Not entirely safe and poorly studied: Perm scientists discuss whether it is advisable to take dietary supplements.

The Nutrition Institute of the Russian Academy of Medical Sciences has identified deviations in the dietary habits of Russians from the balanced nutrition formula in terms of vitamin, micronutrient, essential fatty acid, dietary fiber, and other organic compounds derived from plant and animal sources. The predominance of low-quality imported products and the deterioration of environmental conditions are affecting food quality and leading to health issues. One effective way to normalize the intake of beneficial substances is to use dietary supplements (nutraceuticals) that contain all the missing components.

“According to research, in 2020 only 15 percent of Russians used dietary supplements, but in 2021 more than 52 percent utilized them in the form of vitamin and mineral complexes and individual micro- and macronutrients. Residents of developed countries, such as Japan and the USA, include dietary supplements in their diets and tend to live longer. However, uncontrolled intake can lead to allergic reactions. Most supplements are recommended to be taken in courses with breaks in between,” notes Ekaterina Bankovskaya, associate professor of chemical technologies at PNIPU and candidate of pharmaceutical sciences.

What are dietary supplements made from?

Dietary supplements are produced in the form of tablets, capsules, powders for oral intake, and less frequently as ointments or gels for external use. Raw materials can include meal from medicinal plant raw materials (cake), husks of grains and legumes, ground shells of chicken or pig stomachs, wood cellulose and products of its chemical modification, as well as beekeeping products.
So where do vitamins come from? One option is medicinal plant raw materials. To extract more beneficial substances, it undergoes treatment with enzyme preparations of microbiological origin.

“As an example, ginseng. This is a popular herbal dietary supplement used in sports as an anti-inflammatory, antioxidant, CNS stimulant, and for anabolic processes and immunity. Ginseng contains vitamins A, B, C, and E, minerals, fiber, proteins, and ginsenosides. The latter reduce mental stress, improve immunity, and stabilize blood pressure. Ginseng preparations increase gas exchange, stimulate tissue respiration, reduce heart rate, and normalize blood pressure,” explains Ekaterina Bankovskaya.

Green tea supports metabolism, saturates the body with beneficial microelements, contains caffeine, catechin polyphenols, theobromine, and theophylline, which have antioxidant properties. Taking green tea extract increases endurance, improves antioxidant protection, and enhances lipid oxidation in muscles.

Capsaicin, the active compound in cayenne pepper, has analgesic effects, increases the effectiveness of strength training, and lipid oxidation, and is used to relieve muscle pain.

Are there dietary supplements without vitamins?

By composition, dietary supplements are divided into several types. The first are nutraceuticals – essential nutrients or their close precursors. They include vitamins, provitamins, macro- and micronutrients, polyunsaturated fatty acids, amino acids, carbohydrates, and dietary fibers.

“Hemoglobin contains protein and amino acids essential for maintaining metabolism. Its main advantage is replenishing iron deficiency, a key element of hemoglobin. This substance is responsible for oxygen transport to all tissues in the body and prevents the development of iron deficiency anemia. A good hemoglobin product contains at least three percent albumin, which affects iron levels and blood composition. It is recommended to choose a product without additives, as they may worsen iron absorption and increase calorie content. For dietary supplements, choose hemoglobin from pharmaceutical companies, enriched with vitamins,” says Ekaterina Bankovskaya.

The second group consists of eubiotics, which contain live microorganisms and their metabolites, normalizing the gastrointestinal microbiota. Enzymes improve nutrient absorption, and antioxidants prevent cellular damage and have anti-inflammatory effects. Probiotic preparations are used to restore the normal flora of the intestine: live microorganisms that suppress pathogenic flora (probiotics), organic compounds that stimulate the growth of beneficial microorganisms (prebiotics), and synbiotics — a combination of the first two groups.

“The third group is para-pharmaceuticals. They have pharmacological properties and are intended for targeted effects on specific cells, tissues, systems, and organs. For example, as a diuretic or energy tonic, a supplement for mood normalization or appetite reduction. Although they differ from medications in their lower dosage and are used as prevention or as an adjunct to treatment, they are prescribed only by a doctor. Active components include extracts, amino acids and acids, fiber, and dietary fibers,” explains Ekaterina Bankovskaya.

