Currently browsing posts about: Supplements

NutraIngredients.com alerted me to a study by the Council for Responsible Nutrition, the main trade group for the dietary supplement industry.

Its conclusion: 77% of American adults say they take dietary supplements.

Here are selected results.

Who Takes Dietary Supplements? 77 percent of U.S. adults take dietary supplements.

• 79 percent of female adults
• 74 percent of male adults 
• 81 percent of adults 35 – 54
• 79 percent of adults 55+ 
• 83 percent of adults with children under 18 in the household
• 68 percent of adults without employment
• 73 percent of adults who live in the Northeast
• 80 percent of adults who live in the South

Everybody takes this stuff, apparently.  What are they taking?

What to say?

I wish we had better evidence—how about any evidence—that supplements make healthy people healthier, but we do not.

Supplements, as far as I can tell, are about nutritional magic.

Whatever works, I guess.

In the meantime, NutraIngredients cites data that the dietary supplement market was worth nearly $125 bilion in 2018.

Impressive.

For the record: I don’t take supplements.  I prefer my nutrients from food and sunshine.

Addition

A reader, Charlene Elliott, sends her study of supplement marketing to Canadian children.

This study is the first of its kind to examine the nutrient levels of vitamins, minerals and dietary supplements specifically marketed as for children in the Canadian retail environment. On the one hand, the promotion of gummy and chewable supplements using cartoon and licensed characters and claims that the products are “fun to eat” simply extends contemporary strategies found in child-targeted packaged foods. Yet vitamins are not foods, nor are they regulated as foods in Canada, and this study questions the logic of recommending that children consume up to 15 gummy candies per day in order to “improve” their health.  Beyond this, the substantial variation in dosage depending on the supplement is problematic, given that all of these supplements use the same kinds of appeals on the package.

Curcumin is a flavonoid antioxidant isolated from turmeric, the spice used in Indian curries, among other foods.

It is about as overhyped as any ingredient I have encountered lately for its “proven ability” to fight Alzheimer’s, heart disease, cancer, and anything else that ails you.  If only this could be true.  If it were, people in India who use this in their cooking would all live exceptionally long and healthy lives.

But to convince skeptics like me—and to sell curcumin supplements of course—the makers of such supplements fund studies.

I learned about this study from the industry newsletter, NutraIngredients-Latam.

It reported on a an abstract of a clinical trial of a curcumin supplement, Longvida,™ made by Verdure Sciences. 

The study:  This was a double-blind, placebo-controlled, parallel-groups clinical trial in which participants were given Longvida™ (400 mg daily containing 80 mg curcumin) or a matching placebo.

Results: After 12 weeks, the curcumin group did better on memory performance and other tests, and after 4 weeks showed less tension, anger, confusion and total mood disturbance.

Conclusions: “These results confirm that Longvida™ improves aspects of mood and working memory in a healthy older cohort. The pattern of results…may hold promise for alleviating cognitive decline in some populations.”

Funding: Surprise! “This study was funded by a grant from Verdure Sciences.”

Comment: I see three problems here with the Nutraingredients report.

(1) When funders have a vested interest in the outcome of studies, biases tend to creep in.

(2) The report is based on an abstract, not on a complete account of the trial; this makes the methods difficult to assess.

(3) The report did not mention that study was funded by a company with a vested interest in the result; it should have.

Estimation of Total Usual Dietary Intakes of Pregnant Women in the United States.  Regan L. Bailey, Susan G. Pac, Victor L. Fulgoni III, et al.  JAMA Network Open. 2019;2(6):e195967. doi:10.1001/jamanetworkopen.2019.5967 June 21, 2019

Question  How do the usual dietary intakes of pregnant US women compare with the National Academies of Science, Engineering, and Medicine Dietary Reference Intakes for nutritional adequacy and excess?

Conclusions and Relevance.  This study suggests that a significant number of pregnant women are not meeting recommendations for vitamins D, C, A, B₆, K, and E, as well as folate, choline, iron, calcium, potassium, magnesium, and zinc even with the use of dietary supplements.

