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Nutritional supplements as information from the government authorities indicates are consumable health products that contain one or more ingredients, or nutrients, commonly found in food (Official US Government FDA website, accessed Sept. 2010).
Furthermore, the substances used in nutritional supplements per information from the supplement definition, are usually delivered in the form of tablets, capsules, liquids, powders, or energy bars...
“intended for ingestion by mouth” (Official US Government FDA website, accessed Sept. 2010).
However, by this terminology the FDA refers to a specific way of “ingestion by mouth”: swallowing the supplement products.
Another factoid that is good to know about food supplements is that there are some health supplements available which come in the forms of sprays and gels. Legally, those products are not deemed dietary supplements. As an example, in regard to spray supplements the FDA stated that:
“[...] the Act [=the Federal Food, Drug, and Cosmetic Act] defines the term “dietary supplement” [...] as a product that is “intended for ingestion.” Because oral spray products are intended to enter the body directly through the mucosal tissues at the back of the throat, they are not dietary supplements and are not foods." (FDA, 5-Feb-2019) [explanation & emphasis added]
Therefore, such product items do not fall into the regulatory category of nutritional supplements and information about those types of nutritional supplements, as a consequence, cannot contain any health claims pertaining to these products (FDA, 5-Feb-2019).
Other synonyms, or other equivalent or similar terms, commonly used for nutritional supplements (or certain types of nutritional supplements) are antioxidants, whole food supplements, natural health products, nutraceuticals, or vitamin supplements.
The official definition of nutritional supplements and information thereof that specifies what supplements usually contain, lists the following categories of nutrients:
You know now the answer to “what are supplements?”. You know the official definition of nutritional supplements. But... do you have an idea of just how many supplements are available?
By 2003, there were approximately 30,000 different dietary supplements available on the market, up from around 4,000 in 1994, according to data by the US Food and Drug Administration, also known as FDA (Taylor, 2004; Gibson & Taylor, 2005).
A statement published by the office of dietary supplements (ODS) which is part of the National Institutes of Health (NIH), a US government agency, divulged that there are “at least 50,000 dietary supplement products available” by the year 2011 (ODS, 2011). By 2019, an estimated 80,000 nutritional supplement products are available to consumers in the United States (Pew, 2019).
No doubt, the demand for vitamins and health supplements and information on what they are intended for, or what they do, has been growing steadily since the introduction of the currently valid set of policies on dietary supplement regulation (the DSHEA of 1994).
Nutritional supplements per information from the official authorities are “additions” (an extra bonus if you will) to, hopefully, a balanced good diet:
“Dietary supplements are intended to supplement the diets of some people, but not to replace the balance of the variety of foods important to a healthy diet.” (Official US Government FDA website, accessed Feb. 2011) [emphasis added]
The central idea of not replacing a meal with vitamins and health supplements is that food is primarily composed of energy and structural nutrients (besides water), such as fats, carbohydrates, and proteins, also known as macronutrients. Your body needs these substances in relatively large quantities to function properly.
Ingredients found in supplements, on the other hand, are usually substances such as natural vitamins, minerals, and enzymes. They are also referred to as micronutrients because proportionally small amounts of them are required by the human organism for good health.
Most importantly, none of the micronutrients are a direct source of energy.
Furthermore, food items contain hundreds or thousands of substances and chemical elements (some of which may still not be known to science), making it unfeasible to put them all into nutritional supplements. Thus, eating a nutritious diet assures that you're getting this vast plethora of nutrients, including potentially still undiscovered constituents, above and beyond what you're getting with well-designed food supplements.
Therefore, to re-emphasize one of the facts about vitamins and supplements because it is a vital concept to understand...
Dietary supplements, such as vitamins and mineral supplements, are NOT... a replacement or substitute for healthy food, a meal, or for eating "junk food" (refined, highly processed food).
However, nutritional supplements are intended to "supplement", or complement, a healthy diet.
