2023-11-18 04:20:00
There is no box without a promise: “Energy and vitality”, “Immunity”, “Prostate comfort”. On the shelves of a pharmacy in Barcelona, dozens of boxes are overflowing with pills that, under the formula of food supplements, guarantee to reduce “oxidative damage”, have “energy and sexual desire” or “burn fat”, among other omens. A few meters away, on the shelves of a supermarket, the pattern is repeated: multivitamins, minerals and combined with herbal extracts are offered for “joint well-being”, help with “detoxification” or achieve “extra vitality” . Both of them cover, apparently, all aspects of well-being. But the scientific community views so many promises with suspicion and warns that there is more marketing than effectiveness: they neither cure nor prevent diseases, nor are they harmless.
Nutrition experts warn, in fact, of the limitations of these products and point out that, beyond the indication for people with nutritional deficiencies justified by certain clinical situations, food supplements lack effectiveness in treating conditions or preventing the appearance of ailments. cardiovascular or cancer, for example. In the worst case, these preparations can even pose certain risks if ingested without supervision or in quantities higher than the maximum recommended.
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In the eyes of the law, all these kinds of preparations they are food, not drugs. Foods intended to complement—not replace—a normal balanced diet. They are, for example, vitamins, minerals (such as calcium or magnesium, for example) and probiotics. Also amino acids, such as glutamine, or compounds derived from plants, such as caffeine or ginseng. Unlike medicines, food supplements do not require authorization for sale and are dispensed in any location where food is sold, from a pharmacy to a supermarket. But dietitian and nutritionist Azahara Nieto warns that, no matter how natural they are or seem, “they are not harmless.” And furthermore, she emphasizes: “If the diet is complete, you do not need supplementation.”
Only when there is a nutritional deficiency detected does it make sense to resort to certain food supplements, experts defend. “There are primary deficiencies, when the nutrient is not in the diet, and secondary deficiencies, in which that nutrient, despite being present in the diet, for whatever reason, it does not metabolize well, it does not end up arriving and is contributed through other means,” explains dietitian and nutritionist Juan Revenga. Obese people undergoing bariatric surgery, for example, need vitamin and mineral supplementation. Vitamin B12 supplementation is also recommended for those individuals who follow a strict vegetarian lifestyle. Another “very clear” indication, agrees Jordi Salas-Salvador, professor of Nutrition at the Rovira i Virgili University of Tarragona, is folic acid in women who want to get pregnant: “A supplement of folic acid and iron is recommended to prevent deficiency or neural tube alterations in the baby. A neural tube defect can cause nervous system problems, such as spina bifida, and iron helps too, according to the scientiststo prevent premature birth or low birth weight.
The weight of marketing
In practice, however, the phenomenon of dietary supplements goes beyond necessity. A poll published in the Spanish Journal of Human Nutrition and Dietetics revealed, following surveying 2,630 Spaniards, that 70% of the population studied had taken some supplement in the last year, whether food supplements, plant extracts, products for athletes or for weight loss. , among others. In the United States, a health survey reported that more than half of its citizens had taken a dietary supplement in the previous month. The majority claim that they take them to improve their health, their sports performance or to lose weight. “There is a lot of marketing and a tendency to supplement poor management of daily nutrition with supplements. To compensate for this, we believe that the supplement makes up for the situation caused by our habits,” says Violeta Moizé, dietitian and nutritionist at the Hospital Clínic of Barcelona.
But there are no miracles in those pills. “They are products that contain concentrated substances that we can find in food,” insists Revenga. And more so, in a context like this, that of Western countries, where there is “a beastly food availability,” she says, and there are no shortages of any food. “These products are marketed because people want to be deceived. In those little boxes it says ‘more energy, less fatigue, more vitality’ and that is attractive to us and we want to be deceived. Pseudo-miraculous properties are transferred to these products,” laments the nutritionist. But magic recipes do not exist: “Vitamin D is related to the immune system, but taking more vitamin D will not make us more immune to covid. We will have an immune system within our human nature, we will not be superheroes,” he exemplifies.
According to scientific literature, outside of cases indicated and reviewed by health professionals, food supplements have a limited tour. Neither the intake of vitamin and mineral supplements among healthy people reduces the risk of diseases, nor are weight loss supplements an effective method once morest obesity. Nor do omega-3 fatty acids, which can help reduce triglycerides, have a clear and forceful impact on the prevention of heart ailments.
There is a lot of marketing and a tendency to supplement poor management of daily nutrition with supplements”
Violeta Moizé, dietitian and nutritionist at the Hospital Clínic of Barcelona
Uin review The United States Preventive Services Task Force (USPSTF) on the role of dietary supplements in disease prevention concluded last year that “vitamin and mineral supplementation was associated with little or no benefit in the prevention of cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use.” Beta-carotene was also linked to an increased risk of lung cancer and other harmful outcomes in people at high risk for lung cancer.
