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The Supplement Mirage
Exploring the misconceptions and risks that create demand for dietary supplements in pursuit of health and wellness.
By Cora Bainum
Many kids are raised with the belief that they must take a daily multivitamin to grow big and strong. Each morning over one-third of all American children consume a multivitamin (often a fruity, bear-shaped gummy) with the intention that it will maintain health or prevent health issues. This practice doesn’t stop in adolescence. Approximately 150 million people in the U.S. use supplements to enhance sleep, fill gaps in nutrition, and improve immune function. However, health professionals agree that people overconsume dietary supplements and oftentimes unnecessarily. The misconception that ‘more is better’ can be perilous and result in health problems like kidney stones, kidney failure, reduced bone density, cramps, nausea, and various other symptoms.
The health and wellness industry has successfully capitalized off public interest in personal health promoting the narrative that people need supplements to reach an optimal level of health. Harvard Health estimates that in 2022, in the U.S. alone, people spent over $35.6 billion on dietary supplements. The notion that a person needs a pill or powder to achieve health is now the predominant one. “You have generations of people that have been raised with the idea that our food, what we eat, is not providing all the essential nutrients,” says Cassandra Quave, ethnobotanist and associate professor of Human Health at Emory University. Yet for most people who have a balanced diet, exercise, and stay well hydrated, this is not true. Improving nutrition education and implementing policy reform is necessary to combat supplement misconceptions, overspending on products, and the risk of adverse health effects.
Deciphering the claims made by supplement labels
Leading vitamin brands like Nature Made claim that “multivitamins are a smart option for anyone who wants to make sure they’re getting enough of the nutrients their body needs every day,” and “it [the multivitamin] provides two clinically studied strains of probiotics that help support the healthy gut flora in your intestines.” The companies add links on their websites to studies on the correlation between essential nutrients, gut health, mood, brain function, and several other physiological outcomes. While the studies may appear to endorse the products’ claims, they are actually focused on the roles of specific vitamins and nutrients in the body’s processes rather than the product itself.
Recently popularized greens powder products such as Bloom Greens & Superfoods similarly claim that just one scoop of greens powder will provide all the vitamins and minerals needed for the day, strengthen the immune system, reduce stress, improve digestion, and increase energy. It’s a health fix that sounds too good to be true, and perhaps it is. The ingredient lists of these powders mostly consist of ground-up fruits and vegetables. Some brands such as Athletic Greens, also include vitamins and minerals, providing more than 550 percent of the daily recommended amount of Vitamin E and 1,100 percent of the daily recommended amount of biotin. Since these products incorporate ingredients associated with health benefits, the brands assert health claims based on the ingredients rather than the entirety of the product.
The relaxed regulation surrounding dietary supplements due to the Dietary Health and Supplement Education Act (DHSEA) of 1994, allows the supplement industry to freely make misleading claims about their products. The Food and Drug Administration (FDA) categorizes dietary supplements as food rather than drugs, exempting them from the rigorous pre-market review and approval process. This lack of adequate regulation encompasses a variety of products, including vitamins, minerals, sports performance products, weight loss supplements, protein powders, and herbal remedies. The industry can promote deceptive information, perpetuating the notion that most people need dietary supplements for optimal health. Ultimately, this can result in widespread health misinformation and physical harm.
When supplements do more harm than good
Many dietary supplements contain ingredients that have strong biological effects, which can interfere with the effectiveness of current medicines or exacerbate existing medical conditions, thereby posing a risk to the consumer. A 2019, study published by the National Institute of Health (NIH), exhibits the dangers of supplement overuse. Multivitamins, mineral pills, or protein supplements often contain quantities that surpass the body’s processing capacity. Iron supplements, for example, have a Recommended Dietary Allowance (RDA) of 12 to 18 mg/day for adults. However, people consistently take supplements of 65 mg of iron a day. That amount far exceeds the 45 mg upper limit level of intake even without iron intake from the diet. While many people believe that these excess vitamins and minerals are simply excreted from the body if they aren’t absorbed,15 that is not the case.
“Any excess consumed during the day is not necessarily excreted in the urine,” says Lauren Housley professor of nutritional sciences at the University of Georgia. The overconsumption of fat-soluble vitamins and certain water-soluble vitamins can lead to a toxic build-up of vitamins known as hypervitaminosis. Similarly, minerals taken frequently and in high doses can be toxic and sometimes even fatal. High and frequent intake of iron, for example, causes a toxic buildup of iron in the blood, stomach pain, and nausea. However, the industries profiting from these supplements are disinclined to correct this misconception, and their efforts have been effective.
