This is the time for New Year’s resolutions and many resolve to do better with their health. Diet and exercise changes are frequently at the top of lists of resolutions. One shortcut to better health may be achieved via nutritional supplements, but do they really work?
In 1994, Orin Hatch, Republican of Utah introduced and got passed the Dietary Supplement and Health Education Act (DSHEA.) Before this act, the Food and Drug Administration (FDA) oversaw the regulation of essentially anything sold that made health claims. Oversight was in the form of requiring proof of efficacy – does it really do what it claims to do. Appropriate, properly controlled studies were needed to support any claims of beneficial health effects.
DSHEA created a loophole by allowing a new category of products, dietary supplements, which henceforth would not require any proof of efficacy. Marketers can now define their product as a dietary supplement, not a drug, and thereby escape any oversight by the FDA. Currently, dietary supplements is a forty billion dollar market, growing at five to ten percent per year. Over half the adult population take some sort of dietary supplements.
Claims of effectiveness are made for the supplements generally through testimonials or vague statements of some testing. None of these need be true! When it comes to supplements, caveat emptor, “let the buyer beware.” Actually, the Federal Trade Commission does examine claims for truthfulness. Hence, you will see untestable claims like the nostrum “supports” heart health or memory or some such.
One popular dietary supplement, fish oil capsules, are used daily by eight percent of the adult population of the United States. The fish oil market came about with the recommendations of the American Heart Association. The AHA suggested that fish oil supplementation is beneficial for those with existing cardiovascular disease. It was also recommended to reduce the risk of cancer. The fish oil industry took this recommendation and pitched it to the general population as a way to prevent cancer and cardiovascular disease.
A recent study published in the New England Journal of Medicine tested this hypothesis. A prospective, placebo-controlled study with 26,000 subjects over the age of fifty was conducted. After five years there was no evidence of beneficial health effects, neither reduced rates of cancer nor cardiovascular disease.
Another common supplement, the combination of Glucosamine and Chondroitin Sulfate, is used by many for joint pain, especially weight-bearing joints like knees and hips. The evidence of beneficial effects is variable and limited. Dosage and quality of these agents vary from brand to brand and may account for the variance. The American College of Rheumatology does not recommend the use of Glucosamine/Chondrotin supplements.
Literally thousands of supplements are sold, the effectiveness of which is mostly unproven. Marketing via testimonials and improperly or uncontrolled studies can not provide evidence of efficacy. Whereas a healthier diet and more exercise are well proven to improve health, dietary supplements are not.
Dr. Bob Allen, Ph.D., is Emeritus Professor of Chemistry at Arkansas Tech University.