Even though it's the ultimate goal, getting all the nutrition required for optimal health from food alone is quite difficult. So whether you're just trying your best to eat healthy or you're adhering to a strict vegan, paleo or gluten free diet, chances are you need some help from supplements. Here we look at a few of the most common diet plans and give some general recommendations based on the commonalties existing within each of them in respect to their nutritional shortfalls.
Vegan or vegetarian
Whether you're vegetarian or vegan there is a high likelihood that you're not getting enough vitamin B12 from the foods you eat. Vitamin B12 is found almost exclusively in animal protein and it's very important for red blood cell production, energy production, DNA synthesis and for the health of the central nervous system. It also works with vitamin B9 (folate) to help the body utilise iron, thereby making it important in preventing anemia.
Vegans follow an even more restrictive diet than vegetarians and because they exclude dairy they often don't get enough calcium and vitamin D - both being important to the health of the immune system and in the prevention of osteoporosis. Whilst these nutrients are found in leafy greens and broccoli, you have to consume very high quantities to get the daily recommended amount.
Another important food that vegans and vegetarians miss out on is oily fish, through which omega-3 fatty acids are obtained. Omega 3s are really important for reducing unhealthy inflammation in the body, keeping your brain working at optimal capacity throughout your life and for lowering your risk of heart disease.
There are three different omega 3 fatty acids - ALA, EPA and DHA. ALA is found in a limited number of plant-based foods including walnuts and flax seeds while EPA and DHA are found in fatty fish such as salmon and mackerel. Vegans and vegetarians therefore need to look out for supplements made out flaxseed or walnut oil instead of fish oil. It's also very important to note that ALA is used in the body for energy and to make EPA and DHA - it is EPA and DHA that come with all the health benefits so if you're not getting enough ALA then you may not make enough of the others to meet your body's needs.
The two other supplements that both vegans and vegetarians might need are zinc and iron. These nutrients aren’t absorbed by the body as well when they come from plant based sources, it’s therefore suggested that people who don’t eat meat actually consume double the recommended amount of zinc and iron as meat eaters.
Dairy free diets have become extremely popular in recent times, in fact a survey undertaken by the National Osteoporosis Society found a 5th of under 25's are cutting out or reducing dairy in their diet. Further to this a recent Food Standards Agency survey found that nearly half of 16-24 year olds said they had an intolerance to cow's milk and dairy products, compared to just 8% of over 75's yet only 24% had actually had their condition diagnosed.
If you're following a dairy free diet you run the risk of not getting enough calcium and vitamin D, both of which are crucial for building strong bones and teeth.
Prof Susan Lanham-New, head of nutritional sciences at the University of Surrey and clinical advisor to the National Osteoporosis Society, said:
"Diet in early adulthood is so important because by the time we get into our late 20s it is too late to reverse the damage caused by poor diet and nutrient deficiencies and the opportunity to build strong bones has passed."
Research is now telling us that after the age of 50, half of all women and one in five men develop osteoporosis, a fragile bone condition that causes painful fractures of the hip, wrist and spine.
All this being said, cutting out dairy doesn't necessarily have to be unhealthy if enough calcium is consumed from other sources. This includes nuts, seeds, green leafy vegetables, salmon, sardines, broccoli and baked beans - if these sorts of foods don't feature regularly in your diet however then it's highly recommended that you supplement with calcium. For adults, 700mg of calcium per day is recommended but boys and girls between 11 and 18 need up to 1000mg.
When it comes to vitamin D adults and children over the age of one should have 10 micrograms (mcg) or 400 IU of vitamin D every day - this is extremely difficult to achieve through diet alone so taking a supplement is highly recommended, especially during the winter months when we have limited exposure to the sun.
Going gluten free is the only treatment for coeliac disease (an auto-immune condition affecting about 1% of the UK population) however many are now cutting out grains and other gluten containing foods believing it comes with health and weight loss benefits. In fact, 8% of the British population report avoiding gluten as part of a healthy lifestyle, compared to just 5% that does so because of a diagnosed allergy or intolerance.
The rise in popularly of the diet comes from endorsements from celebrities such as Victoria Beckham who is said to follow a gluten-free diet because it helps her keep her weight down. Those in the wellness movement such as the Hemsley sisters describe it as a common “gut irritant” and even top sports personalities such Novak Djokovic credits his rise to superstardom to Serbian doctor who diagnosed him as having a gluten sensitivity and therefore persuaded him to cut it out of his diet.
Cutting ties with grains definitely means a healthier way to live for some and is certainly essential for those suffering from celiac disease and gluten intolerance but it could mean missing out on essential B vitamins, specifically B1 and B6.
