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Dietary supplements – unspecified components in the composition.
In public consciousness, the intake of dietary supplements is becoming an integral part of a healthy lifestyle. Especially after COVID-19, there has been a surge in demand for products that are advertised as beneficial for health.
Dietary supplements are biologically active substances of plant, animal, or mineral origin. Most people perceive them as something natural, which means, undoubtedly beneficial—manufacturers eagerly support this opinion for their own profit.
The market volume for food additives is currently estimated at $139.38 billion. Japan is the global leader in dietary supplement consumption, with 90% of the population using them, followed by India with 75%, and in the USA, about 53% of residents regularly take supplements.
The demand for dietary supplements is growing, but are they really beneficial for health?
A bit of alarming statistics – in the USA, approximately 20,000 calls to emergency services and 2,000 hospitalizations each year, where a person is in critical condition and therefore stays in the hospital for several weeks, are due to the intake of dietary supplements. Typically, these calls are related to poisoning from toxic components and also overdoses, including in children who accidentally ingested the product. Serious side effects recorded from the use of dietary supplements include stroke, acute liver damage, kidney failure, pulmonary embolism, and death.
But dietary supplements are not considered medications and therefore do not have contraindications. So why are there so many such cases?
As it turns out, dietary supplements may contain undeclared impurities that can have unpredictable effects on the body. These ingredients are often added with one simple goal: to make the consumer feel the benefits of the supplement and continue purchasing it.
For example, the U.S. Food and Drug Administration (FDA) found undeclared ingredients in 776 dietary supplements from 2007 to 2016. Some of these contained even six pharmaceutical ingredients.
Moreover, the total number and variety of products tested by the FDA is unknown, as the FDA can only test a fraction of the products available on the market. Even after warnings and requests to stop selling certain products, not all manufacturers comply; many find it more profitable to pay fines. There are known cases where dietary supplements containing ephedra resulted in over 100 deaths, and attempts to ban them lasted for 10 years.
Undeclared ingredients often appeared in weight loss products, where sibutramine, which enhances the feeling of satiety, was secretly added. In 2010, the FDA required manufacturers to indicate in the instructions that sibutramine should not be used by patients with a history of cardiovascular diseases. This substance can also cause severe addiction and dependency. For individuals dependent on sibutramine, withdrawal can exacerbate chronic conditions and disrupt the functioning of the heart, liver, and kidneys.
Such ingredients are also found in muscle-building supplements, popular among bodybuilders. Synthetic steroids are mixed in, which can lead to serious health consequences, such as liver dysfunction or the development of hypertension—a cardiovascular condition characterized by elevated blood pressure that can lead to heart attacks, strokes, kidney failure, and more.
We often think that if we take a dietary supplement in larger amounts, nothing will happen to us since it contains completely natural and harmless ingredients; however, that is not the case! We do not know what substances are actually present and, more importantly, we are unaware of the quantities in which manufacturers add these substances. This can create serious problems and even lead to overdose.
Even in herbal supplements, which contain only 1-2 components, there have been instances of missing substances listed on the label. Instead, rice flour, wheat, and even laxatives were often found.
Why are there so many negative consequences associated with dietary supplements?
There are several reasons for this. It occurs because:
- Dietary supplements include vitamins, minerals, and various other micronutrients that are not considered medications, as they are intended for healthy individuals rather than for treatment. Therefore, they are relatively easy to allow for sale, with minimal scrutiny in the evaluation process.
- Dietary supplements are not required to undergo clinical trials that would prove their effectiveness and safety.
- All side effects of medications are usually documented and listed in the instructions, which cannot be said for dietary supplements.
Dietary supplements are often recommended to clients by nutritionists and dietitians, many of whom do not even have a medical education. Even if they do have medical training, no specialist can say with 100% certainty what specific substances are contained in a given supplement.
