Dance Health

Dietary Supplements: Are they necessary and safe?

The dietary supplement industry is estimated to be worth between $23 billion and $32 billion per year and growing^1,2. Recent headlines report fraud in the industry, leading us to question if we can trust labels and claims. In some cases we might need to supplement what we are not getting through food alone. It’s undeniably better to get nutrients through food rather than a pill and we can’t expect a bottle to solve all our problems⁹, but for many of my dancer clients, I do recommend specific supplements based on their individual needs.

Dancers and other aesthetic athletes have been found to get most of what they need through food intake with a few key exceptions^3,4. Studies indicate that some don’t get adequate vitamin E (an antioxidant), Vitamin D (bone health and immunity), calcium (bone health, muscle function) iron (oxygen carrying capacity), magnesium (muscle function), and potassium (electrolyte and muscle function). Some might potentially need probiotics (microbes that colonize a healthy gut) for digestive health and immune function. Omega 3’s are essential fats that might help with nerve and brain function or decrease inflammation. Herbs could potentially help with stress relief, sleep, or energy, if they are good quality, fresh, and taken in sufficient quantity. We know we need specific amounts each day for optimal health, but what’s the best way to get them?

List of nutrients shown to be deficient in average dancer’s diets:

Nutrient	Amount/ day	Healthy Food Sources
Vitamin E	11-15 mg	Almond milk, almonds, leafy greens, vegetable oils, nuts, seeds
Vitamin D	600-800 IU	Sunlight, fatty fish, fortified cow’s milk and non-dairy milks/ yogurts. Supplements may be needed
Calcium	1000-1300 mg	Soy milk, tofu, tempeh, beans, broccoli, leafy greens, almonds, non-dairy milks, cow’s milk, soy and coconut yogurts, chia seeds. If supplements are necessary, calcium citrate is better absorbed.
Iron	8-15 mg	Beans, leafy greens, dried fruit, clams, tofu, baked potato, tofu. Eat with fruit to increase absorption. Supplements could cause intestinal problems or constipation so limit them to low doses and only if necessary
Magnesium	240-420 mg	Almonds, cashews, peanuts, tofu, leafy greens, avocado, black beans, sunflower seeds, brown rice.
Potassium	4500 mg	Baked potato (with skin), bok choy, spinach, leafy greens, banana, oranges, pinto beans, tomatoes, broccoli. Most vegetables and fruits.
Omega 3 fatty acids	1.5-2 g	Walnuts, flax and chia seeds, canola oil, fatty fish like salmon, some algae.
Probiotics	Undetermined	Soy, coconut and almond yogurts, kefir, fermented foods like kim chi. Supplements may be needed
Protein	Needs Vary	Only needed through food alone. Powders and supplements typically lead to overconsumption and are not usually necessary in healthy people.

It is especially concerning to read reports of fraud and misleading labels on popular supplements at respected retailers. The New York Times reported on herbal products and “found that four out of five of the products did not contain any of the herbs on their labels. The tests showed that pills labeled medicinal herbs often contained little more than cheap fillers like powdered rice, asparagus and houseplants, and in some cases substances that could be dangerous to those with allergies^5,6.” Last year The Centre for Science in the Public Interest filed a class action lawsuit against the manufacturer of “One A Day” for false and misleading claims on its label⁷.

But before you buy anything that you plan to ingest, it’s important to know that this billion-dollar industry isn’t regulated by any governing body or authority. While there are supplements that don’t live up to their labels, some companies do produce a quality product so we can’t accuse all manufactures of attempting to pull the wool over consumer’s eyes (see resources below).

Nutrition claims are money makers. There is not a lot of money selling carrots, but there is in selling vitamin A. Some supplements might be pitched by someone who may have little to no formal education in nutrition. There may be no ability to cross reference for medicine contraindications or to determine if intake reaches an excessive level that could be harmful.

In the words of a leading sports nutritionist Dan Benardot PhD, RD, FACSM “More than enough is not better than enough”⁸. Mega doses can be harmful. For example essential omega 3 fatty acids are called essential for a reason, but in high doses they also increase blood viscosity and decrease blood clotting time. This could increase risk for bleeding in the event of an accident or surgery. Beta carotene, a form of vitamin A in leafy greens and orange vegetables, can reduce cancer risk when eaten in food. However, beta carotene supplements were shown to increase cancer deaths in smokers by 46%⁸. Excess vitamin C from supplements or powders can increase bone loss and excess vitamin D can lead to hypercalcemia (excessive calcium in your blood leading to weakened bones, kidney stones and/or heart and brain issues.)

There is much lower risk of excess when we get nutrients through food! The body can decide how much of a nutrient to allow into the tissues in most cases. T. Colin Campbell’s ground breaking book ‘Whole’ states that we over focus on individual nutrients when we should realize that the whole is greater than the sum of its parts. This is called “reductionism” and it’s complicating the field of nutrition. It’s the synergistic symphony of a host of related nutrients and phytonutrients that makes the difference in human health.

When we get vitamins, minerals, amino acids, fiber, and even herbs from actual plants and not pills we know what we are ingesting and we are saving money in the process. Eat real food, mostly plants, and talk to a knowledgeable registered dietitian to determine your individual supplement needs. Sports Dietitian Ellen Coleman has a free online reference to help athletes determine whether a supplement is right or safe for them, and nutritionist Kelly Dorfman is a good reference on supplements for kids and those with digestive problems (see sources 10,11). The Centre for Dance Nutrition and Dancer Nutrition LLC also provide services to clarify supplement confusion, and determine individual needs.

Emily Harrison
By Emily Cook Harrison MS, RD, LD
Emily is a registered dietitian and holds both a bachelor’s and master’s degree in nutrition from Georgia State University. Her master’s thesis research was on elite level ballet dancers and nutrition and she has experience providing nutrition services for weight management, sports nutrition, disordered eating, disease prevention, and food allergies. Emily was a professional dancer for eleven years with the Atlanta Ballet and several other companies. She is a dance educator and the mother of two young children. She now runs the Centre for Dance Nutrition and Healthy Lifestyles. She can be reached at emily@dancernutrition.com
www.dancernutrition.com