The new laws coming into effect to regulate health supplements are believed by many to be unnecessary, and prejudice against alternative health. But if you understand how science works and how the health supplements industry uses but oversimplifies science, you will understand that the time has come for some accountability.
It may not be initially obvious but the health supplement industry is reliant on science. It’s ideas and theories have mostly originated from scientific studies. However, for scientists at least, it’s use of science is far too simplistic. Many of the ideas may work but not necessarily. Ideas are just that until you have some evidence that they can be effectively put into practise.
It is estimated that in the UK between 20 and 30% of us supplement our diets with vitamins and minerals. There is a general assumption that they must be safe, because most are found naturally. Even their name implies they can do nothing but benefit your health. Until recently they have come under little scrutiny. They are not considered medicines and therefore do not have to undergo any tests to establish their safety, any side effects and to see if they produce the benefit that they claim to.
Last autumn the Food Standards Agency (FSA) produced a report giving new safety limits for many commonly used supplements. This was part of The Food Supplements Directive, which passed into British law last July. It is intended to tighten up the health food market to better protect the public when using health supplements and herbal remedies. Other parts of the law will see supplements sold to modify physiological function or treat disease being classified as medicines, and having to undergo tests as such.
Many people believe this new legislation is both unnecessary and somehow unfair on the industry. Often health supplements and alternative medicines appear as purist underdogs to the pharmaceutical industry. Their methods and motives are above question. Yet would the drug industry be able to sell things on the vague notion that they should work, but there is no real evidence that they do? They could also have side effects, be toxic at high doses or interfere with other drugs, but no work has been done to find out.
A number of scientific studies (recently highlighted in The Lancet) have found many health supplements have no effect and some may actually be harmful. In a review in The British Medical Journal David Bender (senior lecturer in Biochemistry at University College London), concluded that ‘unless our intake is inadequate as a result of poor diet then supplements will probably do us no good-apart from folic acid taken periconceptually and, possibly, vitamin A by elderly people’.
Advocates of health supplements and alternative medicine say they are safe and many people believe in alternative medicine and have a mistrust of science. There are rumours of conspiracy or pressure from the drug manufacturers, who are reportedly worried about their profits being taken by the increasing public reliance on health foods and alternative medicines. Some people think science and the health industry are against each other.
Yet the health supplement industry is based on science. The information about what vitamins and minerals are essential for our health comes from scientific studies. However most information has come from observing problems caused by a deficiency. But because a lack of a vitamin or mineral in your diet causes problems does not mean that if you overtake it, in the form of a supplement, it will be of super benefit to you.
Take Vitamin A, it helps to regulate the specialising of cells as they divide a process that if it breaks down leads to cancer. Thus a higher intake of vitamin A could in theory reduce your risk of cancer. But the levels of vitamin A in the blood are under tight control by the body. In a normal well-fed person taking a supplement will not affect the amount of vitamin A in the blood. Indeed studies have confirmed that vitamin A supplementation has no effect on cancer risk.
The experience of antioxidants to prevent cancer is another example of how you need more than a good idea to actually bring about a health benefit. Observational studies around the world have shown people who eat lots of fresh fruit and vegetables have less heart disease and cancer. Free radicals are highly reactive products of normal metabolism, believe to be involved in the development of these diseases. Antioxidant vitamins are natural agents found in fruit and vegetables thought to protect against these free radicals. Thus, on the basis of this information, supplements of antioxidants are sold to help protect against cancer and heart disease.
However subsequent scientific studies on the use of antioxidant supplements have found most supplements to have no effect on cancer or heart disease. The exception to this is beta-carotene which has been found to increase the risk of lung cancer in smokers. A number of possible explanations for this have been proposed. It may be that beta-carotene is protective at the high end of the normal diet but becomes toxic when taken in larger doses. Or it may be unstable in the smoke environment of the lungs. This is an example of how a compound can have different effects in different groups of people. The human body and its metabolism are hugely complex. Taking one supplement, especially in high doses, may effect the absorption of other vital compounds. Just because something should work dose not mean it will.
It is not that scientist do not believe that health supplements can work, far from it. Scientist conducted these studies to see if supplementation could benefit smokers. It was certainly not designed to harm the health supplement industry, or the people taking part in the study. What they found out was unexpected. That is how science works. You do not always get the answer you thought you would.
At any point scientists have an opinion based on a balance of the evidence. Not all studies will agree, that is usual in science. Slight differences in the design of studies or the people being studied can bring about a different result. But when the evidence does not support the idea obtained from observational studies, it’s time to rethink the idea.
Some areas of the health supplement industry use scientific information in an even more literal sense. They take information on what compounds are involved in biological systems and conclude that taking a supplement of them will enhance that system.
For example some of the ideas used to boost energy (as in the book ‘Natural Energy’ by Erika Schwartz and Carol Colman, along with others) are based on the body’s production of energy. In cells energy is produced within structures called mitochondria. In mitochondria adenosine triphosphate (ATP) is made and this is the fuel that powers all other processes in the body. Carnitine is an amino acid that transports fatty acids into the mitochondria to be made into ATP and Coenzyme Q10 also plays a role in the production of energy. From this scientific information you are advised to take capsules of carnitine and coenzyme Q10 to give yourself more energy.
The idea may have originated from science and be backed up by science but the interpretation is certainly not science. Just because compounds are involved in energy production does not mean that by taking a supplement of them you will increased that production. It is possible but they’re many other factors to consider. Will these compounds remain intact in the acid environment of the stomach? Will they be efficiently absorbed and transported to all cells? If so will an increase in them indeed lead to an increase in energy? Or will these compounds simply be excreted in your urine?
Why in an age of health scares, and with so little understanding, has the use of health supplements become so popular? Many of us have a desire to live a healthier life. Only drinking less, eating healthily, giving up smoking and doing more exercise is all too much like hard work. It is far easier to take a pill. It’s a quick fix. The greatest harm the health supplement industry may be doing is letting people mistakenly think that by taking supplements they are living healthily. It may stop them taking other positive action towards a healthy lifestyle.
Critics of the FSA’s report giving new safety limits for many supplements have said that the Expert Group on Vitamin and Minerals, who compiled the report, drew their conclusions from old and outdated studies. If so then perhaps it is time for the health supplements industry to start funding new research to show their products are as safe and effective, as they believe them to be. Time for some accountability from an industry with an estimated £300m annual turnover. It may be that science overcomplicates things. Health supplements could provide many answers to disease prevention and cure. Yet they will never be able to say for sure unless the studies are done to prove it.