What Supplements Should I Buy?

Today’s guest blog comes from Kurtis Frank and Sol Orwell from Examine.com. I asked these gentlemen to write me a post that discussed evidence-based supplement usage for health, strength, power, endurance, fat loss, and muscle building. If you haven’t checked out their website yet, please do. It’s one of the most impressive sites I’ve seen, and I’m amazed at the insane amount of time and research needed to pull off this project. Click on the blue links contained in the document to further investigate the supplements. These guys know the research so if you have any questions for them, don’t hesitate to ask in the comments section. 

Supplements Taken for General Health

Vitamins and Minerals

Frankly speaking, multivitamins are more often than not, crap (despite vitamin and mineral supplementation having a lot of potential). The concept of multivitamins is pretty awesome, but there are many flaws in the production and execution thereof:

  • Throwing in 100% of the RDA doesn’t necessarily mean you have the optimal dosage. Vitamin D is a testament to this (RDA being 400-800IU and optimal levels being above 2,000IU daily).
  • There are many micronutrients that you already eat enough of without trying, and throwing in more can run the risk of overdosing (selenium and beta-carotene as examples, as they are linked to increased mortality).
  • People like buying single pills or their ‘one a day’ multivitamins, but physics states that you can only fit so much into a pill. The micronutrients needed in higher doses such as magnesium or calcium are almost always underdosed in these once-daily formulations.
  • You might need more than the classically defined vitamins to assure health, as there are many compounds that are very healthy to the body (creatineCoQ10carnitine) that are not vitamins since they are not required for survival nor do they have a deficiency disease state when you don’t eat enough.

So due to the above, blindly recommending a ‘multivitamin’ is a pretty poor suggestion. A better suggestion would be to recommend vitamins and minerals that are either very difficult to get in optimal levels via diet, or practically hard (which supplementation could just be convenient).

Multivitamins

The vitamins and/or minerals that are damn near impossible to get in ideal amounts include:

And that is about it. Optimal levels of vitamin D are at 2,000IU minimum (anything in the range of 2,000-5,000IU is given) and optimal levels of vitamin K are at 1000mcg of vitamin K1 (somewhat similar levels for any form of vitamin K2). Vitamin K supplementation is not needed if you consume natto daily (30g or more), but this is a highly acquired taste and many people may prefer supplementation.

Those two are mostly catered towards ‘health’ in general, but specifically cardiovascular health and maintaining bone metabolism during the aging process. There are also neuroprotective effects, but that is more just for marketing than anything. A bonus is that since they are synergistic with one another they commonly come in the same supplement (the fewer things you need to buy, the better).

The vitamins and/or minerals that are possible to get in the diet in ideal amounts if the diet is catered to them, but supplementation may be convenient, include:

  • Zinc (mostly for persons who sweat a lot rather than everybody)
  • Magnesium
  • Calcium
  • Iron (mostly for vegetarians or persons with low meat intake)

That being said, calcium can very easily be acquired via whey or casein protein (20% and 60% of the RDA, respectively). Iron is best supplemented via a medical doctor, as it can be overdone quite easily. The last two, zinc and magnesium, can be supplemented via ZMA (a common supplement of these two minerals with some vitamin B6). Anecdotally, people swear that ZMA gives them highly imaginative dreams.

If a vitamin or mineral was not listed above, it is probably sufficient in the diet and supplementation is not needed. Buying solely what you need and not needlessly adding in more micronutrients would not only be cheaper but also more beneficial than blindly buying a multivitamin.

Things that aren’t vitamins, but are similar in concept

As mentioned in the final bullet point of why multivitamins tend to be lackluster, there are many other compounds that have similar potency in helping the body as they are vital to optimal performance. They are, however, not classified as vitamins since if you omit them from your diet you do not get diseased.

This isn’t to say that they are unneeded. A genetic fault that hinders creatine metabolism will outright cause mental retardation and hindering synthesis of CoQ10 causes muscular dystrophy (preventing synthesis would likely kill an organism immediately). These are not something you need to specifically supplement with, but it’s important to know that they are important parts of your metabolism. We can classify these compounds as vitamin-like.

The compounds that follow vitamin-like motifs but are recommended for supplementation (including their conditions) are:

  • Creatine (assuming vegetarianism)
  • Carnitine (assuming either vegetarianism or elderly)
  • CoQ10 (assuming post-myocardial infarction or fibromyalgia)
  • Choline (assuming low egg and meat intake or cognitive decline)
  • Uridine (assuming cognitive decline)

This is not all the molecules that follow a pseudovitamin-like motif (a semi-complete list can be found here), just be aware that this is not a legitimate term and there will be debate on this topic. The above ones are most likely to be relevant.

