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1/27/2020 0 Comments

Are Supplements a Scam?

        The United States supplement industry is worth over $40 billion (1). The global supplement industry is worth over $115 billion, and is expected to expand 7.8% by 2025 (5). Although we should not automatically count a lucrative sector as litigious, supplement manufacturers have been riding a very slippery slope that seems to move them faster than safety regulations can account for.

​        Because supplements are categorized as food and not as medicine, the FDA does not verify the safety or effectiveness of supplements before they can be sold, even as over-the-counter products. 
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​Unverified Claims

        Supplement manufacturers can make “functional” claims, such as marketing lingo regarding how an ingredient or nutrient will improve health. For example, “Folic acid is great for pregnant mothers because it decreases the risk of birth defects.”

​        While their labels may be true and grounded in research, as this one is, the FDA does not verify these claims. This means that a supplement label can promise to prevent a disease or enhance health/athletic performance/longevity/what have you without having any research to back that claim up. And no one is going to hold them accountable (1, 2). 

​Trust the Seal?

        Many supplement manufacturers will submit their product to an independent quality tester such as the U.S. Pharmacopeia or ConsumerLab. If the product passes the independent organization’s testing, they can receive a seal of approval claiming the product was “properly manufactured” and is not “harmful.” However, these phrases have no solid definition, and even these flashy seals that may attract consumer confidences are not regulated, and do not guarantee safety (2). 

​Safety Issues

        Above, I emphasized that supplement manufacturers are allowed to make “functional” claims. These are different from medical claims that pertain to curing diseases or conditions. These medical claims are reserved for medications only, and are regulated by the FDA to ensure effectiveness and safety.

        Alarmingly, this hasn’t stopped supplement developers from including pharmaceutical compounds in their products to achieve desired results. In October 2018, research conducted through the California Epidemiologic Investigation Service Fellowship found:
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“The active pharmaceutical ingredients identified in dietary supplements are present at unknown concentrations and have not been characterized as safe and effective by the FDA, making them unapproved drugs. These products have the potential to cause severe adverse health effects (3).”

        In other words, these ingredients receive government approval at concentrations present within a labeled medication. But then, a supplement developer increases the dose or mixes it with other ingredients to create a new formulation that has not gone through the same regulatory testing (because, again, supplements are considered a food, not a medication).

        Alternatively, dietary supplements can also contain brand new ingredients that have no basis in medicine and thus zero research backing. The law states that the manufacturers must report the new ingredient to the FDA, but the FDA does not approve its safety (4).

​For Athletes

        One of the most common realms for supplementation is within athletic groups, especially those concerned with muscle building. In an effort to constantly exceed limits, trainees look for solutions beyond the gym and their diet, and have found great solace in supplements. Unfortunately, even the best products only have modest efficiency. 

        The National Institutes of Health published a summary of the available research that exposed the following supplements:
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        ​I don’t think anyone will be surprised to learn that, out of their whole list, protein was the clear winner. The literature could find no safety issues when up to 2 g/kg (or 3 oz/90 lbs) of body weight are consumed daily, yet muscle training response and recovery period were optimized. So kudos to the protein powder! 

​In Conclusion

        All of this is not to overshadow the reality that some underlying health conditions are best solved by an increase in a concentrated nutrient or ingredient that cannot be provided through diet. Therefore, an obvious disclaimer should follow that these concerns can be overridden by suggestions from your doctor. In fact, the only safe reason to add supplements to your routine is with recommendation from your doctor. And you should only consume a brand that your doctor recommends in the amount that your doctor recommends at the frequency your doctor recommends. Never ever self-diagnose, or take label claims at face value. 

​Sources

  1. https://www.advisory.com/daily-briefing/2019/02/13/fda-supplements
  2. https://ods.od.nih.gov/HealthInformation/DS_WhatYouNeedToKnow.aspx
  3. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2706496#211236404
  4. https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-dietary-supplements
  5. https://www.grandviewresearch.com/industry-analysis/dietary-supplements-market

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