France is seeing increasing consumption of food supplements, which are concentrates of nutrients, plants or other substances. Whether they are intended for slimming, relieving stress, boosting energy, or for athletes, these products are often perceived as harmless but can in some cases expose consumers to health risks. Who uses them? Are they necessary for certain populations? How can we limit the health risks?
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Updated on 16/02/2021
Food supplements, the need for informed consumption
What are food supplements?
Food supplements are defined as "foodstuffs the purpose of which is to supplement the normal diet and which are concentrated sources of nutrients or other substances with a nutritional or physiological effect, alone or in combination [...]" (Directive 2002/46/EC of the European Parliament, transposed into French law by Decree no. 2006-352 of 20 March 2006).
There are many different food supplements, based on plants, vitamins and minerals, or other concentrated substances for nutritional and physiological purposes (melatonin, glucosamine, etc.). They are marketed in measured doses such as capsules, pastilles, tablets, pills and sachets of powder, or in liquid preparations (ampoules, drop-dispensing bottles).
These supplements are presented as products that contribute to improving consumers' nutritional intakes, or that help them lose weight, prepare them to face winter, improve digestion, maintain healthy hair, reduce the discomforts of pregnancy or menopause, etc.
How are food supplements consumed in France?
In recent years, the French have been using them more and more.
The Second Individual and National Study on Food Consumption (INCA), carried out in 2006-2007, collected information for the first time in metropolitan France on the use of food supplements by adults and children aged 3 and over.
The results of INCA 3, conducted in 2014-2015, showed that the consumption of food supplements and medicinal products that are sources of nutrients doubled between the two studies, both in children between 3 and 17 years of age, and in adults.
According to the INCA 3 study, 22% of adults and 14% of children take food supplements. On the basis of a broader definition that includes medicinal products that are sources of nutrients, these rates are 29% and 19% respectively.
The annual duration of a course of food supplements is on average four and a half months in adults and two and a half months in children, but this varies greatly from one person to the next. This reflects the wide disparity in behaviour with regard to these products.
In adults, the highest consumers are women, individuals age 18 to 44 years, and those with a high level of education. Seasonal consumption is also observed, with consumption being higher in winter.
It should be noted that food supplements are mainly purchased in pharmacies, although Internet purchases have increased sharply among adults since 2015, from 1% to 11%.
How are food supplements regulated?
Unlike medicines, the sale of food supplements does not require marketing authorisation.
These products must be declared to the Directorate General for Competition, Consumer Affairs and Fraud Control (DGCCRF), which examines their composition and carries out tests in the same way as for other categories of foodstuffs.
Several European and French regulatory provisions have laid down lists of authorised ingredients in food supplements: vitamins, minerals and plants, as well as the maximum daily doses not to be exceeded for vitamins and minerals. These lists can be consulted on the DGCCRF website.
A food supplement is not a medicine, so it cannot, by definition, claim any therapeutic effect. In addition, any nutrition and health claims made on products are subject to strict European regulations. A limited number of health claims are currently authorised; the list can be viewed on the European Commission website.
The manufacturer is responsible for ensuring that food supplements placed on the market comply with the regulatory provisions in force, in terms of both consumer safety and information.
Are food supplements necessary?
Inadequate nutrient intakes and, more seriously, deficiencies, are very rare in the general population and only occur with vitamin D.
Generally speaking, in the absence of disease, all nutritional requirements can be met by a varied and balanced diet and a physically active daily life. The consumption of food supplements is then not necessary.
On the other hand, nutrient deficiencies are more likely to affect specific population groups with greater requirements or inadequate intakes, such as pregnant women, children, the elderly, etc.
In addition, certain dietary behaviours can lead to some people reducing or even eliminating their consumption of foods that are sources of essential nutrients. For example, a vegan diet is completely lacking in vitamin B12, which is only found in foods of animal origin. Similarly, a diet that excludes fish and seafood will not meet requirements in EPA and DHA (long-chain polyunsaturated fatty acids).
More generally, an insufficiently varied diet exposes people to the risk of inadequate coverage of nutritional requirements. In these specific cases, the use of food supplements may be warranted. Seeking the advice of a healthcare professional is then strongly recommended.
How can we limit the health risks when taking food supplements?
With the consumption of food supplements containing vitamins and minerals, there may be a risk of exceeding the upper intake levels, even more so when fortified foods are also included in the daily diet.
Generally speaking, to limit the risks associated with the consumption of food supplements, here are five tips you can follow:
- Seek the advice of a healthcare professional
- Avoid taking them on a prolonged, repeated or multiple basis
- Comply with the conditions of use
- Exercise vigilance with products making miraculous claims
- Choose products sold via trustworthy channels
What is the Agency doing to prevent risks associated with the consumption of food supplements?
In 2009, ANSES set up a nutrivigilance scheme to monitor the adverse effects associated with the consumption of food supplements, as well as other food products such as fortified foods, novel foods and foods intended for particular diets (infants, patients suffering from food intolerances, etc.).
This scheme is used to identify and collect adverse effects reported by healthcare professionals (mainly doctors and pharmacists), manufacturers or distributors and individuals, thus helping to improve consumer safety.
ANSES uses these data to carry out expert appraisals to assess the risks associated with the consumption of these products and issue recommendations. ANSES has now published numerous opinions on various products, such as so-called energy drinks and different food supplements (containing red yeast rice or melatonin, for example).
It is also regularly called upon to assess the risks associated with the presence of certain ingredients in food supplements. Where appropriate, this work enables maximum levels to be set for food supplements (e.g. 20 mg/day of p-synephrine).