To take, or not to take? That is the question. Supplements have been a buzzword in recent years, and a focal point of public confusion. The purpose of this article is to accumulate information from reputable organizations including the Food & Drug Administration (FDA), American College of Exercise (ACE), National Institute of Health (NIH), American Cancer Society, and American College of Sports Medicine (ACSM), so you may make an informed decision on taking supplements.
What Is a Supplement?
So what exactly is a supplement? They come in all shapes and sizes, from capsules, to drinks, to powders, and are sold in a multitude of places. We have herbal supplements like Ginseng, St. John's Wort, Echinacea, and Ginseng; vitamin and mineral supplements like Vitamin D, Vitamin B12, Iron, Fish Oil, and Folic Acid; and performance enhancing supplements, or "ergogenic aids", like Creatine, Dehydroepiandrosterone (DHEA), Caffeine, and Beta Alanine. It is a multi-billion dollar industry, and ultimately has very different standards than it's prescription drug cousin.
"Natural" Means Nothing
Herbal and botanical supplements often get the automatic okay in our minds because they are "natural". However, natural means just about nothing in an industry that synthetically creates their products¹.
The perception of a natural supplement product is that it is not artificially fabricated. This is highly ironic given that the vast majority of dietary supplements are synthetically created in a laboratory environment and likely do not contain any natural, plant-based or nonsynthetic ingredients. - Katie Ferraro, MPH, RDN, CDE
Don't believe me yet? In an alarming study in 2015, authorities, including the attorney general of New York, conducted tests on the top-selling store brands of herbal supplements in the four retail giants - GNC, Walmart, Target, and Walgreens - and found that four out of five of the products did not even contain any of the herbs on their labels and that pills labeled "medicinal herbs" often contained little more than cheap fillers like powdered rice, asparagus and houseplants².
Last year alone, there were 22 "dietary supplements" recalled for various reasons, some because they contained salmonella, anabolic steroids, or undeclared ingredients. This has been a trend for some time now. Go back 5 years to a 2013 report published by researchers in Toronto, and you will find the same pattern, in which 44 random herbal supplements containing "single herbs" were sampled and analyzed using DNA bar coding analysis, but less than half the supplements (48%) contained any of the herbs listed on the label. Moreover, at least half of the supplements contained something that wasn’t even on the label (substitutions or fillers).³
Another irony, is that only a tiny percentage of the world's population stands to benefit from supplementation, but yet for some reason we still yearn so badly to feel superhuman that the global supplement industry rakes in over $100 billion dollars annually.⁴
There are countless supplements that claim wonderful benefits by using their product, and truthfully there could be benefits to using what they say is in their product, but unless you have the ability to run DNA analysis on it yourself (or scientists already have), we don't know if what they claim is in there is actually true! It could be ground up doll hair for all we know. Sadly, according to several reputable organizations, sound science supports the use of only a few dietary supplements whose labels claim ergogenic benefits. However, without a healthy diet in place, there is almost no justification for their use.⁵
According to AND, DoC, and ACSM, sound science supports the use of only a few dietary supplements whose labels claim ergogenic benefits . These organizations add that the best way to use supplements is as additions to a carefully chosen diet, that dietary supplements rarely have ergogenic benefits when not used in these conditions, and that there is no justification for their use by young athletes. - NIH
As previously mentioned, supplements are not a substitute for a proper dietary foundation and will not work as effectively if it is not in place. Since we are in the category of "performance enhancement", I will briefly touch on the adequate daily amounts of calories, fluids, and carbohydrates for athlete:
Can you guess?
Sports with the highest percentage of users taking performance-enhancing drugs for men are ice hockey, wrestling, and baseball and among women are volleyball, swimming, and ice hockey. But the biggest target for adulterated supplements? Bodybuilders.⁶
The FDA notes that products marketed as dietary supplements for bodybuilding are among those most often adulterated with undeclared or deceptively labeled ingredients, such as synthetic anabolic steroids or prescription medications . As one example, some products sold for bodybuilding are adulterated with selective androgen receptor modulators (SARMs); these synthetic drugs are designed to mimic the effects of testosterone. - National Institute of Health (NIH)
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How did we get here?
