Nutrivigilance: a critical evaluation of post-market safety surveillance in nutritional and dietary products

The burgeoning global consumption of dietary supplements, nutraceuticals, herbal formulations, and functional foods underscores the necessity for rigorous post-market safety monitoring. While these products are widely perceived as “natural” and therefore safe, accumulating evidence indicates clinically relevant adverse events, including hepatotoxicity, nephrotoxicity, cardiovascular disturbances, endocrine dysfunction, and serious interactions with prescription medications. Nutrivigilance, analogous to pharmacovigilance, provides a structured framework for the detection, assessment, and prevention of adverse events related to nutritional products. For lifestyle medicine, nutrivigilance is especially relevant because supplements are frequently used alongside behavior-change interventions and chronic disease prevention programs, increasing the need for systematic documentation, patient counseling, and early recognition of harm. This narrative review summarizes the concept and scope of nutrivigilance, highlights evidence of adverse events, and outlines key regulatory approaches in the United States, Europe, and India. We additionally present practical implications for clinicians and consumers, identify evidence gaps, and propose future priorities to strengthen surveillance and protect patients. Strengthening nutrivigilance through improved reporting, integration with existing safety systems, product quality oversight, and education of clinicians and consumers can reduce preventable harm and support safer, more informed use of nutritional products.