Dietary supplements are a multi-billion dollar industry in the United States. Approximately 61 percent of Americans take supplements for a variety of reasons: the desire for a quick fix, the benefits of an advertised health claim, the positive effects reported by a friend or relative, or simply to ensure a balanced daily intake of nutrients. Whatever the reason, consumers are faced with a multitude of products to choose from and a variety of nutritional claims to decipher.
The Food and Drug Administration regulates the dietary supplement industry under a different set of standards than it applies to conventional foods and drugs. Dietary supplements are regulated under the Dietary Supplement Health and Education Act (DSHEA). Pharmaceutical drugs must undergo clinical studies to demonstrate their safety, effectiveness, and possible side effects, but dietary supplements are not held to the same requirements. Since 1994, when DSHEA went into effect, many products have found their way into the marketplace that may not otherwise have been approved.
The supplements industry, like most industries, includes both reputable and disreputable companies. Although the FDA does not regulate these companies, they must comply with the 1990 Nutrition Labeling and Education Act. If a dietary supplement does not meet the guidelines for making an approved health claim, the maker may use a statement of “nutritional support” instead, which can be related either to a nutrient deficiency or to the effect of a supplement on the body’s structure or function. An example of a nutrient deficiency claim may be that vitamin C supplementation prevents scurvy; a structure-or-function claim may be that calcium helps build strong bones. To comply with DSHEA, a product that carries a statement of nutritional support must also state on the product label: “This statement has not yet been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.”
Despite existing laws and regulations, dietary supplements are less stringently regulated than foods and drugs and we cannot really be sure of the quality or effectiveness of the supplements we purchase. Supplements can be found almost anywhere these days, and every year many are recalled as the result of safety problems and inaccurate statements about the ingredients they contain.
Until the law requires closer monitoring of dietary supplements, consumers will continue to make “good faith” purchases, guided more by marketing and word-of-mouth than actual proof of effectiveness. Unless you have special circumstances that require dietary supplementation, you should know that it’s possible to get just as much benefit from a healthy and well-balanced diet as from a bottle of supplements. If you plan to start taking a dietary supplement, consider carefully how it will complement your total diet and discuss it with your physician or other health care provider.
