White paper “everyone should take basic supplementation”

Basic supplementation are the nutritional supplements one has to take daily to prevent health complaints as a result of nutritional deficiencies. This white paper provides hard evidence for the fact that basic supplementation is essential for anyone with a Western diet.

Our conviction stems from two main lines of evidence:

 

1. People in Western Europe generally consume far too little vegetables, fruits and fish
2. The things we consume often provide too little of the nutrients we need

For a fact, most people consume insufficient amounts of vegetables and fruits to obtain their recommended daily allowances of vitamins and minerals. In particular of magnesium – a mineral that is used in over 300 processes in the body – we get far too little through our food. On top of that, the quality of vegetables and fruits is steadily decreasing, causing even fruits and vegetable aficionados to obtain suboptimal amounts of nutrients from their food.

 

Vitamin C deserves particular attention: humans cannot synthesise it themselves and we need more of it than our fruits, which are harvested unripe, have to offer. In addition, we do not put fish on the menu frequently enough to provide us with sufficient amounts of omega-3 fatty acids. Yet, there is another deficiency we are structurally at risk for: in Western Europe most of the year there is too little sunlight to synthesise sufficient amounts of vitamin D; this is compounded by the fact that most of us spend most of our time indoors. When we do get sunny days, most people apply sunscreen to protect themselves against UV radiation. 

 

This build up of deficiencies in the long term is bound to have serious detrimental consequences for our health. Basic supplementation should therefore include at the very least a high-quality multivitamin/mineral, magnesium, vitamin C, fish-based omega-3’s and vitamin D. This white paper shows you the evidence on which this claim is based.

 

People consume insufficient amounts of vegetables, fruits and fish

The Guidelines for Proper Nutrition are designed to help people meet the Recommended Daily Intake. This is to prevent serious nutrient deficiencies among the population. When 75 percent does not meet this goal, a very large proportion of the population is thus at serious risk of severe deficiencies. In these people, basic supplementation with vitamins, minerals and omega-3 supplements is just a basic need to stay healthy.

“The Dutch population consumes too few vegetables, fruits and fish. Approximately only a quarter of the population adheres to the Guidelines for Proper Nutrition of the Dutch Health Council (Gezondheidsraad).” 

– Statistics Netherlands, 2015

In addition, several epidemiological studies show that people in the developed world obtain too few minerals from their food. For example, data from the USDA show that the average American gets too little zinc (-30%) magnesium (-57%) and calcium (-69%) to provide the amounts the body needs on a daily basis (USDA, 2009).

 

Supplements are not a replacement for a healthful diet

The government warns us that nutritional supplements are not a replacement for a healthful, varied diet. But as only one quarter of the population consumes enough vegetables, fruits and fish, one might ask what is so healthful and varied about this diet. On the other hand, we do get more than enough potatoes, rice, pasta and bread. These foods contain far fewer vitamins and minerals than vegetables and fruits, plus they contain only marginal amounts of fytonutrients. Perhaps it would be more fitting to warn people that potatoes, rice, pasta and bread are not a replacement for a healthful, varied diet.

Our healthy vegetables are often low in nutrients

“In fruits, vegetables, and grains, usually 80% to 90% of the dry weight yield is carbohydrate. Thus, when breeders select for high yield, they are, in effect, selecting mostly for high carbohydrate with no assurance that dozens of other nutrients and thousands of phytochemicals will all increase in proportion to yield”

– Donald. R. Davis, physical chemist

 

In other words: when the yield of a crop increases, it is most likely that its relative share of carbohydrates increases at the cost of vitamins, minerals and phytonutrients. Below, four lines of evidence are developed to support the claim that the past 50-100 years our food has indeed become less nutrient-dense as regards minerals, vitamins, phytonutrients and proteins (Davis, 2015). The evidence is mostly taken from British and American sources, but the trends involved are visible the world over. 

