Up to 75% of Spaniards consume food supplements, many of them without scientifically proven safety or efficacy. This is revealed by the report Use of nutritional supplements in the Spanish population, carried out by the Spanish Academy of Nutrition and the Mapfre Foundation. The researchers are forceful and point out that "it is necessary to create a legal framework that regulates the consumption of these products", since it can become "a public health problem".
The conclusion is that supplements, whether they are vitamins, minerals, plants or any other nutrient, should not be consumed unless prescribed by a doctor, since some of them can put health at risk. In addition, it is important to remember that "in the case of healthy adults who eat a varied and balanced diet, which includes all the foods of the Mediterranean diet, there should not be a deficit of any nutrient, except in exceptional cases, since all the ones we need They are in the food we eat throughout the day”, explains nutritionist Susana León.
For her part, nutritionist Fátima Branco points out that both the boom in supplements and the rise of miracle diets of dubious efficacy, such as detoxes or prolonged unsupervised fasting, are the result of "we want to get everything from easily, without effort, and that gives rise to making some decisions regarding food that not only do not benefit us, but also contribute to spreading myths that in most cases are wrong”.
One of them is that the more vitamins we consume, the healthier we will be. “If you eat a balanced diet, rich in fruits and vegetables, you do not need to take vitamins, except in the case of pregnant women and always under professional prescription. The diet itself already provides the necessary nutrients, as long as it is eaten in a varied and balanced way, with fresh products and avoiding ultra-processed ones”, affirms, for his part, Ferran Cordon, a family doctor and professor in the Department of Medical Sciences of the Faculty of Medicine of the University of Girona. Therefore, "it is not necessary to take vitamins on our own", except for exceptions prescribed by a medical professional.
Cordon notes, however, from his own experience as a family doctor, that "many people find it difficult to have a healthy diet, since purchasing fresh fruit and vegetables daily requires a high purchasing power and people from lower strata underprivileged cannot afford it. This should not happen in any case, especially in sensitive groups such as the elderly or children. Public policies are urgently needed to lower the price of these foods”, says the doctor. Cordon also points out that self-medication is the order of the day and that it is one of the most frequent consultations with family doctors. "Our obligation is to teach people what diet they should follow and advise against taking supplements."
To understand the function of vitamins in the body, it is necessary to distinguish between two large groups. On the one hand, there are the water-soluble ones, which dissolve in water and are vitamin C and all those of group B. The body uses what it needs and eliminates the excess, so that even if we consume large amounts, the body will end up excreting the excess. through urine. This leads to nonsense such as supplementing vitamin C (something very common, since it is believed to help fight colds) and that all this supplement ends up being eliminated, because it is precisely one of the most common in the diet and is present in many foods, so it is very easy to achieve the recommended daily allowance without effort. Regarding the supposed effects against colds and flu of vitamin C, Cordon points out that it is a "false belief", since "there is no review that affirms that an extra contribution serves as a prevention of these conditions".
On the other hand, there are the fat-soluble vitamins, which are, in the words of Cordon, "those that most concern health professionals, since if there is an excess, they can be deposited in the liver and give rise to a series of problems." They are A, D, E and K. According to the BluaU de Sanitas nutritionist, Isabel Sánchez, in Spain vitamin D is the one with the greatest deficit, while K is the one with the least. “Vitamin D is synthesized through sun exposure and Spain is one of the countries with the most hours of sunshine. Among the reasons for the lack of this vitamin we find the lack of exposure to sunlight (by spending more hours at home or in the office or the increased use of protectors) and a diet in which foods containing vitamin D are scarce. , such as fatty fish, egg yolk or meat. This vitamin collaborates in the absorption and maintenance of calcium levels in the bones, so a sustained deficit increases the risk of osteoporosis and fractures”.
For Cordon, however, it is not always necessary to supplement vitamin D, despite the fact that many professionals do it practically by default. “In recent times it has become fashionable to take it and there are many professionals who ask that it be studied in analytics. But it should only be supplemented in cases of suspected osteoporosis or chronic disease, since at the moment there are no studies that show that taking vitamin D constantly prevents fractures and osteoporosis", explains the doctor, who insists, above all, on the need “not to self-medicate in any case”.
Vitamin K deficiency, however, "is rare because many foods contain it, in addition to the fact that the bacteria in the intestine produce vitamin K," says Sánchez. This favors good blood clotting, so a severe deficiency can cause bruising and bleeding problems.
How do we know, then, if we lack any vitamin? According to Sánchez, “determining if a vitamin is missing can be complicated, since the symptoms are usually generic and vary depending on the specific vitamin that is missing. However, there are some common signs to watch out for that could indicate vitamin deficiency.” In cases of fatigue and general weakness, we could be facing a deficiency of group C and B vitamins, while if sores appear in the mouth it could be due to a lack of vitamin B12, iron or folic acid, which are responsible for the formation of red blood cells. . In the case of persistent hair loss, we could be facing a case of vitamin B8 (biotin) deficiency, which could also manifest itself in the appearance of gray hair, red and scaly skin and brittle nails, as well as muscle pain. If what happens is that we experience difficulty healing, frequent bruising, swollen gums and a feeling of tiredness, it could be due to a lack of vitamins K and C (something very rare) and if we have frequent infections it may be due to a vitamin A deficiency , which affects the skin and the immune system.
When hypervitaminosis occurs (that is, an excess of a specific vitamin), the symptoms can be, paradoxically, similar. "It can give a picture of tiredness, fatigue, muscle pain or lack of concentration," explains Cordon. Sánchez, for his part, especially warns about excessive consumption of vitamins A, D and E, since "being soluble in fat they can accumulate in the body and cause toxicity." Excess vitamin A can cause problems such as nausea, vomiting, headache, dizziness, hair loss, dry and scaly skin, and even liver damage. The main consequence of excess vitamin D is the accumulation of calcium in the body (hypercalcemia), which would cause muscle weakness, headache, nausea, vomiting, diarrhea, and kidney damage. Finally, too much vitamin E can interfere with blood clotting, leading to bleeding and bruising.
Therefore, returning to the study cited at the beginning, Use of nutritional supplements in the Spanish population, "considering the high availability, affordability and ease of access to these products, it is necessary to increase the levels of food and health literacy of citizens to that they can make informed decisions. The authors of the report also point out that to this end, immediate actions are required, such as the incorporation of the dietitian-nutritionist in primary health care, basic training in healthy eating, and public health policies to improve food environments. Otherwise, the indiscriminate consumption of vitamin supplements without a medical prescription "should already be considered as a possible public health problem."
