Consumers now have a wide range of choices when it comes to how they take their supplements. But sometimes, there can be too many great choices, leading to some confusion about which supplement form is best for each individual. Some products are better suited to customers of certain lifestyles and ages thanks to differences in how supplements are absorbed in the body, which materials are used and the intended results. Store owners can help customers pick the right supplement by knowing basic facts about them and staying on top of the latest products, which now include vegetarian, vegan and even kosher options.

Break it Down
In order for a vitamin or dietary supplement to be effective, it must have high bioavailability, which is the proportion of a nutrient or bioactive ingredient that is absorbed from the gastrointestinal tract and made available for use and storage (1). Vitamins can be either water or fat soluble, according to the U.S. Food and Drug Administration (FDA) Web site. Water-soluble vitamins, like vitamins B3, B6, C and folic acid, are easily absorbed by the body and the kidneys help excrete any excess supplies. On the other hand, fat-soluble vitamins, like vitamins A and D, are absorbed with the help of bile acids and they are stored in the body for future use as needed (2).

The delivery method is key to how quickly active ingredients enter the system. For instance, many industry experts feel that the main difference between traditional pills and other delivery forms like liquids is that the latter are absorbed faster into the body (3). Gender, age, health factors and the dosage amount also affect bioavailability.

Remember, however, faster absorption is not necessarily better when it comes to vitamins and each delivery method has benefits for different people.

Marrying Shoppers and Supplement Forms
What consumers think of as “pills” come in various forms including tablets, capsules and softgels. Tablets, which are solid and may have a coating, often include concentrated ingredients plus excipients, which are inactive ingredients (4). These excipients mix with the actives to help with absorption or delivery. One knock against traditional pill forms is that they can be large and difficult to swallow, depending on the formulation. However, they are often very cost-effective when compared with other delivery methods because they are less expensive to manufacture. They also have a longer shelf life than most liquids, powders and effervescents, which is convenient for store owners.

Although some say that tablets are not as bioavailable as liquid supplements and their contents can be destroyed by stomach acids, many high-quality tablets are protected by an enteric coating (5). This type of coating helps slow or delay the release of actives for maximum absorption. Softgels can be recommended for those who have trouble swallowing larger pills, as their gelatinous covering makes them softer and smoother.

Other possible benefits for shoppers is that traditional pill forms often don’t include sugar to improve taste, and often they pack more nutrients into a smaller serving than do other delivery forms.

Chewable tablets are a good option for people who don’t like gulping down solid pills, especially kids. Many companies market chewables towards children, putting them in colorful packaging and using a variety of shapes, gummy textures and all-natural flavors like cherry, grape and orange. Chewable vitamins can also be quickly absorbed since digestion begins as soon as enzymes in the mouth act on the tablet. Solid pills and chewables are convenient since they are small, light and don’t have to be refrigerated. However, to ensure good taste and color, some chewables, as well as liquid supplements, include sweetening and coloring agents. For those who prefer their vitamins without sugar, there are many supplements that add all-natural sweeteners such as agave or stevia.

Liquid supplements are also a squirm-free way to give children their daily vitamins, as they are easy to swallow and come in many different flavors, which make them fun to take. Parents often give liquid supplements to infants, and although this is a great and easy way to provide nutrition for them, the FDA released a consumer update in June 2010 cautioning parents that some droppers in vitamin D products can hold a greater amount of the liquid than an infant should receive (6). Therefore, parents intending to give babies liquid supplements should only use a product with a small dropper specifically developed for young children.

Liquids are not just for children. Many elderly people have trouble swallowing larger pills, so liquids are a good option for them, too. If taste or consistency is a problem for these clients, some liquid vitamins can be taken mixed with water for a subtler taste. Another plus is that liquid supplements allow for more flexible dosing if customers prefer to take smaller doses throughout the day.

Somewhat new on the market are smoothie and emulsion forms of supplements (like fish oil) that share many benefits with liquid supplements and can be very convenient for kids, adolescents and adults. They have a pudding-like consistency and often come in fun all-natural flavors, as well as vegan or sugar-free options so they can be used by anyone with dietary restrictions. One manufacturer of a fish oil smoothie supplement has developed unique flavors like chocolate–raspberry, mango–peach, strawberry–banana and orange cream (7).

