FFrom multivitamins and melatonin to fiber and fish oil, Americans looking to boost their health and immunity can choose from a number of supplements. According to the Centers for Disease Control and Prevention, an estimated 58% of US adults over the age of 20 consume dietary supplements, and the supplement industry is worth more than $ 30 billion annually. The use of supplements has grown rapidly over the past few decades with the wellness industry.
“It’s a common belief that supplements will help improve health,” says Fang Fang Zhang, a professor at the Friedman School of Nutrition Science Policy at Tufts University. She also found that people who use supplements more often are more likely to have a higher level of education and income, a healthier lifestyle, and a healthy diet and exercise. “Therefore, people taking supplements are generally health conscious,” she says.
However, if you are already healthy, most supplements may not be very effective in improving your health or stopping death. “There is no clear evidence to suggest the benefits of using dietary supplements for many common or general health consequences,” says Zhang.
In some cases, the use of supplements can even be harmful.2015 study published in New England Journal of Medicine An estimated 23,000 emergency departments visit the United States each year due to adverse events associated with the use of diet supplements, many of which have been found to be related to weight loss and cardiovascular problems with energy products. Elyseo Galer, a professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health, said:
Some experts are calling for stricter federal regulations to ensure that supplements are safe and effective. Until then, consumers are advised to proceed carefully and perform due diligence before taking supplements.
What are supplements suitable for?
Vitamins, minerals, and many other micronutrients are essential to the body’s functioning and are an important part of a good diet. However, eating the nutrients contained in foods is not the same as taking them in the form of supplements. “The use of dietary supplements is not a substitute for a healthy and balanced diet,” says Zhang.
Vitamin and mineral supplements are very helpful when prescribed to people who are undernourished or have certain illnesses. “High-quality supplements should be widely available and are needed as part of the treatment,” said Dr. Pieter Cohen, an associate professor at Harvard Medical School and a physician at the Cambridge Health Alliance.
However, many packaged foods in the United States are already fortified with additional nutrients, making undernourishment rare for the general public. For most people, supplements may offer suspicious benefits.
In the analysis published in 2020 BMJZhang reviewed the results of several trials, but found no clear evidence that dietary supplements such as vitamins and minerals help healthy people to prevent chronic diseases such as cardiovascular disease and cancer. It was.
Evidence of certain plant-derived dietary supplements known as plants, such as echinacea and ginkgo, is further confusing. Scientists have tried to decipher the effects of many plants and dietary supplements, but there are still weak or contradictory results scattered in this area. “We know a lot,” says Gualar. “The problem is that claims can go beyond what we know.”
Many of the health claims that companies make to label supplements can externalize the results seen in animals to humans or make heavy use of what is still a preliminary finding. “These products shouldn’t be advertised as if they help our health, even if they haven’t been proven to work in humans,” says Cohen.
As a result, consumers do not know what to do with their supplement claims and can be confused about which supplements are useful. “This is also combined with commercial pressure to promote some of these supplements,” says Gualar.
How dietary supplements are advertised and promoted depends on how they are regulated by the US Food and Drug Administration (FDA) in their own right.
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Regulated as food, not drug
Many people take supplements because they want to improve their health, but the FDA regulates them as foods rather than medicines under the Dietary Supplement Health and Education Act of 1994.
“What happened in 1994 was that all of these products, from vitamins and minerals to plant extracts, were subcategories of food,” Cohen explains. “We also created a completely different structure for advertising, like the ability to promote a product that says,” This boosts your immune system, “as the code for” This prevents infection. ” He says.
Manufacturers do not need to prove that a supplement is effective or safe before selling it. In addition, supplements do not comply with the same manufacturing standards as pharmaceuticals, which can lead to adult and substandard products. “At least for now, separating low-quality products from the high-quality products on the market is basically very difficult, if not impossible,” says Cohen.
Part of the problem is that the current system isn’t doing enough work to track when supplements do harm, Cohen says. “I think we have to realize that the law needs to be amended to make high quality vitamins, minerals and plants available to the general public,” he says.
