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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Latest Article

Best Diet For Heart Disease Prevention

Posted July 9, 2019 by Dr. Steve Chaney

Are The American Heart Association’s Recommendations Correct?

Author: Dr. Stephen Chaney

 

What is the best diet for heart disease prevention? 

diet for heart disease preventionHeart disease is a killer. It continues to be the leading cause of death – both worldwide and in industrialized countries like the United States and the European Union. When we look at heart disease trends, it is a good news – bad news situation.

  • The good news is that heart disease deaths are continuing to decline in adults over 70.
  • The decline among senior citizens is attributed to improved treatment of heart disease and more seniors following heart-healthy diets.
  • The bad news is that heart disease deaths are starting to increase in younger adults, something I reported in an earlier issue, Heart Attacks Increasing in Young Women of “Health Tips From the Professor.”
  • The reason for the rise in heart disease deaths in young people is less clear. However, the obesity epidemic, junk and convenience foods, and the popularity of fad diets all likely play a role.

Everyone has a magic diet for reducing heart disease risk. The American Heart Association tells us to avoid fats, especially saturated fats. Vegans tell us to avoid animal protein. Paleo and keto enthusiasts tell us carbs are the problem. Who is correct?

Of course, we don’t eat fats, carbohydrates, or proteins. We eat foods. That is why a recent study (T Meier et al, European Journal of Epidemiology, 34: 37-45, 2019) is so important. It reported which foods increase and which decrease the risk of premature heart disease deaths.

How Was The Study Done?

diet for heart disease prevention studyThe authors of the current study analyzed data from the “Global Burden of Diseases (GBD) Study”, a major world-wide effort designed to estimate the portions of deaths caused by various risk factors.

The current study focused on the impact of 12 dietary risk factors on heart disease deaths between 1990 and 2016 for 51 countries in four regions (Western Europe, Central Europe, Eastern Europe, and Central Asia).

The dietary risk factors were:

  • Diets low in fiber, fruits, vegetables, legumes, nuts and seeds, polyunsaturated fatty acids, omega-3 fatty acids, and whole grains.
  • Diets high in sodium, processed meats, sugar-sweetened beverages, and trans fatty acids.

Saturated fat and meat were not explicitly included in the GBS Study data. However, diets low in polyunsaturated fats and omega-3 fats are likely high in saturated fats. Similarly, diets low in fruits, vegetables, whole grains, and legumes are likely higher in meats. The study also did not include dairy, and some recent studies suggest that some dairy foods may decrease heart disease risk.

For simplicity I will only consider the findings from Western Europe because their diet and heart disease death trends are similar to those in the United States.

 

Best Diet for Heart Disease Prevention?

plant-based diet bestThe study found that in 2016 (the last year for which data were available):

  • Dietary risk factors were responsible for 49.2% of heart disease deaths.
  • 6% of all diet-related heart disease deaths occurred in adults younger than 70, and that percentage has been increasing in recent years.

When they looked at the contribution of individual foods to diet related heart disease deaths, the percentages were:

  • Diets low in whole grains = 20.4%
  • Diets low in nuts and seeds = 16.2%
  • Diets low in fruits = 12.5%
  • Diets high in sodium = 12.0%
  • Diets low in omega-3s = 10.8%
  • strong heartDiets low in vegetables = 9.0%
  • Diets low in legumes = 7.0%
  • Diets low in fiber = 5.7%
  • Diets low in polyunsaturated fats = 3.7%
  • Diets high in processed meats = 1.6%
  • Diets high in trans fatty acids = 0.8%
  • Diets high in sugar-sweetened beverages = 0.1%

So, what is the best diet for heart disease prevention?

In short, this study concluded:

  • A primarily plant-based diet is the best protection against premature death due to heart disease.
  • All plant-based food groups (whole grains, nuts and seeds, fruits, vegetables, and legumes) play an important role in reducing heart disease deaths.
  • Meat was not included in the analysis, but it is likely that most people’s diets in this region of the world contained some meat. The most likely take-away is that meat does not affect heart disease risk in the context of a primarily plant-based diet.
  • Dairy was not included in the analysis either, but some studies suggest dairy, particularly fermented dairy foods, reduce heart disease risk.
  • Finally, the study concluded: “Compared to other…modifiable risk factors (physical inactivity, drug and alcohol abuse, tobacco smoking, obesity, etc.), an altered diet is the most effective means of preventing premature deaths from cardiovascular disease in Western Europe.”

While every study has its weaknesses, this study is consistent with multiple previous studies showing that primarily plant-based diets are best for reducing heart disease risk. You will find a more complete discussion of these studies in my book “Slaying The Food Myths.”

 

Are the American Heart Association’s Recommendations Correct?

With this study’s results in mind we can now ask whether the recommendations of the American Heart Association and other popular diets are correct. Are they likely to reduce heart disease deaths?

  • The American Heart Association Recommends a dietary pattern that emphasizes a variety of fruits and vegetables, whole grains, nuts and legumes, skinless poultry and fish, and low-fat dairy products. This study supports those recommendations.
  • This study also supports the heart-health benefits of the Mediterranean and DASH diets.
  • Meat and dairy were not explicitly considered in this study. Thus, the results of this study are also consistent with vegan and semi-vegetarian diets.
  • However, low carb diets like Paleo and keto eliminate some of the key food groups (whole grains, fruits, and legumes) that appear to be essential for reducing heart disease risk. 40% of the heart-health benefits in this study came from those 3 food groups. Thus, this study does not support claims that those two diets are heart-healthy long term.

 

The Bottom Line

 

Everyone has a magic diet for reducing heart disease risk. The American Heart Association tells us to avoid fats, especially saturated fats. Vegans tell us to avoid animal protein. Paleo and keto enthusiasts tell us carbs are the problem. Who is correct?

A recent study provides some important clues. It looked at dietary patterns associated with reduced risk of premature death from heart disease in Western Europe. The study concluded:

  • A primarily plant-based diet is the best protection against premature death due to heart disease.
  • All plant-based food groups (whole grains, nuts and seeds, fruits, vegetables, and legumes) play an important role in reducing heart disease deaths.
  • Meat did not appear to affect heart disease risk in the context of a primarily plant-based diet.
  • Dairy was not included in the analysis, but some studies suggest dairy, particularly fermented dairy foods, reduce heart disease risk.
  • Finally, the study concluded: “Compared to other…modifiable risk factors (physical inactivity, drug and alcohol abuse, tobacco smoking, obesity, etc.), an altered diet is the most effective means of preventing premature deaths from cardiovascular disease.”

While every study has its weaknesses, this study is consistent with multiple previous studies showing that primarily plant-based diets are best for reducing heart disease risk. You will find a more complete discussion of these studies in my book “Slaying The Food Myths.”

With this study’s results in mind we can now ask whether the recommendations of the American Heart Association and other popular diets are correct. Are they likely to reduce heart disease deaths?

  • The American Heart Association Recommends a dietary pattern that emphasizes a variety of fruits and vegetables, whole grains, nuts and legumes, skinless poultry and fish, and low-fat dairy products. This study supports those recommendations.
  • This study also supports the heart-health benefits of the Mediterranean and DASH diets.
  • Meat and dairy were not explicitly considered in this study. Thus, the results of this study are also consistent with vegan and semi-vegetarian diets.
  • However, low carb diets like Paleo and keto eliminate some of the key food groups (whole grains, fruits, and legumes) that appear to be essential for reducing heart disease risk. 40% of the heart-health benefits in this study came from those 3 food groups. Thus, this study does not support claims that those two diets are heart-healthy long term.

For more details read the article above.

 

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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