Researchers Review Consumers' Views on Supplements

Researchers Review Consumers' Views on Supplements

BOSTON--Consumers want more federal regulation of dietarysupplements, according to the authors of an article published in the March 26issue of the Archives of Internal Medicine (161: 805-10, 2001). Usingdata from six national surveys, the authors examined characteristics of usersvs. non-users of supplements, their views of supplements and their attitudestoward regulation of those products. However, some of the surveys did notdifferentiate between users and nonusers, an influencing factor when opiningabout dietary supplements. The percentages cited in the article were generallytaken from individual surveys, not composite results--a fact that was not madeobvious in the article. And some conclusions and statements (such as"Slightly more than half of the respondents were aware that supplements arenot regulated by the government") were misleading or incorrect.

Authors Robert Blendon (Harvard School of Public Health) et. al., stated in"Americans' Views on the Use and Regulation of Dietary Supplements"that they were concerned with consumers' "false sense of security"about dietary supplements. Between the six surveys, approximately 48 percent ofthe respondents reported taking some type of nonprescription vitamin, dietary ormineral supplement regularly, with approximately 18 percent regularly usingsupplements such as echinacea, ginseng, over-the-counter hormones or aminoacids. Demographically, regular users tended to be highly educated, Caucasianand over 45. Also, of those surveyed, uninsured Americans were more likely totake a supplement (21 percent) than the insured (15 percent).

In one survey, 85 percent of regular users cited that dietary supplementswere good for people's health and well being. Approximately half of thosesurveyed stated that supplements helped colds, arthritis, depression andinfluenza. In addition, 35 percent believed dietary supplements could help treatcancer and 16 percent felt the same about AIDS. Another survey reported that 82percent of the respondents would try alternative medicine--including herbalsupplements--if they were terminally ill.

In terms of the government's role in dietary supplements, one survey notedthat 71 percent of regular users would disregard a government agency's warning(even if it came from the Food and Drug Administration) that a product was notefficacious. Also, a different survey reported that 91 percent of respondentswho were regular users believed that unfettered access to dietary supplements is"very" or "somewhat" important. However, the authors notedthat those surveyed (both regular users and nonusers) were confused about thegovernment's role in dietary supplements: 53 percent believed supplements wereunregulated, 35 percent believed supplements were regulated and 12 percent wereunsure.

"It is unfortunate that the public is unaware that the regulationsconsumers stated they wanted [in this survey] already exist as a body ofsubstantial federal law known as the Dietary Supplement Health and Education Act(DSHEA) and the Federal Food Drug and Cosmetic Act," stated Joseph Betz,vice president of scientific and technical affairs at the American HerbalProducts Association (AHPA). What this means to the industry, said Tony Young,AHPA's legal counsel, is that "Both the government and the industry have todo a better job in explaining to the public that a substantial regulatoryauthority now exists."

In one survey, respondents expressed a desire for the government to regulatedietary supplements' efficacy, safety, dosages and claims. Eighty percent of onesurvey's population supported having the FDA "remove dietary supplementsfrom the market if they proved unsafe."

"We found some of the article's survey questions to be off base andpoorly worded," Betz stated. "For instance, they asked consumers ifFDA should 'test' dietary supplements before they are sold. FDA does not testany of the commodities over which it has regulatory authority." He addedthat companies, including those in the pharmaceutical, food and dietarysupplement industry, are required to test products and submit that data to FDAfor evaluation before a new product reaches consumers. FDA makes the finalassessment as to whether the product reaches the market place. In the case ofdietary supplements, FDA has the legal authority to evaluate the data and rejectnew dietary ingredients if it deems them unsafe or unfit.

Also of note was that 70 percent of regular users reported their supplementusage to their regular physician, although 50 percent believe physicians areprejudiced against supplements. Another survey found that the majority (53percent) of regular users believed people "rarely or never" sufferedadverse events from supplements; however, almost an equal number (51 percent) ofnonusers believed that people "often or sometimes" experienced harmfulevents.

The authors also touched on the subject of labeling and reported that 57percent of regular users believed their supplements' health claims. "Thefederal laws that make false and misleading label claims are illegal and arealready on the books," said Betz. "As such, we have seen the FederalTrade Commission take enforcement action against companies who have labeledtheir products with claims that are false and misleading."

Blendon et. al. concluded that because one in six parents report givingdietary supplements to their children, the medical community should take moreresponsibility in staying abreast of this alternative form of medicine. Foradditional information, visit http://archinte.ama-assn.org.