Myths and Facts About Dietary Supplements


On the old TV program, “Truth or Consequences,” contestants were asked silly questions. When they answered incorrectly or took too long to answer, Beulah the Buzzer would go off. The original host, Ralph Edwards, would tell the hapless contestants that since they had not told the truth they would have to “pay the consequences,” which were often elaborate stunts.

Now while the “consequences” in the show were as silly as were the questions, at least there was a sense in 1950, when this show first aired on television, that not telling the truth would naturally invoke consequences.

In fact, in the real world, misrepresenting facts through misleading assumptions and malicious statements, half-truths and outright lies often leads to civil or criminal charges. Typically, justice or retribution for false statements and characterizations requires that untruths be publicly retracted; sometimes these consequences will lead to lawsuits and even jail time.

The Anti-Supplement Brigade

These real-world standards do not seem to reliably apply to state governments (such as New York State), Capitol Hill, or the media when it comes to discussing or reporting on dietary supplements, however.

Recently, Reader’s Digest ran an article entitled, “The Vitamin Myth.” In the first sentence of the story, the writer says: “Google ‘vitamins’ and you get 50 million results and the wildest claims you can imagine.”

Well, I did Google “vitamins” and, when I did my search, I got 56,800,000 results. What this article did not acknowledge, however, is that the most important results for web searchers is the very first page, as most people don’t go further than this.

Of the top 10 results, result four was from the respected Nemours Foundation www.kidshealth.org, the fifth was from the U.S. National Institutes of Health (NIH), the eighth was from Wikipedia (not the Encyclopedia Brittanica perhaps but fairly credible) and the ninth was from the Harvard School of Public Health—not exactly places where wild claims abound.

Real Dangers Overlooked

In fact, our self-appointed guardians of public health (wielding Senatorial powers, wearing stethoscopes or using a journalist’s pen) almost always forget to discuss those tablets and capsules that are profoundly dangerous and largely toxic: prescription drugs. Each year, prescription drugs injure approximately 2.2 million and kill at least 100,000 Americans.

In fact, I decided to do a separate search on Vioxx and found 12,400,000 results for this problem-haunted drug alone. Do we believe that these “hits” represent multiple postings from the 4 million satisfied users who took the drug? Doubtful. According to a 2004 Forbes.com article, it’s a medication which Food and Drug Administration (FDA) scientist, Dr. David Graham, “thinks caused 140,000 heart attacks.”

Mythbusters

Now that we’ve placed supplements and prescription drugs in more of a realistic safety context, and with the afore-mentioned biases and false beliefs about dietary supplements as a starting point, Vitamin Retailer assembled a panel of 18 industry experts, asking them to identify and “bust” the biggest myths there are out there regarding dietary supplements.

Although there were a few surprises—myths and facts which are not often articulated—without a doubt the biggest and most pervasive untruths, or myths, about dietary supplements are:

MYTH 1. Dietary supplements are unregulated.

MYTH 2. Dietary supplements are unsafe/dangerous.

MYTH 3. Dietary supplements do not work.

Fact: Dietary Supplements Are Comprehensively Regulated.

According to the Washington, DC-based Natural Products Association (NPA), both the FDA and the Federal Trade Commission have regulatory authority over dietary supplements and can—and do—take action when necessary to police the marketplace. Said the association: “The Dietary Supplement Health and Education Act of 1994 (DSHEA) gave the U.S. Food and Drug Administration the power to ensure dietary supplements are safe, properly labeled and that the claims they make are substantiated.”

According to Angelica S. Vrablic, PhD, manager of nutrition research for American Health (Ronkonkoma, NY): “Supplements are also regulated by government agencies in each of the 50 states. In addition, virtually all facets of dietary supplement manufacturing, labeling and marketing are covered by extensive regulations issued and enforced by the FDA and the FTC.”

Andy Fox, president of the Natural Products Association-East agrees with Vrablic, saying: “The real truth is that the industry has regulations which manufacturers must adhere to for not only product quality but also for issues such as advertising and promotion of health claims in media such as radio, TV, magazines and the internet.

"An extremely high percentage of the dietary supplements on the market today are safe and efficacious and are produced in pharmaceutical quality facilties.”

Some panelists pointed to the fact that supplements are regulated as a class of foods, not drugs. Mark Becker, director of advertising/communications for Los Angeles, CA-based Jarrow Formulas expanded on this: “While dietary supplements are not regulated in the same exact manner as are pharmaceuticals, dietary supplements are subject to some of the same types of controls.

"Safety data on new dietary ingredients are subject to FDA review. The FDA also has strict guidelines on how dietary supplements can be labeled and must approve of the types of claims that can be made for them. The FDA has also established quality guidelines for dietary supplement manufacturing [GMPs] and the FTC has its own requirements that advertising claims associated with supplements are substantiated by scientific evidence.”

Are The Regulations Sufficient?

