Supplementation means gains for tax payer's pocket and health

Supplementation by US consumers could save the state $15 billion in health costs according to a study published last week. Philippa Nuttall spoke to Elliott Balbert, president of the Dietary Supplement Education Alliance (DSEA), about what this research really means and why he remains wary about fortified foods.

The study, commissioned by the DSEA and carried out by the Lewin Group, discovered that daily use of calcium by people over the age of 65 would save $13.9 billion over five years - by reducing hip fractures - and daily use of folic acid among women would save $1.3 billion over five years from prevented birth defects.

Omega-3 fatty acids, glucosamine and saw palmetto supplements, which have been around for less time and involved in less research, also showed substantial promise for improving health and quality of life and potentially reducing health care costs.

As far as Elliott Balbert was aware, this was the first time that supplements had been quantified in terms of healthcare, as "savings for the tax payer".

More importantly, he noted that if certain health problems could be avoided by using supplements then the quality of people's lives would be improved. As Balbert stressed this is particularly important in the case of folic acid and its ability to reduce birth defects.

Among other things, he wanted this research to be used to urge congress to support certain bills, which would encourage the use of supplements.

"For example, there is a bill that would allow food stamps to be used to buy dietary supplements," he said, adding that they can be used to buy candy, so why not nutritional supplements.

However, Balbert does not believe that legislation is enough to get the supplementation messages out to the American people. He also thinks that doctors need to have preventative training so that they understand supplements and are thinking as much about preventing diseases as they are about curing them.

The consumer media has been full recently of articles about the problems that can ensue when herbals interact with prescription drugs; greater emphasis on the use of supplements seems to imply greater risk for the consumer. But, Balbert says that it is the responsibility of the individual to check what they are taking and why, as they would with OTC drugs.

"Where there is known information it should be displayed on the bottle, but it is not realistic to think that every supplement can be tested against every drug," he said. Likewise, just because there have been a few problems, he is frustrated that some people may try to tar all supplements with the same brush.

As far as fortified foods and the role they have to play in the nation's health are concerned, Balbert thought there should be more dose specific functional foods, but expressed concern that consumers are not sure to receive the required dose if it is not clearly explained.

While this research is specific to the US and there are no immediate plans to carry out similar research in Europe or Asia, it would obviously be interesting to see how much money and lives could be saved globally through supplementation.

Speaking at this year's World Economic Forum, current chair of GAIN Jay Naidoo, also chairman of the board of the Development Bank of Southern Africa, said that if wheat flour was fortified in the 75 most needy countries with iron and folic acid, iron deficiency could be reduced by 10 per cent, and birth defects could be lowered by a third.

Such fortification would cost a total of about $85 million, or about 4 cents per person, he said.

"As a result, we estimate these countries would gain $275 million in increased productivity and $200 million from the enhanced earning potential," Naidoo claimed. "There are many other examples to emphasize that public-private partnerships to invest in food fortification are investments not only in health, but also in national economies."

Also, recent report from the Copenhagen Consensus, a panel of eight of the world's most distinguished economists, included fortification programmes as one of its top priorities for facing global challenges.