Do supplements even work?

The market for dietary supplements is growing rapidly in European Union countries and the United States, heavily influenced by mass media advertising. The use of dietary supplements may seem like an easily accessible yet simple way to provide valuable nutrients, as well as bioactive compounds with health-promoting properties. So let's find out if dietary supplements work at all.

• What are dietary supplements?
• Are supplements safe?
• When can supplements be useful?
• What supplements are most often recommended for health-promoting purposes?
• Which supplements for athletes actually work?

What are dietary supplements?

According to the definition, dietary supplements are foods whose primary purpose is to supplement the standard diet. They can be a concentrated source of vitamins and/or minerals or other substances (including but not limited to: amino acids, fatty acids, enzymes, dietary fiber, probiotics, herbs, plant extracts, antioxidants) that exhibit nutritional or other physiological effects. They are produced and sold in the widest variety of forms, namely tablets, capsules, dragees, powder, powder sachets, liquid ampoules, dropper bottles, beverages and chewing gum. It is worth noting that dietary supplements are not drugs and are not subject to pharmaceutical law.

Are supplements safe?

Dietary supplements placed on the retail and wholesale market must not pose a threat to the health and life of consumers. Therefore, manufacturers must ensure that the use of dietary supplements according to their indications is 100 percent safe for the consumer. All dietary supplement ingredients and their concentrations should under no circumstances exceed the upper safe levels established for vitamins, minerals and other bioactive substances. Although dietary supplements can be an effective supplement to deficient ingredients in the diet, it is important to keep in mind the possible risk of certain negative side effects when used improperly. For example, heavy smokers should not supplement beta-carotene, as it can increase their risk of lung cancer. In addition, it is worth bearing in mind that some components of dietary supplements may interact with other food ingredients or medications, which may involve the risk of side effects.

When can supplements be useful?

A well-balanced and varied diet provides the vast majority of nutrients necessary for the body to function properly. If a healthy diet is followed over the long term, there is usually no need for ongoing dietary supplementation in a healthy person, except for the following few indications.

• Vitamin D for the entire population, as vitamin D deficiency is common among residents of Poland, as well as the rest of Central Europe.

• Omega-3 long-chain polyunsaturated fatty acids (especially EPA and DHA) in pregnant women and anyone avoiding regular consumption of fatty fish species.

• Folic acid in pregnant women and those planning to become pregnant.

• Iodine in women planning to become pregnant and pregnant and breastfeeding women.

• Iron in women planning to become pregnant and pregnant women with clear risk factors for anemia.

• Vitamin B12 in anyone adhering to an all-plant-based diet and patients taking certain medications (e.g., metformin, proton pump inhibitors) long-term.

• Probiotics with documented effects in certain clinical situations (e.g., irritable bowel syndrome, acute diarrhea, prevention of diarrhea associated with antibiotic use and hospital diarrhea).

• Protein supplements and dietary supplements with a proven effect on improving exercise capacity in athletes, as intensive sports activities increase energy and nutrient requirements in the diet.

What supplements are most often recommended for health-promoting purposes?

There is no doubt that the most commonly recommended dietary supplement in recent years is vitamin D, which has a comprehensive effect on the human body. Current guidelines recommend taking vitamin D during the months of September through April, or year-round (necessarily in seniors) if efficient skin synthesis of vitamin D is not ensured during the summer months. EPA and DHA acids are another dietary supplement that is widely recommended for health-promoting purposes. Pregnant women and anyone who completely excludes fish and seafood from their diet (e.g., vegans, lacto-vegetarians, lacto-ovo-vegetarians) should necessarily supplement their diet regularly with EPA and DHA acids in the form of Schizochytrium sp. microalgae oil or high-quality cod liver oil (cod liver oil) or Antarctic krill oil, depending on individual preference. Other frequently recommended supplements for health-promoting purposes include vitamin B12, zinc, magnesium, iron, selenium, bergamot polyphenols, monacolin K, antioxidants, adaptogens, and probiotics and synbiotics, among others.

Which supplements for athletes actually work?

It is well known that the use of dietary supplements among professional and amateur athletes is widespread. Although the current market for dietary supplements offers a wide assortment of products dedicated to regular athletes, there is a fairly narrow group of dietary supplements that are actually recommended in certain situations by the most prestigious organizations, which include the Australian Institute of Sport and the International Olympic Committee. Professional and amateur athletes who care about developing muscle mass, power and strength should focus primarily on regular supplementation with creatine monohydrate, beta-alanine, caffeine and sodium bicarbonate and nitrates (i.e., concentrated beet juice), as these supplements actually work.

Sources:

• Kaufman MW, Roche M, Fredericson M.: The Impact of Supplements on Sports Performance for the Trained Athlete: A Critical Analysis. Curr Sports Med Rep. 2022 Jul 1;21(7):232-238.

• Peeling P, Binnie MJ, Goods PSR, et al: Evidence-Based Supplements for the Enhancement of Athletic Performance. Int J Sport Nutr Exerc Metab. 2018 Mar 1;28(2):178-187.

• Wierzejska RE: Dietary Supplements-For Whom? The Current State of Knowledge about the Health Effects of Selected Supplement Use. Int J Environ Res Public Health. 2021 Aug 24;18(17):8897.

• Zhang FF, Barr SI, McNulty H, et al: Health effects of vitamin and mineral supplements. BMJ. 2020 Jun 29;369:m2511.

• Batsis JA, Apolzan JW, Bagley PJ, et al: A Systematic Review of Dietary Supplements and Alternative Therapies for Weight Loss. Obesity (Silver Spring). 2021 Jul;29(7):1102-1113.