 

Four trends:

 

1. Degradation of agricultural land
2. Selection and manipulation of crops to achieve higher yield
3. Harvesting of unripe fruits for transport and storage
4. Little freedom of movement for livestock and poultry

 

1: Degradation of agricultural land

An agricultural report of the Food and Agricultural Organization (FAO) of the United Nations shows that 25% of agricultural land in the world is highly degraded or degrading. Another 8% is moderately degraded and 36% is stable, lightly of moderately degraded (FAO, 2011). In addition, the organic content of soils has dropped worldwide by 50-65% since man developed agriculture (Lal, 2004). 

 

Typology of degradation of ecosystem benefits		Intervention options
☻Type 1	High degradation trend or highly degraded lands	Rehabilitate if economically feasible; mitigate where degrading trends are high
☻Type 2	Moderate degradation trend in slightly or moderately degraded land	Introduce measure to mitigate degradation
☻Type 3	Stable land, slightly or moderately degraded	Preventive interventions
☻Type 4	Improving lands	Reinforcement of enabling conditions which foster SLM

Degradation of agricultural land results, as a matter of consequence, in poorer food quality: if there are no nutrients in the soil, they will not be on the menu either. Land degradation is a problem for the South of Europe, for instance, where much of the vegetables and fruits for Western Europe are cultivated (FAO, 2011). 

Degradation is mainly due to modern intensive agriculture which is applied on a massive scale since the Green Revolution of the sixties and seventies of the last century. Intensive agriculture causes pollution, water scarcity, land erosion, infertility of soils and reduces biodiversity. On top of that, monoculture has become the dominant system of modern farming. Each crop takes up its own unique mixture of nutrients from the soil; when only one crop is cultivated, the soil does not get the opportunity to replenish the nutrients the crop needs. 

Another problem is the increased intensity of heavy rains causing nutrients in the soil to wash away. According to agrarian researcher Arjan Reijneveld (Reijneveld, 2014) in particular the micronutrient  boron (B) is sensitive to washing out, but also other nutrients sink deeper away into the soil, becoming more difficult for crops to reach and subsequently absorb them.

 

2: Selection and manipulation of crops

During the Green Revolution the yield of crops in the developed world increased by a factor of two to three. This was made possible by, among others, selection and manipulation of crops, as well as by the use of chemical fertilisers. Yield however turns out to be inversely proportional to nutrient density, causing crops to actually become less nutritious in the process.

Research with raspberry bushes

Research carried out with raspberry bushes shows that artificial fertiliser (phosphorous) increases the yield of the crop, but that per gram of dry weight only the density of phosphorous increases. Eight other minerals that were measured – sodium, potassium, calcium, magnesium, manganese, copper, boron and zinc – showed a marked decrease of 20-50% per gram of dry weight (Hughes et al., 1979).

 

The ‘diluted’ crop as a whole does contain more nutrients; it is rather the amount of nutrients per gram of dry weight that has decreased. Thus, one should eat more of it to obtain all the nutrients we require. Based on the data provided by Statistics Netherlands () it is not very likely that people will begin doing this anytime soon (CBS, 2015).

 

By the way, chemical fertilisers are not solely responsible for the decreasing nutrient density of our crops. Also any other technology that increases crop yield – such as irrigation, selection and hybridisation – falls victim to the general trend that the higher the yield, the lower the nutrient density. 

 

As long as a yield remains the single most important factor in growing, selecting or manipulating crops – and the end of this is not in sight, given the increasing pressures on raw materials the world over – it is not unreasonable to expect that, in the future, nutrient density of our crops will continue to drop.

 

Historical comparative research

If we really want to confirm that the nutrient density of our food crops has decreased, today’s crops should be compared to those we consumed in the past. However, there is a large caveat with historical comparative research: for many vitamins and minerals there are no records, for instance because they had not been discovered, or because they have never been measured in the past. On top of that, historical research mainly deals with large aggregations of crops and/or vitamins, making it impossible to filter out one specific crop or vitamin from the data to assess its influence. 

