Are biologically active supplements necessary for health?
Candidate of Biological Sciences A. Margolina
"Science and Life" No. 7-2008
Eat birch bark and cheer up for the time being,
Tea is not some kind of chemistry, tea is natural gifts.
Leonid Filatov. The tale of Fedot-Sagittarius
Biologically active additives, which are often produced in the form of tablets and capsules, look very similar to medicines. However, dietary supplements, unlike medicines, do not pass the standard procedure of laboratory testing and clinical trials, so you should not expect a therapeutic effect from them.
Those who, for one reason or another, are interested in their health and the possibility of its improvement, know that taking care of health has become an expensive pleasure. If earlier it was enough to stop drinking, smoking, doing morning runs and eating fruits and vegetables more often, now you also have to buy all kinds of goods, without which, according to advertising, you will not get health. In particular, biologically active food additives (dietary supplements) are considered integral companions of a healthy lifestyle, the demand for which is strongly supported by articles in popular magazines, where the advantages of a particular drug are described in detail and with links to scientific data.
All dietary supplements can be divided into several functional groups. These are, first of all, substances that are either not synthesized at all in the body (they are irreplaceable), or their synthesis is often disrupted for one reason or another. Vitamins are the most well-known of this group of dietary supplements. The word "vitamins" itself was coined to denote substances that should enter the body in small quantities and the lack of which leads to various health problems – vitamin deficiency.
Now, along with vitamins, it is recommended to pay attention also to essential fatty acids (omega-3 and omega-6 acids), which are contained in certain oils (for example, in fish oil, linseed and rapeseed oil, black currant, borage and evening primrose oils), some minerals (calcium, selenium, zinc, magnesium), essential amino acids. Preparations of this group most correspond to the name "dietary supplements", as they are designed to make up for the lack of certain substances in the diet. Meanwhile, do not forget that a proper balanced diet remains the most natural way to get all these really important substances. And only in the case of an inferior diet, which obviously does not provide the body's needs for essential substances, dietary supplements become necessary. For example, with strict vegetarianism, there may be a lack of vitamin B12 and calcium, and with a low-fat diet or with the predominance of animal fats and margarine in the diet, the body may lack essential fatty acids.
Another group includes drugs that improve the body's ability to resist harmful effects. Antioxidants are leading here – substances (among them, by the way, many vitamins) that neutralize free radicals (reactive oxygen species), which play a leading role in the aging process and the pathogenesis of many diseases, including cancer and Alzheimer's disease. Vitamins E, C, and A. Of the non-vitamin antioxidants, plant polyphenolic compounds (flavonoids) and plants containing them, such as green tea and red grapes, are the most popular.
Among the herbal preparations of antioxidant action, pycnogenol, an extract of the bark of the seaside pine (Pinus pinaster), should be mentioned. The manufacturers of this dietary supplement claim that, since the seaside pine grows in harsh conditions, exposed to temperature changes, intense exposure to the sun and harsh salty winds, it accumulates especially a lot of powerful antioxidants – anthocyanidins, which can protect not only the pine, but also the human body. Pycnogenol is also found in the seeds and skins of grapes. Green tea extract is also used as an antioxidant supplement, which gained popularity after it was discovered that green tea reduces the likelihood of developing malignant tumors.
Many plant antioxidant preparations have a number of other useful properties: they improve the properties of vascular walls and blood circulation, have wound healing and anti-inflammatory effects. Examples of multifunctional plant antioxidants are silymarin from milk thistle (Silybum marianum), which protects the liver from damage, and resveratrol from red grapes, which has an antitumor effect and strengthens the cardiovascular system.
Almost as well as antioxidants, phytoestrogens are popular – plant substances that resemble female sex hormones in structure (see "Science and Life" No. 5, 2008). They are recommended not only for women to eliminate the troubles of the menopausal period, but also for elderly people of both sexes to prevent cardiovascular diseases. Soy and red clover are most often advertised as a source of phytoestrogens.
Some plants contain substances that improve the functioning of the immune system, increasing resistance to infectious diseases. Echinacea and garlic are the most popular here.
