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[Safety of food supplements].

Food supplements are foodstuffs. Food which is not safe shall not be placed on the market. Adherence to the laws which aim for the safety of food ensures that food supplements are safe. Unfortunately, there are still gaps in the legislation for food supplements. However, even intrinsically safe foods can bear a risk for the consumer if not used appropriately, for example if food supplements are consumed instead of healthy diets or if food supplements are used as substitutes for indicated drugs.

Consumer Product Safety↗

Effects of extracts of commonly consumed food supplements and food fractions on the permeability of drugs across Caco-2 cell monolayers.

PURPOSE: Extracts made from berries, herbs, and various plant materials, which might possess a range of activities, are used as health promoting products. Because little is known about their effects on the absorption of co-administered drugs, the effects of some food supplements, Finnish berries, and herbs were studied on the permeability of some commonly used drugs. METHODS: The permeabilities of verapamil, metoprolol, ketoprofen, paracetamol, and furosemide were studied across Caco-2 cell monolayers with contemporaneously administered extracts from flax seed, purple loosestrife, and Scots pine bark; bilberries, cowberries, and raspberries; oregano, rosemary, and sage. Toxicological tests were conducted to determine cellular damage. RESULTS: The effects of extracts on drug permeabilities were generally minor. Flax seed decreased the permeability of all drugs except verapamil. Purple loosestrife and pine decreased verapamil and metoprolol permeability. Changes caused by berries were mainly pH-related. Rosemary and oregano enhanced furosemide permeability. CONCLUSIONS: Ingestion of extracts of herbs and berries studied are not expected to markedly change the permeabilities of highly permeable drugs. Harmful effects at sites of or during absorption are unlikely. However, if high doses of extracts are administered with low permeable drugs in vitro, effects on drug permeabilities could not be excluded. Use of such extracts should therefore be evaluated during continuous medication.

Biological Transport, Active↗

Food, supplements, and fortified foods: scientific evaluations in regard to toxicology and nutrient bioavailability.

Food, supplements, and fortified foods can all be appropriate sources of nutrients. It is the responsibility of nutrition educators to help consumers use those nutrient sources appropriately. Consumers should consider at least six factors when they select foods, supplements, and fortified foods: flavor, convenience, cost, nutrient content, toxic factors, and bioavailability of nutrients. Consumers are often less concerned about the latter two factors than they should be. For example, many case histories have been published on the symptoms caused by overconsumption of vitamins A, B-6, C, and D and nicotinic acid. Generally those toxic symptoms were caused by the ingestion of supplements, not foods. Current widespread use of supplements containing one or two nutrients may not only cause overt toxicity symptoms but also adversely affect the bioavailability of other nutrients. For example, ingestion of excessive amounts of vitamin C appears to interfere with copper metabolism in human subjects; ingestion of high levels of zinc impairs immune function, depresses copper absorption, and induces anemia; consumption of supplemental calcium as calcium phosphate dibasic is associated with renal calcification in rats; and ingestion of supplemental magnesium depresses the apparent absorption of calcium and retention of calcium in bone by rats.

Adult↗

[Nutrition and health--sense and nonsense regarding food supplements and functional foods].

A functional food is a proprietary food or beverage with a health-related claim. Such functional foods could make it easier to maintain a healthy diet. Unfortunately, in many countries regulations allow manufacturers to imply that a food promotes health without providing proper scientific evidence. At the same time, regulations may forbid claims that a food product prevents disease, even when it does (e.g. folic acid, which reduces the risk of neural tube defects). Functional foods may have beneficial health effects compared with traditional foods in some cases, but current legislation in the Netherlands cannot protect consumers from misleading claims.

Dietary Supplements↗

Effect of targeted food supplementation and services in the Bangladesh Integrated Nutrition Project on women and their pregnancy outcomes.

Monitoring data from the Bangladesh Integrated Nutrition Project and new data collected for this purpose were analyzed to assess the effects of targeted project services, including supplementation of food, on malnourished pregnant women (women with a body mass index [BMI] of < or = 18.5 in early pregnancy). Monitoring data on 456 women--195 receiving food supplement and 261 not receiving supplement--were collected from 17 upazilas (sub-districts) in four districts of Bangladesh. The assessment found that, despite lower economic status, the women with low BMI receiving supplementation of food and intensified services were more likely to have adequate pregnancy-related weight gain than the more economically-advantaged women with higher BMI. Primigravidae receiving supplementation were also more likely to have adequate pregnancy-related weight gain than the better-off non-supplemented primigravidae (85.7% vs 51.9%, p = 0.044). The mean birth-weights of infants of the supplemented women with low BMI were comparable to those of the better-off, non-supplemented women.

