Nutritional Supplements: A Commercial Lie or a Health Necessity?

 

For some people, dietary supplements are an insurance policy against an imperfect diet, while others may take them because they cannot or do not want to eat certain foods. Whatever the reasons, taking vitamin and mineral supplements can seem like an excellent shortcut to a healthy life. But in recent months, serious doubts have been raised about whether these nutritional supplements are actually good for us. Our Omega-3s, for example, for many people, taking these golden capsules is a way to get the essential fatty acids we are told our bodies need without consuming oily fish. However, recent studies suggest that eating Omega-3 or fish oil supplementation does not reduce the risk of heart disease, stroke, or early death, unlike eating fish.

It's the story of every other nutritional supplement, including multivitamins; Findings from a series of studies examining their impact on our health have been disappointing. In some cases, taking high doses of certain nutrients may be harmful. We may also have a greater awareness of the importance of the interactions between the different foods we eat and how they affect the absorption of the nutrients they contain. It turns out that the significance is not in what we eat, but in how we eat it. So are nutritional supplements just a waste of money? If not, what supplements should we take, and how?

It was only in the last century that we began to identify and realize the importance of the various health-supporting nutrients that are found in our food. In 1913, Polish chemist Casimir Funk coined the word “vitamin” derived from “vita” (life) and “amine,” a nitrogenous organic compound, after noting that compounds called “amines” in rice straw could protect chickens from thiamine deficiency disease. . This dangerous condition that also affects humans can lead to nerve damage or heart failure. We now know that thiamine deficiency disease is caused by a deficiency in vitamin B1, also known as thiamine. Similar nutritional deficiencies were common at the time, but their causes were not well understood, for example, vitamin B1 was not recognized until 1926.

In the UK alone, consumers spend £420m on nutritional supplements every year

 

The next two decades saw the discovery of more vitamins and a growing understanding of how their deficiency causes common diseases. This led to the formulation of nutritional strategies that cured diseases such as scurvy, rickets and pernicious anemia caused by a deficiency in vitamins “C”, “D” and “B12”, respectively.The onset of World War II prompted the publication of recommended daily rations for various food groups, vitamins and minerals. In many countries, some countries have also begun to fortify some foods with nutrients, such as adding iron to flour and vitamin D to vegetable butter.

However, in addition to making the population healthier, this reductionist approach to foodstuffs has fueled the growth of what is now a multi-billion dollar supplement industry. The industry is not only focused on filling nutritional deficiencies, but also seeks to sell vitamins and minerals to anxious healthy people who are taking precautions with their supplements. In the UK alone, consumers spend £420m on nutritional supplements each year with vitamin tablets being the most popular, followed by fish oil.

On the surface, the evidence seems to suggest that this is all a good idea. Epidemiological studies that study the prevalence of disease in certain groups show that people who eat a lot of fish or a lot of vegetables, whole grains, and olive oil have lower rates of diseases such as heart disease and dementia. Many of us have taken the idea that a handful of the super-nutrients in these foods, packaged in capsules or tablets, can provide the same benefits without the perceived hassle and expense of preparing healthy meals.

The problem is that these benefits were not necessarily present when the supplements themselves were tested. Randomized controlled trials are used to look at whether and how a food or supplement is beneficial. Within these trials, people are randomly assigned to take either a component of the diet such as omega-3 fatty acids or a placebo[1]. The results of these trials have been mixed: some randomized controlled trials have shown a benefit, others have found no benefit at all. “Dietary supplement tablets and capsules have attracted the industry because they are inexpensive and easy to put together in bullet-like capsules,” says Andrew Prentice, Medical Research Council Chair for the International Nutrition Group at the London School of Hygiene and Tropical Medicine. That benefit hasn't been seen with supplements; we need to understand why and what we need to do about it."

Perhaps the latest major scandal is a massive study published in June by the prestigious Cochrane Collaboration; In a meta-analysis (a statistical approach that combines data from multiple randomized trials to try to obtain a more accurate estimate of effect), 79 studies were considered to assess the long-term effect of omega-3 fatty acids or fish oil supplements on cardiovascular health. It concluded that it had little or no effect on the risk of heart disease, stroke or premature death. Recent meta-analyses support this finding

To similarly disappointing conclusions about the effects of vitamins A, B, C, D and E on various aspects of our health.

