While I tend to promote a balanced and diverse diet to ensure nutrient needs are met, there are a few supplements that I feel confident recommending to others for general use. Keep reading to see my top 5 recommended supplements!

A general multivitamin/mineral

Multivitamin/mineral (MVM) supplements will typically provide a wide variety of important fat- and water-soluble vitamins as well as minerals like zinc and iron. There are a plethora of options available on the market, from extremely basic to condition specific. An MVM can help a consumer meet their micro-nutrient recommended daily allowance (RDA) or adequate intake (AI) when their diet is lacking. It’s important to consider other micro-nutrient sources before deciding to take an MVM by examining food sources and other supplements to avoid excessive intakes or toxicity. Consumers should also be cautious about the percentage of daily value (%DV) for each micro-nutrient the supplement provides. I typically aim to select multivitamins that provide 100%DV or less of a nutrient because I know I will be getting nutrients from my food too. MVM supplements have not been shown to reduce the risk of any chronic diseases, even when taken long-term, however, MVM’s might be beneficial for certain groups of people, such as pregnant people or people that can become pregnant, infants and children, older adults, people with restrictive diets, or people with impaired digestion.

Omega-3 fatty acids

Omega-3 fatty acids are a class of polyunsaturated fatty acids (PUFAs) most commonly associated with high-fat fish like salmon. There are 3 main forms of omega-3s; alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA). ALA is considered essential because it is an essential component to the diet – meaning the human body cannot create it so it must be obtained from our food. The body can convert ALA into EPA, then DHA, so dietary sources of ALA should be prioritized. While all 3 forms are beneficial, EPA and DHA are especially important because ALA does not convert very efficiently. ALA can be found in flax, soy and canola oil while EPA and DHA are found in fish or algae oils, and while these foods are important components to a balanced diet, most Americans aren’t consuming enough. Omega-3’s act as structural components of our cells and are used to form signaling molecules involved in inflammatory mediation. Adults are recommended to consume 1000 – 1600 mg ALA, but DHA and EPA do not have established AI. Other sources recommend 250 – 500 mg DHA and EPA combined for adults, however the scientific basis for this recommendation is questionable. Certain people may benefit from slightly higher omega-3 intakes, especially those with chronic diseases, including heart disease. Since most people consume adequate amounts of ALA from their diets, many omega-3 supplements are derived from fish oil and provide both EPA and DHA. Alternatively, flaxseed oil can be supplemented for those lacking adequate ALA consumption, and some EPA/DHA supplements are derived from algae oil instead of fish oil.

Probiotics

Probiotics are defined as “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host”. Probiotics are typically marketed as beneficial bacteria for health, but can also include yeasts, and are identified by the specific strain which includes the genus, the species, the subspecies (if applicable), and an alphanumeric strain designation. The most often used genera are Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus. Probiotics can influence the microbiome of the large intestine through multiple mechanisms, depending on the baseline microbiota, strain of probiotic, and GI tract region. Mechanisms include inhibiting harmful bacteria growth, altering the colon’s pH, and producing beneficial biproducts like short-chain fatty acids. Recommendations for probiotics are usually species and strain specific because they can have different impacts on human health and disease.

Fermented foods are prepared through the cultivization of live microbial cultures, which play a role in the development of flavors and textures in the final product. Fermented foods are not always a source of probiotics, however, especially products that are further processed after fermentation, like sourdough bread. Many commercial yogurts contain probiotic organisms, but are not isolated strains in specific quantities known to confer a health benefit. Fermented foods may be beneficial for general gut health, but further health benefits are unable to be proven. For general digestive health, I usually recommend consuming yogurts with live active cultures, milk kefir, and authentic kombucha beverages.

Dietary supplements are available in various forms and provide a wide variety of strains and doses – typically marketed for their intended health benefits. Probiotics doses are measured in colony forming units (CFU), indicating the number of viable cells. These are usually listed in the billions, for example 10 billion CFU is a fairly common dose of general probiotics. Numerous strains have been extensively studied for their benefits for specific conditions, like IBS or diarrhea. For general digestive health, the strain Lactobacillus rhamnosus is well-studied for daily use. I tend to recommend a probiotic supplement that contains multiple strains of Bacillus, Bifidobacterium, and Lactobacillus with a dose of 1-10 billion CFU for individuals not seeking supplementation for specific conditions. 

