Complément alimentaire 939327 31189810 2008-07-01T09:58:50Z 80.94.101.42 Un '''complément alimentaire''' est censé fournir un complément de [[nutriment]]s ([[vitamine]]s, [[minéraux]], [[acide gras|acides gras]] ou [[acide aminé|acides aminés]]) manquants ou en quantité insuffisante dans le [[diététique|régime alimentaire]] d'un individu. A la différence des [[additifs alimentaires]] qui sont mélangés à certains aliments, le complément est lui vendu de façon isolée. ==Nécessité des compléments alimentaires== Une [[cuisine]] saine est censée fournir une [[alimentation]] équilibrée répondant aux [[Apport journalier Recommandé|AJR]] et évitant ainsi le besoin de '''suppléments alimentaire'''. Toutefois, le mode d'alimentation moderne peut induire certaines [[carences alimentaires ]]. Par exemple, un homme adulte à l'activité moyenne aura besoin de 0,8 gramme de protéines par jour et par kg ; la consommation de [[viande]] lui permettra d'atteindre ce montant assez facilement ; en revanche, la consommation exclusive de [[salade (plante)|salade]] ne le permettra pas. Toutefois, l'homme a également quotidiennement besoin d'un certain apport de [[fibre]]s pour sa [[digestion]] et son [[transit intestinal]], fibres qui lui seront apportées par la salade et non pas par la viande. Les [[bébé]]s et [[enfant]]s ont besoin d'apports en [[vitamine D]], laquelle devrait idéalement être apportée par l'[[alimentation]], mais sera souvent prise sous forme de [[compléments alimentaires]] en raison de sa faible disponibilité dans la ration quotidienne. En Europe, la vitamine D était jusqu'à récemment souvent apportée par l'[[huile de foie de morue]]. De même, les [[femme]]s ont des besoins 77% plus élevés que les [[homme]]s en [[fer]], et ce dès la [[puberté]] (en raison des pertes dues aux [[Menstruation|règles]] ou aux [[accouchement]]s), ainsi qu'en [[calcium]] lors de la [[ménopause]] (pour éviter l'[[ostéoporose]], conséquence des modifications [[hormone|hormonales]]). Or les aliments vont contenir des quantités variables de vitamine D, de fer ou de calcium. Il en résulte que seule une alimentation équilibrée, associant des aliments de types nutritionnels différents (ou au pis aller un apport en complément alimentaire) peut assurer les apports des éléments indispensables. ==Utilité médicale== L'utilité médicale de ces compléments est controversée et leur statut varie selon les pays : ===Aux [[États-Unis]]=== Le '''complément alimentaire (dietary supplement)''' est défini par le '''Dietary Supplement Health and Education Act of 1994'''<ref>[http://www.fda.gov/opacom/laws/dshea.html US Dietary Supplement Health and Education Act of 1994]</ref> comme un produit répondant aux critères suivants: #Il est conçu pour être complémentaire d'un [[diététique|régime alimentaire]] et peut être un comprimé, une capsule ou un liquide composé de: #*une [[vitamine]], #*un [[minéral]], #*un [[végétal]] à l'exception du [[tabac]], #*un [[acide aminé]], #*une [[enzyme]], #*une [[barre énergétique]], #*un [[métabolite]]. #Il doit être précisé qu'il ne s'agit pas d'une alimentation classique et ne doit pas être consommé comme unique source d'alimentation. #Il doit être clairement étiqueté comme "complément alimentaire". La [[Food and Drug Administration|FDA]] considère les compléments alimentaires comme de la nourriture, et non comme des [[médicament]]s. Elle ne doit donc pas pré-approuver leur sécurité et leur efficacité mais elle peut s'attaquer à des fabricants si elle constate a posteriori la présence de produits dangereux sur le marché. Toutefois, certains aliments (tels que les produits pour enfants ou les [[alicament]]s) sont plus surveillés car ils concernent des populations plus vulnérables. <!--The claims that a dietary supplement makes are essential to its classification. If a dietary supplement claims in any way to cure, mitigate, or treat a disease, it would be considered to be an unauthorized new drug and in violation of the applicable regulations and statutes. As the FDA states it in a response to this question in a [[FAQ]]: <blockquote> '''Is it legal to market a dietary supplement product as a treatment or cure for a specific disease or condition?''' <br> ''No, a product sold as a dietary supplement and promoted on its label or in labeling* as a treatment, prevention or cure for a specific disease or condition would be considered an unapproved--and thus illegal--drug. To maintain the product's status as a dietary supplement, the label and labeling must be consistent with the provisions in the Dietary Supplement Health and Education Act (DSHEA) of 1994.'' <br> <small>*Labeling refers to the label as well as accompanying material that is used by a manufacturer to promote and market a specific product.