Question of the Week
August 2, 2004

A supplement is: "Something added to complete a thing, make up for a deficiency, or extend or strengthen the whole."

Many people realize that their diets are somewhat deficient, so they take a supplement.

"Nutrition supplements are BIG business. An estimated 40% of Americans take a supplement, most commonly a multivitamin. The advertisements selling supplements are very compelling. They depend on the fact that many people are unsure about whether or not they are eating a healthy diet, or would be willing to do so. It makes sense for everyone to take a multivitamin as they can provide some assurance that you are meeting all of your daily requirements. However, let's face it-no supplements make up for a lousy diet."

So, we all should eat better, but a multivitamin makes sense. What about all of those other supplements that specifically target one deficiency or another? While the multivitamin has someone else mixing and matching for you, there is a huge dietary supplement industry that makes it possible for consumers to mix and match for themselves, as well.

"Congress defined the term 'dietary supplement' in the Dietary Supplement Health and Education Act (DSHEA) of 1994. A dietary supplement is a product taken by mouth that contains a 'dietary ingredient' intended to supplement the diet. The 'dietary ingredients'‚ in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites. Dietary supplements can also be extracts or concentrates, and may be found in many forms such as tablets, capsules, softgels, gelcaps, liquids, or powders. They can also be in other forms, such as a bar, but if they are, information on their label must not represent the product as a conventional food or a sole item of a meal or diet. Whatever their form may be, DSHEA places dietary supplements in a special category under the general umbrella of 'foods'‚ not drugs, and requires that every supplement be labeled a dietary supplement."

What does that mean? Neither foods nor supplements need to gain FDA approval before going on the market. Prescription and over the counter medicines do need to gain such approval.

"Under DSHEA, a firm is responsible for determining that the dietary supplements it manufactures or distributes are safe and that any representations or claims made about them are substantiated by adequate evidence to show that they are not false or misleading. This means that dietary supplements do not need approval from FDA before they are marketed. Except in the case of a new dietary ingredient, where pre-market review for safety data and other information is required by law, a firm does not have to provide FDA with the evidence it relies on to substantiate safety or effectiveness before or after it markets its products. Also, manufacturers do not need to register themselves nor their dietary supplement products with FDA before producing or selling them. Currently, there are no FDA regulations that are specific to dietary supplements that establish a minimum standard of practice for manufacturing dietary supplements. However, FDA intends to issue regulations on good manufacturing practices that will focus on practices that ensure the identity, purity, quality, strength and composition of dietary supplements. At present, the manufacturer is responsible for establishing its own manufacturing practice guidelines to ensure that the dietary supplements it produces are safe and contain the ingredients listed on the label."

How are manufacturers doing when it comes to regulating themselves?

"Ten multis and one pet supplement failed tests. A number of the products were significantly short in the amount of important vitamins or minerals. Some contained too much lead and another failed to break apart properly for absorption.... Multivitamins/multiminerals are among those supplements most likely to have quality problems. They contain multiple ingredients and, therefore, more possibility for error.... Additionally, neither the FDA nor any government agency is responsible for testing multis or other dietary supplements for their contents or quality.

While multivitamins and other supplements do have their place, they have their flaws, as well.

"Poor manufacturing practices are not unique to dietary supplements, but the growing market for supplements in a less restrictive regulatory environment creates the potential for supplements to be prone to quality-control problems. For example, FDA has identified several problems where some manufacturers were buying herbs, plants and other ingredients without first adequately testing them to determine whether the product they ordered was actually what they received or whether the ingredients were free from contaminants. To help protect themselves, consumers should:
* Look for ingredients in products with the U.S.P. notation, which indicates the manufacturer followed standards established by the U.S. Pharmacopoeia. * Realize that the label term "natural" doesn't guarantee that a product is safe. "Think of poisonous mushrooms," says Elizabeth Yetley, Ph.D., director of FDA's Office of Special Nutritionals. "They're natural."
* Consider the name of the manufacturer or distributor. Supplements made by a nationally known food and drug manufacturer, for example, have likely been made under tight controls because these companies already have in place manufacturingstandards for their other products...."
(This site: "An FDA Guide to Dietary Supplements" offers more information ranging from understanding claims to monitoring for safety.)

Before you take the time to read the label, take the time to research the product. Is it something that will improve your health? Is it something that your body is missing, and is the supplement the best way to fill that void in your diet?

"WASHINGTON (Reuters) - People hoping vitamins can protect their hearts need to eat healthy foods instead of popping pills, the American Heart Association said on Monday. A review of various studies on whether supplements can reduce heart disease risk shows they have virtually no effect, the group said.... Antioxidants are molecules that work to reduce the damage done to cells and to DNA by free radicals -- charged chemical particles found in the environment and caused by everyday biological processes. It is clear that foods rich in antioxidants can reduce the risk of cancer and heart disease, and scientists have been working to isolate the particular compounds responsible.... But several research studies have shown that people who took antioxidant supplements did not have a lower risk of cancer or heart disease, and one important Finnish study showed that male smokers who took supplements actually had a higher risk of lung cancer. Nutritionists and doctors now argue it is probably a combination of compounds in foods that give the healthy antioxidant benefits."

Eating right is best, but dietary supplements do have their place.

"It makes sense for everyone to take a multivitamin as they can provide some assurance that you are meeting all of your daily requirements. However, let's face it-no supplements make up for a lousy diet. The ideal combination would be a healthy diet along with a multivitamin. But what do you look for in a multivitamin?"

Questions of the Week:
What roles can dietary supplements play in a healthy diet? What roles should they play? What roles should they not be expected to play? How can you find a supplement that compliments your diet and lifestyle in a safe and healthful way? How might that supplement be different from one that is right for your friends, parents or grandparents? How can you find out if the supplement you are taking (or interested in taking) is safe and does what the label claims it will do?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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