Dietitian Claudia Vavasour pauses and reflects on something she sees in her practice regularly. “Most women who come and see me are taking 10 or more supplements,” she says. “They’ve spent a fortune.”
Canterbury-based Vavasour consults with clients around the country, specialising in fertility nutrition, pregnancy and women’s health. She can see the attraction of dietary supplements, especially for women at a vulnerable time, such as when grappling with the uncertainties of starting a family.
“Anyone who’s having difficulty conceiving wants to do everything they can to optimise their outcome, and I think there’s an element of supplements being something that they can control. And if their friend’s neighbour took a supplement and it worked for them, then it’s worth a shot. That comes with its own set of issues … but I think you are tapping into that desire, when people are feeling desperate.”
Sport dietitian Conrad Goodhew is also familiar with this scenario. He’s used to seeing clients pulling out multiple bottles of pills and powders.
“I say to them, ‘You’re taking 12 different supplements over the day. What are you trying to prevent here?’”
The answers can vary, he says. “Some people might be highly stressed, so they’re taking supplements they’ve heard are really important for stress. People might have ongoing illness, so they’re taking supplements they think might help with that. And there are other things they might’ve heard from friends, family, podcasts or whatever, about this amazing new product.
“The marketing that goes into supplements is massive.”
A quick fix
We’re all drawn to the idea of a quick fix, it seems. Popping a pill can feel a lot easier than doing the hard work of healthy eating, exercising regularly, laying off the booze and keeping a lid on stress. Last year, Kiwis spent more than $300 million on vitamins, minerals, herbal and other supplements in pharmacies and supermarkets, a 12% increase on 2021.
Vavasour thinks the convenience factor is a large part of the attraction of supplements.
“Unfortunately, healthy eating and getting your two-plus-five [fruits and vegetables] a day is not very sexy”, she laughs. “I don’t think that’s all that appealing to people. But then there’s this amazing supplement that claims to do a whole lot of wonderful things, which sounds like a great solution, and all you have to do is swallow a pill.”
Goodhew agrees. “It’s easier to sell a pill than a behaviour.”
Vavasour suggests another driver might be that as patients, we may not always feel heard in the overstressed primary healthcare sector, where GPs can’t dedicate much time to patients with complex (read: more than one) problems.
“I do feel that perhaps there is a gap in our standard healthcare system. If you think back to the last time you went to see your GP, how did you feel when you left that appointment? I think sometimes people leave feeling like they want a little bit more, and want some things they can practically do to help their situation.”
Doctors can be dismissive about supplements when patients mention them, Vavasour says, which may not be helpful. “Often, they’re squashed by a doctor, who will say, ‘Oh, no, there’s no evidence for that [supplement].’ And I think that then creates an environment where people feel a little reluctant or nervous to bring their questions – or even be honest about what they are taking – to their GP, because they are worried it might get pooh-poohed.”
Nicky Moore is a fairly typical consumer of supplements. The Palmerston North-based 51-year-old has used evening primrose oil for years, after a doctor suggested it to deal with her PMT (premenstrual tension) symptoms. She found it helpful for that, and for other things, as well.
“It could be in my head, I don’t know, but it certainly helps with your hair and your skin and your nails and things like that. So, I’ve just kept going with it. And I do notice I feel a little different if I run out and then it’s a few weeks before I get any more.”
She has tried other products with less success, most recently to deal with some of the symptoms of menopause.
“They say, ‘Take magnesium because it’ll help you sleep.’ I didn’t find that. And omega-3s for brain fog – I tried that. I had a big bottle, so it was a good three months. I didn’t notice a huge benefit.”
Individual tailoring
Both Vavasour and Goodhew say there’s a place for supplements, and both recommend specific ones for their clients, tailored to their circumstances. Both also take targeted supplements themselves – Goodhew to support his training for the Coast to Coast multisport event, Vavasour to aid her recovery from long Covid.
She says folic acid, iron, choline and potentially pre-conception multivitamins are important for women seeking pregnancy. And Goodhew uses protein powders, sports supplements, vitamin B12 and electrolytes in his practice, depending on people’s individual situations.
