Among general reasons for the possible harmful effects of dietary supplements are: a) absorption in a short time, b) manufacturing quality and contamination, and c) enhancing both positive and negative effects at the same time.[56] The incidence of liver injury from herbal and dietary supplements is about 16–20% of all supplement products causing injury, with the occurrence growing globally over the early 21st century.[41] The most common liver injuries from weight loss and bodybuilding supplements involve hepatocellular damage with resulting jaundice, and the most common supplement ingredients attributed to these injuries are green tea catechins, anabolic steroids, and the herbal extract, aegeline.[41] Weight loss supplements have also had adverse psychiatric effects.[84]
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.

Bodybuilding supplements are dietary supplements commonly used by those involved in bodybuilding, weightlifting, mixed martial arts, and athletics for the purpose of facilitating an increase in lean body mass. The intent is to increase muscle, increase body weight, improve athletic performance, and for some sports, to simultaneously decrease percent body fat so as to create better muscle definition. Among the most widely used are high protein drinks, branched-chain amino acids (BCAA), glutamine, arginine, essential fatty acids, creatine, HMB,[40] and weight loss products.[41] Supplements are sold either as single ingredient preparations or in the form of "stacks" – proprietary blends of various supplements marketed as offering synergistic advantages. While many bodybuilding supplements are also consumed by the general public the frequency of use will differ when used specifically by bodybuilders. One meta-analysis concluded that for athletes participating in resistance exercise training and consuming protein supplements for an average of 13 weeks, total protein intake up to 1.6 g/kg of body weight per day would result in an increase in strength and fat-free mass, i.e. muscle, but that higher intakes would not further contribute.[30] The muscle mass increase was statistically significant but modest - averaging 0.3 kg for all trials and 1.0–2.0 kg, for protein intake ≥1.6 g/kg/day.[30]
What you eat is even more important as you enter your 40s. Women need protein (meat, fish, dairy, beans, and nuts), carbohydrates (whole grains), fats (healthy oils), vitamins, minerals, and water. These foods have been linked to some disease prevention, such as osteoporosis, high blood pressure, heart disease, diabetes, and certain cancers. The American Academy of Family Physicians supports the development of healthy food supply chains in supplemental nutrition programs so as to broaden the availability of healthy food.
^ Siscovick DS, Barringer TA, Fretts AM, Wu JH, Lichtenstein AH, Costello RB, Kris-Etherton PM, Jacobson TA, Engler MB, Alger HM, Appel LJ, Mozaffarian D (2017). "Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association". Circulation. 135 (15): e867–e884. doi:10.1161/CIR.0000000000000482. PMID 28289069.
Poor nutrition can manifest itself in many ways. The more obvious symptoms of a nutritional deficiency include dull, dry or shedding hair; red, dry, pale or dull eyes; spoon-shaped, brittle or ridged nails; bleeding gums; swollen, red, cracked lips; flaky skin that doesn't heal quickly; swelling in your legs and feet; wasted, weak muscles; memory loss; and fatigue.
The U.S. Department of Agriculture's (USDA) food pyramid system (www.mypyramid.gov) provides a good start by recommending that the bulk of your diet come from the grain group—this includes bread, cereal, rice and pasta— the vegetable group; and the fruit group. Select smaller amounts of foods from the milk group and the meat and beans group. Eat few—if any—foods that are high in fat and sugars and low in nutrients. The amount of food you should consume depends on your sex, age and level of activity.
When shopping for an herbal supplement, it's important to verify which parts of the plant were used in its production. Different components can produce different effects, some of which can harm your health. For example, research shows that while the roots of the herb kava seem to be safe, its stem peelings and leaves may contain compounds that could be toxic to the liver. Talking with your doctor or herbalist can help you determine which plant parts to look for.
The average American diet leaves a lot to be desired. Research finds our plates lacking in a number of essential nutrients, including calcium, potassium, magnesium, and vitamins A, C, and D. It's no wonder that more than half of us open a supplement bottle to get the nutrition we need. Many of us take supplements not just to make up for what we're missing, but also because we hope to give ourselves an extra health boost—a preventive buffer to ward off disease.
Some supplements that were found to have health benefits in observational studies turned out, with more rigorous testing, to be not only ineffective but also risky. Vitamin E, which was initially thought to protect the heart, was later discovered to increase the risk for bleeding strokes. Folic acid and other B vitamins were once believed to prevent heart disease and strokes—until later studies not only didn't confirm that benefit but actually raised concerns that high doses of these nutrients might increase cancer risk.
