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Nutrition and dietary supplements.

C M Fillmore1, L Bartoli, R Bach

  • 1Pendleton Community Care, Franklin, West Virginia, USA.

Physical Medicine and Rehabilitation Clinics of North America
|October 12, 1999
PubMed
Summary

Glucosamine and chondroitin sulfate show promise for osteoarthritis treatment. Many dietary supplements lack sufficient evidence or have safety concerns, necessitating further research before widespread use.

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Area of Science:

  • Nutrition and Dietetics
  • Sports Medicine
  • Cardiovascular Health

Background:

  • The efficacy and safety of many nutritional and dietary supplements are not well-established due to variable study quality and subject numbers.
  • While some supplements show promise, many lack robust clinical trial data, raising concerns about their suitability for public use.
  • Existing research highlights both potential benefits and significant risks associated with various supplements, underscoring the need for rigorous evaluation.

Purpose of the Study:

  • To evaluate the scientific evidence supporting the use of various nutritional and dietary supplements for different health conditions.
  • To identify supplements with sufficient clinical trial data to support their efficacy and safety.
  • To highlight areas where further research is critically needed for supplements with potential benefits but insufficient evidence.

Main Methods:

  • Systematic review of blinded controlled clinical trials for nutritional and dietary supplements.
  • Analysis of study quality, subject numbers, reported efficacy, and adverse events.
  • Comparison of supplement evidence against established medical treatments and guidelines.

Main Results:

  • Glucosamine sulfate and chondroitin sulfate have sufficient evidence for osteoarthritis treatment, with fewer side effects than NSAIDs and disease-modifying potential.
  • Ephedrine and phenylpropanolamine show promise for weight loss but have associated safety concerns and fatalities.
  • Chromium and creatine lack sufficient evidence for efficacy in bodybuilding and weightlifting, respectively.
  • Folic acid, vitamin B6, and B12 show potential for hyperhomocysteinemia, but require controlled trials.
  • Soluble fiber demonstrates efficacy in lowering cholesterol levels.
  • Vitamin E data is conflicting, with some studies showing benefit in cardiovascular disease prevention and restenosis, while others show no effect.

Conclusions:

  • Glucosamine sulfate and chondroitin sulfate are supported by sufficient evidence for osteoarthritis management.
  • Many popular dietary supplements, particularly for weight loss and athletic performance, lack robust scientific backing and pose potential safety risks.
  • Supplements like folic acid, soluble fiber, and vitamin E, with low toxicity and some supporting evidence, may be considered for use while awaiting further trials.
  • Rigorous clinical trials, similar to those required for pharmaceuticals, are needed to establish the safety and efficacy of most dietary supplements before public recommendation.

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