However, some researchers question the importance of a meta-analysis of nutrition research; Unlike drug or surgical trials where you have a standard intervention and a largely homogeneous group being tested, nutrition research is usually more messy. When you study a similar omega-3 fatty acid supplement, you group together widely disparate studies; Which may involve doses, combinations, or even different types of nutrients. Finding the right placebo is also difficult, and Jeffrey Bloomberg, who studies antioxidants at Tufts University in Boston, says, "If I'm going to do a study looking at vitamin E supplements, I've had this vitamin since I was a fetus, all my life and all my life." The duration of this study, so there is no purport to be a placebo control.”

RCTs of supplementation usually do not record what other participants ate, nor do they measure baseline levels of nutrients in their bodies. This is important because providing a supplement to someone who already has adequate levels of a vitamin or mineral is very different from giving it to someone who is deficient in it.

Pharmaceutical companies must invest huge sums of money in in-depth studies in order to overcome the regulatory hurdles they must pass in order to obtain certified approval for their drugs. On the other hand, there is less incentive for nutritional supplement companies to do so, as the approval of nutritional supplements is done in the manner of approving the food itself and not in the manner of approving the drugs; They must be safe to consume and properly labeled, but they do not have to prove that these supplements improve health. Simon Dial of the University of Roehampton in London comments: “Studies of dietary supplements tend to be smaller and shorter in duration. But supplements are not medicines, so you are unlikely to see an effect on people’s health after taking them for ten, four or even five weeks. months. You need a study for at least a year, and it's very unlikely that dietary supplement companies will fund this kind of study."

Taking too much vitamin E appears to be associated with an increased risk of hemorrhagic stroke and possibly prostate cancer

Descriptive analyzes often attempt to explain some of this disparity, but the basic problem remains, according to Dial. However, randomized controlled trials are the best method we have tried so far. Where will all of this lead us? Most nutrition researchers agree that taking nutritional supplements is appropriate for those who find it difficult to follow a balanced diet, either due to allergies or lifestyle choices such as vegetarian or vegan.

However, experts are divided on whether healthy and well-nourished individuals should take supplements. "I think we have to realize that supplements may not be completely risk-free, especially at high doses," says Joanne Manson, an epidemiologist at the Harvard Chan School of Public Health in Boston. For example, eating too much beta-carotene appears to increase the risk of lung cancer in smokers, while vitamin E has been associated with an increased risk of hemorrhagic stroke and possibly prostate cancer.

Recently, Manson published guidelines telling doctors what they should tell their patients about nutritional supplements. Her conclusion was: "Micro-routine nutritional supplementation is not for everyone." Prentice agreed. He explained: "In my opinion, people should not take nutritional supplements unless there is evidence that they need them, and in a country like Britain, for example, most people do not need nutritional supplements."

hidden hunger

Bloomberg at Tufts University, however, argues that a country's wealth is a poor indicator of the nutritional status of its population: you can have too much food, and the population remains malnourished. "Sixty-six percent of Americans are obese or obese, and the reason is that they eat high-energy foods that are nutritionally poor," Bloomberg says. This "hidden hunger" does not only affect people who are overweight or obese. A joint US Department of Agriculture and Health and Human Services publication found that vitamins A, C, D, E, choline, calcium, iron, magnesium, potassium, and fiber are “underconsumed” by many people in United State. Those who take a daily multivitamin have amounts that are much closer to the recommended daily allowance, according to Bloomberg work.

We know that people in the UK, the US and around the world are not eating the right way," says Bloomberg, who led the study. "We should try to change that, but I also think it's wise to tell you to take a multivitamin." Bloomberg, who advises several nutritional supplement companies, mentions the Physicians Health II study, one of the largest randomized trials of nutritional supplements conducted to date, led by researchers at Brigham and Women's Hospital in Boston. It tracked the health of more than 14,000 men in the United States over the age of 50 for more than a decade, and found that those taking a daily multivitamin had a small but significant 8 percent reduction in the incidence of all types of cancer.

More studies are still trying to see if these results can be replicated, and if the results apply to women as well. "As an elderly person, I am happy to receive modest benefits for any of my physiological systems," Bloomberg says. For those who follow a poor diet, eating