Filed under: Dietary supplements
Last summer the Netherlands removed the weight-loss dietary supplement product Dexaprine from the market due to reports of serious adverse events, but the results of research into the cause has just been released. A recent article in Drug Testing and Analysis described at least 26 cases of Dexaprine toxicity reported to the Dutch Poisons Information Center. Testing revealed the existence of “a cocktail of synthetic stimulants” including synephrine, oxilofrine, deternol, yohimbine, caffeine, and theophylline, and possibly ß-methyl-ß-phenylethylamines. (Problematic forms of phenylethylamines, including ß-methylphenylethylamine. were discussed in an April 2014 article in the New England Journal of Medicine.) For more information about tainted weight-loss dietary supplements, see the Food and Drug Administration’s information. Note that this product is still available in the U.S. and online.
When something sounds too good to be true, it probably is. Dietary supplements are popular among military personnel, and it’s important to be able to spot the red flags—warning signs of potential problems—when considering a product. Read the OPSS FAQ on how to spot these red flags to help make an informed decision. And be sure to check back often for new FAQs.
An important part of HPRC’s mission of fostering Warfighter resilience and optimizing Warfighter performance is informing you about the potential hazards associated with dietary supplements. But that’s a two-way street—we need your help too. An April 2014 article in The New England Journal of Medicine points out a major problem: Government agencies don’t get information about adverse effects of dietary supplements quickly enough from the public and healthcare professionals.
HPRC offers an easy way for you to directly report side effects you believe are associated with dietary supplements through the Natural Medicines Comprehensive Database (NMCD). Just go to our NMCD page and click on the icon for Natural Medicines Watch. You don’t even need an NMCD account; it’s free for everyone and easy to use. NMCD will make sure the information reaches FDA’s MedWatch.
Don’t hesitate to report something—you’ll be helping others avoid potentially serious health problems. Not sure about your symptoms? Read HPRC’s article about how to know if you’ve had an adverse event.
Two versions of OxyELITE Pro have been removed from the market in the past year. Read the Operation Supplement Safety (OPSS) FAQ to find out why, and to get more information from the Food and Drug Administration (FDA). Also, be sure to check back often, as we add answers to other questions about ingredients in performance-enhancing and weight-loss supplements and how to choose supplements safely.
If you have more questions about a particular dietary supplement ingredient or product, please use our “Ask the Expert” button located on the OPSS home page.
In April, FDA announced that the substance was illegal for use as an ingredient in dietary supplements, after which the number of products that contained it rapidly declined.
Only 19 products were added to the list over the past 12 months; none were actually new to the market, but just ones that came to our attention as other products with DMAA became unavailable. By comparison, 46 products were discontinued/reformulated, and 86 DMAA-containing products (or versions of products) appear to have disappeared completely from online retail availability. Only 61 products remain on the “active” list, and many of these are from non-U.S. sources; some still on the list may have eliminated (or are about to eliminate) DMAA, but their manufacturer/distributor websites are unclear as to their status.
HPRC will continue to update its list and report of “Dietary Supplement Products Containing DMAA,” with the most recent version dated December 2014, but updates will appear less often than in the last two years.
Food and health are hot topics these days. Just turn on the TV, pick up a magazine, or glance at the margins of your social networking site and you’ll hear and read about the supposed health benefits of dietary supplements containing this or that food component and the promises that they will “burn belly fat” or some similar claim.
Many of these promising food components belong to a group of compounds referred to as phytochemicals—chemicals produced by plants as a means of protecting the plants from various diseases.
Interestingly, when you eat plants (such as fruits and vegetables), the phytochemicals they contain might protect you from disease too. Researchers have found that people who eat a lot of fruits and vegetables have lower rates of heart disease, cancer, diabetes, and many other diseases. Scientists haven’t discovered exactly how these compounds work to protect us, but they have discovered that they seem to have a synergistic effect. That is, the compounds seem to work better in combination, especially when they are supplied in their natural form—whole foods. Consuming isolated single compounds, as in dietary supplements, rarely has the same beneficial effect as eating the whole food. See these resources about fruits and vegetables and how they may impact your overall health.
Focusing on single nutrients (in pill form) is not only expensive, it just doesn’t offer the promise that a balanced, varied diet can. Focus on food, instead. For more information about the benefits of food versus dietary supplements, check out this OPSS brochure, “Nutrition: Fueled for Fitness.”
