What are dietary supplements: for whom, when and why

At the time, we used to dream Food of the 21st century would be 100% capsules – they would meet all our nutritional needs, from breakfast to dinner. This has not happened and, given our taste for food, it is unlikely to become a reality. But it goes without saying that the predictions were all wrong.

Understandable: according to a survey conducted by the Brazilian Association of Food Industry for Special Purposes and Conbad (Abiad), the Brazilian Association of the food industry for specific purposes and congeners (ABIAD), supplements are in 54% of Brazilian households. The need to supplement the diet is emphasized as the main reason behind the purchase. Anyone who sees this flow does not imagine that Brazil has no specific regulation for this category. Until July

the National Health Surveillance Agency (ANVISA) approved a series of new rules relating to dietary supplements. "This will contribute to the organization of the sector, facilitate communication on the properties of products and bring more safety to consumers," says food engineer Tatiana Pires, president of Abiad.

To get an idea, 189 claims for benefits were approved. appear on the package – but for that, the supplement must meet certain criteria. "Everyone knows that calcium is fine, but it's not an amount that generates a gain," says Tatiana.

"This standardization should minimize exposure to misleading information," says nutritionist Carla Cristina de Morais of the Genomics Research Group on Nutrition. of the Federal University of Goiás (UFG). For the nutritionist Ceres Mattos Della Lucia, professor at the Federal University of Viçosa (UFV) in Minas Gerais, the benefits are more numerous. "Regulatory modernization will also reduce barriers to commercialization and innovation in this sector, while improving health controls and risk management for these products," he says.

But one thing will not change: they will continue to be sold unnecessarily. prescription. And while the new legislation for the category is seen as a positive step, many experts do not see self-use as an autonomous one. "Consumption of high-dose supplements can cause damage as serious as a micronutrient deficiency," says Ceres.

According to her, the type of disability will depend on the type of product present in the routine in large quantities (at the end of the text). you will see peculiarities on the most sought-after food supplements). "The effects can be acute, such as diarrhea, or chronic, leading to hair and tooth loss and weakening of the nails," he says.

The risks of self-supplementation

Before indicating a calcium supplement, for example, the endocrinologist Marise Lazaretti Castro, professor at the Federal University of São Paulo (Unifesp), performs a nutritional calculation to check how much of the skeleton's favorite mineral comes from the diet. "On this basis, I am only completing what is needed," she said, who is also president of the Brazilian Association for the Evaluation of Bone and Osteometabolism, Abrbado. Thus, all risks badociated with abuse fall.

In any case, this is far from being the first attitude of the doctor. When it is clear that a patient consumes less calcium than he should – which is common here, as the research has proven – he recommends everything from one patient to another. first stir the menu. "It's best to increase the consumption of nutrient-rich foods, such as milk and dairy products, rather than switch to supplementation," he says.

Because, again, this behavior is potentially disastrous, depending on the substance. See the clbadic case of beta-carotene, an antioxidant pigment responsible for the orange color of carrot, papaya and pumpkin. "As part of a healthy diet, it is a powerful ally in the fight against lung cancer," says nutritionist Thaís Manfrinato Miola, coordinator of clinical nutrition at the A.C.Camargo Cancer Center in São Paulo. This is because this type of compound is recognized by dealing with free radicals, molecules that, in abundance, detonate our cells.

A single study involving 29,133 smokers and smokers published in the highly respected The New England Journal of Medicine . , in 1994, fell like a bucket of cold water on the heads of those who imagined that the nutrient isolated in capsules would be even more effective. High dose supplementation increased the incidence of lung cancer by 18% in volunteers.

Further work confirmed the link. One of the explanations advanced is that an excess of beta-carotene would activate the carcinogenic substances present in the cigarette.

The history of beta-carotene still raises an alert about other nutrients with an antioxidant profile, such as vitamins E and C: the causes of abuse these elements change function and acquire a pro-oxidant character. "This facilitates damage to the cells' DNA," says Thais.

Not for nothing, for the purposes of disease prevention, the National Cancer Institute (INCA) recommends to avoid the unlimited use of vitamin and mineral supplements . "Nutrients must be obtained through a varied and colorful diet," says the organization.

For people who already treat cancer, counseling is even more vital. " Studies indicate that the excess of certain nutrients can disrupt the action of chemotherapeutic agents and even potentiate their side effects ," says specialist cancer center A.C.Camargo. In order for the treatment to not be altered – and the tumor to be strengthened – it is essential that the patient opens the game with the doctor and the nutritionist about taking this type of product.