“DSHEA is just one of many federal and state laws that the nutraceuticals industry must comply with or else suffer penalties, fines or worse: prison,” said Elliott Balbert, founder and executive chairman of the board of directors for Chatsworth, CA-based Natrol.

"The federal government has all of the power it needs to take any products it believes are dangerous off the market,” added Balbert. “This isn’t industry saying it but rather three FDA commissioners who have testified, under oath, that they are satisfied as to the extent of the agency’s authority to properly regulate supplements.”

When asked to refute, if possible, the “dietary supplements are not regulated” myth, James Komorowski, VP of technical services and scientific affairs for Purchase, NY-based Nutrition 21 said: “The truth is: DSHEA.”

Fact: Dietary Supplements Are Profoundly Safe.

According to the NPA: “[DSHEA] maintains the U.S. Food and Drug Administration’s (FDA)’s authority to safeguard the public against any unsafe product. A dietary supplement can immediately be removed from the market if the FDA believes that it presents a public health hazard.”

Added the association: “Dietary supplements have a great safety record, especially compared with other consumer goods, such as drugs and even other foods.“

So where’s the fire?, VR asked the association. “One reason there is so much fearmongering about supplements is because few experts can agree on accurate sources for statistical information about their safety. But even when trusted sources, such as the [FDA] or the American Association of Poison Control Centers, do issue statistics on adverse reactions connected with supplements, they are usually dismissed as being unrealistically low.”

According to reports from poison control centers throughout the US, noted the NPA, adverse reactions to drugs are more than 800 percent higher than those to dietary supplements. Not only are supplements safe, but they work.

Fact: Dietary Supplements Work.

It has been established that dietary supplements are able to effectively address—without unwanted side effects—some of Western society’s hardest-to-treat, chronic and debilitating conditions, including arthritis , osteoporosis, allergy and immunity, insulin resistance, diabetes, cognition, certain cardiovascular problems and more; in addition, folic acid’s role in preventing neural tube defects cannot be disputed.

According to the NPA, there are thousands of research articles supporting the efficacy of a wide range of dietary supplements.

Here is only a brief listing of some representative dietary supplement efficacy evidence which the association points to:

Folic acid reduces the risks of heart attack/stroke and Alzheimer’s Disease (British Medical Journal, 2006; Archives of Neurology, 2007).

People with high intakes of the carotenoids, lutein and zeaxanthin, and vegetables in general, could significantly reduce the risk of non-Hodgkin’s lymphoma (NHL) (AJCN, 2006).

Omega-3 fatty acids and the flavonoid quercetin may work together to help alleviate inflammation of the large intestine associated with Crohn’s disease and ulcerative colitis (Clinical Nutrition, 2005)

Zinc supplements may protect against cardiovascular disease (CVD) (Free Radical Biology and Medicine, 2006).

Vitamin C pretreatment can reduce muscle soreness (International Journal of Sport Nutrition and Exercise Metabolism, June 2006).

New research from the University of Basel says that taking potassium citrate supplements could boost bone mineral density by similar amounts as observed with pharmaceuticals.

Supplements and diet, rather than sunlight, should be one’s source of vitamin D (Journal of the American Academy of Dermatologists, 2005).

Omega-3 fatty acids may protect asthma sufferers from exercise-induced bronchoconstriction (EIB) (Chest, 2006).


There are other myths, and fallacies, that our panelists pointed to, including: supplements are a waste of money; because supplements are natural, that means they’re safe; supplements are all the same; you can get all the nutrients you will ever need from your diet; consumers only care about low prices when they look for supplements; and the use of heat during fish oil processing ruins the final product, among others.


Fact: Supplements Are Not a Waste of Money.

“Doctors want you to get your supplementation from eating a balanced diet,” said Sally Byrd, ND, LMBT, director of sales for Orlando, FL-based Dr. Vanessa’s Formulas. “The truth is nobody eats a balanced diet these days; we often don’t even know what’s in the food we’re eating (additives, pesticides, heavy metals, etc). Supplementation is mandatory in the 21st century for optimum health; you also need to take high enough doses to achieve your desired results.”

Lauren Clardy, president of Omaha, NE-based NutriMarketing, agrees: “I think the biggest myth or untruth is that people actually believe they don’t need to take dietary supplements—that they can get all of their nutrients from food. The reality is that no one eats the 5 to 7 servings of fruit and vegetables a day and we don’t get the nutrients we need from our diet. This includes the basics—vitamins A,B-complex, C, D and E —plus macro and micro minerals.

"In fact, most people are walking round with one or another borderline deficiencies. As more research and science is published to recognize this, we will see more foods with fortification and functional ingredients added. The biggest truth is just that, meaning supplementation in whatever form—oral, liquids, foods, dietary supplements—has an actual effect on the physical health as it relates to disease states, both degenerative and acute, as well as overall well being.”

