Don’t throw your money away on food supplements

Plenty of dubious food supplements (Photo: Chris de Rham)

Plenty of dubious food supplements on the market (Photo: Chris de Rham)

We agree with you, we have repeatedly directed an evil eye towards food supplements on this blog site, but we think it has been fully justified. Or more than justified reading about the latest findings.

Yes we have written about food supplements before, being it herbal supplements or micronutrients. But are you heeding the warnings? Well, it doesn’t seem so since the food supplements industry is going from strength to strength. And no one is checking what they are selling, neither governments nor the sales channels. There are some feeble attempts and that is what prompted this new blog.

Major US food retailers caught out

Thanks to the New York State Attorney General’s Office four national US retailers have been caught out selling dietary supplements that were fraudulent and in many cases contaminated with unlisted ingredients. The office bought 78 bottles of herbal supplements and analysed the products using DNA bar coding, a type of genetic fingerprinting that has previously been used to detect fraud in the seafood industry.

Tests on popular brands of herbal supplements sold by Walmart, Walgreens, Target and GNC showed that roughly four out of five of the products contained none of the herbs listed on their labels. That’s right, only 20% of the products actually contained the main ingredient named on the label. Not a trace in the other 80%. How can that happen?

You’re sold cheap fillers

The supplements actually contained little more than cheap fillers like rice and house plants, or substances that could be hazardous to people with food allergies. For example, five out of six samples from GNC’s signature “Herbal Plus” brand of supplements were either unrecognisable or a substance other than what they claimed to be. Pills labelled ginkgo biloba contained only rice, asparagus and spruce, an ornamental plant commonly used for Christmas decorations.

And three out of six samples from Target’s “Up and Up” store brand including ginkgo biloba, St. John’s wort and the valerian root sleep aid tested negative for the herbs listed on their labels. Instead the pills contained powdered rice, beans, peas and wild carrots. A popular store brand of ginseng pills at Walgreens, promoted for “physical endurance and vitality,” contained only powdered garlic and rice. At Walmart, ginkgo biloba, a Chinese plant promoted as a memory enhancer, contained little more than powdered radish, houseplants and wheat, despite a claim on the label that the product was wheat- and gluten-free.

About time that someone checked

The investigation came as welcome support to health experts who have long complained about the quality and safety of dietary supplements. The US Food and Drug Administration (FDA) requires that companies verify that every supplement they manufacture is safe and accurately labeled. But the system essentially operates on the honour code. Under a 1994 federal law, supplements are exempt from the FDA’s strict approval process for prescription drugs, with little oversight as a result. The situation is much the same in most other regions of the world.

The FDA has previously briefly targeted some individual supplements found to contain dangerous ingredients. But the action taken by the authority in the New York State is the first time that a law enforcement agency has threatened the biggest retail and drugstore chains with legal action for selling what it said were deliberately misleading herbal products. The attorney general sent the four retailers cease-and-desist letters demanding that they explain what procedures they use to verify the ingredients in their supplements. I suppose the answer is none!

Can this be right?

The test results are so extreme that the failure to detect some plants even when they were present could be because the manufacturing process had destroyed their DNA. However, this is unlikely since plenty of DNA from unlisted ingredients were detected. So the burden is now with the industry to prove what is in their supplements.

No free lunch for micronutrient pills either

A balanced diet is much better than popping pills (Photo: Christina Roervik)

A balanced diet is much better than popping pills (Photo: Christina Roervik)

And as if this is not enough, a new salvo has been directed towards micronutrient pills. In a recent article the authors found it hard to reconcile the concepts of the Western diet and overconsumption with the risk of micronutrient deficiencies. Sure there are people with bad diet habits, but they are not the supplement customers.

While the role of micronutrients in the prevention or treatment of diseases (including cancer and type 2 diabetes) is of interest, a key driver for the vitamins and supplement market is their advertised potential to optimise health and performance in already healthy individuals. The authors claim that the evidence so far indicates that multivitamin and mineral supplements offer no health protection, increase all-cause mortality, and risk of cancers in some subgroups.

They point out that our bodies are incredibly well adapted to handle different levels of nutrient intakes and that we have mechanisms that help us deal with shortfalls and surpluses of most micronutrients. For a true deficiency to occur, it requires a long time of dietary deficiency. They also point out that more is not always a good thing and that supplementation with high levels of vitamins and minerals can in fact confer risk.

Avoid wishful thinking and go with science

Clearly, being concerned enough about your health to buy food supplements, while no doubt full of hope, isn’t the best place to be spending your money. A nutritionally balanced diet is a much safer way to achieve sufficiency than buying bottles full of wishful thinking.

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Pill popping danger

Dangers lurking in dietary supplements (photo: Steven Depolo)

Dangers lurking in dietary supplements (Photo: Steven Depolo)

We have previously warned about the lurking dangers of herbal supplements. International trade in herbal supplements is a profitable market with increasing demand in both developing and developed nations. There are currently more than 1,000 companies producing a bewildering 29,000 different medicinal plant products with annual revenues in excess of US$60 billion.

We have reported about Canadian results of testing 44 bottles of popular supplements sold by 12 companies. They showed that pills labelled as popular herbs were often diluted by cheap fillers or included herbs other than what was claimed on the label. Some herbal supplements were adulterated with potentially toxic ingredients that could pose serious health risks to consumers. Product substitution occurred in 30 of the 44 products tested and only 2 of the 12 companies had products without any substitution, contamination or fillers. Quite a bad situation.

