Dietary Supplements Should Be Taken With A Grain Of Salt, Researcher Says

FAYETTEVILLE, Ark. - You can find bottles on a shelf in the vitamins and minerals section with names like "Super Charge," "Over Drive," "Cell Forte" and "Optimum Omega." These products promise to "enhance natural killer cell activity," "support cardiovascular health" and "support healthy joint function." But if these promises sound too good to be true, it’s because they are, says nutrition sciences professor Jerald Foote. Foote says that the majority of these products—called dietary supplements—never have been tested to support the claims they make, and they vary wildly in quality, efficacy and safety.

"There are some big gaps as far as consumer safety is concerned," he said. "It’s a buyer beware situation."

Since 1994, dietary supplements have enjoyed a separate status from drugs and foods because of the Dietary Supplement Health and Education Act (DSHEA) passed by Congress that year. The DSHEA defined a dietary supplement as any product that is natural or is a natural metabolite and allows these products to be sold with far less regulation than food or drugs.

"You can go buy an anabolic steroid in the health food store. You can buy a stimulant," Foote said. "You have more legal hurdles to overcome if you want to sell hot dogs on a street corner than if you want to sell dietary supplements."

This lack of regulation has resulted in products that run the gamut from safe and effective to benign but ineffective to downright dangerous. Some products can cause damage to internal organs. Others come contaminated with lead. Many products just lead people to have false hopes about their chances of recovery from cancer and other diseases.

"In many ways, we have not come that far in 100 years from the traveling medicine show," Foote said.

Foote cites St. John’s Wort, a popular natural remedy for depression, as an example of how lack of regulation can be problematic. Studies have shown that the amount of St. John’s Wort varies from bottle to bottle, but depressed people need to have a stable amount of the herb in their system for it to have the desired effect.

Foote studies contaminants in dietary supplements, which appear to vary wildly from product to product because of variations in harvesting and processing techniques. Some supplements are scraped off of South American trees and put in old gasoline cans, while other supplements go through processing procedures similar to those of regulated drugs, creating different contamination levels.

In addition to research, Foote also counsels clients about nutrition and spends a lot of time debunking myths about dietary supplements.

"I spend a lot of time battling misinformation," he said.

But recent stories in the news about adverse side effects caused by dietary supplements—including deaths from supplements containing ephedra—have led to a change in consumer attitudes.

"Consumers are starting to realize that not every supplement is okay," Foote said. "We’re seeing the pendulum swing the other way."

If people feel they must buy dietary supplements, they should ask their physicians to advise them about any potential adverse drug interactions. Unfortunately, doctors don’t always have enough information about dietary supplements to be able to dispense information.

Dietary supplements should be evaluated on a product-by-product basis because of wide variations in the pharmacology, toxicology and drug interactions from product to product, even among the same type of herb. And people should be especially wary of obscure herbs in particular.

"With the more esoteric medicinal herbs, you are setting yourself up to be a guinea pig," Foote said.

Some supplements, like those containing steroids and hormones, contain such powerful pharmacological agents that they should be used only while under a doctor’s supervision.

In addition to choosing dietary supplements with care, Foote suggests that consumers take into account their current health and the benefits they expect to reap from taking the product. Something that might be safe for a 19-year-old male might cause problems for a 70-year-old on multiple medications or for a sick child, Foote said.