Americans looking to improve their health and immune system have a wide variety of supplements from which to pick, including everything from multivitamins and melatonin to fiber and fish oil. The supplement market is worth more than $30 billion annually, and 58 percent of American adults aged 20 and up take dietary supplements, according to the Centers for Disease Control and Prevention. The wellness sector, and the number of people who utilize supplements, have exploded in recent decades.

“The popular belief is that a supplement is going to help promote health,” says Fang Fang Zhang, a professor at Tufts University’s Friedman School of Nutrition Science and Policy. She discovered that those who use supplements more regularly have a better level of education and income, a healthier lifestyle, and are more likely to consume a balanced diet and exercise. “So those who are taking supplements are more health-conscious overall,” she said.

However, if you’re currently healthy, most supplements won’t do much to improve your health or prolong your life. “There’s no clear evidence to suggest benefits of dietary supplement use for many popular or common health outcomes,” Zhang said.

What are supplements good for?

The proper consumption of vitamins, minerals, and a wide variety of other micronutrients is essential to the proper functioning of the body and is an essential component of a healthy diet. However, consuming nutrients through food is not the same as doing so through the use of a supplement. According to Zhang, using nutritional supplements is not a suitable replacement for eating a nutritious and well-rounded diet.

When used as directed, vitamin and mineral supplements can be of tremendous benefit to patients suffering from nutritional deficiencies as well as a variety of ailments. “High-quality supplements should be widely available, and we need them as part of medical treatment,” says Dr. Pieter Cohen, an associate professor at Harvard Medical School and an internist at Cambridge Health Alliance. Dr. Cohen is also the medical director of the Cambridge Health Alliance.

However, in the United States, a significant portion of the food that is already packed is already fortified with additional nutrients; as a result, nutritional deficiencies are unusual among the general population. There is some debate over the usefulness of supplements for the vast majority of people.

In an article that was published in the year 2020 in the British Medical Journal (BMJ), Zhang evaluated the data from various clinical trials and came to the conclusion that there is no compelling evidence to suggest that nutritional supplements such as vitamins and minerals are beneficial for healthy persons in the prevention of chronic diseases such as cancer or cardiovascular disease.

In the case of particular nutritional supplements produced from plants and referred to as botanicals, such as echinacea and ginkgo, the evidence is even more confusing. However, the sector is still plagued with weak or inconsistent results despite the fact that scientists have attempted to interpret the effects of a large number of botanicals or nutritional supplements. “We know a lot,” Guallar says. “We have a lot of information.” “The issue is that oftentimes the claims are inconsistent with what we are aware of.”

There is a risk that many of the health claims that companies put on the labels of their dietary supplements extrapolate outcomes found in animals to humans or make too many findings that are still in the early stages of research. “These products should not be promoted as if they will have health benefits when it has never been proven that they work in humans,” adds Cohen. “It’s unethical.”

As a result, customers may be perplexed by supplement claims and uncertain about which supplements are beneficial. “This is also combined with commercial pressure to promote some of these supplements,” Guallar said.

The way dietary supplements are promoted and advertised is influenced by how they are controlled by the United States Food and Drug Administration (FDA).

Regulated as foods, not drugs

Even though many people use supplements to improve their health, the FDA regulates them as foods rather than pharmaceuticals under the Dietary Supplement Health and Education Act of 1994.

“What happened in 1994 was that all of these products from vitamins, minerals, to botanical extracts became subcategories of food,” Cohen says. “It also created a completely different structure in terms of advertising, like the ability to advertise products to say things like ‘This will boost your immune system’, as code for ‘This will prevent infection,'” he said.

Before selling their supplements, manufacturers are not obligated to prove that they are effective or safe. Furthermore, supplements are not subject to the same manufacturing requirements as pharmaceuticals, which might result in contaminated or subpar products. “It’s basically very difficult, if not impossible, to separate poor-quality products from higher-quality ones in the market, at least at present,” Cohen said.

According to Cohen, one of the problems is that the existing system does not do a good enough job of tracking when supplements cause harm. “I think we have to realize that for the public to have access to high-quality vitamins and minerals and botanicals, we’re going to need to reform the law,” he said.

Cohen has previously proposed reforms to present laws, such as standardizing manufacturing methods, thoroughly testing new components, and establishing tighter criteria for the statements manufacturers can make about their supplements.

However, for the time being, customers should keep a few factors in mind while determining whether to use supplements.

Navigating the supplement aisle

Expensive supplement claims are unlikely to be real. Remember that certain supplements may contain more than you need in one tablet or dosage. “Sometimes these supplements are promoted at much higher doses than one would get with diet,” explains Guallar.

Many supplements interact with drugs, so ask your doctor before taking them. They may be unsafe to take before surgery, while pregnant or breastfeeding, or during cancer or other medical treatments.

Consumers should also recognize low-quality goods. Cohen advises patients to stick to supplements with one substance and avoid mixtures, except for multivitamins. He says USP or NSF International certificates indicate higher-quality products.

Weight-loss pills, muscle builders, and sexual enhancers may contain illegal or obscure components including medicinal medicines and synthetic compounds, according to prior studies. Unknown substances may be more likely in certain supplements.