It is not that supplementation is completely rejected at this time.

How to take supplements – when they are indicated

Confirm the real need for capsules, sachets and company

How to take supplements – when they are indicated

and adjust doses are the main reasons to make an appointment, but not the only ones. Anyone who buys supplements without indication is able to see the potential benefits of ships if they do not use them as suits do.

Well, it's not enough to send them down your throat. "There is a question of bioavailability, which represents the amount of this nutrient that will actually be absorbed and used by our body," says nutritionist Luciana Setaro, of the São Camilo University Center in São Paulo, state capital.

. in a practical case, compete for the same site of absorption in the intestine. "It's like they wanted to end up in the same hole," Luciana translates. If a person is suffering from anemia and consumes the ferrous supplement with a glbad of milk, filled with solid minerals, the product will not work.

The same goes for those who swallow the calcium tablet before eating a piece of overloaded steak. of iron. Thus, the financial investment disappears. And it is not small. According to a survey conducted by the QualiBest Institute among 1,863 people, supplement consumers spend on average between R $ 93 and R $ 125 per month

There are really situations where investment is essential. The above-mentioned anemia (a condition particularly affecting children, women with heavy menstrual flow or vegetarians) often requires ironing. It is also recommended that people who live inside take capsules or drops of vitamin D.

Pregnant women also need folic acid supplements for their baby to develop perfectly. People who have performed bariatric surgery may also resort to a series of capsules. "Nevertheless, it is better to talk to the doctor.Although therapeutic doses are needed, they should be prescribed by him," says Carla Cristina, of the UFG.

In specific circumstances related to problems or stages of life, the experts see no point in completing. "If the diet is adequate, these products will be useless," says nutritionist Felipe Almeida, of São Paulo.

And if the food is messy, it's not the capsules that will reverse the damage. "It's like wanting to speak English and think that simply paying tuition will do," jokes Marise. Cultivating a well-nourished body requires effort. But in a country rich in very rich foods like ours, we can not consider this a sacrifice.

Multivitamin Supplements

They combine many vitamins and minerals in the same product, suggesting a lower risk of exceeding certain nutrients. "But it's exactly the opposite," says Ceres of UFV. According to her, each component usually appears in larger quantities than necessary for the general population. In addition to values ​​from the diet, there is a possibility of exaggeration.

In Brazil, many people use these products to dispel fatigue. For Ceres, this advantage would be felt in case of deficiency in one or more nutrients.

"But it is better to make a correction by the diet," he says. According to Carla, UFG, supplementation can mask what is really causing fatigue – the presumed sources of stress, sedentary lifestyle and poor sleep quality.

Who would benefit: Some think that does not bring gains. Others say that this can be helpful after bariatric surgery, during pregnancy and between vegetarians and the elderly. What to watch for: "Many micronutrients compete for the same site of absorption in the intestine," explains Ceres.

Omega-3

Fish and flax fat has acquired a protective status for the heart. And new studies show virtues in other areas, such as neurological and psychiatric disorders. "But that does not go hand in hand with an increase in fish consumption," says nutritionist Nágila Damasceno, a researcher at the University of São Paulo (USP).

Many of them are soon opting for the capsules. It turns out that, from a preventive point of view, this is not the best solution. A review of 79 Cochrane Collaboration studies confirms this: supplements have not reduced the risk of cardiovascular problems or death from these diseases in the general population. Not to mention the fact that excess omega-3 triggers inflammatory processes.

The message? "It's better to eat fish several times a week," says Nágila. Who would benefit: In principle, people with a risk factor for heart disease, such as high triglyceride levels, in addition to pregnant women who do not eat fish, give priority to baby.

What to Watch For: There are now several fraudulent marks. "In research, we have never detected 100% of what the label describes in the capsules," says Nágila.

Vitamin D

The main task of the substance, obtained mainly by exposure to the sun, is to facilitate the absorption of calcium, bone – but studies have revealed other gains. The fact is that for it to perform its functions, the blood concentration can not be less than 20 nanograms per milliliter (ng / ml) in the blood.

For some groups, such as pregnant women and people with cancer, autoimmune diseases and osteoporosis, who would gain an extra benefit from the nutrient, it did not hurt to get it. raise to 30 ng / ml. However, doses higher than 100 ng / ml are already considered imprudent because of the risk of toxicity.

"Anyone who thinks they are poor in vitamin D because they do not take the sun can take between 400 and 800 IU [unidades internacionais] a day," said Marise.

