Nutritional Supplements – Good For Our Health Or Not!
According to a Zion Market Research report, the global nutritional supplement market was valued at $132.8 billion in 2016. Furthermore, the report projects the value of the global supplement market to surpass $220 billion in 2022.
According to an estimate in the United States, more than 170 million adults use supplements. This is equivalent to 71% of adults in the United States. Research suggests the popularity of nutritional supplements among American adults is growing rapidly. Between 2003 and 2006 for example, only 53% of American adults used a dietary supplement.
Despite the increased prevalence of supplement use in the US, there is still a lot of debate on whether or not people should use nutritional supplements.
Dietary Supplements: What Are They?
The United States Food and Drug Administration defines a dietary supplement as any product which contains a “dietary ingredient” that is intended to enhance the nutritional value of an individual’s diet. A dietary ingredient may include either one or more of;
- Amino acids
- Herb or another botanical
- Substances meant to increase total dietary intake
- Concentrates, constituents, metabolites or even extracts of the above.
Nutritional supplements come in different forms including as tablets, soft gels, liquids, powders, and capsules. According to the Dietary Supplement Health and Education Act (DSHEA), nutritional supplements are categorized as a “food.” This is because they are meant to supplement one’s regular day to day diet. Popular supplements include Vitamin D, Vitamin C, multivitamin, calcium and Vitamin B and Omega 3 among others.
The Case For Using Nutritional Supplements
Nutrition is one of the biggest influencing factors when It comes to health and general well-being. Any gaps or shortfalls in nutrition are therefore believed to have the potential to impact on health negatively.
(Source: The Chiropractic Source)
1. Filling Nutritional Gaps
Surveys conducted in the United States suggest that many Americans have nutritional gaps in their diets. In 2005 for example, a National survey indicated that up to 93% of Americans get less than the estimated average requirement (EAR) for vitamin E from their regular diets.
The same survey shows that despite the relative accessibility of vitamin C (in fruits and vegetables), up to a third of all Americans still get less than the EAR for vitamin C. According to experts, more than two-thirds of American smokers get insufficient vitamin C yet they require it more than non-smokers.
Findings from some studies also indicate that large fractions of the American population do not get the required amounts of minerals such as iron, zinc, and magnesium. These deficiencies may have certain repercussions on the health of the affected. For example, pregnant women with low iron levels may experience an inability to engage in physical work and may even have problems with their cognitive functions.
In the elderly, low levels of zinc minerals may have an adverse impact on their immune systems. People who do not consume dairy products are also likely to have calcium deficiencies. Calcium deficiency may result in severe symptoms such as confusion /memory loss, depression, hallucinations and even fragile bones that break easily.
Based on the above facts, experts suggest that people can use nutritional supplements to fill their nutritional intake gaps. In a study of over 6,000 people, researchers observed that people who use supplements are more likely to achieve the EAR levels of calcium, vitamin C, and even magnesium. Additionally, a 2016 Council for Responsible Nutrition (CRN) report, 28% of nutritional supplement users do it to fill nutrient gaps in their diet.
Nonetheless, it is important to note that the findings of this study indicated that supplement users were also more likely to surpass the tolerable upper intake level of these nutrients. This is the intake level beyond which the excessive nutrients may pose certain risks and health effects.
2. Depleted Nutritional Value Of Food
There are also those who believe that modern day foods are not as nutritional as they once were hence creating a need for supplements. The depletion in the nutritional value of food depends on various factors including;
- Intensive farming prevents nutrients in the soil from naturally replenishing hence resulting in plants with lower nutritional value.
- The popularity of hybrid crops which have lower nutrient contents.
- The widespread use of superphosphate fertilizers in place of manure. These fertilizers are rich in nitrogen, potassium, and phosphorus but are lacking in many other important nutrients.
- Increased use of pesticides and herbicides which have negative impacts on soil microorganisms hence leading to lower nutrient content in crops.
- Food processing is also known to remove huge amounts of nutrient content. For example, polishing rice is known to deplete up to 75% of the zinc and chromium content.
3. Benefits On Health And General Well-being
The 2016 Council for Responsible Nutrition (CRN) report also established that the major most reason behind the prevalent use of supplements among American adults is to improve overall health and well-being.
Much of the debate on vitamin and mineral supplements revolves around the issue of the supplements’ health and well-being benefits. Nevertheless, evidence from various studies indicates that taking certain nutritional supplements has positive impacts on health.
- A National Institutes of Health study submitted that postmenopausal women who took calcium and vitamin D supplements had increased bone density and subsequently, experienced fewer fractures.
- Vitamin D supplements are also known to aid in the digestion of calcium
- Among pregnant women, folic acid (a synthetic B vitamin) is known to play a pivotal role in reducing the risk of neural tube congenital disabilities (NTDs).
Epidemiological evidence shows that the use of multivitamins containing folic acid also protects against other congenital disabilities such as cleft lip and cleft palate. Experts recommend an extra 400 micrograms of folic acid on a daily basis for at least a month before pregnancy and one to three months after conception to protect against NTDs.
4. To Boost Energy And Physical Performance
Based on the 2016 Council for Responsible Nutrition (CRN) report, 30% of nutritional supplement users take them for purposes of boosting energy. This makes it the second most popular reason for supplement use.
B vitamins, for example, are known to play a critical role in the production of energy. They act as coenzymes which make it easier for the body to convert carbohydrates, fats, and proteins into energy it can use.
Indeed many athletes and fitness enthusiasts are known to take supplements to boost their endurance and overall performance.
The Case Against Nutritional Supplement Use
As the popularity of nutritional supplements surges so, does the skepticism around the use of these supplements grow? Over time, opponents of nutritional supplement use have come up with some arguments in support of their stance.
