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VMS: a growing trend

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VMS: a growing trend

The vitamins, minerals and supplements market is in tip-top condition, but are these products really a necessary addition to our diets?

The nutritional value of vitamins, minerals and supplements (VMS) is something of a contentious subject. Pregnant women taking a folic acid supplement to avoid neural tube defects in their babies and some groups of people taking a daily vitamin D supplement for bone health are deemed essential, but that’s generally where the necessity seems to end. A healthy, balanced diet alone should be enough to supply all the vitamins and minerals the body needs to function properly and any additional supplements are, in theory, superfluous.

Despite this, VMS sales are on the up. According to recent research from Mintel, sales of vitamins and supplements increased two per cent between 2014 and 2015 to reach £414 million. This year, sales are set to increase a further two per cent to reach £421 million. What’s more, throughout 2016, the number of daily VMS users increased by five per cent, meaning that just under half of all Britons (46 per cent) now take supplements. 

The drive to buy

Pinning down the exact cause of this rise in sales isn’t straightforward. Rick Miller, clinical and sports dietitian and British Dietetic Association spokesperson, believes it’s three-fold. “People are a lot more clued up now about vitamins and supplements from reading about them online and in magazines – there’s so much information available – and that’s built up an awareness of the different things out there,” he explains. “That’s coupled with celebrity endorsements, so the likes of David Gandy and others in advertising campaigns are making people think about their health and say ‘well that person looks rather healthy, I’ll take supplements too’.” But it’s availability that Rick considers the most important factor. “At one time, there were only a handful of vitamins available and you had to go to a pharmacy or a health shop to get them, but now they’re available in petrol stations, supermarkets – pretty much everywhere. Supplements are now becoming a snowballing trend because of that onslaught of availability.”

On trend

Mintel’s research also revealed that the focus of the VMS market is beginning to shift, with demographic-specific supplements, such as those aimed solely at men, women, children, and the over-50s, becoming more prominent. At the same time, sales of generic adult vitamins have fallen behind. Women’s supplements account for the largest share of the demographic sector sales at £55 million, following an increase of 2.5 per cent in the year ending May 2016. And while the men’s vitamins and supplements market is comparatively small, it has seen some of the biggest growth, with sales rising 29 per cent to £11 million during the same period. This strong sales performance is thought to be largely attributable to a growing customer base, with the proportion of men using vitamins or supplements on a daily basis rising from 37 per cent in 2015 to 43 per cent in 2016.

Rick comments that there are lots of other trends emerging in the VMS market, notably celebrity endorsements: “Men might be more likely to buy vitamins because they think ‘maybe I could look like him’ or perhaps women are more likely to buy vitamins for their husbands because they think ‘maybe he could look like him!’” The emergence of vitamins and supplements in a greater range of formats is also an emerging trend. “We’re seeing capsules, drinks, drops and also foods enhanced with vitamins and minerals – they’re everywhere,” Rick says. As a result, VMS are becoming a part of everyday life, whether people are actively seeking out these products or not.

Personalisation is key

In an ideal world, a healthy, balanced diet is enough to supply all the vitamins and minerals the body needs. In fact, from a vitamin and mineral absorption point of view, food is the best option. “So, for example, iron absorbed from red meat is better than an iron supplement. There are very good reasons to eat a good diet first, and really it’s just a nicer experience than popping pills all the time,” says Rick.

But, as he explains, most people don’t have a model diet. “Busy lifestyles often prevent people from eating as they should from a nutritional point of view – that’s the unfortunate truth,” he says. “And the bottom line is, everyone is different and will need different levels of vitamins and minerals. Personalisation and an individualised approach is key and there’s no ‘one size fits all’. It’s not a blanket ‘dietary supplements are bad’ – it’s about weighing up the pros and cons for individuals and working out what will suit their needs best.”

As such, it’s important for all people considering taking supplements to look at their diet and lifestyle as a first line of action to see where they may be lacking in certain nutrients. Rick points out that vitamins and minerals have a risk of overdose and that’s why personalisation is so important. “People see vitamins and minerals as innocuous but actually, they’re not. It’s a case of one man’s meat is another man’s poison,” he explains. “So a side effect of too much magnesium is diarrhoea and for iron it’s organ failure – it’s worse with fat soluble vitamins as these are absorbed into fat and can’t be excreted in wee. People need to be careful when self-managing supplement intake. It’s wasting money at best and life threatening at worst.”

Not created equally

As well as the risk of overdose, other factors need to be taken into account when choosing or recommending supplements. “People often ask ‘which do I pick?’ and it’s not as easy as picking the one that looks the best. Manufacturers make packaging appeal, but that’s not necessarily the best product,” Rick explains. 

