Sunday Times

Magic bullets

Are we right to pop till we drop?

- By SHANTHINI NAIDOO

Every morning, a handful of pills goes down with my breakfast. A soft golden oval of evening primrose oil, a too-large vitamin C tablet, a bitter echinacea pill, then two capsules: magnesium and a probiotic. Once a month, there’s a nuclear red and extremely painful shot of vitamin B12.

None of these is swallowed for medical reasons, but out of a belief in their prophylact­ic properties based on the recommenda­tions of doctors and our trusty online friend Dr Google.

Am I superhuman at the end of all this?

Probably not, but along with millions of people around the world who are pill-popping for prevention, I do it to feel healthier and theoretica­lly live longer.

A study this year showed that South Africans now spend R5-billion a year on vitamins and supplement­s, a figure that has grown about 13% a year since 2012.

Taking an anti antibiotic­s stand

Globally, the vitamin and dietary supplement market was valued at $132.8-billion in 2016, with at least 9% annual growth, says Yashvir Maharaj, research director of Insight Survey, the company that produced the local report.

He says South Africans are leaning increasing­ly towards natural alternativ­es to convention­al drugs.

“Google seems to be our medical friend. People are also purchasing more online, going on ratings of how well vitamins and supplement­s work for others,” says Maharaj.

His survey showed that in South Africa, the most popular dietary supplement­s include echinacea, ginkgo, evening primrose oil and garlic. Besides herbs we favour probiotics, calcium and fish oils with omega complexes, which are said to be good for cholestero­l management and brain function.

Flu-fighter vitamin C is our most-consumed single vitamin, says Maharaj.

So I am not alone in believing that we can avoid colds and flu with the immune-boosting vitamin C and echinacea and keep my premenstru­al symptoms at bay with magnesium and evening primrose oil.

Money well spent?

Probiotics are an all-rounder; those who advocate them say good gut health is vital to fixing everything from depression to acne, and boosts the immune function. Vitamin B12 is for cell developmen­t and energising tired bodies, and who doesn’t need that?

“If we look at the growth in spend every year from 2014 to 2017, it shows just how serious South Africans are about their health despite a strained economy,” Maharaj says.

“It is stimulated by an ageing global population and increased focus on health, wellness and preventati­ve healthcare. Interestin­gly, the global market has managed to appeal to all consumer segments with no discrimina­tion in terms of dietary habits, culture, age or gender.”

Locally, it is middle-class consumers who seem to turn to preventati­ve medicine, probably because of the expense.

But dietitian Lila Bruk says certain vitamin supplement­s are “quite ubiquitous” across income groups. “For example, folic acid is generally not expensive and is prescribed to all pregnant women to prevent neural tube defects.”

Just eat your veggies

But do they work?

This is the subject of fierce debate among medical profession­als, many of whom believe a well-balanced diet will provide everything a person needs for good health.

And there is a danger of overdosing or mixing the wrong tinctures and tonics.

“There is definitely the misconcept­ion that because a supplement is ‘natural’ that it’s safe,” says Bruk.

“This is certainly not the case. St John’s Wort, which is used as a form of ‘natural antidepres­sant’, can interfere with the contracept­ive pill and bloodthinn­ing medication,” she says.

“There is the risk of toxicity with taking excessive amounts of certain vitamins and minerals. It is always important to choose vitamin and mineral supplement­s that are as close as possible to 100% of the recommende­d daily allowance, rather than taking mega doses of the nutrient. When it comes to supplement­s, more is not necessaril­y better.”

Dr Ela Manga, an “integrated health” medical doctor, says, however, that “many of the supplement­s do work, and very powerfully”, if you get it right.

“Our modern diets are so deficient in vitamins and minerals and full of processed food that supplement­s are often necessary to support the body to do what it has been designed to do,” says Manga.

Raised eyebrows at the medical aid provider

“However, not all supplement­s are of the same quality. How efficaciou­s a supplement is is dependent on the quality of the ingredient­s, dosage and manufactur­ing process. They should also not be used indiscrimi­nately.”

Dr Noluthando Nematswera­ni, who heads the clinical policy unit at Discovery Health, says the medical aid provider does not encourage members to take vitamins and supplement­s that have not been clinically prescribed. “We know multivitam­ins are popular from our member data, and they are certainly marketed well. But look for clinical details before you take something. What are the trials saying? Have there been clinical trials?”

Manga agrees. She says the ideal is that supplement­s should be prescribed by a health profession­al who knows what works, and why.

The breakfast cocktail can then be personalis­ed.

While some pharmaceut­ical drugs are necessary, there are others that are designed to suppress symptoms and work against the body’s natural healing ability and lead to many side effects Dr Ela Manga, explaining the popularity of alternativ­es

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Illustrati­on: Keith Vlahakis

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