We are continually told we eat a nutrient-poor diet and need more nutrients.
Bruce Ames’ Triage Theory shows us that, with more essential nutrients, we will not just survive for the short term but thrive for the longer term.
But the all-too-common ‘solution’ recommended (usually advertised) to us is to simply:
- “buy my new supplement X that will cure ailment Y” (that you didn’t know you had), or
- add a heap of synthetic vitamins to this ultra-processed food to make the label look better.
But, when it comes to nutrients, it’s critical to understand,
- how much is too much?
- at what point are we wasting our valuable time, money and limited focus on chasing more nutrients with supplements?
- could the more-is-better approach with supplements and fortification be detrimental to our health and waistlines? and
- despite the cost and the marketing, supplements may provide inadequate levels of nutrients because they are less well absorbed and utilised than when they are obtained from whole foods.
To clarify, this article digs into the data to help you understand at what point more of each nutrient is not helpful and why excessive supplementation could negatively impact your health.
Your body will quickly excrete most excess supplements, creating brightly expensive coloured pee.
However, as you will see, because we crave each nutrient, obtaining them from supplements and fortified foods could decrease your appetite for whole foods that create greater satiety.
- The Data
- Nutrient Leverage
- The Optimal Nutrient Intakes
- What Happens When We Consume Too Much of a Nutrient?
- What Nutrients Are Supplemented Most Frequently?
- Nutrients That Correlate with Increased Calorie Intake
- Nutrients that Correlate with the Rise in Obesity Rates
- Nutrients that We See a ‘Rebound Satiety’ Response To
- Pros and Cons of Fortification
- Why is there a greater calorie intake with supplementation and fortification?
- We’re Being Fed Fortified Pig Slop!
- Could Supplements and Fortification be Bad for You?
- Should You Take Supplements?
We now have one hundred and fifty thousand days of food logging data from forty thousand people who have used Nutrient Optimiser over the past five years in our Macros Masterclass and Micros Masterclass. In addition, many have taken our Free 7-Day Nutrient Clarity Challenge to assess their typical diet without doing a class.
This large data set gives us powerful insights into how we respond to the nutrients in our food at the extremes of excess and deficiency.
In our Micros Masterclass, we encourage people to dial back their supplementation and intake of fortified foods, which are typically ultra-processed, once they can get the DRI from whole foods in their diet.
Unfortunately, it is impossible to eliminate fortified foods and supplements from the Optimiser data. While supplementation tends to dilute the quality of the data analysis, we can also analyse the effect of supplementation to understand whether it is helping or hurting.
Generally, people who obtain more of each essential nutrient per calorie from food tend to eat less, at least in the normal range we can get from food.
Our analysis shows we have a unique satiety response to foods that contain more of each essential nutrient. We appear to crave more of the foods that contain the required nutrients until we get what we need.
Rather than just protein leverage, we see a more general nutrient leverage effect from all the nutrients.
So, like a nutrient-seeking monster, your appetite will keep munching through as much food as required to get the nutrients you need.
As you can see from the charts below, we have a strong satiety response for some of the larger macro minerals that just ‘keeps on giving’. Our energy intake decreases as we get more of that nutrient per calorie. We often reach a point where more is not better, but we don’t see a rebound satiety effect (i.e., more = worse).
This doesn’t mean you should go out of your way to supplement with these.
- Your gut will quickly tell you when you’ve overdone the sodium and potassium – you’ll be on the toilet and drinking heaps of water trying to clear them.
- Potassium supplementation is typically advised against because it can interfere with blood pressure medications which help you retain potassium.
- Studies have shown that calcium supplementation increases the risk of cardiovascular disease due to excessive calcium deposition.
- While not commonly supplemented, chronic selenium toxicity can lead to nail brittleness and other issues.
The Optimal Nutrient Intakes
The data from Optimisers has enabled us to develop a new satiety index to estimate how much you’ll eat of a particular food or meal based on its nutritional profile.
Nutrients are critical. But as you will see, more is not better. There is a limit to the benefit of many nutrients, particularly when it comes from supplementation.
