You know that overwhelming feeling you get walking into a GNC or Vitamin World? That is how I felt writing this blog. From 1994 to 2017 the number of supplement manufacturers went from 600 to over 7,000, a total of around 4,000 products to over 75,000 products and it went from a $4 billion-dollar industry to a $40 billion-dollar industry (a tenfold increase). All in the course of just 23 years. The supplement world is expanding daily and there are just so many different directions I could take this article. After talking to a few clients this week though, it became clear that we would all benefit from discussing the basics: effectiveness, quality, safety, and regulation. But don’t you worry, this is just the first of many posts uncovering the saga that is supplementation. So from the top…
Dietary supplements include vitamins, minerals, herbals, botanicals, amino acids, enzymes and many others (too many others if you ask me). All of these products must have a supplement fact panel that include product content and a list of active ingredients and other added ingredients per serving. Now, while I said they need to have all of these things on the label, I did not say that is actually what is in the container. Which brings me to regulation.
Time and time again supplement companies have been scrutinized about the quality and actual presence of listed ingredients in their products (i.e. GNC, Target, Walgreens and Walmart scandal and the Progenex scandal). Regulating supplements has become a monumental task for the FDA which also regulates medications. For medications the FDA requires premarket review and approval and is much more tightly regulated. This is not required for supplements.
For supplements, the FDA set up strict standards for companies regarding facility & labeling regulations, good manufacturing practices, and adverse event reporting requirements. They then monitor label information and claims. But like anything else in business, there are always going to be people looking to cut corners. This is where the FDA is struggling most right now. The steep increase in manufactures over the last 20 years has saturated the market and makes regulating all supplement companies and their products post-production incredibly challenging. So how can you be sure you are getting a quality product?
Dietary supplements are pretty complex, as you can probably already tell. The FDA has standards but many manufacturers have ignored these standards. Although the FDA can and does periodically inspect facilities and dietary supplements, they are really only finding existing problems. Want to avoid getting a bad product in the first place? Look for products that are third party tested. This means an independent organization tests the product’s quality to ensure their products contain exactly what they say it contains. These companies then get a seal of approval from these third-party organizations which is present for consumers to see on the label. Here is a list of the third-party organizations that offer quality testing:
As a general rule, the more ingredients or “Mega boost blends” (code for fillers) a supplement contains the worse off you are. If is says it’s a whey protein, the first ingredient better be whey protein. Minimal ingredients are always a better way to go in the case of supplements.
I want to start by saying supplements can NOT take the place of a variety of essential nutrients. There is no magic pill (bummer, I know). Supplements are quite literally meant to supplement your diet where and if needed. I also want to note that you should never take a supplement in place of a prescribed medication without discussing it with your doctor first. With that said, some people who do not have a very nutritious diet, or are struggling to meet their needs, could benefit from taking a supplement to ensure they are reaching their needs.
Research has shown that some supplements can be beneficial for overall health and health conditions. For example, vitamin D for bone strength and improvement in some forms of depression, folic acid to reduce certain birth defects, creatine to improve strength and lean muscle mass , and omega 3 fish oil for cardiovascular, endocrine and pulmonary function. However, for every supplement scientifically proven to be functional, there are 100 that are complete bologna. For example, Garcinia Cambogia, Cat’s Claw, and Ginseng. Or worse some that actually can cause serious harm, remember ephedrine? Unsure about the effectiveness of a supplement you are taking or looking to take? Ask a dietitian, or consult your doctor. We are here to help!
Supplements can have side effects and interfere with medication you are currently taking. Again, never take a supplement in place of your prescribed medication without consulting your doctor. The guy at GNC or the self-proclaimed health coach at your gym do not count. If you are currently on daily medications you should consult a doctor before starting to take any new supplements, just to be safe. For example, someone on blood thinners should not be taking a supplement with vitamin K in it as it will reduce the medications effectiveness. Another great example is St. John’s Wort, (which has been shown inconclusive in helping with anything) which can speed the breakdown, decreasing the effectiveness, of many drugs including antidepressants and birth control pills. Being pregnant and sad sounds like a bad combination.
Moral of Story:
Supplements can be beneficial for a number of people struggling to meet their nutrient requirements. As a dietitian, I have recommended supplements to clients I felt would benefit from them. On the other hand, it is important to note the supplement business is just that, a business trying to sell you a product in order to turn a profit. Not every company is looking out for your best interest. If something sounds too good to be true, it probably is. Unsure of the effectiveness of a product, ask someone like myself, a dietitian who will put your health and needs first.
Grow Strong My Friends!
Have Questions? Ask!