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Does everyone really need health supplements?

SINGAPORE — In the hope of enhancing her general health, Madam Susan Tan has been taking a multivitamin and fish oil supplement every day for the last three years. The manager, who is in her 40s and does not have any chronic illness, said she feels more alert and falls sick less frequently after taking them.

SINGAPORE — In the hope of enhancing her general health, Madam Susan Tan has been taking a multivitamin and fish oil supplement every day for the last three years. The manager, who is in her 40s and does not have any chronic illness, said she feels more alert and falls sick less frequently after taking them.

“I don’t always eat well due to my hectic work schedule. If I can get my vitamins quickly and easily from a pill, why not? I hope that the extra health boost can keep me healthy and prevent illnesses as I age,” she said.

Latest figures from the Health Supplements Industry Association of Singapore (HSIAS), which represents over 90 per cent of the health supplements marketed here, show that many Singaporeans share Mdm Tan’s sentiments.

It estimates that Singaporeans spent about S$594 million on supplements last year, a figure that is expected to increase 8 to 10 per cent annually, said the association’s president, Mr Daniel Quek, who added that multivitamins, calcium and Vitamin C pills are among the most popular supplements sold here.

TO SUPPLEMENT OR NOT TO SUPPLEMENT?

Popping a pill seems like a convenient way to boost health and ward off certain diseases. But does the average person really need a health supplement?

Ms Louisa Zhang, a nutritionist in private practice, said a multivitamin may be considered by those who wish to make up for any nutrition shortfalls. But it has to be sourced from a reliable company with a good track record, and taken according to the recommended dosage.

When used appropriately, Mr Quek said, health supplements can be a “low cost” way to maintain health and reduce risks of chronic health conditions.

According to Ms Lynette Goh, senior dietitian at National Healthcare Group Polyclinics, there is some scientific evidence to show that supplements may help manage some conditions. They include calcium and Vitamin D to improve bone health, folic acid to reduce risk of birth defects and Omega-3 fatty acids to improve heart health.

But she added that there is not enough evidence to suggest that healthy people benefit from taking supplements. “They are meant to fill in nutritional gaps in certain situations when the person is not eating well. In such cases, a doctor will be able to advise and prescribe the right supplements to meet those nutritional gaps based on clinical findings or medical judgment,” said Ms Goh.

For instance, supplements can help people with chronic diseases, food allergies and intolerances, as well as those recovering from surgery, illness or those who are on a restrictive diet, meet their nutritional needs.

Vegans and vegetarians who have a limited diet, women who intend to conceive or are already pregnant, and older adults who are not eating well may also benefit.

A spokesperson from the Health Sciences Authority (HSA) said supplements should not replace any prescribed treatment or medication from a doctor, nor can it treat or manage a medical condition.

Pharmacist Jacqueline Wee, sole distributor in Singapore of WHC Nutrogenics, added that consumers must first determine the reasons for taking supplements.

“Supplements cannot claim to diagnose, treat, cure or prevent any diseases. People who have food allergies, chronic medical conditions or take multiple medications should always consult their doctor or pharmacist before taking a supplement,” she said.

TOO MUCH OF A GOOD THING

It is also possible to have too much of a good thing, especially when specific nutrients are taken in large doses. Ms Goh warned that taking extra vitamins may result in an overdose if the person’s diet also concentrates on particular foods containing the same nutrients.

“For example, taking too much calcium from supplements, in addition to calcium-rich foods, can increase the risk if kidney stones, nausea, loss of appetite, constipation and impair iron absorption,” she said.

Unlike with medication, Ms Goh added there are also no guarantees on ingredient quality, purity or safety of supplements as they are currently imported and sold without a licence, approval or registration by HSA.

The HSA has a post-market surveillance framework to detect adverse events associated with health products, but importers, wholesale dealers and manufacturers are responsible for ensuring safety and quality of their products.

Its spokesperson said: “Even with regulatory oversight, there is no guarantee that all health supplements in the market are 100 per cent safe. All health products carry varying degrees of risk when consumed or used.”

That is why it is important for consumers to learn to differentiate between marketing hype and objective facts on product labels (see Choosing the Right Supplement), said Ms Wee.

Even if you choose to take a supplement, Ms Zhang said nothing can replace nutrients from whole foods.

Ms Goh added: “Wholefoods provide a variety of vitamins and minerals that work together to protect and promote health. In addition, fruit, vegetables and wholegrains also provide fibre, which helps prevent certain chronic diseases like Type 2 diabetes and heart disease, that supplements don’t.”

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