Dietary Supplements: Who Needs Them and How to Choose
According to the Office of Dietary Supplements at the National Institutes of Health, most Americans take some type of dietary supplement on a regular or occasional basis. Most, however, are taking vitamins on their own, rather than based on the recommendation of a physician and even researchers disagree on the benefits of nutritional supplements. In trying to sort through the pros and cons of adding a multivitamin to their daily routine, there are several governmental agencies and independent organizations that consumers can turn to for guidance.
Are Dietary Supplements Necessary?
In a perfect world we would get all of the vitamins and minerals we need from the food we eat. But the world is far from perfect and many factors affect our ability to make good dietary choices. Busy lifestyles that rely too heavily on fast food or processed foods prevent many consumers from getting proper nutrition. Even attempting to combat the dangers of obesity by losing weight can lead to vitamin deficiency.
A great deal of research has been done and continues to be done on the benefits of vitamin supplements, including what supplements are most important and which should be avoided. The thinking among nutritional researchers is that most Americans can benefit from a dietary supplement. After reviewing currently available data, the Harvard School of Public Health recommends eating a balanced diet and taking a daily multivitamin in order to stay healthy.
Recommended Levels of Dietary Supplements
The nutrients that people need in order to stay healthy is determined by the Food and Nutrition board of the Institute of Medicine of the National Academy of Sciences. The recommended nutrient levels are called Dietary Reference Intakes or DRIs and are the units currently in use in the U.S. and Canada. DRIs provide information on both the adequate daily intake of a specific vitamin or mineral as well as the safe upper limit. DRI levels are provided by gender and for specific age groups and are regularly updated to reflect learning from new research.
Ongoing studies have identified specific nutrients that are especially important in certain populations and that are not typically provided in adequate amounts through regular diet and a multivitamin. For these specific nutrients, an additional supplement may be necessary for some.
Probably the greatest focus of nutritional research recently has been on vitamin D, an important component of bone health. Unlike most vitamins and minerals which can be brought to appropriate levels through food or supplement intake, vitamin D is synthesized by exposure to sunlight. The increased use of sunscreen, important in preventing skin cancer, has also lead to decreased exposure to sunlight. As a result, many people need to supplement their vitamin D intake, with most experts recommending between 1,000 and 2,000 IUs daily.
Health benefits of folic acid include reduced risk of cardiovascular disease, Alzheimer’s disease, colon cancer and breast cancer. When women take a folic acid supplement before becoming pregnant, there is evidence of a decrease in certain birth defects.
Getting an adequate amount of vitamin B12 is problematic for older consumers and for vegetarians. Vitamin B12 is found only in animal products and the ability to absorb it from food decreases with age. As a result, many people need to supplement their vitamin B12 intake in order to achieve the recommended amount on a daily basis.
Choosing a Dietary Supplement
There are a large number of companies selling dietary supplements and it is not easy for consumers to assess their relative quality. While the U.S. Food and Drug Administration (FDA) does regulate dietary supplements, they are not given the same level of oversight as food or drugs. The FDA does not test dietary supplements for safety or effectiveness, but does provide a list of requirements called Good Manufacturing Practices (GMPs) that manufacturers are required to follow. Among other things, GMPs require that labeling claims must be truthful and not misleading.
Perhaps the best sources of information for consumers on the quality of available supplements are independent organizations who conduct testing and provide certification for manufacturers meeting their standards.
Founded in 1999, ConsumerLab.com tests, reviews and rates a wide range of health products and nutritional supplements.? Manufacturers can voluntarily submit their products for evaluation and inclusion on the CL list of Approved Quality products. Products that receive the CL seal are posted on the CL website; manufacturers can also pay for a license to use the CL seal to market their products. The website provides information on research being done on nutritional products, safety warnings and general background information. Paid membership is required in order to access all available product information.
NSF International Dietary Supplement Certification
NSF International provides public health and safety information on a variety of products, including dietary supplements. An NSF certification means that the manufacturer has met the quality standards set by NSF International. Dietary supplements are tested to ensure that the label accurately reflects the content of the supplement and that no contaminants are present. Supplements are not tested for effectiveness.
U.S. Pharmacopeial Convention (USP) Dietary Supplement Standards
The oldest of the three organizations (established in 1820), the USP sets standards for the manufacture of food ingredients, medicines and dietary supplements. These standards are used worldwide and are enforced by the FDA. USP standards address the quality and purity of the ingredients on dietary supplements. For consumers, the USP Facebook page provides information on USP verified products.