Cohen previously proposed changes to current regulations, including standardization of the manufacturing process, careful inspection of new ingredients, and the creation of higher standards for claims that manufacturers can make about supplements.
But for now, consumers can remember a few things when deciding whether to take a supplement.
Navigate the supplement corridor
When assessing supplements, keep in mind the extravagant claims as they are unlikely to be true. Also, keep in mind that some supplements may contain much higher doses per tablet or serving than necessary. “Sometimes these supplements are promoted at much higher doses than you get on a diet,” says Gualar.
In general, talk to your doctor about using supplements, as many supplements can interact with the medications you are taking. It may also be unsafe to take during pregnancy, lactation, surgery, cancer treatment or other treatments.
Consumers also need to know how to find low quality products. “My general advice to patients is to stick to supplements that list only one ingredient and avoid mixing things, except for multivitamins,” Cohen says. He cites certain certifications such as USP and NSF International as a sign of higher quality products.
Weight loss supplements, muscle builders, and sexual enhancers found in previous studies may contain illegal or obscure ingredients such as medicines and synthetic chemicals. These types of supplements are most likely to contain these private ingredients.
Finally, consumers can find information about specific vitamins, minerals and plants on trusted websites, such as those run by the Memorial Sloan-Kettering Cancer Center and the National Institutes of Health.
Conclusion
“We don’t eat a single nutrient. We eat food,” says Zhang. “That’s why many supplements don’t achieve the same benefits as natural nutrients that come from food sources,” she says.
Zhang states that scientific evidence can constantly evolve as researchers continue to study dietary supplements. But for now, there are more reliable ways to improve your health. “The use of dietary supplements should not be a substitute for a healthy diet and lifestyle,” says Zhang. “Unfortunately, there is no magical medicine.”
Details of popular supplements
Generally considered useful
Folic acid during pregnancy: Folic acid supplementation during pregnancy is well established to help prevent birth defects. “It’s considered a success story,” says Gualar.
fiber: Fiber supplements like plantain may help reduce constipation, prevent heart disease, and lower cholesterol, but dietary fiber also provides the vitamins and micronutrients found in all foods. ..
Melatonin: It may help with jet lag. However, the evidence that it helps with insomnia and sleep disorders is not particularly strong.
Postmenopausal Calcium and Vitamin D: Postmenopausal women may benefit from taking calcium and vitamin D supplements to prevent bone loss.
Supplement mix for adults with age-related macular degeneration: The combination of zinc, vitamins C and E, copper, lutein, and zeaxanthin may help delay vision loss in people with this eye disease.
Mixed or no evidence that they are useful
multivitamin: They are very common and an estimated one-third of adults in the United States consume them, but they reduce the mortality rate of healthy people and prevent major chronic diseases such as cancer and heart disease. There is no clear evidence that it helps. But experts say that multivitamins probably won’t hurt you either.
Echinacea: It may slightly reduce the chances of catching a cold, but the evidence is weak and there is little evidence that it can help treat colds and respiratory infections.
Ginkgo leaf: Studies show that this supplement does not improve cognitive ability or prevent Alzheimer’s disease or dementia.
Glucosamine and chondroitin: There is mixed evidence that they help relieve the symptoms of osteoarthritis.
Vitamin D: Despite much interest in its many potential health benefits, it is still unclear whether D supplements will be of great benefit to healthy people. And in people who do not have deficiency, Zhang found that very high doses of vitamin D may increase the risk of death from all causes and cancer.
Antioxidant: Antioxidants, including vitamins A, C, E, selenium, beta-carotene, and folic acid, have been touted for many health benefits, but so far they haven’t responded to hype. They do not appear to protect against heart disease, stroke, or cancer, and some can be harmful at high doses.
Omega 3 fatty acids: Eating foods rich in omega 3 fatty acids, such as fish, has been shown to prevent heart disease, but it is still unclear if taken in the form of supplements has the same protective effect. Some studies have shown that they may help protect against certain heart conditions, while others have shown no benefit.
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