Dietary Supplements: What They Are and How to Choose One

Dietary supplements, or synonymously over the counter (OTC) medications, nutrition supplements, or health foods, are continuing to grow in availability and popularity. The term dietary supplements includes multivitamins or a single micronutrient, digestive enzymes, live-active bacterial cultures, fiber, laxatives, electrolytes, protein and amino acids… to name a few. So how do you know as a consumer which product is the best one for you? Or the better question being, are supplements necessary to achieve overall health and wellbeing? In this blog I’ll give you the facts on how to choose the best supplement for you and some general points to consider when beginning the supplement hunt.

Dietary Supplement Regulations

The term dietary supplements and their products are regulated under the Dietary Supplement Health and Education Act (DSHEA), enacted in 1994, an adjustment to the Federal Food, Drug and Cosmetic Act. This law has (a) designated supplements as their own entity vs a drug and (b) does not require the Food and Drug Administration’s (FDA) approval before its release to consumers. However, there are a couple of caveats in which the FDA has authority: if the dietary supplement contains a “new dietary ingredient” the manufacturer must submit a proposal at least 75 days before it lands on the market, the organization must be informed if a serious adverse event occurs from use of the product, and defines labeling of the products. This label must include the clear designation that the product is a “dietary supplement”, the product name, supplement facts label (similar to a nutrition facts label on food), manufacturer’s name, place of distribution, net quantity of its contents, serving size, and an ingredients list (i.e. fillers and other components not on the supplements facts list but are in the supplement). One key point to note is that there must be a serving size on the label, but is not defined by the FDA and is per the discretion of the manufacturer. Lastly, the supplement must also contain contact information for consumers to report adverse events or ask questions about the product. 

Dietary supplement labels cannot state that they are designed to cure, prevent, or treat disease.  Certain claims are allowed that designate the general use of the product and must include the statement “disclaimer”. The three disclaimers defined by the DSHEA include: defining the specific nutrient’s structure and function on the human body, associations with improving nutrient deficiency disease, and that it supports overall health and wellbeing. These are not regulated by the FDA and a product must include so on its label if using one or multiple of these disclaimers.

Good Manufacturing Practices

In 1999 the FDA defined good manufacturing practices (GMP) for dietary supplements. GMP is regulated by the National Products Association (NPA). Audits are conducted by the NPA to ensure manufacturers are following the rules and regulations to meet GMP. Manufacturers must meet standards of “identity, purity, quality, strength, and composition” defined in their product(s) sold. Today, dietary supplements will include GMP labels verifying they have met these standards.

Certifications that confirm a well-regulated product

As the FDA is not approving the release of most dietary supplements, and the DSHEA does not have third party testing labels, some independent organizations have created certifications for an easy way to spot reputable products. The main three I look for personally and professionally when recommending supplements include the National Sanitation Foundation (NSF), United States Pharmacopeia (USP), and NPA GMP. 

Do I even need to take dietary supplements?

First and foremost, I recommend discussing the use of supplements with your doctor, pharmacist, and, if you have one established, a dietitian. It’s essential to understand the supplement-drug interaction with any current medications before starting a supplement. As a dietitian, I explore my client’s diet and dietary interventions regarding food and fluids, lab values, activity level, and any chronic disease states before encouraging supplements. With a well balanced diet and no health concerns, it may not be necessary to add a supplement(s) to meet one’s nutritional needs and improve their health. Some individuals may require support from multiple supplements or just one, depending on their specific case. If taking supplements due to abnormal lab results, especially for fat soluble vitamin deficiencies like vitamin D, K E and A, I would recommend speaking with your health care team to understand the dose required and when rechecking labs is necessary. Many micronutrients, like the popular magnesium, come in different forms and one form may be better than the other depending on the support it’s intended for. Dietary supplements like electrolyte additives and protein powders should still be considered the same as taking a gummy or capsule: understand your specific dietary needs and potential medication interactions with ingredients in these supplements, search for third party tested certifications, and it’s very individualized whether someone needs to consume these to achieve overall health and wellbeing.

Have further questions on starting a dietary supplement? Consider reaching out to us at Enhance Nutrition and we can support you with integrating these products, if appropriate, into your overall nutrition goals. 

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