Conflict of Interest Disclosures: Dr Bailey reported serving as a consultant to Nutrition Impact LLC, Nestle/Gerber, RTI International, and the National Institutes of Health Office of Dietary Supplements. Dr Fulgoni, as Senior Vice President of Nutrition Impact LLC, reported performing consulting and database analyses for various food and beverage companies and related entities. Ms Pac and Dr Reidy reported being employees of Nestle Nutrition. No other disclosures were reported.

Funding/Support: This research was funded by Nestle Nutrition. Nestle Nutrition and Nutrition Impact had a financial agreement for completion of the statistical analysis. Drs Bailey and Catalano received an honorarium for the time contributed to manuscript development.

Role of the Funder/Sponsor: Nestle Nutrition had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Comment: It’s Nestlé, not Nestle, the company, not me.  Nestlé is the largest food and beverage company in the world, selling $94 billion worth of products in 2018.  This study is part of the company’s plan to focus on personalized nutrition—functional food products targeted to the personal nutritional needs of individuals.

We continue to invest in long-term innovation projects with the potential for high returns. Examples include infant and maternal nutrition, healthy aging, personalized nutrition, and understanding the microbiome.

It is in Nestlé’s corporate interests to demonstrate that pregnant women are deficient in essential nutrients as a basis for creating nutrient-supplemented products targeted to this group.  Are U.S. pregnant women really deficient in 13 nutrients as reported here?  This study’s conclusions are based on comparison of self-reported dietary intake to average daily nutrient intakes.  They are not based on laboratory or observed measurements of clinical signs of deficiency. To me, this looks like a typical industry-funded study with results favorable to the sponsor’s marketing interests, as I discuss in my book, Unsavory Truth.

A notice from FoodNavigator-Asia got my attention: Coca-Cola is partnering with the New Zealand dairy company Fonterra to produce “Nutriboost” products for Southeast Asia.

What are these?

• Nutriboost Kids is targeted at children above three years of age, with each of its products being fortified with different occasion-based vitamins and minerals:…Morning Growth (fortified with vitamins for growth), Playtime (designed for stronger immunity) and Good Night (fortified with DHA for brain development).
• Nutriboost To-Go is an energy-providing breakfast range enriched with oats and fibre.
• Nutriboost Beauty is fortified with fitness and beauty-associated minerals like collagen and zinc.

Given the lack of evidence for significant nutritional benefits of any of these things, and the high prevalence of lactose intolerance among Asian populations, why this partnership?

• Vietnam is the third largest dairy market in the ASEAN region.
• To grow [sales] to 40 million or 50 million cases within the next five years.
• Coca-Cola’s strategy is to evolve away from drinks with high sugar content.

The article doesn’t say how much money is going into this partnership, but both companies must think there is a big market for such products.

I’m not a fan of “functional” foods, alas.

Real food, anyone?

NutraIngredients-USA.com has posted a set of articles celebrating the 25th anniversary of the Dietary Supplement Health and Education Act of 1994 (DSHEA), which effectively deregulated the supplement industry.  The articles that follow are from the perspective of that industry.

Personally, I’m not a fan of DSHEA, and view deregulation of dietary supplements as a mistake for the industry as well as for the public.  Strong regulation inspires trust.  Weak regulation encourages distrust of supplement products and the entire industry.  When I see a Supplement Facts label, I have no reason to trust that the label reflects the contents of the package.  Until supplements are subjected to the same level of regulation as food products, caveat emptor.

Special Edition: DSHEA at 25

The Dietary Supplement Health and Education Act of 1994 created the framework for the modern supplement industry. In 1994, the industry was worth $4 bn. Now it is estimated to be worth over $40 bn.

In this special edition we will talk to some of the industry legends who helped to craft the law, we’ll learn about NPQAA, we’ll hear from the head of the FDA’s Office of Dietary Supplement Programs on the need to modernize the law, get the views of some of the industry association leaders, and look to the future.

