Is there evidence to suggest that nutrients in vitamin capsules are not as readily absorbed as the same nutrients in whole foods?

Question

I recently fell ill with a cold, and began to take a vitamin C capsule each day to help my immune system. When I noticed no change in my condition, I began to incorporate an abundance of citrus into my diet instead of taking the capsules. When I ate the citrus my condition began to improve markedly.

The ingredients listed by the vitamin manufacturer are:

• Ascorbic Cellulose Gel
• Hydroxypropyl Cellulose
• Croscarmellose Sodium
• Stearic Acid
• Magnesium Stearate
• Silicon Dioxide

Not excluding the possibility of coincidence, I was was intrigued. Has evidence been published to suggest that nutrients in whole foods like vitamin C in citrus fruits are more readily utilized in the body than nutrients in vitamin capsules?

Answer 1

The answer probably varies for different nutrients. An informal article by ConsumerLab.com indicates that many vitamins are better absorbed from natural sources, but a few are actually more readily absorbed from supplements.

Looking at Vitamin C specifically, a 2013 review article by Carr and Vissers concluded as follows (emphasis mine):

Overall, a majority of animal studies have shown differences in the comparative bioavailability of synthetic versus food-derived vitamin C, or vitamin C in the presence of isolated bioflavonoids, although the results varied depending on the animal model, study design and body compartments measured. In contrast, all steady state comparative bioavailability studies in humans have shown no differences between synthetic and natural vitamin C, regardless of the subject population, study design or intervention used. Some pharmacokinetic studies in humans have shown transient and small comparative differences between synthetic and natural vitamin C, although these differences are likely to have minimal physiological impact.

In other words, with vitamin C natural and synthetic sources appear to be equally bioavailable for humans. The authors do note that "Although synthetic and food-derived vitamin C appear to be equally bioavailable in humans, ingesting vitamin C as part of a whole food is considered preferable because of the concomitant consumption of numerous other macro- and micronutrients and phytochemicals, which will confer additional health benefits."

References:

• Carr, Anitra C.; Vissers, Margreet C. M. (2013). "Synthetic or food-derived vitamin C—Are they equally bioavailable?". Nutrients 11 (5). pp. 4284–4304. doi:10.3390/nu5114284. PMC 3847730.

Answer 2

Vitamin C bioavailability

According to the review Synthetic or Food-Derived Vitamin C—Are They Equally Bioavailable? (Nutrients, 2013), the bioavailability of vitamin C from foods and supplements is similar:

...all steady state comparative bioavailability studies in humans have shown no differences between synthetic and natural vitamin C, regardless of the subject population, study design or intervention used.

and, according to Institute of Medicine (in the US):

The type of food consumed has not been shown to have a significant effect on absorption of either intrinsic or supplemental vitamin C.

Vitamin C supplements as prevention for common cold

Vitamin C supplements, even in doses 200+ mg/day (more than 3 x recommended dietary allowance - RDA) do not likely help in common cold:

This review is restricted to placebo‐controlled trials testing 0.2 g per day or more of vitamin C. Twenty‐nine trial comparisons involving 11,306 participants contributed to the meta‐analysis on the risk ratio (RR) of developing a cold whilst taking prophylactic vitamin C. The failure of vitamin C supplementation to reduce the incidence of colds in the general population indicates that routine prophylaxis is not justified. Vitamin C could be useful for people exposed to brief periods of severe physical exercise. (Cochrane, 2007)

To get 200+ mg vitamin C from citruses, you would need to eat at least 3 oranges or 7 lemons.

Considering the above evidence, the improvement of cold symptoms was likely a natural process.

Bioavailability of other nutrients from foods/supplements

There is no general rule to say that nutrients from foods or supplements are absorbed better or worse; it can depend on a specific food and a specific supplement formulation.

Iron:

In our in vitro model, naturally iron-rich mineral waters and synthetic liquid iron formulations have equivalent or better bioavailability compared with ferrous iron sulphate tablets. (European Journal of Nutrition)

Iron-fortified foods:

Bioavailability of fortification iron varies widely with the iron compound used (56), and foods sensitive to color and flavor changes are usually fortified with water-insoluble iron compounds of low bioavailability. Iron compounds recommended for food fortification by the World Health Organization (WHO) (56) include ferrous sulfate, ferrous fumarate, ferric pyrophosphate, and electrolytic iron powder. Many cereal foods, however, are fortified with low-cost elemental iron powders, which are not recommended by WHO (57) and these have even lower bioavailability (AJCN, 2010).

Magnesium:

The results of serum and urine analysis indicated that Mg bioavailability was comparable for mineral waters with different mineralization levels, bread, and a dietary supplement. (Tandofline, 2017)

Mg supplements comparison:

Studies on the bioavailability of different magnesium salts consistently demonstrate that organic salts of magnesium (e.g., Mg citrate) have a higher bioavailability than inorganic salts (e.g., Mg oxide) (Nutrients, 2019)

Potassium:

The bioavailability of potassium is as high from potatoes as from potassium gluconate supplements. (AJCN, 2016)

In conclusion, even if most studies mentioned in this answer suggest that nutrients from foods and supplements are equally bioavailable, you need to check specific supplement formulations, for example, iron from many fortified foods and magnesium oxide can have poor bioavailability. Anyway, the studies show that most people with normal blood nutrient levels do not need dietary supplements (Int J. Prev. Med., 2012 ; Annals of Internal Medicine, 2014).

Answer 3

This is not a coincidence. Food-sourced vitamins are prized because of being in bio-available form, soluble and absorbable. The only way to make a vitamin more absorbable is to deliver it elementally, with no digestion required at all.

The best absorption rates are through sublingual administration of elemental sprays, no additives,no fillers, nothing except what your body needs for maintenance and repairs. There is a 2011 review of research here:

http://www.ijplsjournal.com/issues%20PDF%20files/nov2011/10.pdf