Dietary Supplements: What the Science Says

Do You Actually Need Supplements?

Supplements are additions, not replacements for a balanced diet. Supplements are exactly that: supplements. No pill replaces a balanced diet, adequate sleep, and regular exercise.

According to the Federal Food Safety and Veterinary Office (FSVO), dietary supplements are not a substitute for a varied diet. For healthy people with a varied and balanced diet, they are generally not necessary.

Which Nutrients Have Approved Health Claims?

Vitamin D

Evidence: Vitamin D contributes to the normal function of the immune system (approved health claim).

Need in Switzerland: In late autumn, winter and early spring, solar radiation is too weak for the skin to produce sufficient vitamin D (FOPH, 2021). In a Swiss population study (2010 to 2011), 61.6% of adults had a blood vitamin D concentration below 20 ng/ml, equivalent to 50 nmol/l, from January to March (Guessous et al., 2012).

Dosage: The Swiss Federal Commission for Nutrition recommends 600 international units (IU) of vitamin D per day for people up to the age of 60 (FOPH, 2021). Whether a dietary supplement is appropriate should be discussed with your doctor. EFSA gives a tolerable upper intake level of 100 µg (4000 IU) per day for adults.

Creatine

Approved health claim: Creatine increases physical performance in successive bursts of short-term, high intensity exercise (EFSA, 2011). The beneficial effect is obtained with a daily intake of 3 g of creatine.

The ISSN Position Stand (Kreider et al., 2017) cites no compelling evidence of harmful effects of creatine monohydrate in healthy individuals, not even with long-term use.

Dosage: 3g of creatine monohydrate daily. A loading phase is not necessary. Why the quality of the raw material is decisive here is explained in the article Creatine: Why Quality Matters.

Myth: There is no evidence in humans of a link between creatine and hair loss (Antonio et al., 2021). The assumption goes back to a single study (van der Merwe et al., 2009): it measured elevated DHT levels in rugby players, but no hair loss, and has not been repeated to date (Antonio et al., 2021).

Omega-3 Fatty Acids (EPA/DHA)

Approved health claim: EPA and DHA contribute to the normal function of the heart. The beneficial effect is obtained with a daily intake of 250 mg of EPA and DHA.

For whom: Individuals with low fish consumption.

Dosage: 250 mg of EPA and DHA combined daily. Pay attention to quality (avoid oxidation).

Protein Powder

Evidence: Two approved health claims: “Protein contributes to a growth in muscle mass.” and “Protein contributes to the maintenance of muscle mass.”

For whom: Individuals who struggle to meet their protein requirements through regular meals alone. You can calculate your individual requirements with the protein calculator.

What to look for:

• Minimal additives
• No artificial sweeteners
• For plant-based proteins: combination of different sources

Caffeine

Safety: According to EFSA, single doses of up to 200 mg of caffeine (around 3 mg per kg of body weight) and a total intake of up to 400 mg per day from all sources do not raise safety concerns in healthy adults.

Other Nutrients

Vitamin B12

For whom: Vegans (essential according to the SGE), vegetarians (can be useful).

Approved health claim: Vitamin B12 contributes to normal functioning of the nervous system. According to the Swiss Society for Nutrition (SGE), it is essential to supplement vitamin B12 on a vegan diet.

Iron

Important: Only supplement with confirmed deficiency. Excess iron can cause oxidative stress (Galaris et al., 2019).

For whom: Menstruating women, endurance athletes, vegetarians/vegans - after a blood test.

Magnesium

Approved health claims: Magnesium contributes to normal muscle function. Magnesium contributes to a reduction of tiredness and fatigue.

Dosage: For magnesium from dietary supplements, EFSA gives a tolerable upper intake level of 250 mg per day for adults. In a study with 46 participants, organic forms (citrate, amino acid chelate) were absorbed better than magnesium oxide (Walker et al., 2003).

Quality Indicators

Look for:

• Transparent dosage information
• Independent quality certificates (e.g. Informed Sport, NSF)
• No “Proprietary Blends” (hidden dosages); more on this in the article Fairy Dusting
• Realistic, not exaggerated claims

Conclusion

According to the FSVO, dietary supplements are generally not necessary for healthy people with a varied and balanced diet. Invest first in high-quality food, good sleep, and a well-designed training programme.

Further Reading

• Creatine: Why Quality Matters
• Problematic Additives in Dietary Supplements
• Fairy Dusting: When Supplements Only Work on the Label
• How Much Protein You Really Need

Sources:

• Federal Food Safety and Veterinary Office FSVO. Dietary supplements: basics and legal aspects (in German). blv.admin.ch
• Federal Office of Public Health FOPH (2021). Vitamin D and sunlight. Fact sheet, 9 June 2021. Bern: FOPH (in German). bag.admin.ch
• Guessous I, Dudler V, Glatz N, Theler JM, Zoller O, Paccaud F, Burnier M, Bochud M (2012). Vitamin D levels and associated factors: a population-based study in Switzerland. Swiss Medical Weekly, 142, w13719. DOI: 10.4414/smw.2012.13719
• EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) (2011). Scientific Opinion on the substantiation of health claims related to creatine and increase in physical performance during short-term, high intensity, repeated exercise bouts (ID 739, 1520, 1521, 1522, 1523, 1525, 1526, 1531, 1532, 1533, 1534, 1922, 1923, 1924), increase in endurance capacity (ID 1527, 1535), and increase in endurance performance (ID 1521, 1963) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal, 9(7), 2303. DOI: 10.2903/j.efsa.2011.2303
• Kreider RB, Kalman DS, Antonio J, Ziegenfuss TN, Wildman R, Collins R, Candow DG, Kleiner SM, Almada AL, Lopez HL (2017). International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14, 18. DOI: 10.1186/s12970-017-0173-z
• Antonio J, Candow DG, Forbes SC et al. (2021). Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? Journal of the International Society of Sports Nutrition, 18(1), 13. DOI: 10.1186/s12970-021-00412-w
• van der Merwe J, Brooks NE, Myburgh KH (2009). Three weeks of creatine monohydrate supplementation affects dihydrotestosterone to testosterone ratio in college-aged rugby players. Clinical Journal of Sport Medicine, 19(5), 399-404. DOI: 10.1097/JSM.0b013e3181b8b52f
• Galaris D, Barbouti A, Pantopoulos K (2019). Iron homeostasis and oxidative stress: An intimate relationship. Biochimica et Biophysica Acta, Molecular Cell Research, 1866(12), 118535. DOI: 10.1016/j.bbamcr.2019.118535
• Walker AF, Marakis G, Christie S, Byng M (2003). Mg citrate found more bioavailable than other Mg preparations in a randomised, double-blind study. Magnesium Research, 16(3), 183-191.