 

As a result, the scope of historical comparative research is rather narrow. However, the research that has been carried out structurally supports the conclusion that the amounts of vitamins and minerals in our food have been steadily declining since the forties of the previous century. Three studies show a decline of 5-40% or more in vegetables alone. One study shows that the density of vegetable proteins has declined (-6%). The strongest evidence can be found in a study with 43 food crops, showing a broad decline in calcium (-17%) and particularly copper (-80%). Vitamin A, vitamin B2 and vitamin C declined by 15-38% (Davis et al., 2004; Mayer, 1997; White en Broadley, 2005).

 

Last, a study carried out in Finland shows that, between 1970 and 2000, vegetables, berries, cereals, and apples declined in potassium, manganese, zinc, copper, magnesium, calcium and iron. Somewhat surprisingly, phosphorous densities (artificial fertiliser) dropped too. The only increase that was found was in selenium, which Finnish farmers have been using since 1985 to enrich their soils (Ekholm et al, 2007). Selenium is an important antioxidant which is used by the body to prevent damage to red blood cells.

 

Comparison of cultivars with high and low yields

The best method for comparing relative nutrient densities is using different cultivars of the same species, some with high yield and some with low yield. To date, this type of research has been carried out for three crops: broccoli, wheat and maize (Davis, 2014). 

 

Research with 27 broccoli cultivars shows that calcium and magnesium are strongly and negatively correlated to yield: the larger the yield, the lower the amount of calcium and magnesium per unit of dry weight (Farnham et al., 2000). The same goes for wheat. In addition, research shows (Scott et al., 2006) that maize has declined by 22-39% in iron, zinc, phosphorous and sulphur in the past 100 years. Protein concentrations in wheat and hops have declined by 30-50% over a similar period.

 

The effects mentioned above are called ‘genetic dilution effects’, meaning a thinning out of nutrient concentrations as a result of different genetic qualities. Hybridisation and genetic manipulation may therefore – as has been mentioned under Research with raspberry bushes – also cause dilution of nutrient densities and are therefore not a solution to the food problem.

 

3: Fruits are harvested unripe

For logistic reasons it is more ‘convenient’ to harvest fruits unripe; this way they are easier to transport and store for longer periods of time before they have to be sold. This solution is preferred by nearly all large supermarkets, as they usually do not have a direct connection to the farms. However, many nutrients – including vitamin C – are only produced when fruit is ripening in the sun while still attached to the tree. 

 

In short: the longer the journey fruits have to take, the less nutritious they are and the more one has to consume of it to obtain sufficient amounts of nutrients. This poses a problem that often goes unnoticed. The few of us who do get enough pieces of fruit a day, may still get insufficient amounts of vitamins if we do not structurally choose for biological fruits grown on fertile soil.

 

4: Little freedom of movement for livestock and fowl

Chickens, pigs and cows that have little space to move about get hardly a chance to develop any real muscle. Muscle is made up of proteins that, in our bodies, are converted into the amino acids we need for our metabolism. Factory meat is made out of animals that have hardly had any space and which have been fed grains, which is not their natural diet and which may have been grown on poor soils. Meat produced from these animals contains relatively large amounts of water and is usually full of antibiotics. Therefore, also in meat production, one may recognise the so-called ‘dilution effect’, leading to a lower nutrient density. When we eat this meat we are at the risk of developing deficiencies, even while strictly adhering to dietary guidelines.

 

If we wish to eat meat, it is best to opt for more muscle mass, not for a bigger size or lower price of the steak. Just as in food crops, the size says very little about its nutritional value and, just as in crops, this is due to intensive agricultural production methods. Wild game has had the chance to move about extensively and is fed on natural resources such as plants and herbs to which the animal is evolutionarily adapted. Even a small steak of game can be very nutritious. 

 

Does biological farming solve everything?