In the UK there are strict regulations set by the Medicines and Healthcare products Regulatory Agency (MHRA), whose policy is to take supplements off the shelves or not allow them onto shelves in the first place if they don’t meet these quality control standards. The problem is, however, that this is only the case for British made products. “In the age of the internet, it’s very easy to get your hands on products in other countries and you can’t guarantee the same rigorous quality controls,” says Rick. “The best advice for customers is to buy from a reputable source like a pharmacy, and to buy British. It is especially important for at-risk groups like young people to drive the message home that buying these types of products on the internet isn’t advisable or necessarily safe. I’m a champion of choice, but there needs to be boundaries when health is at stake.”

Recommendations

It’s advisable for all people wishing to take supplements to get professional advice first, and this is where pharmacy can step in. A large proportion of people who visit a pharmacy to buy vitamins or other supplements will already have taken supplements after self-diagnosing. “They’ll go to a pharmacy, look at a bottle, decide it’s what they need and take the directed amount,” says Rick. “But really they need to look at their diet before doing anything else.” Ask why they are taking the supplement, or why they want to take the supplement, assess their needs and find out their budget so that you can advise and recommend as appropriate.  

In terms of usage, multivitamins remain the most popular type of supplement, with 46 per cent of UK adults having taken multivitamins either daily or occasionally in the last 12 months, according to Mintel. This suggests that customers tend to take something of a catch-all approach when it comes to ensuring they get enough nutrients. However, Rick suggests that this might not be the best course of action. Instead, he advises: “When it comes to choosing products, absolutely choose individual vitamins rather than a multivitamin. Some vitamins compete for the same transportation in the gut. For example, calcium and iron are two that have very similar absorption. If both of these are in a multivitamin, they’ll be fighting for absorption and that means neither will work as effectively as it should.” 

Rick suggests that pharmacy staff could have a discussion with a dietitian to get a bit more information. “Or even better,” he advises, “look for CPD opportunities on nutrition to boost your knowledge and build confidence for talking about the subject with customers.”

The sunshine supplement

Vitamin D is required for healthy bones, muscles and teeth. A deficiency can lead to rickets in children and osteomalacia in adults, which means the bones become soft, weak and prone to deformity.

Generally, from late March to the end of September, people are able to make enough vitamin D by spending time out in the sun, but from October to early March, UK sunlight doesn’t contain enough UVB radiation for the skin to make vitamin D. Although there are dietary sources of vitamin D, it is extremely difficult to meet the 10mcg recommended daily intake from food alone.

This is why Public Health England has revised its guidelines to state that all adults and children over five years of age should consider taking a daily supplement containing 10mcg of vitamin D in the autumn and winter months. There is separate guidance for infants and young children.

In addition, some people are at an increased risk of vitamin D deficiency, so the Department of Health recommends that they take a daily supplement containing 10mcg of vitamin D throughout the year. This includes people who:

  • Are not often outdoors, such as those who are frail or housebound
  • Are in an institution such as a care home
  • Usually wear clothes that cover up most of their skin when they are outdoors.

People from minority ethnic groups with dark skin, such as those of African, African-Caribbean or South Asian origin, should also consider taking a vitamin D supplement year-round.

Pharmacy staff should be aware of this updated guidance so they can appropriately advise customers. Leyla Hannbeck, chief pharmacist at the NPA, who worked with Fultium Daily-D3, says that it’s important for pharmacy staff to increase the availability of vitamin D supplements, especially for at-risk groups, and this should include improving promotion strategies and stocking a range of price points. “Pharmacy staff should be aware of the Healthy Start initiative, which aims to improve the health of low-income pregnant women and families with young children who are claiming tax credits and Government benefits,” says Leyla.

Focusing training on vitamin D supplements is important, especially for pharmacies located in areas where there is a large demographic of at-risk groups. “Pharmacy staff can become involved in healthy living champion courses in order to make sound recommendations on vitamin D for at-risk groups,” explains Leyla. In particular, she encourages teams to focus on:

  • Groups at risk of low vitamin D status
  • The importance of vitamin D for good health
  • Vitamin D sources in the UK (i.e. safe sun exposure, supplements and dietary sources)
  • Recommendations on supplements for different at-risk groups
  • Ways to encourage people to start and continue taking supplements.

Advising on vitamin D should be a priority all year round, not just during the winter months. Pharmacy staff should be having conversations with patients about their lifestyle and considering whether they are getting enough sunlight during the summer. 

Another key consideration for pharmacy staff is that some over-the-counter products contain more than the recommended amount of vitamin D required for the prevention of deficiency, says Leyla. “Therefore care should be taken when recommending products to avoid excessive intake of the vitamin, which could lead to thirst, passing a lot of urine, nausea and vomiting, dizziness and headaches,” she explains.

People see VMS as innocuous, but actually, they’re not. It’s a case of one man’s meat is another man’s poison

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