Dietary supplements are products intended to supplement the diet. They’re widely available in the United States (and online) and come in many forms, including tablets, capsules, powders, energy bars, and liquids. They’re labeled as dietary supplements and include, among others, the following:
• Vitamin and mineral products
• Botanical or herbal products (may include plant materials, algae, macroscopic fungi, or a combination of these materials)
• Amino acid products
• Enzyme supplements
Dietary supplements can be made available to consumers without prior proof that they’re safe or that the nutrient, health, or other claims they boast on labels are truthful. They cannot, however, be marketed as treatments or cures for or ways to reduce symptoms of any specific diseases. The FDA does provide safety and other regulations for dietary supplements only after they’ve hit the market. If a product appears to pose a risk of illness or injury, or if it appears to be adulterated or misbranded, the FDA can take the necessary action to protect consumers, such as requiring it be removed from shelves.
According to the American Dietetic Association’s position paper on fortification and dietary supplements, “while consuming a wide variety of foods is the best strategy to promote optimal health and reduce chronic disease risk, additional nutrients can be provided by fortified foods and/or supplements can help some people meet their nutrition needs.”
Dietary supplements must be labeled with the term “dietary supplement” or with a term that substitutes the word “dietary” with a description of the product’s dietary ingredient(s) (for example, “herbal supplement” or “calcium supplement”).
The following five statements must be included on a dietary supplement label:
A statement of identity (name of the dietary supplement)
• The net quantity of contents statement (amount of the dietary supplement)
• The nutrition labeling
• The ingredient list
• The name and place of business of the manufacturer, packer, or distributor
Similar to the nutrition facts panel on foods, dietary supplements have a supplement fact panel, which lists the serving size, the dietary ingredient(s) and amount preserving, ingredients list, and percent Daily Value (DV) if a DV is available. Amounts of nutrients that do not have a DV can also be included.
Many dietary supplements have a history of being safe. For example, millions of Americans have consumed multivitamins safely. Other supplements that have been safely consumed include
• Folic acid supplements by women who might be or are already pregnant (taken to reduce the risk of certain birth defects).
• Vitamin B12 supplements in crystalline form. These are beneficial to people over age 50 who often have a reduced ability to absorb naturally occurring vitamin B12.
• Vitamin C supplements to help strengthen the immune system. Smokers may also supplement since their needs are higher.
• Vitamin D if not exposed to ample sunlight and/or don’t consume enough vitamin D-rich foods.
• Calcium supplements to strengthen bones for those who don’t consume enough calcium-rich foods in the diet.
Tips for Buying Supplements
If you and a health-care professional (such as a physician or a registered dietitian) decide a dietary supplement is safe and appropriate for you (based on your health status, medical history, and current supplement/medication use), here are some tips to help you make the safest, most informed selections:
• Look for a USP logo on the supplement bottle – The United States Pharmacopeia (USP), a nongovernmental, not-for-profit public health organization, sets widely recognized standards for foods, prescription and nonprescription medications, and dietary supplements. These standards can be enforced by the FDA. However, the USP analysis and logo is a voluntary program; if you don’t’ see it, it doesn’t mean a product does not meet certain criteria, only that there is no third-party guarantee of that. A “USP Mark” on a product label indicates that the supplement meets the following criteria:
1. It contains all the ingredients listed in amounts declared on the bottle; if it doesn’t, this could cause a significant health risk, especially for those who take a supplement to prevent a specific health problem.
2. It is pure and free of harmful contaminants such as lead, mercury, pesticides, bacteria, molds, toxins, or other harmful chemicals that can cause health problems.
3. It will break down and release the ingredients into the body, where they dissolve; if it doesn’t, you won’t reap the full potential benefits of the supplement.
4. It has been made under good manufacturing practices (these ensure safe, clean conditions and well-controlled and well-documented manufacturing and monitoring processes).
• Be aware that some supplement ingredient, including nutrients and plant components, can be toxic. Some can also be harmful when consumed in high amounts, when taken for a long time, or when used in combination with certain other drugs, substances, or foods.
• Never replace a prescription medicine or therapy, or a variety of foods in a healthful diet, with a dietary supplement.
• Do not assume that the term “natural” in relation to a dietary supplement means the product is wholesome and safe.
• Be wary of dietary supplements hyped in the media – Sound advice should be based on accumulated evidence and not on a single research study.
• If you experience any adverse effects associated with a supplement, be sure to contact or see a healthcare professional immediately – Report any adverse effects to the FDA as soon as possible.
A supplement facts panel is a clear identity statement that includes the amounts of specific nutrients in vitamin and mineral products and the part of the plant used in herbal products. It also includes suggested serving sizes, information on nutrients present in significant levels, the percent DV when applicable, and other dietary ingredients including botanicals and amino acids (even if no DVs exist for such ingredients).