Vitamins: too bitter a pill for us to swallow?

A CONTROVERSIAL law that could ban hundreds of vitamin and mineral supplements from being sold in Britain was upheld by the European Court of Justice earlier this week.

Groups from the health food industry, backed by celebrities including Carole Caplin, former personal assistant to Cherie Blair, lost an appeal against the introduction of the Food Supplements Directive, which comes into force on 1 August.

The directive will oblige manufacturers to submit all natural remedies, vitamin supplements and mineral plant extracts for approval and inclusion on a list of recognised food supplements. If they fail to be included, many popular supplements, such as Viridian High-Five, Nature's Plus Source of Life and Holland & Barrett Vitamin C-1, could soon be outlawed.

About 21 million Britons - a third of all women and a quarter of men - take supplements in the belief that they will improve their health, or offset the effects of everything from blood pressure and diabetes to osteoporosis.

The Alliance for Natural Health believes it knows how to get around the tighter controls, saying the ban applies only to synthetically produced supplements and not to vitamins and minerals normally found in or consumed as part of the diet.

A is for Approved List. This is the masterlist of more than 112 substances passed fit for sale, including vitamin C, calcium and iron. However, many popular substances, such as selenium, yeast, tin, manganese and vitamin K2, have been omitted and are subject to 505 separate appeals. The European Food Safety Authority is working its way through these appeals. Getting ingredients on the approved list is now the objective of health food manufacturers.

B is for Boron, a trace element found in many foods which helps to strengthen bones in the human body by protecting calcium. Some boron compounds show promise in treating arthritis. It is not on the Approved List, but it stands a better chance of passing the regulatory hurdle than some of the other elements.

C is for vitamin C, the most widely known food supplement, and its essential role in prevention of disease has been known for centuries. The first attempt to give scientific basis for the cause of scurvy was by a Royal Navy surgeon, James Lind, who at sea in May 1747 provided some crew members with two oranges and one lemon per day, in addition to normal rations, while others continued on cider, vinegar or seawater, along with their normal rations. Lind wrote up his work and published it in 1753, in Treatise on the Scurvy. The navy later adopted lemons or limes as standard issue at sea. Vitamin C often needs topping up because no human organ stores it, so levels deplete quickly. The amount of vitamin C found in processed food is often so low that many adults are not reaching the daily target of 60 micrograms, despite having a balanced diet.

D is for Daily Allowances, the guidelines on food labels which recommend how much of one (or a group) of vitamins we should consume for good health. When it is not possible to achieve these amounts through food, supplements are used. Most vitamins sold as supplements carry a dosage of essential vitamins as 100 per cent of the RDA.

E is for EU, which sparked fury by drafting the Food Supplements Directive back in 2002. Originally intended to introduce European free-trade principles to the sale of vitamin pills, it effectively took control over food supplements away from Westminster, despite the existence of competent food standards agencies in most EU countries.

F is for Ferritin, an iron-storing protein found mainly in the liver. Levels of ferritin are measured in patients as part of studies into anaemia. Ferritin is also used as a marker for iron-overload disorders, such as haemochromatosis.

G is for Government, which has failed to secure a reversal of the directive, despite motions opposing the law in both Houses of Parliament. Patricia Hewitt, the Health Secretary, said this week that Britain would use its EU presidency to ensure that the laws do not deny products to people.

H is for Holland & Barrett, the UK's leading retailer of vitamins, minerals and herbal supplements, with more than 400 stores and one of many that does well out of Britain's appetite for health supplements - a market worth an estimated 335 million a year. A spokeswoman for the firm said yesterday that 90 per cent of the its products were affected in some way by the directive, but all already had been reformulated and would not need to be taken off the shelves.

I is for Iron, the most common dietary deficiency in the world and a frequent indicator of serious underlying disease causing blood loss, such as bowel cancer. Iron deficiency anaemia causes developmental and learning problems in children: symptoms include tiredness, lack of concentration and problems fighting infections. Iron deficiency is most common among children, women and pregnant women. Iron tablets are among the most commonly used food supplements.

J is for Jenny Seagrove, the actress who first found fame in the 1983 film Local Hero and who has become one of the most vocal campaigners against restrictions on food supplements. "This is a black day for health in Britain," she said of this week's ruling. "This will reduce consumer choice and cause disruption to the health food industry. I am devastated by the ruling."

K is the chemical symbol of potassium, the second lightest metal after lithium and an important substance for muscle contraction and in maintaining fluid and electrolyte balance in body cells. Potassium is also important in sending nerve impulses, as well as releasing energy from protein, fat and carbohydrates during metabolism. A shortage of potassium can cause a potentially fatal condition known as hypokalemia. Eating a variety of foods that contain potassium is the best way to get an adequate amount. But many potassium sources are excluded from the Approved List.

L is for Liver failure, which is among the nasty side-effects that some experts say are caused by the unregulated sale of vitamins and food supplements. The British Dietetic Association (BDA) supports the principles behind the EU directive, saying there are not enough controls on the nature and dosage of health products. The BDA says there is evidence of patients suffering from acute digestive problems, nerve damage and liver failure by taking too much of some vitamins, particularly vitamin A.

