Are Food Supplements Safe?

Written by Dr. Steve Chaney on . Posted in current health articles, Health Current Events, Supplements and Health

Author: Dr. Stephen Chaney

 

are food supplements safeIf you saw the recent headlines proclaiming that dietary supplements were responsible for 23,000 emergency room visits and 2,100 hospitalizations every year, you are probably wondering are food supplements safe to use at all. The study behind these headlines (Geller et al, New England Journal of Medicine, 373: 1531-1540, 2015) was based on an extrapolation from 63 hospitals to every hospital in the United States.

Some experts consider this to be an overestimation since it is almost 8 times higher than the 3,200 cases/year in the official FDA’s Serious Adverse Event Reporting database. However, for the purposes of this article I will accept the 23,000 numbers.

Let me start by putting the 23,000 number into perspective.

  • It represents about 0.015% of the 150 million people in the US who use supplements.
  • It represents about 1% of the emergency room admissions caused by side effects of properly prescribed medications.

In short, the headlines are over-dramatizing the dangers of dietary supplements. Dietary supplements are actually quite safe. However, even one emergency room visit due to a dietary supplement is too many – especially if it were to happen to you or a loved one. Consequently, I will analyze the study in more detail so that I can show you how to recognize and avoid those few supplements that are truly dangerous.

Are Supplements Dangerous?

Here is a breakdown of the data:

  • 13% of the ER visits were due to allergic reactions. These were seldom serious enough to require hospitalization. This is also a type of problem that is probably unavoidable. Since many food supplements use natural ingredients, some degree of food allergies are to be expected.
  • 13% of the ER visits were due to swallowing problems, primarily in people over the age of 65. The preventative measure here is also pretty simple. If you or a loved one has difficulty swallowing, choose pills that are small and slick, chewable, powder or liquid supplements.
  • 20% of the ER visits were due to adverse effects caused by unsupervised ingestion of the supplements by children. The preventative measure here is pretty simple. Keep your supplements out of reach of small children – especially if they are chewable or have attractive colors. While the supplements may be perfectly safe when taken as recommended, the unsupervised ingestion of a whole bottle of almost any supplement by a small child is problematic.
  • 41% of the ER visits were due to weight loss products (25.5%), energy products (10%), sexual enhancement products (3.4%) and bodybuilding products (2.2%). The most common adverse effect for these products were heart palpitations, chest pain, and irregular heartbeat. These are the kinds of supplements you really need to be most careful about.

Why Are Dangerous Supplements Even On The Market?

are supplements dangerousLet’s start with the obvious question: Why are weight loss, energy, sexual enhancement and bodybuilding products the ones most likely to be dangerous? To quote Pogo (now I’m really dating myself): “We have met the enemy, and he is us”

  • Weight Loss Products: We can listen all day long to experts tell us that we need to make lifestyle changes, and we should aim for no more than one or two pounds of weight loss per week. However, for most of us that advice goes in one ear and out the other. We want to lose weight fast, and we want it to be easy.
  • Energy Products: Many of us are just plain exhausted because our diets are terrible; we are under stress; and we are burning the candle at both ends. We don’t want to eat better and change our lifestyle. We want high octane energy, and we want it now.
  • Body Building Products: The story is similar, especially for males in the 20-34 age range. We want big muscles, and we don’t want to wait for the years of workouts it will take to build that kind of physique naturally. We want it now.
  • Sexual Enhancement Products: ER admissions for sexual enhancement products were 100% male. What does that say about us guys? I won’t even go there.

Most supplement manufacturers are ethical and don’t make supplements that could harm us. However, there are a few unscrupulous sports supplements companies that misleadmanufacturers who are only too happy to exploit our human weaknesses if they can make a buck in the process. They will give us exactly what we want, even if it kills us in the process.

I’ve warned about these unscrupulous manufacturers in the past. The easiest way to create products that will burn off weight effortlessly, build muscle rapidly, and give you energy are to add chemically synthesized stimulants in the amphetamine family. For example, I’ve warned you about products containing stimulants such as DMAA and  DEPEA  in Are Dietary Supplements Safe and BMPEA in Are Sports Supplements Safe. They all work, but they also cause heart palpitations, chest pain, and irregular heartbeat. They can land you in the emergency room, and sometimes they can kill you.

