Will Dangerous Dietary Supplements Finally Be Reined In?

By Henry I. Miller, M.D. and Josh Bloom, Ph.D.

Dietary supplements are big business. Three out of four Americans take one or more on a regular basis, and for older Americans the fraction is four out of five. One in three children also takes supplements. The estimated number of supplement products increased from 4,000 in 1994 to 50,000-80,000 today. Out-of-pocket expenditures for herbal and complementary nutritional products are about $50 billion.

However, one of the great hoaxes perpetrated on health-conscious American consumers is the hype and outright fraud of dietary supplements that don’t work and are sometimes dangerous...........To Read More.... 

A Closer Look at (Mostly Useless) Supplements

By Ruth Kava — February 28, 2018 @ American Council on Science and Health

Anyone who regularly reads ACSH's writings knows that we look askance at the practice of many Americans to gulp down vitamin and/or mineral supplements (VMS), in the belief that even if one isn't deficient they will provide some sort of insurance against dietary deficiencies, or even better that they can protect against diseases. Recently a couple of Harvard doctors, Dr. JoAnn E. Manson and Dr. Shari S. Bassuk, attempted to educate physicians about what supplements are useful (or harmful) when. Their editorial was published in JAMA. Although their message is directed towards other clinicians, it's worth a look for all of us.
 

First, they point out that most randomized trials of VMS simply do not provide any evidence that they protect against chronic diseases such as heart disease, diabetes or against cancer in generally healthy people who are not experiencing nutritional deficiencies. And second, they note that supplementation in excess of the RDAs (e.g. of folic acid or beta-carotene) can in fact have harmful consequences.

Further, they state

Micronutrients in food are typically better absorbed by the body and are associated with fewer potential adverse effects. A healthful diet provides an array of nutritionally important substances in biologically optimal ratios as opposed to isolated compounds in highly concentrated form. Indeed, research shows that positive health outcomes are more strongly related to dietary patterns and specific food types than to individual micronutrient or nutrient intakes

They're not inveighing against all supplementation. Instead they point out the situations in which additional nutrients provide a benefit. These include:

• folic acid and prenatal vitamins for pregnant women
• vitamin D until weaning and iron from 4-6 months of age for breastfed babies
• vitamin B_12, vitamin D and calcium might be of benefit for middle-aged and older adults
• vitamins A,E,D,and K, B vitamins, iron, zinc, copper, magnesium for patients undergoing some types of bariatric surgery
• vitamin B₁₂ for patients with pernicious anemia
• iron, B vitamins, vitamin D, zinc, magnesium for those with inflammatory bowel disease or celiac disease
• vitamin D, calcium, magnesium for bone health issues such as osteoporosis
• vitamin B₁₂, calcium, magnesium people using proton pump inhibitors or long-term 
• vitamin B₁₂ for those using metformin long-term
• VMS, vitamin B₁₂ calcium, vitamin D,magnesium for people with restricted diets or poor eating habits

I repeat these indications to emphasize that we at ACSH are not against all supplementation — it can be life-saving when needed. However, most of us don't fit in those categories. Also, they reiterate what we've said before:

...the US Food and Drug Administration is not authorized to review dietary supplements for safety and efficacy prior to marketing. Although supplement makers are required to adhere to the agency’s Good Manufacturing Practice regulations, compliance monitoring is less than optimal. 

Yes, because of the 1994 Dietary Supplement Health and Education Act (DSHEA) supplement manufacturers can put anything on the market, and then the FDA must show how and why a supplement is dangerous.

In spite of repeated statements of these facts, the US supplement industry is now valued at around $30 billion, and 52 percent of US adults recently reported that they take at least one supplement product. That's a lot of money being wasted. Hopefully, clinicians will pay attention to the words of wisdom in this editorial, and advise their patients accordingly

American Council on Science and Health, 2011: Week 17

...

Editor's Note:  The presence of linked articles here are a way of showing what is going on, whether I agree or disagree with the positions presented or not.

I have highlighted what I think are "must read" articles with three asterisks. RK

***Still breathless: Asthma rates rising even as smoking and pollution decline Asthma rates in the U.S. have increased over the past ten years, according to the CDC.

***Does asthma crop up more on the farm? The results of a recent study of the epidemiology of asthma may come as a surprise to some of our readers.

***“Save the Frogs” campaign: Follow the money to an anti-pesticide ruse Two recent articles in The American Spectator and the Huffington Post, as well as a posting on JunkScience.com, have pulled back the veil of deception of the current "Save the Frogs" campaign; we'd like to praise Robert James Bidinotto, Jon Entine, and Steve Milloy, respectively, for these editorial contributions.

***Dr. Ross tells it like it is (and then some): people vs. pests — and “environmentalists” Remember all those environmental activist reports that cropped up around Earth Day, alleging that prenatal exposure to certain pesticides will decrease your child's IQ? Well, ACSH's Dr. Gilbert Ross was sufficiently disturbed by the hype that he quickly decided to compose an op-ed pointing out the overwhelming body of evidence attesting to the safety of these pesticides for agricultural use.

Flame-retarded media continue to fan fears of chemicals An article yesterday in USA Today - which has apparently decided to become the bête noir of chemicals - demonstrates that even so-called "science journalists" are ill-informed about the risks (or, rather, lack thereof) associated with flame retardants used in household products.

Danes propose restrictions on certain phthalates Denmark's Environmental Protection Agency is calling for the restriction of four phthalates under REACH (the European Union's precautionary chemical regulation protocol).