Neither recommends blanket supplementation for everybody. And both stress the first place to focus on getting optimal nutrition is from food.
“The bottom line is, earn the right to use supplements,” Goodhew says. “That’s the message I always send: make sure you are trying to do the best that you can with diet. A supplement is an addition. It won’t make a bad diet good.”
Vavasour likes to use an ice-cream sundae analogy. “Your nutrition – the food you eat – is the ice-cream. Without the ice-cream, there is no sundae. Then the supplements are the sprinkles on top. You can take all the supplements in the world, but unless you actually address the food that you eat, you can be wasting your time and money.”
For those of us not consulting a dietitian or other expert, navigating the supplement aisle in the supermarket or chemist can be tricky, especially given the vague nature of the claims on natural health products. Phrases such as “supports immunity” and “promotes healthy sleep” abound, hinting at – but not promising – beneficial effects.
The reason claims are made in this way is down to the nature of the way supplements are regulated. “The regulations don’t permit you to say anything further than that,” says Samantha Gray, government affairs director with Natural Health Products New Zealand, an industry body representing many popular supplement manufacturers and marketers.
Natural health products currently fall under the Dietary Supplements Regulations, which date back to 1985 and are part of the Food Act. Medsafe is responsible for administering the regulations and the Ministry for Primary Industries the Food Act. The regulations were developed when the most complicated supplements on our shelves were multivitamin pills and Berocca, says Gray.
This regime will be replaced by the newly passed Therapeutic Products Act, which is scheduled to come into force late in 2026.
Parliament has sought to reform the rules around nutritional products and their marketing for more than two decades and the long lead time to 2026 means the legislation may yet not be a done deal – New Zealand First leader Winston Peters is staunchly opposed. But if it survives largely unscathed, supplement makers will be able to make more concrete claims as long as they’re backed by evidence, says Gray.
“If a product is developed with the right ingredients at the right levels, supported by adequate evidence, then the consumer should be able to know about the functions of those products. And at the moment, the consumer is actually prevented from receiving information about what the products they’re buying can do for them.”
It’s arguable consumers right now are filling in the blanks themselves. Browse one of the local online supplement retailers’ websites and it won’t be long before you’re convinced about the effectiveness of a product, whether it’s to “support a healthy balance of hormones” or “encourage restful sleep”. Language on labels and in advertising often skirts very close to the line of claiming benefits.
No assessment
Supplemented foods, a different class of product, are subject to more oversight. New Zealand Food Safety this month ordered “brain drink” manufacturer Ārepa to improve its labelling after finding it breached health claim requirements in the Food Standards Code. The drink promises to “make brains work better” using ingredients such as blackcurrant, pine bark extract and L-theanine. But NZ Food Safety head Vince Arbuckle said the claims were unsubstantiated.
Dietary supplements, on the other hand, are currently surprisingly lightly regulated. According to Medsafe, there’s no approval process before they can be placed on the market, and once on the market, they are “not assessed for compliance with the regulations”. No one routinely checks that what a manufacturer says is in a product is in the product and no one checks that products do what they say they do (even though they’re not allowed to say they do anything). It’s a self-policing system that’s not really ideal for manufacturers – who want to be able to make more specific therapeutic claims – or consumers, who might reasonably expect supplements to do what they say on the bottle.
“It’s a minefield,” says Vavasour. “I think it’s really challenging for a consumer to walk into a health food shop or a supermarket and choose supplements [from] a naturopath or someone who’s an unregulated health professional. It’s really tricky.”
On top of that, the evidence around supplements ranges from solid and well established, to insubstantial. As with Ārepa, marketers are often well ahead of the evidence in that respect.
Collagen powders are an example Vavasour worries about. “Every second person I see in my practice is taking a collagen supplement.” Yet the body of evidence on collagen supplements is far from conclusive. Some experts point out that there’s no direct relationship between consuming collagen and the collagen showing up in your joints, skin or cartilage. Your body decides how to use what you take in, it seems.