After analysis, thea USPSTF advised once morest the use of beta-carotene or vitamin E to prevent cardiovascular diseases or cancer and concluded that the available evidence is insufficient to calculate the risk and benefit of taking other nutritional supplements to avoid these same diseases. Regarding these conclusions, scientists from Northwestern University in Chicago signed an editorial in JAMA magazine in which they warned: “The most common reason people report taking supplements is to improve or maintain general health. However, whole fruits and vegetables contain a blend of vitamins, phytochemicals, fiber, and other nutrients that likely act synergistically to provide health benefits. “Isolated micronutrients may act differently in the body than when naturally packaged with a host of other dietary components.”
On the other hand, since these are products considered food, not drugs, “they have no obligation to prove what they say they do,” protests Revenga, and they do not require a medical prescription either. Any individual can consume them on their own, although these preparations are not without risks.
The dangers of excess vitamins
To begin with, one of the dangers is the control of quantities. “If you eat very well and take a multivitamin, maybe you are overdoing it,” observes Revenga. The dietician points out that there are recommended maximum daily intakes of all nutrients and, if these limits are exceeded, “it can be toxic or have deleterious effects.” “So much of these nutrients can limit the absorption of other nutrients,” he explains. Or interfere with the activity of other organic functions. Or cause adverse side effects. “If you give too much phosphorus, you will limit calcium absorption. If you give too much iodine, thyroid function can be disrupted. If you take a lot of vitamin D, you can have diarrhea,” says the nutritionist.
Along these lines, Salas-Salvadó warns that “absorption and bioavailability is not the same as if you take it in food” and gives another example: “With antioxidants, such as vitamin A, E or selenium, if We eat a varied diet, we take various amounts of different antioxidants that are good for health. But if you go overboard and take large amounts, this can have oxidizing effects. The important thing is to have a balanced diet and that you consume nutrients at normal physiological doses.” Moizé also warns of the danger of “overmineralization”: “You can saturate other channels because all these micronutrients are cofactors of reactions that happen in our body: they are needed in a certain amount for a function to be carried out and, if you exceed it, “You can saturate some road.”
With preparations that incorporate plant extracts in their composition, experts draw attention to the lack of studies on their safety. Revenga denounces that they assume unproven benefits: “It is the exotic component that serves the manufacturer as a sales lever. It’s putting glitter and neon on it,” he says. In an article Published in the International Journal of Environmental Research and Public Health, Polish researcher Regina Wierzejska points out: “In recent years, numerous preparations have appeared that include plants that have never before been used in Western medicine. Their mechanisms of action have not been sufficiently researched and described, and labels do not usually include information on contraindications, which does not mean that they do not exist. Herbal components, especially herbal mixtures, can have a negative effect on the mechanisms of action of drugs, either by accelerating excretion from the body or producing dangerously high concentrations in the blood.”
Adulterated supplements
Another threat with these products is the illegal incorporation of substances that the manufacturer does not identify on the box and the consumer ingests without knowing it. There are substances that can cause adverse effects or interact with other drugs that the individual is taking. The Spanish Agency for Food Safety and Nutrition (AESAN) closely monitors what they call “pharmacologically active substances marketed as food supplements” and alert of his presence. This happens, above all, with compounds used to increase sexual vigor, promote muscle development or accelerate weight loss.
In A study where the adulteration of dietary supplements to improve sexual function was analyzed, it was found that the majority contained phosphodiesterase inhibitors, such as sildenafil, present in Viagra. And in several samples, there was even a dose of these substances well above the maximum approved dose recommended in drugs. “This is an adulteration that is especially dangerous when a person takes medication, for example, for blood pressure and heart, and is not aware of it,” Revenga denounces. And the same thing happens, she says, with natural slimming products, to which antidiabetic active ingredients are incorporated. The AESAN launched last year three alerts due to the presence of active ingredients similar to those of Viagra in food supplements and another notice due to the appearance of an anti-obesity drug in a supplement that was presented as a “natural product.”
Plant extracts are the exotic component that serves as a sales lever for the manufacturer. It’s putting glitter and neon on it.”
Juan Revenga, dietitian and nutritionist
“The word natural is a key that opens many doors. A snake bite or a volcanic eruption are also natural,” Revenga jokes. Experts urge caution with the consumption of these substances and, before making any decision, Nieto recommends, citizens should “review their diet to see what they need, but not self-diagnose or self-prescribe anything.” Better, always, consult with your family doctor or other health professional. And be careful with miraculous promises.
“There is a lot of marketing and advertisements are made for things that have no evidence that they work and there is no talk regarding the unwanted effects they may have,” recalls Salas-Salvadó. In its recommendations, AESAN itself also warns that “natural does not mean safe, help for weight control only makes sense with a healthy lifestyle, sports performance requires adequate training and a healthy diet and no food supplement is useful.” in sexual relations.”
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