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Human Nutrition and Supplements

Mahak Sharma*, Divya Sanghi and Ankita Sharma

Department of Nutrition and Dietetics, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India

Abstract

Dietary supplements are isolated or bound nutrients consumed by individuals to improve their nutritional status. They are usually consumed when an individual is deficient in a particular nutrient or wants to increase his/her muscle mass. The ingredients usually used as supplement are amino acid, herbs, minerals, vitamins and enzymes. Dietary supplements are used in the form of softgels, powder, capsules, liquid, and gelcaps. There are many health benefits of dietary supplements like Iron, Zinc, Protein supplements, Vitamin D, Calcium, Omega-3 fatty acids and many more. To maintain optimal growth and development while prevent deficiency, adequate intake is advisable but excess use or high dose cause the possibility of toxicity. This chapter emphasizes various health benefits of dietary supplements and their uses.

Keywords: Food supplements, sports supplements, nutrition, health

1.1 Dietary Supplements - Introduction

There is a broad variety of dietary supplements in the market. More than 56,000 distinct dietary supplements are available, according to the US Food and Drug Administration (FDA), with thousands of new products/ supplements being introduced to customers each year [1].

Dietary supplements, by definition, are formula that can supplement our regular diet with nutrients and reduce the risk of deficiency diseases and health problems like Protein Energy Malnutrition (PEM) and osteoporosis. Dietary supplements can be used as remedy in case of nutrient deficiencies either due to any chronic disease course or lower intake of nutrients but it cannot replace a normal/regular diet and daily nutrients of a meal, which are necessary for a healthy life. Many ingredients, such as herbs/medicinal plants and hormones, are used to make dietary supplements that have not been identified as nutrients or as having any nutritional functions [2]. It was explained that, when labeled correctly, these compounds should be called supplement ingredients rather than drug ingredients.

Along with natural supplements, many synthetic supplements are also in trend. Dietary supplements [3] are presumed healthy, when taken as directed dosages, they do not pose a serious or unreasonable risk of injury or illness. The FDA now regulates the dosage limit, marketing, advertising, and most importantly the labeling of these dietary supplements.

Dietary supplements come in many forms such as pills, capsules, powders, gels and extracts, although the most popular form of consumption is in powder form. They contain many nutrients which are difficult to get from daily normal diet like amino acids, vitamins, minerals, fiber and enzymes.

1.2 Global History of Dietary Supplements

In most countries, supplements are not regulated as a whole. Instead, they are covered under a collection of already existing laws and regulations [4, 5]. That is, they are "hanging from the hook" of pre-existing law. Previously, the dilemma was whether these goods should be classified as medications or foods; however, a third alternative is to classify them as bio-logics under existing rules. The Dietary Supplement Health and Education Act (DSHEA) of 1994 established supplement control in the United States. In the US, the FDA regulates dietary supplements as foods rather than drugs as a result of DSHEA; however, they are treated differently from traditional foods. Even if the ingredients used in supplement preparation can have nutritional benefits or occasionally adverse consequences, they are not tested for protection or effectiveness before being released into the market, unlike drugs. When a nutritional supplement is launched/ available in the market, the FDA has the duty of demonstrating that it is having adverse consequences in order to limit its use or withdraw it from the market. The FDA bases its decision on a "MedWatch" programme in which healthcare professionals have reported supplement-related complications and side effects. Consumers, on the other hand, were expected to notify the FDA of any potential supplement-related side effects. Some nutritional supplements, particularly botanical formulations, and pharmaceuticals were regulated. In most of the countries only those supplements got permitted that met recommended criteria.

1.3 Usage of Dietary Supplements

The usage of dietary supplement is popular in all age groups to get the perfect body image or according to disease course to prevent chronic nutrient deficiencies. Usage of supplements is much more common in Western countries or developed countries in comparison to underdeveloped countries. Ethnographic studies revealed that cultural factors and family rather than individuals also have the impact on potential usage of supplements [6]. Many misconceptions exist in society about the use of iron tablets. Honduran women believe that using iron tablets will result in larger infants, and they are also concerned about gaining too much weight and creating deformities in their children. Due to the low cost of iron tablets, it has little social standing. Tiredness, fatigue, and dizziness were considered common symptoms of pregnancy in India, so women did not seek treatment [7].

There are several research studies that show that various forms of perceiving or responding to public health messages or initiatives may have a substantial effect on their success or failure.

There are also other factors which act as a barrier for usage and selection of different supplements.

1.4 Types of Dietary Supplements

Supplements can be classified in three categories according to ingredients selected for their preparation: 1. Natural Dietary Supplements, 2. Semi-Synthetic Supplements, 3. Synthetic Dietary Supplements.

1.4.1 Natural Dietary Supplements

Natural supplements are made up with original extract of the natural ingredients or botanicals (herbs, fruits, vegetables, etc). No added chemicals are used in preparation of these supplements. These supplements are more expensive in comparison to synthetic supplements.

1.4.2 Semi-Synthetic Supplements

These types of supplements contain some amount of natural ingredients but their nutrient density will depend on the synthetic chemicals also, which are easily prepared in vitro and easily added to natural ingredients to increase the nutrient density of the product. These are a cheaper source of nutrients and sometimes have low bioavailability.

1.4.3 Synthetic Supplements

These types of products are prepared by using all synthetic ingredients in vitro. No natural ingredients are required to prepare these products. Mostly these products contain predigested or simple monomers which can easily be digested and absorbed by the human body. Many differences were reported between certain natural and synthetic vitamins in regard to physiochemical properties, proven clinical advantages of natural vitamins. Recent studies also proved the fact that natural vitamins are nutritionally better than synthetic vitamins [8].

To prove the difference between natural and synthetic supplements, many randomized control trials were conducted. Meinrad Lindschinger [9] in 2019 conducted a trail for effect of B complex vitamins on Homocysteine, Oxidative Stress, and Antioxidant Level and found no statistically noticeable difference between both the groups but some favorable tendencies like more sustainability, and less oxidative stress and homocysteine levels were observed in natural vitamins, which have more sustainability in comparison to synthetic ones.

Apart from this, supplements can also be classified in another way by number of nutrients present in one entity such as single nutrient mineral/ vitamin (high protein, caloric dense, etc.) and multiple micronutrients or having multiple nutrients in single tablet/capsules. Many supplements are available in the market which is targeting organ-specific disease such as kidney disease or liver disease.

The quality of supplement is a challenge; either it is botanical or synthetic, and many adulterants or misidentifications are related to this. Certain categories of supplements, like supplements related to sport and sexual performance, particularly use some unlabeled prohibited substances to deliver "spiking" and even sometimes the addition of active synthetic drugs.

1.5 Nutritional Adequacy and Dietary Diversity

Nutritional Adequacy is defined as a diet providing all the nutrients in balanced form, thus providing adequacy.

A diet is called a diverse diet when it includes various food groups (cereals, pulses, milk products, vegetables, fruits, meat product, etc.), which is important for attaining sufficient nutrient adequacy and sufficient development and body expansion [10, 11, 14].

Dietary diversity is defined as "the number of different foods or food groups consumed over a given reference period" [12, 14]. A diet covering all the food groups in balanced amount will provide adequate macronutri-ents and micronutrients, which could improve overall health especially in schoolchildren and decrease the prevalence of many chronic diseases such as cardiovascular diseases (CVDs), diabetes mellitus, metabolic syndrome and cancers, etc. [13,...