Vavasour worries these products could do harm. She refers to a 2020 report by the US-based Clean Label Project, in which popular collagen supplements sold on Amazon.com were tested. It found 64% of collagen powders tested positive for “measurable levels” of arsenic; 37% had lead, and 34% tested positive for trace levels of mercury.
Vavasour says collagen products are “effectively ground-up bone. so they’re coming from a bovine or fish source. Heavy metals are stored in bone … they are very detrimental to the development of a fetus and they accumulate in your own body.”
![Conrad Goodhew: “I think it’s really challenging for a consumer to walk into a health food shop or a supermarket and choose supplements [from] a naturopath or someone who’s an unregulated health professional.” Photo / Supplied](https://www.nzherald.co.nz/resizer/v2/HYUMWFF2YBEVHEMCFCGHODCKQI.jpg?auth=81e528f6eb5f68fb5732e583f3ed3ae35df1d0be50368c1d249265c1c9a4a379&width=16&height=11&quality=70&smart=true)
What you can do
How, then, to navigate the minefield? The first step is to buy local. Shopping on overseas websites means we’re subject to whatever regulations apply in the host country, and the regulation of supplements around the world “varies wildly”, says Gray. In the US, for example, supplements are close to unregulated, meaning marketers can make effusive, unchecked claims about their products.
Moore was “sucked in” to one American product, a probiotic aimed at menopausal women called Provitalize. At more than $100 a month, it was expensive. “I was desperate for anything to ease my menopause symptoms, and honestly, it did nothing to help.”
Provitalize is aggressively marketed on social media, often using personal anecdotes. This was what drew Moore in. “It was the marketing, and I think it was my desperation for something to help. I think it’s terrible that they do this – [targeting] belly fat.”
There’s no current evidence specifically linking any probiotic strain with the treatment of menopause symptoms and the product has been criticised by health experts.
Natural Health Products NZ’s Samantha Gray says to avoid buying products that don’t comply with local regulations, seek out the words “dietary supplement” on labels. “That’s the first clue that [a product] could well be compliant with New Zealand regulations.” She also recommends checking that the quantities of all the individual active ingredients in a product are declared on the label. “Some products use a ‘proprietary blend’ approach where they don’t declare individual ingredients. That’s permitted in some countries. But in New Zealand, consumers should expect to see the declaration of the individual ingredients, so they know what they’re getting, and how much of those ingredients they’re consuming.”
Consumers should also be reassured if a manufacturer is a member of a local industry body actively engaged with government,” adds Gray.
Vavasour is a fan of seeking out supplements that have been independently tested and certified by a third party. Otherwise, she says, “you are relying on the company selling the product to be doing their own independent testing – you’re relying on their goodwill, effectively. Which I think is problematic.”
Certification from Hasta (Human and Supplement Testing Australia), which conducts independent testing and certification of supplements, means a supplement will be free from erroneous ingredients. “It’s a really good indicator that it’s a good-quality product and what they say is in the product is actually in it.”
She also warns about inadvertently doubling up when taking supplements. “Make sure that you are not ‘stacking’ your supplements. Often, people will go out and buy a magnesium or a zinc supplement but it also has vitamin D, it also has some vitamin A and some vitamin C … and they’re also taking a multivitamin. So, before you know it, you’re taking a couple of supplements which are doubling up on ingredients. Then you can run into issues of toxicity.”
Anyone undergoing treatment for any condition should declare all their supplements to their health professional, who’ll be able to check up on safety.
Moore is now not inclined to try any new supplements. She will stick to what she’s using to manage her symptoms and focus on lifestyle as well. “Apart from the HRT and the evening primrose I’m trying now to just eat well, to get as much as I can out of my food. I’m trying to exercise, and do more strength stuff, and walk.
“I’m not a fan of the supplements now … I just hate how they market on our desperation to feel better.”
What’s the evidence that our most popular supplements work? See Chill Pills: How the evidence stacks up for our most popular supplements