According to a recent article released by the Centers
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for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), dietary supplement usage has increased in the United States by 10% since 1994 (per NHANES III). The most commonly ingested supplements reported by those surveyed included multivitamins (MVI), folic acid, and calcium/Vitamin D supplements, with adults over the age of 20 and women in particular being the chief consumers.
When it comes to dietary supplements, there are several common misconceptions that cloud the general population's understanding of what they are and what their function is within the body. To help clarify these misunderstandings, Congress developed an official definition of the dietary supplement, which is as follows:
A dietary supplement is defined as a product other than tobacco that:
· is intended to supplement the diet;
· contains one or more dietary ingredients (including vitamins; minerals; herbs or other botanicals; amino acids; and other substances) or their constituents;
· is intended to be taken by mouth as a pill, capsule, tablet, or liquid; and
· is labeled on the front panel as being a dietary supplement
There are several different types of dietary supplements, ranging from vitamins, minerals, botanicals, sports nutrition supplements, weight management products, and speciality supplements. Dietary supplements are also available in different forms. They typically appear as capsules, tablets, and liquids but can also be purchased as powders, bars, and beverages.
Several regulating agencies exist to monitor the usage of dietary supplements: the Food and Drug Administration (FDA), the Federal Trade Commission (FTC) and the Adverse Events Reporting (AER). The FDA works to regulate supplements through a framework established by the Dietary Supplements Health and Education Act of 1994 (DSHEA). The act instated Good Manufacturing Practices (GMP), labeling requirements, health claims, registration of new ingredients, and an "alert system" for products that caused adverse reactions.
The afore-mentioned methods work well to regulate supplement usage; but there is a distinction between "regulating" a supplement and approving its usage. When DSHEA was passed, it stated that dietary supplements do not need to be FDA-approved before appearing on the market.
An example of regulation vs. approval can be found in the registration of new dietary ingredients. According to the Office of Dietary Supplements, "Supplement ingredients sold in the United States before October 15, 1994, are not required to be reviewed by FDA for their safety before they are marketed because they are presumed to be safe based on their history of use by humans". In layman's terms, dietary supplements are not guaranteed by the FDA to be safe or effective.
Occasionally a disclaimer will appear on the label that reads: "These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease".
The FDA requires this label when a company is making a structure-function claim. A structure function claim is one that mentions a specific nutrient, a health/nutrient related condition or deficiency, and a claim that links the two. For example, "Calcium is linked to the reduced risk of osteoporosis" would be a structure-function claim that would merit an FDA disclaimer.
Choose your supplements wisely:
· Look for a label that includes a name, net quantity, directions, a list of ingredients, storage conditions, a warning label, an expiration date, and contact information for the manufacturer.
· If your label bears a structure-function claim, it should always carry the FDA disclaimer.
· Avoid any product that claims to be a legal alternative to an FDA-approved drug.
· Use common sense - if a product sounds too good to be true, it probably is!
Additional questions on safety, efficacy, and other information regarding dietary supplements can be found on the Office of Dietary Supplements website. Always consult your primary care physician before adding/altering your dietary supplements.