Learn how to choose high-quality vitamins and supplements
Learn how to choose high-quality vitamins and supplements
Dietary
supplements are products that people use to add nutrients or other compounds to
their bodies.
From
individual vitamins and minerals to blends of nutrients and herbs, there are
many supplements on the market that claim to offer specific health benefits.
However, due
to limited regulation, it is not always clear which supplements are high
quality, or which are a waste of money or even potentially dangerous.
This guide
covers everything you need to know about what supplements are and how to choose
a safe, high-quality product.
What are
proprietary supplements, vitamins, minerals, and blends?
Dietary
supplements are products that are taken orally and contain a "nutritional
component" such as vitamins, minerals, herbs and plants, amino acids,
enzymes, probiotics, antioxidants, or other nutrients (1).
Diet
supplements come in many forms, including capsules, gums, tinctures, powders,
and liquids. They are usually marketed as a simple and effective way to improve
your physical or mental health.
Other
important definitions to understand when considering supplements are (2, 3, 4):
Vitamins Vitamins are essential nutrients
that your body needs to function properly and stay healthy.
Many help
regulate vital metabolic functions, including growth, nerve function, and
digestion.
Fat-soluble
vitamins. These
vitamins dissolve in fat and can be stored in your body. These include vitamins
A, D, E, and K.
Water-soluble
vitamins. These
vitamins dissolve in water and the body does not store them. These include
vitamin C and vitamin B.
Minerals
Minerals are inorganic building blocks that are essential for certain body
functions such as growth, bone health, and water balance.
Proprietary
mix. Proprietary
Blend is a unique combination of ingredients made by a manufacturer of
nutritional supplements. It is often difficult to tell on the label how much of
each ingredient is in the mix.
For most
healthy people, it is possible to get all of the vitamins and minerals you need
from food alone. However, there are certain conditions, medications, and
circumstances that supplements may be required to meet nutritional needs.
However, one
important point to keep in mind about supplements is that they are meant to complement,
not replace, nutrients, or other compounds in your diet.
This means
that it is important to have a varied and balanced diet as much as possible
when you are taking a food supplement.
Nutrients
in food versus vitamin and mineral supplements
Eating a
variety of foods is the best way to ensure that you are getting your vitamin
and mineral needs.
After all,
different foods contain different amounts and combinations of nutrients. For
example, citrus fruits are known to be high in vitamin C, while leafy green
vegetables are a good source of vitamin K (5, 6).
In addition
to vitamins and minerals, foods contain other essential nutrients such as
protein, healthy fats, and fiber, all of which are required for overall health
and optimal body function (2, 7).
Additionally,
plant-based foods in particular are rich in antioxidants and phytochemicals,
two classes of compounds that have been linked to benefits in reducing
inflammation and protecting against chronic disease (8, 9, 10).
In contrast,
dietary supplements do not offer the same nutritional benefits. Since they are
intended to complement, not replace, a healthy diet, they generally only
provide concentrated amounts of specific nutrients
(11).
An
observational study of 30,899 adults in the United States found that adequate
dietary intake of certain nutrients was associated with a reduced risk of death
from heart disease, as well as death in all cases. or the cause (12).
However,
consuming the same nutrients in the form of dietary supplements did not reduce
the risk of dying from heart disease or other causes (12).
People with
nutritional deficiencies or those at increased risk of inadequate consumption,
such as pregnant women, may benefit from taking supplements recommended by a
healthcare professional.
Who Needs
Supplements?
In general,
vitamin and mineral supplements for healthy adults do not need to be taken with
an adequate intake of these nutrients. While it is best to get these essential
nutrients through food, some may find it difficult to do so.
There are
also some instances when supplements may be indicated. Some of the people who
may benefit from supplements include (13, 14, 15, 16):
-pregnant or
breastfeeding women
-exclusively
or partially breastfed infants
-Adults or
children diagnosed with nutritional deficiencies
-People with
diseases that cause nutrient malabsorption
-those who
have had weight loss surgery, such as gastric bypass surgery
-Adults or
children with restricted access to food
-some vegans
and vegetarians
Certain
nutritional deficiencies are also more common, such as vitamin D (17).
Unlike other
vitamins, it is difficult to get enough vitamin D from food alone. Although
your body can produce vitamin D from sun exposure, it is estimated that 1
billion people worldwide are low in this vitamin (18).
Frequent use
of sunscreen, living far north or south of the equator, staying indoors, and
darker skin are risk factors for vitamin D deficiency (19).
