Dietary Supplements: The Myths and Realities
In 1994 Congress passed the Dietary Supplement Health and Education Act, which led to an explosion of manufactured compounds which are now number to more than 80,000 products on the market and the number continues to grow. Types of dietary supplements include:
- Vitamins and minerals (Vitamin C and E, selenium)
- Herbs (botanicals such as ginseng, ginkgo)
- Proteins and amino acids (chondroitin sulfate, creatine)
- Hormones, hormone precursors (DHEA, vitamin D)
- Fats (fish oils, EPA, DHA)
- Other Plant extracts (garlic capsules, fiber, echinacea, green tea)
A recent edition of Consumer Reports (December 2019) has provided a very comprehensive article by Kevin Loria entitled “Shop Smarter About Supplements” that everyone should read if you take any dietary supplements to fully understand why consumers should be aware of the realities, both positive and negative of these products. Americans place lot of trust in diet supplement safety even though they are largely unregulated.
Here are some FACTS: Source: Consumer Reports
- Percentage of Americans who take a supplement at least once a week: 68%
- Percentage of Americans who take a supplement once a day: 54%
- Percentage of Americans who say “supplements are safe”: 71%
- Percentage of Americans who think supplements are tested by the Food and Drug Administration (FDA): 48%
- Percentage of Americans who think the term “natural” means a supplement is safe or wholesome: 33%
- Percentage of Americans who think supplements are safer than Rx or over-the-counter drugs: 38%
- Percentage of Americans who think supplements usually work as well as Rx drugs: 32%
However, under the Dietary Supplement Health and Education Act, diet supplements do not have to be tested prior to marketing or shown to be safe or effective. Although they are often advertised to relieve certain ailments, they are not considered to be drugs. They are not subjected to vigorous testing to prove safety or effectiveness, as drugs must be. The FDA largely relies on any claims from the manufacturers. It has been shown that many industry-funded studies only favor positive results and many negative effects never see the light of day. So when you read in a headline for a supplement, “clinical trials have shown…,” the bias of the manufacturer of the study results may be suspected.
In fact, each supplement label must include the following declaration of any claim:
“This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”
To summarize the realities:
- FDA does not approve, test, or regulate the manufacture or sale of dietary supplements.
- The FDA has limited power to keep potentially harmful dietary supplements off the market.
- Dietary supplements often do not list side effects, warnings, or drug or food interactions on product labels.
- Ingredients list on dietary supplement labels may not include all active ingredients.
- Dietary supplements may not relieve problems or promote health and performance as advertised.
- Many products may remain on the market because “there’s a strong placebo effect.”
- “People will feel better if they think they’re going to feel better.”
What Can You Do?
- Purchase supplements labeled USP (U.S. Pharmacopeia) and Consumer Laboratories (CL). They are tested for purity, ingredients and dose but does not address product safety of effectiveness directly.
- Terms such as release assured, laboratory tested, quality tested, and scientifically blended on supplement labels guarantee nothing.
- Check expiration dates on supplements.
- Choose supplements containing 100% of the Daily Value or less.
- Take supplements with meals.
- Avoid calcium supplements made from oyster shells, bone or coral calcium. They may contain lead or aluminum.
- Store supplements where small children cannot get at them. A high incidence of trips to the ER involve overdosing of a certain supplement by young children. Taking a large dose of iron can be life-threatening that can damage the intestinal lining and and may cause liver damage.
- Tell your health provider about the supplements you take. Consult your provider about health problems before you start taking supplements to try to treat health problems with herbal supplements.
Source: Judith E. Brown, Nutrition Now, 7th Edition.