Dietary supplements: business and utility

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Section 4. Pharmaceutical sciences
Petrella Alessandro, Dr., Expert in Regulatory Affairs E-mail: petrella. ale@libero. it
Dietary Supplements: business and utility
Abstract: The use of dietary supplements is rapidly increasing but, are we using them in a proper way? Are they really useful for us?
Keywords: Dietary supplements, Business, Pharmaceutical distribution, USPSTF, Disease prevention.
On the occasion of the conference & quot-Global trends, Regulation and Innovation in Food Supplement Products& quot- held last May 29 by FederSalus and Parco Tecnologico Padano, the experts showed a panoramic of the global nutritional supplement industry. The surveys demonstrate that between 2009 and 2014 the Vitamins, Minerals, Supplements (VMS) sector doubled its worldwide turnover, reaching in 2014 a global market value of 66 billion euro [1]. The states determining the 65% of the total value markets are US, China, Japan, South Korea and Italy which in perspective will continue growing in the period between 2014 and 2019: in particular, it is estimated an average annual growth between 0.8% and 0. 9% for South Korea and Japan, 2.9% for the US and 4.2% for Italy [6]. The market that will grow more than the others is the Chinese, with an average annual rate of 4.9%. Between 2009 and 2014, the VMS sector has doubled its worldwide turnover, reaching the threshold of 88 billion dollars. In the United States, which are the largest market of reference for the sector, there are 85 thousand different types of supplements in pills, powders and elixirs of health. In relation to the kind of supplements used, over the past five years, the US and Canada showed the highest growth in absolute terms of probiotics, followed by fish oils oils/omega fatty acids and multivitamins [6]. The most purchased category in Europe is that of the vitamins: while in the European countries the most purchased and sold category is that of the probiotics, followed by the combinations
of vitamins and minerals, in the Eastern European countries excel product combinations, followed by multivitamins and probiotics. The pharmacies and drugstores, which are the traditional sales channel, are confirmed to be the prevalent channels (62%). Non-traditional channels such as the internet began to take on a certain importance (17%) with a growing trend. Milk enzymes, multivitamins and mineral supplements are the top products sold in pharmacies, while sports supplements, dietary supplements and multivitamins the most sold in the modern channels. On the podium of the people who love food supplements are Italy, Russia and Germany, although even in Eastern Europe, the sector grew by 15% in recent years. In Italy, in the period between April 2014 and March 2015, the food supplements market produced nearly 2.5 billion euros value with 170.5 million packs sold. Compared to 2014, the average price to the public raised by 0.6% in the pharmaceutic channel with a value of 15. 04 euro, while it remained stable in the supermarkets (-0.4%) amounting to 6. 14 euro [8- 9]. Moreover, the 80% of the population used at least one dietary supplement in the last year (+15% since 2012). Among the reasons for this choice, next to & quot-tone and reinforcement& quot- (38%), there are the needs for & quot-care"- (40%) and & quot-prevention"- (39%), especially among the over 65 women. In fact, the women confirm their prevalence in the consume of supplements (58% of the total), although the number of man who use them (42%) is growing. The
Dietary Supplements: business and utility
use of supplements for tone and the reinforcement mainly affects young people (20%) that aim to improve the physical and cognitive performances and the immune defense [9- 10]. The overall European dietary supplement market is projected to grow by around 9.5% in the next few years — hitting an estimated 7.9 billion euro market value by 2020. The global food supplement market is estimated to reach 250 billion dollars in 2018 with a CAGR of 7% over the forecast period [8- 10]. The cake is shared among many small companies and a few large corporations. Pharmaceutical giants like Pfizer and Bayer focused on the sale of multivitamins filling the television advertising space during the summer. In the Pantheon of the multivitamins there are also the Japanese Pharmavite, which produces 15 million pills a day, and Perrigo, which specialized in vitamins and pro-biotics. Not to mention the specialized in door to door sales as Amway and Herbalife [5- 8].
In short, every day we take millions of tablets, sachets, capsule elixirs to improve our quality of life with the belief that these multivitamins may be the right remedy for any circumstance. Even when we do not need them, we often use supplements for a support which is more mental than physical! But, is this use of multivitamins good for us or is it good only for the manufacturers?
The substantial effect of cardiovascular disease and cancer on health status and mortality in the United States has been well described, and many supplements are promoted to prevent these conditions [12].
Nonetheless, high supplement usage, fueled by industry claims ranging from wrinkle to cancer prevention, has resulted in a continued rise in nutritional supplement sales, estimated to be approximately US $ 30 billion annually [7]. In the US, the Preventive Services Task Force met to evaluate the hypothesis that a regular intake of supplements decreases the risk of heart disease or cancer, coming to the conclusion that there is currently no evidence
supporting it, and we should pay attention to the potential risks arising from the use of drugs. In fact, there are several known adverse effects caused by excessive doses of vitamins- for example, the use of beta carotene in persons who smoke tobacco or have an occupational exposure to asbestos can increase the risk of lung cancer- moderate doses of vitamin A supplements may reduce bone mineral density, but high doses may be hepatotoxic or teratogen-ic [11- 3]. However, the vitamins reviewed by the US Preventive Services Task Force had few known risks [3- 4]. Nevertheless many of these vitamins are fat soluble, the lifetime effect of high doses should be taken into consideration.
