Understanding Nutritional Supplements: Who Guarantees Quality?

After being bombarded on social media with all of the latest “must-have supplements” ranging from vitamin D to turmeric, you have decided to pick up a supplement of your very own. But out of the hundreds of bottles in this aisle, how can you make an informed decision for your health? As you struggle with this decision, it may help to realize you have a lot of company. According to the CDC, from 2017-2018, 57.6% of US adults reported using some form of supplements. This is a significant increase from the 34.7% of adults who reported supplement use just 10 years prior. [1] The supplement industry has been growing rapidly in recent years and with this new industry comes lots of confusion. 

As of right now, supplements are not regulated by the FDA, so companies can make claims about the benefits of their products and their content without being directly checked for safety and efficacy. [2] The Dietary Supplement Health and Education Act of 1994 defined supplements as a food product as opposed to a drug/medicine, making it so supplements can not be regulated as pharmaceuticals. Under this law, supplement labels are required to state: “This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. [3] Even so, according to the Council for Responsible Nutrition over ¾ of Americans are still taking some form of supplement. [4] Given the power that the supplement industry has in this country, and the lack of standardization and quality control, buyers are largely on their own. However, there are some steps that everyone can take to be an informed consumer. 

First, before taking a supplement, consider talking to a doctor or getting your nutrient levels checked to see if you need it. A well-balanced diet should provide most if not all of your nutrient requirements. Certain groups may struggle with getting their nutrient needs solely from food including pregnant women, those with metabolic disorders, and those following special diets such as veganism. If there is a certain nutrient you lack, consider if there are ways you can increase your absorption of it in the diet. For example, many Americans are deficient in vitamin D and according to the NIH, fat-soluble vitamins like vitamin D have been shown to have better absorption when consumed with healthy fatty foods like eggs, dairy, fish, etc. [5, 6]. In fact, many nutrients are best absorbed when in combination with other nutrients, so taking supplements in isolation may not be the best for improving nutrient levels. [6]

The NSF supplement certification verifies 3 main claims about a supplement. First, the company checks all the ingredients in the supplement to make sure that what is in the bottle is present in the quantities declared on the label. Next, they perform a toxicology test to help ensure the supplement is safe. Finally, they review a plethora of possible contaminants such as heavy metals to make sure there are no undeclared dangerous ingredients such as lead, arsenic, or cadmium. [8]

 Next, you should carefully consider the brand of supplement you choose. Always look for labels that indicate the product has been quality tested by a reputable company. Having a 3rd party test the product helps make up for the lack of FDA regulation in supplements. These are some of the common testing companies that you may find on a supplement label. [7]

 The USP verification process includes all of the above tests, plus it verifies that the supplement will break down and release into the body within a specific amount of time to help prove the efficacy of the supplement. They also ensure the supplement was prepared in accordance with the FDA Current Good Manufacturing Practices. [9]

 ConsumerLab (CL) similarly tests for ingredients, contaminants, toxicology, and contaminants. Unlike the other third-party testing certifications, CL does not accept samples directly from the manufacturer. Instead, CL will purchase the supplement from the store to test it. [10] Looking for one of these labels on your supplement will help ensure that what is on the label is what is actually in the bottle. 

You can also go to the testing websites directly to find a supplement with their certifications. There are other reputable 3rd-party testing companies; just make sure to do research on how the supplement was tested and certified. By following these steps, you can maximize the chances that you will get the right supplement for you that will support your overall health. The supplement aisle at the grocery store may be daunting at first, but once you know how to tackle it you can take charge of your own health.

References

[1] Mishra S, Stierman B, Gahche JJ, Potischman N. Dietary supplement use among adults: United States, 2017—2018. NCHS Data Brief, no 399. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://doi.org/10.15620/cdc:101131 

[2] Nutrition, C. for F. S. and A. (2022). What You Need to Know about Dietary Supplements. FDA. https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-dietary-supplements 

[3] Office of Dietary Supplements–Dietary Supplement Health and Education Act of 1994. (n.d.). Retrieved February 23, 2022, from https://ods.od.nih.gov/About/DSHEA_Wording.aspx

[4] Dietary Supplement Use Reaches All Time High | Council for Responsible Nutrition. (n.d.). Retrieved February 23, 2022, from https://www.crnusa.org/newsroom/dietary-supplement-use-reaches-all-time-high

[5] Parva, N. R., Tadepalli, S., Singh, P., Qian, A., Joshi, R., Kandala, H., Nookala, V. K., & Cheriyath, P. (n.d.). Prevalence of Vitamin D Deficiency and Associated Risk Factors in the US Population (2011-2012). Cureus, 10(6), e2741. https://doi.org/10.7759/cureus.2741

[6] Office of Dietary Supplements–Vitamin D. (n.d.). Retrieved February 5, 2022, from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

[7] O’Connor, A. (2015, February 12). Knowing What’s in Your Supplements. Well. https://well.blogs.nytimes.com/2015/02/12/107141/ 

[8] Supplement and Vitamin Certification. (n.d.). NSF International. Retrieved February 5, 2022, from https://www.nsf.org/consumer-resources/articles/supplement-vitamin-certification

[9] Dietary Supplement Manufacturing–USP Verified Mark | USP. (n.d.). Retrieved February 5, 2022, from https://www.usp.org/verification-services/verified-mark

[10] Quality Certification Program. (n.d.). ConsumerLab.Com. Retrieved February 5, 2022, from https://www.consumerlab.com/quality-certification-program/

[11] Quality Supplements. (n.d.). [Text]. Quality Supplements. Retrieved February 5, 2022, from https://www.quality-supplements.org/