• Vitamin and mineral supplements are most commonly taken by women.
  • Men are more likely to use shakes, energy bars and gels to improve their athletic performance.
  • Both men and women use these products with the main objective of improving their overall state of health.                                               
  • Spain is among the countries with the highest rate of food supplement consumption.
  • Products for medicinal use, including those that help people to lose weight, are perceived as the most effective.                                                                       
  • There is a huge array of nutrition-related products on the market whose safety and efficacy have not been tested.                                                                       
  • Experts recommend the inclusion of a dietician/nutritionist in primary healthcare services, and the promotion of clear and transparent information directed at consumers.

Vitamins, calcium and Omega 3 are among the food supplements most widely used by Spaniards. Seven out of every ten people use these types of products frequently, which also come in the guise of probiotics, plant extracts, such as bran, ginseng and brewer’s yeast, energy bars and meal replacements.

Most people use these products with the main objective of improving their general state of health (70.9%), as well as to give them more energy (35%), improve the function of bones and muscles (34%), treat diseases such as osteoporosis and gastrointestinal disorders (28%), and lose weight, among other reasons.

A large number of people use them without sufficient health justification, often with no beneficial outcomes, and even risking their health in some cases. This is due to the fact that few studies have been conducted to analyze the safety of these types of supplements, and those that have been done provide little or no information to clearly demonstrate that they have healthy properties and are safe and effective to use.

These are some of the main conclusions of the report entitled Use of Food Supplements in Spain presented today by Fundación MAPFRE and the Spanish Academy of Nutrition and Dietetics, which aims to analyze the current consumption of food supplements and products for special medicinal uses.

This market, with an estimated current worth of 12,000 million euros, is expected to experience high growth in the coming years due to the increasing popularity of sport, the so-called ‘personalized nutrition’, and the ageing population, especially among millennials, women, and people over the age of 60.

The study has also revealed the potentially positive and negative impacts of these substances based on scientific evidence from numerous national and international reports, and conducted a survey of 2,630 adults to ascertain the frequency of use of these types of products and whether they perceived any beneficial or adverse effects.

Young women: more vitamins and minerals  

Of all the supplements available on the market, the ones with the highest consumption figures (63.4%) are those that provide vitamins, minerals and Omega 3-rich oils (63%), a figure that places Spain among the countries with the highest food supplement usage alongside Denmark and the United States.

Specifically, four in ten people (39.4%), especially women aged between 26 and 35 with a university education, who do regular physical exercise and believe they weigh the right amount, take vitamins and complexes, especially vitamins D and C, which are generally prescribed by healthcare professionals other than dieticians/nutritionists.

When it comes to minerals, the most widely used are magnesium (13%) and calcium (12%), especially in the 26-35 age group; and Omega 3 from plant sources such as evening primrose oil, flax and nuts, which are taken by 21% of people, especially in the 18-35 age group. A multivitamin with minerals is the most popular combination of vitamins and minerals, taken by some 18% of the population either daily, weekly or monthly. A similar proportion of the people surveyed also take probiotics (27.3%), especially women in the 26-45 age group, and 28.6%, also primarily women, take some form of non-prescription supplement such as a plant extract or phytotherapy; for example pollen, royal jelly or fiber, which they tend to buy in health food shops.

Increasing energy (men) and losing weight (women)

Men tend to consume more energy bars while women are more disposed to use weight-loss products. This was borne out by the report, which shows that two out of every ten people (19.9%), especially men in the 18-45 age group who feel they are in good health, take products for sportspeople such as energy bars (15%), protein preparations, serums and shakes (14%), special drinks (13%), and hydration gels (9%), which they usually self-administer (without a medical prescription) and generally buy online.

The report also shows that in the last year 13.8% of those surveyed had taken specific products to lose weight, the most widely used being products to replace some (11%) or all (6%) meals during the day. The most common users of these kinds of products, which in most cases are prescribed by dieticians/nutritionists, are women aged in the 18-45 age group, who see themselves as slightly or very overweight.

The report also shows that 30.2% of those surveyed recognize that they have taken products for specific medicinal purposes such as treating a disease or the effects of a treatment, this being more common among women in the 56+ age group and people with a university education. The most widely used products are shakes to supplement the regular diet in the case of undernourishment or the risk of malnutrition (9%) and preparations to treat metabolic diseases such as phenylketonuria (7%).

Half of users believe they get results

Half of those surveyed believe that they achieved the expected results from the use of these products, albeit in a mild or transitory way. Food supplements and plant-based products are those that the people surveyed generally saw as being the safest (60%), a percentage that decreases when it comes to products for athletes (53%) and weight-loss products (45%), among others. The most commonly-perceived adverse effects from their consumption are gastrointestinal, followed by tachycardia, although most of these effects are mild or transitory.

The report also highlights the fact that most Spaniards would be willing to take some kind of supplement, mainly nutritional, firstly because they view them as safe, and secondly because they believe they can help to improve their general state of health.

With proven efficacy

Folic acid: The most proven nutritional supplement for the prevention of neural tube defects (spina bifida) in pregnancy.

-Caffeine: Unquestionably one of the supplements with the most positive assessments, having been shown to improve athletic performance.

-Vitamin D: Improves the treatment of respiratory infections in people with chronic obstructive pulmonary disease (COPD).

-The use of calcium supplements can also have a positive effect on the prevention of hypertension, especially in men and people under 35, and iron supplements can be effective for deficiencies such as anemia.

Special products for medicinal use for weight loss in very low calorie diets are also effective, although experts recommend they are only used under medical supervision.

Of doubtful efficacy

Probiotics: These are only effective for rehydration in the event of acute diarrhea or from the consumption of antibiotics, but there is little evidence to indicate their efficacy against respiratory infections, to increase the body’s defenses, or to lose weight.

-Compounds rich in Omega-3: In most cases, there is not enough high quality evidence to draw definitive conclusions, although positive effects have been observed in preventing cardiovascular diseases, treating gastrointestinal disorders, and improving cognition, among others.

-Plant extracts: Herbal extract complexes (in general), and glucosamine, ginseng and garlic extract in particular are the most widely-studied products, while there are fewer studies of echinacea and blueberry and artichoke extracts, and there is no clear evidence to support the efficacy of any of these supplements.

With adverse effects

-The assumption that taking more vitamins or minerals will lead to better health is false. Indeed, an excess of these nutrients can actually be harmful, a prime example being calcium and iron, and in some cases can have very serious consequences, such as taking vitamin A during pregnancy, which can lead to birth defects.

-Plant extracts: Cases have been recorded of acute liver toxicity and there have even been deaths due to overdoses of certain supplements, such as the recent example of the consumption of lipoic acid for weight loss.

Experts believe that not all supplements are made in accordance with best manufacturing practices and may not include the quantities of active ingredients they claim on their labels. In addition, they may promise unsubstantiated health benefits and contain substances that are not declared on the label, and even pollutants that may affect people’s health, an example being cases of unintentional doping in athletes.

More basic training and more consultations with dieticians/nutritionists

The report emphasizes the need for health professionals, who prescribe many of these products, to acquire sufficient academic knowledge about these supplements in order to base their recommendations on scientific evidence.

It also considers it essential to increase the general public’s knowledge of nutrition and health so they can take informed decisions; to include dieticians/nutritionists on the staff of primary healthcare services; and to promote current European legislation so that the information given to consumers is clear, transparent and based on scientific evidence, especially with regard to efficacy and safety.

The full report is available at: