In Vivo What makes a dietary supplement different from a drug?

Luc Cynober The differences vary from country to country. Basically, dietary supplements are designed to make up for an actual or presumed deficiency. They have three defining criteria. In Europe, they must be on a positive list. In other words, anything that is not legal is banned. In the United States, it’s the other way around. Anything that is not banned is legal, which is obviously not the same thing. Then, there is dosage, which cannot be higher than the recommended amount, i.e. in line with normal requirements. For example, the recommended daily amount of vitamin C is 120 milligrams. Lastly, there are the nutritional, functional and health aspects. The thinking is as follows: a given product is rich in calcium, calcium increases bone density, calcium intake can therefore prevent osteoporosis.

IV Are dietary supplements recommended to stay healthy?
LC There is no universal answer. In essence, supplements address a given sub-population. Typically, folic acid is recommended for pregnant women and women who want to have a baby because folate deficiency can cause neural tube defects in the foetus. Omega-3 fatty acids are useful for the development of the brain and nervous system in children. Then in the elderly, vitamin D helps prevent hip fractures in the event of a fall.

IV Are there substances that promote sleep, improve memory or boost intellectual capacity?
LC Any cerebral stimulant, such as caffeine or especially B vitamins contained in certain grains and types of meat, is good for the brain. Some supplements can promote sleep or help fight depression, but they can also interact with other drugs, either boosting or cancelling out their effects.

IV What forms can supplements take?
LC The list of authorised forms is a long one. They are available in capsules, powder, tablets, bars or drops. For most people, this adds to the confusion between medicine and supplement, as the line between the two can be rather hazy.

IV Can natural foods have the same effects as supplements?
LC Of course. That would be a functional food. For example, tomatoes contain lycopene and other active constituents, some of which have not yet been identified. Other examples include salmon and sardines, which are rich in fatty acids.

IV Isn’t it better then to use the foods directly?
LC It is. But it’s also important to remember that the concentration is lower in food. Plus, the ripeness of fruit and how it’s prepared also need to be factored in. For example, the highest bioavailability of lycopene is not in tomatoes, but in ketchup. However, that doesn’t necessarily mean that ketchup is a healthy and well-balanced food. There is also the issue of taste and price. Not everyone likes fish, for example, and it’s relatively expensive.

IV Which encourages people to consume more and more dietary supplements…
LC Fundamentally, many people also take them to feel better about not eating structured, well-balanced meals. This is particularly true in the United States, where more than half of the population takes dietary supplements, of which 10% to 20% take more than ten or even twenty per day. In Europe, the figure varies between 20% and 30% of the population.

IV Is growth comparable to that in the United States?
LC It depends on the segment. Slimming products are stable or even falling. But products for the elderly or those affecting the memory are rising. People commonly take supplements to stay younger and stronger, boost their intellectual performance and remain healthy as long as possible.

IV What about sick people?
LC If it involves illness, we move into the clinical realm. For example, supplements have nearly no effect in preventing obesity. Due to its genetic and environmental traits, this disorder requires medical treatment. If someone is sick, supplements won’t be as effective as the appropriate treatment. Many people want effectiveness without side effects. It can be even dangerous for cancer patients, especially with the interaction between antioxidant supplements and chemotherapy. Many forms of chemotherapy require a pro-oxidant environment to be effective.

IV What side effects can arise if someone takes too much of a supplement?
LC Depending on the person, there may be neurological problems or bleeding. There have also been a number of cases of tainted products, which is true of 30% of supplements in the United States. That’s why you should never buy them online from unidentified companies.

IV Experts have only recently begun looking into the the differences in how men and women react to medicine. Does that also apply to dietary supplements?
LC Similar differences certainly exist. The regulation of muscle mass varies between the two genders, simply due to the differences in anabolic hormones. But there is not a lot of data on the subject. The problem is that there is only a very limited possibility of patenting results. Manufacturers don’t want to finance studies on a concept that could be immediately copied by others.

IV Do you have other examples of foods that have positive effects on health?
LC In France, studies have shown that cranberry is recommended for preventing urinary infections in women. We also know that intestinal problems can affect the skin or hair. Interesting studies show that some probiotics can have positive effects in this area.

This is particularly true in the United States, where more than half of the population takes dietary supplements, of which 10% to 20% take more than ten or even twenty per day. In Europe, the figure varies between 20% and 30% of the population.

IV What about sick people?
LC If it involves illness, we move into the clinical realm. For example, supplements have nearly no effect in preventing obesity. Due to its genetic and environmental traits, this disorder requires medical treatment. If someone is sick, supplements won’t be as effective as the appropriate treatment. Many people want effectiveness without side effects. It can be even dangerous for cancer patients, especially with the interaction between antioxidant supplements and chemotherapy. Many forms of chemotherapy require a pro-oxidant environment to be effective.

IV What side effects can arise if someone takes too much of a supplement?
LC Depending on the person, there may be neurological problems or bleeding. There have also been a number of cases of tainted products, which is true of 30% of supplements in the United States. That’s why you should never buy them online from unidentified companies.

IV Experts have only recently begun looking into the the differences in how men and women react to medicine. Does that also apply to dietary supplements?
LC Similar differences certainly exist. The regulation of muscle mass varies between the two genders, simply due to the differences in anabolic hormones. But there is not a lot of data on the subject. The problem is that there is only a very limited possibility of patenting results. Manufacturers don’t want to finance studies on a concept that could be immediately copied by others.

IV Do you have other examples of foods that have positive effects on health?
LC In France, studies have shown that cranberry is recommended for preventing urinary infections in women. We also know that intestinal problems can affect the skin or hair. Interesting studies show that some probiotics can have positive effects in this area.