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HPRC Fitness Arena: Dietary Supplements
The FDA held a press conference on 12/15/2010 announcing that it was sending a letter to all dietary supplement trade associations, as well as posting a message to consumers, about the growing problem related to the sale of various misbranded drug products masquerading as "dietary supplements."
A recent systematic review found that nutritional and herbal supplements may be an effective way to treat anxiety and anxiety related problems without serious side effects. Although scientists reported that positive outcomes may be due to a placebo effect*, based on the review, there is scientific evidence to support the use of certain nutritional and herbal supplements to treat these conditions. If you are currently being treated for anxiety, discuss with your physical the option of using or including a natural supplement.
* A placebo effect is the beneficial effect in a patient following a particular treatment that arises from the patient's expectations concerning the treatment rather than from the treatment itself.
The Montreal Gazette is reporting that a new study made public yesterday links glucosamine, a popular over-the-counter dietary supplement for joint problems with a risk of developing diabetes. The study, which was published in the Journal of Endocrinology, looks at in-vitro cell lines from mice and rats.
The experiment showed that the supplement triggers a mechanism intended to lower high blood sugar levels, but it also destroyed about 50 per cent of the cells by affecting SIRT1, a protein crucial to cell survival.
Click on link to access the article.
The Federal Trade Commission (FTC) recently filed a complaint against POM Wonderful products due to deceptive advertising. POM Wonderful has claimed that its products will reduce (or treat) heart disease, prostate cancer and erectile dysfunction. The FTC says that these claims are not supported by scientific research.
So, what’s a health claim and what’s considered acceptable advertising as such?
A health claim statement has to have a food substance, food, or dietary ingredient, and a health condition or disease. The Food and Drug Administration (FDA) has approved certain health claims that, based on scientific evidence, show a link between a food or supplement and a health condition or disease. Health claims cannot state that a food product or supplement can treat or cure a disease. It may claim to minimize a disease risk; for example, a product advertised as low sodium can state the approved claim that “diets low in sodium may reduce the risk of high blood pressure, a disease associated with many factors.”
Health claims shouldn’t be confused with structure/function claims. These claims do not have to be approved and reviewed by the FDA, yet they must be truthful in stating that a substance maintains structures and/or functions of the body. We see these claims on many fiber-rich products, like “fiber maintains bowel regularity,” or a dairy product stating that “calcium builds strong bones.” Unlike health claims, structure/function claims cannot be linked to a health-related condition or disease. Also, an important point to keep in mind: if a dietary supplement label makes a structure/function claim, it must also state this disclaimer: “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”
There are also nutrient content claims. These describe the amount of a nutrient in a product. Descriptions such as free, low, high, and rich in are used, or other terms that describe the nutrient content to that of the content in another product, such as reduced, lite, less, or more.
Manufacturing companies want consumers to buy their products. We, as consumers, must be savvy as we try to choose products that are healthy for our families and us. False health claims are used on food products as well as dietary supplements. They claim to help us lose weight, cure diseases, and prevent memory loss. The FDA has not approved claims that focus on the treatment of diseases. They have, however, set forth regulations to authorize health claims after the scientific evidence has been presented and reviewed.
Protein powder supplements are a popular source for packing on muscle. The September 27, 2010 edition Health section of the L.A. Times contains an article that poses the question of how much supplements, if any, should one use in building muscle mass?
Wandering down the aisle of a store looking for a dietary supplement can be overwhelming and intimidating. There are so many to choose from, and we often have to make our choices based on advertising claims and rely on the manufacturers for ingredient information. Does the supplement actually have the ingredients claimed on the label? Will it have the reported effect on our health?
The Natural Medicines Comprehensive Database is the “scientific gold standard” for evidence-based information on dietary supplements and natural medicines, including drug interactions, effectiveness, safety and use, and more. HPRC has partnered with Natural Medicines Database to allow healthcare providers, Warfighters, and military families to search this comprehensive database in order to make informed decisions about dietary supplement use. The Natural Medicines Database also has “Natural MedWATCH,” which allows users to report an adverse event associated with the use of dietary supplements or natural medicines so that they can then forward the report on to the appropriate regulatory agency.
By going to the HPRC homepage, users can access any of the three database choices provided: Natural Medicines Comprehensive Database for Health Professionals, Consumers, or Natural MedWATCH. After choosing one of the sites, first-time users should sign up for an account, which is done with an active DoD email address. Once inside this vast database, a user can search for an individual natural medicine ingredient of interest or a brand name product.