This analysis has enabled us to identify an Optimal Nutrient Intake for each essential nutrient we can target from food without relying on supplements. The Optimal Nutrient Intakes have been set based on the 85th percentile intake of each essential nutrient or the point at which the satiety response tapers off (whichever is the lesser). So, these Optimal Nutrient Intakes, while challenging, are achievable with whole foods containing synergistic nutrients.
Once we get enough of each nutrient from our food, our appetite settles down—at least for food that contains more of that nutrient—and our appetite sends us in search of foods and meals that contain the higher priority nutrients that we will still need more of.
What Happens When We Consume Too Much of a Nutrient?
As you will see, we often see a ‘rebound satiety response’ at higher nutrient intakes that are not achievable from food.
The analysis also gives us a fascinating insight into what happens when we consume more essential nutrients than we require, particularly from supplements and fortification.
So, you can’t simply add handfuls of supplements and expect to achieve the same satiety response as you will get from whole foods that naturally contain the nutrients in the forms and ratios your body understands, can absorb and use.
As we’ll discuss later, supplements and fortification may confuse your healthy appetite signals. So rather than seeking healthy foods that naturally contain the essential nutrients, you’ll be satisfied to keep chowing down on the fortified junk food without getting bored of them.
What Nutrients Are Supplemented Most Frequently?
The vitamins and micro minerals are most commonly packed into supplements due to size and cost considerations. Meanwhile, the larger macro minerals (e.g., sodium, potassium and calcium – the nutrients that tend to provide the largest satiety response) are not frequently supplemented because the amount required is too large and expensive to add in meaningful quantities in multivitamins and fortified foods.
The absolute quantity of vitamins in our diet is tiny. To illustrate, let’s take a quick look at the satiety response curves to show how they compare in terms of quantity needed.
To the right of the chart below, we can see that B3 (niacin) and vitamin E are two vitamins present in the diet in the largest quantities. Even then, we ingest l less than 100 mg each. In contrast, the vitamins we require in smaller amounts like B12, folate and K1 toward the left of the graph are measured in micrograms, which are 1/1000 of a milligram!
So, it’s cheap and easy to fortify processed foods or to produce multivitamin pills that people can take as ‘nutritional insurance’, hoping to compensate for a poor diet.
When we look at all the nutrients together in the multivariate regression analysis, we see that we have a statistically significant satiety response to some vitamins like riboflavin (B2), folate and pantothenic acid (B5). However, the effect size is much smaller.
Your body uses minerals for many purposes, including keeping your bones, muscles, heart, and brain working properly and making enzymes and hormones.
In contrast to vitamins, we need a lot more of the larger macro minerals. For example, as shown in the chart below, we can consume up to 10 g of potassium or sodium per day.
If someone were to rely solely on fortification to achieve daily mineral requirements, this would require a large volume of powder that could not feasibly fit into fortified foods. For example, our Optimised Electrolyte Mix recipe, which provides potassium, magnesium and sodium in the optimal ratios and amounts, would require you to consume 45 g of powder each day to get the optimal intake of just these three minerals! That’s a passive amount of powder that tends to cause gut distress, so most people can only tolerate a little dose.
In the multivariate regression analysis, the larger macro minerals not commonly used in supplements and fortification, like potassium, sodium and calcium, always provide a significant satiety response, while we see a smaller satiety response to vitamins.
|pantothenic acid (B5)||0.006||4||15||-18||-1.1%|
The amount of amino acids required is even more again! As you can see in the chart below, we can consume up to 25 grams of lysine per day. Protein, or the combination of all the amino acids, tends to have the largest satiety response by far!
While some people use protein powders and amino acid supplements like BCAAs, you have to go out of your way to do this, so it’s much less frequent. It’s also worth noting that, because protein powders are a processed food, they will be less satiating than protein contained in whole foods.
Nutrients That Correlate with Increased Calorie Intake
The table below shows the nutrients that have declined in our food system since the 1960s and their correlation with the rise in obesity.