Can tea be a dietary supplement?

A simple store-bought drink is generally not considered one. It is safe to drink 2-3 cups of green tea a day. However, as previously mentioned, dietary supplements are made from it. They specifically use extract — a highly concentrated content of beneficial substances. It’s best to consult a doctor before using such supplements. There have been cases of poisoning due to an overdose of polyphenols.

“I would say this: if it concerns plants for tea or infusions, where the content of the active component is known, and a treatment plan is developed, then it is no longer a dietary supplement, but a full-fledged medicine. However, if the tea contains a small amount of medicinal plant in a dose that is not therapeutic, as well as, for example, vitamins, then it will be considered a dietary supplement,” ponders Sergey Solodnikov, scientific consultant on pharmacology at the ChemBio Research Center of PNIPU, candidate of medical sciences.

For those who don’t eat meat

“Humans are omnivorous, and vegetarianism should not be viewed as the only correct diet. Many amino acids are absent in plants, without which the human body will not function properly. For example, valine, leucine, isoleucine, threonine, methionine, phenylalanine, tryptophan, lysine. The production of these amino acids is quite costly, so finding a package of dietary supplements that contains all these components at an acceptable price is a challenging task,” says Ekaterina Bankovskaya.

“Plant foods almost never contain vitamin B12, which is necessary for blood formation and the creation of new DNA molecules. To replenish the deficiency, a supplement will need to be taken,” notes Sergey Solodnikov.

Those who do not consume animal products may have iron deficiency. Food contains this mineral in two forms: heme — in meat, poultry, and fish, and non-heme — in plant products. The first option is absorbed at 17-22 percent, while the second is significantly less — at 1-7 percent. Another element that is poorly absorbed from non-animal food is calcium. Oxalic and phytic acids in plants hinder its accumulation in the body. Vegetarians may also experience a deficiency of omega-3 fatty acids, primarily sourced from fatty fish and seafood.

What is better absorbed — substances from dietary supplements or food?

“A person can consume both natural and synthesized substances. The degree of their absorption depends more on the individual's health and the proper functioning of all organs and systems, rather than the source. Problems with the absorption of food components begin when diseases of the endocrine and digestive systems arise,” explains Ekaterina Bankovskaya.

What are the risks of abusing dietary supplements?

If one takes a single complex and only for a specific period — complications are unlikely, except for individual intolerance. However, exaggerating the duration of supplement intake or the daily norm will lead to an excess of substances in the body. Any excess is harmful by definition: potassium, for example, is necessary for the health of the cardiovascular and nervous systems, but its excess can cause arrhythmia, thus disrupting heart function.

“Some believe that vitamins do not accumulate because they are quickly utilized by the body, but in cases where they are introduced in excessive doses (especially fat-soluble A, D, E, K), we can experience poisoning,” adds Sergey Solodnikov.

What is the difference between dietary supplements and medications?

“Dietary supplements are compositions of biologically active substances designed to support the body and reduce the risk of diseases. They are not considered medications and are classified as food additives. They undergo certification by sanitary and hygienic services but do not require obligatory preclinical and clinical studies, which simplifies their path to the consumer. While medications are dispensed only in pharmacies, sometimes requiring a doctor's prescription, dietary supplements can also be purchased in health food stores, supermarkets, and on marketplaces,” explains Ekaterina Bankovskaya.

Dietary supplements are not the primary method of treatment and are used as preventive measures, supporting basic treatment methods and enhancing their effectiveness.

“There is a therapeutic effect from dietary supplements, this is indisputable: we take vitamins to improve well-being and enhance the body's protective mechanisms. There are two extremely different opinions in society regarding supplements: some use them for treatment, while others are categorically against taking dietary supplements, considering them 'placebos.' The best approach is to adhere to a third viewpoint: if there are indications for using a dietary supplement, for example, a doctor has prescribed dietary fibers to eliminate bile acids, then it is worth listening to. But if you haven't had tests done, have no symptoms of deficiency in any microelements