Dietary supplements are complex products. The FDA has established good manufacturing practices (GMPs) for dietary supplements to help ensure their identity, purity, strength, and composition. These GMPs are designed to prevent the inclusion of the wrong ingredient, the addition of too much or too little of an ingredient, the possibility of contamination, and the improper packaging and labeling of a product. The FDA periodically inspects facilities that manufacture dietary supplements.
A review of clinical trials registered at clinicaltrials.gov, which would include both drugs and supplements, reported that nearly half of completed trials were sponsored wholly or partially by industry. This does not automatically imply bias, but there is evidence that because of selective non-reporting, results in support of a potential drug or supplement ingredient are more likely to be published than results that do not demonstrate a statistically significant benefit. One review reported that fewer than half of the registered clinical trials resulted in publication in peer-reviewed journals.
As continual research on the properties of supplements accumulates, databases or fact sheets for various supplements are updated regularly, including the Dietary Supplement Label Database, Dietary Supplement Ingredient Database, and Dietary Supplement Facts Sheets of the United States. In Canada where a license is issued when a supplement product has been proven by the manufacturer and government to be safe, effective and of sufficient quality for its recommended use, an eight-digit Natural Product Number is assigned and recorded in a Licensed Natural Health Products Database. The European Food Safety Authority maintains a compendium of botanical ingredients used in manufacturing of dietary supplements.
Scientists still have much to learn even about common vitamins. One recent study found unexpected evidence about vitamin E. Earlier research suggested that men who took vitamin E supplements might have a lower risk of developing prostate cancer. “But much to our surprise, a large NIH-funded clinical trial of more than 29,000 men found that taking supplements of vitamin E actually raised—not reduced—their risk of this disease,” says Dr. Paul M. Coates, director of NIH’s Office of Dietary Supplements. That’s why it’s important to conduct clinical studies of supplements to confirm their effects.
However, some herbal supplements may not be safe. They could contain unlisted ingredients that make you sick. Drugs that aren’t listed on the label can include, steroids or estrogens. Products may even contain toxic, or poisonous, substances. Examples include, as arsenic, mercury, lead, and pesticides. Supplements must be recalled if they are found to contain toxic ingredients.
"These products provide a subtle, incremental effect. You can't use a sports supplement for a week and expect to gain pounds of muscle, but if used properly, research shows they can provide a slight, not overwhelming, edge," says Andrew Shoa, PhD, vice president for regulatory affairs for the Council for Responsible Nutrition, a trade association for the dietary supplement industry.
After basic nutritional requirements are supported, supplements may be used to target specific needs and health conditions. For instance, athletes, men, women, children, the elderly, and vegetarians have differing needs for nutrients, and an informed use of supplements would take these differences into account. People suffering from health conditions and diseases may use specific supplements to target their condition and to support the body's healing capacity by providing optimal amounts of nutrients.
The Food and Drug Administration (FDA) defines a supplement as “a product taken by mouth that contains a 'dietary ingredient' intended to supplement the diet. The 'dietary ingredients' in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites.” Supplements are intended to supplement nutrients missing in your diet, not replace them.
Not everyone who is underweight suffers from an eating disorder, but anorexia and bulimia are serious health problems in this country; an estimated 500,000 women suffer from anorexia, and 1 to 2 million women struggle with bulimia. Women with anorexia nervosa starve themselves and/or exercise excessively, losing anywhere from 15 percent to 60 percent of their normal body weight. Some die. Women with bulimia nervosa binge on large quantities of food—up to 20,000 calories at one time—and then try to get rid of the excess calories. Some purge by inducing vomiting, abusing laxatives and diuretics or by taking enemas. Others fast or exercise to extremes.
Eat all the foods you enjoy—but the key is to do it in smaller quantities, says Elisa Zied, RDN, who has lost and kept off more than 30 pounds since her highest weight in high school. In fact, she says it's the number one change she made that's helped her maintain her smaller frame. "I didn't want to feel deprived as I had in previous attempts to lose weight," she says. The worst thing you can do is be too strict, then rebound by overeating because you're not satisfied.
5. Wrap unhealthy foods in tin foil. Wrap healthy foods in plastic wrap. The old saying, “out of sight, out of mind” turns out to have some truth to it. Eating isn’t just a physical event, but also an emotional one. Your mind often determines what it wants to eat based on what your eyes see. Thus, if you hide unhealthy foods by wrapping them up or tucking them away in less prominent places, then you are less likely to eat them.