Friday, June 9, 2017

One More Time: Dietary Supplements (3)

In previous entries, most recently last October, I warned about the use of dietary supplements.  Manufacturers and retailers continue to get bolder in their advertising trying to maintain and grow the size of their market.  This is big business in America with these companies cashing in on misleading claims about the benefits of their products.  Products classified as dietary supplements include vitamins, minerals, herbs, probiotics and fish oil.

Near the end of last year, the New York Times put it bluntly:  “Americans spend more than $30 billion a year on dietary supplements – vitamins, minerals and herbal products, among others – many of which are unnecessary or of doubtful benefit to those taking them. That comes to about $100 a year for every man, woman and child for substances that are often of questionable value.”  These are often the same people who see themselves as being so careful in other cases about what they put into their bodies.

A boom in sales came after the Dietary Supplement Health and Education Act of 1994, pushed through by lawmakers with close ties to the supplement lobby.  The number of products grew from 4,000 to 55,000+ over the next 20 years.  The law allowed the industry to sell their products without submitting any evidence to the Food and Drug Administration as to their safety or effectiveness.  Marketers are legally allowed to promote products as supporting the health of various parts of the body but are banned from any claims that they prevent, treat or cure any condition.  Clever advertising often skirts this provision and sometimes violates it completely.

But the problem is not just that they may be ineffective, that is, a waste of money.  Last fall the Journal of the American Medical Association (JAMA) published a summary of studies done on supplements.  “During the past 2 decades, a steady stream of high-quality studies evaluating dietary supplements has yielded predominantly disappointing results about potential health benefits, whereas evidence of harm has continued to accumulate.”  They cite various examples of the increased problems including more than 10,000 calls per year to national poison centers since 2002 “related to ephedra poisonings.”

Surprisingly, as more research shows that particular substances are no more effective than the sugar pill, the sales do not generally decrease.  Consumers seem to think that if they don’t work for the target ailment, they at least promote general good health.  A list of supplements that have failed to live up to the advertisers' promises includes vitamin C, vitamin E and glucosamine/chondroitin.

What about consumer protection?  The government is very involved in this – considering the fact that they cannot act until actual harmful effects are reported or the vendors cross the line by promising more than supporting good health.  According to this release from the Truth in Advertising website, the supplement store GNC, “which has more than 9,000 store locations worldwide, has been the subject of numerous federal and state actions and has been named in more than 100 consumer lawsuits.”

Since 1984 the Department of Justice has cited problems in advertising 3 times.  Two resulted in fines or settlements and the latest in an agreement to take aggressive steps to prevent illegal products and ingredients from being sold in its stores.  The Federal Trade commission has taken seven actions against GNC or its suppliers, including “Sensa for its deceptive ‘sprinkle, eat and lose weight’ claims.”  On top of that there have been three USPS probes, six investigations by individual states and ten problems with the Food and Drug Administration (FDA).  (Details are provided in the Truth in Advertising link.)

There are valid reasons to use supplements such as for known deficiencies.  In the UK for example, some researchers are recommending that vitamin D be added to some food, like it is to milk in the US, to address the problem of a populations with lower exposure to sunlight.  In general, though, it is always better to get nutrients from food rather than popping a pill.  If supplements are needed, patients should use caution and critical thinking and consult with a health care professional to confirm that a problem exists and that the particular supplement will be effective in solving it.  Research continues to show that taking a pill just because it “makes you feel better” is about the same as throwing away your money.

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