Health

Dietary Supplement: Pop Goes the Pill

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Valued at over $2 billion, the dietary supplement market in India promises buyers an irresistible cocktail of convenience, choice and good health

THERE’S ONLY so much that coconut oil and eggs can do for your hair. With that thought in mind, Aarti Bhasin, 32, picked up her first box of dietary supplements in 2013—‘extra strength hair, skin and nails rapid release softfels’ by Nature’s Bounty. Infused with argan oil, the pills claim to contain enough biotin, vitamin A, C and E to provide 100 per cent of our daily recommended needs (based on a 2,000 calorie diet). “It was suggested by my hair dresser. She said, ‘Instead of monthly hair spas, try biotin supplements.’ I did some research and Nature’s Bounty products came highly recommended,” says Bhasin, a manager with Wipro Bengaluru. Since then she’s added three other pills to her daily diet. “I take Alpha Liphoic Acid (300 mg), Glutathione (50 mg) and Zinc Magnesium Aspartate. All three are manufactured by GNC. The first helps reduce vitamin loss during periods of stress, the second is a good antioxidant for immunity and the third promotes restful sleep and high metabolism,” adds Bhasin. The supplements cost her around Rs 9,000 a month. None of them has been prescribed by a doctor. “I just read the labels and decide accordingly. They aren’t bad for me though, else they wouldn’t be sold over the counter.”

But they aren’t necessarily good for you either. Several studies on the food supplement market in the US and abroad by the Harvard School of Public Health and American Heart Association show that dietary supplements have no scientifically proven health benefits. Yet, the studies noted, people continue to take them, believing that the pills will make them healthier than their non-pill-taking counterparts. Ironically, a 2015 study by the University of Colorado further points out that those taking regular artificial health supplements were more likely to suffer from health problems and genetic diseases such as cancer. And this January, a study by ASSOCHAM in India found nearly 70 per cent of food supplements sold in the country to be fake, counterfeit, unregistered and unapproved, with no tested results of the benefits they claim. Yet, people continue to take them.

In India, the nutraceutical market is expected to be worth nearly $ 2.8 billion by the end of the year, according to a report by Frost & Sullivan. In 2011, it was estimated to be around $1.5 billion. The report also says dietary supplements make up 40 per cent of nutraceutical sales, and functional food and beverages (energy drinks, sports drinks, branded nutrient flour, probiotic food, omega fatty acid fortified foods) account for the rest. Vitamins and minerals are the leading supplements consumed by Indians, followed by probiotics and omega-3 fatty acids. According to another market study of food supplements by Euro Health in Delhi and Mumbai, the leading factors driving consumers to make a purchase include fear of falling ill, increasing cost of healthcare, rapid globalisation, increasing disposable income and the belief that supplements do indeed make them healthier.

I felt almost proud taking a vitamin every day, like it was the grown-up thing to do. Now I feel it’s like junk food, doing more harm than good

“The vitamin supplement market in India has been growing annually at around 10 per cent over the last five years. There is a notable trend in recent years of people increasing the amount of fats and processed foods in their diets, which often comes at the expense of vegetables and fruits. Eating fewer vegetables and fruits means we’re consuming fewer phytonutrients, and missing out on their remarkable nutritional benefits. It is a matter of concern that the majority of people in Asia do not consume the recommended 400 grams of fruits and vegetables per day,” says Sudip Shah, chief marketing officer at Amway India. Launched in India in 2000, Nutrilite is Amway’s food supplement arm and accounts for more than 50 per cent of its revenue in India. The brand has diversified its supplements to include four main categories: multivitamins, omegas, all plant proteins, concentrated fruits and vegetables. These in turn branch out to serve specific purposes, gender groups or organs which include heart, bones and joints, vision, brain, cellular, energy, digestion, immunity and congestion, men, women and kids. Consumers can buy their doses in normal packs, on-the-go MyPacks or mixed into convenient vitamin beverage infusers.

In 2015, Nutrilite, sensing a growing market for its products in India, appointed Farhan Akhtar as its brand ambassador and featured him in a commercial where Akhtar is seen outrunning an aggressive dog, running up flights of stairs and impressing women with his seemingly endless energy—all thanks to the Nutrilite capsule and drink he takes thrice daily. The same year, the company also conducted a study to prove that there is a nutrient shortfall in the country. The report, Shortfall of Fruit, Vegetable and Phytonutrient Consumption in Asia with a Focus on India, showed that around 85 per cent of Asians are not consuming the World Health Organization’s minimum recommendation of five servings per day of fruits and vegetables, thus losing out on essential phytonutrients. These are natural chemicals that occur in plant- based food. When consumed by humans, phytonutrients help in reduction of cancer and heart disease risk, promote DNA repair, detoxify carcinogens and alter oestrogen metabolism. “It’s not just plant nutrients alone; research in India also indicates that 8 out of 10 Indians consume less than adequate protein on a daily basis. While supplements are not a substitute for a balanced diet, when people are not able to consume the recommended diet, they can look at them as an option,” says Shah.

Avik Sanyal, country manager (SAARC and India) of Glanbia Performance Nutrition, says that India is a hotbed for nutritional and sport supplements. “Indians are now conscious of their long-term health,” he says. In 2014, Glanbia, one of the largest suppliers of whey protein and micronutrient supplements in the country, signed up with HealthKart.com to start selling its line of Optimum Nutrition products online. These include its best selling 100 per cent whey protein powder in fruit punch, vanilla custard and chocolate flavours. “There is great potential for food supplements in India especially with the busy and hectic lifestyles that young people lead today. Often, they aren’t able to get the right dose of nutrients from their food alone,” adds Sanyal.