Now similar alarming findings have been reported in an American study. The U.S. Food and Drug Administration (FDA) is responsible for looking after the dietary supplement legislation. Between January 2009 and December 2012 the FDA recalled 274 dietary supplements under the class 1 recall legislation for adulteration with pharmaceutical ingredients. Earlier research had found that even after an FDA recall, the dietary supplement remained available on store shelves. However, it was not known if the supplements on sale after FDA recalls were free of the adulterants.

In the new survey, 27 of the 274 recalled supplements met inclusion criteria for the study and were analysed using the same methods at the FDA’s laboratories. Of the 27 products, 20 were produced by U.S. manufacturers and the rest fully imported. About two-thirds of the recalled dietary supplements analysed still contained banned drugs at least 6 months after being recalled, according to the survey, irrespective of their origin. Most still contained the same adulterant identified by the FDA. Six supplements contained one or more additional banned ingredients not previously identified by the FDA. Some supplements contained both the previously identified adulterant as well as additional pharmaceutical ingredients.

Promises of herbal supplements might be more than you asked for

Herbal supplement effects might be more than you asked for

Illegal substances identified in recalled supplements included:

  • sibutramine and sibutramine analogs (oral anorexiants prescribed as an adjunct in the treatment of obesity but have been associated with increased cardiovascular events and strokes and have been withdrawn from the market in many countries),
  • sildenafil (trade name Viagra, is a drug used to treat erectile dysfunction and pulmonary arterial hypertension),
  • fluoxetine (trade name Prozac, is an antidepressant),
  • phenolphthalein (has been used for over a century as a laxative, but is now being removed from over-the-counter laxatives because of concerns over carcinogenicity),
  • aromatase inhibitor (a class of drugs used in the treatment of breast cancer and ovarian cancer in postmenopausal women), and
  • various anabolic steroids (increase protein in skeletal muscles with androgenic and virilizing properties, including growth of the vocal cords, testicles and body hair).

A revered previous Prime Minister of Australia, Gough Whitlam, passed away on 21 October 2014. His slogan in winning the election was “It’s time”. I think it is high time that someone takes some serious action in preventing the sale of potentially harmful herbal supplements worldwide.

Do you trust herbal supplements?

Cart in Mexico selling herbal remedies (Photo: Wikimedia)

Cart in Mexico selling herbal remedies (Photo: Wikimedia)

Herbal supplements, sometimes called botanicals, aren’t new. As a matter of fact, the use of medicinal plants is the most common form of traditional medication worldwide. They have been used by human medicine for thousands of years. A considerable part of commercial pharmaceuticals currently on the market are derived from botanical sources. Examples include aspirin (from willow bark), quinine (from the quinine tree) and digoxin (from the foxglove plant). But pharmaceuticals have gone through extensive testing, herbal supplements have not.

The international trade in herbal supplements is a considerable part of the global economy and the demand is increasing in both developing and developed nations. There are currently more than 1,000 companies producing medicinal plant products with annual revenues in excess of US$60 billion. Echinacea to prevent colds. Ginkgo to improve memory. St. John’s wort to treat mild depression. Flaxseed to lower cholesterol. The list of herbal remedies goes on and on. There are now a bewildering 29,000 different products available on the market.

New research uncovered fraud

There is nothing inherently wrong in trusting herbal remedies, as long as you know what you’re getting. And do you? Maybe not according to new research.

Using a test called DNA barcoding, a kind of genetic fingerprinting that has also been used to help uncover labelling fraud in the commercial seafood industry, Canadian researchers tested 44 bottles of popular supplements sold by 12 companies. They found that pills labelled as popular herbs were often diluted — or replaced entirely — by cheap fillers like soybean, wheat and weeds. A bottle labelled as St. John’s wort was made of nothing but rice. They also found that many supplements were not what they claimed to be. For instance, the study found that one product advertised as the North American black cohosh, a popular remedy for hot flashes and other menopause symptoms, actually contained the related Asian baneberry plant that can be toxic to humans.

Some herbal supplements were discovered to be adulterated with ingredients not listed on the label. Such contamination could pose serious health risks to consumers. For example, they identified black walnut contamination in a gingko product and contamination of many products with Santa Maria feverfew. This latter plant can trigger respiratory and skin reactions in people. One of the bottles tested even contained Alexandrian senna, a powerful laxative made from an Egyptian yellow shrub.

Product substitution occurred in 30 of 44 of the products tested and only two of the 12 companies had products without any substitution, contamination or fillers. Many people assume that if their local pharmacy or health food store carries a particular herbal supplement, it can’t be harmful. But it certainly can since many contaminants will have significant medical effects.

How serious is it?

Not necessarily safe because it is sold in a pharmacy (Photo: Chris de Rham)

Not necessarily safe because it is sold in a pharmacy (Photo: Chris de Rham)

Some of the adulteration problems may be inadvertent. Cross-contamination can occur in fields where different plants are grown side by side and picked at the same time, or in factories where the herbs are packaged. Rice, starch and other compounds are sometimes added during processing to keep powdered herbs from clumping, just as kernels of rice are added to salt shakers.

But it is clear from the results that product adulteration and deliberate ingredient substitution is not uncommon as species of a lower market value are substituted for those of a higher value. This practice constitutes not only product fraud, but according to the World Health Organization, the adulteration of herbal products can be a threat to consumer safety. And as if this is not enough, pesticides and heavy metals are often found at high levels in herbal supplements, but that will be a topic of a further blog.

Consumer advocates and scientists say the research provides more evidence that the herbal supplement industry is riddled with questionable practices. But of course industry representatives argue that the problems are not widespread.

You make up your own mind.

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