The ‘Wellness‘ trend picked up the pace with the software boom in this millennium. Studies in the 1990s indicated that the ‘Lifestyle’ diseases like Obesity, Diabetes, Hypertension, and atherosclerotic heart diseases (possibly strokes) had taken root. And India would indeed become the Diabetes capital of the world. In addition, a few scientists were surprised at the younger age of South Asians who died of sudden cardiac arrest, as compared to the rest of the world. ‘Metabolic Syndrome’ was coined for them. The young people who had died were found to have higher body-fat content even though they were apparently not obese. All the above factors made the younger working-class realize the importance of ‘Preventive health’. Their enthusiasm for exercising was fulfilled by the mushrooming of gyms. The wellness industry from the world over converged to India to satiate this hunger. Some even wanted to remain healthy without exercising. Amway, Heinz Kraft, Nestle jostled with the MNC Pharma companies like GSK, Pfizer, Merck, Bayer and Abbot.
The BOOM
Apart from this awareness, the boom in this sector occurred due to:
- Massive media advertising and digital growth.
- Flooding of gyms and selling products by word of mouth.
- Luring housewives to sell products in their spare time from their own homes.
- The simultaneous rise of Wellness experts, nutritionists, and dieticians. Even the beauty parlors were roped in for the sale of these products.
- Newer medical sciences like Holistic medicine and Alternative medicine resurfaced in a big way.
- TV gurus like Baba Ramdev and his products got a big following in rural and suburban India.
- Doctors of all systems of medicines started prescribing supplements in addition to vitamins.
- Google searches for diseases also led to trying out supplements.
- Home-grown wellness products of Ayurveda, Siddha, and Unani systems got the backing of the Ministry of Ayush. They reoriented and advertised their now ‘Approved’ products like Chayvanprash, Aloe vera, Shilajeet, Laboob Kabir, Shifain, and many more.
WHAT ARE SUPPLEMENTS IN THE CONTEXT OF HEALTH AND NUTRITION?
In simple terms, a Supplement in the above context is a concentration of essential nutrients obtained from natural sources (plants/ animals) or are made artificially. They fulfill a gap in the diet and bodily requirements and prevent specific diseases or improve well-being. Broadly, these include vitamins, minerals, amino acids (of proteins), enzymes, fats, and many more. Older keywords for their marketing were ‘energy’ and ‘youthfulness’. In present times, ‘immunity‘ is the IN thing. These products are generally available in the form of pills, capsules, gels, liquids, powders, pastes, teabags, and many more.
WHAT DOES THE LAW SAY?
These health products can be seen in three different ways.
- Vitamins, minerals, and micronutrients fall under the purview of the Drug Controller of India or DCGI. These can be sold as a single vitamin/ mineral/ micronutrient or their combinations. Earlier there were thousands of licensed but unscientific combinations in medical stores. After a review, only 471 combinations have been retained. Drug Controllers of each state oversee the manufacture and sale of these products.
- Under the Food Safety and Standards Act, 2006, regulations for Health products other than those mentioned above were framed in 2011. The Food and safety and Standards Authority of India, FSSAI, has identified the following categories:-
- Health Supplements – A substance used to supplement a normal diet of a person over 5 years of age. It should be a single-use product and should not be a food product.
- Nutraceutical – This should provide a physiological benefit to the user and should help maintain good health.
- Foods for special dietary use – These are food products that can be consumed without medical supervision. However, not for children below 5 years. They belong to one of these 3 categories-
- For Obese, Low weight persons, Diabetics, and Hypertensives.
- For Pregnant or Lactating mothers.
- For the Geriatric population and for those having coeliac or other diseases relating to malabsorption.
- Foods for Special Medical Purpose, but under Medical advice only – These foods should be nutritionally complete foods with all components of calories, proteins, fibers, and so on.
- Others – These are broadly under 4 subcategories.
- Food with Probiotic Content – Cultures of microorganisms with name and number to be specified.
- Food with Added Probiotics – Should have no microorganisms.
