Most of us find it difficult to catch our breath and smell the roses while living in this breakneck pace of life in Singapore. We have deadlines and targets to meet, or errands to run, sometimes at the expense of our well-being. Occasionally, we are stopped in our tracks when we start feeling slightly under the weather. In our usual true fashion, we look for quick cures and easy solutions just so we can get the all-important work done. Popping pills from the pharmacy seems more convenient as a quick fix than having nutritionally-balanced meals and the much dreaded regular exercise or physical activities. Is this lifestyle sustainable? Do health supplements really help?

WHAT ARE HEALTH SUPPLEMENTS?
Health supplements are products which are taken to complement a diet to support and maintain healthy functions of the human body. They may contain vitamins, minerals, amino acids or substances derived from botanical or non-human animal materials. Each product may contain either a single active ingredient or a combination of active ingredients. They usually come in very simple and convenient forms like oral tablets, capsules or liquids that make popping them into our mouths such a breeze.

As the definition implies, they are meant to supplement, and not for the medicinal purpose of curing or treating any disease or disorder. A perfectly healthy diet provides all the nutrients and minerals we need. Unfortunately, when that seems unattainable, some people resort to health supplements to fill the nutritional gaps.

WHO CAN TAKE THEM?
It is worth to note that health supplements are unnecessary for healthy people who maintain a perfectly healthy diet and lifestyle. Considering that it is quite a tall order for some of us to attain this, general health guidelines are endorsed.

Certain groups of people in different stages of life like the pregnant, breast-feeding, young or very sick may need these recommendations to enhance their bodily functions, if their health professional has not already done so. People who practise certain lifestyles such as the vegan, the physically active, and the health- and diet-conscious can consider taking various products which are marketed with them in mind.

It is best to seek advice from a pharmacist or qualified professional before taking any supplement.

RECOMMENDATIONS FOR THE OTHERWISE HEALTHY
Your health status needs to be assessed prior to taking any supplement. Those with chronic medical conditions need clearance from their doctors. Caution must be exercised for those with allergies of any kind, be it medicine or food.

Multivitamins and minerals are generally recommended for those who are not receiving sufficient nutrients from their diet. A complete source of B vitamins can help combat the effects of stress and anxiety that have become part of our daily life. Postmenopausal women, those who do not drink milk, or do not get enough skin exposure to the sun may need calcium and vitamin D supplementation. Adults and the physically active who need better joint health may take products containing glucosamine or chondroitin. The vegans probably need iron, calcium, vitamin B12, vitamin D and omega-3 supplements. Fish oils have the most scientific evidence for use to support heart health. These recommendations are certainly not exhaustive considering the myriad of products available in the market.

GUIDELINES & BENEFITS
Health supplements sold are currently not subject to any approval, licensing or registration by the authorities. The Health Sciences Authority (HSA) of Singapore monitors but does not assess them. The responsibility to ensure their safety and quality lies with the dealers. Dealers must be ethical, accurate and honest in their advertisements and claims. Therefore, consumers are always advised to exercise personal caution when taking health supplements.

A lot has been written about the benefits of health supplements. Vitamins and minerals are usually prescribed or recommended by the doctor for a person to take when there is known deficiency. Certain vitamins and minerals can minimise problems associated with ageing, immunity, memory, bone loss or fractures. For example, glucosamine, chondroitin and collagen are recommended for good joint health, while omega-3 products are said to be good for the heart and brain.

It is important to bear in mind that unlike medicines, many health supplements are not rigorously studied in clinical trials. The health benefits may be factual in some, but may probably be theoretical, psychological, or at best, a placebo effect in others. As information is readily available on the internet, the health claims reported from studies may lack robust scientific evidence. The observational studies are subject to bias and may not prove the cause and effect relationship. How often do we read about beneficial claims reported today, but found conflicting information and subsequently debunked tomorrow?

Potential benefits can only be maximally derived from taking supplements with the proviso that the following steps are taken:

• Discuss with a health professional what you really need. Read and understand the labels and strictly adhere to the recommended dosage. The benefits may not be seen immediately or not seen at all, but closely monitor your health for progress. When any severe undesirable effects are experienced, stop and seek advice.
• Most supplements can be consumed without causing harm for healthy people. However, when large or mega doses of them are taken either accidentally or inadvertently for extended periods of time, it may cause stones in the urine (from too much vitamin C), birth defects (from too much vitamin A) or increase in chronic disease (from too much iron), just to name a few.
• Herbal remedies may seem innocuous as they are considered natural supplements. However, Ginkgo biloba, St. John’s wort, ephedra and kava, when taken as health supplements, may interact with prescription drugs resulting in undesirable and dangerous effects.
• All allergy sufferers must be extra vigilant when choosing health supplements. Those with shellfish allergy must avoid products containing glucosamine, which is derived from shells of crabs, lobsters and shrimps.
• The products should be bought from reputable sources. Failure to do so may render the consumer susceptible to unscrupulous dealers with adulterated products containing actual medicinal active ingredients. There are instances where the HSA had to seize illegal health products for weight loss claiming 100% natural containing herbal ingredients. Upon investigation, these products contain sibutramine, which is an active ingredient controlled in the Poisons Act.

HEALTH TRENDS
These days, people are keen to look into different areas of their life to improve overall mental and physical well-being partly due to increased pressure and stress levels. They will look for alternative and convenient ways to better their quality of life. With a wealth of information online, consumers can very easily research what they can eat or drink that will help to increase alertness, de-stress, or even lose weight.

As alternatives for immune and gut health, herbal and natural remedies containing echinacea, peppermint and flaxseed oil are greatly sought after. Brain boosters are highly desirable within the health and fitness industry. These nootropics may contain choline, creatine, caffeine and curcumin, which are purported to promote memory, mood and energy.

Manufacturers are also getting creative with the advent of vitaminised water or drinks for convenient vitamin supplementation. The jury is still out on whether people will catch these trends. But with issues as vital as health and life, due diligence is highly recommended before jumping on this bandwagon.

PARTING THOUGHTS
Health supplements can be beneficial but the key to vitamin and mineral success is eating a balanced diet. When the attempt to reach the recommended intake fails and there are nutritional deficiencies, supplements may be the next step. It is easy to forget that supplements are not replacements for proper bodily functions. There is hitherto no concrete evidence that health supplements are able to reverse the course of any chronic disease.

If you really need to consume health supplements, exercise caution. For safety, treat supplements like medications by being transparent with your healthcare providers about what you are taking. Do your research on proper usage and possible side effects or interactions. Carefully read the labels and consult a qualified professional for any clarification. Buy good quality products from reputable sources. Be wary of marketing claims and advertisements that are not easily verified. These include personal testimonies and statements such as “all-natural ingredients” or “used safely by millions”.

Looking for quick cures for our busy lifestyle is no excuse not to be prudent in our decision. After all, our health is an investment, not an expense. It’s better to be safe than sorry. ⬛

Abdul Rahman Mohamed Aspar has been a pharmacist for 30 years. Previously worked at the National University Hospital and Ministry of Health Singapore, he currently co-manages a family practice clinic with his wife, Dr Masayu Zainab Masagos Mohamed.