Dietary supplements

Dietary supplements are not drugs, and are not intended to prevent, diagnose, treat, mitigate, or cure disease.

Presently one half of adults report using one or more dietary supplements.

More than $30 billion spent on dietary supplements 2011.

Dietary supplements often contain vitamins, but may also include other ingredients, such as minerals, herbs, and botanicals.

In the United States, a dietary supplement is defined under the Dietary Supplement Health and Education Act of 1994.

There is no FDA approval process for dietary supplements, and no requirement that manufacturers prove the safety or efficacy of supplements introduced before 1994.

The US Code of Federal Regulations (CFR) Title 21, part III regulates Good Manufacturing Practices (GMPs) in the manufacturing, packaging, labeling, or holding operations for dietary supplements.

Even though product registration is not required, these regulations mandate production and quality control standards (including testing for identity, purity and adulterations) for dietary supplements.

Patients who utilize supplements are older, have a lower body mass index, are more physically active, less likely to smoke, have higher educational levels, and higher socioeconomic status compared with non-users.

Primary reason for using dietary supplements as to improve or maintain overall health.

Multivitamin-mineral products of the most commonly reported type of supplement.

Dietary supplements users generally use moderate amounts of alcohol, abstain from smoking, have health insurance, have higher intakes of vitamins and minerals from their food choices than non-users.

There is insufficient evidence to recommend either for or against the use of multivitamin vitamin/minerals as a dietary supplement to prevent chronic disease.

Meta-analysis of the use of B vitamins to lower homocysteine concentrations showed no significant effects in 5 years for cardiovascular events, cancer incidence, or all-cause mortality (Clarke R et al).

Meta-analysis that examined antioxidant dietary supplements of vitamin D or beta-carotene showed that there was no association between vitamin E supplementation and prevention of cardiovascular disease for mortality, while the beta-carotene trial showed small increase in all-cause or cardiovascular related mortality (Vivekananthan DP et al).

Studies have shown that supplementation with fatty acids has little or no value in preventing the risk of major cardiovascular diseases or all-cause mortality.

Older adults are likely to use supplements for site-specific health reasons such as bone, heart disease, or vision reasons.

Younger adults are likely to use dietary supplements to enhance energy, or to boost immune function.

Among couples seeking infertility treatment, the use of folic acid and zinc supplementation by male partners, compared with placebo did not improve semen quality or couples’ live birth rates.

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