Manufacturers advertise dietary supplements as effective means for improving cognitive abilities, boosting the immune system, and maintaining health. Those who see this advertising may develop a false impression that dietary supplements are the “magic pill” that is even better than medications, as they supposedly have almost no side effects due to their “natural” composition.
However, there is no scientific evidence to support this. For example, after summarizing 28 studies on the potential beneficial effects of various dietary supplements on the cognitive activity of elderly individuals, researchers from the Cochrane Collaboration — a reputable global entity in evidence-based medicine — found no confirmation of their effectiveness.
Currently, only supplements containing:
- Folic acid to reduce the risk of stroke,
- Omega-3 fatty acids, which may help alleviate symptoms of rheumatoid arthritis,
- Zinc,
are proven to have positive effects.
Other supplements, at best, will be harmless, and at worst, may cause side effects, especially when they contain toxic components, allergens, or when they interact with medications, which can also lead to complications.
Moreover, dietary supplements are so easily allowed for sale that anyone can start producing them without the necessary conditions and knowledge. For example, the author of this article has an acquaintance who produces dietary supplements in his garage, packing the tablets by hand and sticking on labels himself! His sales on Amazon are successful simply because he knows how to present his product well and how to properly advertise on that platform.
The main reason why people buy from him is that customers blindly trust manufacturers, who, in turn, take advantage of this trust. Most of us do not even consider that such “harmless” and “safe” supplements may contain additional ingredients. We hope that everything is controlled and tested, but that is not the case! For manufacturers, our faith is just a way to make money.
Statistics only prove this point. Currently, there are about 15,000 manufacturers in the market producing around 85,000 different types of dietary supplements per year, while regulators conduct only 400 inspections, with 60% of those revealing violations. Another important point is that inspections are conducted only after consumer complaints or reports of side effects.
Journalists discovered that behind the research and developments of Holik was financial gain. He received money from pharmaceutical companies producing dietary supplements with vitamin D and from laboratories that conducted analyses.
He even had a stake in companies that sold home tanning beds, promising that they would raise vitamin D levels without the need for dietary supplements. However, scientific research indicates that vitamin D obtained from tanning beds may be less effective and even dangerous, especially when it comes to an increased risk of skin cancer.
Agree, after this, it is already hard to believe in the good intentions of this person and those like him. But that’s not all.
How to protect yourself?
It has already been proven that the body absorbs trace elements better when they are part of food rather than taken separately. Nutrients in food are present in the optimal amounts and proportions for absorption, so it is best to stick to a balanced diet and a healthy lifestyle rather than trying to replace all of this with “miraculous” tablets, the real composition of which we can only guess.
Question/Answer:
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Is the quality of dietary supplements on the market currently monitored?
No. The FDA has the authority to conduct inspections only after products are released on the market, but such inspections are only carried out after consumer complaints.
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Are studies and tests conducted before dietary supplements are released on the market?
No, as they are not classified as drugs.
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Are dietary supplements really beneficial for health?
Despite their growing popularity, the safety and effectiveness of many dietary supplements have not been proven. Research shows that some supplements may contain undeclared ingredients, including those that are harmful to health. Currently, only dietary supplements with folic acid for reducing the risk of stroke, omega-3s which may help alleviate symptoms of rheumatoid arthritis, and zinc for collagen and protein synthesis have demonstrated positive effects.
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Why do health problems arise from taking dietary supplements if they are not classified as drugs?
Dietary supplements do not undergo the same strict quality control as drugs. They may contain impurities not listed in the ingredients, as well as hidden pharmaceutical components. Additionally, the lack of dosage control and interaction with other medications can lead to overdoses and side effects.
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What is important to remember when deciding to take dietary supplements?
- Dietary supplements are not a panacea and do not replace a healthy lifestyle.
- The safety and effectiveness of most dietary supplements have not been proven.
- Dietary supplements may contain undeclared and potentially harmful components.
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Author: Nadezhda Mikhalyeva.