Dietary supplements: Sorting fact from fiction

June 6, 2018 | By Jeremy Appleton, ND

Nutritional dietary supplements use is on the rise in the United States, both among consumers and recommending healthcare practitioners. This article provides an overview of supplement trends and quality guidelines and practices that serve as a guidepost for identifying reliable quality nutritional supplements.

Dietary Supplement Use

In 2016, the Council for Responsible Nutrition consumer survey reported that an estimated 71% of US adults use dietary supplements.[1] The Nutrition Business Journal further elaborates that the most common categories include vitamins/minerals, followed by botanicals and specialty supplements such as probiotics.[2] Yet this trend is not only consumer-driven. Quality nutraceutical use is routinely supported and recommended, across specialties, by both integrative and allopathic practitioners. According to the 2017 Integrative Physician Market Landscape survey, dietary supplements are incorporated into more than 80% of practices and are recommended to approximately two-thirds of the patient population.[3]  Professional brand selection among practitioners however, is not taken lightly.  Although many factors come into play, including formulation and clinical evidence, on the basis of both formal research and patient outcomes, it is trust in the company and its manufacturing processes that consistently rank as the most significant factor when choosing a professional supplement brand.

Good Manufacturing Practices

Dietary supplement manufacturer practices are guided by Good Manufacturing Practice (GMP) guidelines and the FDA’s Dietary Supplement Health and Education Act (DSHEA) which defines quality manufacturing as consistently meeting established specifications for identity, purity, strength and composition, and contaminant limits. Although FDA is responsible for enforcing compliance with good manufacturing practices, labeling requirements, and post-market product safety, the agency does not itself establish specifications. Nor are dietary supplements subject to the same pre-market approval requirements expected of pharmaceuticals. Supported by quality agencies such as NSF International, the task of defining the process specifics are ultimately left to each individual manufacturer. It is therefore vital to understand the manufacturing processes and philosophy behind a supplement brand. And although it’s not always easy, a high-quality manufacturer will be enthusiastic about sharing insights into their processes.

Clean Formulations

It is clear that food allergies and sensitivities are on the rise, with epidemiologic studies indicating prevalence rates estimated at approximately 1 in 15 children in the United States.[4] Although the causes are ill-defined, factors such as hygiene, diet, and environmental chemical exposure have been suggested as contributors to the alarming increase.

Beyond the common examples of extreme peanut allergy and seemingly ubiquitous gluten sensitivity, consumers are increasingly aware of hidden allergens and undesirable food ingredients. According to the Food Business Journal, three-quarters of consumers in 2018 claim to have read the nutritional and ingredient labels on foods purchased. The demand for identifiable ingredients and clean formulations in consumer goods is no longer a trend, but rather the expectation. Even the largest food companies including Campbell Soup Co., Kellogg and Nestle have committed to removing artificial ingredients.

The demand for clean formulations is even more prominent in nutritional supplements. In fact, many individuals use nutraceutical products specifically to support gut barrier integrity, more complete digestion, and healthy immune response in order to help combat such sensitivities. In these cases, it becomes particularly important to minimize the use of potential allergens and non-essential excipients. Achieving consistently clean formulations is a daunting challenge in a high volume, automated environment, however, where additives such as flow agents can play a decisively useful role in the manufacturing process. It is therefore critical to understand the philosophical drivers behind a brand. Only a focused dedication to clean label practices will provide assurance that wherever and whenever possible, allergens and undesirable agents and ingredients will be minimized and/or avoided altogether.

Healthcare Practitioner Guidance

Although variety and availability of dietary supplements has never been greater, sorting fact from fiction, and quality from commodity, can be a difficult journey. Fortunately, practitioners like Dr. Ronald Hoffman make it their business to understand which brands are safe, effective, and reliable for even the most sensitive individuals. Professional guidance will also take your greater health needs into consideration, providing personalized protocols and recommendations for a healthy and balanced lifestyle.

[1] https://www.crnusa.org/resources/crn-2016-annual-survey-dietary-supplements

[2] Nutrition Business Journal Supplement Business Report 2017 (New Hope Media)

[3] Integrative Physician Market Landscape 2017 (Pure Branding)

[4] J Allergy Clin Immunol. 2014 Feb;133(2):291-307

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