(OMNS Sept 12 2018) One of the most vitamin-restrictive countries in the world is Norway. There, authorities limit potencies to only slightly higher than RDA (Recommended Dietary Allowance) levels for dietary supplements sold outside of pharmacies. The traditional reasoning is that most people receive the nutrients they need from a "balanced diet." [1] The authorities are also obsessively concerned that some vitamins and minerals are harmful in high doses. And, since an intake of water-soluble vitamins in excess of needs is excreted in the urine, Norwegian "experts" advise that taking supplements is a waste of money. Accordingly, the argument goes, the public should be protected not only from possible harm, but also from wasting money on unnecessary nutrients. The official policies on nutritional supplements vary within OECD (Organization for Economic Cooperation and Development) countries. Some are more liberal, while others are even more restrictive.

Much of the sugar we eat is added to other foods, such as regular soft drinks, fruit drinks, puddings, ice cream and baked goods, to name just a few. Soft drinks and other sugary beverages are the No. 1 offenders in American diets. A 12-ounce can of regular soda contains 8 teaspoons of sugar, exceeding the daily maximum amount recommended for women.
After menopause. Lower levels of estrogen  after menopause raise your risk for chronic diseases such as heart disease, stroke, and diabetes, and osteoporosis, a condition that causes your bones to become weak and break easily. What you eat also affects these chronic diseases. Talk to your doctor about healthy eating plans and whether you need more calcium and vitamin D to protect your bones. Read more about how very low estrogen levels affect your health in our Menopause section. Most women also need fewer calories as they age, because of less muscle and less physical activity. Find out how many calories you need based on your level of activity.
Animal products, such as meat, fish and poultry are good and important sources of iron. Iron from plant sources are found in peas and beans, spinach and other green leafy vegetables, potatoes, and whole-grain and iron-fortified cereal products. The addition of even relatively small amounts of meat or foods containing vitamin C substantially increases the total amount of iron absorbed from the entire meal.
Manufacturers must follow certain good manufacturing practices to ensure the identity, purity, strength, and composition of their products. If the FDA finds a product to be unsafe or otherwise unfit for human consumption, it may take enforcement action to remove the product from the marketplace or work with the manufacturer to voluntarily recall the product.
Getting enough water also is important. Many experts recommend at least eight 8-ounce glasses of water daily—more if you exercise frequently or are exposed to extremes of heat and cold. The 2010 Dietary Guidelines for Americans emphasize drinking more water and other calorie-free beverages, along with fat-free or low-fat milk and 100 percent fruit juices, instead of calorie-packed regular sodas.
Compared to pharmaceutical drugs, supplements of most essential nutrients are quite harmless. However, some supplements may have poor quality, or contain toxic metals such as lead or cadmium. Therefore, it is the duty of our authorities to ensure that potentially hazardous products or supplements of poor quality are not sold, and that consumers are offered fair prices in a free market. An example where the Norwegian authorities do not follow up such basic duties is that pharmacies demand more than 1,600 Norwegian Kroner (about $190) per kg of vitamin C in powder form, which would cost less than $20 with free competition and no restrictions in permitted doses or outlets.
Notice that alcohol isn't included in a food group. If you drink alcohol, do so in moderation, up to one drink per day for women and two drinks per day for men. Alcohol offers little nutritional value, and when used in excess, can cause short-term health damage, such as distorted vision, judgment, hearing and coordination; emotional changes; bad breath; and hangovers. Long-term effects may include liver and stomach damage, vitamin deficiencies, impotence, heart and central nervous system damage and memory loss. Abuse can lead to alcohol poisoning, coma and death. Pregnant women should not drink at all because alcohol can harm the developing fetus and infant. According to the March of Dimes, more than 40,000 babies are born each year with alcohol-related damage. Even light and moderate drinking during pregnancy can hurt your baby. If you are breastfeeding, discuss drinking alcohol with your health care professional. After clearing it with your doctor, you may be able to have an occasional celebratory single, small alcoholic drink, but you should abstain from breastfeeding for two hours after that drink.
Maintaining a healthy weight is important piece of the puzzle to achieve good health. A healthy weight can be determined using the body mass index charts (see web source below). If you find you are overweight or obese, weight loss may be beneficial for you. Before you begin any weight loss efforts, consult with your medical provider and/or consult a registered dietitian to create a weight loss plan. If you are underweight, consult a medical provider to assess your weight status.
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