1. Supplements Are Synthetic
Many of those advocating for the stand against the use of supplements point to the fact that a healthy diet is way more efficient in addressing the body’s nutritional needs. This is because supplements are more often than not synthetic versions of essential nutrients.
The synthetic nature of the supplements makes it harder for the body to absorb and utilize them effectively. Furthermore, experts have drawn attention to the fact that supplements often contain additives such as fillers, food color and other ingredients which may have an impact on how vitamin is absorbed in the body. In some cases, the combination of these ingredients may cause toxicity.
It is also worth noting that not everyone requires nutritional supplements. Especially not people who eat healthy and balanced diets. Experts recommend a less is more approach, even where supplements are necessary to fill nutritional gaps,
2. Dietary Supplements Are Inadequately Regulated
This is one of the biggest reasons behind the increased criticism of dietary supplements. As noted earlier, the Dietary Supplement Health and Education Act (DSHEA) supplements are included in the category of food because they supplement shortcomings in a daily diet.
The DHEA act has several implications. Firstly, dietary supplements do not need FDA approval before they are marketed for sale. This is unlike prescription drugs and over the counter drugs which have to meet strict FDA manufacturing requirements.
Manufacturers of nutritional supplements bear the responsibility of demonstrating through evidence, that their products are safe and that any information on the product label is truthful and accurate. On the downside, however, they are not legally mandated to provide evidence of this to the FDA.
The lack of proper regulation also means that the legibility of health-related claims on supplement labels is questionable. In fact, according to the law, manufacturers of dietary supplements must make it known to their consumers that the claims they make are not FDA approved. Additionally, they are required to state that the product is not meant for purposes such as diagnosis, treatment, curing or preventing any disease.
The FDA plays a largely reactive role when it comes to supplements. It is tasked with monitoring supplements in the market to ensure content information is accurate and any claims made are truthful. The FDA may also pull out supplements it deems unsafe from the market.
The inadequate regulatory environment means that many manufacturers are free to make false and misleading claims. For example, a survey conducted on 41 different multivitamins sold in the U.S and Canada established that some had unsafe amounts of ingredients such as niacin, vitamin A, and magnesium. Others had lower levels of the nutrients stated on the nutritional supplement label.
3. Safety Concerns
Contrary to what most people think, they are a myriad of concerns surrounding the general safety of supplements to health and well-being.
- There is a heightened risk of contamination in dietary supplements. As a matter of fact, researchers have often found materials such as lead, cadmium and other metals in dietary supplements. These metals increase the likelihood of developing cognitive problems. Additionally, they increase the risk of life-threatening conditions such as cancer and heart disease.
- Some dietary supplements may also have the effect of interacting adversely with prescription drugs hence resulting in more health risks. For example, taking supplements before surgery may affect an individual’s response to anesthesia. Secondly, the use of Ginseng or even vitamin K supplements together with the blood thinners may prevent blood clotting. On the same line, antioxidant supplements including vitamin C and vitamin E may have an adverse impact on the effectiveness of some types of cancer chemotherapy.
- Many supplement manufacturers pack their products with extra amounts of active ingredients such as vitamins, herbs, and other nutrients even without knowing the possible effects of the heightened levels. Some ingredients may also have severe side effects.
In 2004 for example, the FDA banned the use of ephedrine alkaloids (found in the ephedra plant). Supplement manufacturers at the time marketed it as suitable for weight loss, enhancement of energy and improved physical performance.
Upon research, however, the FDA found a clear link between the presence of these alkaloids and an increased risk of cardiovascular diseases and even death. Ephedra is also linked with intensified seizures in individuals with seizure disorders. At the time of the ban, the FDA had received 16,000 reports of injuries, 62,000 consumer complaints, and at least 155 deaths from supplements containing ephedrine alkaloids.
4. Questionable Health Benefits
Most research on nutritional supplements tends to focus on the benefits of supplements to health. However, research critiquing and questioning the supposed health benefits of supplements is fast emerging.
- Previous research suggested that men who take vitamin E supplements are less likely to get diagnosed with cancer of the prostate. This claim is rebuffed in a more recent NIH-funded study which established that vitamin E supplements might actually increase the risk of prostate cancer.
- Some studies also seemed to suggest that vitamin and mineral supplements may help people live longer However many studies have proved these findings wrong. The most famous of these is the Iowa Women’s Health Study conducted on more than 38,000 women beyond 50 years and under 70 years. It was established that women who took multivitamin pills had a 6% increased rate of mortality than women who did not use supplements.
- Even in cases where supplements may have a positive impact on health and well-being, excessive amounts of the nutrients may have adverse health effects. Excessive amounts of vitamin C, for example, are known to increase the risk of contracting painful kidney stones.
On the other hand, Vitamin A is an antioxidant, but excessive amounts of the vitamin may cause severe symptoms such as nausea, vomiting, diarrhea and even blurred vision among other symptoms. Excessive vitamin B6 intake may also result in severe damage to the nerves.
Based on the facts above and evidence, three things stand out:
First, a healthy and balanced diet is the most important and most reliable source of vitamins and essential nutrients.
Secondly, nutritional supplements are recommended only for people with nutritional gaps in their diet and not as a replacement for food.
Third and perhaps most important, even when supplements are needed, experts recommend taking them in small amounts. In fact, it is advisable to seek the advice of a doctor before taking any supplements.
People who may need dietary supplements include;
- Those with medical conditions that may result in vitamin deficiencies. These include inflammatory bowel disease and celiac disease.
- Vegetarians and vegans may have nutritional gaps.
- People over the age of 50 years
- Pregnant women or those who are breastfeeding.
- People who suffer from food allergies