The authors provide an in-depth analysis of dietary supplements through the lens of CMS, identifying issues such as a range in active ingredient percentages and unknown bioavailability data and concluding that fish oil, coenzyme Q10 and magnesium-containing products could prevent CMS.
The dietary supplement industry is growing, with an estimated $151.9 billion USD in sales for 2021, although fewer than 25% of dietary supplements are recommended by doctors and healthcare professionals.
Commenting independently on the review, Jeff Ventura, VP of communications at the Council for Responsible Nutrition, told us: “Last year, the Council for Responsible Nutrition Foundation released a report that demonstrates the use of key dietary supplement ingredients can reduce the direct and indirect medical costs associated with coronary artery disease (CAD).
“This Health Care Cost Savings report, Supplement to Savings (“S2S”), identified up to $17.74 billion in annual net savings if specific dietary supplements (i.e., omega-3 fatty acids, magnesium, vitamin K2, and soluble fiber) are used by the at-risk target populations most susceptible to coronary artery disease (CAD). As for improvements that could be made regarding how supplements are regulated, CRN recently sent a letter to the FDA in response to Reagan-Udall Report and FDA Foods Programs Reorganization, detailing our perspective on this important issue.”
To better understand dietary supplements and their effectiveness, the authors picked three supplements that have been used in the prevention of CMS: Fish oil, coenzyme, and magnesium.
The key factors for safety and efficacy the authors examined included chemical representation, nutrient values, dosage information, bioavailability and production strategies.
One example of chemical representation studied was coenzyme Q10, which can be included in the oxidized form ubiquinone or the physiologically active reduced form ubiquinol. According to the authors, ubiquinol creates better results for those consuming it but is not often used in commercial supplements. The authors also cite a study in New Zealand that found a majority of tested fish oil products had peroxide levels above industry standards, suggesting a quality issue. However, such studies have been refuted by others in the industry, notably GOED.
Dietary supplements’ nutrient values can vary over a significant range. “[T]he accepted tolerance for differences between the nutrient values declared on the label and those established in the course of official laboratory control is +50% and −20% for minerals in food supplements,” the review noted. Because the amount of the actual active ingredient can vary, the authors suggested that some people may be taking too low of a dose, noting that manufacturers often indicate lower dosages on label "to minimize customers expenditure and gain an advantage over rivals".
The last area of dietary supplement concerns mentioned is the lack of bioavailability testing. “Moreover, their production strategy (e.g., to strive for high quality management or choose less expensive processing and sub-quality raw materials) determines the quality,” the study noted.
After analyzing the three dietary supplements for these safety and efficacy issues, the authors concluded that “dietary supplements could generally provide a moderate preventive value, as does healthy eating and lifestyle. They are neither toxic nor induce more complications compared to placebo controls and, therefore, can be purchased without any prescription. Moreover, from a cost-effectiveness point of view, they are accepted by the public and medical professionals.”
Source: Frontiers in Cardiovascular Medicine
“Dietary supplements could prevent cardiometabolic syndrome: Are they safe and reliable enough for disease prevention and health promotion?”
Authors: I. Telessy, et al.