We spend the 4th of July exercising and celebrating our inalienable rights: Life, Liberty, and the pursuit of Happiness. In the latter, many of us reach for a supplement – a vitamin, a weight loss pill, an herb – something to help author our healthy lifestyles. Mass builders claim to Improve Muscle Stamina & Strength*, and herbal teas Support Natural Resistance*. These sound like amazing products, but there’s a little declaration of independence in that asterisk.
* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Like a lazy John Hancock, the supplement industry declares its independence from regulation, and effectively, science.
A dietary supplement is any ingested product intended to add nutritional value for the consumer, and can include vitamins, minerals, herbs, amino acids, or metabolites. Roughly 50% of Americans consume them every year, contributing to a 20 billion dollar per year industry. Yes, supplements are as American as baseball and apple pie. And like apple pie, supplements are considered food under the Dietary Supplement Health and Education Act of 1994, or DSHEA. This legislation essentially removed FDA oversight on efficacy and content. What does this mean? Well, while a “drug” must be both safe and effective, a “supplement” only has to be safe, and the lax regulations mean that companies basically police themselves.
That law may seem innocuous enough, but it carves out a lucrative niche where supplements can be marketed like drugs without having to stand up to scientific inquiry. This practice is exemplified in the so-called structure/function claims that relate a product to a function of the body. Supplement labels are littered with such claims: fish oil for healthy skin, Echinacea for immune defense, creatine to boost metabolism and burn fat. The veracity of these statements are inconsequential as long as they’re qualified with that asterisk above. In the end, we’re watching a follow-the-ball trick where marketing and sales revolve around effectiveness – the one thing that the industry isn’t required to show!
This sleight of hand is by design as the effectiveness of many supplements is uncertain except in cases of nutrient deficiencies. The problem for the industry is that as long as you’re eating a variety of foods, nutrient deficiencies are rare, rendering supplements mostly useless. What if you want to use a supplement for something other than a deficiency? You’re going to have to put in a lot of time. This infographic is a good starting point. Here, data analysts ranked popular supplements by evidence of their effectiveness, and included links to the corresponding studies. This is by no means a scientific analysis, as any expert might rank the evidence for each supplement differently. There’s also a wealth of accurate information from the NIH. Be careful; it’s easy to get caught up in the hype! Overselling the effectiveness of weight loss supplements is exactly what led to Dr. Oz testifying in front of a congressional hearing.
Let’s say now that you’ve done your work. You found a supplement that you feel reasonably delivers on its promise. Time to go to your store and reap the benefits, right? Not exactly. Remember how I mentioned that supplement companies are left to police themselves? Take a look at what one Canadian study found amongst North American herbal supplements.
In other words, what you’re purchasing is likely to contain foreign additives or none of the desired product at all! Compounding this revelation are the numerous food allergies that could cause fatal reactions to mislabeled supplements. Even multivitamins can be suspect, as a ConsumerLab report indicated that up to a third of them are mislabeled. While we do not know how widespread this deception is, the lack of industry oversight means that consumers have virtually no way of finding out.
All of this obfuscation undermines the few instances where we can really benefit from supplements. In special cases of pregnancy, age, and absorption deficiencies, a simple multivitamin can help you lead a healthier life. Unfortunately, we’re forced to deal with an industry that owes the consumer very little in terms of transparency, efficacy, and safety. It is a cautionary tale of independence from regulation. I propose that as we continue to take supplements in the pursuit of happiness, let’s fight for the inalienable principles of science: controlled study, objectivity, and reproducibility.
Austen is a 5th year graduate student and president of Science ACEs. His dream is to go fishing every day once he’s finished with this bacterial pathogenesis thing. You can follow him on twitter @austenleet.