Final RRL

Chapter 2
REVIEW OF RELATED LITERATURE
In the year 1994, a law was established under Dietary Supplement Health and
Education (DSHEA), which governs the sale of dietary supplements. [1,2,4,5] According
to DSHEA, dietary supplement is a product that is intended to supplement the diet to
which it contains one or more dietary ingredients (including vitamins, minerals, herbs,
amino acids and enzymes). [1,2,4] These supplements are not permitted to be marketed
for the purpose of treating, diagnosing, preventing, or curing diseases. That means
supplements should not make disease claims, such as lowers blood pressure or treats
asthma. Claims like these cannot be legitimately made for dietary supplements. [8]
Dietary supplements are available without a prescription and usually come in many
forms, including tablets, capsules, powders and liquids. [6,8] These products are available
in stores as well as on the internet. People take these supplements to make sure they get
enough essential nutrients and to maintain or improve their health. [1,3] Although
manufacturers are legally responsible for ensuring the safety of dietary supplements and
for ensuring any product claims are not false, they are not required to provide conclusive
pre-market substantiation to the safety of these products, therefore it is very essential for
a consumer to have a good knowledge about dietary supplements so that they are used
safely and effectively. [2,4] But it does not mean that everyone needs to take these
supplements. [1]
The label of a dietary supplement may contain one of three types of claims: first is
the health claim, which describes the reducing of risk of a disease or health-related
condition, meaning to say that it reduces the risks of a certain medical condition. Second
is the nutrient content claim, describe the relative amount of a nutrient or dietary
substance in a product, meaning to say it focuses on the amount of nutrient/s a product
contains. And lastly the structure/function claim, that describes how a product may affect
the organs or systems of the consumers body. Even this product does not require Food
and Drug Administration (FDA) approval. The manufacturer must provide a message for
approval on putting the product on the market for 1 month. [9]
Dietary supplement use among adults has increased in the United States, and
currently about half of adults report using 1 or more dietary supplements. [3,7] These
supplements are commonly consumed by Americans to promote general health, improve
energy or memory. [1,3] Similarly, the usage of supplement among children and
adolescent athletes is widespread in terms of the product that is taken is a form of vitamin
supplement thus consider that anyone could take dietary supplement. In general, females
are found to use supplements more frequently and are associated with reasons of health,
recovery, and replacing an inadequate diet. [11] Males are more likely to report taking
supplements for enhanced performance. Both genders equally rated increased energy as
another reason for engaging in supplement use. [10,11]

[1] Aina, B. A. and Ojedokun, O. A. (2014). Journal of Basic and Clinical Pharmacy.
Knowledge and use of dietary supplements by students of College of Medicine,
University of Lagos, Idi-Araba, Lagos, Nigeria, 5(2), 34-39. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074693/
[2] Axon, D. R., Vanova, J., Edel, C., et al. (2017).
American Journal of Pharmaceutical Education. Dietary Supplement Use,
Knowledge, and Perceptions Among Student Pharmacists, 81(5), 92. Retrieved
from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508091/
[3] Waddington, F., Naunton, M., Kyle, G., et al. (2015).
International Journal of Clinical Pharmacy. A Systematic Review of Community
Pharmacist Therapeutic knowledge of Dietary Supplements, 37(3), 439-446.
Retrieved from https://link.springer.com/article/10.1007%2Fs11096-015-0092-5
[4] Carvey, C. E., Farina, E. K., & Lieberman, H. R. (2012).
BMC Complementary and Alternative Medicine. Confidence in the efficacy and
safety of dietary supplements among United States active duty army personnel.
Retrieved from
https://bmccomplementalternmed.biomedcentral.com/articles/10.1186/1472-
6882-12-182
[5] Marinac, J. S., Buchinger, C. L., Godfrey, L. A., et al. (2007).
The Journal of the American Osteopathic Association. Herbal Products and Dietary
Supplements: A Survey of Use, Attitudes, and Knowledge Among Older Adults,
107, 13-23. Retrieved from http://jaoa.org/article.aspx?articleid=2093317
[6] (2014). National Center for Complementary and Integrative Health.
Using Dietary Supplements Wisely. Retrieved from
https://nccih.nih.gov/health/supplements/wiseuse.htm
[7] Bailey, R. L., Gahche, J. J., Miller, P. E., et al. (2013).
JAMA Internal Medicine. Why US Adults Use Dietary Supplements, 173(5), 355-
361. Retrieved from
http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1568520#39287
215
[8] (2017). U.S. Food & Drug Administration.
Dietary Supplements: What You Need to Know. Retrieved from
https://www.fda.gov/food/resourcesforyou/consumers/ucm109760.htm
[9] (2011).
National Institutes of Health Office of Dietary Supplements. Dietary Supplements.
Retrieved from https://ods.od.nih.gov/factsheets/DietarySupplements-
HealthProfessional/
[10] McDowall, J. A. (2007).
Journal of Sports Science and Medicine. Supplement Use by Young Athletes, 6(3),
337-342. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3787284/
[11] Gardiner, P., Kemper, K. J., Legedza, A., & Phillips, R. S. (2007).
BMC Complementary & Alternative Medicine. Factors Associated with herb and
dietary supplement use by young adults in the United States, 7, 39. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2213683/

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Chapter 2

REVIEW OF RELATED LITERATURE

to DSHEA, dietary supplement is a product that is intended to supplement the diet to

substance in a product, meaning to say it focuses on the amount of nutrient/s a product

approval on putting the product on the market for 1 month. [9]

supplements are commonly consumed by Americans to promote general health, improve

another reason for engaging in supplement use. [10,11]

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