The Dietary Supplement Decision

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GENETIC ALLIANCE BY CLAIRE MENA

While dietary supplements do give reason to consume with caution, certain supplements, particularly vitamins, can play an important role in a child’s health.

Throughout my life I have gone through bouts of anemia. When I disliked meat as a child, my iron levels dropped and the pediatrician recommended a diet filled with leafy greens, whole grains, and my least favorite—cream of wheat. The iron levels continued to fluctuate with diet and various life factors, and when I began college, a cafeteria offering overcooked burgers and wilted spinach was not compatible with a well-balanced meal. Again, the anemia spiked and so iron supplements came to the rescue. Within a short amount of time, periods of exhaustion and fatigue were nearly eliminated with a simple daily pill.

Like me, millions of Americans take various forms of dietary supplements to ensure a sufficient intake of vitamins and minerals. Supplements such as calcium for strong bones, and iron for anemia, can play a vital role in assisting children as they grow to be strong and healthy. The market expands beyond vitamins and minerals and includes other supplements such as Hydroxycut for weight loss, Creatine for muscle gain and Viagra for sexual enhancement for adults. In total, Americans spend more than $30 million a year on various dietary supplements averaging about $100 per person.

As consumers in the U.S., we typically shop with certainty that the products in the store are safe and even tested, if necessary. We assume the baby food on the shelf contains only the ingredients listed on the back and we trust the children’s Advil isn’t mixed with any additives or fillers. Yet this confidence cannot be held for dietary supplements. Dietary supplements do not look like food or medicine; they are packaged, purified ingredients and can be found containing illicit pharmaceuticals. In 2014, various weight loss products such as Magic Slim, Super Fat Burner, and Forever Beautiful, were recalled for containing substances deemed unsafe by the FDA such as Meridia, a weight loss drug, and the laxative, phenolphthalein.

In another case, Doctor’s Best Red Yeast Rice, a dietary supplement used to treat high cholesterol, was found laden with additives such as chlorzoxazone (a muscle relaxant), ibuprofen, and diclofenac. Unlike prescription  medications, the FDA does not know what dietary supplements are on the market. With minor oversight to regulate these products, Kapoor and Sharfstein (in Breaking the Gridlock: Regulation of dietary supplements in the United States) describe the market as disorganized, deceptive, and dangerous.

Many individuals question how such little oversight can be possible. How does a dangerous, even life threatening product, enter the market and sit on the shelves of our local pharmacies? In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA) in hopes of defining and regulating dietary supplements. Consequently, it became possible to sell a dietary supplement on the market without evidence to prove the product is safe or effective. Under the law, any product can be advertised as a tool to promote health as long as it does not claim to prevent, cure or treat a condition. Yet many individuals continue to fall victim to this wording, believing the products ensure a certain result.

Although DSHEA set these guidelines for dietary supplements, many manufacturers continue to make illegal and unauthorized claims. Certain products are falsely advertised as an aid to prevent, treat or cure a condition. This not only encourages a consumer to buy an unnecessary product, but can deter seeking alternative, more effective treatments. According to Kapoor and Sharfstein, a 2003 review of 273 websites selling dietary supplements found 55 percent made illegal claims regarding treating or preventing illnesses. More recently, manufacturers for hundreds of  products have been cited by the FDA for falsely claiming to treat conditions such as diabetes, heart disease, HIV/AIDS, and cancer. And without a system enforcing the supplements to be tested prior to selling, trial and error of the product can come at the expense of the consumer.

While dietary supplements do give reason to consume with caution, Dr. Sharfstein believes that certain supplements, particularly vitamins, can play an important role in a child’s health. Often, vitamin D is recommended for babies and children that take iron for iron deficiency. The greater focus though, should be on ensuring a well-balanced diet filled with nutrients necessary for a child to grow. One cup of milk contains around 308 mg of calcium and three ounces of beef contains about 3.5 mg of iron. When deciding whether to use dietary supplements with your child, it is important to check with your child’s pediatrician, discuss various options, and address any underlying issues that could be causing a deficiency. •

ABOUT THE AUTHOR:
Claire Mena is an Engagement and Outreach Specialist at Genetic Alliance. She previously worked in breaking news and now focuses on the relationship between health care and enhancing patient-centered information. You can find her @clairemelise