In addition,
the elderly may not be able to synthesize vitamin D as well because of the
biological changes in the skin that naturally occur with age (20).
Therefore,
vitamin D supplements are generally recommended.
If you want
to get the right vitamins and minerals from food only, contact your doctor for
personalized recommendations on what type of supplement you might need and what
dosage you might need.
Although prenatal vitamins are recommended during pregnancy and sometimes while breastfeeding, these populations should avoid herbal supplements unless directed by a doctor (21).
Supplements
for children
Healthy
children can usually only meet their nutritional needs with a varied diet (22).
However,
there are certain age groups and circumstances under which supplements may be
recommended.
For example,
the American Academy of Pediatrics recommends that partially and exclusively
breastfed infants receive approximately 400 IU of vitamin D per day in
supplement form until the child begins taking vitamin D-fortified milk (15).
In addition,
plant-based children or adolescents are at increased risk of being deficient in
several essential nutrients, including vitamin B12, calcium, iron, zinc, and
vitamin D (23).
While
children on a plant-based diet can get enough of these nutrients from food
alone, careful planning is required. Accordingly, supplements may be indicated
depending on the types of foods the child is eating (23).
Because
children and teenagers have different nutritional needs than adults, it is
important to speak with a pediatrician for recommendations on what types of
supplements (and dosages) are safe.
Regulation
of supplements
The Food and
Drug Administration (FDA) does not evaluate the effectiveness, safety, or
quality of dietary supplements or their ingredients before they hit the market
(1).
This is
important to know as there is no guarantee that the product will contain what
it says it will.
In addition,
a product can even contain different amounts of the ingredients from batch to
batch.
While the
FDA requires dietary supplement manufacturers to follow current Good Manufacturing
Practices (CGMP) to ensure the quality and safety of these products, compliance
does not always apply (24).
The best way
to ensure the quality of a product is to look for a product that has been
certified by an outside company.
Third-party
testing
Tests
performed by third parties are not a legal requirement.
However,
some supplement manufacturers voluntarily choose to test to demonstrate their
commitment to making high-quality products.
An objective
indicator of product quality is a Certificate of Analysis (COA) issued by an
independent third party such as NSF, USP, the Banned Substances Control Group
(BSCG), or ConsumerLab.
Most
products certified by one of these third-party companies have been tested for
one or more of the following properties (25):
-The
supplement contains the information on the label and in the specified
quantities.
-The products
are standardized from batch to batch.
-The
supplement is free of harmful levels of contaminants or other potential drug
contaminants.
-The product
does not contain any undeclared ingredients.
Additionally,
if you're an athlete, it may be worth looking for NSF certified sports
products. This certification guarantees that the product is free of more than
270 substances that are banned or banned by most major sports organizations
(26).
Possible
problems with taking supplements
Although
dietary supplements contain ingredients found in foods, potential safety
concerns should be considered prior to ingest concentrated amounts of these
ingredients in supplement form.
Possible
interactions
In addition
to talking to your doctor about the type of supplement you would like to take,
it is important that you read up on the possible interactions.
The
ingredients of dietary supplements, including vitamins, minerals, herbs, and
other herbal ingredients, when combined with certain drugs, other dietary
supplements, foods, and alcohol, can cause unintended adverse effects (27).
For example,
vitamin E supplements can increase the risk of bleeding in people who take
anticoagulants, while calcium supplements can limit the effectiveness of
antibiotics and reduce iron absorption from foods and supplements (28, 29).
Some
supplements can also affect the accuracy of laboratory results.
For example,
the FDA has issued a warning that supplements containing biotin (vitamin B7)
can falsely lower laboratory results based on troponin, a key biomarker for
diagnosing heart attacks (30).
Supplements
that contain herbs and herbal remedies can be of particular concern as many of them
have been shown to interact with various medications. Additionally, many herbs
don't have enough human research to confirm possible interactions and side
effects (31, 32).
Ingredients
that can become toxic over time or in high doses.
One of the
problems with consuming vitamins and minerals through dietary supplements
instead of food is the increased risk of overeating or becoming toxic over
time.
In addition
to the recommended amounts, many vitamins and minerals have what is known as a
tolerable upper intake level (UL). UL is the highest intake of the nutrient
that is unlikely to cause negative side effects in the general population (33).
The UL for
vitamins and minerals varies by age and gender. There are also separate UL
recommendations for pregnant or breastfeeding women (34, 35).
Fat-soluble
vitamins are of particular concern in terms of toxicity risk as excessive
amounts can build up and be stored in your body.