Omega_3_Fish_Oil_Capsules

Following these pseudovitamin compounds is fish oil, or specifically ‘omega-3 fatty acids.’ The fatty acids that can be called essential to the body are divided into either an omega-6 class or an omega-3 class (with saturated fats and omega-unsaturated fats of other classes not being absolutely vital to survival). As a general statement the ratio of omega-3 to omega-6 should be somewhat even.

Macronutrients that are also Supplements

There are some supplements that give the body calories. While they follow the same motifs as the above pseudovitamins, they are somewhat different in the sense that they are also food products. For practical purposes, this includes fish oil and protein supplementation.

Fish oil supplementation is not per se needed. Anything that can be done to normalize the ratio of omega 3s to omega 6s will bring about the benefits attributed to fish oil supplementation. This can include:

  • Eating less arachidonic acid (AA), the most biologically relevant omega-6 fatty acid
  • Eating more food sources of EPA or DHA, the biologically relevant omega-3 fatty acids
  • Eating more alpha-linolenic acid (ALA) relative to linoleic acid (LA)

A pescetarian diet with daily fatty fish intake and no other animal products likely does not need fish oil supplementation if it is balanced, and a diet inclusive of other meat products can potentially be sufficient if enough fish is eaten.

Fish oil supplementation is popular because of its convenience. It just so happens that dietary sources of arachidonic acid and linoleic acid (omega-6s) are delicious. Due to this, encapsulated fish oils are sought after to normalize the ratio of omega-3 to omega-6 by merely putting more of the relatively deficient one in the diet.

The ideal ‘dose’ of fish oil should be taking your diet into consideration, but for an otherwise normal person living in a developed nation (standard western diet), an oral dose in the range of 1,500-3,000mg combined EPA+DHA is more than sufficient. Diets that include fish or are lower in omega-6 would require less EPA+DHA than this.

Protein is in a similar boat, as there is a daily requirement to be hit, and for the most part it doesn’t matter where you get your protein from. Some rough guidelines for protein intake can be found here, and intentionally seeking out animal sources over plant sources is only important for the lower protein targets.

200010255-001

If protein is required in the diet and a protein powder would be convenient, then it can be used. Otherwise, food is more than sufficient to fuel the body’s requirements. Unless operating within very strict guidelines, one’s primary motivation in selecting a protein powder should be its taste and its cost. The type and source of protein are not very important.

Things to be taken dependent on your goal

Muscle Building, Endurance and Power Output

Creatine: Is the first go-to for increasing power output and muscle building potential, and despite it previously being recommended for vegetarians, it is now recommended for any diet type for the purpose of building muscle. This is the most well-researched and supported ergogenic aid in existence, and has a very impressive safety threshold as well.

It is recommended that a loading period is undertaken if you have never used creatine before solely because the gains in water weight will be much more noticeable. There is a group of people who do not seem to respond to creatine supplementation, but these persons also do not get an increase in water weight gain. If a loading period does not change your body weight then you can feel free to cease creatine supplementation, but if it does increase your body weight then take 5-10g daily forever. There are no downsides to it, and you do not need to cycle it. Just ensure you drink enough water (not drinking enough water can cause gastric distress).

creatine

Buffering Agents: Buffering agents are those that reduce intracellular acidity and thus prolong time to muscular exhaustion, with the two main players being beta-alanine (via carnosine) and sodium bicarbonate (baking soda). Both of these are reliably effective, but to a relatively small degree and only one of them is needed.

The benefit of baking soda over beta-alanine is limited to its price efficacy and having more literature on it, but usage of baking is also somewhat complicated since it has such a high sodium load and very well known intestinal side-effects (they can be avoided, but the dosing needs to be meticulous). For daily usage, beta-alanine is much more feasible and convenient.

Beta-alanine has also been implicated in promoting muscle protein synthesis independent of increased workloads, although it is not really known why.

Nitric Oxide promoting agents: When nitric oxide is increased, physical performance is enhanced. This is reliable per se, but the actual increase in nitric oxide is not as reliable. The first round of supplements that were marketed to increase nitric oxide (arginine and citrulline) were definitely effective in some instances, but their unreliability prevented their mainstream recommendations (didn’t seem to impair their usage though, as nitric oxide supplements have become by far one of the most popular supplements to take).

