From fish oils to iron pills and even multivitamin gummies, dietary supplements have flourished into a global industry with an estimated worth of US$ 132.8 billion that is projected to rise to US$ 220.3 billion by 2022. With growing focuses on fitness and physical wellbeing, members of the public are thinking more carefully about their diets and daily habits. To many, supplements are an attractive way of improving overall health, boosting energy levels, and even preventing disease.

Not one size fits all

A dietary supplement is defined by the National Institutes of Health (NIH) as an umbrella term for any product that is intended to supplement the diet. It can contain one or more ingredients — including vitamins, minerals, herbs, and amino acids — and is administered orally in many different forms such as a pill, liquid, or powder. With approximately 76 000 dietary supplement products available in the United States alone, just how is one to know which ones to take?

Though research has provided evidence of the benefits of certain supplements, such as iron for anemic women during pregnancy, many common supplements still require a deeper investigation into their health effects and who should actually be taking them. For example, just earlier this year, the results of the Vitamin D and Omega-3 Trial (VITAL) Study were published in The New England Journal of Medicine, showing that vitamin D and fish oil — both long been thought to lower the risk of developing cardiovascular disease (CVD) — had no significant protective effects in the majority of individuals. In addition, it has also been shown that too much vitamin A, normally involved in cornea function and cell growth, may increase the risk of bone fractures in mice — further illustrating that there is still much to learn about supplements and the potential dangers that come with using them.

It’s a supplement, not a replacement

Accurately named, supplements are meant to be used to complement a healthy diet. In the Prevención con Dieta Mediterráne (PREDIMED) Study, researchers questioned as to whether a change in diet rather than supplementation could aid in maintaining cardiovascular health. Interestingly, individuals who followed a Mediterranean diet with extra-virgin olive oil or nuts as the primary source of culinary fat experienced lower incidence of major cardiovascular events, as compared to the low-fat diet control group. The Mediterranean diet also recommends a low consumption of red meats and high intakes of plant-based foods — illustrating that the benefits of a healthy diet that cannot be replaced by supplementation alone.

Not as safe as one might think

Many believe supplements are safe, because they are made from ingredients that we are meant to be eating in our regular diets already. However, the U.S. Food and Drug Administration (FDA) does not test supplements for safety risks before they are put on the market. In fact, manufacturers of the supplement are responsible for quality assurance and the monitoring of potential side effects, and they are required to report to the FDA only after serious health issues arise. This is why many healthcare providers urge patients to seek professional advice before starting any dietary supplement regimen to inquire about proper dosage and whether the supplement is even necessary. When it comes to dietary supplements, more is not always merrier.

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Sharon Ling

Sharon is an MSc candidate within the lab of Dr. Rae Yeung in the Department of Immunology at the University of Toronto. Outside of the lab, Sharon enjoys watercolour painting, working out, and grabbing weekly dim-sum with her grandma.

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