Even the famed “Super Mouse” would be proud to observe how well his advice has aged. His words – “…and don’t forget to super-vitaminize and mineralize” – resonate today as we enjoy unprecedented access to food.
Despite this abundance, more and more people are turning to supplements, a trend increasingly supported by healthcare professionals. This shift in thinking comes as research questions the necessity and safety of widespread supplementation.
Science indicates that supplement use is often unnecessary, can be costly, and isn’t without risks. Concerns also exist regarding potential illegal practices by those promoting these products. This raises important questions about consumer safety and the reliability of health claims surrounding supplements.
However, supplementation remains appropriate in specific, well-defined situations, such as secondary deficiencies – where proper digestion, absorption, transport, or utilization of a nutrient is impaired despite adequate intake – vegetarianism, or pregnancy. These cases are not under debate.
A Historical Perspective
The foundations of modern physiology were laid in the early 20th century, with the identification of various substances and their functions. Thiamine, the first vitamin, was identified around 1910, and cobalamin was discovered in 1948. This era was marked by widespread hunger and nutritional deficiencies due to wars, economic downturns, and depressions, justifying the rise of supplementation as a means to address these critical needs.
Today, the situation should be different. Supplements don’t offer anything we can’t obtain from a plentiful food supply. Yet, marketing has perpetuated a belief that focusing on individual nutrients is more important than the food itself, a trend that has continued for seven decades – a phenomenon described as “nutricionism.”
Legal Framework
Commonly known as “supplements” and legally defined as “food supplements,” these products are subject to food regulations. Contrary to popular belief, they cannot be marketed with claims exceeding those permissible for regular foods. This contrasts with the widely held – but inaccurate – Hippocratic view that “food is medicine,” as supplements are not legally considered medications.
However, supplements benefit from a marketing advantage: their presentation in capsules, tablets, powders, and liquids often resembles pharmaceuticals. This packaging, combined with certain advertising messages, can lead consumers to believe they are purchasing remedies for conditions like fatigue, hair loss, weakness, impotence, obesity, joint pain, or menopause.
Crucially, unlike drugs, supplements do not require proof of clinical efficacy for market authorization. Compliance with food legislation, the same standards applied to apricot jam, is sufficient. As outlined in RD 1487/2009, companies producing supplements are subject to the General Register of Food Establishments.
Potential Risks
A recent study involving over 20,000 supplement users found no objective data to support their use. Whereas participants reported feeling better, these subjective improvements weren’t reflected in any analyzed variables. However, the lack of effectiveness is less concerning than the potential for harm.
Due to limited quality control – unlike pharmaceuticals – supplements may contain undeclared substances, incorrect dosages, or even pharmaceuticals, resulting in adulterated products. For example, over 80% of “natural” supplements marketed for sexual performance have been found to contain intentionally added phosphodiesterase 5 inhibitors, while over 20% of “natural” weight loss supplements contained sibutramine.
a review found adulteration with doping substances in 14-50% of samples of sports performance supplements. These examples highlight the public health risk posed by the limited oversight of supplements.
The Business Model
A vast ecosystem of manufacturers and laboratories offers a wide range of ready-made supplements. This differs from the traditional pharmaceutical model, where companies market their own products. Instead, companies sell formulations to others who brand them with their own image. These intermediaries provide catalogs of pre-designed formulations and offer customization of packaging, labeling, and advertising, centralizing the business around the brand’s public face.
The Belgian non-profit organization Journalismfund Europe, dedicated to investigative journalism, highlighted this structure, revealing how easy This proves to launch a supplement line in a matter of days. Their study was titled The ‘influencer’ as pill pusher.
The process is straightforward: selecting product categories like sports supplements (creatine and whey protein are popular), vitality boosters (such as magnesium bisglycinate), or preparations for inflammation or women’s health. The manufacturer then handles the technical and regulatory aspects, while the visible brand – often an influencer – focuses on promotion, typically on social media.
The key point is that, legally, these products are regulated as food, not medicine: demonstrating efficacy is not required. Registration as a food business operator and compliance with tax obligations are necessary, but no specific health qualification is needed to market your own supplement brand.
The inherent value of a supplement lies in the narrative: promises of “high quality,” “unique formulations,” or “premium ingredients” aim to differentiate virtually identical products. In this market, the ability to create an appealing story around supplements often outweighs proof of their effectiveness.
The Problem
Ninety percent of health claims made by influencers promoting supplements on Instagram are unsubstantiated, according to an evaluation by an official German food control center. These claims are also illegal under EU law, specifically Regulation 1924/2006, which explicitly prohibits (Article 12) commercial recommendations from healthcare professionals.
In Spain, nearly half of the resolutions and opinions issued by Autocontrol, the advertising self-regulatory body, in the last year were related to violations involving influencers. The latest involved a pharmaceutical company being cited for promoting a supplement “for immunity” in violation of three regulations: Regulation 1924/2006, Royal Decree 1907/1996 on health-related advertising, and Law 17/2011 on food safety and nutrition.
The problem is that today the capacity for effective oversight is far behind the volume of messages on social media and other platforms, meaning most of these illegal acts proceed unnoticed and few are ever prosecuted.
