Do you know the difference between a Dietary Supplement and a Food Label?
Take a look at the labels on your sports nutrition products. As long as you have a variety of brands, you are likely to notice that the labels you see are different. Some labels say “Nutrition Facts” in bold at the top, while other products say “Supplement Facts.” The products with “Nutrition Facts” are Food labels and, thus, food products. Those with “Supplement Facts” are Dietary Supplements. There are distinct differences between these two labels in term of the definition of products and regulation.
Food Labels (Nutrition Facts)
Food labels are placed on food and beverage products in the United States that have met certain criteria. These products have a Nutrition Facts label and must contain ingredients that are generally regarded as safe (GRAS) or formally approved by the FDA. The ingredients listed on a food label must also come in quantities that the FDA has deemed to be GRAS.
Dietary Supplements (Supplement Facts)
According to the Dietary Supplement Health and Education Act of 1994, the definition of Dietary Supplement is:
A product (other than tobacco) intended to supplement the diet that bears or contains one of more of the following dietary ingredients: a vitamin; a mineral; an herb or other botanical; an amino acid; a dietary substance for use by man to supplement the diet by increasing the total dietary intake; or a concentrate, metabolite, constituent, extract, or combination of any ingredient described previously.
Unlike new drugs, dietary supplements do not have to be vetted for safety or efficacy prior to being sold. The only time supplement manufacturers must notify the FDA prior to distribution is if they are using an ingredient not marketed prior to Oct. 15, 1994. For supplements using previously-distributed ingredients, the FDA only takes action against the manufacturer after they have evidence that the product is unsafe. This generally happens after the product has been in the marketplace and has been sold to consumers.[i] One example of a product that was deemed unsafe after being sold to numerous individuals was Ephedra. The FDA only intervened in 2004 after this supplement caused numerous health issues in susceptible individuals, including death. More recently, dimethylhexanamine (DMAA) has been implicated in causing liver toxicity in individuals who took the weight loss supplements Hydroxycut and OxyElitePro[ii].
Simply put, Food Labels have higher standards than Dietary Supplements. This is important for athletes to consider when making a choice on nutrition.
Contamination Rates in Supplement Studies
In 2004, the IOC performed a study in which they tested 634 supplements for contamination with banned substances. They found that 15% of the supplements contained hormones or prohormones not listed on the label. In fact, 20% of the products advertising that they contained prohormones also contained additional unlisted prohormones. Furthermore, 10% of the supplements from companies that did not sell steroid-containing supplements were also positive for banned substances. Since the 2004 study emerged, other researchers and supplement auditors have reported additional cases of inaccurate product labeling, contamination, and deliberate adulteration.ii
Dietary Supplements and Athletes
The most important thing for an athlete to understand is that you are responsible for what is in your body. This is important in terms of drug tests and your health. A drug test does not differentiate between an athlete who purposefully took a banned substance or an athlete who accidentally ingested a contaminated supplement. The bottom line is that if the drug test is positive, you can lose your ability to compete. Furthermore, you want to protect your health. Thus, it is important to pay attention to whether a supplement is safe, pure, and serves the purpose you expect it to serve.
Things to Consider Before Choosing to Take a Supplement
In some cases, dietary supplements do serve a purpose. For example, a dietary supplement might help to correct a deficiency or offer another food source for an efficient means of increasing a nutritional need. The key is to limit your use of supplements to cases when it is absolutely necessary. If you eat a variety of nutrient-dense foods, chances are you won’t need a supplement. In some cases, you can also eat certain food sources to correct minor deficiencies. This is where working with a sports dietitian is beneficial.
Before taking a supplement, you should ask yourself: Is it safe? Is it legal? Is it effective? Do I REALLY need to take this or are there other ways to get this nutrient (i.e., food)? Can I afford it (in general, food provides superior nutrients to a supplement at a much lower cost)?
What if a Person Requires a Supplement?
Sometimes, I see athletes who do need a supplement to correct a deficiency, such as an iron deficiency. In other cases, an athlete might follow a diet that makes it harder to get enough of certain nutrients (e.g., sometimes this happens in the case of my busy vegan athletes). In these situations, you want to choose your supplement wisely. Supplements produced by reputable pharmaceutical companies that have been third-party tested can take quite a bit of risk out of the equation. Third-party certification by NSF Certified for Sport is the label I generally look for when recommending any supplement to an athlete. Also, beware of supplements most at risk of contamination such as weight loss products or pre-workout mixtures.[iii]
In conclusion, take a food-first approach to getting the nutrients you need to fuel your training and racing. Also, look at labels when using sports products. If the label has “Nutrition Facts”, that means it has gone through more regulation (specifically the FDA reviews and approves the ingredients as GRAS) than a product with a label of “Supplement Facts.”
Also, take your health and your ability to compete seriously, regardless of your status as an amateur or professional athlete. Training and racing are valuable gifts that you should appreciate, treat with integrity, and work hard to preserve.
[i] National Institutes of Health (2013). Health Information: Frequently Asked Questions. Retrieved from: https://ods.od.nih.gov/Health_Information/ods_frequently_asked_questions.aspx.
[ii] Karpinski, C. (2017). Sports Nutrition: A Handbook for Professionals. Academy of Nutrition and Dietetics.
[iii] USOC Sports Nutrition. Dietary Supplement Fact Sheet. Retrieved from: https://www.usaswimming.org/docs/default-source/camps/national-select-camp/home-coach-presentations/dietary-supplement-fact-sheet-2015-(1).pdf.
Katie Elliott is a Registered Dietitian Nutritionist. She is the founder of Elliott Performance and Nutrition, based in Aspen, Colorado. Katie works with clients nationwide via tele-health and provides counseling and exercise testing at Achieve Health and Performance.
Katie’s specialties include sports nutrition, nutrition for the prevention and treatment of disease, weight loss, and worksite wellness. She has coached athletes to several podium finishes as a Triathlon Coach.
In addition, Katie attended IMG Academies as a junior tennis player. She played Division I tennis at Davidson College. She has competed on numerous amateur world triathlon teams. Since 2004, Katie has won numerous overall amateur titles. She has been on 6 World Championship teams and has finished 2nd at two National Championships. Furthermore, Katie achieved a 6th place finish at the World Championship in her age group.
Contact her here: Katie Elliott, MS, RD.
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