This form isn’t just about the taste. A recent study conducted by the Centre for Nutritional Studies found that an emulsified fish oil product was 90% more bioavailable than standard fish oil and one two-teaspoon dose of the product would equal  the bioavailability of 20 standard fish oil softgels (7).

Other forms include powders, effervescents, sublinguals and sprays. Powders are often cost-effective and allow for flexibility with dosing like liquid supplements, but they are more practical for supplements taken in gram quantities such as creatine, protein and glutamine. A typical five gram serving of creatine is a small scoop of powder mixed in with water or juice, but to get the same dose with capsules, one would have to take 10 500-mg capsules. For those who don’t want to mix powders with liquids, some supplement makers are offering powders that dissolve in the mouth. They often come in premetered packages like straws with flavored powder inside. According to one supplier of such supplements, this form is ideal for those who travel and want to take their nutrients on the go (8).

Effervescent vitamins, which taste like a fizzy drink, are also increasing in popularity. A report in Nutrition Business Journal states that 15% of supplements sold in the United States between 2005 and 2008 were effervescent products (9). According to a study published in Clinical Therapeutics, carbon dioxide makes a vitamin more bioavailable, so the carbonation from effervescent supplements can make them highly absorbable (10).

Sublingual tablets, or those placed under the tongue or between the cheek and gums to dissolve, are a good alternative to swallowing pills or liquids. Manufacturers of these say that they are directly absorbed into the bloodstream and the nutrients are not destroyed by the strong acids found inside the digestive tract. Similarly, sprays enriched with vitamins have similar properties and also add flavor.

Clearly, the supplement market keeps expanding and it is a good idea to be proficient when it comes to the benefits and drawbacks of the various supplements delivery methods. Matching up a consumer with the right product will make it easier for them to incorporate supplements into their daily routines. WF

References
1. National Institutes of Health/American Society for Nutritional Sciences, “Bioavailability of Dietary Supplements,” The Pharmaceutical Journal, 264 (7084), 304–305 (February 19, 2000), www.pharmj.com, accessed June 26, 2010.
2. U.S. Food and Drug Administration (FDA), “Consumer Update: Fortify Your Knowledge About Vitamins,” February 21, 2009, www.fda.gov, accessed June 26, 2010.
3. “Sorting Out Supplements: Tablets vs. Capsules vs. Liquids vs. Powders vs. Chewables,” October 23, 2008, www.allstarhealth.com, accessed June 26, 2010.
4. C. Margolin, “Many Health Supplements Contain Excipients,” July 6, 2009, www.vitaminbenefits.info, accessed June 26, 2010.
5. Colorcon, “Nutrateric Nutritional Enteric Coating System,” www.colorcon.com, accessed June 26, 2010.
6. FDA, “Infant Overdose Risk With Liquid Vitamin D,” June 15, 2010, www.fda.gov/ForConsumers/ConsumerUpdates/ucm214343.htm, accessed June 26, 2010.
7. Barlean’s Organic Oils, “Barlean’s Omega Swirl is 90% More Bioavailable that Standard Fish Oil,” press release, January 13, 2010.
8. Rich Vitamins, www.alternavites.com, accessed June 26, 2010.
9. “Powered, Effervescent Delivery Modes Grab Growing Market Share,” Nutr. Bus. J. July 28, 2008.
10. M. Darwish, et al., ?Relative Bioavailability of the Fentanyl Effervescent Buccal Tablet (FEBT) 1080 pg versus Oral Transmucosal Fentanyl Citrate 1600 pg and Dose Proportionality of FEBT 270 to 1300 Ìg: A Single-dose, Randomized, Open-Label, Three-Period Study in Healthy Adult Volunteers,” Clinical Therapeutics 28 (5), 715–724 (2006).

Published in WholeFoods Magazine, Aug. 2010 (epub July 2010)