Are popular dietary supplements worth the money?

Source: Web exclusive, April 2010

There seems to be a dietary supplement for just about every health complaint these days. Need a mood boost? Try SAM-e. Want to banish insomnia? A little valerian may do the trick. Or will it? We’ve selected five popular supplements targeted at women, then studied up to find out what they can really offer’and how much they cost per day.

1. SAM-e

SAM-e (S-adenosyl-methionine) is a molecule that our bodies manufacture for everyday cellular processes, including some involving brain signalling. SAM-e supplements contain a synthetic form of this chemical.

What it’s used for: Treating depression.

Does it work? There’s mounting evidence that SAM-e is an effective treatment for mild-to-moderate depression. For example, a large study from 2002 compared SAM-e to tricyclic or first-generation antidepressants (such as imipramine). Over six weeks, SAM-e proved just as effective at treating depression’and was better tolerated. But not much is known about the long-term effects of this supplement on mood, since most studies have lasted eight weeks or fewer. Recent research suggests SAM-e may also help treat perinatal depression.

Cost: About $1.20 per day at the manufacturer’s recommended dose of 200 mg per day. But studies suggest you need 800 to 1,600 milligrams (mg) per day for any therapeutic benefit.

2. Fish oil

The major health-boosting omega-3 fats in fish are EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), not to be confused with ALA (alpha-linoleic acid) from plants such as soybeans. They are important for brain and heart health as well as immune function.

What it’s used for: Preventing heart disease.

Does it work? For decades, researchers have known that people with diets high in oily fish (and therefore omega-3s) have low rates of cardiovascular disease. But do fish oil supplements deliver the same benefits to people who don’t eat much fish? The answer appears to be yes. There is good evidence that supplementing with fish oil pills (containing EPA and DHA) decreases death from heart disease, especially for people at high-risk of developing cardiovascular problems. And the good news doesn’t stop there. Omega-3s also appear to help decrease blood clotting and lower triglycerides.

The Heart & Stroke Foundation of Canada recommends two servings of fatty fish per week (equivalent to 400 to 500 mg per day of EPA and DHA). The American Heart Association suggest that people with heart disease get 1,000 mg per day of EPA and DHA, either from fish or a pill.

Cost: About $0.23 per day for 1,000 mg of fish oil (containing 600 mg omega-3s). To get the recommended dose of 1,000 mg of DHA/EPA, double that figure.

Shopping tip: Fish oil supplements usually contain 1,000 mg of oil’but only part of that is EPA and DHA. So look for supplements that are more concentrated (and are consequently more expensive). Skip formulas containing omega-3s and -9s. If you’re worried about the sustainability of fish stocks or toxins, some companies now offer DHA capsules made from algae. Vegetarians and vegans, who usually have low omega-3 concentrations, can get omega-3s from echium oil, which is new to the market. Echium oil contains an omega-3 called stearidonic acid (SDA).

3. Glucosamine, chondroitin and MSM

Glucosamine is a molecule found in cartilage, the connective tissue that cushions the ends of bones within a joint. It is often sold with chondroitin, which helps cartilage retain water, and methylsulfonylmethane (MSM). 

What it’s used for: Relieving joint pain from osteoarthritis.

Does it work? In a large clinical trial in 2006, 67 percent of people who took 1,500 mg per day of glucosamine plus 1,200 milligrams per day of chondroitin reported less knee pain. But the placebo effect was strong, too, leading researchers to conclude that glucosamine plus chondroitin was generally no better than sugar pills. The study also provided some evidence that the combo helped people with moderate-to-severe (but not mild-to-moderate) osteoarthritis.

The MSM factor: A lot of glucosamine plus chondroitin supplements contain MSM, also found in connective tissue. A small U.S. study, also from 2006, showed that people who took MSM supplements (3,000 mg twice a day) for 12 weeks experienced less pain and stiffness in their knees compared to placebo. Other studies have had mixed results.

Cost: To get the recommended combo of 1,500 mg glucosamine, 1,200 mg chondroitin sulfate and 1,200 mg MSM per day, you’ll spend at least $0.55 per day.

4. Valerian

A flowering plant native to Europe and Asia, the root of valerian has been used to treat insomnia since the 2nd century.

What it’s used for: Treating insomnia.

Does it work? Studies conflict on whether valerian will help you sleep. In several randomized, placebo-controlled trials, adults who took valerian before bedtime for two weeks or more reported an improvement in sleep. But when researchers measured their sleep patterns using various technologies (instead of asking people to rate the quality of their sleep), valerian provided little or no improvement.

Cost: Prices vary greatly, from $0.16 to $0.82 per day (liquid) to get 400 to 900 mg per day.

5. Chromium

This essential element is usually available as chromium picolinate, which is readily absorbed by the body and non-toxic.

What it’s used for: Weight loss.

Does it work? Despite chromium’s early promise as a natural weight-control product, recent research hasn’t been encouraging. A 2007 study in which healthy women consumed 200 micrograms (mcg) of chromium picolinate a day for 12 weeks while on a controlled diet showed that it did not promote changes to body weight or composition. More recently, researchers tested the effects of daily 1,000 mcg chromium picolinate supplementation for 24 weeks’alone and in combination with nutritional education’on weight loss in overweight adults. Neither group lost weight or fat.

Cost: You’ll pay $0.10 per day for 500 mcg or less.

Related:
‘ 6 supermarket foods and their health claims: Are they true?
‘ Relaxation drinks: Can you sip your stress away?
‘ The best sources of vitamin D

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