Dietary supplement consumption

In the last decade, dietary supplement consumption has increased in Europe and the United States. This has prompted regulatory agencies to enact... 

The consumption of a mixture of phenolic compounds presented in apple or purple grape juice inhibited mammary carcinogenesis in 7,12-dimethylbenzo[a]anthracene (DMBA) treated rats (Liu and others 2005 Jung and others 2006). However, the individual antioxidants of these foods studied in clinical trials, including (3-carotene, vitamin C, and vitamin E, do not appear to have consistent preventive effects comparable to the observed health benefits of diets rich in fruits and vegetables, suggesting that natural phytochemicals in fresh fruits and vegetables could be more effective than a dietary supplement. 

Another popular herbal dietary supplement that has a long history of use for medicinal purposes is ginseng. Much like Echinacea, three primary species of ginseng exist for therapeutic consumption Panax ginseng (Asian ginseng), Panax notoginseng and Panax quinquefolius (American ginseng). These herbal varieties can be readily authenticated... 

Intakes are calculated on the basis of the fat content of each food with the exception of chewing gum. Table 4.3 provides data on the mean, 90th percentile and 97.5th percentile consumption of food, fat consumption for each food group, daily BHT intake and daily BHT intake corrected for bodyweight. For chewing gum and dietary supplements the number of consumers was too small to make reliable predictions of intake across the population. The results of such analyses should therefore be interpreted with great caution. 

In 1989, the amino acid dietary supplement L-tryptophan was thought to he associated with an outbreak of eosinophila-myalgia syndrome (EMS), a condition characterized by an increase in white blood cell count, severe muscle pain, and other skin and neuromuscular problems. Later studies showed that an impurity present during the manufacture of the amino acid was probably responsible for the outbreak of EMS and that the amino acid itself was probably safe for human consumption. 

Ca is a comparatively difficult element for the body to absorb and digest. It is essentially only available for consumption associated with various other moieties (e.g., citrate, phosphate, and other anions). Each Ca source has unique physical, structural, and chemical properties such as mass, density, coordination chemistry, and solubility that are largely determined by the anions associated with the Ca +. Aqueous solubility of various Ca salts can vary markedly and comparisons are frequently made under standardized conditions. The water solubility of CCM is moderate when ranked versus other Ca sources frequently used as dietary supplements and food/beverage fortificants. The solubility of CCM (6 2 3 molar ratio) is 1.10-g salt in 100 ml of H2O at 25 °C (Fox et ah, 1993a). Table 6.4 lists the solubility of various Ca sources in water at specific temperatures, and also includes some information on potential sensory characteristics. 

Ca carbonate is often used in supplement tablets or pills because of the high Ca density and low cost. However, a powdered Ca dietary supplement, intended to be mixed /dissolved into beverages or other fluid foods (e.g., soups and sauces) by the consumer just prior to consumption, is a novel product form applicable only to a soluble Ca salt such as CCM. A powdered Ca supplement would of course avoid the problems some consumers experience with swallowing pills and tablets, as well as eliminate any uncertainty associated with tablet disintegration and dissolution. 

Adverse effects have been documented for a variety of dietary supplements however, under-reporting of adverse effects is likely since consumers do not routinely report, and do not know how to report, an adverse effect if they suspect that the event was caused by consumption of a supplement. Furthermore, chemical analysis is rarely performed on the products involved, including those products that are described in the literature as being linked to an adverse event. This leads to confusion about whether the primary ingredient or an adulterant caused the adverse effect. In some cases, the chemical constituents of the herb can clearly lead to toxicity. Some of the herbs that should be used cautiously or not at all are listed in Table 64-1. 

Ertas et al. (2005) investigated the potential effects of dietary supplementation by coriander seed (considered as a lipolytic and antioxidant compound) on carcass lipid composition of quails. Their aim was to reduce saturated fatty acid consumption and to increase essential fatty acids (particularly n3 unsaturated acids) in alimentation. Dietary supplementation by coriander seed affected the lipid composition of carcass greatly by decreasing saturated fatty acid (SFA) contents (palmitic and stearic acids) and by increasing monounsaturated and polyunsaturated fatty acid (MUFA and... 

Covaci et al. (2007b) also studied BDEs in fish oil dietary supplements. Despite being taken daily, the authors concluded that their consumption did not significantly increase daily intakes of BDEs. The median daily intake from dietary supplements was 8 and 16 times lower than the intake from fish consumption alone or from a total diet, respectively. 

The effect of dietary sesamin and sesaminol on the ethanol-induced modulation of immune indices related to food allergy has also been studied. Although chronic ethanol drinking would increase the plasma IgA, IgM, and IgG concentrations, 0.2% sesamin in the diet could suppress this increase of IgA and IgM, whereas sesaminol was not effective. In addition, the increase in relative liver weight because of ethanol consumption was alleviated by dietary supplementation of sesamin but not by sesaminol (154). 

Although laws do not require reporting of adverse events of dietary supplements to the FDA at this time, many untoward events have been documented. The FDA has created MEDWATCH [(800) FDA-1088] to receive and compile reports of adverse reactions from pharmaceuticals. Healthcare providers are encouraged to report to this organization any and all adverse events related to dietary supplements and their consumption. 

A review of adverse events related to herbal medicines reported in the medical literature from 1992 to 1996 has been compiled. This report highlights cases of hypersensitivity reactions, hepatotoxic reactions, and various types of renal damage associated with various herbal products. Some Chinese herbal preparations appear to be notorious for causing nephropathy.One of the more infamous adverse events related to the consumption of a dietary supplement was associated with the amino-acid L-tryptophan, touted for it s ability to reduce pain and promote sleep. 

Neff GW, O Brien C, Montalbano M, et al. Consumption of dietary supplements in a liver transplant population. Liver Transpl 2004 10 881-885. 

---