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 Nevertheless, there are more than 90,000 supplements on the U.S.
market that include a wide range of vitamins, minerals and
chemicals, and many of them don't live up to their advertised health
benefits, the author writes.
"Anybody who works in healthcare comes across folks who are taking
numerous supplements and spending a lot of money to do so," said Dr.
Michael Incze of the University of California, San Francisco, who
wrote the one-page primer for patients.
"Direct-to-consumer advertising and even popular media suggest
benefits, but many of the claims have been disproven," he said in a
phone interview. "There's a lag between medical recommendations and
popular culture, and people become reluctant to give them up."
Available for free, the new patient page (https://bit.ly/2H4ITfb)
offers practical advice and answers to questions about vitamins and
nutritional supplements that patients often bring up with their
doctors. The resource includes facts about how little safety testing
and regulation there is on these products.
"The supplement industry is like the Wild West right now," Incze
said. "There's not much regulation that happens before companies put
these products on the market."
The products often advertise health benefits such as improved
thinking, better heart health and a stronger immune system, and for
years, doctors have recommended certain supplements such as fish
oils and multivitamins. However, medical research doesn't tend to
support the claims, he writes.
Most basic vitamins and minerals are presumed safe at the
recommended doses, but bad reactions are possible. About 23,000
emergency department visits each year are related to nutritional
supplements, often resulting from toxic ingredients such as heavy
metals, steroids and stimulants, Incze writes.
"With supplements that come from overseas or certain stores in the
U.S., it can be hard to know what's in them, and some have strong
medicines or potent steroids mixed in," he told Reuters Health.
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Although the U.S. Food and Drug Administration oversees the vitamin
and dietary supplement industry, the products are assumed to be safe
without testing, unlike prescription drugs, which undergo an
approval process. This lack of upfront safety and efficacy testing
often makes regulation of the market impossible, Incze writes.
In the U.S., people who generally eat a balanced diet already
receive the vitamins and nutrients they need, and the body is
typically better at absorbing nutrients from food than from
supplements, Incze writes.
Likewise, vegetarian, vegan, gluten-free, paleo and other special
diets generally provide adequate nutrients without a need for
supplementation. Although vegans face a risk of vitamin B12
deficiency, almond milk and other replacements are usually fortified
with the vitamin to ensure adequate daily intake, he notes.
In fact, even those who eat out somewhat regularly or have
less-than-stellar diets likely consume what they need simply because
foods in the U.S. are often fortified, said Dr. Pieter Cohen of the
Cambridge Health Alliance in Somerville, Massachusetts, who wasn't
involved in the patient resource.
"More than half of adults in the U.S. use some type of supplement,
and it's important to take a moment and think about what we're
actually putting into our bodies," Cohen said in a phone interview.
Over-the-counter drugs require label information about ingredients,
directions for use and potential adverse effects. Supplements should
have similar labeling, he said.
"What we need to work on is this regulatory framework," he said.
"Consumers should have the information they need to make wise
choices."
SOURCE: https://bit.ly/2H4ITfb JAMA Internal Medicine, online
January. 7, 2019.
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