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| home : how we can help : prevention, screening, & diagnostics : answers to cancer : diet & nutrition
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You read about a dietary supplement from its advertising brochure or the information on its container and you assume it must be factual. After all our government does have guidelines and wouldn't let manufacturers intentionally deceive consumers. But think again. That may be true for the labels on foods you purchase, prescription or over the counter drugs you buy, but it is not necessarily true for dietary supplements.
Dietary supplements encompass a large array of products, including those that contain one or more dietary ingredients such as vitamins, minerals, herbs, other botanicals, aminoacids, enzymes, extracts, or other ingredients used to supplement the diet. Prior to the passage of the Dietary Supplement Health and Education Act (DSHEA) in 1994, the Food and Drug Administration (FDA) had a role in evaluating the safety of new ingredients in dietary supplements and assuring that their labeling was truthful. The passage of DSHEA actually decreased regulation of dietary supplements making them no longer subject to safety evaluations before being sold to consumers. Much of this change was due to manufacturers strong lobbying to sell supplements with minimal regulation. This occurred in response to the FDA's initial proposals to better regulate products. Manufacturers, not the FDA now hold responsibility for assuring that the ingredient list is accurate, the ingredients are safe, and the strength of active ingredients match the amounts stated on the label. Few consumers realize this means that manufacturers and distributors do not need to register with the FDA or get FDA approval before manufacturing or selling dietary supplements.
In February of this year the supplement industry gained even greater liberty to make claims to promote their products without review or approval by any government authority. The FDA has never allowed manufacturers to make false claims against "diseases." There was concern that many other conditions throughout life, such as pregnancy, menopause, and aging, although not diseases, often produce symptoms which lead consumers to seek treatment. The FDA wanted to protect consumers as they seek remedies for such symptoms by including "symptoms recognizable to health care professionals or consumers as constituting an abnormality of the body" be included in its regulation of "disease" claims. Fierce objections from the dietary supplement industry and consumers didn't allow the FDA to amend its original wording to include the additional phrase. Instead, it appears that the supplement industry can take this victory as license to further exaggerate claims of the health benefits of their products. The new ruling did state that if a claim has not been approved by the FDA, it must state on the bottle "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease." Of course this statement is usually in the smallest of print, but its presence should serve as a warning for consumers to be wary.
The supplement industry has grown rapidly, in part due to the lack of regulation and ease of putting products on the store shelves and to consumer interest and demand, partly due to the fantastic health benefits claimed by many of the products, many of which have not been put to the test. Unfortunately, American consumers are often unknowingly the guinea pigs for many untested, unproved, unsafe dietary products claiming to improve their health. The FDA takes action only when supplements are proven to be dangerous by the voluntary reporting of adverse side effects or death. Even in such cases, it takes much evidence before a product is taken off the shelves.
Recently, the FDA announced that it plans to strengthen guidelines on the manufacture and use of dietary supplements. The agency plans to have its new dietary supplement strategy in place by 2010. In addition to the ingredient list which is already required, the FDA is planning to increase supplement safety by providing a system for reporting adverse side effects, the publication of "good manufacturing practices" for supplements, stricter labeling guidelines, enforcing better compliance of its rules, and greater scientific review of supplement research.
At least for now, it is buyer beware. Although certain supplements can be useful and safe for some people if taken in reasonable doses, it is not readily apparent which ones these are or who should be taking them. Although some manufacturers do have truthful labeling and do conduct rigorous scientific research, these are in the minority and it is not easy for the consumer to distinguish who they are. It is best to rely on the advise from your qualified health professional on these matters rather than a supplement distributor or salesperson.
In relation to cancer, there are no known dietary supplements that can prevent or cure cancer. Research continues to show over and over again that whole foods are the best way to get our nutrients. A healthy balanced diet which includes a minimum of 5 servings of fruits and vegetables a day is a person's best dietary defense against cancer.
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