The charts below show the change in availability of various nutrients over the past century using data from the USDA’s Economic Research Service. It’s interesting to see that many of the nutrients that have decreased the most show a more powerful satiety response in our analysis. This suggests we have strong cravings for many of the nutrients we can no longer get enough of from our food.
But what about the other nutrients?
Don’t we need them too?
If nutrient leverage is a thing, shouldn’t we also crave those as well?
Nutrients that Correlate with the Rise in Obesity Rates
While many nutrients have declined due to degraded soil quality and rapid growth of crops and animals fuelled by synthetic fertilisers, the intakes of several nutrients positively correlate with increased obesity rates since the 1960s.
The table below shows the nutrients that have increased in our food system since the 1960s and positively correlate with the increase in obesity.
Interestingly, when we dig in a little deeper, we find that the increase in nutrients is due to widespread, and even mandatory, fortification programs. This is because we realised that our food system had become so deficient that we had to fortify the food system due to public health concerns.
As you’ll see in the following sections, there are many nutrients we may be getting ‘too much of a good thing’.
Nutrients that We See a ‘Rebound Satiety’ Response To
In the following section, we’ll look at the nutrients where we see a rebound satiety response. That is, a very high intake that can only be achieved with supplementation or fortification tends to align with eating more. We’ll also look at the role of fortification in our food system, for better and worse.
If you’re not eager to delve into the charts for each nutrient, you can scroll through to the discussion and important implications in the next section.
The word folate comes from the same Latin root word as foliage. We get folate from green veggies, so it is probably not surprising that most people don’t get a lot of folate.
As shown in the chart below, created using population intake data from the USDA Economic Research Service, the availability of folate in the food system doubled in 1998 after fortification with folic acid was mandated to prevent neural tube defects.
Before this time, the average population intake was around half the DRI of 400 mcg per day and much less than our Optimal Nutrient Intake for folate of 1000 mcg/2000 calories (which is also the tolerable upper limit from supplementation).
The median folate intake of our optimisers is 444 mcg per 2000 calories, but as we can see in the distribution chart below, some people are getting more than 4000 mcg per 2000 calories. This intake level could only be achieved from supplements and fortification
The satiety response curve shows that, although people who get more folate from food, people who get very high intakes of folate do not see the same satiety response. So beyond around 4000 mcg/2000 calories, more folate is not better.
While there is no upper limit for folate for food, excess folic acid supplementation can mask B12 deficiency.
Large doses of folic acid given to an individual with an undiagnosed vitamin B12 deficiency could correct megaloblastic anaemia without correcting the underlying vitamin B12 deficiency, leaving the individual at risk of developing irreversible neurologic damage.
Vitamin E has risen in line with the increased use of plant oils since hydrogenation enabled the isolation of plant oils from crops high in vitamin E.
The chart below shows a significant amount of people are getting more than the ONI for vitamin E of 25 mg/2000 calories, and some are even getting more than 150 mg/2000 calories.
Foods containing more vitamin E per calorie (e.g., asparagus, broccoli, almonds, and kale tend to align with a lowered caloric intake. However, people who get more than 80 mg of vitamin E per 2000 calories from supplements or industrial seed oils tend to have a higher daily calorie intake.
Iron availability in the food system has increased since the fortification of enriched grains began in the 1940s to combat anaemia. While many women take supplemental iron, excess iron is also a concern for many.
While many try to limit meat to reduce its ferritin levels, fortified foods like enriched grains may be a better place to start if you want to reduce your iron intake.
The median iron intake in our Optimiser data is 16 mg/2000, which is less than the ONI of 30 mg/2000 cal. However, we can see that many people are getting more than 80 mg/2000 calories.
When we look at the satiety response to iron, we see a rebound satiety effect beyond about 80 mg/2000 calories.
While foods containing more iron per calorie (liver, egg, beef, and vegetables) align with a lower calorie intake, fortification of grains or supplemental iron does not appear to help with satiety.
Thiamine (vitamin B1) is a B vitamin whose deficiency is causative of a condition known as beriberi. Thiamine was the first B vitamin to be isolated in 1926 and manufactured in 1936. Shortly after, the fortification of grain products began in 1939 to combat beriberi.