- Foods containing Botanical ingredients.
- Novel ingredients, made with newer technology.
- Health Fortification – It simply means the addition of key vitamins or minerals to certain materials which go into our food like salt, edible oils, dairy products, and others. Everyone is aware of Tata salt being fortified with Iodine. Iodine deficiency leading to Goiter was rampant amongst girls and women in the sub-Himalayan belt from J&K right up to the Seven sister states of Northeast, prior to the fortification of Tata salt with Iodine. Now, Goiter is hardly seen in India. A true success story. Some senior citizens are aware of the Dalda and Rath vanaspati tins of the 1950s, 60s and 70s having the inscription ‘Fortified with Vit A and D’. Now all packaged edible oils need fortification. Fortification of branded atta/ wheat flour with Iron, Vitamin B12, and Folic acid have been left to manufacturers and some have already started. Free staples for the BPL categories are compulsorily fortified since 2016. F+ label of FSSAI is embossed on all fortified products. All milk in pouches, most fruit juices, all packaged breakfast cereals, and dairy products are fortified with appropriate vitamins and minerals.
THE GOOD, THE BAD AND THE UGLY
Is it GOOD to supplement our diet with above products? Which vitamins, minerals and supplements if taken in excess, are harmful to our body and hence considered BAD?
The third category is of UGLY. I would like to place the many products which we are emotionally blackmailed to buy and consume, which may not have any beneficial or harmful effect, but certainly burn a hole in our pockets in this category. And in these Corona times, every rupee saved, counts. Our money spent on such products, helps fatten the wellness industry which is growing at the rate of 18% every year in India. World-over the growth rate is just 6%. This industry – MNC or our own large brands are taking advantage of our mental weakness.
ILL EFFECTS OF VITAMINS AND MINERALS TAKEN IN EXCESS
- Vitamin A – Abdominal discomfort with nausea and vomiting, skin rashes and hair fall, bone pains. If taken in excess for a longer period, liver damage may occur.
- Vitamin C – Diarrhoea, nausea, interference with anti oxidation mechanism. Over a few days, it may interfere with Iron storage in body causing thalassemia.
- Vitamin D – High blood level of calcium can occur leading to bone loss, kidney damage and high blood pressure.
- Vitamin E – Headache, nausea, vomiting, diarrhea, fatigue. If continued for a longer period, bleeding tendencies can result.
- Vitamin K – Jaundice in newborn, risk of anaemia and rise of bilirubin levels.
- Iron – Usually causes nausea, vomiting, diarrhea or constipation. If taken for a longer periods, it gets accumulated in vital organs causing varied problems.
- Calcium – High blood calcium levels initially cause headache, lethargy and muscle pain. Later, constipation, kidney stones, heart problems and convulsions can occur.
- Selenium – The new found mineral may cause nausea, vomiting, diarrhea, fatigue and hair loss. If taken for a longer period, nerves may be damaged.
- Zinc – The darling of the Corona crises, excess of zinc has manifold side effects. Apart from nausea, vomiting, diarrhea it may cause fatigue and hair loss. Surprisingly, excess of the mineral may actually reduce immunity in place of improving it.
MY TWO CENTS
Please take vitamins, minerals or micronutrients only on the advice of a doctor. Please do not exceed the recommended dose.
The BAD and the UGLY side of the supplements might take a whole blog. Hence, they will be discussed next week. Till then stay safe, stay protected. And be aware of ‘Emotional Atyachar’ by the greedy wellness industry. They have already made a lot of money from us in the last year and a half. Hence, spend wisely in future.
Maj Gen Krishan Chauhan is a second-generation army officer. He studied in Sainik School Kapurthala, graduated from IG Medical College, Shimla and did his MD from AFMC/Pune University. He has served in the Army Medical Corps for 36 years and retired as the Addl DGMS army. He is an avid marathon runner and a writer. He first wrote articles for children in The Young Chronicles. Later, he started writing his own blog as Genkris, on WordPress where over 25 articles on various subjects can be accessed.
