Too Much or Too Little: The needs for education about dietary supplements

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Have you ever found yourself wandering down a store aisle looking for a vitamin or other dietary supplement? The options can be overwhelming!

What the the Situation? 

  • The financial effect: For the large portion of the population living in settings of financial/food insecurity, choosing the wrong product is a waste of critical resources.
  • The health effect: choosing the wrong product can result in our bodies getting too LITTLE of what they need or too MUCH both of which can be very serious- even fatal.

Iron-deficiency anemia is the most common form of poor nutrition, affecting 2 billion people globally. Some of its effects are weakness, fatigue, and poor learning. A doctor tells a mother that her child has mild anemia and needs to start a multi-vitamin. They go to the store and pick out a gummy multivitamin. All is well, right? No. The vitamin is “Complete” but has NO iron. Her condition is going UNtreated but they are UNaware.

What are Sources of Information?

    • The FDA: is in charge of regulating dietary supplements. However, according to the Dietary Supplement Health and Education Act of 1994 (DSHEA) the manufacturers are required to assure the product is safe and that the labels are truthful. They are NOT required to register the product with the FDA or produce any data about the product before it is placed on the market.
    • The Media: Commercials and labels promote products as “all-natural”, “new and improved”, “plus”, “essential”, etc.
    • Health professionals: Public health professionals can help their patients in the area of dietary supplement education: is a supplement needed? If so, which one?

What is the Significance of a public health educational campaign on dietary supplements?

  • Informed and empowered patients
  • Money better-spent
  • Increased safety!!
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8 Responses to “Too Much or Too Little: The needs for education about dietary supplements”

  1. ruthjhsph Says:

    Thanks for tackling this important topic. My son’s pediatrician recommended that I buy a multivitamin with iron for him when he turned 1. I happen to know the effects of iron deficiency in children and took the recommendation very seriously. I went straight to the store only to discover that the yummy gummy vitamins do not contain iron (as you mention). To find this information, I had to read through the tiny print on the rounded bottle with a magnifying glass. When I finally located a vitamin with iron, the dosing was for ages 2 and up. I decided to buy the bottle and cut the vitamins in half. I sincerely doubt that the manufacturer had tried cutting the tiny hard vitamin because it is virtually impossible. Vitamin supplementation is important for obvious reasons, but I would have liked my pediatrician to recommend a vitamin by name so that I would know exactly what to buy for my son. My wishes are directly in line with your recommendation above.

  2. badcafos Says:

    I really enjoyed your article! I think your topic is very relevant to the society in which we live in! As a parent I very cautious about what I consider safe for my child but I am alway amazing at how so many people believe the marketing propaganda!

    I think another issue to raise is that the FDA considers dietary supplements just that, something dietary or from a food source (mineral, vitamins etc) rather than a “medicine” However this thinking is dangerous because is makes the assumption that it cannot be harmful, when in fact in may be very harmful. If supplements are not regulated they may contain various heavy metals such as arsenic ( a known carcinogen!) and lead or contain less than adequate dosage amounts. Many consumers are just plain unaware that these products are so loosely monitored.

    On the opposing side I once read that it can take several years to get a drug FDA approved. Although it may be “safer” once it has been through the long and tedious process of drug approval, if we label these dietary supplements, or treat them more like a drug, we run the risk of some rather decent products on our shelves never making it to the consumer marketplace. What do you suggest we do to ensure these products have been through a more regulated process and therefore deemed safer for consumption?
    Thanks again for a great article!
    Kristy

  3. sbfphc Says:

    This is a challenging area, not the least because recommendations and research change. Just yesterday I recall seeing something about Vitamin E supplements not being good for bone health. The consumer may naturally be confused, and some of the regulatory issues around supplements are a gray area.

  4. kakuete Says:

    Thank you for your post! I agree this is a very important issue that can cause a lot of confusion for parents and individuals who have dietary deficiencies. In actuality its confusing for everyone because I find myself confused by all the options despite being a practicing physician. I’m curious to hear what you feel are possible solutions for this issue. Any thoughts on how or if the FDA can make the situation better?

  5. msherry4 Says:

    Very interesting topic. One question I had while reading this (making me recognize my own ignorance on supplementation in general) is what constitutes a “vitamin/dietary supplement” versus a workout type supplement such as creotine? It seems like there is so much public confusion on what the FDA regulates and doesn’t regulate, what is a supplement that adds things into your diet you would theoretically get from foods versus unnatural supplements to improve looks/performance/muscle size that may not be naturally occurring in food? A great example is 5 hour energy, which is theoretically “just B vitamins.” Yet it is hardly natural, and is not used as a dietary supplement…

    I also know so many people that use unregulated workout type supplements without really knowing what is in them or what long term affects they have on the body. It’s very concerning, but perceived as safe since they are sold in “health food” stores and it is generally assumed that the FDA would pull unsafe products from the market. Even without further FDA involvement in regulation, I think its very important that the risks are articulated to the public, and that information on what really is in supplements is made apparent.

  6. alazarben Says:

    Shopping for the right supplement (vitamins) sometimes turns out to be a wild-goose chase. It was a few days back that I went to one of the ‘vitamin shoppe’ stores to buy vitamin-D supplement. There were lots of them. The difficulty really turned out in picking the appropriate dosage. Is it 400 units, 1000 units, 1,500 or 2,500 units? While the recommended daily allowance is 600 units, the rest must have a specific indication to take. What if someone takes the higher dose for a long period of time? That’s going to be Hypervitaminosis D, another condition that needs to be diagnosed and treated as well. A few days later, I learned that I need to take one of the vitamin B’s on top. Another shopping…
    This could have been an easier and safer task for the patient if healthcare providers handed out a slip/script describing the specific vitamins or other supplements and the daily dose required. Otherwise the uninformed patient will squander his/her money on a supplement with the least or no benefit.

  7. blossom1000 Says:

    Thank you for this very important post. It is so frustrating when you receive these prescriptions and the required nutrient/vitamin is absent. It is even more perplexing when you browse through different products each promising better absorption properties. I have a friend who had received a prescription of 1000 I.U. of Vitamin C for treatment of mouth ulcers. Well, after several days on the treatment with no relief, she purchased and consumed half a dozen oranges. And what do you know, her ulcers were almost gone in 24 hours. Clearly, all the money spent on this supplement could have been saved. I think the medical community needs more thorough education on this subject if we are going to save our patients money and time.

  8. mphsrinivasan Says:

    This is an extremely important topic which probably does not get nearly the attention it deserves. Everyone is now looking to dietary supplements, especially the ‘natural’ alternatives to heal their particular disease or ailment. Even places like Costco have huge volumes of everything from acai, hoodia, green tea etc., as well as all kinds of vitamins as dietary supplements. While there seems to be plenty of information on the labels of the products, it is unclear what the correct concentration and dosage is for the average person. It can be mind boggling to find the right product. Also, we are all looking for the magic bullet that is going to cure all problems and this makes us vulnerable to the marketing of dietary supplements. National Institutes of Health’s Office of Dietary Supplements partners with the National Library of medicine (http://ods.od.nih.gov/) and has a website with fact sheets directed to health professionals and just quick facts for the lay person, in a format that is user-friendly for both consumers and researchers.
    Still the danger of using the wrong dietary supplement is always there and there needs to be more oversight on usage of dietary supplements.

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