There has been a significant increase in thiamine availability in the food system since the 1940s. A further update of nutrient fortification standards for breakfast cereals was introduced in 1974, accounting for the second rise of thiamine.
The 2014 paper Excess vitamin intake: An unrecognised risk factor for obesity highlights that the sharp increases in the fortification of infant formula and breakfast cereal correlated with sharp increases in obesity rates when introduced in different countries.
The study notes that B vitamins also promote fat synthesis, and when found in high-glycaemic foods (e.g., fortified bread and cereals, rather than meat, seafood and vegetables), they may cause hypoglycaemia (i.e., low blood sugars), thus compounding our increased appetite for high glycaemic foods.
While our ONI for B1 is set at 3 mg/2000, the chart below shows that many Optimisers are getting more than 20 mg/2000 calories of vitamin B1.
When we look at the satiety response to thiamine, we see a significant rebound satiety effect with more than 10 mg/2000 calories of B1. Multivitamins and fortified foods that contain B1 are not providing greater satiety.
Niacin (vitamin B3) availability follows a similar trajectory to thiamine. Since the introduction of fortification in the 1930s, levels of vitamin B3 have markedly increased in the food system. In 1974, it increased again with the revised guidelines for fortifying cereal products.
The median niacin intake in the Optimiser data is 33 mg/2000 calories. However, many people are getting more than 200 mg/2000 calories.
The satiety response curve for niacin indicates that intake levels above what is available in whole foods (e.g., vegetables and meat) show a rebound satiety effect.
Magnesium is an essential mineral frequently supplemented due to its many enzymatic functions in the body.
The median magnesium intake of our Optimisers is 400 mg/2000 calories compared to the ONI of 825 mg/2000 calories. However, we can see that some people are getting more than 3000 mg/2000 calories. Most people find it hard to overdo magnesium supplementation due to its laxative effect.
Again, we see a rebound satiety response above 3000 mg/2000 calories of magnesium.
While seafood, meat, dairy and vegetables are good sources of zinc, fortified breakfast cereals became a significant source of zinc with the introduction of fortification in the 1970s.
The median zinc intake of our Optimisers is 15 mg/2000 calories which is less than the ONI of 30 mg/2000 calories. However, many people get more than 100 mg/2000 calories.
Again, we see a rebound satiety response from supplementation above 130 mg/2000 calories.
The median copper intake of our Optimisers is 1.4 mg/2000 calories compared to the ONI of 3.0 mg/2000 calories. However, many people are getting more than 10 mg/2000 calories.
The satiety response curve also shows a distinct rebound satiety effect once we get about 5.5 mg/2000 calories of copper.
Without fortification, the US intake of vitamin A has plummeted since the 1970s.
Vitamin A is one nutrient where the RDA of 900 micrograms appears to be extremely low compared to the median intake of 10,162 micrograms/2000 calories, similar to the upper limit of 10,000 micrograms.
The 85th percentile intake of Optimisers is 35,278 micrograms per 2000 calories. The distribution chart for vitamin A shows that some people are getting more than 100,000 micrograms per 2000 calories from either a lot of organ meats or supplementation.
The satiety response curve shows that we have a positive satiety response to vitamin A up until around 90 mg/2000 calories, with a small rebound after that.
Vitamin C is commonly supplemented and used as a browning agent in processed foods.
While the median intake is only 150 mg/2000 calories and our ONI is 350 mg/2000 calories, the distribution chart below shows that many people are getting more than 2000 mg/2000 from supplements.
However, there doesn’t appear to be any significant benefit from more than 350 mg/2000 calories of vitamin C, at least from a satiety perspective.
Although ‘panto’ means ‘in everything’, pantothenic acid (B5) is commonly contained in supplements and fortification. The median Optimiser intake is 8 mg/2000, and the ONI is 12 mg/2000. However, many get more than 100 mg/2000 calories from supplements and fortification.
Again, we see that more B5 beyond around 30 gm/2000 calories aligns with a higher calorie intake.
The US intake of vitamin B6 jumped in the 1970s with increased fortification.