Adult↗

Effects of liver-supplemented food on the development of embryos in mice.

We examined whether dietary intake of cattle liver-supplemented food induces reproductive effects in dams and developmental effects in embryos in the mouse model. Seven groups of 19 to 35 female mice each were given either powdered food or the food supplemented with crude liver homogenate, its lipophilic component, the defatted liver homogenate or vitamin A (retinol palmitate) during a 25-d period spanning from a week prior to mating to gestation day 18 (GD18). Fetal mortality and incidence of external abnormalities of the fetuses whose dams were given the diet supplemented with the crude liver homogenate increased dose-dependently with an increase in the supplemented amount of the crude liver homogenate. On the other hand, the defatted liver homogenate did not induce any reproductive or teratological effect. The vitamin A (VA)-supplemented food (950 IU/5 g food as VA) induced approximately the same levels of the incidence of total external abnormalities appearing at the same affected regions or organs as the foods supplemented with the 700 mg crude liver homogenate (1029 IU/5 g food as VA) and its lipophilic component (950 IU/5 g food as VA). The content of VA (as 1029 IU/5 g food) in the crude liver homogenate was found to be approximately equal to that in the lipophilic component (950 IU/5 g food as VA). Therefore, it was concluded that VA plays an important role in induction of the lethal and teratogenic effects in the fetuses whose dams were given the powdered foods supplemented with the crude liver homogenate and its lipophilic component.

Animals↗

Human intake of arsenic and iodine from seaweed-based food supplements and health foods available in the UK.

A number of seaweed-based products were analysed for total and 'reducible' arsenic and total iodine. Maximum potential intakes of the two elements were estimated using the manufacturers' recommended does. The levels of reducible arsenic found were generally low and, with one exception, ingestion of the products is unlikely to lead to the Joint Expert Committee on Food Additives (JECFA) Tolerable Daily Intake being exceeded. Iodine levels varied widely even between different samples of the same product. In a number of these cases the potential iodine intake is very high.

Arsenic↗

Cognitive aging, childhood intelligence, and the use of food supplements: possible involvement of n-3 fatty acids.

BACKGROUND: Food supplement use is widely promoted, but little is known about the cognitive effects of food supplements. OBJECTIVE: We examined the effects of food supplement use on cognitive aging. DESIGN: This was an observational study of subjects born in 1936 whose mental ability was tested in 1947 and who were followed up in 2000-2001, at which time cognition, diet, food supplement use, and risk factors for vascular disease were assessed. In a nested case-control study, fish-oil users were matched with nonusers, and cognitive function was related to erythrocyte n-3 fatty acid composition. RESULTS: Childhood intelligence quotient (IQ) did not differ significantly by category of food supplement use (ie, none, fish oil, vitamins, and other). At the age of 64 y, cognitive function was higher in food supplement users than in nonusers before adjustment for childhood IQ. After adjustment for childhood IQ, digit symbol (mental speed) test scores were higher in food supplement users. Fish-oil supplement users consumed more vitamin C and vegetable and cereal fiber than did non-supplement-users. In a nested case-control study, erythrocyte membrane n-3 content was higher in fish-oil supplement users than in nonusers, but cognitive function did not differ significantly between groups. Total erythrocyte n-3 fatty acids and the ratio of docosahexaenoic acid to arachidonic acid was associated with better cognitive function in late life before and after adjustment for childhood IQ. CONCLUSIONS: Food supplement use and erythrocyte n-3 content are associated with better cognitive aging. If associations with n-3 content are causal, optimization of n-3 and n-6 fatty acid intakes could improve retention of cognitive function in old age.

Aging↗

Attitudinal and demographic correlates of food supplementation practices.