Vitamin B1, also known as thiamine, plays a role in converting food you eat into energy so if you consistently feel worn out, taking a supplement may help. Vitamin B6, also known as Pyridoxine, helps you fight off infections, maintain normal nerve function, and carry oxygen throughout your body. You also need it to keep your blood sugar within normal limits.
Research has shown that people with celiac disease don't tend to get enough of vitamin B12 in their diets, the reason for that low intake may be that most conventional breakfast cereals are fortified with 100% of your daily vitamin B12 requirements, and of course people who avoid gluten will need to avoid many of those cereals, as well. Vitamin B12 helps maintain your nerve and blood cells, and those who are particularly deficient in B12 can find themselves fighting constant fatigue so in this case a B12 supplement will help.
It's worth noting that even though most of us could do with cutting back on our processed carbohydrate consumption, there is no evidence that removing gluten from the diet has any benefits for non-coeliacs. In fact the reason health professionals don’t want to see people on gluten-free diets unless absolutely necessary is that, for the 98% of people that don’t have gluten issues, whole grains, including the gluten grains wheat, barley and rye, are health promoting, linked to reduced risk of coronary heart disease, cancer, diabetes, obesity, and other chronic diseases.
Further to this it's important to remember that a cake is a cake whether it’s made from wheat or not! Going “gluten-free” is certainly not synonymous with being “healthy”- this was illustrated by a recent study by the European Society for Paediatric Gastroenterology Hepatology and Nutrition. It discovered, after comparing 654 products to similar items containing gluten, that the gluten-free versions had a significantly higher fat content and were often less nutritious than their ordinary equivalents.
The idea of the Paleo Diet is to eat only foods that we could hunt or gather back in the caveman era, so things like pasta, cereal, grains, bread, and dairy as well as processed foods such as refined flour and sugar are a no go. Instead you can load up on meat, fish, vegetables, fruit, nuts and seeds.
There is a lot about the paleo diet that is positive such as the elimination of processed and refined foods, however just like any other restrictive eating plan it doesn't ensure you get all your nutrient requirements.
Eating strict paleo means no dairy which in turn puts you at risk of calcium and vitamin D deficiency so again, just as recommended for the dairy free diet above if you're worried that you're not getting adequate amounts from dietary sources then it's worth looking at calcium and vitamin D supplementation.
As paleo stipulates the removal of grains from the diet then just like the gluten-free eaters, you might also need to start taking a vitamin B supplement.
The ketogenic is high-fat and low-carb diet that is very trendy at the moment. Grains, sugar (including the unrefined type), fruit and tubers (potatoes and yams) are all out while meats, leafy greens, vegetables, high fat dairy, nuts and seeds, avocado and berries, fats including saturated fats such as coconut oil are all in. The keto diet is high in fat, moderate in protein, and very low in carbs so nutrient intake should be something around 70% fats, 25% protein, and 5% carbohydrate.
A high fat diet can potentially increase urinary calcium excretion, this can lead to deficiency and increased risk of osteoporosis or kidney stones therefore calcium supplementation may be required. Remember, that vitamin D is necessary to absorb calcium so it's a good idea to supplement with both.
On the keto diet, if you are fit and healthy, you’ll lose your body's sodium and water in the first couple of weeks (this is common for low-carb diets). In fact, during the keto diet, the weight loss in the first few weeks will only consist of half body fat - the other half will be water and sodium. If you're combining the diet with an exercise plan then you will also lose sodium through your sweat. It's therefore important to consider offsetting this loss by consuming extra sodium - around 3,000-5,000 mg of sodium per day is typically a good amount.
When you lose your body’s stored sodium, the depletion of salt leads to a corresponding potassium loss. A potassium deficiency, also known as hypokalemia, can cause you to feel weakness, constipation, muscle cramps, skin problems, and irritability. Keto friendly foods high in potassium include avocados, salmon, mushrooms and leafy greens.
Most people on a ketogenic diet find themselves turning to high amounts of foods that are notoriously difficult to digest, including nuts, low-starch vegetables such as crucifers, and full-fat dairy products - these are 3 of the top causes of chronic constipation. A probiotic could therefore come in handy to prevent or alleviate this unwanted side effect.
A final comment
The eating plans focused on here can all be a healthy way to live as long as some key supplements are used to fill in the gaps. There is one diet however that typically doesn’t require much extra help and is the only one backed by science for it's health benefits - it is the Mediterranean Diet. It’s very well balanced and as long as someone is sticking to the portion sizes, they are very likely getting most of the daily vitamins and nutrients they need for optimal health.