The median intake of vitamin B6 in the Optimiser data is 2.9 mg/2000. However, many people are getting more than 40 mg/2000.
Again, more vitamin B6 beyond the ONI of 6 mg/2000 doesn’t align with greater satiety.
B12 is in many supplements, particularly if they follow a plant-based diet. We can see that the US intake of B12 has dropped since the Dietary Guidelines for Americans encouraged people to avoid saturated fat and cholesterol.
While the median B12 intake is 9 mcg/2000 calories, we see a large number of people logging more than 100 mcg/2000 calories.
However, we see a rebound satiety response with intakes of more than 30 mg/2000, or the amount we can get from an omnivorous diet.
Vitamin K1 is not typically used in food fortification but is sometimes supplemented. The median K1 intake in the Optimiser data is 262 mcg/2000 calories compared to the ONI of 1100 and the DRI of 90 mcg/2000 calories. We see only a tiny number supplementing with a large amount of K1. However, while there is no tolerable upper limit for K1, excessive supplementation has been known to cause blood clots.
Beyond 5000 mcg/2000 calories, we tend to see a rebound satiety response to higher supplemental intakes of vitamin K1.
Pros and Cons of Fortification
We see a substantial decrease in energy intake with an increased intake of most nutrients from whole food.
However, high intakes of nutrients that could only be achieved with supplements and fortification tend to lead to a rebound satiety response. If your body has plenty of a certain nutrient, more will not provide greater satiety. Nutrient leverage occurs when nutrients come in food rather than pill, powders and fortification.
Fortification and supplementation can be beneficial to address frank deficiencies, or nutrient-dense foods are hard to obtain. For example, fortification has undoubtedly been helpful by providing folic acid to mitigate neural tube defects, vitamin B1 to prevent beriberi, and vitamin B3 to minimise pellagra in a nutrient-poor environment.
However, data analysis suggests that supplementation and fortification of isolated nutrients in levels over and above what is naturally found in whole foods do not correlate with an overall lowered calorie intake. Therefore, the beneficial satiety impact shown in this analysis can only be assumed for minimally processed foods that naturally contain these nutrients.
Why is there a greater calorie intake with supplementation and fortification?
The increased calorie intake seen with very high nutrient intake levels only achievable from supplementation or fortification may be because:
- isolated synthetic supplements do not provide the same satiety benefit as whole foods, where nutrients come in the form and the ratios that the body understands, and (or)
- there is an increased craving for fortified foods without providing the same satiety we would see from nutrients in whole foods.
Research by Dana Small suggests that foods providing nutrients out of line with their taste send the brain into a more risk-averse behaviour. Rather than trusting the food environment to provide nutrients reliably in line with taste sensations, the appetite upregulates to ensure adequate energy and micronutrients are obtained in a more uncertain environment. Thus, ultra-processed foods and fortification may increase appetite and overconsumption beyond our biological requirements.
We’re Being Fed Fortified Pig Slop!
In 1959 the University of Illinois produced a landmark pamphlet titled “Balancing Swine Rations”, documenting their research to identify the feeding regime that optimised growth while minimising the feed ratio (i.e., maximum weight gain with minimum food inputs).
Before vitamin supplementation, farmers needed to ensure that the pigs had time on pasture or were fed alfalfa to obtain adequate vitamins to grow and remain healthy. They also found that pigs would predominantly choose the pasture and unfortified feed if given the choice of pasture or fortified feed.
Farmers had observed that pigs housed in barns fed solely on grain and corn would get sick, lose their hair, and fail to thrive. However, pigs in enclosures that had only fortified feed with no alternative gained weight the quickest at the lowest cost. Rather than seeking pasture or consuming alfalfa, they ate more of the cheap fortified feed.
In his book, The End of Craving, Mark Schatzker likens our modern food system to the fortified pig food designed to maximise growth while preventing deficiencies. The fortification of processed food overrides our innate drive to seek out a variety of foods that contain the full spectrum of nutrients we need to thrive and avoid excess calorie intake.
