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  • Do you often blame your dry skin, hair loss, wrinkles for vitamin deficiency?
  • Do you think your diet lack in protein?
  • Have you ever tried “herbal” products for weight loss?

If any of the answers is a “yes”, then this blog is for you.

Only a diet is not enough to support your daily nutrition need. Your diet lacks vitamins, minerals, antioxidants, proteins, omega-3-fatty acids, probiotics, and whatnot. You must have heard such lines during advertisements. And why not?

According to a report by Grand View Research, the global dietary supplements market is expected to reach USD 278.02 billion by 2024 from 132.8 billion in 2016 with a 9.6% of the anticipated growth rate. India is also not that far. The report suggests from 4 billion in 2017, the dietary supplement market in India is going to reach 18 billion by 2025. It is needless to say dietary supplements are gaining popularity day by day worldwide.

Is it necessary to take dietary supplements

What are dietary supplements?

Dietary supplements look like normal medicines. These are available in various forms – pill, capsule, tablet, powder, or liquid. The only difference is it’s freely available in medical stores, health stores, online, sometimes even in your grocery shop. You don’t need any prescription to buy them. Just follow the advertisement, read the label and buy.

Dietary supplements are manufactured to supplement your daily nutrition. It provides one or more nutrients extracted from any natural or synthetic sources. Dietary supplements may contain active ingredients along with some added ingredients like fillers, binders, and flavors.

 

Why do we have nutrient deficiencies?

Deficiencies can take place for various reasons –

• lower intake than usual – it generally happens once people follow a restrictive fad diet or follow a poor diet loaded with ultra-processed foods
• poor absorption – It may happen that you are consuming enough vitamins and minerals but somehow due to some clinical conditions nutrients are poorly absorbed in the gut. And finally not reaching the cells
• poor utilization – it may happen due to some defect in the metabolic pathway after absorption. The reason needs to be detected and the necessary actions to be taken as soon as possible.
• Excess requirement– special phases like pregnancy, lactation or sometimes post surgery additional nutrients are required, if not supplied enough deficiency takes place.

Therefore deficiency does not only mean a lack of intake of a particular nutrient. It may happen for other reasons also. The dietary supplement works better when deficiency arises due to low dietary intake.

When do we need dietary supplements?

You are free to buy dietary supplements without consulting a doctor or any prescription. But does that mean you need it? Mind it, dietary supplements are effective only if you have any particular deficiency in the body. So go for the clinical tests before consuming any such supplements. Don’t just presume that you may lack certain nutrients and start popping them just like candies.

Dietary supplements are beneficial for a few specific physical conditions –

A. When you need EXTRA nutrition –
• During pregnancy, lactation- eg- the additional requirement of iron and folic acid is supplied through iron-folic acid tablets
• Athletes associated with endurance or strength-related sports – required extra nutritional support through dietary supplements

B. When you are unable to meet daily nutrition through diet –
• During old age – People age above 60 can take a multivitamin tablet for supporting the nutritional need
• Post-surgery or special medical condition – Surgery in the digestive tract or, any specific medical condition like anemia, diarrhea, food intolerance/ allergy, a disease in liver/gall bladder/pancreas/intestine, etc or,
• Clinically proved nutrient deficiency – specific dietary supplements work quite effectively
• During a restrictive diet – people who consume a restricted diet (either calorie or any food groups) eg- vegan need the support of dietary supplements

Is it necessary to take dietary supplements 1

Types of dietary supplements

Food advertisements are constantly pointing out probable dietary deficiencies. Everyone is feeling their diet is inadequate and need something special. No wonder, the dietary supplements market is booming every year.

Dietary supplements can be of various types –

• Vitamins and minerals supplements
• Protein supplements
• Fatty acid supplements
• Herbal/ botanical/ natural supplements
• Weight loss supplements
• Probiotic supplements

Diet vs. Dietary supplements – Vitamins and Minerals

Traditional dietary supplements like vitamins and minerals are great if you are clinically diagnosed with a particular deficiency. Therefore iron-deficient anemia is treated with iron supplements or calcium and vitamin D deficiency is tackled by adequate supplementations. Similarly vitamin supplements under expert guidance act fantastic to cure any deficiency caused by poor food intake.

But unnecessary intake of multivitamin-mineral tablets is of no use. In fact, they can create harm rather than giving any benefits. Therefore it is best to depend on natural food sources.

Check the table below for natural nutrient sources –

VitaminsRDA (Adult- based on calorie requirement of sedentary workers)Natural sources
Vitamin A (Retinol)600 ugGreen leafy vegetables, yellow fruits, and vegetables- pumpkin, mango, papaya, tomato, carrot, etc, animal liver, ghee, oil
Vitamin C40 mgAmla, guava, lime, lemon, green leafy vegetables
Vitamin DNot recommended 400 ug if supplementedSunlight, egg yolk, butter, milk, animal liver, cod liver oil
Vitamin ENot known with certaintyVegetable oils, nuts, whole grams
Vitamin KNo recommendation neededDark green leafy vegetables, seeds, dairy, meat, fruits
Thiamine(B1)1.2 mg (men)

 

1.0 mg (women)

Whole wheat, raw rice, millets, groundnut, organ meats
Riboflavin(B2)1.4 mg (men)

 

1.1 mg (women)

Milk and milk products, eggs, animal liver, green leafy vegetables
Niacin(B3)16 mg (men)

 

12 mg (women)

Whole cereals, pulses, nuts, meat, milk
Pantothenic acid(B5)5 mgAnimal liver, kidney, egg yolk, fresh vegetables, milk, meat
Pyridoxine (B6)2.0 mgPulses, wheat, meat
Biotin(B7)30 ugCereals, legumes, nuts, egg yolk, animal liver
Folate (B9)200 ugFresh green vegetables, animal liver, pulses
Cyanocobalamin ( B12)1.0 ugAnimal liver, egg, milk, meat
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RDA of minerals and their natural sources –

MineralsRDANatural Sources
Calcium600 mgMilk, green leafy vegetables, ragi, cereals, millets
Potassium Fruits, vegetables, legumes, nuts
Zinc12 mg(men)

 

10 mg (women)

Nuts, fruits, vegetables, cereals, pulses, vegetables, meat, poultry, eggs dairy product
Magnesium340 mg(men)

 

310 mg (women)

Green leafy vegetables, nuts, seeds, fruits, whole grain
Iron17 mg (men)

 

21 mg (women)

Cereal, millets, pulses, green leafy vegetables, animal liver
Manganese5.5 mgWhole wheat, cereals, legumes, nuts, leafy vegetables
Selenium55 ugBeans, animal liver, poultry, seeds, mushroom, nuts

 

Diet vs. Dietary Supplements – Protein

Protein supplements are getting much attention these days. Suddenly everybody especially vegetarians are getting threatened with protein deficiency.
Protein and amino acids as ready to drink or as powder available in the market.

How much protein you need per day: RDA –
• with normal activity, an adult requires 0.8 to 1g protein /kg body weight
• athletes for better strength and endurance need about 1.2 -.8 g protein /kg body weight
• maximum daily protein intake should not exceed 2 -2.5 g/kg body weight

Companies have started promoting sports supplements to everybody irrespective of their activity or physical training level. Thus bodybuilding supplements – like whey protein, BCAA( Branched-chain amino acid – Leucine, valine, and isoleucine), sulfur-containing amino acids (cysteine, methionine), glutamine, arginine is becoming a hot favorite, especially to young adults.

Whey protein is the most popular among all protein supplements. It is the mixture of proteins present in whey. This is high in quality and is loaded with amino acids. There are mainly 3 types of whey protein available in different flavors –
1. Concentrate – contain 70-80% protein, some lactose, and fat
2. Isolates – contain 90% protein, less lactose, and fat
3. Hydrolysate – a pre-digested form of whey protein that absorbs very fast

 

Benefits of protein supplements

Protein supplements help to-

  • stimulate muscle protein synthesis
  • increase body weight, muscle mass
  • improve athletic performance
  • decrease fat percentage

Can I take whey protein?

Whey protein is an excellent source of protein. and it is proved to be effective for muscle development and maintenance when taken along with proper strength training.

Don’t copy your favorite actor’s or player’s diet. Your wish to develop muscle is great for overall health but it won’t come only having 2 scoops of whey protein every day. You need to work out hard to utilize that protein otherwise it is going to harm you.

If you are not sure of hard physical training, then just stick with a naturally balanced diet. Consume a variety of pulses, nuts, seeds, milk and milk products, eggs, fish, chicken, meat on a regular basis. Trust me you will be fine.

