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Updated on 11/04/2019
Definition and the Agency’s role
Nutrition, Food supplements, Minerals, Vitamins, Nutrivigilance
Consumption of food supplements, which provide a concentration of nutrients or other substances, has become increasingly common in France. These products are used for slimming, relieving stress, boosting energy or for athletes. While they are often perceived as harmless, in some cases they can expose the consumer to health risks.
What work is ANSES doing on food supplements and what are its recommendations?
What are food supplements?
Food supplements are defined as "foodstuffs intended as a supplement to the regular diet and which are a concentrated source of nutrients or other substances which alone or combined have a nutritional or physiological effect [...]" (Directive 2002/46/EC of the European Parliament, transposed by Decree No 2006-352 of 20 March 2006).
There are many dietary supplements on the market containing plants, vitamins and minerals or other substances. These supplements are intended to help improve consumers' nutritional intake in order, for example, to help them lose weight, cope with winter, improve digestion, beautify hair, reduce the discomforts of pregnancy or menopause, etc.
Food supplements are marketed in the form of capsules, lozenges, tablets, pills, powder packets or liquids (ampoules, vials with droppers). They must be declared to the DGCCRF (General Directorate for Consumer Affairs, Competitions Policy and Fraud Control), which examines their composition and carries out the same types of controls as for other categories of foodstuffs.
Several regulatory provisions at the EU and French levels establish the list of ingredients authorised in food supplements. These include vitamins, minerals and plants, and also provide the maximum daily intakes not to be exceeded for vitamins and minerals.
However, unlike medicinal products, the marketing of food supplements does not require an individual marketing authorisation based on prior assessment by an expert body of the dossier submitted by the manufacturer. The manufacturer is responsible for ensuring that food supplements placed on the market comply with the regulatory provisions in force, both in terms of safety and consumer information (no fraudulent claims).
Food supplements: the need for informed consumption
In recent years, the French have been consuming more and more food supplements and enriched foods. Intake deficiencies are very rare in the general population as are nutrient deficiencies, which only concern vitamin D. On the other hand, intake deficiencies are more likely to affect particular groups of the population such as pregnant women, children, the elderly, etc.
In general, in the absence of pathology, nutritional needs can be met through a varied and balanced diet combined with appropriate physical activity. If these conditions are met, consumption of food supplements is unnecessary.
However, certain eating habits can lead to a reduction or even the elimination of certain foods that provide essential nutrients. A case in point, the vegan diet is totally devoid of vitamin B12, a nutrient found only animal-based foods. Similarly, a diet that excludes the consumption of fish and seafood will not meet the body’s requirements for EPA and DHA (long-chain polyunsaturated fatty acids). More generally, an insufficiently varied diet exposes one to the risk of an insufficient coverage of nutritional requirements. In these particular cases, the use of food supplements can be helpful. It is therefore strongly recommended to seek the advice of a health professional.
When food supplements containing vitamins and minerals are taken, there may be a risk of exceeding safety limits, especially when they are taken in combination with fortified foods.
Moreover, the nutrition and health claims that may be indicated on product packaging are strictly regulated by the European regulations. To date, a limited number of health claims are authorised; the list can be found on the European Commission's website. European Commission. It should also be noted that food supplements are not medications, so by definition they cannot claim any therapeutic effects.
In general, it is important to:
- avoid taking prolonged, repeated or multiple doses of food supplements during the year without seeking advice from a health professional;
- to scrupulously follow the conditions of use set by the manufacturer, who is responsible for the safety of the products he markets;
- to report to a health professional any adverse reaction occurring following the consumption of a food supplement;
- to favour supply chains monitored by the public authorities.
What are ANSES’s missions with regard to food supplements?
Safety assessment of the substances in food supplements
The Agency is regularly called upon to assess the risks associated with the presence of certain ingredients in food supplements. When necessary, this work can enable content limit values for food supplements to be set (e.g. 20 mg/d of p-synephrine).
Study of food supplement consumption
As part of the INCA Individual and National Food Consumption Surveys, the Agency collects useful information and data on habits and consumption patterns regarding food supplements in France. INCA2, conducted by ANSES in 2006-2007, collected information on the intake of food supplements by adults and children aged 3 years and over, for the first time in metropolitan France. The results of INCA3, conducted in 2014-2015 and including for the first time children under 3 years of age, show that the number of consumers of food supplement increased significantly between the two studies.
According to the INCA3 study, over the 2014-2015 period, the percentage of people consuming food supplements, in the regulatory sense, was 22% for adults (18 to 79 years) and 14% for children (3 to 17 years). Based on a broader definition that includes medicinal products containing nutrients, these rates rise to 29% and 19% respectively. According to INCA2 (2006-2007), nearly one in five adults and more than one in ten children consumed food supplements or vitamins and minerals in medicinal form. Thus, the rate of consumption of food supplements (including medicinal products containing nutrients) increased by about 50% between the 2006-2007 and 2014-2015 periods, both among children aged 3 to 17 years and among adults.
The average annual duration of food supplement treatments is 4.5 months for adults and 2.5 months for children, but varies greatly from one person to another. This reflects a great disparity in behaviour with regard to these products.
Regarding adults, the number of food supplement users is higher among women, individuals aged 18 to 44 years and those with a high level of education. A seasonal pattern of consumption is also observed, with higher consumption in winter.
It should be noted that food supplements are mainly purchased in pharmacies (78% for children and 45% for adults) but sales via the Internet have increased sharply among adults (from 1% to 11%) since the INCA2 study (2006-2007).
A nutrivigilance system
In 2009, ANSES set up a nutrivigilance scheme as part of the French Act on Regional Health Governance (Loi Hôpital, Patients, Santé et Territoires). The objective of the scheme is to monitor adverse reactions related to the consumption of food supplements as well as other food products such as fortified foods or novel foods for special dietary uses (infants, athletes, patients with food intolerance, etc.).
This scheme makes it possible to identify and collect adverse reactions reported by health professionals, in particular doctors and pharmacists, and in this way contributes to improving consumer safety. Thanks to this data, ANSES can carry out expert assessments to evaluate the risks associated with the consumption of these products and can then issue recommendations. To date, ANSES has published numerous opinions on a variety of products such as energy drinks and different food supplements.
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