In fact, according to Season Solorio, director of public relations for the Council for Responsible Nutrition (CRN): “A new study from the ‘Life…supplemented’ campaign found that 72 percent of physicians personally use vitamin-mineral , herbal or other supplements and 79 percent recommend supplements to their patients—so not only do physicians see a benefit to taking supplements but they also practice what they preach in this case.”

Fact: Supplements Are Safe But Not Only Because They Are Natural.

Although the fact that supplements are natural, or are analogues of natural substances, is part of the reason they are safe, it is not the only reason.

According to Kristen Reynolds, associate director of marketing and sales for KGK Synergize (London, Ontario, Canada): “One of the biggest myths about dietary supplements is that because they are derived from natural sources, they are safe to consume. The truth is that many natural substances can be unsafe and, until you complete the necessary safety and toxicity studies, you cannot merely” presume safety because a substance is natural.

Deanne Dolnick, MS, director of sales for Salinas, CA-based Next Pharmaceuticals, couldn’t agree more, and adds: “Consumers believe that they should get results immediately from every supplement. They believe that a multi-vitamin should give them an energy rush and, if it doesn’t, then it’s not working. They also believe that every substance used is natural, that nothing is synthesized and, yes, that if it is natural it must be safe—obviously these are incorrect beliefs, as such.”

Darin Johnson, national sales manager for Flora Inc. (Lynden, WA), agrees with Reynolds and Dolnick, adding: “When taking dietary supplements, many people believe that more is automatically better. Actually, if your body can assimilate it, less is more.”

Other Myths Busted

“I think one of the biggest myths about dietary supplements is that they are all the same,” said Kay Kapteyn, product manager for FutureCeuticals (Momence, IL). “The truth is that the ingredients in dietary supplements can vary greatly in quality and efficacy. It is important for purchasing departments to research their ingredient suppliers and ask questions about quality and efficacy.

"Obviously cost is an issue that needs to be taken into consideration but, in the end, adding quality products will help you build a reputation as an ingredient supplier or supplement manufacturer that people can trust.”

In terms of cost, Cheryl Sturm, director of marketing for Embria Health Sciences (Ankeny, IA), had this to say: “I think there’s widespread belief throughout the industry that purchasers of dietary supplements have abandoned the concept of brand loyalty in favor of low price. Because of this, manufacturers may at times be tempted to sacrifice efficacy over price in order to hold costs.

"In reality, according to a study for Embria Health Sciences, LLC, conducted by the Natural Marketing Institute in August of 2007, 57 percent of purchasers state that they are loyal to their supplement brands and regularly buy the same brand. As no manufacturer or retailer is greater than the value of their brand, keeping and maintaining brand esteem should be a priority.”

And Douglas “Duffy” MacKay, ND, research advisor for Nordic Naturals (Watsonville, CA), is amazed by myths relating to omega-3 fish oil products: “There is a myth which holds that the use of heat during fish oil processing ruins the final product because it causes excess oxidative damage.

"The fact is that many manufacturers of highest quality and freshest fish oil products (low objective laboratory measures of oxidation including peroxide, anisidine, and totox value as well as excellent non-fishy taste) use hot water and/or steam distillation during processing. These manufacturers are able to avoid oxidation by manufacturing in (a) a vacuum and (b) in a nitrogen-rich, oxygen-free environment and (c) in the absence of free radical catalysts such as iron and/or copper.”

"Oxygen-dependent deterioration of lipids, known as rancidity, has been noticed since antiquity as a major problem in the storage of oils,” added MacKay. “There are three known mechanisms for lipid oxidation, (1) free radical oxidation, (2) singlet oxygen oxidation, and (3) enzyme catalyzed oxidation. Free radical oxidation requires the presence of a free radical and oxygen. Singlet oxygen requires the presence of oxygen, and ‘enzyme catalyzed’ refers to how the enzyme cyclooxygenase (and others) convert fatty acids into prostaglandins via an oxidative reaction.

"The only thing that heat has to do with any of this is that heat will speed up the rate of reaction, but without free radical or oxygen—there is no reaction to speed up. Heat itself does not cause the oxidation—it only affects the rate of oxidation. It has been verified that the most significant and sensitive equipment to measure oxidation in oils is still not nearly as sensitive as the human nose. The aldehyde byproducts of oxidative damage to fish oils have a high vapor pressure (thus the fish burp) and distinct rank taste and smell of rancid fish.”

Facing Facts

Whenever I hear the term, I invariably think of Warner Oland, in those 1930s-era Charlie Chan movies saying, “You must face fox” [meaning “facts”].

Sometimes I wish we could bring Oland back (minus the political incorrectness by today’s standards) so Chan could face the bad guys—or in this case the purveyors of untruth—with all of the bald-faced facts that our panel touched on.

But that can’t happen, so it’s up to all of us to be myth-busters on a daily, or weekly or monthly basis— so that one day our guardians of public health will have no choice but to acknowledge what we already know: the power and promise of safe dietary supplements that are produced by a responsible, well-regulated dietary supplement industry: in other words, the facts.