Recent research on nitrates from beetroot, which increase nitric oxide via a different pathway, seem to be much more reliable in their benefits and the magnitude is either comparable to or greater than beta-alanine. Although nitrate cannot be legally sold as a supplement at this time, consuming beetroots is actually sufficient for the performance enhancement (so switching your pre-exercise meal to have carbs from beets would be quite beneficial).

beets

Agmatine is also appearing to be a promising and more reliable nitric oxide promoting agent, but since it lacks human studies at this point in time it cannot be recommended.

Fat Burning and Body Recomposition

These supplements are those that, assuming you already have a good workout and diet regimen down, can provide an additional push for losing body fat. Legal fat burners are much less potent than what many people claim them to be, so the following compounds should be seen as nothing more than the icing on the metaphorical cake (by far the most interesting part, but requires a solid base to work off of).

CaffeineAside from being the most popular fat stimulant in the world, caffeine is one of the few compounds that fairly reliably burns fat. It actually does so quite potently when you take a large dose that you are not tolerated to (causes a release of adrenaline and noradrenaline), but this potent fat burning effect lasts for a week or so until it is lost. For habitual coffee/tea drinkers, the benefits gleaned from caffeine will be dampened.

Beyond that, caffeine has minor fat burning effects via inhibiting PDE enzymes which then increase levels of an intracellular molecule known as cAMP (by preventing its breakdown). When cAMP is increased, fat burning tends to be increased in direct relation to it. This isn’t too potent per se, but many things that increase cAMP including exercise work nicely with caffeine because of this.

coffee-black

In part because of its popularity, its stimulant effects, its (relatively) nice safety profile, and the overall cheapness of putting it in a supplement, caffeine is almost always found in fat burning supplements.

ECAThis is an acronym for Ephedrine:Caffeine:Aspirin that is commonly stacked for the purpose of losing fat mass. It is not sold commonly due to ephedrine being unable to be sold as a fat burner, but ephedrine can still be legally purchased at pharmacies (as a nasal decongestant) and the other two ingredients are widely available.

All three ingredients seem to work synergistically, as the aforementioned PDE inhibition of caffeine promotes fat burning caused by ephedrine (it also releases adrenaline, but the body does not get tolerated to ephedrine like it does to caffeine) while aspirin augments the effects of ephedrine and is sort of a cardioprotective failsafe. In a few individuals ephedrine may promote blood clotting, which aspirin can inhibit to a degree.

ECA may be the most potent combination formula that can be bought legally, but even then is at best good for 2-3lbs of fat per month.

Fail Burners

There are a few compounds that are incredibly popular as fat burning compounds but don’t really work, or require some conditions to be met in order to work (and these conditions rarely are relevant). These ones include:

Carnitine: Yes, carnitine and its enzyme (CPMT) are intimately involved in the mitochondria and fat burning and deficiencies in carnitine do impair fat burning. Yes, it is indeed the rate limiting step and increasing the CPMT enzyme does increase the rate of fat burning.

For such claims, it is somewhat odd that all studies using carnitine in otherwise healthy omnivorous persons have noted a failure for carnitine to burn fat. The studies that do note fat burning effects are either in strict vegans (still lacklustre results) or in elderly individuals (somewhat more respectable).

Carnitine seems to burn fat if you are relatively deficient in it, but this appears to be quite infrequent.

CLA: Conjugated Linoleic Acid is promoted as a fat burner because something to do with PPARs. Honestly, as soon as the PPARs are mentioned (a class or receptors that mediate oxidation of fatty acids via peroxisomes, which can burn fat independent of the mitochondria), most logic is thrown out the window in favor of marketing.

PPARs are indeed really cool molecular targets, and there are many drugs that target PPARs to induce potent effects (many antidiabetic drugs target the gamma subclass). CLA, however, is a pretty poor ligand for these receptors.

PPARs are very, very general receptors and almost any fatty acid or linear looking molecule can activate them in sufficient quantities. Thus, they are ripe to be abused and their studies misinterpreted.

When looking at all human studies on CLA, although there are some that note weight loss, more than half of them report no significant effect (and one study noted an increase in fat mass). With such unreliability that sometimes results in statistically significant fat gain, how can this be recommended as a fat burning supplement?

Green TeaDoes kind of work, but this is pretty unreliable as well. It seems to work in most people when augmenting the initial effects of caffeine, but due to this initial phase lasting a week or so, the overall fat loss is not too appreciable. From there, the efficacy of green tea is very much based on your genetic makeup.