“I do know that most of my colleagues are still of the opinion that only a few rare health problems can be solved with proper nutrition or added vitamins and minerals.” (Jonathan V. Wright, MD, in 1979)
Among the many facts about dietary supplements is that studies (e.g., Ashar, et al., 2007 & 2008) show that both physicians and medical students are poorly educated about nutritional supplements and information on the regulations thereof. As a consequence, traditional physicians convey little meaningful information on the health risks of dietary supplements or vitamin benefits to their patients (Tarn, et al., 2013).
This suggests that a conventional doctor (or a medical student) is not a reliable source to go to for advice on supplements. (For supplement advice I propose you consult with a certified nutritionist or an orthomolecular practitioner, or closely scrutinize the scientific literature on your own to form reliable answers.)
But, ironically, the advice from US government authorities on where to look for reliable dietary supplement information is...
“Your doctor is a good place to start.” (Official website of nutrition.gov, part of US Department of Agriculture (USDA), accessed July 2013)
It isn't... because what the official authorities suggest entirely contradicts what the scientific data indicate.
Trust facts, not authorities.
These research findings also makes sense when you examine the reasons why doctors don't have adequate knowledge about nutritional supplements and information on their regulations.
Here's a clue...
“[...] there are lots of data to show that doctors spend little time reading the original research in [medical] journals.” (Smith, 2006) [explanation added]
But this is really just a "symptom" of a much more basic reality...
The core reason why doctors, in general, are not well informed about nutritional supplements and information closely related to them is because conventional physicians learn little about nutrition, supplements, and other non-orthodox treatments in medical school (Crayhon, 1994).
A circumstance, which in itself is a "symptom", or outcome, of an even broader reality (the hard truth)... that of an authoritarian, corporation-dominated, commercialized culture of corruption:
Allopathic modern medicine is primarily a highly profitable business of sickness management, preferentially over the long run (e.g., the lifespan of the patient). The commitment to proper nutrition, including the resort to nutritional medicine with food supplements, is primarily a lifestyle of health maintenance.
Therefore, the nutritional orientation to life encroaches on the big profits of the medical “business with disease” (Rath, 1997 & 2003). Consequently, in one of their prime “milieus of control”, such as medical schools, the unethical, criminal allopathic medical system (Carter, 1992; Walker 1993; Lanctôt, 2002; Angell, 2009; Gøtzsche, 2013) has systematically and deliberately neglected the genuine education of their uncritical indoctrinatees (conventional doctors) with authentic nutritional information.
In spite of the fact that most medical schools offer courses on alternative therapies, such as on nutrition, their emphasis is inconsistent, incoherent, and marginal within the full school curricula (Wetzel, et al., 1998; Berman, 2001; Adams, et al., 2006; Colquhoun & ten Bosch, 2008; Gramlich, et al., 2010; Frantz, et al., 2011).
This situation is reflected in the practically unchanged view of physicians, since the 1950s, that nutrition education in medical schools is inadequate (Frantz, et al., 2011).
It's not by coincidence...
“[The allopathic medical monopoly, a.k.a conventional official medicine, or the colluding corporatist governments and corporate medicine] want to end any evident connection between nutrition and health so that in the public perception, health is dependent upon professional medicine and pharmaceutical products.” (Martin Walker, Independent English Health Researcher & Author [Mclean, 2004]) [explanation added]
However, the steady growth of the health industry (alternative or natural medicine), particularly since around the 1960s, and the accompanying increase in the frequency and complexity of questions and concerns patients ask their doctors about nutrition and food supplements (Gramlich, et al., 2010), has ignited, or rather inevitably “enforced”, more interest by the medical profession in nutritional supplements and information thereof (Dickinson, et al., 2011). Although some research (e.g., Frantz, et al., 2011) suggests that there is a decline in the number of physicians who pursue education about nutrition.
The reality is that it is not uncommon for patients to know more about nutritional supplements and information related to nutrition than their physicians.
