A beginner’s guide to dietary supplements – Las Vegas Sun
WHAT ARE SUPPLEMENTS?
According to the Dietary Supplement Health and Education Act of 1994, in order to be identified as a dietary supplement, a product must:
1. Enhance the human diet
2. Contain one or more dietary ingredients
3. Be taken orally in whatever form
The Consumer Healthcare Products Association defines a “dietary ingredient” as any of the following: vitamins, minerals, herbs and other botanicals, amino acids, enzymes and potentially beneficial bacteria or yeasts. But supplements aren’t just about promoting health by filling in nutritional gaps or fortifying stores of particular vitamins and minerals. Some products advertise better mental, athletic or sexual performance. They might be natural, single-source extracts from plants or animal tissues, or targeted blends with chemically altered natural materials and others that are entirely synthetic.
How are supplements regulated?
“It’s a misconception that the industry isn’t regulated,” said Damon McCune, head of UNLV’s Didactic Program for Nutrition and Dietetics. “It is regulated, just very poorly.” Dietary supplements are jointly regulated by the Food and Drug Administration and the Federal Trade Commission.
• FDA: Supplements don’t need FDA approval before going to market, though companies must notify the agency of their product information and intent to sell. The onus is on the FDA to investigate products and manufacturing facilities and prove something isn’t safe in order to restrict use or remove items from shelves. “(Supplements) go through a more rigorous process than food inspection and a less rigorous one than drugs,” said the Council for Responsible Nutrition’s Duffy MacKay. Unlike prescription medications, supplements may only make claims about health broadly (though some companies break that rule), or about nutrient content or specific functions.
In its own effort to engage companies in bringing supplements to a level of consistent quality, the Council for Responsible Nutrition built a self-regulatory registry called the Supplement Online Wellness Library to “help create a rich and more complete picture of the marketplace for regulators, retailers and industry.”
• FTC: The FTC tracks responsibility in advertising claims. If it comes down on a supplement brand for having misleading practices, MacKay said, it sends a message throughout the industry that encourages other companies to get in compliance. But with limited resources and so many supplements to watch, matters get complicated. Among factors making regulation more difficult is abundant misinformation on the internet, MacKay says. “Just remember there are no magic bullets or quick fixes …”
Proven supplements work well for …
Can I take too much of a vitamin or mineral?
From Carol Haggans, registered dietitian and consultant for the National Institutes of Health’s Office of Dietary Supplements:
“It is possible to overdose. … All vitamins and minerals have a recommended intake, which is the amount people should strive to get from foods — and, if needed, dietary supplements — each day.”
“Vitamin A is one nutrient that can cause serious problems at high doses, including birth defects if a woman is pregnant. Iron can also be toxic at high intakes. Even some of the B-vitamins can cause problems at high doses.”
“Some vitamins, like B12, do not have an upper limit because they have not been found to be toxic at high doses. But even if there is no upper limit, consuming more than the recommended amount doesn’t necessarily have any benefit.”
Early in her journey to becoming a registered dietitian, Crystal Petrello said, she was obstinate when it came to incorporating supplements.
“I saw it as a snake-oil industry, and people were spending so much money,” she said.
But after working in the nutrition field, her mind was changed about the potential of certain products. She says she has experienced the benefits of supplements, though dietitians and even supplement-industry officials agree the approach to better health should be “food first.”
“There is a magic we don’t understand when it comes to eating food,” said Dr. Duffy MacKay, a licensed naturopathic physician and senior vice president of scientific and regulatory affairs for trade group the Council for Responsible Nutrition. “Some cool stuff happens when you eat a salad.”
Carol Haggans, a registered dietitian and consultant for the Office of Dietary Supplements at the National Institutes of Health, said it is possible to get all essential nutrients by eating a nutritious variety of foods, though there are exceptions.
“For example, all women who might become pregnant should get 400 micrograms of folic acid a day from either fortified foods or dietary supplements,” she said. “And men and women over 50 should get the recommended amounts of vitamin B12 from fortified foods or dietary supplements, because they might have trouble absorbing the vitamin B12 that is naturally present in food.” According to the NIH, scientific evidence backs some supplement use for overall health, such as taking calcium and vitamin D to fortify bones.
Damon McCune, who directs UNLV’s Didactic Program in Nutrition and Dietetics, said that while there are legitimate cases for taking supplements, consumers too often don’t consult physicians and dietitians about potential benefits and harmful interactions with other over-the-counter products or prescription medications. He also said food provides trace nutrients that supplements can’t, and that people jump to them too quickly without considering dietary changes that might pack more nutrition at a lower cost.
“The first thing people get wrong is that an overwhelming number don’t need supplements. People use supplements in place of food,” McCune said. “They are marketed so well that people go to them first.”
MacKay disagrees. He said studies have shown that supplement users already engage in healthy habits, from regulating their diets to staying away from cigarettes. “I’m not going to be popular for saying this, but I’ve heard this statement from the dietitian community forever,” he said. “People aren’t using supplements to offset terrible habits. That’s a myth.”
He further asserted that even the most health-conscious eaters might miss important nutrients. “We all travel, get stressed and eat birthday cake,” he said. “A multivitamin is a good insurance policy.”
Most people aren’t aware of their nutrient intake on a level specific enough to inform what needs supplementing, so conversations with a dietitian are a way to get started. Once you’ve created a food log and broken down your diet, you can apply Dietary Reference Intakes recommended by the Institute of Medicine’s Food and Nutrition Board.