Core37: Nutritional supplements

💊 High-yield / 要点：Dietary supplements are concentrated nutrients supplementing diet. Clinical examination is not mandatory; healthy people usually do not need them with adequate nutrition.

Definition / 定義

• Nutritional/dietary supplements are foods that supplement the traditional diet.
• They contain nutrients in concentrated form.

Regulation / 規制

• Only notification is obligatory.
• Clinical examination is not mandatory.
• They can be registered with National Health Authorities.
• Side effects can be reported.
• Unlike medicines, there may be no formal instructions for use.

Clinical principle / 臨床的考え方

• Healthy individuals generally do not need supplements if nutrition is adequate in quality and quantity.
• Supplements can still cause side effects or interactions, so use should be asked about.

Example: omega-3 fatty acids / 例：オメガ3脂肪酸

• Mechanism:
  • Very weak substrates for triglyceride synthesis enzymes.
  • Inhibit esterification of other fatty acids.
  • Increase β-oxidation of fatty acids.
• Uses:
  • Hypertriglyceridemia.
  • Adjuvant therapy after myocardial infarction.
• Side effects:
  • Mainly GI: abdominal distension, abdominal pain, GERD.

Remember / 覚え方

• Supplement ≠ automatically safe or necessary
• Clinical trials not mandatory
• Ask patients about supplement use