Biological farming solves many of the problems stated above, but not all of them. Biological farms also fall victim to declining nutrient densities in the soil. This happens at the very foundation of the food chain and therefore has a strong effect on everything that depends on it. Biological farms cannot shelter from heavy rains and are therefore also confronted with washing out of micronutrients from the soil. Even while on a biological diet, basic supplementation remains essential. 

 

Fish: Omega-3-fatty acids

Omega-3 fatty acids from fish play a key role in human health. Omega-3 fatty acids determine the quality of the cellular membranes in our bodies, including the heart and the brains. The better one cares for the membranes, the better they can do their work for us. Unfortunately, not many of us eat enough fish.

Anyone who does eat fish, should make sure to primarily eat fish that has been caught in the wild. Wild fish species are always preferred to fish from aquaculture, which has antibiotics in its feed. In addition, fish must have been able to swim freely to reach an optimum nutrient density. In this regard, oily fish from cold waters is preferred, as they produce more essential fatty acids to provide good insulation from the cold. 

There is a catch though: many species of fish contain heavy metals and other contaminants. If one does not consume fish more often than twice a week, this probably does not pose a serious risk, especially when fish is supplemented with vegetables and garlic. These contain a range of substances such as methionine, cysteine, chlorophyll and choline, which are able to bind to (chelate) toxic substances. 

The question remains, however, whether consuming fish twice a week is really sufficient. What is most important to the body is the relative amounts of omega-3 and omega-6 fatty acids. We do get copious amounts of omega-6 fatty acids through vegetable oils, meats and processed foods. In our western diets, the proportion of omega-6 to omega-3 fatty acids is 15-25 : 1, while ratios of about 5:1 to 1:1 are most desirable. When there is relatively more omega-6’s in our diets compared to omega-3’s this has a pro-inflammatory effect, which, in the longer term, is associated with a range of chronic inflammatory diseases. 

To regain a balance between omega-3’s and omega-6’s, it is of the essence to drastically reduce the intake of omega-6’s. This puts quite some strain on the consumer, for instance because they have grown accustomed to being able to grab anything appealing a supermarket has to offer, while alternatives have to be actively looked for. In short: basic supplementation with purified omega-3’s is crucial for nearly anyone to regain a healthy ratio of omega-6’s to omega-3’s in the order of 5:1, or preferably 1:1.  

Lack of vitamin D

The amount of vitamin D3 that the body can synthesize while unprotected from sunlight in half an hour is more than 20,000 IE (500 mcg). The amounts that may be obtained from food are listed in the  table below.

 

Sources of vitamin D	IU/100 g	mcg/100 g
Herring liver oil	140.000	3500
Cod liver oil	10.000	250
Sardines	1.500	38
Skin (chicken, turkey)	900	23
Salmon	200-400	5-10
Herring	330	8

 

Based on the table above, it can be concluded that one needs to eat oily fish such as salmon at least on a daily basis to obtain the recommended daily allowance, or to at all obtain anything close to blood levels that are common in hunter-gatherers living around the equator (see below RDA versus hunters-gatherers). Therefore, in Western Europe, nutritional supplements need to be used to increase blood levels to more natural values.

 

Dutch RDA and supplementation advice

In the table below, you will find the RDA for the Netherlands (Voedingsraad, 2000) and the supplementation advice of the Dutch Health Council (Gezondheidsraad).

 

Population	RDA*	Supplementation advice 2012**
(mcg/IE)	(mcg/IE)
Kinderen
0-4	5/200	10/400
4 and up	2,5/100	-
Volwassenen
General	2,5/100	-
Woman (4-49)	-	10/400 (dark skin)
Woman (50-69)	-	10/400
Woman (70+)	-	20/800
Pregnant woman	7,5/300	10/400
Men (4-69)	-	10/400 (dark skin)
Men (70+)	-	20/800
Eldery (70+) general	12,5/500	-

(*voedingsraad 2000, **Gezondheidsraad 2012)

 

RDA versus hunters-gatherers

The recommended daily allowance in the Netherlands is based on maintaining blood levels of, on average, 30 nmol/L. In many people, blood levels are even lower than that. Western European city-dwellers have blood levels of, on average, 20 nmol/L. Hunters-gatherers around the equator have blood levels of around 115 nmol/L. Natural blood levels of vitamin D3 are therefore nearly six times as high as those of people living in cities.

