This week, the PBS program FRONTLINE aired “Supplements and Safety,” a joint report into the dietary supplement industry by FRONTLINE, the New York Times, and the Canadian Broadcasting Corporation. In the course of many interviews, and reporting on specific instances of contaminated supplements, the episode portrayed the entire industry as one that is relatively unregulated and rife with dangerous products. FRONTLINE also questioned the evidence supporting most scientific claims about the benefits of supplements.
The truth about the supplement industry is, however, more nuanced and complicated. As the Natural Products Association (a trade group that represents the natural products industry) acknowledged in a press release anticipating the FRONTLINE episode, there are, without a doubt, “bad actors” in the industry. These are manufacturers who sell contaminated supplements—some of which have proved dangerous—as well as ones that lack scientific support. There are also manufacturers who fail to abide by the FDA’s federally required Good Manufacturing Practices (GMPs)—a set of rules that cover every stage in the manufacturing process, including testing the ingredients for identity, purity, and strength; establishing rigorous quality control; and keeping records of manufacturing activities.
However, the data seems to indicate that most Americans who consume dietary supplements do so safely. According to the Council for Responsible Nutrition (CRN), a trade group representing dietary supplement and functional food manufacturers and ingredient suppliers, over 150 million Americans regularly take dietary supplements. And, based on figures from the CRN, the number of adverse events that occurred from 2004 to 2013 represented an incredibly small percentage of those supplement consumers—about one-tenth of one percent. And just to drive home the point that the context is key for an accurate understanding of the supplement industry: it seems that 25% of these adverse events were due to weight loss supplements, a category which, unfortunately, has a history of not following GMPs, and 21% were due to accidents, such as misuse by unsupervised children.
With respect to the science, the FRONTLINE episode makes it sound as though there is no research to support supplement use. That couldn’t be further from the truth. While there are many supplements that need more research before their benefits can be validated, there are plenty on the market with solid evidence of their effectiveness for at least one health benefit. The best research on these supplements follows the same methodological protocols and peer-review processes that other areas of medicine attempt to follow. And, some supplements, such as vitamin C, have decades of research to support their use in particular circumstances, such as for immune support.
What does all of this mean for consumers? Generally, consumers should speak with their healthcare practitioner before taking any new supplements to find out the correct dosage and to see if it would be beneficial for them to take. In addition, sticking with reputable brands that follow GMPs is key. The FRONTLINE piece also stressed the importance of doing your research when considering nutritional supplements; they themselves recommended that, among other precautions, consumers find out if the product has been tested by independent labs, and check the FDA’s website to see if a product has triggered any health warnings or recalls.