Some things like water and liquor are meant to be bottled, while other things like emotions, crackers, and green beans are not. In recent times, nutrition is increasingly being sought after in bottle, powder, and bar-forms, rather than through naturally occurring forms (also known as food). Bottled versions of vitamins and minerals clutter our kitchen countertops and cabinets so much so that the lyrics of “99 bottles of beer on the wall” should be changed to “99 bottles of supplements in the kitchen.”
The National Institute of Health (NIH) reports that Americans spend over $30 billion annually on dietary supplements. This converts to >$100 spent monthly on dietary supplements by every man, woman, and child in the United States. Dietary supplements can be found at a variety of locations including: supermarkets, drug stores, specialty stores (Vitamin Shoppe, GNC), warehouse stores (Costco, Sam’s Club), and large commercial stores (Target, Walmart). They are sold in different elemental forms, amounts, colors, and brands, making it difficult for us to know what it is we are actually purchasing. As a consumer, it is important to ask yourself why you are taking a particular supplement and whether you truly need it.
In order to understand the truth behind dietary supplements, we must first define what they are. The Food and Drug Administration (FDA) defines a dietary supplement as any dietary ingredient (including vitamins, minerals, amino acids, and herbs and botanicals) taken by mouth “that can be used to supplement the diet.” Supplements also include protein powders and energy bars. Simply put, a dietary supplement is intended to “supplement” the diet when something is missing rather than replace real food. So, if you eat a balanced diet containing a variety of foods from all five-food groups (grains, fruits, vegetables, protein, and dairy) you will essentially meet your nutrient needs, making it unnecessary to take supplements. In cases where we may eliminate specific foods or food groups due to a special diet (i.e. vegan/vegetarian, food allergies or intolerances) or we have a specific disease/health condition (epilepsy, kidney disease, GI diseases, cancer), supplements may be warranted for use. It is important to meet with a Registered Dietitian and/or get a blood test to check for any specific nutrient deficiencies before reaching for your wallet.
Americans are all about getting their hands on the latest food trend or product when information circulates about its benefits. For example, one day we hear that garlic is all the rage and the next thing we hear is that everyone and their mother, brother, sister, father, and neighbor are deficient in Vitamin D. We are results-driven, which often times puts science and safety in the passenger and back seats respectively. Unlike the food and beverages that you eat, the FDA does NOT regulate dietary supplements on the same standards. Federal law “does not require dietary supplements to be proven safe to FDA’s satisfaction before they are marketed…[additionally] the law does not require the manufacturer or seller to prove to FDA’s satisfaction that the claim is accurate or truthful before it appears on the product.” This means there may be ingredients that could cause unwanted side effects and/or interfere with prescription medications you may be taking. Many supplements contain ingredients that have strong biological effects, and such products may not be safe for all people. Because the FDA does not regulate supplements, scientific and evidence-based studies are not required to show the effectiveness of taking them. Therefore, you may be taking a bunch of capsules, powders, and chewables that do not even give you the result you are looking for. Next time you consider buying a dietary supplement, ask yourself, would you want to ingest something that has not been proven to be safe, proven to work, and may contain unsafe ingredients? My guess is that most of you would say “no” to all these questions.
There is some relief for consumers when it comes to evaluating the contents and safety of supplements. Third party companies, such as U.S. Pharmacopeia (USP) and NSF, are hired by manufacturers to test and evaluate the ingredients of their products for consumer safety. Remember, this service is not required of dietary supplement makers and serves as an extra step they voluntarily take to prove to consumers that their products do in fact have the exact ingredients in the specific amounts as advertised. So when you are selecting the best supplements, look out for the USP or NF seal to ensure the company went the extra mile to test its products.
Each nutrient is sold in a variety of elemental forms, making it difficult to identify the differences between them. For example, calcium supplements come in the following forms: calcium carbonate, calcium citrate, calcium phosphate, calcium orotate, calcium gluconate, and calcium lactate. And this is just one single nutrient! It is important to know which form you specifically need because not every form absorbs the same in the body. For most consumers, this information would have to be researched prior to making that trip to the store. Even though dietary supplements contain ingredients found in foods, you have to remember that they are still manufactured forms of nutrients and may not always mimic the exact chemical structure and elemental form of that nutrient as it occurs naturally in foods. Under the U.S. Dietary and Health Education Act 1994 (DSHEA), “nutritional supplements are regulated under ‘food’ good manufacturing practices, which means “absorption rates do not have to be tested.” There are several factors that determine the bioavailability, or the amount of the active ingredient that is actually absorbed by the body. However, without science-based studies to back up products, we are left somewhat in the dark. The key thing for consumers to understand is that the ingredients and amounts of each found on a supplement label is not a realistic indication of the amount that actually makes it into your bloodstream for use in your body.
When it comes to meeting your nutritional needs, always think food first and dietary supplements second. Dietary supplements serve as your back-up source of nutrients when you are deficient or eliminate foods from the diet. They should only be used to complement a balanced diet once it is determined that you actually need one or more particular nutrient. We each spent $1200 annually on supplements, which means you could be saving hundreds of dollars and loads of time driving to stores and reading labels that don’t make sense. To find out if those many bottles of vitamins, minerals, protein powders, botanicals, and herbs on your kitchen counter are necessary, meet with a Registered Dietician. Let them help you sort out the facts and take your nutrition to new heights so that you can elevate your plate!