Journal Club / Research Updates

Dietary Supplements: Big for Business but Bad for Health

The dietary supplement industry is big business in the US, projected to generate nearly $60 billion in revenue within the next five years. A recently published study by public health and adolescent medicine researchers at Harvard University confirms that this is also a dangerous business for our nation’s young people.

In the US, the Food and Drug Administration (FDA) is charged with evaluating if medications, food, and other substances are safe and effective. The risks of dietary supplements are well known, and the FDA has, over the years, issued many warnings on the safety of products sold for weight loss, muscle building, energy, etc.

Image by Bruno Glätsch from Pixabay

Supplements sold for weight loss have been associated with:

  • Constipation
  • Diarrhea
  • Dehydration
  • Low potassium and other electrolyte abnormalities
  • Abnormal heart rhythms

Use of these supplements is common in people with eating disorders, a set of disorders already known to negatively impact physical health. As we have previously described, supplement use to compensate for eating or to promote weight loss is not only dangerous, it doesn’t actually help long-term maintenance of a healthy body weight.

Despite all the risks and the alarms sounded by the FDA, dietary supplements remain on the market and can be sold to people of all ages. Given that half of adults mistakenly believe that dietary supplements are approved for safety and effectiveness before they can be sold, it seems likely that young users – children, adolescents, and young adults – don’t know much about the harm that might come from taking these supplements.

The aim of this study, “Taking Stock of Dietary Supplements’ Harmful Effects on Children, Adolescents, and Young Adults,” was therefore to assess the rate of severe medical events in young people using a range of dietary supplements. Results were published in the Journal of Adolescent Health.

Study Specifics

This was a retrospective, observational study. This means that the researchers looked back (retrospective) at FDA-recorded dietary supplement adverse event reports from 2004 to 2015. They were checking to see (observe) how high the risk was for severe problems (like death, disability, or hospitalization) linked with the use of dietary supplements as compared to the use of vitamins. In this report, the scientists were especially interested in the relative risk of supplements use in children (ages 0-11), adolescents (ages 12-17), and young adults (ages 18-25).

Study Results

The study authors focused on adverse event reports including single (rather than multiple) dietary supplements to isolate the association for each supplement group with the medical outcome. Between 2004 and 2015, 977 single-supplement-related adverse events were reported in children, adolescents, and young adults. One hundred sixty-six reports involved hospitalization, 39 involved life-threatening events, and 22 involved death. The frequency of negative physical health outcomes was highest among young adults and lowest among adolescents, for both males and females. In the young adult group, adverse events were most frequently linked to dietary supplements for weight loss.

Compared with vitamins, dietary supplements sold for weight loss, muscle building and energy were linked to nearly three times as many severe medical outcomes in young people. Supplements purported to cleanse the colon were associated with approximately twice the risk for a severe medical outcome compared to vitamins.

What does it all mean?

The American Academy of Pediatrics has previously recommended that dietary supplements should not be used for weight loss, muscle building, or energy purposes, and this study’s findings further support this recommendation.

In a press release by the Harvard School of Public Health, senior study author, S. Bryn Austin, ScD, summarized what the findings mean quite well:

“How can we continue to let the manufacturers of these products and the retailers who profit from them play Russian roulette with America’s youth? . . . It is well past time for policymakers and retailers to take meaningful action to protect children and consumers of all ages.”

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