Food Law News - UK - 2003

FSA News Release (2003/0371), 8 May 2003

SUPPLEMENTS - New FSA advice on safety of high doses of vitamins and minerals

The Food Standards Agency today issued new advice on some vitamins and minerals that could have possible harmful effects if taken in too high a dose.

The FSA is advising consumers on what levels of supplements are unlikely to cause any harmful effects. The advice follows the publication of the report of the Expert Group on Vitamins and Minerals (EVM), which makes recommendations on 31 vitamins and minerals.

The EVM has assessed the available evidence on safety, in response to concern over possible risks of taking high doses of vitamins and minerals. Current intakes of most vitamins and minerals are not thought to be harmful. However, the Food Standards Agency has said one substance may have the potential to cause cancer and has consulted on a proposal to ban its use; six substances may have irreversible effects if taken in large amounts over long periods of time; and three substances may have short-term harmful effects, which would disappear if people stopped taking the supplement.

In more detail:

• Chromium in the form of chromium picolinate may have the potential to cause cancer; consumers are advised not to take chromium in this form. The FSA has consulted on a proposal to ban its use in the manufacture of food supplements. Having 10mg/day or less in total of chromium in other forms is unlikely to cause any harm.
• Levels of vitamin C above 1000mg/day could cause abdominal pain and diarrhoea. Similarly, high intakes of calcium (above 1500mg/day) and iron (above 17mg/day) may result in similar symptoms in some people. These symptoms should disappear once people stop taking the supplements.
• There are some substances that may have irreversible harmful effects if taken for long periods at the highest supplemental doses. These include beta-carotene (especially for smokers and those exposed to asbestos), nicotinic acid, zinc, manganese (especially for older people) and phosphorus.
• Current advice on vitamin B6 is being re-emphasised. The Agency advises against taking more than 10mg/day of vitamin B6 from dietary supplements unless acting on medical advice. High intakes taken over a long period of time can lead to a loss of feeling in the arms and legs.

Advice is also being given on biotin, folic acid, pantothenic acid, riboflavin, niacin, thiamin, vitamin B12, vitamin D, vitamin E, vitamin K, boron, cobalt, copper, iodine, molybdenum, nickel, selenium, tin, magnesium, potassium, and silicon.

Sir John Krebs, Chair of the Food Standards Agency, said:

'While in most cases you can get all the nutrients you need from a balanced diet, many people choose to take supplements. But taking some high dose supplements over a long period of time could be harmful. We are using an extremely thorough independent expert review of the scientific evidence on the safety of vitamins and minerals as the basis for new advice to help consumers make informed choices. In addition, the Board of the Food Standards Agency will be considering what further action we would wish the supplements industry to take.'

The FSA Board will today receive a report recommending voluntary action by the supplements industry to reduce the dose and/or provide label warnings for some high dose food supplements.

Agency advice on vitamins and minerals is available on the FSA website.

The following notes are included:

• The Expert Group on Vitamins and Minerals carried out a detailed nutritional and toxicological review of 34 vitamins and minerals, with particular reference to safety in long-term use. Safe upper levels were suggested for eight of them, guidance suggested for 23, and statements were issued for three minerals. Guidance was given where there was not enough evidence to suggest a safe upper level for a particular vitamin or mineral. Guidance and safe upper levels were set for total intake from food, supplements, or a combination of the two. The EVM is an independent group made up of 11 members from the medical and scientific community, one lay member, and four observers representing consumer organisations, the health and food industries, and alternative medicine interests.
  
• Supplements are recommended for certain groups of people:
  
• Women of child bearing age and pregnant women (until the 12th week of pregnancy) should take a daily dietary supplement of 0.4mg folic acid and eat plenty of folate-rich foods in order to reduce the risk of neural tube defects in their babies.
  
• Some women with high menstrual blood losses may need to take iron supplements, as advised by their GP.
  
• If you are pregnant or breastfeeding, you should take supplements containing 10 micrograms (0.01mg) of vitamin D per day. Some older people may need to consider taking vitamin D as advised by their GP.
  
• Pregnant women, or women who are thinking of becoming pregnant, should not take supplements of vitamin A, except on the advice of their GP. This is because there is an association between very high levels of retinol (a source of vitamin A) consumption during pregnancy and the incidence of some birth defects. As an additional precaution, pregnant women should not eat liver or liver products as these are a very rich source of retinol.
  
• From the age of six months to two years (or five if they are not eating a wide enough range of foods), most young children will benefit from vitamin drops (A, C, and D). These are available free of charge from health clinics for children under five years of age in families receiving Income Support or an income-based Job Seekers' Allowance.
• A varied and balanced diet, which includes plenty of fruit, vegetables, and starchy foods, and moderate amounts of dairy products, meat, fish, and meat alternatives will provide all the nutrients that most people need without having to take supplements.