Nutritional supplements include vitamins, minerals, herbs, meal supplements, sports nutrition products, natural food supplements, and other related products used to boost the nutritional content of the diet.
Nutritional supplements are used for many purposes. They can be added to the diet to boost overall health and energy; to provide immune system support and reduce the risks of illness and age-related conditions; to improve performance in athletic and mental activities; and to support the healing process during illness and disease. However, most of these products are treated as food and not regulated as drugs are.
The Natural Nutritional Foods Association estimated that in 2003 nutritional supplements amounted to a $19.8 billion market in the United States. By category, vitamins provided $6.6 billion in sales, herbs $4.2 billion, meal supplements $2.5 billion, sports nutrition products $2.0 billion, minerals $1.8 billion, and specialty and other products totaling $2.7 billion. The nutritional supplement industry provides a huge array of products for consumer needs.
Vitamins are micronutrients, or substances that the body uses in small amounts, as compared to macronutrients, which are the proteins, fats, and carbohydrates that make up all food. Vitamins are present in food, but adequate quantities of vitamins may be reduced when food is overcooked, processed, or improperly stored. For instance, processing whole wheat grain into white flour reduces the contents of vitamins B and E, fiber, and minerals, including zinc and iron. The body requires vitamins to support its basic biochemical functions, and deficiencies over time can lead to illness and disease.
Vitamins are either water-soluble or fat-soluble. Water-soluble vitamins dissolve in water and pass through the body quickly, meaning that the body needs them on a regular basis. Water-soluble vitamins include the B-complex vitamins and vitamin C. Fat-soluble vitamins are stored in the body's fatty tissue, meaning that they remain in the body longer. Fat-soluble vitamins include vitamins A, D, E, and K.
The amount of vitamins needed by the body has been the subject of much research. The U.S. government has published recommended dietary allowances (RDAs) for each vitamin for the general population. These figures can be used as guidelines, but individuals may have different needs depending on gender, age, and health conditions.
Vitamins can be natural or synthetic. Natural vitamins are extracted from food sources, while synthetic vitamins are formulated in laboratory processes. The only vitamin for which there is a noted difference between the natural and synthetic forms is vitamin E. The natural form is labeled d-alpha-tocopherol while the synthetic form is named dl-alpha-tocopherol, with the extra "l" signifying laboratory production. Natural vitamin E has been shown to be slightly more absorbable by the body than the synthetic version, although for other vitamins no significant differences in absorption have been noted.
Minerals are micronutrients and are essential for the proper functioning of the body. Cells in the body require minerals as part of their basic make-up and chemical balance, and minerals are present in all foods. Minerals can either be bulk minerals, used by the body in larger quantities, or trace minerals, used by the body in minute or trace amounts. Bulk minerals include sodium, potassium, calcium, magnesium, and phosphorus. Trace minerals include iron, zinc, selenium, iodine, chromium, copper, manganese, and others. Some studies have shown that the amount of minerals, particularly trace minerals, may be decreasing in foods due to mineral depletion of the soil caused by unsustainable farming practices and soil erosion. Supplemental minerals are available in chelated form, in which they are bonded to proteins in order to improve their absorption by the body.
Herbal supplements are added to the diet for both nutritional and medicinal purposes. Herbs have been used for centuries in many traditional medicine systems, and as sources of phytochemicals, or substances found in plants that have notable effects in the body. Chinese medicine and Ayurvedic medicine from India, two of the world's oldest healing systems, use hundreds of herbal medications. Naturopathy and homeopathy, two other systems of natural healing, also rely on herbal preparations as their main sources of medication. The medicinal effects of herbs are getting scientific validation; about one-fourth of all pharmaceuticals have been derived directly from plant sources, including aspirin (found in willow bark), codeine (from poppy seeds), paclitaxel (Taxol), a patented drug for ovarian and breast cancer (from the Pacific Yew tree), and many others.
