In my last post, I concluded the controversial topics series, however I’m afraid this week’s topic is controversial as well . . .  Sorry.

On one end of the spectrum, those who think supplements are – at best – a waste of money which give false hopes and – at worst – a health hazard.  On the other end of the spectrum, those who claim supplements solve every health problem known to man with complete safety.

Both sides have points, but neither is correct.

Why Supplement?

Most people involved in healthcare will agree that America is in a self-induced health crisis.  The top four causes of death are between 60% and 90% attributed to poor lifestyle choices.

• Heart Disease is 80% preventable
• Cancer is 60% preventable
• Stroke is 80% preventable
• Diabetes (type 2) is 90% preventable

All these diseases continue to increase in prevalence year after year.

Most experts agree – lifestyle choices such as getting adequate physical activity, lowering body fat, quitting smoking, and consuming proper nutrition will bring these numbers down more than a little bit.

Study after study proves that simply eating 10 servings of fruits and vegetables per day makes a significant dent in these statistics.  But a huge gap remains between a well-known healthful lifestyle and the typical American diet.  The CDC estimates that less than 13% of Americans eat even 2 servings of fruit and 2-3 servings of vegetables per day.

And even healthy eaters have the deck stacked against them on the nutrition front due to reduced nutritional value of produce over the last 50+ years.  A 2004 study of 43 crops and six nutrients showed a decline in the nutrient content of 8% – 38% since 1950.

The fact is, 90% of Americans fall short of one or more important nutrient in their diet.

Do Supplements Work?

Yes.

A 13 year study of 15,000 physicians using multi-vitamins showed:

• 8% reduction in cancer incidence
• 12% reduction in cancer deaths
• 9% reduction in cataract formation

 

“Taking a daily multivitamin and mineral supplement not only helps fill known nutritional gaps in the diet of most persons in the United States (thereby ensuring normal body function and supporting good health), but may have the added benefit of helping to reduce the risk for chronic disease.” Frei et al, Annals of Internal Medicine, 160: 807-809, 2014

And a 20-year study of Shaklee supplement users compared to general multi-vitamin users and non-supplement users showed:

• 73% reduction in diabetes
• 39% reduction in high blood pressure
• 4x more likely to describe health as very good or excellent

 

Highly publicized pronouncements of supplements as an unnecessary waste of money are usually nothing more than opinions without scientific backup.  And when studies are cited, they usually relate to safety issues, false claims, or poor quality supplements.

Are Supplements Safe?

Safety is a real concern when choosing nutritional supplements.  The FDA does little to regulate the industry, so buyer beware is the rule.

Research your manufacturer.  Before purchasing a nutritional product, ask to see the source and processing methods for all ingredients.  Check out quality control standards and how they are enforced.  Only do business with a company that has a track-record of integrity and commitment to safety.

This is especially important when considering products for weight loss, energy, sexual enhancement, and bodybuilding.

98% of the drugs recalled by the FDA between 2004 and 2012 were dietary supplements.  All supplements recalled were for sexual enhancement, bodybuilding, and weight loss.

Almost half of supplement related ER visits are due to these high profit products with fly-by-night companies looking to capitalize on our desire for quick and easy results in a simple pill (or shake, or whatever).  These products can contain chemical stimulants such as DMAA and DEPEA, which work – but also cause heart palpitations, chest pain, and irregular heartbeat.  Also watch for weight loss products using diuretics, energy products with dangerously high levels of caffeine, and sexual products containing unsafe yohimbe bark.

Extreme caution is necessary with these types of products!

In case you are wondering about the other half of supplement related ER visits, about 13% are due to allergic reactions.  Just to be clear, 13% of supplement users do not end up in the ER with allergy attack.  About .015% of supplement users end up in the ER, and 13% of those are due to allergies.  The remainder (other than the four dangerous products mentioned) have to do with the elderly choking on large pills or children swallowing massive amounts of tasty vitamins.

Are Benefits of Supplements Exaggerated?

Where there is money to be made, marketing claims are exaggerated.

In general, weight loss of more than 1-2 lbs per week simply is not healthy and products promising more rapid weight loss should not be trusted.

And any company claiming a product will cure a bunch of diseases is probably lying.  Certain nutritional products can absolutely heal some conditions for many people and in some cases even reverse the progression of some serious diseases for some people, but not all illness in all people – or even some illnesses in all people.  The claim that a product will without a doubt cure all cases of something like cancer, for instance, is just irresponsible.

A common scenario . . . a company gathers some studies indicating the benefits of a certain ingredient, then creates a product with some amount of the ingredient and declares scientific research proves the effectiveness of the product.

There are two problems here.

First, the studies are not about the actual product.  Without considering ingredient levels and/or other ingredients, the studies are not much value.  Second, companies often cite only favorable studies even when less favorable studies also exist.

And sometimes products don’t even contain the nutrients claimed on the label.  At various times over the years, researchers have tested random samples of supplements available at retailers, supermarkets, and online vendors.  Invariably many samples fail to contain the primary ingredient(s) listed on the label.

The nutrition industry gets a black eye.

But the real problem lies with cost cutting and poor quality control measures of less scrupulous companies.  If a supplement company does not test its final product, it cannot declare with certainty the truth of the label.

Make sure your supplement company performs quality control tests throughout the entire manufacturing process.  And make sure the company performs peer-reviewed clinical studies published in scientific journals to back up product claims.

What About Cost?

Many lifestyle choices necessary for better health cost money.  In some parts of the country fresh fruits and vegetables are very costly, and organic produce can add to the expense.  Diet programs, gym memberships, and nutritional supplements all cost money.

Some people believe their health is worth the price tag.

Others are not so sure.  Studies about the cost savings associated with better health can be helpful.  More specific and thorough research is needed, but a 2015 meta-analysis using over 16,000 published studies found the following cost benefits of supplementation:

• decreased overall health care costs by 8.1%
• reduced hospital admissions by 16.5%
• decreased length of hospital stay/infections/post-operative complications
• reduced falls and limitations in the elderly

 

As I said, more work needs to be done to clearly show the cost of supplements compared to the cost savings for an average consumer.  We may be able to say an ounce of prevention is worth a pound of cure, but we can’t yet put dollar amounts to the prevention or cure.

What to Look For

Be cautious of exaggerated claims and nutritional fads.  Sound scientific research should back up all assertions.  Just because the internet is flooded with outrageous ads, doesn’t mean all nutritional products are fake . . . but the responsibility falls to the consumer to find a reputable company with safe products.

Understand – labels such as “natural”, “organic”, and “non-GMO” don’t guarantee quality or safety.  Companies with strict quality control standards and a reputation for safety carry weight.

Look for nutrients combined in similar balance to nature.  For instance, all eight essential B vitamins should be found in equal measure in a multi-vitamin or B-complex.  Daily Value of any nutrient should not exceed 250%.

 

Any claim that vitamins are derived from food is physically impossible – a company making such a statement is not trustworthy.

So yes, there is reason for skepticism and caution when considering nutritional supplements, but the weight of scientific evidence bears out a significant health benefit to nutritional supplements manufactured by an honest company which bases product development on proven science and which ensures quality and safety through rigorous quality control measures.