Description	Choline is a vitamin-like water-soluble organic compound. It is an essential nutrient naturally present in some foods and in dietary supplements. Although the body can produce small amounts of choline in the liver, we still need to consume it in foods to gain enough.
Function/ Used for	Choline is a source of methyl groups needed for many steps in metabolism. The body needs choline to synthesize phosphatidylcholine and sphingomyelin, two major phospholipids vital for cell membranes and also the neurotransmitter acetylcoline. It is vital for good brain health and brain development in unborn babies1. Choline also contributes to normal lipid metabolism, homocysteine metabolism and liver function¹.
Intake	Adequate Intake (AI) as recommended by EFSA2: 400mg/day The AI for pregnant women is set at 480mg/day and for lactating women is raised to 520mg/day.
As a supplement	Commonly available as a single supplement. Also available in combination with B-complex vitamins, and in some multivitamin/multimineral products. Different multivitamin and minerals products will vary in the percentage NRVs amount of choline they include. People should always check the label for information about a specific product.
Found in (dietary sources)	Good sources of choline include mostly animal products such as eggs, milk, oily fish such as salmon, and meat. Plant-based sources include cruciferous vegetables, beans, mushrooms, peanuts and soya products.
Deficiency	Choline deficiency (although rare) can cause muscle and liver damage as well as non-alcoholic fatty liver disease (NAFLD)². Genetic pre-dispositions and gender can influence individual requirements for choline³.
Precautions and contraindications	Safe Upper Level (Guidance Level): not established.
Use in pregnancy and breastfeeding	Suggested choline intakes increase during pregnancy and lactation² (see ‘Intake’).
Interactions e.g. with other medications	Choline is not known to have any clinically relevant interactions with medications.
Adverse effects	Choline is considered to be very safe in quantities consumed through the diet. Excessive intake (>7g/day) has been found to cause hypotension and gastrointestinal effects alongside a fishy body odour. Choline has also been shown to increase trimethylamine-N-oxide (TMAO) production which has been linked to increased risk of cardiovascular disease².
References	1 EU Community Register of Nutrition and Health Claims http://ec.europa.eu/food/safety/labelling_nutrition/claims/register/public/?event=register.home 2 EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA); Dietary Reference Values for choline. EFSA Journal 2016. 14(8): e04484. [online]. Available at: https://doi.org/10.2903/j.efsa.2016.4484 3 National Institutes of Health Office of Dietary Supplements; Choline: Fact Sheet for Health Professionals [online]. Available at: https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/#en4

Description	Co-enzyme Q10 (CoQ10), sometimes called Ubiquinone, is a naturally occurring vitamin-like substance produced by the body. It is found in the mitochondria of all cells in the body, but particularly in those of the heart, liver, kidneys and pancreas. Co-enzyme Q10 is produced in the body but the ability to synthesise CoQ10 reduces with age.
Function/ Used for	CoQ10 is needed for the process that converts the energy from food into energy that can be used by the body. CoQ10 also works as an antioxidant, neutralising potentially damaging free radicals to stabilise cell membranes and protect both lipids (fats) and proteins. It also works to regenerate other antioxidants such as vitamin E. CoQ10 is also essential for the normal function of the heart muscle.
Intake	N/A
As a supplement	CoQ10 is sold in capsules and tablets in strengths of 10–200 mg. Absorption is increased when capsules containing CoQ10 in an oil base are taken with meals.¹
Found in (dietary sources)	CoQ10 can be mainly found in organ meats such as liver and kidneys; fish and shellfish; and the germ portion of whole grains. It can also be found in smaller quantities in soya beans, nuts and vegetables, particularly spinach and broccoli.
Deficiency	N/A
Precautions and contraindications	CoQ10 should not be used to treat cardiovascular disorders without medical supervision.
Use in pregnancy and breastfeeding	Safety in pregnancy and breastfeeding has not been established.
Interactions e.g. with other medications	In patients on warfarin (an anti-coagulant) and heart medication (eg. Beta-blockers), high doses of CoQ10 should be used with caution. The synthesis of CoQ10 follows a similar biochemical pathway as cholesterol and, therefore, drugs which lower cholesterol such as statins also inhibit CoQ10 production in the body. Other drugs which may reduce levels of CoQ10 include hypertensive drugs (used to treat high blood pressure, e.g. clonidine, hydralazine, methyldopa), thiazide diuretics (e.g. hydrochlorothiazide) and tricyclic antidepressants (e.g. amitriptyline).²
Adverse effects	CoQ10 appears to be safe and relatively well tolerated in doses of 10–200 mg daily. There are occasional reports of gastrointestinal discomfort, dizziness and skin rash, but these tend to occur with doses in excess of 200mg daily.¹
References	¹ Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. ² Gaby A.R et al. A-Z Guide to Drug-Herb-Vitamin Interactions. Health Notes. Three Rivers Press. New York. 2006

