Trends of Dietary Supplement Usage in Malaysia and the Impact it Brings

Weight management has always been common among the community as everyone is concern about their outer appearances. According to the study, it is found that Malaysians had spent an average of US$17.30 per month just for the dietary supplements. It is said that there is a huge market of dietary supplements in Malaysia and it was shown that there is an increasing trend of the dietary supplements intake to enhance their well-being (Ghazali, Mutum, & Ching, 2006). However, a lack of knowledge and experience which leads people towards an extreme way to reach their goals such as engaging themselves into unhealthy eating habits and imbalanced lifestyle. They think that it is tolerable to have unhealthy foods as long as they are consuming dietary supplements in their daily basis. This write up aims to discuss about the effects of overconsumption of dietary supplements towards our health.

The National Pharmaceutical Regulatory Agency (NPRA) is a regulatory body in Malaysia since 1978 to control the registration, licensing, monitoring the quality control and good manufacturing practice of all supplement manufacturers and importers in Malaysia. However, some Malaysian herbal supplements in the aspects of quality, safety, efficacy and even informations or nutrient labelling on the products are not supported by scientific evidence (Ibrahim J. 2006). There are reports of various toxic symptoms during consumption of herbal supplements. These plants contains allergen that gives allergic reaction of skin, hepatic, irritant and purgative effect. As the poor quality control during the manufacturing of supplements, there are contamination of heavy metals such as mercury, cadmium, lead and arsenic are dangerous chemicals that can cause damage to vital organs such as the kidneys, liver and nervous system even in a low dosage (Yang et al. 2012).

Heavy metal contamination usually happened naturally on the water resources and land and thus can cause pollution to animals and plants. A research has shown that lead is known to induce renal tumors, damage cognitive development, raise blood pressure and coronary heart diseases in young adults (Navas-Acien et al. 2007). Childrens are more vulnerable to lead which can decrease IQ, poor learning and neurological disorders including seizures and even death (Raman et al. 2004). Cadmium can cause chronic kidney disease especially in the presence of other comorbidities such as diabetes or high blood pressure (Johri et al. 2010). Some plant-based supplements are contaminated with Arsenic which can lead to cancer of lung, skin and urinary bladders (Hedegaard et al. 2013).

Apart from that, there are commonly used multivitamins and multi-mineral supplements such as vitamin C, E and multivitamin. Although tocopherol (Vitamin E) acts as antioxidant that helps in scavenge and combat free radicals, reactive oxygen species produced during normal metabolism that can damage DNA and other components of cells meanwhile it also facilitate tumour growth and metastasis until the publication of several recent studies (Yang et al. 2012). The use of vitamin E supplement is prevalence among Malaysian elderly as they believe that the antioxidant properties provides overall health and prevent or treat disease. However, it is not advisable for cancer patient to take vitamin E as antioxidant activity can promote the survival of ECM-detached cells causing successful tumor metastasis (Hawk et al. 2016). This is because tumour cells often acquire the ability to mitigate programmed cell death pathways and recalibrate the redox balance to continue growing after ECM detachment thus facilitating metastatic dissemination and tumour growth (Hawk and Schafer 2018).

Then, a research has been done to assess supplements use among adults who exercise in gyms at least twice a week in Setapak, Kuala Lumpur. There are total of 344 respondents aged between 19 and 60 years old, 66.3% of respondents were supplement users (Sedek 2018). Results shown that protein shake is the modest which has 73.7% among vitamin C, whey protein, energy fuel drink, Vitamin B complex, branched chain amino acid (BCAA), Vitamin E and protein powder both animal and plant-based. The estimated average requirement (EAR) of 0.66 g good-quality protein/kg body weight/day or recommended daily allowance (RDA) of 0.80 g protein/kg body weight/day (Pedersen et al. 2013). Overconsumption of protein powder only bring adverse effect of health including hypercalciuria causing bone loss as too much of acid in body fluid that inhibits the absorption of calcium and causes the formation of calcium kidney stones (Delimaris 2013). Then, overconsumption of protein-rich supplements also lead to gout when there is deposition of monosodium urate crystals (MSU) in tissues (Villegas et al. 2012). Acute symptoms involves inflammation occurs around peripheral joints such as the big toe and finger. Long term of overconsumption can leads to chronic gout that an individual may suffer from cartilage damage and tophi formation (Ragab et al. 2017).

In a nutshell, dietary supplements are able to maintain our health but not advisable as the main consumption or take in large amount. All human beings are required to gain nutrients from a variety of fresh foods because supplements are lack of some essential bioactive compounds. An attentive checkup of the details of the supplements such as looking through the ingredients of the supplements before purchasing the product, as there is certain adulteration of supplements from its manufacturers and distributors. Besides, more healthcare professionals should be trained up to provide healthcare services to the consumer and rectify the misperception of consumers towards the supplements. Lastly, human health should not be depending on the consumption of supplements but to engage a healthy eating habit and lifestyle to sustain a better life.