</small> </blockquote> Dietary supplements are permitted to make structure/function claims. These are broad claims that the product can support the structure or function of the body (e.g., "glucosamine helps support healthy joints"). The FDA must be notified of these claims within 30 days of their first use, and there is a requirement that these claims be substantiated. Nevertheless, many critics claim that dietary supplements overstate their importance and their impact on overall health. Evidence of many of the claimed benefits of certain dietary supplements has yet to meet standard scientific criteria of credibility, based on large scale, [[double blind]] testing with statistically significant outcomes. Other claims that required approval from FDA include health claims and qualified health claims. Health claims are permitted to be made if they meet the requirements for the claims found in the applicable regulations. Qualified health claims can be made through a petition process, including scientific information, if FDA has not approved a prior petition. ==European Union== The '''Food Supplements Directive'''<ref>[http://europa.eu.int/eur-lex/lex/LexUriServ/LexUriServ.do?uri=CELEX:32002L0046:EN:HTML Directive 2002/46/EC of the European Parliament and of the Council of 10 June 2002 on the approximation of the laws of the Member States relating to food supplements]</ref> requires that supplements be demonstrated to be safe, both in quantity and quality. Some vitamins are essential in small quantities but dangerous in large quantities. Some herbal remedies, notably [[St Johns Wort]], may interact with drugs or render them less effective. Such an issue has been raised in the case of oral contraceptives. Consequently, only those supplements that have been proven to be safe may be sold without prescription. In practice, the number of reported incidents with food supplements is nevertheless low. In Europe, it is also an established notion that food supplements should not be labeled with drug claims but can bear -to a degree that differs from one member state to the other- [[health claim]]s. ===Legal challenge=== The dietary supplements industry in Europe strongly opposed the Directive. A large number of consumers throughout Europe, including over one million in the UK, and many doctors and scientists, have signed petitions against what are viewed by the petitioners as unjustified restrictions of consumer choice <ref name="Times">[http://www.timesonline.co.uk/article/0,,13509-1690686,00.html "Controversial EU vitamins ban to go ahead" (the Times, July 12 2005)]</ref>. The [[European Court of Justice]] ruled<ref>[http://www.curia.eu.int/en/actu/communiques/cp05/aff/cp050066en.pdf The Court confirms the validity of the Community Directive on food supplements (Press release)]</ref> on 12 July 2005 that the Directive is valid, although the court's own Advocate General advised that the declaration was invalid under EU law <ref name="Times"/>. The court made clear, however, that it must be possible for manufacturers to add vitamins and minerals to the list of ingredients of a food supplement, that refusal must be on scientific grounds, and that there should be a right to appeal. ==Russia== Russian legislation, Ministry of Health's order № 117 dated as of 15 April, 1997, under the title “Concerning the procedure for the examination and health certification of Biologically Active Dietary Supplements”, provides the usage of the following terminology: : As a rule, BADSs are foodstuffs with clinically proven effectiveness. BADSs are recommended not only for prophylactics, but can be included into a complex therapy for the prevention of pharmaceutical therapy's side effects and for the achievement of complete remission. The development of BADSs and their applications has been very fast moving. They were originally considered as dietary supplements for people who had heightened requirements for some normal dietary components (for example, sportsmen). Later, they were employed as preventive medicines against chronic diseases.--> ==Voir aussi== Dans les pays souffrant de [[malnutrition]], on parle plutôt de [[supplémentation]]. ==Notes== <references /> ==Liens externes== *{{en}} [http://www.cfsan.fda.gov/~dms/supplmnt.html Dietary Supplement] ''Further information'' *{{en}} [http://www.cfsan.fda.gov/~dms/dietsupp.html US FDA/CFSAN Dietary Supplements] *{{en}} [http://www.lsro.org/aers/frames_aers_reports.html Monitoring the Adverse Health Effects of Dietary Supplements] ''Further information'' *{{en}} [http://nccam.nih.gov/health/bottle/ What's in the Bottle? An Introduction to Dietary Supplements (NCCAM)] *{{en}} [http://nccam.nih.gov/health/supplement-safety/ NIH info on herbal supplements] *{{en}} [http://www.nnfa.org National Nutritional Foods Association] *{{fr}} [http://www.fortepharma.com Forté Pharma, spécialistes des compléments alimentaires] ''En savoir plus'' [[Catégorie:Complément alimentaire]] [[cs:Doplněk stravy]] [[de:Nahrungsergänzungsmittel]] [[en:Dietary supplement]] [[es:Suplemento dietético]] [[it:Integratore alimentare]] [[ja:サプリメント]] [[nl:Voedingssupplement]] [[no:Kosttilskudd]] [[pl:Suplement diety]] [[ru:Биологически активные добавки]] [[sl:Prehransko dopolnilo]] [[sv:Kosttillskott]] [[zh:膳食补充剂]]