DEEPIKA KHAITAN, 35, and her three children (aged nine, six and four) are all regular consumers of multivitamin and calcium supplements. Khaitan, a Delhi-based entrepreneur and founder of Deepika Khaitan’s Cakes in New Friends Colony, has been taking multivitamins for as long as she can remember. After she turned 30, she added primrose oil, vitamin E and vitamin C to her list. “My mother used to say that women need certain supplements once they turn thirty. A lot of my self-medication is based on her advice. For example, to counter hair loss I often take a Vitamin B Complex or Becosule. I’ve never had a doctor formally tell me to take any supplements. I decide and regulate based on blood test results which I take every six months. All my results have been normal till now. Primrose oil and vitamin E have definitely improved my skin and hair. I’m not so sure about the multivitamins but they certainly don’t do any harm,” she says.

I take supplements based on my mother’s advice. Some have benefited me. Others, I’m not too sure about. But they don’t do any harm

Arjun Jain, 28, a graduate of Brunel University in London, is another frequent user of supplements. His favourites include whey proteins and Vitamin B12. “There is nothing wrong with taking supplements. Extra nutrition cannot possibly be bad for you. My gym instructor advised me to start taking whey protein. I usually buy a 10 kg pack of Optimum Nutrition Gold for a month in the double chocolate flavour and have a two or three glasses a day,” says Jain. This sets him back by Rs 7,699. Another 1 kg jar of glutamine by Muscle Effect costs him Rs 1,500 a month. “I started glutamine on my own. I was browsing through products at a store and came across the jar. It just sounded good to me. My muscles were aching at the point and glutamine helps counter the pain,” he explains. Jain also takes joint support supplements by Nature’s Bounty. Today, he says, he can just walk across the street from his home in Bandra, Mumbai, to pick up a supplement of his choice. But three years ago, when he first started taking supplements, he often had to import them through Amazon or buy them on holidays abroad. “As a student in London, I used to love taking kola nut and green tea extract gummies by Nature’s Bounty. You couldn’t buy them in India back then [in 2013]. When I returned to Mumbai to look for work, I used to ask friends or family to pick up a carton of gummies for me when they visited the US or UK. But now they are available at my local chemist,” says Jain, adding that he takes only protein and vitamin B12 now. “The gummies were an illusion. I thought I was being healthy by taking them, but in factual terms, I have no proof if they were beneficial or not. It was more health for my mind than my body. With protein, I know it is helping with my muscle build-up.”

When it comes to the benefits of protein supplements, Nayantara Parikh, 27, a freelance photographer based in Delhi, has a different story to tell. “A close friend used to take protein powder regularly and it led to kidney stones,” she says. Parikh herself started taking multivitamin supplements when she moved to New York. “I’m embarrassed to say now, but six or seven years ago, I started taking vitamin gummies because they were so delicious. I never stopped to consider that they could negatively impact my health in any way. I just thought that they were vitamins and so they had to be good for me. I felt almost proud taking a vitamin pill every day, like it was the grown-up thing to do,” says Parikh. She stopped taking off-the- shelf vitamins a few years later after being diagnosed with Lyme disease. “My vitamin levels were dangerously low after I got sick and the doctors prescribed me a mix of supplements to take every day—magnesium, vitamin D, vitamin B12, folic acid, the list was endless. They helped because I needed additional nutrients at that point. My body was unable to absorb what it needed from food alone. When I first tried to stop taking the pills I felt weak and my energy levels would drop. After some time, through testing we discovered I was recovering and my vitamin levels had returned to normal. That’s when I stopped taking the prescribed pills. At the end of the day, off-the-shelf supplements are a mix of chemicals and you don’t know what they can do to your body. You can’t assume that they are good for you. If you are testing positive for deficiencies, then it makes sense—otherwise, if you don’t need them, why are you taking them?”

BUT THAT’S NOT a question anyone asks. At his chemist shop in Sushant Lok, Gurgaon, Narendra Kumar, has seen sales and requests for nutritional supplements increase drastically over the last few years. “Two or three years ago, we only received a shipment of whey protein or fish oil or spirulina from neutraceutical firms. Now we receive weekly shipments and high commissions from eight or nine different brands,” says Kumar. Glanbia, GNC, Nature’s Bounty, Muscle Blaze, Himalaya and Viva Health products are some of his best-selling brands. He displays the ones giving him the highest commission (25-35 per cent, a significant increase from the 5 per cent offered four years ago) on his counter top. At the back of the shop there are lesser known brands such as TaraCare, Nutri1, VitaJuice, Max Muscle and New Age. “No one ever comes in with a prescription for food supplements. First-time buyers usually come in to buy something else and scan the shelves while waiting for the bill. Then they spot a product that catches their fancy. From then on, it becomes a regular item on their medicine lists. A few buyers come after they are recommended a product by a gym trainer, beautician or friend,” adds Kumar, who recently received a Rs 35,000 order for vitamin supplements alone from a customer. “She was going to visit her in-laws in Kerala and was worried she wouldn’t be able to purchase the pills there.”

According to nutritionists and doctors, the jump in commercial food supplement sales isn’t confined to health alone, but begs a larger question about urban lifestyles and aggressive marketing. “Indians have traditionally been consuming several supplements with their food such as spirulina, chyawanprash, cod liver oil,” says Ishi Khosla, founder of Whole Foods. “However, our parents were not paranoid about health. We are paranoid about health now. We are desperate not to fall ill, especially with the growing list of health problems being written about. And we will believe any amount of jargon when it comes to ‘great health’. But health cannot be bought or manufactured. There is no shortcut to well-being. Health comes from investment in yourself. Instead of popping a pill, why not go for a walk or cook yourself a meal? Supplements are great if you really need them. Else you’re just consuming a ‘naturally extracted’ chemical, for no real reason.”

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