Vitamin D3

Vitamin D is a fat soluble vitamin known for being associated with sunshine because it’s produced by the body upon exposure to UV rays or sunlight. The vitamin is also found in a few foods, although not quite as predominantly as most other vitamins. Vitamin D is important for calcium absorption and utilization, making it a key component for bone health, but also has many other roles in the body, including reducing inflammation and modulating various cellular processes. Serum vitamin D status is assessed by 25(OH)D concentration, which may have some variability regarding what is considered sufficient for most people. The Endocrine Society suggests 25(OH)D concentrations >75 nmol/L (30 ng/mL) is optimal for calcium, bone, and muscle metabolism, while sufficient levels are reported as >50 nmol/L (20 ng/mL). The recommended dietary allowance (RDA) for vitamin D for adults is 15 mcg (600 IU) or 20 mcg (800 IU) for adults older than 70. The Endocrine Society suggests that adults should consume at least 37.5 – 50 mcg (1500 – 2000 IU) per day to maintain adequate levels. 

Food sources of vitamin D include the flesh of fatty fish, such as trout, salmon and tuna and fish liver oil. Beef liver, egg yolks, and cheese also have varying amounts of vitamin D and some mushrooms grown with UV lights provide small amounts too. Milk is fortified with vitamin D with about 3 mcg (120 IU) per 8 oz. serving. Sunlight also provides various quantities of vitamin D, however many factors can affect how much of the vitamin can be synthesized, making it difficult to provide guidelines. Some research suggests approximately 5–30 minutes of sun exposure (or UV), particularly between 10 a.m. and 4 p.m., either daily or at least twice a week to the face, arms, hands, and legs without sunscreen usually leads to sufficient vitamin D synthesis.

Vitamin D3 supplements are typically derived from lanolin obtained from the wool of sheep, allowing for an inexpensive and readily available supplement. Non-animal versions can also be derived from lichen, but will be more costly. Vitamin D2 supplements are also available, derived from UV irradiation of ergosterol in yeast. Both vitamin D2 and D3 supplements are effective methods to increase serum values and address deficiencies. I tend to recommend regular vitamin D3 1000 IU for the average person, especially if not regularly having serum values checked by a medical professional.

Soluble fiber

The average American only consumes about half of the recommended 25-30 g of fiber per day, mostly due to dietary patterns lacking adequate fruits, vegetables and whole grains. While the obvious solution is to increase fiber-rich food intake and both soluble and insoluble fiber are important components to a healthy diet, consumers might still benefit from increased fiber by supplement, especially for situations where fiber-rich foods have not been adequate in the diet. Soluble fiber forms a gel during digestion and is typically sourced from guar gum, pectin or psyllium. Soluble fiber can be helpful for regulating bowel movements, increasing satiety with meals, and reducing LDL cholesterol. I prefer soluble fiber supplements because the powder is easily mixed into liquids without grit or texture, making it a versatile option.

Always make sure to discuss any supplements you decide to use with your primary care physician and pharmacist to reduce the risk for harmful interactions.

References:

U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements – multivitamin/mineral supplements. NIH Office of Dietary Supplements. Retrieved October 7, 2022, from https://ods.od.nih.gov/factsheets/MVMS-HealthProfessional/

U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements – dietary supplements for weight loss. NIH Office of Dietary Supplements. Retrieved October 7, 2022, from https://ods.od.nih.gov/factsheets/WeightLoss-HealthProfessional/#h6

U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements – omega-3 fatty acids. NIH Office of Dietary Supplements. Retrieved October 7, 2022, from https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/

U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.

U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements – probiotics. NIH Office of Dietary Supplements. Retrieved October 28, 2022, from https://ods.od.nih.gov/factsheets/Probiotics-HealthProfessional/ 

Landes, E. (2022, August 8). The best probiotic supplements of 2022 and how to choose. Healthline. Retrieved October 28, 2022, from https://www.healthline.com/nutrition/best-probiotic-supplement#our-picks 

World Gastroenterology Organisation practice guideline: Probiotics and prebiotics. (2009). Arab Journal of Gastroenterology, 10(1), 33–42. doi:10.1016/j.ajg.2009.03.001 

U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements – vitamin D. NIH Office of Dietary Supplements. Retrieved October 28, 2022, from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/#h4