Alan R. Gaby, MD, stated in an investigative report:
"[...] most doctors know less about nutrition than do many of their patients." (Gaby, 2003)
In an editorial of a medical journal, physician Victor S. Sierpina, MD, wrote:
“Many of us did not receive adequate training about supplements in either medical school or residency.” (Sierpina, 2008)
In 2010, Carolyn Dean, MD, ND, a physician educated both in conventional medicine as in non-orthodox healing methods, explained:
“There are no nutrition classes in [medical] school there is no nutrition training given to doctors.” (Dean, Feb. 2010) [explanation added]
Another physician corroborates these statements:
“Neither you nor your doctor are aware that the health benefits of vitamins are a non-issue during medical education and that natural therapies have been systematically removed from the teaching calendars at medical schools during the 20th century and replaced by lectures in “pharmacology”.” (Matthias Rath, MD)
A pro-supplement industry funded 2008 survey of 900 doctors revealed that most physicians did not receive any formal training or education about nutritional supplements (Dickinson, et al., 2011).
(More frightening, and revealing –and further corroborating– that the official, allegedly evidence-based, medicine business is in fact a highly unethical evidence-biased medical business, is that allopaths get a smidgen of meaningful education in medical school about state-authorized toxic vaccines they go on peddling to unsuspecting customers to enrich themselves (Burrowes, 2019)).
Unsurprisingly, because orthodox medical doctors generally have a lackluster understanding of natural food supplements a relatively small percentage of them recommend these health products to their patients (Bailey, et al., 2013).
In a culture where the authorities of medical education decide it is rather unimportant for doctors to get exposed to scientific data on some rather basic modalities of health like nutritional supplements and information about nutrition, and other unconventional, non-patentable remedies and healing methods, it will virtually seamlessly install...
... a bias in physicians towards the medical procedures of conventional, allopathic medicine,
... a bias against any "alternative", non-orthodox medical approaches, leading to a neglect of involvement thereof on the part of traditional doctors.
Marcia Angell, MD, former editor of The New England Journal of Medicine, explained:
“One result of the pervasive bias is that physicians learn to practice a very drug-intensive style of medicine. Even when changes in lifestyle would be more effective, doctors and their patients often believe that for every ailment and discontent there is a drug.” (Angell, 2009) [emphasis added]
The biologist Dr. Raymond Peat referred to the deliberate one-sided indoctrination process in medical school when he said in an interview:
“Doctors never have any idea about anything except what they're told is good practice.” (Raymond Peat, PhD, in 2009) [emphasis added]
Similarly, in an editorial the author stated:
"The typical doctor is authoritarian. He or she, as a medical student or a qualified doctor, accepts what is imparted to her/him from the medical teachers, textbooks, and journals as gospel, “the revealed Truth”, not to be questioned." (Paterson, 2006)
In view of these various scholarly statements and observations, suddenly a highly incriminating verdict such as that made decades ago by a conventional "heretical" doctor who had also been known as "The People’s Doctor", Robert Mendelsohn, MD, (1926-1988), about his very own profession and professional colleagues appears much less inconceivable and outlandish but is reality-based in both yesterday's and today's times:
"[...] doctors turn out to be dishonest, corrupt, unethical, sick, poorly educated, and downright stupid more often than the rest of society. [...]. When I meet a doctor, I generally figure I'm meeting a person who is narrow minded, prejudiced, and fairly incapable of reasoning and deliberation. Few of the doctors I meet prove my prediction wrong." (Mendelsohn, 1979)
Of course, doctors are busy with keeping up on just the latest information in their specialized narrow field of medicine. Yet it is quite apparent that physicians, more often than not, don't (closely) examine anything outside what they learn in medical school because they feel it's "politically incorrect".
Most disturbingly though...
It isn't only information from "competing" or "outside" fields to orthodox medicine, such as alternative healing modalities (e.g., nutritional supplement therapy, accupuncture), that is being disregarded but also within the arena of modern medicine itself there is an apathy present among many (and probably most) doctors against data that threaten or question the officially propagated ideology of organized medicine.
A personal experience of mine corroborates this...
When I began to investigate mammograms, during 2010-2011 (by the way, the (e)book The Mammogram Myth is the culmination of that investigation –see Mammograms: Dangerous! Mammography Risks, Myths & Breast Cancer Facts), I noticed huge differences among the magnitude of positive effects from screenings with mammography in the scientific literature. It didn't make much sense to me. So I contacted some of the mammography scientists, among them Per-Henrik Zahl, MD, PhD, who had published many studies on the subject, hoping to get to the bottom of the matter.
