Health conscious Kiwis are spending more than a billion dollars a year on vitamin supplements yet a leading nutritionist says many of us do not eat enough fruit, vegetables or whole foods.
Sarah Hanrahan, CEO of the New Zealand Nutrition Foundation, says while supplements can be beneficial for people in certain situations eating plenty of vegetables, fruit, whole grains and whole (unprocessed) foods is the most affordable and sustainable path to a healthy diet.
"Feeding your family shouldn't require you to even consider words like carbohydrate, magnesium and omega 3, 6 and 9," she says. "I always start with food, plenty of whole foods like eggs but with an emphasis on vegetables. When it comes to vegetables I say the more the better, yet on the whole, unfortunately, a lot of people don't eat enough of them."
Her comments come as figures show supplements are big business. Food and nutrition writer Niki Bezzant estimates more than a billion dollars a year is spent on supplements in New Zealand (in Australia the figure is over $9 billion) while a 2015 Southern Cross Healthcare Group survey suggested more than 1.5 million Kiwis regularly take supplements - many spending $50 or more a month to do so.
"Some are really expensive," says Bezzant. "There are prominent natural health advocates and self-titled nutritionists who will happily sell you supplements online that will set you back close to $300 a month."
Hanrahan says there are situations where people may need to supplement - such as women or teenage girls deficient in iron, for example - but most people should be able to get all the nutrients they need from eating a balanced whole food diet and the recommended servings of three vegetables and two fruits a day.
She says eggs - which have been labelled by some as nature's multivitamin - are a good example of a highly nutritious whole food that is also affordable. On average a single egg costs around 46c or around 32c by buying a tray of 30 (and even at the upper price range for cage free eggs the price would only be around 61c).
Hanrahan says she believes one of the reasons people don't eat enough fruit, vegetables and wholefoods is because they think they can't afford to (a 2019 University of Auckland study supports this view, saying poverty is a factor in why only one in two Kiwi children eat three or more servings of vegetables a day).
"But this is where eggs can be so valuable," Hanrahan says. "They are versatile and affordable and fit well into most diets. They contain a wide range of important nutrients and are a complete protein meaning they contain all the essential amino acids needed for healthy body functions."
Included among the vitamins, minerals and antioxidants eggs contain are selenium (helps protect the immune system), vitamin B12 (for brain and nervous system functions), vitamin A (for eye health), vitamin E (protects against disease), iron (produces haemoglobin which carries oxygen around the body), vitamin D (bone health) and calcium (for building and maintaining bones and teeth).
The New Zealand Ministry of Healthy Eating and Activity Guidelines say eggs can be eaten every day of the week. The NZ Heart Foundation advise that six to seven eggs a week is okay even for people at risk of heart disease - while Hanrahan says eggs should be considered a key part of a balanced diet.
"No single food can give you all the nutrients you need and there is no one right dietary pattern," Hanrahan says. "But if people follow dietary guidelines and especially eat plenty of vegetables then this will give them a really good healthy base."
Advocates for the use of supplements argue they are necessary in part because modern and intensive agricultural methods have stripped nutrients from the soil in which food grows - and have exposed people to ever increasing levels of pesticides.
But Bezzant, who is also editor-at-large of the Healthy Food Guide, says there is no evidence this is true in New Zealand and only limited evidence it's true anywhere else in the world.
In an article published in the NZ Herald in February, Bezzant said if people eat well and live a generally healthy life they should, in theory, get everything they need from food.
And like Hanrahan, she is a fan of eggs. "They are right up there on my list of favourite foods and not many days pass for me without an egg in them."
She said around a third of Kiwi women and a quarter of men regularly take some form of supplement: "It's estimated we spend more than a billion dollars a year on supplements like vitamin C, omega 3, garlic and Echinacea."
However Bezzant said supplements might be useful in specific situations under medical advice.
"For example, folate and iodine are recommended during pregnancy, vegans need to take vitamin B12, or eat foods fortified with B12, since they can't get it from a plant-only diet," she said.
"People who spend very little time outside and have dark skin may need vitamin D supplements during the winter; people with osteoporosis or low bone density can be prescribed calcium supplements or infusions."
Bezzant said in the article multi-vitamins are probably not a great long-term solution to health: "That's because the vitamins and minerals are all wrapped up in what they call the 'food matrix'. That means whole foods are more than the sum of their nutrients, they're complex and their benefits come from that whole.
"So what's the best advice when you're standing in front of all the rows of supplements in the store? Think about how much fresh whole food you could buy for that money. In the end that is highly likely to give your health more of a long-term boost."
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