Dietary Supplements

Faris Mahmud
Pegawai Farmasi U41
Klinik Kesihatan Seberang Jaya

What is a Dietary Supplement?

Definition of Dietary Supplement

A dietary supplement is a product taken by mouth that contains a "dietary
ingredient" intended to supplement the diet.
The "dietary ingredients" in these products may include: vitamins, minerals,
herbs or other botanicals, amino acids, and substances such as enzymes and
metabolites.
Dietary supplements can be found in many forms such as tablets, capsules,
softgels, gelcaps, liquids, or powders.
Supplements do not have to go through the testing that drugs do
Dietary supplements is placed in a special category under the general umbrella
of "foods," not drugs, and requires that every supplement be labeled a dietary
supplement.

What are the types of dietary supplements?

Types of Dietary Supplements

Vitamins
Dietary Elements
Amino Acids & Proteins
Essential Fatty Acids
Herbal Medicines & Botanicals

Vitamins
Vitamin is anorganic compoundrequired by anorganismas a vital
nutrientin limited amounts
An organic chemical compound (or related set of compounds) is
called a vitamin when it cannot besynthesizedin sufficient
quantities by an organism, and must be obtained from the diet.
Supplementation is important for the treatment of certain health
problems but there is little evidence of benefit when used by
those who are otherwise healthy.
Examples: Retinol (Vitamin A), Ascorbic acid (Vitamin C)

Dietary Elements
Commonly called "dietary minerals" or "minerals"
Thechemical elementsrequired by livingorganisms, other than
the four elementscarbon,hydrogen,nitrogen, andoxygenpresent
in commonorganic molecules
Example: Calcium, Magnesium, Iron, Zinc

Amino Acids & Proteins

Amino acids can be divided into three categories: essential amino
acids, non-essential amino acids, and conditional amino acids.
Essential amino acids cannot be made by the body, and must be
supplied by food.
Non-essential amino acids are made by the body from essential
amino acids or in the normal breakdown of proteins.
Conditional amino acids are usually not essential, except in times
of illness, stress, or for someone challenged with a lifelong
medical condition

Herbal Medicines & Botanicals

Use of plants or certain parts of plants for certain medicinal
purposes.
Plants have been the basis for medical treatments through much
of human history, and suchtraditional medicineis still widely
practiced today.
Example: Milk Thistle, Ginkgo Biloba, Tongkat Ali

Essential Fatty Acids

Essential fatty acids, or EFAs, arefatty acidsthat humans and
other animals must ingest because the body requires them for
good health but cannotsynthesizethem.
The term "essential fatty acid" refers to fatty acids required for
biological processes but does not include the fats that only act as
fuel.
Example: Omega-3 Fatty Acids (EPA, DHA)

Other Substances
Including other enzymes, metabolites, and various other
substances
Example: Alpha-Lipoic Acid, CoQ10

Why take supplements?

Reasons for people taking supplements

Belief that supplements will improve their health
Concern that they dont get enough nutrition from their regular
meals
Rumors or hearsays that certain product may improve certain
conditions
Certain disease or medical condition that requires them to take
certain supplements

Is it necessary to take dietary supplements?

Necessity to take dietary supplements

For generally healthy population, dietary supplements are not
necessary
Most of the nutrients can be obtained from various meals, provided
they are taking variety of balanced meals
However, supplements might benefit certain population with certain
conditions

Pregnant ladies
Malnourished population
Children/elderlies
People with certain medical conditions

Advantages of Dietary Supplements

For pregnant ladies

Women who are pregnant, or who are trying to get pregnant, are
advised to take to ensure normal neural development of fetus.
400 micrograms of folic acid is advised to be taken each day
during the first 12 weeks of pregnancy.
This is recommended over and above the 200 micrograms of folic
acid that most of us would have in our diet every day from regular
food.
Vitamin B Complex and Iron were also generally supplemented to
pregnant & lactating ladies

For hectic populations

If your diet is not wholesome due to a hectic lifestyle, you might
not get all of the necessary vitamins or nutritions.
Most adults have deficiencies of potassium, vitamin D and vitamin
B 12.
Supplementation with Multivitamins & Minerals might help in such
populations.

For people who dont consume certain foods

If you are a vegan or a vegetarian, you may not be getting enough
vitamin B 12 as this vitamin is present in meat and eggs.
Hence a supplement of vitamin B 12 may be of great help.

Those who have an allergy to milk and milk products may be

deficient in calcium
So taking a calcium supplement will be helpful.

For children & elderlies

Children can be fussy eaters
Elderlies usually dont get enough nutrition either due to reduced
food intake or reduced nutritional absorption
Both of these populations might not get their daily nutritional
requirement met
Hence, dietary supplement of multi-vitamins might help to bridge
nutritional gap of these group

For people with certain medical conditions

Those with osteoarthritis might benefit from supplementation of
glucosamine
People with heart failure or ischemic heart disease might benefit
from supplementation of CoQ10
People on Statins might also benefit from supplementation of
CoQ10 to alleviate or reduce the risk of myopathy

Disadvantages of Dietary Supplement

Poor legal regulation

Unlike prescription medications, dietary supplements
have:
No proper clinical trials
No requirement for efficacy (to proof they do what they claim)
No requirement for safety (to proof they cause no harm)

Not a food replacement!

Supplements do not contain the complex constellation of vitamins and
nutrients that foods contain, including phytochemicals.
If you are taking dietary supplements, it doesnt mean that you do not
need to take the daily recommended servings of grains, fruits, and
vegetables.
Getting your essential body minerals and nutrients from foods is still
better compared to relying on dietary supplements.
A supplement cannot take the place of a well-balanced diet. It is best
to get your daily allowances of vitamins from food and rely on a
supplement to only take care of specific deficiencies.

Potential overdosing & toxicity

The more the better is a rule that is untrue to dietary supplements.
Fat-soluble vitamins E, D, and A can accumulate to toxic levels within the
body if taken in doses exceeding the recommended daily allowance (RDI).
It is recommended to take extra precautionary actions when taking more
than one dietary supplements to ensure that they will not exceed your RDI.
Its best to avoid taking vitamin A supplements while youre pregnant, as
this may damage the development of your baby
More than 10mg per day of vitamin B6 can lead to loss of feeling in the
arms and legs.

Interactions with prescribed medications

Some vitamins may react adversely with other medications you are prescribed.
An example is vitamin D which lowers the blood levels of the cholesterol lowering
drug atorvastatin.
Vitamin K can reduce the ability of the blood thinner Warfarin to prevent blood
from clotting.
St. John's wort can speed the breakdown of many drugs, including antidepressants
and birth control pills, and thereby reduce these drugs' effectiveness.
Antioxidant supplements, like vitamins C and E, might reduce the effectiveness of
some types of cancer chemotherapy.
So it is best to tell your doctor if you are taking any supplements.

Expensive!
Compared to daily food from which you can reach your nutrional
requirement normally, supplements is much more expensive in a
long run
If you are planning to take them long term, you need to consider if
you can afford it.

On the bottom line....

Conclusion
Supplements are not needed with a balanced diet
Supplements are not regulated on the market and can be unsafe
Choose wisely and consult with a healthcare professional for more
information

Thank you!!!
Be a wise consumer!