Description	Glucosamine is a substance which occurs naturally within the human body. It is found within the fluid around joints and within other connective tissues.
Function/ Used for	The body uses glucosamine to build and repair cartilage and it may help to maintain healthy joints. It has an anti-inflammatory action and has been used to relieve pain, stiffness and swelling of the knees, fingers and other joints, as well as arthritic back and neck pain. Glucosamine may also increase the production of cartilage components and has been used to speed up the healing of sprains and strengthen joints. A 2005 Cochrane review of 20 randomised controlled trials demonstrated the effectiveness of Glucosamine in the reduction of pain and improvement of joint function in osteoarthritis and also demonstrated its safety².
Intake	N/A
As a supplement	Glucosamine comes in capsule, tablet or powder forms. It is available as a synthetically manufactured food supplement in the form of glucosamine sulphate and glucosamine hydrochloride. A dose of glucosamine sulphate 500mg three times a day (1500mg daily) is generally recommended. A minimum of 4 weeks may be needed for the full benefit to be seen.¹ Glucosamine is sometimes provided in supplements with chondroitin, an important component of cartilage, with which it may act synergistically.
Found in (dietary sources)	Small amounts are provided in the diet by animal and fish products.
Deficiency
Precautions and contraindications	People who are allergic to shellfish should not take glucosamine supplements, unless taking the vegetarian form.
Use in pregnancy and breastfeeding	No problems have been reported, but there have not been sufficient studies to guarantee the safety of glucosamine in pregnancy and breast-feeding.¹
Interactions e.g. with other medications	None known. Although insulin or oral hypoglycaemics used for the treatment of diabetes may be less effective. People with diabetes taking glucosamine should be aware of its potential influence on glucose metabolism¹.
Adverse effects	Glucosamine is relatively non-toxic, although some side-effects reported include constipation, diarrhoea, heartburn, nausea, drowsiness, headache and skin rash¹.
References	1. Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001. 2. Towheed et al. Glucosamine therapy for treating osteoarthrtitis. Cochrane database, issue 2, 2005.

Description	Prebiotics are forms of dietary fibre which cannot be digested, but which can be fermented within the gut by specific colonies of gut bacteria that are recognised as being beneficial to health. The fermentation process feeds the bacterial species and produces chemical byproducts which are also thought to be beneficial.¹ Different types of fibre support different species of bacteria.
Function/ Used for	There are a number of different types of prebiotic recognised which support different types of gut bacteria; the two most researched forms are: Fructo-oligosaccharides (FOS) which is fermented by the Lactobacillus forms of gut bacteria Galacto-oligosaccharides (GOS) which is fermented by the Bifidobacterium colonies in the gut The benefits of prebiotics are still being explored and may go beyond those conferred by probiotics (the colonies of beneficial bacteria that FOS and GOS support). Current understanding of prebiotics indicates that they support the health of the gastrointestinal tract, may reduce blood lipid levels and may support the immune system.²
Intake	N/A
As a supplement	Both FOS and GOS are widely available in health food stores across the UK. Dosage will vary between products; however it is a regulatory requirement that dosage is noted on the packaging of any food supplement.
Found in (dietary sources)	N/A
Deficiency	N/A
Precautions and contraindications	None known.
Use in pregnancy and breastfeeding	No known problems.
Interactions e.g. with other medications	None reported.
Adverse effects	Some reports of flatulence, bloating and diarrhoea which is reversed on stopping treatment.
References	Schrezenmeir J, de Vrese M. Probiotics, prebiotics, and synbiotics – approaching a definition. The American Journal of Clinical Nutrition 2001; 73:2 361s-364s Gibson GR, Hutkin R, Sanders ME, Prescott SL, Reimer RA, Salminen SJ, Scott K, Stanton C, Swanson KS, Cani PD, Verbeke K, Reid G. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nature Reviews GI & Hep 2017; 14:491–502

Description	A probiotic is a live microbial food supplement that contains microbial substances normally found in the gut.
Function/ Used for	Probiotics such as acidophilus and bifidus are consumed to improve digestion. Once in the gut they work by multiplying and restoring the balance of the normal bacterial population of the intestine. Probiotics may also help to support the health of the immune system.
Intake	N/A
As a supplement	Available as bio-yoghurts or fermented milk based drinks. Also as capsules and tablets. To be effective, they should be consumed daily. Many probiotics should be kept refrigerated and should be consumed before the expiry date. There is no established dose for these products.
Found in (dietary sources)	N/A
Deficiency	N/A
Precautions and contraindications	None known.
Use in pregnancy and breastfeeding	There is no evidence of adverse effects in pregnancy.
Interactions e.g. with other medications	None reported¹.
Adverse effects	None known.
References	1. Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.