Herbs can supplement the diet to aid in overall health or to stimulate healing for specific conditions. For instance, ginseng is used as a general tonic to increase overall health and vitality, while echinacea is a popular herb used to stimulate the body's resistance to colds and infections. Herbs come in many forms. They can be purchased as capsules and tablets, as well as in tinctures, teas, syrups, and ointments.
Meal supplements are used to replace or fortify meals. They may be designed for people with special needs, or for people with illnesses that may affect digestion capabilities and nutritional requirements. Meal supplements may contain specific blends of macronutrients, or proteins, carbohydrates, fats, and fiber. Some meal supplements consist of raw, unprocessed foods, or vegetarian or vegan options, or high protein and low fat composition. Meal supplements are available to support some popular diet programs. Meal supplements are often fortified with vitamins, minerals, herbs, and nutrient-dense foods.
Nutritional supplements may be designed to provide specialized support for athletes. Some of these consist of high-protein products, such as amino acid supplements, while other products contain nutrients that support metabolism, energy, and athletic performance and recovery. People engaging in intense athletic activity may have increased needs for water-soluble vitamins, antioxidants, and certain minerals, including chromium. Sports drinks contain blends of electrolytes (salts) that the body loses during exertion and sweating, as well as vitamins, minerals, and performance-supporting herbs.
Other nutritional supplements
Other nutritional supplements include nutrient-dense food products. Examples of these are brewer's yeast, spirulina (sea algea), bee pollen and royal jelly, fish oil and essential fatty acid supplements, colostrum (a specialty dairy product), psyllium seed husks (a source of fiber), wheat germ, wheatgrass, and medicinal mushrooms such as the shiitake and reishi varieties.
Specialty products may offer particular health benefits or are targeted for specific conditions. These products may consist of whole foods or may be isolated compounds from natural or synthetic sources. Examples include antioxidants, probiotics (supplements containing friendly bacteria for the digestive tract), digestive enzymes, shark cartilage, or other animal products, or chemical extracts such as the hormone DHEA (dehydroepiandrosterone) and coenzyme Q10, an antioxidant.
Considering average dietary needs and the prevalence of certain health conditions, some basic guidelines may provide the foundation for the effective use of nutritional supplements. First, a high quality, broad-spectrum multivitamin and mineral supplement, taken once per day, is recommended to provide a range of nutrients. This should contain the B-complex vitamins B6, B12, and folic acid, which may help prevent heart disease, and the minerals zinc and copper, which aid immunity. In addition to a multivitamin, antioxidants can be added to a supplementation routine. These include vitamin A (or beta-carotene), vitamin C, and vitamin E, and the mineral selenium. Antioxidants may have several positive effects on the body, such as slowing the aging process, reducing the risks of cancer and heart disease, and reducing the risks of illness and infection by supporting the immune system. Coenzyme Q10 is another antioxidant in wide usage, as studies have shown it may improve the health of the heart and reduce the effects of heart disease. Essential fatty acids, particularly omega-3, are also recommended as they are involved in many important processes in the body, including brain function. Calcium supplementation is recommended for the elderly and for women, to strengthen bones and prevent bone loss. Calcium supplements that are balanced with magnesium have a less constipating effect and are better absorbed.
After basic nutritional requirements are supported, supplements may be used to target specific needs and health conditions. For instance, athletes, men, women, children, the elderly, and vegetarians have differing needs for nutrients, and an informed use of supplements would take these differences into account. People suffering from health conditions and diseases may use specific supplements to target their condition and to support the body's healing capacity by providing optimal amounts of nutrients.
Dosages of nutritional supplements vary widely, depending on the product and individual needs. For vitamins and minerals, U.S. RDA's are essential guidelines. For other products, manufacturers' guidelines, consumer information sources such as nutritional books and magazines, and practitioners including nutritionists and naturopathic physicians may be consulted.
