MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

Dietary supplements (DS) are heavily promoted usually with the claim that they have stood the test of time and that they are natural and hence harmless. Unsurprisingly, their use has become very wide-spread. A new study determined the use of DSs, factors associated with DS use, and reasons for use among U.S. college students.

College students (N = 1248) at 5 U.S. universities were surveyed. Survey questions included descriptive demographics, types and frequency of DS used, reasons for use and money spent on supplements. Supplements were classified using standard criteria. Logistic regression analyses examined relationships between demographic and lifestyle factors and DS use.

Sixty-six percent of college students surveyed used DS at least once a week, and 12% consumed 5 or more supplements a week. Forty-two percent used multivitamins/multiminerals, 18% vitamin C, 17% protein/amino acids and 13% calcium at least once a week. Factors associated with supplement use included dietary patterns, exercise, and tobacco use. Students used supplements to promote general health (73%), provide more energy (29%), increase muscle strength (20%), and enhance performance (19%).

The authors of this survey concluded that college students appear more likely to use DS than the general population and many use multiple types of supplements weekly. Habits established at a young age persist throughout life. Therefore, longitudinal research should be conducted to determine whether patterns of DS use established early in adulthood are maintained throughout life. Adequate scientific justification for widespread use of DS in healthy, young populations is lacking.

Another new study investigated the use of DSs in 334 dancers from 53 countries, who completed a digitally based 35-question survey detailing demographic information and the use of DSs. Supplement use was prevalent amongst this international cohort, with 48% reporting regular DSs use. Major motives for supplement use were to improve health, boost immunity, and reduce fatigue. Forty-five percent believed that dancing increased the need for supplementation, whilst 30% recognized that there were risks associated with DSs.

The most frequently consumed DSs were vitamin C (60%), multivitamins (67%), and caffeine (72%). A smaller group of participants declared the use of whey protein (21%) or creatine (14%). Supplements were mainly obtained from pharmacies, supermarkets, and health-food stores. Dancers recognized their lack of knowledge in DSs use and relied on peer recommendations instead of sound evidence-based advice from acknowledged nutrition or health care professionals.

The authors concluded that this study demonstrates that DSs use is internationally prevalent amongst dancers. Continued efforts are warranted with regard to information dissemination.

Finally, a third study investigated use of DSs in patients in Japan. This survey was completed by 2732 people, including 599 admitted patients, 1154 ambulatory patients, and 979 healthy subjects who attended a seminar about DSs. At the time of the questionnaire, 20.4% of admitted patients, 39.1% of ambulatory patients, and 30.7% of healthy subjects were using DSs, which including vitamin/mineral supplements, herbal extracts, its ingredients, or food for specified health uses.

The primary purpose for use in all groups was health maintenance, whereas 3.7% of healthy subjects, 10.0% of ambulatory patients, and 13.2% of admitted patients used DSs to treat diseases. In addition, 17.7% of admitted patients and 36.8% of ambulatory patients were using DSs concomitantly with their medications. However, among both admitted patients and ambulatory patients, almost 70% did not mention DSs use to their physicians. Overall, 3.3% of all subjects realized adverse effects associated with DSs.

The authors concluded that communication between patients and physicians is important to avoid health problems associated with the use of DSs.

There is little doubt, DSs are popular with all sorts of populations and have grown into a multi billion dollar industry. There is also no doubt that the use of only very few DSs are evidence-based (and if so, in only relatively rare situations). And there can be no doubt that many DSs can do harm. What follows is simple: for the vast majority of DSs the benefits do not demonstrably out-weigh the risks.

If that is true, we have to ask ourselves: Why are they so popular?

The answer, I think, is because of the very phenomenon I am constantly trying to fight on this blog – IRRESPONSIBLE CHARLATANS PULLING WOOL OVER CONSUMERS EYES.

7 Responses to The current craze for dietary supplements: irresponsible charlatans pulling wool over our eyes?

  • I think that one reason for the popularity of supplements is the widespread belief that the food available in markets in the Western world has lost it’s nutritional value. I was working with a professional colleague (dentist) this weekend who is convinced that food available in grocery stores has lost 95% of its vitamin and mineral content. He takes supplements to make up for this perceived lack. He actually had a bag of pills with him. He also had some magazines with articles confirming his biases. You can tell from the advertisements just how much misinformation the articles are likely to contain. This person is a successful dental specialist but exhibits the general worldview described in Chris Moody’s book “the Republican Brain”. He is convinced that he is more knowledgeable than the rest of us and that we just do not know the “facts”. It seems that many of the consumers of alt-med scams have a need to feel superior to others and the growth of pseudo-scientific research allows them to believe that they are the ones with the scientific support.

  • Another reason for the popularity of this stiff is probably ordinary fear (which I can relate to). Popping DS pills regularly might have more to do with the fear management qualities of religion than with nutrition or medicine after all.

    • I find the patterns of thinking very similar to what you find with many religious people. It involves accepting different evidence for facts. There is usually a conviction that they have evidence supporting their beliefs not just “faith”. It is therefore not so much the belief itself that is irrational but the criteria for selecting the supporting evidence. This way they can feel that they have an evidence supported belief.

  • “If that is true, we have to ask ourselves: Why are they so popular?”

    Our office is close to the local university. The students that come through our place may have the answer you’re looking for: hangover prevention. Pretty much to the person…that’s their answer as to why they are taking supplements.

  • As the theory suggests important thing in the use of dietary supplements is to consult with your doctor or health care expert before using it as it can harm your body in numerous ways. Use of dietary supplement is common among Americans especially in the college students.

  • New Holland & Barrett TV advert claims that all their staff are trained in ‘nutrition & supplements.’ Apparently if they are unable to answer queries from customers a 25% discount is available on purchases.

    One can only guess at the verbal diarrhoea uttered during the annual ‘new year, new you’ post Christmas, resolution fest at this time of the year. ‘That’s a waste of time & money!’ highly unlikely to be heard.

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