Dietary supplements, what everybody must know

I usually see patients in my practice with obesity who I give nutritional advice and treat when It is indicated with medicines for obesity according to the current guidelines. However, lately I have been surprised when I’ve been asked in a consultation about certain nutritional supplements to lose weight or increase muscle mass with physical training.
This has prompted me to seek reliable information in this regard, which I want to share with you.

Why do I think this is Important?, because any person uses them for different purposes and often seeks support for services that are not necessarily offered by doctors. Approximately half of United States adults consume dietary supplements for different reasons, such as boosting their energy, losing weight and mental focus, among others.

What is exactly a dietary supplement?

A dietary supplement is defined as food by the Dietary Supplement Health and Education Act (DSHEA). It’s a product (other than tobacco) intended to supplement the diet that bears or contains dietary ingredients like vitamin, mineral, herb etc.

This definition is important because it has implications on supplements regulations.

We can categorize them like this:

  1. Sports food for optimizing energy, protein, and carbohydrate intake
  2. Vitamin and mineral supplement for treating deficiencies
  3. Ergogenic supplements for enhanced sport-specific performance
  4. Other supplements for various interventions, such as weight loss and increased lean body mass

Are Dietary Supplements effective and safe?

In relation to the topic of effectiveness, we could say that it depends on the particular supplement, for this reason I will be doing a series of articles to expand specific information on the most used supplements.
Talking about their safety, there is a lack of regulation in supplement production and this can place the consumer at significant risk. The FDA’s authority over dietary supplements is very different from its authority over drugs and other medical products. Since supplements are defined as food, its production is not evaluated as rigorously as in the case of medicines.

The top three of the supplements categories that are more problematic prone are sexual enhancement, weight loss, and sports performance/body building. However, less than 1 percent of Americans experience adverse events related to supplements, and the majority was classified as minor, with many of these related to caffeine, yohimbe, or other stimulant ingredients.

Additionally, it is important to mention that there is economically-motivated adulteration. In the case of weight loss supplements the primary adulterant is sibutramine, along with phenolphthalein, but others can include substances such as diuretics, laxatives, anorexiants, and stimulants.

Sibutramine, is a prescription appetite suppressant which was withdrawn from the market in the United States and many other countries in 2010 because it increased blood pressure, pulse rate, cardiovascular events, and strokes. Phenolphthalein is a laxative that is no longer marketed due to carcinogenicity concerns.

I recommend whenever possible to obtain a concept from a doctor, especially in the following circumstances: those who are undergoing organ transplant, are pregnant (except prenatal vitamins and minerals) or lactating, taking concomitant medication, or have an underlying disease.

We will talk about specific cases in the next articles, such as Garcinia cambogia, creatine, beta-alanine, among others.

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