FOOD SUPPLEMENTS AND YOUR HEALTH

The reasons individuals take dietary supplements probably vary as much as people do, whiles most people take dietary supplements simply as part of a healthy lifestyle, important motivations for others may include ensuring nutritional adequacy, protecting tissue structures and functions, decreasing the risk of certain diseases and age-related change and certain birth defects. Limited use for short-term benefits includes sleep management and enhanced physical performance.

Dietary supplements may be grouped into three major classes related to dietary function or origin: 1) substances with established nutritional function, such as vitamins, minerals, amino acids and fatty acids; 2) botanical products and their concentrates and extracts; and 3) other substances with a wide variety of origins and physiologic roles.

Documented evidence in developed countries indicates that consumers are not well-informed about the safety and efficacy of dietary supplements and have difficulty interpreting labels on these products. Uninformed use of dietary supplements may expose consumers to health risks. Dietary supplements can also be extracts or concentrates, and may be found in many forms, such as tablets, capsules, liquids, or powders.

Who needs dietary supplement?
The factors impinging on the individual nutritional status are not only limited to dietary intake. Malabsorption (genetic or otherwise) and increased nutritional requirements (e.g. during a disease period) also greatly affect the nutritional status of individuals. Dietary supplements may be appropriate if you are: a vegan or a vegetarian who eats a limited variety of foods, pregnant, trying to get pregnant or breast-feeding, a woman who experiences heavy bleeding during your menstrual period or a postmenopausal woman. Others include people with a medical condition that affects how their body absorbs, uses or excretes nutrients, such as chronic diarrhoea, food allergies, food intolerance or a disease of the liver, gallbladder, intestines or pancreas and those who have had surgery on their digestive tract and are not able to digest and absorb nutrients properly.

Health and safety concerns
Vitamins and minerals in food supplements may interact with certain drugs and result in adverse clinical outcomes caused by an increase or decrease in nutrient or drug concentrations or the synergistic effect of combined compounds. The potential for adverse effects in the use of food supplements is prominent among older adults because they have more health conditions and are usually on multiple medications. These adverse events can stem from nutrient–drug interactions, excess nutrient intakes, and use with certain health conditions and surgical procedures. For example, both iron and calcium supplements can interfere with the absorption of thyroid hormone medications, decreasing their effectiveness. Taking of food supplements containing vitamin K on an inconsistent basis could minimize the effectiveness of anticoagulant medications.

Another major safety concern is the potential for excess nutrient intakes from combinations of dietary supplements and fortified foods. Some fortified foods such as breakfast cereals contain nutrients at levels comparable to dietary supplements. Consumers of fortified breakfast cereals who take food supplements are at an increased risk of excess vitamin-mineral intake. In addition, consumption of too much preformed vitamin A or retinol (i.e., more than 214% of the recommended dietary allowance or 100% of the daily value, an amount sometimes found in most dietary supplements), but not beta-carotene, has been associated with increased hip fracture risk among postmenopausal women. Dietary supplements that provide a portion of the vitamin A from beta-carotene may be a better choice. Adverse effects of excessive use of preformed vitamin A include liver abnormalities and reduced bone mineral density. Other nutrients most likely to exceed tolerable levels are iron, zinc, vitamin A, niacin, and folate. Excessive levels of folic acid may mask or precipitate vitamin B12 deficiency, which, if left untreated, can lead to progression of nervous complications. Other reported adverse events include abdominal pain, blood pressure problems, nausea, vomiting, allergy, dizziness, itching, and rash.

It is prudent to note that herbal supplements may contain dozens of compounds and that its active ingredients may not be known. In addition, herbal supplements may not contain the correct plant species. For example, Aloe (vera), genus of plants with more than 150 species, and yet not all the species has medicinal values. And only a few of the 5 species of garlic has medicinal value.

Dietary supplements can lose potency over time, especially in hot and humid climates. If a supplement doesn't have an expiration date, don't buy it. If your supplements have expired, discard them. Put supplements in a locked cabinet or other secure location out of children's reach. Store dietary supplements in a dry, cool place. Avoid hot, humid storage locations, such as in the bathroom. The Food and Drug Board keeps a list of dietary supplements that are under regulatory review or that have been reported to cause adverse effects. Check its website periodically for updates.

Benefits and complexity of whole foods
Whole foods contain a whole symphony of other micronutrients (phytonutrients or photochemical) that work in concert with vitamins and minerals to orchestrate a natural harmony in our bodies. These phytochemicals, may help protect you against cancer, heart disease, diabetes and high blood pressure. Many are also good sources of antioxidants — substances that slow down oxidation, a natural process that leads to cell and tissue damage. Whole foods also provide dietary fiber. Fiber, as part of a healthy diet, can help prevent certain diseases, such as type 2 diabetes and heart disease, and it can also help manage constipation.

Moreover, whole food ingredients are natural; they contain a host of nutrients that exist within a complex. A food complex includes not only vitamins and minerals, but also many cofactors (helper nutrients). Cofactors and food complexes therefore cannot be made in a laboratory nor can they be duplicated by scientists. More than 25,000 different micronutrients, also known as cofactors, have been discovered in whole fruits and vegetables alone. An orange, for example, provides vitamin C plus some beta carotene, calcium and other nutrients. A vitamin C supplement lacks these other micronutrients.

Whole foods do not only provide additional nutritional support, they also enhance the effectiveness and absorption of other nutrients contained in whole foods. The ingredients within whole foods operate on a system of synergism; in other words they work as 'teams' to maintain our bodies. The interwoven, interrelated and complementary functions of food particles represent some of Nature's most wonderful properties of synergistic power and function. Synergism is defined as the interaction of two or more agents or forces so that their combined effect is greater than the sum of their individual effects working together. Humans are biologically suited to ingest and utilize nature's whole foods for its sustenance.

Dietary supplements aren't intended to be a food substitute because they can't replicate all of the nutrients and benefits of whole foods. So if you're generally healthy and eat a balanced diet, daily dietary supplements may not be worth the expense. However, if you can't eat enough healthy foods or have certain conditions, you may benefit from taking dietary supplement. When using dietary supplements, assess your needs, evaluate the merits of taking supplements, and understand how to choose and use them. You can seek expert advice if you are not sure about your supplements.

The writer is a dietician and a member of Ghana Dietetics Association. Email:[email protected]