Green-Tea

The enzyme that the catechins in green tea inhibits (catechol-o-methyltransferase or COMT) fluctuates greatly depending on genetic makeup, with Asian populations seeming to have much higher levels of COMT (and Caucasian lesser). Those with a higher COMT activity are more sensitive to its inhibition.

Due to this, it would be wrong to say that green tea is not a fat burner but at the same time its unreliability limits its recommendations. If it works for you, great, if not then do not worry too much about it.

Supplements?

It’s common to bash supplements as useless and an un-needed cost. While this can be true, the reality is that supplements can be very useful in plugging gaps in your diet and aiding with specific goals. Ideally, this article has given you pertinent information to make more informed decisions.

About the Authors

Kurtis Frank and Sol Orwell are the co-founders of Examine.com. They created the site to serve as the scientific compendium on supplementation and nutrition.

25 thoughts on “What Supplements Should I Buy?

  1. Phil Anthony

    Great post guys but questioning the concept of a multi being ‘useless’…

    Say you cant see a client and establish, from the various skills you could potentially employ such as BF% Kinesiology etc… a specific protocol.

    So an online client for example.

    Would you say a multi is a safe bet to get them rolling? What if they have a poor diet – granted they should eat clean first but then you have the whole ‘soil saga’ and how food lacks superior nutrient quality.

    When would you suggest a multi because personally with clients, if I can’t see them face to face, I high dose them for 4-6 weeks and notice massive improvements. Then I taper them off and have them take a minimal dose.

    Thoughts appreciated :)

    Reply
  2. Michelle

    Really like this post…although I’m still going to take my multi vitamins (they’re capsules, not tablets) everyday because I notice a huge difference when I STOP taking them. I’m glad you mentioned Magnesium, that’s a big one.

    Would love your thoughts on Fermented Cod Liver Oil…just read this piece from “Balanced Bites” and thought it had some interesting points….I suppose I’m a fish oil freak because I find that it improves my MOOD more than anything else.

    http://balancedbites.com/2013/02/faqs-all-about-fermented-cod-liver-oil-and-why-i-dont-take-fish-oil.html

    Reply
    1. Sol Orwell

      It’s an example of people focusing on the minutiae and losing sight of the forest. In a similar situation is krill oil – it’s “better” than fish oil, but if your n3 ratio is already good, it is a marginal improvement.

      Reply
  3. Will Arias

    Bret, you nailed it… again… Hoping i don’t sound too cheesy but one of the things i respect most about you is the fact you represent prolifically the “art of delegation”, which should be followed by many people within our industry… I mean, no everyone can claim that he/she is simultaneously a S&C expert, and rehab master, a mobility authority, an endurance training bible, a powerlifting record holder, a yoga leader, a phycology mentor, a brain plasticity scientist, a bodybuilding role model and a MMA legend, etc, all at he same time!…. Anyway, my point is you have the decency or refer to other professionals within the industry when you don’t know the answer or, as it’s evidence in this case about nutrition/supplementation, you pass us tons on information from other authors who clearly dominate a topic that concern to all of us involved in the health and fitness industry (for instance, in the same way that good physios and coaches shouldn’t hesitate to refer to each other)…. According to a marketing point of view, it could be qualified as a clever way to exhibit and enhance your brand by giving your costumers what they need, which keep them, me included, waiting for more tons of knowledge communicated through your site… According to my principles, that is pure honesty and unselfishness… In two words, “Thanks, man”….

    Reply
  4. Michael Zweifel

    What are your thoughts on a greens or super food drink? I really like them and feel they help bridge the gap on many vitamins and minerals, while also helping out with probiotics, phytonutrients, and antioxidants

    Reply
  5. Austinite

    Very interesting. I wholeheartedly agree that the majority (if not all) of multivitamin/mineral tabs on the market are a waste of money. I personally supplement every vitamin, mineral and herb separately. I’ve essentially created my own multivitamin. I do however, want to point out a few things here…

    One of the reason most folks are not benefiting from Fish Oils is because they do not take it with Vitamin E, which would protect the EFA’s that we crave so much. Vitamin E mixed Tocopherols preferred. Otherwise it’s mostly a waste.

    With regards to Vitamin K, I honestly don’t see any reason why anyone should supplement with it. Unless you’re under doctors orders, bleed too much or have issues clotting, there is need for Vitamin K. What little that you get out of a basic diet is more than plenty and lack of it will not hurt.