Description	Royal Jelly is a milky-white substance produced by the salivary glands of worker bees as a food source for the queen bee. It is an essential food for the queen bee.
Function/ Used for	Royal jelly supplements are thought to assist general well-being. It may have antiseptic properties and also act as a vasodilator (widening of blood vessels).
Intake	N/A
As a supplement	Royal jelly is available in the form of tablets and capsules. The dose is not established. Dietary supplements provide 250-500mg daily¹.
Found in (dietary sources)	N/A
Deficiency	N/A
Precautions and contraindications	Not to be taken by asthma sufferers or those allergic to bee stings.
Use in pregnancy and breastfeeding	No problems reported, but there is insufficient evidence to guarantee the safety of royal jelly in pregnancy and breastfeeding.
Interactions e.g. with other medications	None reported
Adverse effects	Allergic reactions, which can be severe.
References	1. Mason, P. Dietary Supplements. Pharmaceutical Press, London, 2001.

µg	Microgram a measurement of weight equal to one millionth of a gram (or one thousandth of a milligram). Microgram (µg or mcg) is used for a number of nutrients found in food supplements.
Amino Acid	The building blocks of protein, there are eight essential amino acids which cannot be synthesised within the body and therefore must come from the diet. These are: isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan and valine. In addition arginine and histidine are amino acids required by infants and young children which supports their rapid growth.
Antioxidant	A substance or nutrient which helps to protect our cells from damage caused by free radicals, damaging molecules which are found in pollution and tobacco smoke. Our bodies also produce free radicals as part of the normal biochemistry of living.
Deficiency	A lack of essential macronutrients or micronutrients which results in malnutrition and or disease. This may be the result of inadequate intakes or absorption issues associated with gastrointestinal disease. There are a number of recognised deficiency diseases including (but not exclusively): scurvy (vitamin C deficiency); rickets (vitamin D deficiency); anaemia (iron deficiency, but also deficiencies in B12 and folic acid) and Kwashiorkor (protein deficiency).
DH	The Department of Health is a UK Government department. It has responsibility for nutrition legislation and sets health policy for nutrition.
DHA	Docosahexaenoic acid; one of the key omega-3 fats that provides health benefits
Dietitian	An individual qualified in nutrition and dietetics who can assess, diagnose and treat health issues associated with nutrition and diet. Dietitians are governed by law with a statutory code of practice; they often work within the health service although increasing numbers are also working in a freelance capacity.
EFA	Essential fatty acids (omega 3 and omega 6) cannot be synthesised by the body and must be derived from the diet. EFAs do not provide fuel for energy production and are required for vital biological processes which support growth, development and health.
EFSA	European Food Safety Authority; the European Union food risk management agency which scientifically evaluates safety across all areas of food.
EPA	Eicosapentaenoic acid; one of the key omega-3 fats that provides health benefits.
Fat soluble vitamin	The fat soluble vitamins are vitamins A, D, E and K. Because they are fat soluble these substances can accumulate in the body, often being stored in fat cells, or in the liver. This can create health issues, particularly if intakes have been high for a prolonged period of time. For example, long term high intakes of vitamin D may lead to the laying down of calcium in tissues such as liver and kidneys which can cause nausea and vomiting.
Food supplement	A food supplement is a concentrated source of vitamins, minerals or other substances with a nutritional or physiological effect which is sold in small, measured unit doses.
FSA	The Food Standards Agency is a non-ministerial UK Government department responsible for food safety and food hygiene.
GLA	Gamma-linoleic acid is an omega-6 fatty acid (an essential fatty acid considered to be necessary for human health which must be derived from the diet). GLA is most commonly found in evening primrose oil (EPO), borage or starflower oil and blackcurrant seed oil.
Health claim	A health claim is any claim which states, or implies, that consumption of a specific food will have a beneficial effect on health. Claims may be written, verbal or pictorial.
Herbal medicine (herbal remedy)	A product is considered to be a herbal medicine if the main active ingredient/s are only herbal substances or preparations. Not all herbal products are medicines, some may be food supplements and some may be cosmetics. What determines if a product is, or is not a medicine is complex but generally rests with how the product is presented (i.e. does it make medicinal claims to treat, prevent or cure any disease) and what it does (i.e. does it have a physiological impact on, or alter, any body functions).
Macronutrient	Dietary constituents which are needed in significant amounts, generally protein, fat, carbohydrate, fibre and water.
Malnutrition	Malnutrition is a state in which the deficiency of nutrients such as energy, protein, vitamins or minerals results in measurable adverse effects on the body. Malnutrition may refer to insufficient intake of protein, carbohydrate and fats (macronutrients) which can result in overly low BMI. It may also be insufficient intake of vitamins, minerals and other micronutrients, which can impact on overall health and could include obese individuals with poor diets.
