How to choose a safe and effective dietary supplement?

Author Dr Francesco Cappitelli

The supplement industry is booming; this growth involves not only multinational pharmaceutical companies, but especially small and medium-sized companies.

While supply is increasing, there is also a growing demand and search for information, insights from a growing segment of users who often find themselves wanting to choose a dietary supplement on their own or avail themselves of the expertise of a pharmacist or prescribing physician.

Today, there are several thousand notified and marketed references, and therefore those who are not in the industry or do not have specific expertise may face some difficulties in identifying a product that is effective, as well as safe for their health.

So how is it possible to identify safe yet effective and high quality dietary supplements?

First of all, what are dietary supplements?

Food supplements are defined by the relevant legislation Directive 2002/46/EC, implemented by Legislative Decree No. 169 of May 21, 2004, and defines them as food products intended to supplement the common diet and constitute a concentrated source of nutrients, such as vitamins and minerals, or other substances having a nutritional or physiological effect, particularly, but not exclusively, amino acids, essential fatty acids, fiber, and extracts of plant origin, whether mono- or multi-compound, in predosed forms.

Dietary supplements can contribute to well-being by optimizing the state or promoting the normality of the body’s functions by providing nutrients or other substances with a nutritional or physiological effect.

In addition in order to improve the level of consumer health protection and promote proper information and more informed food choices, Regulation 1924/2006 is defined at the EU level to regulate nutrition and health claims proposed on food supplement labels and/or with advertising.

Going into specifics, the nutritional table is the most important aspect to evaluate: it reports all components endowed with nutritional or physiological activity expressed in quantitative terms.

For vitamins and minerals, in addition to the respective amount expressed in the ‘appropriate unit of measurement (milligrams or micrograms), the nutritive reference value (%VNR) is also given, which suggests the amount that an individual, in good health, must take in daily to maintain that (100%VNR).

Many supplements report values that deviate even widely from the suggested average value of vitamins and minerals (values above 100%VNR), and this is possible because evidently that particular supplement was designed with a view to supplying important amounts of such vitamin and/or mineral nutrients to restore normal physiological conditions severely challenged by nutritional deficiencies due to pathological or dietary causes.

More than half of the dietary supplements notified at the Ministry of Health and marketed have at least one component of plant and extractive origin; plant preparations are allowed if they have recorded a history of consumption and are endowed with an appropriate physiological effect due to the presence of secondary metabolites that for the plant play an ecological role of survival and allow chemical interactions with the environment, while for humans are endowed with very important and scientifically proven physiological and health properties.

In dietary supplements we can find herbal preparations in different forms such as powders, which are homogeneous solid preparations obtained by a mechanical operation of grinding a plant or part of a plant that has been previously dried.

The active ingredients contained in the plant processed into powder not having undergone any extractive process could become trapped in the plant tissue and thus be poorly bioavailable or at reduced bioavailability when ingested orally.

Or we can find herbal preparations as extracts, such as liquid, solid or intermediate preparations obtained following extraction with an appropriate solvent depending on the chemical and physical nature of the plant matrix and are more concentrated than the powder.

Fluid extracts are liquid preparations obtained following solvent extraction from the plant matrix and we generally find them in liquid preparations such as syrups, drops, and suspensions.

Dry extracts are solid preparations obtained following total evaporation of the extraction solvent and are more concentrated than the starting raw material.

Dry extracts are called standardized if the extractive reproducibility is constant; if the presence of the secondary metabolite is also standardized they are called standardized and titrated dry extracts; we generally find them in oral solid preparations, such as tablets, capsules, granules etc etc

Therefore, it is very important to check the type of a plant preparation contained in an appropriate supplement, evaluating its form (whether powder or extract), but also its quantity, information that can be obtained by looking closely at the nutritional table.

A formulation is effective when the choice of pharmaceutical form or co-formulants reflects those technological criteria that are able to draw maximum benefit from the active ingredients contained: on the packaging you can also find such information, for example the protection of active ingredients from the stomach acidic pH (this is referred to gastroresistant capsules or tablets), to the correct method of preserving the product (in the refrigerator, at room temperature, at temperatures not exceeding 30 degrees, etc.), to the appropriate dosage (you can not always find indications about how and when to use it correctly ; instead, this indications is mandatory since, for example, food in the stomach could slow down or limit the absorption of some of the active ingredients within the formulation, as well as consume it away from meals could create irritative phenomena).

On the packaging of a dietary supplement is possible to find useful information in order to protect the consumer’s health, such as the presence of any allergens that must be very prominently listed (in bold) in the list of ingredients, any presence or absence of artificial sugars or sweeteners, warnings indicating which individuals cannot consume the product, such as pregnant or lactating women, children under 12, and so on.

In general, dietary supplements should be purchased through safe channels, where you can find serious and qualified professionals who can clear up any doubts regarding the product you are going to buy.