    Lastly, I’d like to discuss green tea. As pictured above, when the average consumer hears about the fat loss benefits of green tea, they run to the store and pick up some Lipton Tea bags or pre-made tea in a bottle. Those quantities will never suffice to make any type of impact.

    Green tea contains EGCg, which is the main catechin for fat loss. A cup of tea or 6, will not provide enough EGCg for fat loss. You have to supplement in either powder or pill form. 400mg of EGCg will most certainly provide results, as it will affect your daily expenditure where you will burn more calories than you normally would, even at rest.

    When shopping for green tea, do not search for green tea, search for EGCg rather. Those supplements that are specifically labeled EGCg, generally contain high/concentrated amounts. It would be too bitter to drink, so you would take it in pill form. Be sure to read the label and look for the milligram content of EGCg, not the percentage.

    Overall, really enjoyed the article and love examine.com; really an amazing resource.

    Reply
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  8. Andy

    Overrated & over-complicated.

    A important question I would ask myself is, Are the people this article was aimed towards the epitome of INTERNAL health?, clean blood, de-calcified joints, strong internal organs etc & then give me the evidence to prove it?. By all accounts, animal protein actually weakens/overburdens the organs, caffeine fries the nerves & CNS, baking soda & creatine improves anaerobic glycolysis (stiffens the body).

    So, if the internal is weak (dirty blood, calcified joints, weak organs etc) from supposedly “good nutrition/supplementation advice”, how does this affect the external from a performance perspective?.

    Is Kurtis Frank and Sol Orwell really telling me people like bodybuilders are the epitome of health because of there over-analysis of nutrition & supplementation?.

    Reply
    1. Austinite

      I think you completely misunderstood. No one is saying you must use these supplements to achieve a healthy state. You can be healthy with diet alone. However, that does not mean you’ve reached optimum levels.

      Caffeine does not fry CNS. Anything you intake could result in ill effects. Caffeine, aspirin, protein and even water.

      You don’t have to supplement with everything under the sun, but you’re not maximizing on some of the health benefits with a basic diet.

      This article was not with regards to deficiencies specifically, for that you’d need a doctors care, not a supplement store. Most of what was mentioned are non-essentials, but beneficial.

      Reply
    2. Will

      “By all accounts”?… Name a few, Andy, including the most holistic ones and/or the ones you consider the healthiest… I reckon you need to be a bit more tolerant about other opinions or, at least, sustain your claims based on scientific evidence. By any means Frank & Orwell are nominating bodybuilders as the paradigm of health but probably many of them know about more nutrition and supplementation than you or me…

      Reply
    3. Sol Orwell

      It is hard to take anyone seriously that claims stuff like “animal protein actually weakens/overburdens the organs” and “creatine improves anaerobic glycolysis (stiffens the body)” not to mention that the only mention of BBers were in the comments.

      Reply
    4. Jason

      A big LOL! And the pale, skinny fat, demuscled, irritable vegan is surely the epitome of health….

      Reply
  9. Rebecca Cooper

    Carnatine has just been studied and found to actually cause heart disease. metabolized in the liver, its metabolite poses danger to the cadiovascular system.

    Reply
  10. marenghi

    thanks for the summary to the guys behind examine.com. a very informative site!

    two points:

    vitamin d: vitamin d indeed seems to be deficient in a majority of people. but …it mostly depends on factors indicating uva-ray exposition: where u live, what time of the year it is, what skin color u are, what age u are.

    so if you live anywhere from around 50° to 35° north/south, just go outside around noon for 15mins during the summer months. in the winter, vitamin d supplementation may be needed.

    think of permanent vitamin d supplementation only if u live farther away from the equator, dont get enough sun during the summer months (dont stay indoors kid playing vid games all day – thats what your doctors say ;) ), have very dark skin color or are older than 65.

    dont think of any vitamin d supplementation (if youre not older than 65) if u happen to live in regions other people fly to during the winter months and you see the outside of your home from time to time.

    vitamin k: is not at all difficult to get in sufficient amounts. hell, just put a teaspoon of dried (or a handful of fresh) parsley into your salad/soup/butter on your steak – and thats it! contains 4000mcg/100g or 5700% (!) of the (admittedly a bit too low) rda. that is good news, isnt it: u dont have to eat natto holding your nostrils closed.

    so for both cases, i agree there often is a deficiency which – and there i disagree – can relatively easily be fixed without supplementation.

    Reply
  11. Shane

    Telling me that something great for me is an acquired taste just makes me more eager to give it a go. I’ll have to figure out what natto is and give it a try!

    Reply
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