Attitudinal and demographic correlates to food supplement use were ascertained for 689 adults residing in seven Western states. Of the 689, 372 (54%) were food supplement users and 317 (46%) were non-users. The only attitudinal variable significantly (p less than .001) related to the practice of food supplementation was the belief that vitamin C could cure and prevent a cold. More users than non-users agreed with the statement that "vitamin C can both prevent and cure a cold." Demographic variables found to be significantly (p less than .05) related to food supplement use included education, marital status, home type, employment status, and population of town/city in which the respondent resided. Food supplement users tended to be living together without marriage, never married, or divorced and living in town houses or "other" types of dwellings. More users than non-users resided in communities with populations of 2,500 or in communities with populations of 10,000 to 49,999.

Adult↗

Food supplement usage in seven Western states.

Data on food supplement usage were collected from 2451 adults in seven Western states. No significant differences were determined among states. A majority (66.6%) of the sample used some form of food supplements, with 40.0% consuming one to three supplements per day. The archetype food supplement user was likely to be a young female with some college education, who believes that the nutritional quality of food has decreased in the last 10 yr and in the efficacy of supplements for disease prevention or cure, and primarily receives information concerning food and nutrition from books and health food stores. Correspondingly, one of the most frequently cited reasons for using food supplements, next to "to prevent colds and other illnesses" was "to make up for what is not in food." The three most frequently used food supplements, in rank order, were multiple vitamins, vitamin C, and multiple vitamins plus iron.

Adult↗

Age and gender effect on the use of herbal medicine products and food supplements among the elderly.

OBJECTIVE: To describe the users of herbal medicine products and food supplements with regard to age and gender specifically among persons aged > or = 60 years. DESIGN: A descriptive study with baseline data from a longitudinal study of the elderly, stratified into different age cohorts (60-69, 70-79, 80-89, and > or = 90 years). SETTING: Blekinge county, situated in south-eastern Sweden. SUBJECTS: In total 1380 persons aged 60-96 years (median age 78 years). MAIN OUTCOME MEASURES: Current use of herbal medicine products and the use of food supplements. RESULTS: Of the participants, 264/1380 (19.1%) used at least one herbal medicine product, 184/1380 (13.3%) used at least one food supplement and 382/1380 (27.7%) used herbal medicine products and/or food supplements. In all regression models, women had a higher probability of using herbal medicine and/or food supplements in comparison with men. Focusing on the use of herbal medicine products alone and the combination of using herbal medicine and/or food supplements, decreased use was seen with increasing age. However, 27.9% were still users of herbal medicine products and/or food supplements in the age group 80-89 years. In comparison, 14% were users in the age group > or = 90 years. Age did not have an impact on the probability of taking food supplements. CONCLUSION: General practitioners need to consider the high use of herbal medicine products and food supplements among the elderly when making decisions on treatment.

Age Factors↗

Medical evaluation of the special supplemental food program for women, infants, and children.

The special supplemental food program for women, infants, and children administered by the United States Department of Agriculture, was evaluated nationally. Participating infants, children under 4 years old, and pregnant and nursing women were investigated initially, and after receiving food supplements. The supplements were iron-fortified infant formula, iron-fortified infant cereals, and fruit juices for the infants, and milk, cheese, iron-fortified cereals, eggs, and fruit juices for the children and women. Initially, the average birth weight was lower and the infant mortality rate was higher than expected in a well nourished population. There was also evidence of slight growth retardation, a high anemia rate, and a high percentage of participants having saturation of transferrin values less 15%. The program had no effect on the prevalence of unsatisfactory values for saturation of transferrin. There was an increase in weight gain during pregnancy, and increase in birth weight, an acceleration of growth, and a reduction in the anemia rate in all participant categories except women in the first and second trimesters of pregnancy.

Agriculture↗

Food supplement usage by the elderly.

A variety of food supplements were taken by 66 percent of the elderly persons in this study. Ascorbic acid and vitamin E were the most popular choices. Some supplements may have improved nutritional status, while others were probably inappropriate or unnecessary. The findings indicate that the elderly have a number of erroneous beliefs about the efficacy of food supplements. Reasons for supplementation were often inappropriate, and unreliable sources of information were used. In addition, substantial amounts of money were spent on food supplements by those already existing on a limited budget. Nutrition education is needed to demonstrate the relationship between adequate diet, good health, and appropriate versus inappropriate food supplement consumption.

Aged↗

Immune function and hematology of male cotton rats (Sigmodon hispidus) in response to food supplementation and methionine.