Sports products and dietary supplements are often discussed on social media, but think twice before taking other’s word for it. A recent article in the British Medical Journal notes that claims and endorsements made on social media such as Facebook & Twitter are not regulated and may promote statements that have not been supported by science. Some red flags noted include:
- Paid endorsers. Do you know that some comments and images about a product can come from people (celebrities and non-celebrities) paid by companies to post great reviews about their products? Be careful that such claims may be coming from a paid sponsor and may exaggerate their results from a product.
- Endorsed hashtags. The hashtag such as “#ad” is a disclosure recommended by the Federal Trade Commission (FTC) to indicate that a social media post is coming from someone being paid (or otherwise reimbursed) by the company of the product they are endorsing. If such a hashtag appears in a social media post, then you know that it is sponsored and may be biased. (For more about FTC’s new endorsement guidelines, visit their FAQs web page.)
- Biased research. Assessing the science behind claims is the best way to evaluate a product. However, a common practice is that companies cite their own labs and research. When it comes to dietary supplements, it’s best to get information about products from unbiased, evidence-based organizations such as Natural Medicines Comprehensive Database, United States Pharmacopeias (USP), or NSF International.
- Unbalanced comments. When you scroll through a product’s social media page, do you find that all the reviews are positive? On platforms such as Facebook, companies have the ability to delete comments. A transparent company usually addresses negative comments and provides support to establish its position.
Look for these and other red flags when it comes to dietary supplements and their advertising. If you have a question about a particular sports product or dietary supplement and can’t find the answer on HPRC’s website, please use our “Ask The Expert” button located on the Operation Supplement Safety (OPSS) home page.
The Department of Defense (DoD) Safety Review Panel published their findings on DMAA in a recent report now available through HPRC. The Assistant Secretary of Defense for Health Affairs asked the Safety Review Panel to evaluate the safety of DMAA-containing dietary supplement products. The Panel has recommended that the sale of DMAA-containing products be prohibited in all military exchanges.
HPRC maintains a list of dietary supplement products containing DMAA and periodically updates this list. The most recent version can be found on HPRC’s website. Note that, as of the FDA announcement in April 2013, DMAA is illegal in the U.S. as an ingredient in dietary supplements. For more information, visit the OPSS FAQ about DMAA. Operation Supplement Safety (OPSS) can provide service members and their families with information to make informed decisions about dietary supplement use. For the full DoD Safety Review Panel report, see the link on HPRC's Dietary Supplements web page.
The Food and Drug Administration (FDA) has issued warning letters to 15 companies regarding illegally marketed diabetes products that are in violation of federal law. These products are either dietary supplement products or unapproved prescription drugs with claims that they “prevent and treat diabetes” and “can replace medicine in the treatment of diabetes.”
FDA is warning consumers to stop using these products since they may harmful, and their use may interfere with receiving the necessary medical treatment for diabetes. More information is provided in FDA’s “Illegally Sold Diabetes Treatments,” which includes the news release, warning letters issued, and a consumer update.
The dietary supplement and fitness industries are filled with sport drinks, powders, bars, pills, gels, footwear, clothing, and an array of devices all claiming to provide you with a competitive advantage, whether it be improved performance or enhanced recovery. With the ever-growing popularity of team and individual sports, professional and recreational athletes of all ages are an easy target for these claims. But how many of these claims are backed by evidence-based research?
A recent report now reviews the quality of evidence behind the claims of improved sports performance made by advertisers for a wide range of sports-related products, including sport drinks, supplements, footwear, and clothing. The team identified 431 performance-enhancing claims for 104 products advertised in more than 100 general, sport, and fitness magazines in the UK and U.S. for a single month in 2012. They found that more than half of the advertisements and their associated websites provided no evidence to support the claims of enhanced sports performance. Only 146 references were found, and only 74 of these met basic criteria for research quality and almost all of the 74 were found likely to be biased or lacking scientific objectivity. Only three studies were rated as “high” quality and probably unbiased. Such lack of evidence makes it very difficult for consumers to make well-informed decisions about using performance-enhancing sports products.
This review makes it clear that many of the claims made for sports and fitness products lack reliable evidence to support them and that more and better studies are needed to help inform consumers. In the meantime, consumers should be cautious when reading claims of enhanced performance and recovery and always remember that “true” evidence-based results mean that a substantial number of independent research studies have been performed, with findings that clearly support the claims made by advertisers. Presently, there is still no substitute for sound physical conditioning and nutrition practices.
For more information on dietary supplements and how to choose supplements safely, please visit Operation Supplement Safety (OPSS). For information on physical fitness and conditioning, please explore HPRC’s Physical Fitness domain. The original British Medical Journal open-access article is available online.