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Diet vs. Dietary Supplements – Fatty acids

Omega 3 fatty acids have grabbed more attention in this category. It is true that omega 3 fatty acids have numerous health benefits starting from fighting against depression and anxiety, improving eye health, reducing long-term inflammation, fighting against autoimmune diseases, preventing cancer, improving brain health, etc along with reducing the risk factors for heart disease.

Omega -3 fatty acids are polyunsaturated fats that your body can not produce need to be taken from the dietary source. Thus it is called essential fatty acids. There are 3 main types of omega- 3 fatty acids.
• Eicosapentaenoic acid (EPA) -found in seafood
• Docosahexaenoic acid(DHA) -found in seafood
• Alpha-linolenic acid (ALA) – found in high fat plant

How much omega-3 do you need? What are the natural sources?

It is generally recommended to take at least 250-500 mg of EPA and DHA per day from a supplement. People who do not eat fatty fish or seafood can consider omega 3 supplements. Otherwise salmon, cod liver oil, flaxseeds, chia seeds, walnuts are good natural source of omega-3.

However, a recent study has shown omega 3 fatty acids help to reduce the risk of heart diseases but omega -3 supplements do not seem to be effective for reducing heart attacks or strokes.

Diet vs. Dietary Supplements – Herbal products / Botanicals/ Natural products

Dietary supplements can be manufactured from intact sources or extracted from plants, animals, algae, fungi or lichens like curcumin, St. John’s wort, ginseng, resveratrol, glucosamine, collagen, cranberry, ginkgo biloba, etc. India is the largest supplier of herbal extracts and raw materials for the dietary supplement market worldwide.

There are numerous herbal supplements in the market promoted with various health benefits. For eg – Echinacea to prevent cold, ginkgo to improve memory, ginseng for improving libido, erectile dysfunction, etc.

Herbal supplements generally meet certain quality standards but do not go through scientific scrutiny and are not strictly regulated as medicines. All herbal products are labeled as “natural” but that does not mean they can be consumed at any amount. Especially once they claim like lower cholesterol or improve mood which are strong enough to carry risk if taken without much care.

So be a smart consumer and don’t only rely on its advertisements. Check the label thoroughly and try to find out research results related to the product if any. If you consume a balanced diet with enough seasonal variety, you don’t really need such herbal support.

Diet vs. Dietary Supplements – Weight loss supplements

It is needless to say that weight loss supplements are extremely popular. These supplements tend to work in 3 ways –
• reduce appetite so that you eat fewer calorie
• reduce absorption especially fat
• increase fat burning capacity

Few popular weight loss pills and supplements are –
• Garcinia Cambogia Extract
• Hydroxycut
• Caffeine
• Orlistat
• Green coffee bean extract
• Green tea extract
• Conjugated linoleic acid (CLA)

All these weight loss supplements actually enhance the metabolism to some extent and may help to reduce a few kilos initially. But unfortunately, that is it. None of the supplements work extremely well for weight loss. So before you plan to invest in such products think not twice but thrice and even more.

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Diet vs. Dietary Supplements – Probiotics

Our large intestine hosts more than 1000 species of microorganisms, mostly bacteria. Probiotic is orally consuming specific live bacteria (or yeast) species that are beneficial to the body. Probiotics can improve the number and diversity of “good” gut bacteria that help to keep the digestive system healthy and allow it to work efficiently. It may help to boost immunity, improve blood sugar, reduce blood pressure, etc.

Taking this advantage, markets are filled with various probiotic supplements. However, most scientific research points out that probiotic supplements can increase the concentration of good bacteria in the gut, can reduce abdominal discomfort caused by constipation or irritable bowel syndrome, may boost the immune system. Feeling excited?

Well, the study suggests all these benefits are short-lived. That is once you stop having supplements again you can get back to the same old condition within 1- 3 weeks. Therefore instead of having probiotic supplements, it is better to feed your gut bacteria right for long-lasting effects. So foods rich in dietary fiber such as vegetables, fruits (also called prebiotics) are better for this bacterial survival.

Every tradition has a concept of some fermented foods – curd, kanji, sauerkraut, kimchi, pickle, overnight soaked rice are the perfect example of this. So do include them as natural probiotics in your daily diet rather than depending on supplements.

Are dietary supplements effective?

Studies suggest some supplements are beneficial eg – calcium and vitamin D supplements are effective to keep bone strong and reduce bone loss, folic acid is beneficial for reducing certain birth defects, whey protein is excellent for promoting muscle growth and maintenance when coupled with strength training.