The problem of supplement overuse extends beyond those who lack health knowledge. Rates of dietary supplements are even higher amongst those who are already focused on health and nutrition. So many people have adopted the mentality pushed by health and wellness markets that more is better. It’s actually the opposite, explains Dan Benardot, professor of nutrition at Emory University and world-renowned sports nutritionist. Long-term and high-dosage use of specific supplements can lead to detrimental health consequences. “More is not better than enough,” says Benardot.
Some claims made by the health and wellness industry regarding certain dietary supplements are more harmful than others. Fat-soluble vitamins such as A, D, E, and K are stored in the body for longer periods, posing a greater risk for toxicity. Other popular health and wellness supplements like greens powder and fish oil capsules are unlikely to pose any health risks, though they are also not shown to be effective. The health and wellness industry’s marketing endeavors have effectively molded public perceptions of dietary supplements, despite the absence of direct scientific evidence supporting their efficacy claims.
The lofty expenses of the U.S. healthcare system further contribute to the widespread overuse and misuse of dietary supplements. With professional healthcare costs often exceeding thousands of dollars, Americans resort to self-treatment to cure or prevent illness. In a 2014 study published by the Journal of the American College of Nutrition, the reasons most often cited for supplement use are “for overall health and wellness” and “to fill nutrient gaps.” Therefore, suggesting that individuals are primarily using supplements as a preventative measure to evade the substantial costs associated with seeing primary care physicians and specialists.
There are, however, situations in which dietary supplements are effective in treating and preventing health issues. “When used as a supplement, and not a sledgehammer, adding in dietary supplements can work. You just have to take them correctly,” says Benardot. Regular daily intake of a high dose of a vitamin or mineral is not advisable for most people as the body may become accustomed to such levels, leading to a reduction in absorption explains Benardot. Instead, after consulting a medical professional and determining a need for a supplement, a small, frequent dose of the vitamin or an infrequent high dose would prove more beneficial and much less dangerous than the current practice of supplement consumption.
Still, many individuals are taking many supplements without a medical need or professional guidance. Quave explains that there is a lot of interest by the public in taking greater control of personal health. People often turn to supplements to bolster their immune systems or address overall health concerns a practice that has only increased since the COVID-19 pandemic. While supplements can have pharmacological properties, the lack of regulation and education makes it important for individuals to not substitute supplements for medicine. Experts advise consulting with a medical professional before incorporating dietary supplements into one’s routine. “Anything that has a medicinal property also has the potential to become a poison,” says Quave.
Embracing a balanced diet for true health
Compounding scientific evidence shows that it is more effective to meet dietary guidelines and resolve health concerns through diet alone. When people eat a varied, balanced diet with proper portion sizes, their bodies are better able to absorb essential nutrients and utilize them. Dietary supplements are popular because they are thought to be an easy, quick-fix solution. If an individual consumes a daily greens powder or multivitamin, it appears to take the stress off the diet. Yet, non-medicinal pills and powders are not going to outwork an unbalanced diet nor are they a long-term solution for health issues.
Resisting the belief systems that this industry has successfully created will be extremely challenging. The health and wellness industry’s multi-billion-dollar revenue makes them powerful to scientific evidence demonstrating that health and longevity lie in a nutritious diet and active lifestyle. For people who may live in a food desert, have financial constraints, or be under time limitations, adhering to dietary recommendations is challenging. It’s no wonder the marketing claims of dietary supplements are enticing.
Yet, this idea that health and longevity can be more easily addressed with a supplement than a dietary change is harmful. Individuals are using dietary supplements at rates and doses much higher than the upper-level daily intake recommended by health professionals
, and spending significant amounts of money on understudied products. Enforcing stricter regulations on dietary supplement claims through legislation and imposing a tax on major health and wellness companies to fund research on their products is necessary. Additionally, there is a critical need to increase education efforts regarding diet, dietary supplements, and health outcomes. These combined efforts could potentially reduce misinformation and misuse of dietary supplements. Encouraging individuals to scrutinize familiar daily habits can lead to adopting simpler, more cost-effective practices that better facilitate the achievement of health and wellness objectives.