In 1994, a law called the Dietary Supplement Health & Education Act (DSHEA) was passed, which lightened the standards on supplements treating them as "food products" instead of drugs. The following are outlined standards and regulations on drugs vs. supplements⁷:
The DSHEA was designed to protect the American people, but in actuality puts responsibility back on the supplement manufacturer to simply honor the laws outlined. There is no system in place for policing this other than the FDA, which will only take action if someone is actually harmed from these products. Basically, anyone who can grind up some herbs and come up with a good marketing strategy can sell a dietary supplement and make millions until caught. This literally happens more than you think.
Do Your Due Diligence
By now, I hope you have come to realize that for the most part, supplements are a complete waste of time and money. I encourage you to be as informed about something as you can before buying and consuming it, and if you are already taking supplements, ask yourself the following questions:
The best option, of course, is to ask your physician or Registered Dietitian what they think. As a fitness professional, I (or any other for that matter) cannot recommend you supplements. Please keep in mind the risk you take in purchasing supplements, you are always at the mercy of their honesty. Here is a list of claims to watch out for, all recommendations from the FDA⁷.
Why Has it been hard to change?
The self-proclaimed "champion" of reforming the supplement industry is Senator Orrin G. Hatch, a Republican of Utah. He played a large role in getting the DSHEA passed in the first place and within the past few years has fought against amendments to the current lack of supplement standards, arguing that there is nothing wrong with the current policies in place.⁴ According to a report by the New York Times, Hatch "has accepted hundreds of thousands of dollars in campaign contributions from the industry and repeatedly intervened in Washington to quash proposed legislation that would toughen the rules." Thanks fellah.
Signs you may have goofed
We are all human, so if you feel you've been duped and your supplement is actually doing you more harm than good, check out this list of signs directly referenced from FDA.gov⁸:
The Sunshine Vitamin: All about Vitamin D
Go Wild: Eating wild salmon vs. farmed salmon
Be a Grape Not a Raisin: Importance of proper hydration
¹Ferraro, Author Katie Ferraro Contributor Katie. "5 Reasons Why Most Supplements Are a Waste of Time and Money." ACE. Accessed May 22, 2018. https://www.acefitness.org/education-and-resources/lifestyle/blog/6513/5-reasons-why-most-supplements-are-a-waste-of-time-and-money.
²O'Connor, A. (2015, February 03). New York Attorney General Targets Supplements at Major Retailers. Retrieved May 16, 2018, from https://well.blogs.nytimes.com/2015/02/03/new-york-attorney-general-targets-supplements-at-major-retailers/
³American Cancer Society. (2015, March 15). FDA regulation of drugs versus dietary supplements. Retrieved May 16, 2018, from https://www.cancer.org/treatment/treatments-and-side-effects/complementary-and-alternative-medicine/dietary-supplements/fda-regulations.html
⁴Stulberg, Brad, and Steve Magness. Peak Performance: Elevate Your Game, Avoid Burnout, and Thrive with the New Science of Success. Emmaus, PA: Rodale Books, 2017.
⁵, ⁶"Office of Dietary Supplements - Dietary Supplements for Exercise and Athletic Performance." NIH Office of Dietary Supplements. Accessed May 22, 2018. https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-HealthProfessional/.
⁷US Senator Orrin Hatch. JOINT RELEASE – Hatch, Heinrich Urge DOJ to Enforce Dietary Supplement Rules - Press Releases - United States Senator Orrin Hatch. Accessed May 17, 2018. https://www.hatch.senate.gov/public/index.cfm/keeping-supplements-safe-for-all-americans#2E709075-0958-4171-A73A-48EAF216E4A2.
⁸ Commissioner, FDA. (2017, December 22). Consumer Updates - Dietary Supplements. Retrieved May 17, 2018, from https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm153239.htm
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