But most of the other supplements need extensive studies to prove their effectiveness.
Most of the exciting supplement studies are based on observation without a controlled setting. That means, researchers did not test the particular supplement against placebo effect. There are few randomized control trial which show a completely different result for the same supplement.

Can dietary supplement create any health hazards?

Remember dietary supplements are only effective only if your body actually requires it. So if you are taking supplements just out of your own imagination, it is not going to give you any results.
Many supplements contain an active ingredient that has a strong effect on the body.

Supplements cause side effects when people take them instead of prescribed medications or combine with other supplements, eg- vitamin K can reduce the ability of blood thinners to prevent blood from clotting.

In fact, overdosage of supplements is more dangerous and can have side effects like nausea, vomiting, diarrhea, headache, hair loss, joint pain, allergic reaction, muscle cramps, liver damage, etc.

Ever been confused with RDA and DV? What are they?

RDA is a regular dietary allowance for nutrients that vary depending on age, gender, and for pregnant and lactating women. It denotes the safe amount of nutrients to be consumed for ensuring normal body function. Consumption of less or extra than the specified amount for any nutrients for a period of time can cause deficiency disorder or toxicity respectively.

For example, as per the ICMR guideline, the RDA of calcium for an adult (male and female) is 600 mg, which means an adult should consume 600 mg of calcium every day to support normal physiological activity.

DVs are daily values generally mentioned on the label of dietary supplements. This indicates the percentage of RDA is being provided by a particular serving size of the dietary supplements. For eg – if a calcium supplement bottle mention DV 15% that means one tablet is providing 15% RDA of calcium.

Since RDA depends on age, gender, and special physical condition, the calculation of DV should consider such minute calculation before mentioned on the label. Otherwise, DV gives a vague idea in certain cases. So check your supplement bottles carefully.

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Adulteration in dietary supplements

As the business of dietary supplements grows every year, companies manufacturing dietary supplements are sprouting everywhere. Many dietary supplements were alleged and proved to be unsafe and adulterated to a larger extent. The no of cases reporting health problems consuming supplements has increased. It was found that –

• 92% of tested herbal supplements contain lead, 80% contain other contaminants and unsafe levels of arsenic, mercury, and cadmium in such supplements.
• many products in herbal supplements were inferior in quality.
• one third did not contain any active ingredients that were claimed on the label
• 78% of products contain animal DNA which was not identified as an ingredient on the product label.
• unlisted pharmaceutical drugs were added in dietary supplements especially in products claimed weight loss and improved sexual performance.
• muscle building supplements were contaminated with anabolic steroids.
It is unfortunate that despite these findings action was taken against very few adulterated products.

Bottom Line

As the interest in preventive health is growing among the public, the sales of dietary supplements have surged. The market is flooded with numerous dietary supplements. Their lucrative claims on the label without any scientific backing (or mostly on biased observational case studies) misleading people to a greater extent. A robust clinical trial is lacking to prove that these supplements do more good than harm.

Self-prescribed dietary supplements are not effective until you have a clinical deficiency. So if you are taking supplements under mere presumption, you must stop now. Go for biochemical assessment, consult your doctor and then take supplements for a particular period of time as per your doctor’s prescription.
Remember the effectiveness of most dietary supplements is based on bias observational studies. So do not fall for the exciting claims on its label.

A healthy balanced diet, cutting processed food, enough activity, regular exercise, and adequate sleep have no alternative. So instead of wasting your money, time, and energy on presumptuous quick fixes, invest in developing a sustainable healthy lifestyle. Remember, no supplement can help you until you start living a healthy life. That clearly indicate the limited power of supplement.

Don’t let anybody fool you with the miraculous claim. Stay mindful to adopt the right choice.

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Dr. Soma Chakrabarty is based in Hyderabad. She has 15 yrs of working experience in nutrition. She guides people to modify eating behavior and achieve goals for wellness. She believes in a practical diet that helps people to live rather than survive.

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4 Comments

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  • Preetha , 12th April 2019 @ 8:32 pm

    Nice article

  • Sreenivasa V , 12th September 2020 @ 10:39 am

    Really an eye opener article. Thanks a lot. I used to take Herbal Life Multivitamin tablets and other supplements along with that because of my sinus issue. Initially it reduced to an extent but now same problem continues now. Don’t know what to do for Sinus to get rid of that. I have been a victim of this since 15+ years.

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