Navigating Dietary Supplements
Separating a few facts from the latest hype about nutrition and the proper role of dietary supplements can help you achieve optimum health

By Diana Koenning, MPH, RD, LDN

Navigating the role of dietary supplements requires more than just being familiar with basic vitamins and minerals. Especially since the multivitamin now shares crowded shelf space with supplements containing herbals, botanicals, amino acids and enzymes and claim to affect everything from the immune system to joint mobility to proper digestion to brain-power.

There is good reason why marketers continue to steadily increase the offerings in this industry. It is estimated more than 40 percent of us use some form of supplement each day, spending a whopping $6 billion last year in just the United States. Many consumers typically do little research before a purchase and see these dietary aids
as harmless.

Vitamins and Minerals 101
The word “vitamin” is a great example illustrating the power of marketing in today’s culture. When speaking to a nutritionist or dietitian, it is not uncommon for patients to interchange the word “vitamin” when referring to a pill or other nutritional supplement they are taking. The fact is vitamins are not pills or powders. Vitamins are the organic building blocks of good nutrition, and we get them exclusively from plant and
animal foods. There are 13 identified vitamins, and they are needed in certain quantities and combinations for normal growth, metabolism, and control of the chemical mechanisms in our bodies.

When considering a nutritional supplement, it is important to understand that vitamins are classified in two categories: water soluble and fat soluble. Water solubles include Vitamin C and the Bs. The body takes what it needs of these and expels the rest through the kidneys.

Fat soluble vitamins like A, D, E and K are stored in the body’s fat cells and liver. These pose a greater toxicity concern when taking a supplement, because they could build-up in the body.

Minerals are the partners to vitamins in good nutrition. Minerals are inorganic elements also found in food products that affect the production and activities of enzymes and hormones. They serve as raw material for structures such as bones. Essential minerals include chromium, copper, magnesium, selenium and zinc.

Vitamins and minerals compete for absorption and utilization in the body. If you increase one, it is likely that you will decrease the effectiveness of another. This is why there are established Daily Values for vitamins and minerals and exceeding the upper limits of these established Daily Values can be harmful.

Understand the Regulatory Rules
This one is fairly easy to cover: there really are no rules. The fact is the Food and Drug Administration does not regulate most claims on supplement bottles. The FDA only takes action against a supplement if it presents significant risks after entering the marketplace. So, in essence, the makers are free to say whatever they want. False claims include any supplement that says it can “cure” or “treat” disease. Another term that causes confusion with consumers is “high potency.” To the FDA, a multivitamin can call itself high potency if two-thirds of the nutrients have at least 100 percent of the Daily Values. Most consumers perceive high potency to be more than the DVs.

It can become easy to chase the latest headline, but it is recommended that you look for the following on the supplement bottle: an expiration date, “USP Approved,” and “Release Assured.” USP stands for The United States Pharmacopoeia. They test supplements if manufacturers pay the fees to cover the testing. The mark means that the listed ingredients are in the supplement and will dissolve or disintegrate. But even the USP does not guarantee safety or efficacy.

Be Proactive
Nutritional supplements have come a long way since the term vitamin was coined in 1920. However, you should not have a false sense of security because supplements can be purchased over-the-counter alongside baking mixes and laundry detergent at the grocery store. It is always important to follow the U.S. Recommended Daily Allowance guidelines for vitamins and minerals. Additionally, your healthcare provider should be aware of any dietary supplements you are taking, especially as you age.

One final thought: supplements are titled so for a reason. They are supposed to complement a well-balanced diet that includes fruits, vegetables, grains and proteins. The bottom-line is the only way to get the perfect dose of vitamins and minerals is to eat them. Because that is not always possible on a consistent, day-by-day basis or because our nutritional needs change over time, supplements that have been well-researched play an important role. But the more you understand about total nutrition will keep you on the road to better health for the long haul.

Diana Koenning, MPH, RD, LDN is a Registered Dietitian and North Carolina Licensed Dietitian/Nutritionist. She has been employed at Healthworks-WakeMed since 1986.