In addition to stimulants, some weight loss products use diuretics, and some energy products use dangerous levels of caffeine, both of which can cause problems. Sexual enhancement products often use herbal ingredients like yohimbe bark that can be quite dangerous

Don’t Count On The FDA To Protect You

Unfortunately, you can’t count on the FDA to protect you. For example, in the case of the DMAA scandal, the FDA did not act until the day before a big expose was to air on 60 Minutes about the deaths caused by DMAA. They were shamed into taking strong action and removing DMAA from the shelves of retailers.

Case closed, you might think, but the truth is a bit scarier. That action was back in 2013. Since then, the FDA has ignored DMAA-containing products. The Human Performance Resource Center, an initiative of the Department of Defense, recently listed 39 products containing DMAA  that are readily available, either online or from retail stores. Even though the FDA has classified DMAA as an illegal ingredient, it is still readily available, and they don’t act.

This is just one of many examples I could cite. It’s not clear whether the FDA is unwilling to protect us, or if it is overwhelmed. However, it is clear that if we want to avoid dangerous supplements, it is up to us.

How Can You Protect Yourself From Dangerous Supplements?

protect yourself against dangerous supplementsIf the FDA isn’t going to protect you, what can you do to protect yourself from dangerous supplements? There are threesimple things that you can do to protect yourself;

#1: Use common sense.

  • Don’t even consider those weight loss supplements that promise you’ll lose 5-10 pounds/week, or that they will make the fat melt away effortlessly.
  • Walk away from those bodybuilding supplements that promise to make your muscles “explode” or give you “insane energy”.
  • Put those energy supplements that promise a jolt of energy back on the shelf.
  • As for sexual enhancement products, consult your doctor before you reach for a magic pill. Your problems in the bedroom may be caused by a treatable medical condition.

#2: Make the Commitment. A holistic lifestyle change that includes weight control, exercise, diet and supplementation may be more work, but it is so much safer and more beneficial in the long run.

#3: Choose wisely. Look for a supplement company with integrity.

  • A company that is committed to only making products that are both safe and effective.
  • A company that does clinical studies to make sure their products are safe and effective and publishes those studies in peer-reviewed scientific journals.

Are food supplements safe?

The Bottom Line

  • A recent study reported that 23,000 emergency visits and 2,100 hospital admissions each year were caused by dietary supplements. Some experts consider this to be an overestimate. It is an extrapolation from 63 hospitals to every hospital in the United States, and it is approximately 8-fold higher than the FDAs Adverse Events database.
  • While the headlines sound scary, when you put the data into perspective it is clear that dietary supplements are actually quite safe. Even if we accept the 23,000 ER visits/year as accurate, this represents:
  • 015% of the supplement users in the US.
  • Approximately 1% of the annual ER admissions due to side effects of properly prescribed medications.
  • The main value of this study is that it allows us to identify what the dangers are and what strategies can help us avoid those dangers.
  • 13% of the ER visits were due to allergic reactions. This is probably unavoidable. Since many food supplements use natural ingredients, some degree of food allergies are to be expected.
  • 13% of the ER visits were due to swallowing problems, primarily in people over the age of 65. If you or a loved one has difficulty swallowing, the solution is pretty simple. Choose pills that are small and slick, chewable, powder or liquid supplements.
  • 20% of the ER visits were due to adverse effects caused by unsupervised ingestion of the supplements by children. The preventative measure here is also pretty simple. Keep your supplements out of reach of small children.
  • 41% of the ER visits were due to weight loss products (25.5%), energy products (10%), sexual enhancement products (3.4%) and bodybuilding products (2.2%). These are the kinds of supplements you really need to be most careful about. Some supplements in this category are truly dangerous.
  • If we ask why these dangerous supplements exist, the answers are pretty simple.
  • Many Americans are looking for quick and easy solutions. They want a magic pill or powder.
  • A few unscrupulous supplement companies are only too happy to give them exactly what they want, even if it kills them in the process.
  • Unfortunately, the FDA is not doing a good enough job of protecting us from the truly dangerous supplements on the market, so we need to protect ourselves.
  • To protect ourselves from the dangerous supplements on the market we need to take 3 simple steps:
  • Use common sense. Don’t fall for the advertising hype promising quick and easy solutions.
  • Commit to true lifestyle change. Adopt a holistic lifestyle that includes weight control, diet, exercise, and supplementation.
  • Choose your supplement manufacturer wisely. Choose one with integrity – one that is committed to making supplements that are both safe and effective.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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High Protein Diets and Weight Loss

Posted October 16, 2018 by Dr. Steve Chaney

Do High Protein Diets Reduce Fat And Preserve Muscle?