Mg	Milligram is a measurement of weight equal to one thousandth of a gram. Mg is used for a number of nutrients found in food supplements.
Micronutrient	A substance derived from food which is needed in extremely small amounts for the normal growth and development of living beings. Micronutrients are vitamins, minerals and essential fatty acids (omega-3 fats)
Mineral	Inorganic micronutrient essential to health and wellbeing. Minerals are absorbed from soil by plants which are in turn eaten by animals or humans. Minerals may be split into minerals which are needed in relatively high amounts (calcium, phosphorus, magnesium, sodium, chloride and potassium) and trace elements (iron, zinc, cobalt, copper, chromium, fluoride, iodine, manganese, molybdenum, boron and selenium) which are needed in very small quantities.
Multivitamin	A product which contains more than one vitamin, often multivitamins will contain all 13 vitamins although some may contain only the eight B vitamins, or a combination of some of the vitamins and some additional minerals.
NDNS	The UK National Diet and Nutrition Survey is a continuous rolling survey of the dietary habits and nutritional status of adults and children in the UK. The results are used to assess whether intakes of food and nutrients are adequate across different ages and population groups.
NRV	Nutrient Reference Value is the amount set by the European Food Safety Authority (EFSA), primarily to support food labelling, which the majority of the population requires to maintain health. Previously known as RDA
Nutrient	A substance derived from food which provides nourishment to the body and is essential for the maintenance of life and for growth and development.
Nutritionist	Nutritionists generally work for public bodies or governments, although some do work with private clients. They tend to look at large populations to determine risk factors and make dietary recommendations that are applied at population levels. For example, evidence on the incidence of type II Diabetes led public health nutritionists to determine that some populations are more at risk of developing this disease, and to make recommendations for dietary changes to either reduce the risk or manage the disease. However, public health nutritionists do not practice with individual patients.
Omega-3 fats	Essential fatty acids which cannot be synthesised by the body and must be derived from the diet. Primary sources for omega-3 fats are oily fish and fish oil supplements with some also coming from enriched eggs and fortified foods. There are a number of scientifically proven health benefits for omega-3 fats including supporting the health of the eyes, brain and heart, maintaining an appropriate balance of triglycerides in the blood and reducing blood pressure.
Omega-6 fats	Essential fatty acids which cannot be synthesised by the body and must be derived from the diet. Primary sources for omega-6 are vegetable oils such as sunflower and corn oils as well as nuts and seeds. There are a number of health benefits associated with omega-6 fatty acids; they are thought to be beneficial in the management of premenstrual syndrome and in some skin conditions including eczema and psoriasis.
PAGB	Proprietary Association of Great Britain (PAGB) is the UK trade association which represents the manufacturers of branded over-the-counter medicines, self care medical devices and food supplements.
Prebiotics	Foods which promote the growth of probiotics, the beneficial bacteria that inhabit our gut. Prebiotics are generally fibres such as inulin, which our bodies cannot digest and absorb but which provide a food source for probiotics.
Probiotics	Live bacteria (and some yeasts) which inhabit the digestive tract which are viewed as being beneficial to human health. There are thousands of different bacterial strains; some are resident in specific areas of the digestive tract whilst others are transient, simply passing through.
Public Health England (PHE)	Public Health England is an agency of the Department of Health responsible for improving public health. They work with local government, the NHS and non-governmental organisations as well as communicating public health messages to the general public.
PUFA	Polyunsaturated fatty acids (PUFA) are found in nuts, seeds, fish (and fish oil), krill and some algae, small amounts are also found in leafy greens. The omega-3 and omega 6 fats are PUFAs, which are generally associated with health.
RDA	Recommended Daily Amount; previously used terminology for the amount set, primarily to support food labelling, which the majority of the population require to maintain health. Now described using nutrient reference value (NRV)
SUL	Safe Upper Levels of vitamins and minerals were established by the Expert Group on Vitamins and Minerals who published a report in 2003 (https://cot.food.gov.uk/sites/default/files/cot/vitmin2003.pdf). The UK food supplements industry works to the levels set in this report.
Vitamin	Organic micronutrient essential to health and wellbeing. Vitamins cannot be synthesised in sufficient amounts by the animal or human body and must therefore be obtained from the diet. Plants manufacture vitamins which move up the food chain as the plants are consumed by animals or humans. Vitamins can be divided into fat soluble (vitamins A, D, E and K) and water soluble (vitamins B1, B2, B3, B5, B6, B12, biotin, folic acid and vitamin C).
Water soluble vitamin	The B vitamins and vitamin C are water soluble. They are not stored in any significant quantities within the body and are generally either utilised or excreted in the urine. As they are not stored in the body, they tend to have low toxicity and are needed on a daily basis.

Choline

Co-enzyme Q10

Glucosamine

Prebiotics

Probiotics

Royal Jelly