M is for Magnesium, which is important for the synthesis of protein and the functioning of certain enzymes in the body. Green vegetables such as spinach provide magnesium because the centre of the chlorophyll molecule contains the mineral. Nuts, seeds and some whole grains are also good sources, but the magnesium content of refined foods is usually low. Whole-wheat bread, for example, has twice as much magnesium as white bread, because the magnesium-rich germ and bran are removed when white flour is processed. Magnesium is another mineral which is not yet on the Approved List.

N is for Nickel, a mineral present in the diet whose sources include nuts, peas, grain, chocolate and particularly baked beans. It is associated with benefits to the liver, but has yet to be approved for use in supplements by the EFSA.

O is for Organic food, which still accounts for only 1.2 per cent of Britain's groceries, despite being much richer in nutrients. A recent study for the Soil Association reveals that, on average, organic produce contains significantly higher levels of vitamin C, iron, magnesium and phosphorus than ordinary produce.

P is for Pregnancy, which accounts for a large chunk of the annual demand for food supplements. Most women know that folic acid has been found to reduce neural tube defects (spina bifida) in newborns and is extremely important prior to becoming pregnant, but few know that excessive doses of vitamin A or B6 can be harmful. Women who take large doses of vitamin A at about the time of conception or early in their pregnancy run a higher than average risk of delivering infants with birth defects. For expectant mothers more than any other consumers, it is important to pay attention to the Recommended Daily Allowances (RDAs) and to seek advice from the family doctor.

Q is for Quorn, the meat-substitute that provides the chicken fix for hungry vegetarians. Food supplements are particularly important for non-meat-eaters: a vitamin B12 supplement, or regular consumption of foods fortified with B12, is recommended, due to the fact that B12 is found in significant quantities only in animal products.

R is for Research, which experts on both sides of the regulation debate agree is in short supply. While some dieticians claim excessive doses of vitamins can cause health problems, others in the health-food industry believe there is little or no evidence of harmful effects. There also is not enough evidence about the benefits of taking added vitamins or minerals. Dr Robert Verkerk, a world-renowned scientist working with the Alliance for Natural Health, says: "We urgently need to find out more about food supplements - why we need them, what they do, and how we should take them."

S is for Selenium, a mineral needed by the body to make proteins, for healthy liver function, to boost the immune system, and help to remove heavy metals from the body. Crucially, it is a micronutrient - adults need only 60 or 70 micrograms as a daily requirement. Too much is toxic, so it is not currently on the Approved List.

T is for Tin, a mineral which some experts say delays hair and hearing loss, but there is insufficient proof to suggest that it is essential and no recommended daily intakes have been set. Furthermore, tin in food is generally considered to be a contaminant. It remains off the Approved List.

U is for U-turn, which is in effect what the European Court of Justice performed earlier this week. It upheld the Food Supplements Directive, rejecting British claims that the law is a breach of EU rules, and went against the opinion of the court's top legal adviser, who said in April that the directive should be scrapped for contravening basic EU principles of "legal protection, legal certainty and sound administration". But it also has created new ways for health-food manufacturers to get around the restrictions by using natural mineral sources as ingredients, and has made it easier to get ingredients added to the Approved List.

V is for Vanadium, a mineral commonly found in prawns and crayfish which is linked to energy production and the prevention of heart disease. The best dietary sources of vanadium are seafood, spinach, parsley, mushrooms and oysters.

W is for When? When do these changes take effect? The EU directive comes into play on 1 August, but many health-food stores have either already changed their products to comply with the ruling or applied to have ingredients added to the Approved List. The next stage will be a ruling on dosages, which many argue is the most important area of debate: should our daily intake of vitamins be restricted, and, if so, by how much and by whom?

X is for X-factor, the unquantifiable "zing" allegedly provided by effervescent tablets such as Berocca, which claims to provide a top-up for those whose 60-hour week or midweek drinking binges have depleted the body's store of vitamins. A Berocca tablet contains 12 per cent of the RDA of calcium and 32 per cent of the RDA of magnesium - but it also contains an eye-popping 793 per cent of the RDA for vitamin C and 850 per cent of the RDA of riboflavin (vitamin B2).

Y is for Why? Why can't we just get all these vitamins and minerals by eating more fruit and vegetables? The problems is that a combination of natural variety and the harmful effects of modern food production makes it impossible to guarantee how much of a particular nutrient is in each mouthful. For example, a brazil nut might contain trace levels of a mineral or a hefty dose of 100 micrograms. This could lead to excessive dosages. Ready meals are also driving up the need for supplements, because the levels of nutrients in the food is much lower than in fresh dishes.

Z is for Zinc, which is required for many of the body's functions. Zinc is crucial for proper growth. It promotes cell reproduction and tissue growth and repair. This is needed for wound healing. Zinc also is key to the proper working of the immune system. Zinc picolinate, which provides zinc in an easily absorbed form, is not on the Approved List.