From the chalky children's vitamins many endured — or enjoyed — during their youth, to the rows of dietary supplements on offer on retailers' shelves today and social media feeds inundated with protein-powder-pushing influences, dietary supplements have long boasted an array of potential health benefits.

Today, many adults and children in the United States take one or more vitamins or other dietary supplements to help boost their health and help fill gaps in their nutrition. While most needs can be safely met through a healthy diet, regular physical activity, good sleep and proper hydration, supplements are sometimes used to help support overall nutrition.

No matter your health or performance goals, this National Nutrition Month, here are five tips to help you navigate the world of supplements.

1. Food should come first

Supplements should only supplement your diet and not replace healthy eating. A balanced diet built on whole foods, fruits, vegetables, lean proteins, whole grains and healthy fats can safely provide all the nutrients your body needs. Additionally, many nutrients found in whole foods are more bioavailable than nutrients in supplements, meaning your body is able to absorb and use the nutrients more readily. The nutrients found in whole foods also work together synergistically to maximize health benefits, a characteristic you often don’t see in supplements. Supplements should only be considered when the diet cannot provide all essential nutrients (like in the case of food intolerances or aversions) and all nutritional strategies and habits to support balanced whole food intake have been established.

2. Supplements are not closely regulated

Unlike food and medications, dietary supplements are not regulated by the Food and Drug Administration before hitting the market. This means that manufacturers don’t have to prove safety or effectiveness before selling a product. Products are only removed from the market or banned after safety concerns have been proven. Ultimately, this means that when you take a supplement, there is no way of knowing what you are putting in your body and how it may affect you and your health. Because of this lack of regulation, some supplements may:

• Contain different ingredients than listed

• Contain incorrect or unsafe dosages

• Be contaminated with harmful substances

• Lie or bend the truth on supplement claims

3. You should look for third-party products

Third-party testers are independent organizations that test products for content and quality. There is still risk involved with taking a supplement, but choosing third-party tested products helps to mitigate some of these risks by adding some level of verification of quality and purity. Some common third-party testing organizations to look out for include:

• NSF

• USP Verified

• Informed Choice

A certification from one of these third-party testers helps ensure the product contains what the label says. A few additional things to note about third-party testing are that if a product is third-party tested by one of these organizations, a stamp of verification is on the physical bottle of the product in addition to the webpage. Secondly, third-party testing typically goes by product and not by brand. A single brand may have some third-party tested products and other products that are not. Refer to the resources to find links to verified products search pages.

4. More is not always better

Taking high doses of vitamins or minerals can be harmful. When we consume more of a specific nutrient than recommended, our body can’t always process and remove it well, which leads to buildup and toxicity in the body.

Too much of some nutrients may cause:

• Liver damage

• Kidney problems

• Heart rhythm issues

• Digestive problems

• Changes to vision

• Bone and joint pain

• Skin changes

• Muscle weakness

• Increased risk of bleeding

Minerals and fat-soluble vitamins A, D, E and K are especially easy to take in excess because our body does not excrete them as easily. Water-soluble vitamins — vitamin C and B-vitamins — don’t pose as much risk for toxicity, but generally consuming quantities above the recommended daily allowance won’t provide additional benefits and the excess will be removed through the urine.

Remember, a high-quality and balanced diet will provide the RDA for most nutrients, but if you are interested in supplementation, make sure to avoid supplements with doses above 200% of the RDA.

5. Supplements can interact with medications

Some supplements, especially herbal supplements, can interfere with medications. In these cases, the combination of supplements and medication can have adverse effects on the body or decrease the efficacy of the medication, increasing complications with health status or chronic disease management.

Common examples include interactions between herbal supplements and:

• Blood pressure medications

• Blood thinners

• Diabetes medications

• Antidepressants

If you are taking medication, always talk with a health care provider or pharmacist before starting a supplement. Understand potential interactions with your medications and supplements you may be considering. Refer to the helpful resources provided for sites that can help you identify any potential interactions.

About the author:

Grace White is a registered dietitian with experience working in clinical, telehealth counseling and sports performance settings. She is currently pursuing her PhD in nutritional sciences at OSU and works with the Human Performance and Nutrition Research Institute as a graduate researcher and Project ECHO team member. She is passionate about delivering research-based resources to all communities and bridging the gap between evidence-based recommendations and practical and sustainable habits.