Who would benefit: Those who do not expose themselves to the sun, pregnant women, the elderly, obese patients, menopausal women and patients with certain diseases . Vitamin D overdose causes increased absorption of calcium, which can lead to kidney failure.

Collagen

Supplements for beauty, it's the darling – that is, it's a protein. In a study conducted by the Faculty of Pharmaceutical Sciences of Ribeirão Preto, USP, the sachet containing hydrolysed collagen (that is, broken) improved the skin of volunteers in three months – they were between 45 and 60 years old .

For researcher Patricia Maia Campos, the author of the paper, would supplement supplementation after 40 years. "Especially at menopause, when there is a loss of collagen and elastin because of the decline in estrogen," he says.

According to the dermatologist Fabiane Kumagai of the Brazilian Society of Dermatology, the effective dose is 5 to 10 grams per day. But many pills offer less than 1 gram of substance – a substance that would make no difference.

Who would benefit: People with low protein intake (like some vegetarians and vegans) and menopausal women

What to watch for: sometimes adds collagen to vitamins. Beware of excesses. And do not expect results in a few days.

Vitamins of Complex B

"These vitamins can improve the use of nutrients by the body, thus helping the body to produce energy more efficiently", explains Ceres, UFV. The addition of vegetables, whole grains and meats in the diet already helps to guarantee the quality of these substances.

But some become more relevant than others at certain stages of life, requiring supplements. In case of folic acid (the synthetic form of vitamin B9) for pregnant women, since it avoids the defects of the neural tube of the child

Do not overdo it – this was linked to an increased risk of autism in the baby. Already, vegetarians and vegans need vitamin B12 because it is found mostly in meats. "This vitamin is essential for all cells, bone marrow and the nervous system," says Ceres.

Who would benefit: The elderly and restrictive regimes. Folic acid is essential for pregnant women, while vitamin B12 would be beneficial for those who do not eat meat. risk of autism.

Calcium

Research shows that the average Brazilian ingests 500 milligrams of this mineral – the recommended for adults is twice that. The deficit threatens most of the bones. Justification of the complement? "No, it's a reason to consume more dairy products," says endocrinologist Marise, of Abrbado.

Lactose, the milk sugar, even contributes to the absorption of calcium by the intestine. Two to three servings of the drink and its derivatives a day solve the problem.

If the subject does not even pursue this goal – because of intolerances, for example – supplements come into play. But only to provide what the food does not stand alone. Nothing more. Those who cramp the mineral are more likely to suffer from kidney stones.

Who would benefit: The part that can not at all put the right amount of dairy products on a daily basis, in addition to vegans and obese patients. who keep an eye: Some studies have badociated high dose calcium supplements with higher cardiac risk. There is no confirmation. For nutritionist Felipe Almeida, the general population, which trains a few times a week, has no reason to invest in many of them, such as BCAA and glutamine .

Sports Supplements

From the sports supplements team, it is in whey protein that Almeida sees more qualities. "It contributes to the adequacy of protein in the diet," he says. Composed of whey protein, the product would be most welcome to the establishment.

It is known, for example, that older people eat less meat over time. But the lack of this nutrient causes the loss of muscles, resulting in accidents. "Apart from that, in a hurry, there are people who can not eat properly every time," he recalls.

These are scenarios where whey stands out. "But for a person who eats well, it may not be relevant," he said. Better to invest in a consultation and learn to potentiate nutrition.

Who would benefit: Whey is interesting for people with low protein intake. What to watch out for: It is not because the clbadmate uses it, that one must follow the same path. The good thing to do is to seek the support of a nutritionist.

Vitamin C

According to research by the QualiBest Institute, 60% of the most consumed supplements were composed of this nutrient. One of the most vaunted attributes is protection against colds. Balela, according to a review of 29 studies conducted by the Cochrane Collaboration. Vitamin C is no longer a partner of the immune system. "But sufficient amounts can be obtained through food," says Carla, of the UFG.

Citrus fruits, guava, peppers and other vegetables fulfill this role. In Cochrane's research, this supplement has been shown to be useful in preventing respiratory infections in people exposed to intense exercise. Nutritionist Luciana, from São Camilo, points out that, being an antioxidant, the nutrient would lessen the formation of free radicals, normal during aerobic exercise, such as running and swimming.

are engaged in extremely intense activities. And during the process of healing larger wounds.

What to Watch Out for: Ceres says that abuse carries risks of kidney stones. But, as it is a water soluble vitamin, the excess is usually eliminated in the urine.