As in the case of vitamins and minerals, the result that food additives give can be achieved by adjusting the diet – drinking green tea and, if there are no contraindications, red wine (in moderation), eating more fruits, berries and vegetables, not forgetting garlic. Many spices have antioxidant and antimicrobial effects, so it is useful to include Indian and Oriental dishes in your diet from time to time. Phytoestrogenic effect can be obtained by including more soy products in the diet. By the way, the first information that phytoestrogens alleviate the symptoms of menopause and prevent cardiovascular diseases was obtained precisely as a result of the analysis of morbidity statistics in Asian countries, where people traditionally consume a lot of soy products (see "Science and Life" No. 5, 2008).
The third group of drugs causes the most controversy, including substances that can affect physiological processes, although they are not formally medicines. For example, ginkgo biloba is claimed to normalize blood circulation in the brain and is therefore recommended for improving brain activity, especially in the elderly. Herbs containing ephedra and caffeine are used in preparations for "fat burning". And preparations of St. John's wort and kava-kava are taken to lift the mood. There are also many drugs to affect the functions of various organs and systems – to improve vision, cleanse the liver and kidneys, increase joint flexibility, etc. They may contain combinations of two or three herbs or complex multicomponent cocktails of herbs, minerals and vitamins. On the one hand, we are talking only about medicinal herbs that have been treated for centuries. On the other hand, these herbs are increasingly recommended to healthy people as a scientifically sound way to insure themselves against possible ailments.
It is possible that some dietary supplements advertised on the pages of the popular press, under certain conditions, can have a beneficial effect on health. At least theoretically. In other words, behind many advertising promises there are real scientific studies confirming this or that property of this substance. The problem is that the intense advertising that has been showered on readers in recent years has successfully created two major misconceptions. First, all dietary supplements are as safe as food products, and therefore they can be taken without restrictions, in arbitrary combinations and for as long as you want. And secondly, dietary supplements undergo about the same (well, maybe only a little less rigorous) testing as medicinal substances, and therefore deserve the same (well, maybe a little less) trust.
Indeed, most of the substances used as food additives are safe, since they are either obtained from food products (black currant oil, red grape extract, green tea, etc.), or they have been used in folk medicine for so long that there is no doubt about them anymore. However, there are exceptions. For example, the medical literature describes several cases of serious side effects after taking the extract of the kava-kava plant, used to improve mood and combat depression. In particular, skin and liver lesions were noted. Currently, cava-cava-based products are already banned in the UK, but they continue to be sold in other countries.
Perhaps the most striking example of the negative consequences of "safe and natural" treatment is "Chinese nephropathy". The first case of this disease was recorded in 1991 in one of the Belgian hospitals, where a young woman with a strange kidney disease was admitted. Against the background of general health, in the absence of hypertension, bad habits and kidney problems in the past, she suddenly developed acute renal failure, which required emergency measures to save her life. The examination showed kidney fibrosis and a number of changes in the composition of the blood. Doctors managed to find out that shortly before the illness, the woman underwent a course of "slimming" therapy in one of the clinics in Brussels and that Chinese herbs were part of this therapy. Over the next year, seven more women with a similar kidney disease were admitted to hospitals in Brussels, who "lost weight" in the same clinic. Concerned doctors visited a suspicious clinic and examined 22 randomly selected patients. As a result, three more of them were found to have kidney disorders. It turned out that some Chinese herbs that were treated at the clinic contained a plant toxin – aristolochiic acid. At the moment, Belgium and a number of other countries have banned the import of herbs containing aristolochiic acid.
In 2004, dietary supplements containing ephedra (Ephedra sinica), also known as Ma-Huang, were banned in the United States. The reason for the ban was a study that revealed 16 thousand cases of various problems after taking ephedra, such as palpitation, tremor, insomnia, etc. In Russia, ephedra is still part of many "fat burners" and drugs for athletes.
Even obviously safe herbs can have side effects or have contraindications for certain diseases. For example, ginkgo preparations are not recommended to be taken before surgery, as they can increase bleeding, and St. John's wort and bergamot increase the sensitivity of the skin to UV radiation, which can lead to photodermatitis.
