Dietary supplements

Do you know what you are getting?

photo of dietary supplements on store shelvesWe are all tempted to try to slow down the inevitable aging process. Dietary supplements seem attractive as a means to hold the aging process at bay. Some people perhaps see supplements as a shortcut to proper nutrition. Stores such as GNC specialize in supplements and grocery stores usually devote several shelves to these products. Dietary supplements include fish oil, herbal products, vitamins, minerals, fiber, fatty acids, and amino acids and maybe some other things. In fact, use of dietary supplements is growing and as an industry it generates something like $30 billion in annual sales in the US. CNN reports that more than half the adult US population uses dietary supplements and that there are over 50,000 dietary supplement products.

However, dietary supplements have been under suspicion for some time. The New York Times has published a series of articles dealing with dietary supplements. This series began with an article November 3, 2013 reporting on studies that found that “DNA tests show that many pills labeled as healing herbs are little more than powdered rice and weeds.” According to a subsequent report in the Times, their November 3 article prompted an investigation by the New York Attorney General. In February 2015 The New York Times reported that the New York AG “accused GNC and three other retailers of selling herbal supplements that were fraudulent or contaminated with unlisted ingredients that could pose health risks to consumers…” Most of us expect that products are what they say they are.

Unfortunately for the public, regulation of diet supplements is minimal. Contrary to what you might think, supplements are considered food under US law and not subject to any mandatory testing prior to being put on the market. In the case of the tested supplements, consumers were not even getting what was listed on the labels. The Times article said: “The authorities said they had conducted tests on top-selling store brands of herbal supplements at four national retailers — GNC, Target, Walgreens and Walmart — and found that four out of five of the products did not contain any of the herbs on their labels. The tests showed that pills labeled medicinal herbs often contained little more than cheap fillers like powdered rice, asparagus and houseplants, and in some cases substances that could be dangerous to those with allergies.” The New York Times also published a more detailed list of the results of the AG’s analysis. To its credit Walmart said it would remove the products in question from its stores nationwide. GNC later came to a significant agreement with the New York AG. The New York Times, this time on its editorial page, praised GNC’s announcement that it would toughen its standards and tests to authenticate its herbal products. GNC is, by the way, the largest specialty retailer of dietary supplements and hopefully will set the standard for others to follow.

This agreement really covers herbal products only. Many other types of dietary supplements are probably not covered and much remains to be wary of. As an example, many people also turn to certain types of supplements for weight loss and as alternative medicine. Another report from the New York Times on December 21, 2013 describes an incidence of severe liver damage from dietary supplements. The Times reports that: “New data suggests that this is not an isolated case. Dietary supplements account for nearly 20 percent of drug-related liver injuries that turn up in hospitals, up from 7 percent a decade ago, according to an analysis by a national network of liver specialists.”

Another quote from the December 2013 article shines light on the real problem. The article states: “The F.D.A. estimates that 70 percent of dietary supplement companies are not following basic quality control standards that would help prevent adulteration of their products. Of about 55,000 supplements that are sold in the United States, only 170 — about 0.3 percent — have been studied closely enough to determine their common side effects, said Dr. Paul A. Offit, the chief of infectious diseases at the Children’s Hospital of Philadelphia and an expert on dietary supplements.” Apparently some weight and work-out supplements contain BMPEA, which is an amphetamine-like substance. Instead of BMPEA some supplement manufacturers have listed acacia rigidula, a rather obscure botanical, in the ingredients to mask the presence of the substance. This can be a serious health risk according to Canadian authorities who had all supplements containing BMPEA pulled from shelves.

Once again the New York Times on April 7, 2015 provides coverage. “The Food and Drug Administration documented two years ago that nine such supplements contained the same chemical, but never made public the names of the products or the companies that made them.” Only this week Vitamin shoppe announced that the retailer is pulling all products containing acacia rigidula from store shelves.

Fortunately, the most commonly used supplements, vitamins, minerals and fish oil have so far been free from such serious adverse side effects. But even if you get what is listed on the label, does it do you any good? Even if it is known that calcium strengthens bones, does taking a supplement truly increase your bone density? No one really knows because no testing is required. As a consequence, not much research has been done, but the little that has does not seem especially encouraging. One supplement that has been studied is fish oil, “…the third most widely used dietary supplement in the United States.” The bulk of the studies call into the question the efficacy of fish oil supplements. To quote from the article: “The vast majority of clinical trials involving fish oil have found no evidence that it lowers the risk of heart attack and stroke.”

So back to the question, will taking supplements provide me any health benefits? One of the more honest and straight forward appraisals I could find begins with the question: Do I really need them? The answer is “First and foremost, nutritional needs should be met by eating a variety of foods as outlined in the Dietary Guidelines for Americans. In some cases, vitamin/mineral supplements or fortified foods may be useful for providing nutrients that may otherwise be eaten in less than recommended amounts. If you are already eating the recommended amount of a nutrient, you may not get any further health benefit from taking a supplement. In some cases, supplements and fortified foods may actually cause you to exceed safe levels of intake of nutrients.”

For now I leave it at that. You might also consider a subscription to the New York Times.

Do you need a dietary supplement? “Usually not” according to the NIH Institute on Aging. Read more on their website.