Food supplements - a trend without risks?
Calcium effervescent tablets for breakfast, vitamin D capsules at lunch time and folic acid and isoflavones with dinner - from a health perspective, what food supplements are advisable for whom and when? On the occasion of the BfR forum "Food supplements - a trend without risks?", the German Federal Institute for Risk Assessment (BfR) provided information on the benefits and potential risks of food supplements and the consumption behaviour of different end user groups. "Knowledge is important for risk communication, for too high a dose of vitamins and minerals can under certain circumstances be harmful to health" said BfR President Professor Dr. Dr. Andreas Hensel. "Provided consumers eat a balanced diet, the body normally receives all the nutrients it needs. There are only a few exceptions: for example, folic acid for women who would like a child and for pregnant women." Taking place as part of the International Green Week 2017 in Hall 3.2 (adventure farm) in Berlin on Thursday 26 January 2017 from 1 to 4pm, the BfR forum provided participants with a multifaceted perspective on food supplements. The discussions covered regulatory framework of food supplements, assessment of vitamin D and of herbal food supplements (botanicals) as well as related risk communication.
As a general rule, food supplements are superfluous for healthy persons who eat a varied and balanced diet. Provided a balanced diet is eaten, the body is supplied with all the nutrients it needs. In contrast, uncontrolled consumption of food supplements can entail health risks. For this reason, consumers should be educated to ensure cautious use of food supplements and to sensitise them to the potential risks.
Excessive vitamin D intake through high-dosage supplements can lead to unwanted side effects such as kidney stone formation or renal calcification. In general, vitamin D-containing food supplements are only recommended, if a deficiency has been detected and if this deficiency can be systematically alleviated neither by making dietary changes nor by activating the body’s own vitamin D production through sunlight exposure. Risk groups for vitamin D deficiency include persons who never or hardly ever go outdoors, people who completely cover their body when outside, and people with dark skin. Persons whose exposure to sunlight is insufficient and irregular notably include mobility-impaired, chronically ill, and care-dependent elderly people (nursing home residents, geriatric patients, old and fall-prone patients at risk of osteoporosis). As part of paediatric care and depending on their needs, infants are given specific vitamin D supplements for a certain period of time to prevent rickets, irrespective of whether they are breastfed or not.
The synthetically produced form of the vitamin folate is referred to as "folic acid". Folic acid is used in food supplements and to fortify foods. The BfR’s recommendation for women who would like or are likely to get pregnant and women in the first third of their pregnancy is to eat foods rich in folate and additionally to take folic acid in the form of a food supplement. It is possible thereby to mitigate the risk of a neural tube defect ("open back") in the child. In contrast, it is only advisable for the general population to take folic acid supplements, if there is medical evidence of a deficiency. There is no scientific evidence that folic acid supplement intake over and above normal need-based requirements is beneficial in any way. Folate compounds are naturally contained in plant and animal-based foods such as kale, lambs lettuce and hen's eggs.
From all corners of the world, food supplements made of plant, algae, mushroom, spore extracts (so-called "botanicals") are now easily available via the Internet. However, data on their safety for human health, their properties, and on many of the bioactive substances contained therein are available only to a limited extent. This lack of data poses challenges both for conducting risk assessments of the active compounds and for inferring safe intake levels.
Consumers often don’t know that food supplements are classified as food rather than drugs, even though, like drugs, they are offered as tablets, sugar-coated pills and powders. Unlike drugs, they are not subject to a licensing procedure. Instead, the only requirement is registration with the Federal Office of Consumer Protection and Food Safety (BVL). Responsibility for their safety exclusively lies with their manufacturer. As is the case with other foods, monitoring of transactions involving supplements including control of product labelling and compliance with regulations governing food are monitored by the food control authorities of the federal states.
About the BfR
The German Federal Institute for Risk Assessment (BfR) is a scientifically independent institution within the portfolio of the Federal Ministry of Food and Agriculture (BMEL) in Germany. It advises the Federal Government and Federal Laender on questions of food, chemical and product safety. The BfR conducts its own research on topics that are closely linked to its assessment tasks.
The BfR is celebrating its 15th anniversary this year. To mark the occasion, the institute has published a jubilee brochure which can be downloaded or ordered free of charge at www.bfr.bund.de