Safety assessment of daily doses of zinc, magnesium, calcium and iron in food supplements higher than recommended daily doses

Uvod: Prehranska dopolnila so živila v različnih oblikah, ki se uporabljajo za dopolnjevanje običajne prehrane in najpogosteje poleg vitaminov, vsebujejo tudi minerale. Minerali so anorganski snovi potrebne za normalno rast, razvoj in zdravje, vendar jih organizem ne sintetizira sam in jih zaužijemo s pestro in uravnoteženo prehrano. Namen: Namen naloge je pregledati in ovrednotiti varnost cinka, magnezija, kalcija in železa v prehranskih dopolnilih za odrasle osebe, ki presegajo priporočene dnevne vnose (PDV), določene z Uredbo 1169/2011. Želimo ugotoviti, ali je uporaba le-teh varna za potrošnika, oz. kakšna so tveganja, če so vrednosti prekoračene. Metode: Pregledali smo slovenski trg prehranskih dopolnil, ki vsebujejo cink, magnezij, kalcij in železo. Osredotočili smo se na prehranska dopolnila za odrasle osebe, ki vsebujejo količine mineralov v dnevnem odmerku, ki presegajo PDV vrednosti. Rezultati in razprava: Raziskali smo prehranska dopolnila različnih oblik, ki vsebujejo cink, magnezij, kalcij in železo, priporočene dnevne odmerke, količine mineralov v dnevnih odmerkih, odstotek PDV ter kemijske oblike mineralov. Zbrali smo prehranske referenčne vrednosti za vnose mineralov. Ugotovili smo, da so PDV vrednosti in navedene na ovojnini prehranskih dopolnil načeloma nižje od priporočil Nacionalnega inštituta za javno zdravje (NIJZ) ali Evropske agencije za varnost hrane (EFSA), ki podajata priporočene prehranske vrednosti glede na spol, za različne starostne skupine in fiziološke potrebe. Preverili smo, ali vzorčena prehranska dopolnila presegajo zgornjo sprejemljivo mejo vnosov (UL), ki upošteva vnos hranil iz vseh virov v enem dnevu. Eno prehransko dopolnilo s cinkom in dve z železom vsebujeta količino minerala v dnevnem odmerku, ki presega UL vrednost. Ugotovili smo, da nekatera prehranska dopolnila, ki vsebujejo cink ali železo, presegajo Dnevni odmerek, ki ne bi smel biti prekoračen pri izdelkih v farmacevtskih oblikah, ki niso zdravila glede na Smernice Javne agencije Republike Slovenije za zdravila in medicinske pripomočke (JAZMP). Sklepi: V primeru neuravnotežene, enolične in nekakovostne prehrane prehranska dopolnila lahko prispevajo k doseganju referenčnih vrednosti mineralov v našem telesu in imajo ugodne učinke na zdravje. Po drugi strani lahko z nepremišljeno uporabo prehranskih dopolnil presežemo UL vrednost posameznega hranila, kar lahko predstavlja tveganje za neželene učinke in vpliv na zdravje uporabnika.Introduction: Food supplements come in various forms and are used to supplement the normal diet and usually contain vitamins as well as minerals. Minerals are inorganic substances necessary for normal growth, development and health, but which the body does not synthesize itself so we consume them with a varied and balanced diet. Aim: The aim of this work is to review and evaluate the safety of zinc, magnesium, calcium, and iron in food supplements for adults, whose doses exceed the Recommended Dietary Allowance (RDA) declared by Regulation (EU) No. 1169/2011. We aim to determine if their use is safe for the consumer or what are the risks if the recommended levels are exceeded. Methods: We studied the Slovenian market for food supplement containing zinc, magnesium, calcium, and iron. We focused on food supplements for adults that contain amounts of minerals in a daily dose that exceed the RDA levels. Results and discussion: We collected the following about zinc-, magnesium-, calcium-, and iron-containing food supplements in various forms: recommended daily doses, amounts of minerals, percentage of RDA and chemical forms. We collected various dietary reference values for mineral intake. We found that the RDA values declared on food supplements are in principle lower than the recommendations of the National institute of Public Health (NIJZ) or the European Food Safety Authority (EFSA), which provide dietary reference values for different gender, age groups and physiological needs. Our aim was to find out if any of food supplements exceed the Tolerable upper intake level (UL), which considers the total daily intake of nutrients from all sources. For one zinc- and two iron- containing food supplements the amount of the mineral in the daily dose exceeded the UL. We found that some zinc- and iron- containing food supplements exceeded the daily dose, that should not be exceeded according to the Guidelines of the Agency for Medicinal Products and Medical Devices of the Republic of Slovenia (JAZMP). Conclusions: In the case of an unbalanced, monotonous and low-quality diet, food supplements can contribute to the achievement of reference values and have a positive impact on health. On the other hand, careless use of food supplements may exceed the UL value of nutrients, which may pose a risk of side effects and impact on the health of the user