After numerous personal exchanges with Zahl, who had been extremely forthcoming, gracious, open, and very detailed in the information he shared with me, he made this comment to me (assuming that I'm a physician):
“Most doctors do not try to understand the numbers in this discussion. I really appreciate your effort to understand why people publish very diverging results." (Per-Henrik Zahl, MD, PhD, Personal Communication, Dec. 30th, 2011)
A lot of laypeople are somewhat aware of the controversies about the merits of mammograms, which have been raised since the 1970s. Within orthodox medicine, however, remarkably conflicting, deviating, or opposing results, among the body of scientific-medical evidence, is apparently of no (real) interest to “most doctors” for further investigation. Presumably, not even to radiologists who ought to be intimately familiar with all of the pertinent research data, particularly with the “very diverging results”, regarding the benefits of screening with mammography.
Thomas E. Levy, MD, summed up the customary, "politically-correct" behavior of traditional physicians with an observation:
“Doctors have a very strong herd mentality, […].” (Levy, 2010)
Now, what about consumers of vitamins and supplements, are they knowledgeable about supplements?
Research investigations reveal that the majority of consumers are equally poorly informed about nutritional supplements and information pertaining to how they are regulated (Dodge & Kaufman, 2007).
On the other hand, a study indicated consumers of vitamin supplements believe that traditional doctors are poorly educated about these types of health products (Blendon, et al., 2001).
Their perception confirms the empirical data on nutritional supplements and information relating to who is not knowledgeable about them.
One of the major facts about dietary supplements is that both physicians and consumers alike are poorly educated about nutritional supplements. And information and knowledge on dietary supplement regulations are equally lacking among both of these groups.
Information retrieved from numerous studies found that approximately half the adult US population routinely takes supplements (Ervin, et al., 1999; Satia-Abouta, et al., 2003; Radimer, et al., 2004; Rock, 2007; Cohen, 2009; Gershwin, et al., 2010; The Washington Post, 2010; Bailey, et al., 2011).
One study claimed the figure is even over 70% (Sadovsky, et al., 2008). A survey (Daniells, March 2012) corroborates that the 70% mark seems to be the accurate figure, while multivitamins remain the mostly used supplements. A nationally representative 2019 survey, too, found that 70% of American adults are using nutritional supplements (Pew, 2019).
Undoubtedly, the number of users has steadily increased since the 1970s (Bailey, et al., 2011). By the late 1970s/early 1980s, the figure was at 35% (Koplan, et al., 1986). It grew rapidly during the 1990s (largely enabled by new policies of dietary supplement regulation), but appears to have slowed down a bit at around the turn of the 21st century (Kelly, et al., 2005).
A number of studies on nutritional supplements found information which demonstrated that people who are obese are the least likely to consume all natural nutritional supplements. Well-educated, fit, older (45+) Caucasians (especially women) with higher incomes are the most likely to use vitamins and supplements (Eliason, et al., 1997; Satia-Abouta, et al., 2003; Yu, et al., 2003; Gunther, et al., 2004; Harrison, et al., 2004; Kennedy, 2005; Kelly, et al., 2006; Rock, 2007; Bailey, et al., 2011).
By the way, a large percentage of traditional physicians and nurses, closely matching the consumption figure of the general population, also appear to regularly take nutritional supplements as information, obtained from various research investigations, revealed (Gardiner, et al., 2006; Dickinson, et al., 2009; Dickinson, et al., 2011).
Information and data gathered from extensive research (Eliason, et al., 1997; Hathcock, 2001; Kaufman, et al., 2002; Satia-Abouta, et al., 2003; Gunther, et al., 2004; Kennedy, 2005; Artz, et al., 2006; Gardiner, et al., 2007; Bailey, et al., 2013) show that the main reasons why people use nutritional supplements are...
...to improve, protect, or preserve their health,
and another vitamin use is...
...to treat their specific health issues.
(Originally published: ca. July-2012 | This is a revised version)
Recommended next page(s):
The Shady World Of Dietary
Supplement Regulation" (–3-Part Article)