What You Really Need to Know About Supplements

It’s no secret the average American diet falls nutritionally short.

Do you really need a supplement? (Image: Nikolai Titov/Adobe Stock)

All of the “eat the rainbow” advice seems to have gone in one ear and out the other.

And we don’t just stop at diet. A 2016 study found that less than 3 percent (no, that’s not a typo) of all Americans actually lead a healthy lifestyle, which entails hitting the four big markers: abstaining from smoking, eating well, exercising and maintaining a healthy body fat percentage.

So how does one rectify the situation?

Kick the cigarettes, stock up on leafy greens and hit the gym?

It seems, instead, we turn in droves to dietary supplements to compensate for the nutritional failings of our diets.

In 2014, Americans purchased $36.7 billion worth of supplements, of which $14.3 billion were vitamin- and mineral-containing supplements.

But are supplements really necessary?

And, in the midst of recent news of dietary supplement “scams” — with products being contaminated with dangerous compounds or not doing what they claimed to do — how can you be so sure the bottle you’re buying is effective (or even safe)?

Here’s what you really need to know about supplements.

Do I Really Need a Supplement?

Official recommendations set by the Dietary Guidelines Advisory Committee (DGAC) do not encourage dietary supplementation as the first line of defense for the general population.

The 2015 Dietary Guidelines (established by the DGAC), which sets nutrition standards for the country, states, “nutritional needs should be met primarily from foods.”

Basically, Mother Nature has our backs. The majority of us can get what we need — vitamins, minerals, fiber and other natural substances — primarily through food.

But the guidelines go on to say: “In some cases, fortified foods and dietary supplements may be useful in providing one or more nutrients that otherwise may be consumed in less-than-recommended amounts.” So perhaps your diet doesn’t cut the mustard.

But supplementation can be dangerous. People with health conditions, pregnant women and people taking medications should be especially cautious when considering dietary supplementation.

In fact, the DGAC report says: “Dietary patterns among Americans, including typical use of fortified foods, rarely lead to overconsumption of folate, calcium, iron or vitamin D. However, each of these nutrients, as well as other nutrients, are overconsumed in some supplement users, especially those taking high-dose supplements.”

Supplements: When to Say When

While not exactly encouraged, limited dietary supplementation is condoned in national guidance.

“The public may safely use dietary supplements containing RDA level of nutrients,” says the DGAC report, “so long as total intake from diet plus supplements does not exceed the UL.”

Two important acronyms to remember here.

First, the RDA is the Recommended Dietary Allowance — the average amount of a nutrient needed to meet the requirements of nearly all healthy people.

Do you know what's in your protein powder? (Image: Syda Productions/Adobe Stock)

The second is the UL, which is the Tolerable Upper Intake Level; the highest level of daily intake deemed safe for a given nutrient. Going above the UL can lead to some dangerous effects.

Remember, foods and dietary supplements contribute to nutrient intake, and it can be difficult to evaluate the amount of a given nutrient you consume from all sources.

How to Find a Supplement You Can Trust

Unfortunately, the FDA does not ensure the safety of dietary supplements before they go to market.

Once on store shelves, according to the FDA, “if a serious problem associated with a dietary supplement occurs, manufacturers must report it to FDA as an adverse event. FDA can take dietary supplements off the market if they are found to be unsafe or if the claims on the products are false and misleading.”

This process can lead to some dangerous consequences. News headlines recently have announced multiple investigations into some supplement products and popular retailers. An investigation by the New York State Attorney General’s office found Target, GNC, Walgreens and Walmart to be selling fraudulent and potentially harmful herbal supplements under their store brands.

The retailers were ordered to cease sales of these products.

And a federal investigation is ongoing in the sale of tainted products that have caused liver failure in consumers across the country. While the tainted products being investigated were marketed for weight loss, workout aids or as herbal supplements, the news does shine a light on the difficulty of evaluating the quality of dietary supplements across the board.

3 Important Tips for Choosing Dietary Supplements

Mary Beth Augustine, RDN, CDN, FAND, senior nutritionist at New York’s Mount Sinai Beth Israel Center for Health and Healing, gives three tips for choosing dietary supplements:

1. Do not buy dietary supplements manufactured outside of the U.S. Many contain adulterants and contaminants.

2. If a dietary supplement claims it can cure a disease, is all-natural or has a money-back guarantee, beware. If it sounds too good to be true, it probably is.

3. Look for independent third-party verification of ingredients by United States Pharmacopeia, ConsumerLab or NSF International.

Consumers can identify supplements with these certifications by looking for the corresponding icon (usually a small seal with the letters “USP” or “NSF”) on the supplement package.

Each third-party verifier has its own quality standards, but they are generally very similar and include criteria for identity, quality, purity and potency. For instance, the USP seal confirms that the product contains the ingredients in the declared amounts as listed on the label; does not contain harmful levels of specified contaminants; and follows FDA guidelines for sanitary and well-controlled production processes.

Dietary supplement lines from the brands Nature Made, sold widely in retail stores, and Kirkland Signature, Costco’s store brand, are USP verified.

The USP seal confirms that the product contains the ingredients in the declared amounts as listed on the label. (Image: monticello/Adobe Stock)

Why Do Some Verified Supplements Cost More Than Others?

Of course, there is even variation amongst supplements with third-party quality verifications. If you want to find top-of-the-line products, look for supplement companies that set their own standards for quality control and make them transparent on their website. Julie Starkel, M.S., M.B.A., RDN, of Starkel Nutrition in Seattle, says, “I recommend professional-line supplements for my clients because I know that they meet my criteria for quality.”

Starkel starts with a simple requirement that the product meet current good manufacturing practice (cGMP) guidelines set by the FDA to ensure quality production, accurate labeling and absence of contaminants in dietary supplements.

From there, Starkel’s criteria build to include significant testing. “I recommend supplement companies that test every raw material batch for potency and authentication of the listed ingredients and for the presence of contaminants like heavy metals, chemical solvents, herbicides, pesticides and aflatoxins.

Some brands that meet these standards are Thorne, Pure Encapsulations, Perque and Integrative Therapeutics.” These professional-grade products tend to cost more than the average supplement on your drugstore shelf.

“Most confusing to consumers is the question of why they should pay more for one product versus a similar one, because retail brand marketing suggests they are all the same,” explains Starkel. But cheaper dietary supplement products are not always available in the most absorbable forms, and they don’t always do what they say they’ll do. “Even if a retail brand is cheaper, it may be less effective — and then you have wasted your money altogether. Why not get the high-quality product that is actually suited to your needs?” she points out.

Starkel recommends Emerson Ecologics, an online distributor of many brands of dietary supplements, because they have a “medical board of advisors who espouse similar quality criteria” to those mentioned above.

Lastly, take a look at ingredient labels.

Some supplements contain many fillers and undesirable ingredients like sweeteners. Similar to choosing a healthy food product, steer clear of anything with a lengthy ingredient label.

Keep in mind that certain ingredients may be necessary to the product. For instance, gelatin is often one of the ingredients in a supplement that comes in capsule form.

The overall quality recommendations hold for finding dietary supplements of any kind.

Building on that, each nutrient has an acceptable and/or optimal dose, and some have preferred forms.

What Do You Think?

What do you look for in a supplement? What supplements do you take? Share your thoughts and comments with us in the below.

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