Supplement sales have skyrocketed since the start of the pandemic, and many of us see them as a kind of health insurance policy to give our immune systems a much-needed head start against Covid.
More than half of us take a supplement in 2020, according to market research company Kantar, while a 2021 review of more than 20 market studies found that sales of vitamins and minerals continued to rise, up 9% in the UK in 2021.
But are the supplements we’re laundering in droves really all that they’re supposed to be? Not everyone is created equal when it comes to their ingredients and health benefits – here’s what to keep in mind.
Supplement sales have skyrocketed since the start of the pandemic, and many of us see them as a kind of health insurance policy to give our immune systems a much-needed head start against Covid.
More than half of us will take a supplement in 2020, according to market research firm Kantar, while a review of more than 20 market studies found sales of vitamins and minerals increased by a further nine per cent in the UK in 2021.
But are the supplements we’re laundering in droves really all that they’re supposed to be? Not all of our supplements are created equal when it comes to their ingredients and health benefits. This is what you need to keep in mind.
rancid omega-3
Omega-3 has been linked to brain and heart health and longevity, and is usually taken to reduce excess chronic inflammation that can lead to diseases such as cancer, heart disease, and Alzheimer’s. However, new research shows that more than one in 10 omega-3 supplements is rancid, and half are near maximum recommended levels of rancidity.
The report from the American testing company Labdoor analyzed the 54 best-selling fish oil supplements available worldwide, compared to international voluntary standards for rancidity.
“Fish oil is quite unstable,” explains Margaret Rayman, professor of nutritional medicine at the University of Surrey. “It has a lot of bonds that are easily oxidized, so it needs to be stored away from light and needs some antioxidant, like vitamin E, to take care of it. If you open the box and there’s a strong fishy smell, that means it hasn’t been stored properly and has gone off and you shouldn’t take it.”
But what does it mean for our health if supplements are off?
“At best, you’re wasting your money, because as it oxidizes, you lose the benefits of EPA and DHA (the anti-inflammatory fatty acids) you paid for,” says Aidan Goggins, pharmacist and independent industry consultant. of supplements. “At worst, you’re actually creating the very problem you were trying to prevent by introducing damaging free radicals into your system. They increase cellular stress and increase inflammation.”
Unfortunately, it’s not always that easy to tell if supplements are bad, as omega-3s often come in capsules or have added flavorings that could mask the smell. Goggins advises looking for brands that commit to Good Manufacturing Practices (GMP), meaning they have voluntarily subscribed to higher standards than those legally required, usually stated on his website. Consumers should also check the company’s website for the Totox value: the total oxidative value, which indicates purity. This should be less than 20, or even 10, says Goggins. Mike Wakeman, a pharmacist with a master’s degree in nutritional medicine, says UK and EU brands have more stringent testing than US-produced supplements, and generally test for acidity levels. “Stick to reputable brands,” he says.
At the end of the day, quality is key. “This is probably why we see such conflicting evidence in omega-3 studies. Some show that they are very beneficial and others say that they are useless, and it is not surprising to me that those who show the benefits tend to use pharmaceutical-grade products where they are very controlled,” says Goggins.
Added sugar and sweeteners
A spoonful of sugar can make the medicine go down, but is it really justified when it comes to vitamins? We have seen an explosion of gummy supplements in recent years and there is no doubt that they are very popular and are a delight, but are they good for us?
Often the first ingredient in gummy supplements is sugar or glucose syrup, with most supplements providing a gram or more per serving. The larger the gummy, the more sugar it contains.
“It’s not as much of an issue from a dietary standpoint, as you won’t be eating a lot of them,” says Gunter Kuhnle, a professor of nutrition and food science at the University of Reading, who gives vitamin D gummies to his daughter. “It’s a bigger problem if she takes them at night and goes to bed without brushing her teeth.”
Goggins says we should think of chewing gums as “fortified candy” rather than multivitamins. “It’s the same as when you have fortified cereals or vitamin drinks and the main ingredient is sugar.”
Some manufacturers use sugar alcohols to reduce the sugar content or artificial sweeteners such as maltitol, mannitol, and sorbitol, which can cause digestive problems such as stomach pain and diarrhea in some people. Gummy supplements also tend to contain fewer vitamins and minerals than pills or capsules. “You’re pretty limited in how many nutrients you can add and maintain the gelatin structure. Compared to a capsule, you’re paying for a very expensive candy,” says Goggins.
Absorption
Another issue is absorption: do the nutrients we’re paying for end up where they’re supposed to? Some experts have suggested that some nutrients may not be as stable in the gummies and may become less potent over time.
“I don’t know how much evidence there is, or how bioavailable (what the body absorbs and can use) they are,” says Professor Kuhnle. “And that’s the big difference between drugs and supplements. In the case of drugs, the company has to show how bioavailable they are and how quickly they are consumed. But because the supplements are licensed as a food, not a drug, they don’t need to show this data. Therefore, they could do an excellent job and do a lot of research. Or they could just put things together and sell them. And that is a problem for the consumer, because it is not clear”.
The only real way to know how much you’ve absorbed would be with blood tests and urine tests, something Goggins does with the elite athletes he works with, but for most of us, it’s just not practical.
But does the recent trend of sprays and drops help with absorption? Vitamin D seems to be pushed more and more in spray or drop form, for example.
“They’re really just a marketing gimmick,” says Dr. Geoffrey Mullan, a functional medicine physician who helps clients address nutritional deficiencies. “Capsules are generally fine for most people.”
The exception is b12 vitamin. “So it can be very helpful for those who can’t absorb B12 through the stomach, such as those with pernicious anemia (an autoimmune condition that affects the stomach), or in older people whose stomach acid has decreased,” says Goggins.
Damaging effects
Just because they’re easy to buy doesn’t mean all supplements are harmless.
Between 2007 and 2019, 965 products tested by the US Food and Drug Administration were found to contain hazardous ingredients. Heavy metal contamination, such as lead and cadmium, can be a problem for brands outside the EU, which are subject to less stringent testing for safety (the UK still operates under complementary EU laws for now), Goggins says. Therefore, it is best to avoid buying online from companies you have never heard of.
Drug interactions can also be a problem for some. For example, ginkgo can interact with various medications, such as aspirin and ibuprofen, increasing the risk of bleeding. Acacia can prevent the absorption of the antibiotic amoxicillin, while St. John’s wort can interact with a host of medications, reducing their effects, including blood pressure medications and medications for cholesterol and heart disease.
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