The professional version of the database includes:
- Evidence-based monographs available for individual natural ingredients.
- Scientific names of ingredients
- Information on safety, effectiveness, mechanism of action, adverse reactions, interactions, and dosage/administration (which are not necessarily recommended or safe doses) of ingredients
- Patient handouts
- Brand-name product searches by ingredient
- “Natural Product Effectiveness Checker” for medical conditions
- “Natural Product Drug Interaction Checker” for a list of drugs/natural products interactions
- Comprehensive information on brand-name products, including ingredient lists and summary reports on effectiveness, interactions, and adverse effects.
- Up-to-date information for over 60,000 brand name products
The consumer version, for military families and Warfighters, contains the same research-based information on herbal remedies, dietary supplements and other natural products, but in an easier-to-understand version. An important point consumers should be aware of is that it may be necessary to research each individual ingredient in a product before making a decision to use it for health benefits.
So, if you want to find credible, evidence-based information on dietary supplements and/or natural products, search the Natural Medicines Comprehensive Database. Evaluating natural health products can be daunting and there is no other comprehensive, reliable site like it to guide you in making your decision.
There is a growing trend in the U.S. of consumers using a variety of dietary supplements in hopes of getting healthier, warding off disease and easing symptoms of various conditions.
In a September 14, 2010 article, The Wall Street Journal reports that the federal government is stepping up research into the safety and effectiveness of a wide range of products to help consumers make more informed choices about supplements. The article in full-text can be accessed here.
The Columbus Dispatch (Ohio) recently ran a five-day series titled "Little leagues, big costs" In this series, The Dispatch explores where youth sports have taken wrong turns in recent years.
The link below from that series contains an article that focuses on the dangers of how some unregulated dietary supplements are being targeted at teens
Despite widespread access to internet-based healthcare information, there’s almost a complete lack of evidence showing any effects all this information may have on health outcomes. According to a study published in Health Expectations, this indicates that there’s a disparity between the health information we find online and our ability to use it properly.
So, with as much information as there is on the internet, how can we, as consumers, find reputable sources for our health questions? The internet can be a great resource when you want to learn about a specific disease or health condition. You can also find tips on staying healthy. But among the millions of websites that offer health-related information, many present myths and half-truths as if they are facts.
To avoid unreliable health information when you’re surfing the internet, use these tips to find reliable information:
- Keep in mind that anyone can publish anything they want on the internet, regardless of the facts. Ultimately, it’s up to the consumer to determine which information source is credible.
- In order to determine a trusted, verified source for credible and objective information, stick with well-respected health websites. A good starting point is healthfinder.gov, which provides a “Health A to Z” topic listing (http://www.healthfinder.gov/HealthAtoZ/ ) of over 1,600 health topics from the most trusted sources.
- Newspapers always use more than one source for verifying factual information. The same should hold true for health information. When searching a topic, it’s important to find at least a second reference to confirm your findings. Find a third reference, too, if possible. When several sources report similar information on a topic, it’s more likely to be accurate and up-to-date. In general, if you can't find the information duplicated in more than two or three references, then the information is questionable at best.
- Become skilled at separating facts from opinions. This can sometimes be difficult, as the evidence that exists may be minimal. It's important that you know the difference between fact and opinion, especially when you're researching treatment alternatives.
- Testimonials and personal stories tend to focus on a patient’s subjective point of view. If you find a website that quotes patients about the effectiveness of a treatment or therapy, this information is biased and cannot be trusted as a reliable source. However, there is information to be learned from the experiences of patients by using other sources (for example, through blogs and wikis, and support group message board forums). In those situations, refer back to point 1 (above) as your first line of review.
- Make sure the information you find is the most current available. Often, you will find that research and studies conflict with one another, or that newer information trumps older information.
Finally, information that you find on a website does not replace your doctor's advice. Your doctor is the best person to answer questions about your personal health. If you read something on the internet that doesn't concur with what your doctor has told you, make a point to speak with him or her about it.
In a report from the September 2010 issue of Consumer Reports®, the twelve most dangerous dietary supplements posing health risks have been identified. According to the report, these are dietary supplements which are taken by millions of Americans and have been found to cause serious health problems, including cardiovascular, liver, and kidney problems.