Phony pharmaceuticals profusely propagating In yesterday's Los Angeles Times, William Weir offers a thorough overview of the dangers of increasingly prevalent counterfeit drugs.

***Narcotic overdoses in infants a real problem Disturbing new research by Dr. William T. Basco, Jr., director of the division of general pediatrics at the Medical University of South Carolina, and colleagues finds that about 4 percent of kids up to the age of three were given an overdose of a narcotic-containing drug.

***More supplements bite the dust — this time for prostate cancerDespite hopes to the contrary, a new study demonstrates that neither Vitamin E, selenium, nor soy can prevent or even slow the development of prostate cancer.

Dr. Siegel hits two grand slams in doubleheader For the second time in as many days, we'd like to give a tip of the hat to ACSH advisor and Boston University School of Public Health Professor Dr. Michael Siegel for his essays on two different smoking-related policies.

NEJM lights up TPSAC’s menthol cigarette evaluation Two perspective pieces addressing the menthol cigarette problem appear in today's New England Journal of Medicine.

***Not always worth the wait: Prostatectomy for younger prostate cancer patients? today we learned that for younger men - those under the age of 65 - diagnosed with early prostate cancer, a prostatectomy may be better than watchful waiting (WW) when it comes to both prostate cancer-specific and all-cause (total) mortality.


Insurance coverage for exercise could work out for diabetics A new study published in Tuesday's Journal of the American Medical Association lends credence to the idea of providing insurance coverage for exercise programs - at least for diabetes patients.

Take salt dogma with a grain or two Even though the American Heart Association is now advising that people ingest no more than 1,500 milligrams of sodium daily, you don't have to throw away that saltshaker just yet.

Food stamp ban on soda purchases is flat-out paternalism In March, ACSH challenged the validity of a proposal by New York City's Mayor Michael Bloomberg to prohibit the purchase of sugar-sweetened beverages with food stamps.

Activist Attack on Coke’s Use of BPA Fizzles ACSH staffers would like to take our hats off to Coca-Cola CEO Muhtar Kent, who announced in an annual company meeting Wednesday in Atlanta that he does not believe there exists sufficient scientific evidence to stop using BPA in the epoxy linings of the company's iconic cans.

Junk food ads for kids may fall under same restrictions as X-rated content
Four governmental agencies - the Federal Trade Commission (FTC), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA) and the U.S. Department of Agriculture (USDA) - yesterday proposed voluntary guidelines for the food industry that would limit "junk food" advertisements aimed at children up to the age of 17.

Study yields more perspective on what kind of fruit you should resemble Let's talk fruit - in terms of body shape, that is. Researchers from the Mayo Clinic published a new study in the Journal of the American College of Cardiology suggesting that being "pear-shaped" (carrying more fat in the hips, buttocks and thighs) is associated with a lower risk of adverse cardiovascular events compared to those who are apple-shaped (having excess fat around the midsection).

The Times column nukes its own anti-nuclear fallout Perhaps the folks who write for The New York Times should read each other's work! We'd like to note that a very informative article in today's The Times, "Drumbeat of Nuclear Fallout Doesn't Resound with Experts," resoundingly refutes yesterday's op-ed by Helen Caldicott.

In the sun or in a bed, excessive UV exposure produces (un)healthy tan  As summer draws near, a new survey from the American Academy of Dermatology reports that a striking number of young women tan despite the established health risks.

Fewer Mammograms, and no consensus yet on when to begin  The use of mammograms has decreased ever since the U.S. Preventive Services Task Force (USPSTF) made a controversial recommendation in 2009 advising women in their 40s to wait until age 50 to get routine mammography screenings, and then only every two years.

Minn. “anti-cloning” bills called anti-business: We call them monkey business  All the common misconceptions about stem cell research have reared their ugly heads in an ongoing dispute in Minnesota that pits businesses against a so-called anti-cloning proposal that we thought had died an ignominious demise when we last skewered it.

Federally-funded embryonic stem cell research may proceed In a victory for embryonic stem cell (ESC) researchers, a U.S. appeals court has ruled that the Obama administration may continue to federally fund ESC studies using embryos that would otherwise be discarded.

Hormone Replacement Therapy not deserving of bad rap — as we said  An article in today's Los Angeles Times reports that women who begin to take hormone replacement therapy (HRT) at the onset of menopause (often called peri-menopause), around age 50 or so, and take it for five years or less, run fewer risks than benefits, including relief from hot flashes and pain during sex, as well as reduced bone fractures.

Plan B is underused: maybe ‘behind the counter’ is one reason  A new study indicates that although the number of women who have used the "morning-after pill" - officially named Plan B - has more than doubled, relatively few women are actually using this emergency contraceptive (EC).

Some good news to stomach A 2009 report highlights the need to include a rotavirus vaccine in national immunization programs of the underdeveloped world.

Unusual dilemma for Genentech: Competing against itself  The results from a multicenter trial funded by the National Eye Institute (part of the National Institutes of Health) demonstrate that after one year of follow-up, both Lucentis (ranibizumab) and Avastin (bevacizumab) had equivalent effects on maintaining or improving visual acuity in the treatment of wet age-related macular degeneration (AMD), a common cause of irreversible blindness among the elderly.

If there is a health scare today, the American Council on Science and Health will most likely have the answer by tomorrow; and for members it will appear in your e-mail. No effort on your part, except to read the answer. All that the ACSH is interested in are the facts and they are prepared to follow them wherever they lead. Who can ask for more?  Please Donate Now!

###