There are numerous food supplements in the market, but whom are they for? When are they beneficial, ineffective or even harmful? In this article, we explore all general recommendations on taking the food supplements.
What are Food Supplements?
An idea behind the food supplements, also called dietary or nutritional supplements, is to deliver nutrients that may not be consumed in sufficient quantities. Food supplements can be vitamins, amino acids, minerals, fatty acids, & other substances delivered in the form of tablets, pills, capsules, liquid, etc.1Supplements are available in a range of doses, & in different combinations. However, only a certain amount of each nutrient is needed for our bodies to function, & higher amounts are not necessarily better. At high doses, some substances may have adverse effects, & may become harmful. For the reason of safeguarding consumers’ health, supplements can therefore only be legally sold with an appropriate daily dose recommendation, & a warning statement not to exceed that dose.
Supplement use varies in Europe. For example, it is common in Germany & Denmark (43% & 59% of the adult population respectively) but is less so in Ireland & Spain (23% and 9% respectively). Women use supplements more than men.
Who Needs Food Supplement?
Supplements are not the substitute for a balanced healthy diet. A diet that includes plenty of fruits, whole grains, vegetables, adequate protein, & healthy fats should normally provide all the nutrients needed for good health. Most of the European countries agree that messages aimed at the general public should focus on food-based dietary guidelines. Supplements do not feature in these guidelines, but there are certain population groups or the individuals who may need advice about supplements, even when they eat a healthy balanced diet, i.e. women of childbearing age, individuals on specific medications.
Partly due to our modern lifestyle, not everyone manages to eat the healthy diet. In Europe, dietary surveys have suggested that there are suboptimal intakes for the several micronutrients. The EU-funded EURRECA project found inadequate intakes for vitamin D, vitamin C, folic acid, calcium, selenium & iodine. A recent comparison of the national surveys showed widespread concern about vitamin D intakes, whereas certain age groups are more likely to have low intakes of minerals. For example, there is concern about adequate intakes of iron amongst teenage girls in Denmark, Poland, France, Germany & the UK. Poor iron status in young women also increases the risk of infants being born with low birth weight, iron deficiency & delayed brain development. Folate status is also critical for the women who may become pregnant. They are advised to take folic acid before conception, & continue for the first 12 weeks of pregnancy. An adequate folate status can decrease the risk of having a baby with neural tube defects such as the spina bifida. Recent research suggests that 50 to 70% of Europeans have poor vitamin D status. Since vitamin D status is dependent not only on dietary intake but also exposure to the UV light, there may be a stronger case for advising supplements for vitamin D in Northern European countries. In some countries (including UK, Ireland, the Netherlands & Sweden) there are already recommendations for certain groups in the population to take a vitamin D supplement, although there are calls for more research.
Although groups considered at risk are not the same in few countries.
Examples of population groups requiring specific advice about a supplement.
|People over age 50||Vitamin D, folate, Vitamin B12, Frail elderly may benefit from a low-dose of a multivitamin supplement.|
|All Women of childbearing age||Folic acid & vitamin D, possibly iron|
|Children under the age 5||Vitamin A, vitamin C, vitamin D, although children with a good appetite who eat a wide variety of food may not need them.|
|Breastfeeding women||Vitamin D|
|People who cover their skin, are housebound or are dark-skinned||Vitamin D|
Particular risks for the specific population groups Despite having a role in the health of some individuals, not all supplements are useful for everybody. In fact, for few people, it is not advisable to take certain supplements, in particular, & in high doses. Some studies show multivitamins can contribute to an increased risk of excessive nutrient intakes, & it has been suggested that multivitamins should be formulated with greater consideration for the intakes of micronutrients from foods. Individuals should pay particular attention to reading the label & assure that a supplement is suitable for them. For the pregnant woman, for example, supplements containing vitamin A (retinol) including fish liver oil may be harmful & cause birth defects if the recommended dose is greatly exceeded, or exceeded over an extended period of time.
Studies have also highlighted that smokers should be wary of several supplements, in particular, high doses of beta-carotene. The European Food Safety Authority (EFSA) has considered the evidence in this area & has concluded that exposure to β-carotene below 15 mg/day is safe in the general population, including smokers.
Some population groups are advised to take the specific supplements. The overall message is: follow a balanced diet, healthy, carefully read labels of supplements & fortified foods, & avoid taking multiple doses that exceed the Recommended Daily Amounts (RDAs). In case of doubt, seek the advice from a dietitian or medical doctor before choosing a dietary supplement.