Author: Dr. Stephen Chaney

Healthy Diet food group, proteins, include meat (chicken or turkAre high protein diets your secret to healthy weight loss? There are lots of diets out there – high fat, low fat, Paleolithic, blood type, exotic juices, magic pills and potions. But recently, high protein diets are getting a lot of press. The word is that they preserve muscle mass and preferentially decrease fat mass.

If high protein diets actually did that, it would be huge because:

  • It’s the fat – not the pounds – that causes most of the health problems.
  • Muscle burns more calories than fat, so preserving muscle mass helps keep your metabolic rate high without dangerous herbs or stimulants – and keeping your metabolic rate high helps prevent both the plateau and yo-yo (weight regain) characteristic of so many diets.
  • When you lose fat and retain muscle you are reshaping your body – and that’s why most people are dieting to begin with.

So let’s look more carefully at the recent study that has been generating all the headlines (Pasiakos et al, The FASEB Journal, 27: 3837-3847, 2013).

The Study Design:

This was a randomized control study with 39 young (21), healthy and fit men and women who were only borderline overweight (BMI = 25). These volunteers were put on a 21 day weight loss program in which calories were reduced by 30% and exercise was increased by 10%. They were divided into 3 groups:

  • One group was assigned a diet containing the RDA for protein (about 14% of calories in this study design).
  • The second group’s diet contained 2X the RDA for protein (28% of calories)
  • The third group’s diet contained 3X the RDA for protein (42% of calories)

In the RDA protein group carbohydrate was 56% of calories, and fat was 30% of calories. In the other two groups the carbohydrate and fat content of the diets was decreased proportionally.

Feet_On_ScaleWhat Did The Study Show?

  • Weight loss (7 pounds in 21 days) was the same on all 3 diets.
  • The high protein (28% and 42%) diets caused almost 2X more fat loss (5 pounds versus 2.8 pounds) than the diet supplying the RDA amount of protein.
  • The high protein (28% and 42%) diets caused 2X less muscle loss (2.1 pounds versus 4.2 pounds) than the diet supplying the RDA amount of protein.
  • In case you didn’t notice, there was no difference in overall results between the 28% (2X the RDA) and 42% (3X the RDA) diets.

Pros And Cons Of The Study:

  • The con is fairly obvious. The participants in this study were all young, healthy and were not seriously overweight. If this were the only study of this type one might seriously question whether the results were applicable to middle aged, overweight coach potatoes. However, there have been several other studies with older, more overweight volunteers that have come to the same conclusion – namely that high protein diets preserve muscle mass and enhance fat loss.
  • The value of this study is that it defines for the first time the upper limit for how much protein is required to preserve muscle mass in a weight loss regimen. 28% of calories is sufficient, and there appear to be no benefit from increasing protein further. I would add the caveat that there are studies suggesting that protein requirements for preserving muscle mass may be greater in adults 50 and older.

The Bottom Line:

1)    Forget the high fat diets, low fat diets, pills and potions. High protein diets (~2X the RDA or 28% of calories) do appear to be the safest, most effective way to preserve muscle mass and enhance fat loss in a weight loss regimen.

2)     That’s not a lot of protein, by the way. The average American consumes almost 2X the RDA for protein on a daily basis. However, it is significantly more protein than the average American consumes when they are trying to lose weight. Salads and carrot sticks are great diet foods, but they don’t contain much protein.

3)     Higher protein intake does not appear to offer any additional benefit – at least in young adults.

4)     Not all high protein diets are created equal. What some people call high protein diets are laden with saturated fats or devoid of carbohydrate. The diet in this study, which is what I recommend, had 43% healthy carbohydrates and 30% healthy fats.

5)    These diets were designed to give 7 pounds of weight loss in 21 days – which is what the experts recommend. There are diets out there promising faster weight loss but they severely restrict calories and/or rely heavily on stimulants, they do not preserve muscle mass, and they often are not safe. In addition they are usually temporary.  I do not recommend them.

6)    This level of protein intake is safe for almost everyone. The major exception would be people with kidney disease, who should always check with their doctor before increasing protein intake. The only other caveat is that protein metabolism creates a lot of nitrogenous waste, so you should drink plenty of water to flush that waste out of your system. But, water is always a good idea.

7)     The high protein diets minimized, but did not completely prevent, muscle loss. Other studies suggest that adding the amino acid leucine to a high protein diet can give 100% retention of muscle mass in a weight loss regimen – but that’s another story for another day.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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