Overall diet is an important first consideration for those considering nutritional supplementation. Healthy dietary habits can help optimize nutrition and the absorption of supplements, and nutritional supplements cannot substitute for a diet that is not nutritionally balanced in the first place. Supplements are best used moderately to supply any extra nutritional requirements. Sound diets contain a variety of wholesome foods. At least five servings per day of fruits and vegetables are recommended, as well as the inclusion of whole grains in the diet. Variety in the diet is important to provide a full range of vitamins and minerals. Overeating inhibits digestion and absorption of nutrients, while regular exercise contributes to sound nutrition, by improving metabolism and digestion. Drinking plenty of clean water prevents dehydration, improves digestion, and helps the body flush out impurities.
Generally, nutrients from food sources are more efficiently utilized by the body than isolated substances. For instance, fresh fruit and vegetable juice could be used to provide concentrated amounts of particular nutrients, such as vitamins A and C, to the diet. As another example, eating plenty of leafy green vegetables is a healthy option for those wishing to add calcium to the diet.
Vitamins and minerals are most easily digested with food. Fat-soluble vitamins should be taken with food that contains fat. Vitamins tend to work synergistically, meaning that they work together in order to be effective. For instance, vitamin E requires some of the B-complex vitamins and the minerals selenium and zinc for most effective absorption. Some minerals may not be absorbed or may inhibit each other when taken in improper ratios. Generally, a high quality, broad-spectrum vitamin and mineral supplement will be formulated to prevent unfavorable interactions.
Vitamin A can become toxic when taken in large amounts (over 100,000 International Units) on a daily basis over time, as can vitamin D. Substituting beta-carotene for vitamin A can alleviate this risk. Very large doses of minerals taken over long periods may have toxic effects in the body. Dosages far exceeding RDA's of vitamins are not recommended, nor are large doses of other supplements.
Consumers can make wise choices for nutritional supplementation by consulting professional nutritionists and naturopathic physicians. Nutritional supplements are best added into the diet slowly, starting with small dosages and working up to the manufacturers' recommended amounts over time. Also, some supplements, such as herbal medications that may stimulate processes in the body, are best taken intermittently, allowing the body occasional rest periods without the supplement. To avoid unfavorable interactions, nutritional supplements are best used moderately and individually, rather than taking handfuls of capsules and tablets for various needs and conditions at the same time. Finally, consumers should be wary of excessive or grandiose health claims made by manufacturers of nutritional supplements and rely on scientific information to validate these claims.
Some nutritional supplements can cause upset stomach and allergic reactions, including rashes, flushing, nausea, sweating, and headaches.
Herbal preparations and nutritional supplements may interact unfavorably with pharmaceutical drugs. For instance, some nutritional supplements recommended for nervous system function may not be recommended for those taking pharmaceutical antidepressants, such as taking 5-HTP, a nutritional supplement for the brain, or the herb St. John's Wort, with prescription antidepressants. Vitamin C should not be taken with aspirin, as it can irritate the stomach and limit absorption. Minerals should be taken in proper proportions to prevent unfavorable interactions; large amounts of zinc may deplete the body of the mineral copper, while too much calcium adversely affects the magnesium levels in the body. Balanced mineral supplements are recommended to alleviate these interactions.
Antioxidants— A class of biochemicals that have been found to protect cells from free-radical damage.
Enzymes— Chemical catalysts that help initiate biochemical processes.
Essential fatty acids— Sources of fat in the diet, including omega-3 and omega-6 fatty acids.
Naturopathic physicians— Physicians specializing in the treatment of disease using a variety of natural methods and plant-based medicines.
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Center for Science in the Public Interest. 1875 Connecticut Avenue NW, Suite 300, Washington, D.C. 20009. (202)332-9110. 〈http://www.cspinet.org〉. Publishes Nutrition Action Newsletter.
National Nutritional Foods Association. 1220 19th Street NW, Washington, D.C. 20036. (202)223-0101. 〈http://www.nnfa.org〉.
USDA Food and Nutrition Information Center. 〈http://www.nal.usda.gov/fnic〉.