Nutritional supplements ➤ what to know about supplements

Nutritional supplements are exactly that, they are supplementary nutrition, not a substitution or replacement for nutrition. The use of multivitamin supplements in nutrition programs for older americans is a concern because of their potential use in nutrition programs to substitute for a diet that follows the dietary guidelines for americans ( 69 ). Patients may not tell health professionals about their use of dietary supplements and herbal medicines, so there can be a risk of interactions or substitutions for prescribed medications or treatments ( 7 ). This risk is particularly relevant for patients with long-term diseases with a poor prognosis, such as cancer, as hope begins to wane.

Dietary supplements are included within the category of health functional foods (hff) in south korea, which is regulated by the ministry of food and drug safety (mfds) under the hff act to ensure safety ( 94 ). Tablets, capsules, powders, granules, pastes, gels, jellies, and bars were covered in the act, but this legislation was extended in Improve life style to include conventional foods and other dietary supplements ( 72 ). In south korea, individual ingredients must be approved by the kfda (korean food and drug administration) to carry health claims, whereas in japan, finished product approval is required.

The nhanes questions on dietary supplements include the following description: supplements could be a capsule, tablet, pill, softgel, chew or gum, or other product containing one or more supplements” ( 59 ). They can also be manufactured into other forms, such as a snack bar or toothpaste to provide vitamin b12 to vegans ( 100 ).

As the use of dietary supplements has increased, the number of liver injuries reported as complications of their use has also increased, and these complications are usually dose related ( 26 , 79 , 99 ). Commonly implicated agents include anabolic steroids used for body building, green tea extract, and multi-ingredient nutritional supplements.

The new chinese food safety law (enacted in 2015) includes 13 items related to health food regulation ( 27 ). The china food and drug administration (cfda) then implemented regulatory system changes, covering the registration and notification processes, creation of a health function claim catalog and an ingredient catalog for health foods, and labeling ( 20 ). Major changes include the following: a new notification system for products that use approved dietary ingredients from the health food ingredient catalog (domestic products), as well as vitamin and mineral products (imported products); and the establishment of the provincial food and drug administrations to oversee domestic health food product notification.

In 1989, there were more than 1,500 cases and 27 deaths from eosinophilia myalgia syndrome due to contaminated tryptophan in muscle powders” ( 103 ). Millions of consumers took hydroxycut products before these supplements were voluntarily recalled in 2009 ( 83 ). The fda issued a consumer warning only after it had received 23 reports of serious health problems related to liver damage and a teenager had died.