The honest answer: a balanced diet beats a handful of pills. But most people don't eat perfectly, and some nutrients are hard to get from food alone. Here's how to think about it.
Why Food Is Usually Better
Nutrient synergy: Vitamins and minerals in food come with cofactors that enhance absorption. Vitamin C in an orange comes with bioflavonoids. Iron in meat comes with B12.
Fiber and phytochemicals: Pills can't provide fiber or the thousands of plant compounds that affect health in ways we're still discovering.
Satiety and behavior: Eating real food is satisfying. Taking pills is not a meal.
Lower risk of overdose: It's hard to get toxic doses of vitamins from food. Easy with supplements.
Studies show the difference: Large trials (like VITAL and COSMOS) often show supplements don't replicate the benefits seen in people who get nutrients from food.
When Supplements Make Sense
Documented deficiency If blood tests show you're low in something, supplementation is the fastest fix. Getting your vitamin D from 80-100 ng/mL to normal through diet alone would require drinking a gallon of milk daily.
Dietary restrictions Vegans need B12. It's not in plants, period. Vegetarians may need iron. Those avoiding fish need an omega-3 source.
Therapeutic doses The doses used in clinical trials often exceed what's practical from food. Getting 3g of omega-3s would require eating a pound of salmon daily. A few capsules is easier.
Specific life stages Pregnancy: Folate from supplements is actually better absorbed than from food (folic acid vs folate). Elderly: B12 absorption from food decreases with age.
Poor absorption conditions Celiac disease, Crohn's, gastric bypass, and other conditions impair nutrient absorption from food.
The Both/And Approach
Smart supplementation isn't food vs pills. It's:
1. Eat as well as you can. Prioritize vegetables, fruits, whole grains, lean proteins, healthy fats.
2. Identify your gaps. Blood tests can reveal deficiencies. Your diet type (vegan, etc.) may have predictable gaps.
3. Fill gaps strategically. Supplement what you can't reliably get from food.
4. Don't use supplements as permission to eat poorly. A multivitamin doesn't negate a fast food diet.
The Supplements Worth Taking Anyway
Even with a good diet, these are hard to get enough of:
Vitamin D - Unless you live near the equator and spend hours outside daily, you're probably not making enough.
Omega-3s - Most people don't eat enough fatty fish. The conversion from plant ALA to EPA/DHA is very inefficient (5-10%).
Magnesium - Modern diets are lower in magnesium than historical diets. Soil depletion, food processing, and stress increase needs.
The Bottom Line
Food first, then fill gaps. The ideal approach combines a nutrient-dense diet with strategic supplementation of what you can't get enough of from food alone.