We examined effects of supplementation of food quantity and quality (=enhanced methionine) on hematologic and immunologic parameters of wild, but enclosed, adult male cotton rats (Sigmodon hispidus) in north-central Oklahoma. Sheet metal enclosures were stocked with a high density of wild-caught cotton rats (160 animals/ha) and randomly assigned a treatment of no supplementation, mixed-ration supplementation or methionine-enhanced supplementation. Aside from small increases in counts of red blood cells and hematocrit levels, most indices of erythrocytic characteristics were not affected by supplementation with the mixed-ration or enhanced methionine. In contrast, platelet counts were highest in mixed-ration and methionine treatments and counts of total white blood cells were highest with methionine supplementation, albeit relative proportions of different leukocytes did not differ among treatments. Immunologically, neither delayed-type hypersensitivity response nor hemolytic-complement activity differed among treatments. Supplementation of food quantity and quality did not broadly affect hematologic parameters and immune function of male cotton rats, but enhanced platelet and leukocyte counts may confer advantages to overall health. Clarification of the role of such effects on population limitation or regulation requires additional research.

Animals↗

[The use of food supplements - beverages and concentrated food products in tablets made from plants in sanatory and health resort rehabilitation of patients with chronic pathology].

The effectiveness of a recovery complex optimization in conditions of the sanatorium-resort rehabilitation of patients with chronic pathology by provision of the dietotherapy ration balance on nutrients, the use of natural (of the plant raw material cryopowders in the form of teas and tableted forms) and the "Centrum" synthetic vitamin-mineral complexes, probiotics was substantiated and demonstrated.

Beverages↗

Effect of prenatal food supplementation on birth weight: an observational study from Bangladesh.

BACKGROUND: National nutrition programs in Bangladesh have included prenatal food supplementation to reduce maternal and child malnutrition. The knowledge base is weak regarding the effect of prenatal food supplementation on the birth weight (BW) of infants in populations in whom low BW is prevalent and regarding any variation in effect based on maternal nutritional status. OBJECTIVE: We examined whether observational data support an effect of daily prenatal food supplementation on BW by considering the duration of supplementation and whether the effect is modified by maternal postpartum weight (a proxy of prepregnancy weight) groups. DESIGN: A cohort of undernourished pregnant women (n = 777) who received prenatal food supplementation (608 kcal/d) was followed. The association between the uptake of food supplements and BW was analyzed after adjustment for potential confounders (n = 619 with complete information). Differential effects in lower and higher maternal postpartum weight groups were examined. RESULTS: The average BW was 2521 g. On average, the women received daily supplements for 4 mo, which resulted in an increase in BW of 118 g (1.0 g/d). The strongest effect was found for births occurring in January and February. There was a linear dose-response relation between duration of supplementation and BW for women with higher postpartum weights (> or = 42 kg, above the median). In women with lower weights (< 42 kg, below median), a shorter duration of supplementation (< 4 mo) had no such dose-response relation with BW, but there was a linear dose-response relation for longer durations of supplementation. CONCLUSIONS: The association between duration of prenatal food supplementation and BW varies with maternal postpartum weight. A large effect was observed after the season with food insecurity (mid-August to mid-November).

Adult↗

Impact of the Special Supplemental Food Program on infants.

The Special Supplemental Food Program for Women, Infants, and Children, popularly known as WIC, provides participants with supplemental foods and nutrition education. The WIC participants are eligible pregnant, postpartum, and breast-feeding women, infants, and children up to their fifth birthday. The program currently serves 1.2 million infants each month. The U.S. Department of Agriculture National WIC Evaluation Study of Infants and Children is the most comprehensive assessment of WIC's impact on a national infant sample. Its findings indicate that WIC infants consumed more iron-fortified infant formula (the core of the WIC infant food package) than non-WIC infants and, as a result, had higher daily intakes of formula-related nutrients--namely, iron and vitamin C. Because of lower consumption of whole cow milk, WIC infants had lower daily intakes of milk-related nutrients--calcium, protein, magnesium, and vitamin B6. The research team concluded that increased dietary intake of specific nutrients occurs only during program participation and has no residual effect after participation ceases. Possible scientific and social science research that would be useful in federal policy decisions affecting infant participation in the WIC program is discussed.

Child, Preschool↗