 

Orthomolecular advice

For several health-related reasons, from an orthomolecular viewpoint, blood levels of at least 80 nmol/L are advisable. Neither the RDA, nor the supplementation advice of the Health Council are sufficiently high to achieve this goal. Optimum levels differ per client, but to obtain 80 nmol/L one should administer at least 45-50 mcg vitamin D a day. The higher the dose, the easier it is to increase vitamin D3 in the blood to desirable levels.

 

Tips on choosing (multi)vitamins, minerals  and fatty acids

When opting for basic supplementation, it is important that the vitamins and minerals one administers do indeed help one reach the desired blood levels. That is why one has to pay close attention to biological availability. Below, please find a list with a number of characteristics that nutritional supplements should ideally have.

 

(Multi)vitamins and minerals

• Should mainly contain organically bound minerals with a high bioavailability which are easily taken up by the body
• Should contain all important minerals, including selenium, chromium, boron, molybdenum, iodine, manganese, copper, sulphur and silicon
• Should mainly contain vitamins  in their natural complex forms, for instance all eight B vitamins together with the synergists PABA, inositol and choline
• Should be sufficiently highly-dosed to be effective
• Should contain synergists for a better effect and better absorption such as amino acids and herbal extracts
• Should not contain undesirable excipients, such as talc, lactose, titanium dioxide and iron oxide
• Should not contain unnecessary sugars, sweetening agents, starch, artificial colourings, flavourings and aromas

 

Fatty acids from fish and krill

• Only use fish fatty acids that are in the form of triglycerides; this form is of natural origin, is more highly bio-available, is better absorbed by the body, is more effective at a lower dose and is safer in use than the much-used artificial ethyl esters
• Fatty acids in krill are made up of phospholipids; this form of the fatty acid is best absorbed by the body
• Fatty acid emulsions offer convenience, but should be produced using triglycerides, not ethyl esters

 

Vitamin C

• The most effective form of vitamin C offering the highest bio-availability is ascorbate complex with the supporting minerals potassium, magnesium and zinc
• Vitamin C occurs in nature together with supporting citrus bioflavonoids and should therefore also be of this form in nutritional supplements

 

Vitamin D

• Vitamin D3 binds better to the vitamin D receptor and as a result is about ten times as effective as vitamin D2
• An olive oil matrix offers better absorption of vitamin D in the intestinal tract which makes it more effective at a lower dose

 

Magnesium

• There are two organically bound forms the body can absorb very well: bisglycinates and citrates
• Magnesium oxide is not effective: the body does not take it up, but excretes it while causing loose and watery stools
• At least the synergist vitamin B6 is included in the nutritional supplement

 

Conclusion

As nutrient densities in our crops are proven to be decreasing, the RDA has not been adapted to the current nutrient content of fruits and vegetables, we consume insufficient amounts of fish and receive insufficient quantities of sunlight, it is essential that multivitamins and minerals, omega-3’s, vitamin C, vitamin D and magnesium are taken as basic supplementation by everyone in Western Europe.  

In addition, the fact remains that people who do get enough sunlight, consume biological fruit and vegetables on a daily basis and love to eat fish are seldom encountered in your practice. Therefore, in particular within a therapeutic setting, it is essential to offer basic supplementation to your client from day one. 

This has another benefit: it becomes clear soon enough whether the problems are strictly related to nutrition, or that something more is the matter. As many health professionals undoubtedly know, many problems can be prevented or treated by taking care of proper nutrition, supplementation and physical exercise alone.

 

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