• DSHEA at 25: In conversation with Scott Bass and Loren Israelsen: The brilliant strategy of Sen. Orrin Hatch, the upswell of grassroots consumer pressure, and the ‘highly unusual’ personal intervention of an FDA Commissioner: The development and passage of the Dietary Supplement Health and Education Act is a fascinating story….. Read
• What was NPQAA and what role did it play in the successful passage of DSHEA?  While much of the focus around DSHEA was on Capitol Hill and the machinations of government, an important behind-the-scenes contribution came from the short lived Natural Products Quality Assurance Alliance. But what was NPQAA and how did it help?.. Watch now
• FDA’s Tave: ‘Opportunity to strengthen regulatory framework couldn’t come at a more pivotal time’: With scientific advances and the growth of the dietary supplements industry on one hand, and the proliferation of adulterated and misbranded products on the other, the opportunity to modernize DSHEA couldn’t come at a better time… Read
• DSHEA Was Not Carved in Stone: Want to spark controversy? Just suggest to some audiences that it’s time to amend DSHEA… Read
• Balancing consumer access and safety: Looking back 25 years, there are several remarkable aspects of the Dietary Supplement Health and Education Act (DSHEA) amendments to the Food Drug and Cosmetic Act (FD&C Act), which transformed how dietary supplements are regulated… Read
• Fabricant on DSHEA: ‘Why are we talking about modernizing something that has never been fully implemented?’  As talk in the industry and at the FDA continues around the modernization of DSHEA, not everyone thinks big changes are needed. “The best thing the Agency does is inspect and test,” says NPA’s Dr Daniel Fabricant… Watch now
• Critic says FDA’s slow enforcement makes ‘DSHEA 2.0’ a side issue: Industry critic Dr Pieter Cohen, MD, said FDA’s enforcement is overly deliberate, making any discussion about revisions to DSHEA more or less moot… Read
• Bodybuilding.com VP on DSHEA: What changes could improve the regulation of dietary supplements: Bodybuilding.com’s John Venardos shares some of his ideas to improve the regulation of the dietary supplements industry, from better transparency to greater FDA staff accountability, and how to level the playing field… Watch now
• If botanicals don’t fit easily under supplement heading, why not try to fix that?  Should the creation of a new herbal medicine category be one of the goals of the upcoming discussions about a new regulatory framework? If it were possible, such a change could clear up many of the ambiguities surrounding the marketing of these products as dietary supplements… Read
• What should DSHEA 2.0 look like? Here are a couple of suggestions: On Monday FDA Commissioner Scott Gottlieb put forward some ideas about where the regulation of dietary supplements should go in the coming years. This is an opportunity that should not be missed. What should be tops on the industry’s wish list?.. Read

 

I thought the FDA had decided long ago that dietary supplements were untouchable, given the Courts’ interpretation of the Dietary Supplement Health and Education Act (DSHEA) of 1994.  DSHEA essentially deregulated dietary supplements and blocked the FDA from doing much about them unless it could prove substantial harm.

Whenever the FDA tried to intervene, supplement companies took the agency to court on First Amendment grounds, and won most of the time.  So the FDA appeared to have given up.

But here we have FDA Commissioner Scott Gottlieb announcing new steps to take back some oversight of this industry.

These steps include communicating to the public as soon as possible when there is a concern about a dietary supplement on the market, ensuring that our regulatory framework is flexible enough to adequately evaluate product safety while also promoting innovation, continuing to work closely with our industry partners, developing new enforcement strategies and continuing to engage in a public dialogue to get valuable feedback from dietary supplement stakeholders.

The FDA issued a press release to announce 12 warning letters and 5 online advisory letters to companies illegally selling more than 58 misbranded products claimed to prevent or treat Alzheimer’s disease.  The demographic change to an aging population:

has been accompanied by a growth in the number of marketers who prey on this population, pitching products that make unproven claims that they can prevent, treat, delay, or even cure Alzheimer’s disease.  These purported miracle cures are sold primarily on the Internet. They are often, though not always, falsely labeled as dietary supplements. Regardless of their form, these products fly in the face of true science. What these companies are selling is the false hope that there is an effective treatment or cure.

Commissioner Gottlieb also sent out a chain of Twitter announcements explaining what this is about.

Cheers to the FDA for this one.  And now get busy on the rest of the bad apples in this barrel.

The Government Accountability Office has just published a report on memory supplements.

Available data indicate that memory supplements constitute a small segment of the overall dietary supplement market, but their sales nearly doubled in value from 2006 to 2015, increasing from $353 million to $643 million. Consumers searching to prevent or treat age-related memory loss, including Alzheimer’s disease, have increasingly turned to dietary supplements for help.