The name "dietary supplements" indicates that these are substances that should be taken in addition to the diet. However, in order to make the intake of dietary supplements more convenient, they are produced in the form of capsules, tablets, potions, powders, etc. As a result, they become very similar to medications. But if medicines undergo a multi-year testing procedure, including both animal trials and extensive clinical trials, then the situation with dietary supplements is different. In the USA, for example, the manufacturer of a dietary supplement determines which tests must be carried out before offering the drug to consumers. In Russia, in order to certify a dietary supplement, it is necessary to submit protocols of clinical trials for effectiveness, however, even here the requirements are incomparably lower than for drug testing.
Since dietary supplements should not act like medicines (otherwise they will have to be tested and certified in a completely different way), such streamlined words as "improves", "normalizes", "stimulates", "strengthens", "promotes", etc. are usually used to describe them. For example, if a medication for hypertension reduces blood pressure, then dietary supplements of the same direction "contributes to the normalization of pressure." If the medicine has a diuretic effect, then the dietary supplement "cleanses the body" or "removes toxins". If the medicine has a hypnotic effect, then the dietary supplement "improves sleep". In the USA, where the indication on the packaging of a known medicinal effect can create serious problems for the manufacturer of dietary supplements, many manufacturers prefer not to write about the effects on the packaging at all, hoping that the buyer will receive the necessary information from magazine articles and advertising booklets.
Since the information on the packaging of dietary supplements can not always be trusted, meticulous consumers try to collect the necessary information on their own. For example, after reading that a dietary supplement with red grape extract strengthens the heart and blood vessels, they look for whether there are scientific studies that confirm these properties, whether the mechanism of action is known, and based on the search results they make a purchase decision. However, there are also pitfalls here. Unlike medicines, dietary supplements that have the same composition and even the same name can vary greatly in their qualities. For example, in plant extracts, the amount of active substances varies depending on the quality of the raw materials and the extraction method. Standardized extracts with a precisely defined amount of the main active ingredient can provide some guarantee of effectiveness, as well as the reputation of the manufacturer – if this is a large company that has been on the market for a long time, then we can hope that it makes maximum efforts to ensure the quality of its products. And yet, even the highest quality dietary supplements produced by the largest and most respected companies may or may not give the expected result.
Originally conceived as dietary supplements, dietary supplements are increasingly expanding their sphere of influence, increasingly finding themselves in the hazy domain of alternative medicine, where fragments of scientific data are closely intertwined with an ineradicable belief in a miracle. This area has not been practically explored yet. Undoubtedly, in some cases, dietary supplements can support the body's strength in the fight against the disease, which leads to recovery. However, often the belief in the power of dietary supplements, laced with advice not to expose yourself to "harmful" and "chemical" drugs, leads to the fact that people do not rush to the doctor and miss precious time, trying one advertised supplement after another and wandering from one charlatan to another. As a result, in our age of early diagnosis, extremely neglected cases of diseases (for example, malignant tumors) are in front of the doctor, when it is already difficult to do anything.
Nutritional supplements promise the realization of a cherished dream of a person – health that money can buy. However, so that the pursuit of health does not lead to the opposite results, precautions should be taken. First of all, you need to remember that dietary supplements are neither medicines nor magic elixirs. Therefore, you should not blindly believe what the advertisement says, but you should try to collect as much information as possible about how this drug works, whether there is evidence of its effectiveness and whether anything is known about side effects. The safest food additives are those containing edible plants and vitamins, as they include substances to which the body is well adapted. However, do not forget that the basis of health is still a proper, varied diet, and not sets of capsules and tablets. Particular caution should be exercised with regard to preparations containing medicinal plants, especially those that have only recently been used in Russia (for example, herbs of Chinese medicine). It is undesirable to take such drugs immediately for a long time and for a long time. It is also not recommended to take dietary supplements independently, without consulting a doctor, during pregnancy and lactation, before any operations, as well as in case of problems with the liver and kidneys.
Portal "Eternal youth" www.vechnayamolodost.ru
02.10.2008