In addition to what already said, in a forum held the American Association for Cancer Research (AACR) during the Annual Meeting of 2015 at the University of Colorado, Tim Byers, the investigator of the Cancer Center, describes research showing that over-the-counter supplements may actually increase cancer risk if taken in excess of the recommended daily amount. Evidence show that people who take more dietary supplements than needed tend to have a higher risk of developing cancer, explains Byers [2- 3].
The line of research started 20 years ago with the observation that people who ate more fruits and vegetables tended to have less cancer. Researchers including Byers wanted to see if taking extra vitamins and minerals would reduce cancer risk even further [3- 4].
& quot-When we first tested dietary supplements in animal models we found that the results were promising& quot-, says Byers. & quot-Eventually we were able to move on to the human populations. We studied thousands of patients for ten years who were taking dietary supplements and placebos& quot- [3- 4]. As recommended by the associate director at the University of Colorado Cancer Center, we can say that people can get the daily recommended doses of vitamins and minerals in their diets by eating healthy meals and many adults who take vitamin supplements may not need them.
1. Euromonitor Internatioal: Vitamins and Dietary Supplements in the US/25. 01. 16. //[Electronic resource]. — Available from: http: //www. euromonitor. com/vitamins-and-dietary-supplements-in-the-us/report
2. Bayers T. Dietary supplements and cancer prevention: balancing potential benefits against proven harms. //Journal of the National Cancer Institute. 23. 01. 16. //[Electronic resource]. — Available from: http: //www. ncbi. nlm. nih. gov/pubmed/22 534 785
3. Tim Bayers University of Colorado Cancer Center, Dietary supplements shown to increase cancer risk. — 23. 01. 16//[Electronic resource]. — Available from: http: //www. coloradocancerblogs. org/di-etary-supplements-shown-to-increase-cancer-risk/
4. University of Colorado Cancer Center. & quot-Excessive use of dietary supplements linked to increase cancer risk. "- ScienceDaily. ScienceDaily, 20 April 2015. //[Electronic resource]. — Available from: http: //www. sciencedaily. com/releases/2015/04/150 420 182 403. htm.
5. Bottero G. Health Tips, in Italy there is a boom of dietary supplements. // La Stampa: Torino, 11. 08. 15//[Electronic resource]. -Available from: www. lastampa. it/2015/08/11/italia/ cronache/ benessere-in-pillole-in-italia-boom-di-integratori-alimentari-Xirild9LKnsjE6bWHz7wIJ/pagina. html
6. Gray Nathan. Number cruncher: Europe'-s key supplement markets, brands & amp- opportunities revealed. — 22. 09. 15//[Electronic resource]. — Available from: http: //www. nutraingredients. com/Mar-kets-and-Trends/Number-cruncher-Europe-s-key-supplement-markets-brands-opportunities-revealed
7. Pieter A. Cohen, M. D. Cambridge Health Alliance, Somerville, MA- and Harvard Medical School, Bos-ton. /Hazards of Hindsight — Monitoring the Safety of Nutritional Supplements. //The New Engalnd Journal of Medicine. — 2014. — 370: 1277−1280. -April 3, 2014. — DOI: 10. 1056/NEJMp1315559.
8. Salus Feder. Global Trends in the market for food supplements: a comparison between the US and Europe. — 22. 01. 16//[Electronic resource]. — Available from: http: //www. federsalus. it/news. php? id=1385
9. Cecchini I., Director Department Health Research Gsk Eurisko. The guidelines ofthe consumer to the dietary supplements: logic ofconsumption and rolepharmacist. — Bologna, 09. 05. 14//[Electronic resource]. — Available from: http: //www. cosmofarma. com/wp-content/uploads/2014/05- www. cosmofarma. com/Cec-chini_GfK-EuriskoBologna-9-Maggio-Cosmofarma. pdf
10. Euromonitor Research. Georgij Grebinskij — Research Analyst. Presentation Topic: Food Supplements: Global Market Trends — EU vs USA. — 29. 05. 15. //[Electronic resource]. — Available from: http: //blog. euromonitor. com/2015/05/euromonitor-to-speak-at-federsalus-2015. html
11. Fortmann Stephen P., MD. Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer//Rockville (MD): Agency for Healthcare Research and Quality (US). — 2013, Nov. — Report No.: 14−5 199-EF-1
12. Denham B. E. Dietary supplements — regulatory issues and implications for public health. //JAMA. -2011, Jul 27. — 306 (4): 428−9. doi: 10. 1001/jama. 2011. 982. Epub, 2011, Jul 5. //[Electronic resource]. -Available from: http: //www. ncbi. nlm. nih. gov/pubmed/21 730 229

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