

About 20 years ago I was having elevated AST/ALT liver enzymes three tests in a row indicating liver damage. Doctor ordered every test to see what was going on but everything came up negative. She asked me if I took a multivitamin which I did. She told me to stop.

Haven’t had elevated liver enzymes since.

What was in that multivitamin you took? Interesting anecdote but I worry you are throwing the baby out.

It was a mass-market Centrum multivitamin.

There is also the triage theory of aging where the idea is that when micronutrient levels are low (not low enough to cause acute symptoms but below the recommended daily allowance), they are triaged and used where needed (such as ATP production) at the expense of being used normally. The theory is that this can cause long-term problems such as neural decay, cancer, and other signs of aging.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1693790/

+1 for Bruce Ames. This idea profoundly shaped my thinking a few years ago.

The one nit is I'm not sure how we'd go about testing it.

I wish him being alive at 94 was proof of something but afaik my smoking grandmother with no exercise doing nothing particularly healthy lived that long...

However, she also wasn't doing novel research at age 86. Wow.

That’s a perfectly fair point, I took Vitamin D during lockdown because I wasn’t getting enough sunlight. I’m just saying that it makes sense that beyond satisfying your body’s needs there’s no higher plane of health that supplements will take you to.

> The assumption being that your body will just dispose of any excess safely.

Not always. Fat-soluable vitamins (A, D, E, and K) will build up in fat tissue and can lead to toxicity.

Source?

Search for "hypervitaminosis A", for example.

It may also be worth noting that people with excess body fat will absorb fat soluble vitamins into the excess fat and it will not be available for the thousands of functions in the body that need them until the person is fat adapted. Ideally the high priority goal should be to remove the excess fat but until they do they will need more than the RDI of each component. How much more gets complicated as there are not yet any good tests for testing how much was absorbed into the fat.

You would have to take a lot of vitamin D supplements to cause clinical symptoms. Some people have done it, but as a practical matter the risk of hypervitaminosis D from regular multivitamin pills is virtually zero.

Whether those pills actually have any health benefit is a separate issue.

Or, in my case, I am 100% certain that my diet is missing many nutrients as I rarely eat fruits or vegetables. I take various supplements and so far things seems to be okay (based on yearly physical and blood work).

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