In
particular, overconsuming vitamins A, D, and E can be toxic, leading to side
effects like irregular heartbeat, organ damage, hemorrhages, hemorrhagic
stroke, and in extreme cases, even coma and death (36, 37, 38, 39).
As
water-soluble vitamins are not stored in your body, they’re less likely to
cause toxicity from an overdose.
That said,
consistently taking very large doses of water-soluble vitamins may still cause
digestive upset, liver damage, and even potentially irreversible neurological
damage (40, 41).
Unless under
the supervision of a medical professional, it’s important not to exceed the UL
of vitamins or minerals. While some side effects may be mild, others can be
more serious.
Additionally,
as the UL for kids is often much lower than for adults, kids are particularly
at an increased risk of overdose and toxicity (34).
For safety purposes, make sure to always store supplements out of reach of children. This is especially important for gummy vitamins, as their sweet flavor may appeal to kids (42, 43).
May have
negative side effects
Dietary
supplements may cause negative side effects, even when taken at the recommended
doses.
Reported
side effects are often mild, such as nausea, diarrhea, or headaches. In
particular, iron supplements are known for causing digestive distress (44).
However,
some ingredients in supplements, especially herbs, may have more serious side
effects, such as allergic reactions, increased blood pressure, and elevated or
irregular heartbeat (45, 46).
May not
be effective
As dietary
supplements are subject to fairly limited regulation, there’s also the risk
that the product contains less of an ingredient than it claims to.
In addition
to not getting your money’s worth, this can be potentially dangerous in
individuals who are relying on the supplement to help meet their essential
nutrient needs.
It’s also
important to be cautious of claims on the product. Due to FDA regulations,
manufacturers cannot claim that their product cures, treats, or reduces the
risk of a specific disease or condition unless it has been proven by research
to do so (47).
However,
they can include structural or functional claims, which describe how the
ingredients in the product may affect systems or organs in your body (47).
For example,
a supplement can say that it supports energy levels. Yet, this claim does not
require that the product was scientifically proven to help improve energy
levels. As a result, there’s no guarantee that taking the supplement will
result in this desired benefit.
Precautions
about multi-level marketing companies that sell supplements
The demand
for health and wellness products continues to grow, and one of the results of
this demand has been an increase in multi-level marketing (MLM) supplement
companies.
While there
are variations in the exact structure, MLMs operate using a business model in
which independent, non-salaried representatives earn affiliate income by
selling a specific company’s products.
Some
companies also use a pyramid-shaped commission system in which the
representative makes additional money by recruiting and selling to new
representatives.
Due to the
popularity of vitamins, minerals, and other supplements, many MLM companies
offer a variety of supplement products, many of which are often advertised as
ways to boost various aspects of health or support weight loss.
Some common
MLM companies you’re likely to come across include Herbalife, Shaklee, Amway,
and Plexus.
While some
products may be perfectly safe, many products sold by MLMs are not third-party
tested for safety or accuracy. As a result, you could end up spending a lot of
money on an ineffective or low-quality product (48).
Additionally,
these products often contain a mix of herbs and other botanicals, many of which
haven’t been proven to be safe for long-term use. These supplements can also
contain potentially dangerous levels of vitamins and minerals (48).
Finally, the
ingredients used in these products are not always of high quality and may
include artificial colors, flavors, and additives.
Overall,
when buying supplements from an MLM company, it’s still important to look for
indicators of safety and quality, including the ingredient list, dosage, and
certification from third-party testing.
Extract
Safety and
quality are the most important factors when buying vitamins and nutritional
supplements. However, there are other things to think about as well.
For example,
some coatings and ingredients added to supplements may be derived from animal
products. Therefore, if you are vegan, you should look for products that are
vegan certified.
Complementary
products can also contain gluten or other common allergens such as soy or dairy
products.
According to
the Law on the Labeling and Consumer Protection of Food Allergens, foods and
dietary supplements must explicitly indicate the presence of one of the eight main
allergens (49).
People with
celiac disease or gluten intolerance should choose a product that is certified
gluten-free.
Read this
guide to learn more about what to look for with supplement labels.
You should
also consider how often to remember to take it and what form you prefer, e.g.
B. liquid, tablet, powder, or gum.
While it is
a high-quality product, it is important to buy it from a reliable source. Most
supplements should be kept in a cool, dry place, and some should even be refrigerated.
It is for this reason that you should choose a distributor that you trust to handle the products properly.
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