What did the GAO do?

This report examines the extent to which selected memory supplements contained: (1) their stated ingredients at the quantities stated on their labels and specific adulterants, and (2) certain contaminants.

Uh oh.  Never mind whether memory supplements do any good (a dubious claim).  They don’t even contain what they claim to contain:

• One product, marketed as Ginkgo biloba, did not contain that ingredient. Instead it contained an unknown substitute; as such the safety of the product is unknown.
• The second product was marketed as a supplement that included Ginkgo biloba. It also contained an unknown substitute, instead of Ginkgo biloba.
• The third product, marketed as a fish oil supplement, contained the stated ingredients.

Supplement products, you will recall, are essentially unregulated, by Congressional fiat (see the Dietary Supplement Health and Education Act of 1994).

Since none of these supplements has been shown to improve memory, what’s in them only matters if it causes safety problems.  Fortunately, the study found contaminants to be a low levels.

When it comes to dietary supplements, caveat emptor.

The food industry is intensely interested in personalized nutrition because it can create and sell products appeared to be aimed directly at individual lifestyles and preferences.

This approach is aimed much more at marketing than it is about public health.

With that said, take a look at how the food industry is using this idea.

Special Edition: Personalized Nutrition

The future is personal, but the revolution is already taking place around us. Innovative science is combining with entrepreneurial endeavor to bring personalized nutrition to our fingertips.

Personalized nutrition is breaking down the silos and bringing together experts in genetics and genomic profiling, microbiology, nutrition and diet, mobile technology, big data, healthcare and more.

In this special edition we talk to the pioneers and experts in this sector, the scientists and the emerging brands, and the tech developers bringing the personalized nutrition future to the present day.

• Personalized nutrition approaches helping to drive evolution of supplement retailing: Personalized nutrition is being folded into the ongoing evolution of retailing in the dietary supplement space, market experts say… Read
• Research backs personalized nutrition process, even if data on customized products lacks, expert says: While personalized nutrition proponents like to push the benefits of the approach, there is little research that backs the notion that products customized for individual consumers lead to better health outcomes than do more generic formulas. But that misses the point, said one expert… Read
• Persona CEO: ‘Chase the shiny new technology that has a big price tag – that’s not always the best solution’: Is a lifestyle questionnaire ‘personal’ enough for personalized nutrition? Persona’s founder and CEO Jason Brown talks about growing a business in the personalized nutrition space.. Read
• Personalized nutrition ‘milestone’: InsideTracker data validates algorithmic platform to improve wellness: Data from 1,033 generally healthy individuals using InsideTracker shows that the automated, web-based personalized nutrition platform is capable of normalizing serum biomarker levels in healthy subjects… Read
• Food selfies and data: Nutrino wants to make personalized nutrition easier for users:A mathematician and an engineer bootstrapped a nutrition-tech company about seven years ago. Their goal was to create a platform that documents the diverse ways human bodies extract nutrition from food… Read
• ‘Hyper-personalised’ recommendations: Spoon Guru targets global domination with growing list of partnerships:UK food tech start-up Spoon Guru has a goal of becoming the dominant technology platform for users looking for product recommendations based on specific lifestyle goals or dietary needs, says co-founder and CEO Markus Stripf, as the company looks to increase its partners globally and launch in the USA… Read
• Nordic Group: Nutrigenomics needs to be ‘done with integrity’ – it’s too early for direct consumer models: Nutrigenomics is gaining plenty of attention but it remains extremely complex and unadapted to direct-to-consumer models, says the MD of Nordic Group – owner of DNA Life and more recently AthGene… Read
• Lux Research: ‘It’s paramount that microbiome data is used for personalized nutrition’: A new market research report explores how the personalized nutrition space can elevate itself beyond “just recommending diets” and become an integral part of preventive health care… Read
• Weight loss presents ‘lucrative’ opportunity in nutrigenomics, says analyst: Nutrigenomics remains a growing niche within the burgeoning personalised nutrition trend but there is significant potential to spark mass market appeal with a focus on weight loss, says a consumer expert… Read