Since 1959, this understanding of the role of supplementation has been used heavily in the feeding of livestock to maximise growth rates for meat production. The increased rates of fortification of breakfast cereals and other ultra-processed foods may have inadvertently had a similar impact.
Because ultra-processed foods now contain more nutrients required to thrive, we are content to continue eating more of them. Unfortunately, as a result, we have a reduced appetite for food that naturally contains the nutrients that are commonly fortified.
Rather than craving vegetables, meat and seafood, we’re more likely to be content chowing down on our heavily fortified, flavoured and coloured breakfast cereal, although they would taste blander than the box without the extra help from the added flavours and fortification.
Meanwhile, processed foods proudly brag about their nutrient content on the label. But these nutrients are merely synthetic additions to nutritionally void basic ingredients. If a food requires fortification, flavours and colours, it’s a sure sign that the main ingredients are nutritionally deficient and you probably should look for more optimal options.
In summary, it can only be assumed that the positive satiety impact of increased nutrient density comes from whole foods containing a broad range of essential and non-essential nutrients, not isolated synthetic nutrients.
If we have innate cravings for vitamins, fortification may increase cravings for processed and fortified foods and drown out cravings for whole foods containing other essential nutrients (i.e., amino acids, potassium, sodium and calcium) that we need to thrive.
Could Supplements and Fortification be Bad for You?
Targeted supplementation may be appropriate for someone who cannot consistently meet the DRIs and AIs for specific nutrients.
However, these levels are easily achieved by intentionally and intelligently focusing on foods with more nutrients they need to prioritise. Nutrients are synergistic with one another in the form they appear in whole foods. However, supplements contain concentrated synthetic forms of nutrients in formats and ratios unnatural to the body. Hence, supplements are unlikely to provide the same benefit as nutrient-dense whole foods.
Not only can fortification cause imbalanced nutrient ratios, but it may also reduce cravings for foods that naturally contain nutrients they need to prioritise. This may negatively impact satiety by increasing cravings for nutrient-poor fortified foods without the narrow band of nutrients they are enriched with.
Finally, the absorption and bioavailability of synthetic vitamins and minerals compared to their food form counterparts have also been questioned. Studies looking at bioavailability rates of synthetic vitamins like thiamine hydrochloride are between 3.7 and 5.3%.
Additionally, many forms used for fortification may require additional steps to be considered active by the body for biological processes. Genetic and epigenetic factors can also influence how readily available they can absorb and utilise vitamins in synthetic forms.
Should You Take Supplements?
Supplements and fortification certainly have a role if you have a diagnosed deficiency in a specific nutrient based on clinical tests.
But higher intakes of the vitamins from supplementation don’t appear to provide anything other than a false sense of security, so you don’t need to put as much effort into dialling in the nutrients in your food.
Many supplements that promise magical results for a condition you didn’t know you had can be expensive. But potentially, more importantly, they provide a false sense of security that you’re getting the nutrients you need. This removes your focus from food quality, which is undoubtedly more important.
In our Micros Masterclass, we guide people to reduce their intake of supplements and fortified foods once they can meet the DRI or AI for that nutrient. Once you know you’re getting them from your food, they’re a waste of money and headspace.
In the Micros Masterclass, we use Nutrient Optimiser to systematically review your current diet to identify your major nutrition gaps and the foods and meals that will provide them most effectively with the fewest calories.
Rather than relying on expensive testing, the best way to identify which nutrients you require more is to track your diet for a few days.
Our satiety analysis of one hundred and fifty thousand days of nutrient data from forty thousand people shows that we crave and have a distinct satiety response to the essential nutrients in food. However, we do not see this same response with high intakes of nutrients that could only be achieved with supplements and fortification.
While supplements are fortification can play a role where there are legitimate deficiencies, it appears that a mismatch of nutrients in foods that they don’t belong in could:
- confuse our appetite and lead us to eat more, and
- continue to eat low-satiety foods rather than craving whole foods that naturally contain those nutrients.
Rather than relying on supplements and fortification, Nutritional Optimisation enables us to identify food that contains the nutrients we require to maximise satiety and thrive.