CPSDA Newsroom

CPSDA's Dave Ellis gets down and dirty on dietary supplements

Editor’s note: Consumer Reports magazine published extensive news and analysis in its September 2010 issue under the heading “Dangerous Supplements,” with a breakdown of the “Dirty Dozen.”  CPSDA President Dave Ellis, RD, CSCS, who counsels and works with many major college and professional sports teams, teaches coaches and athletes about the potential dangers of dietary supplements every day.  Ellis wrote and distributed his analysis of the Consumer Reports story even before network news anchors had time to feature it August 2, 2010.   

Consumer Reports magazine does a good job of identifying holes in 1994 federal regulations (DSHEA) that allow supplements to enter the American marketplace without first proving safety and substantiating claims (unlike Europe).  So while the U.S. federal regulators have lots of great regulations on the books, the propensity for enforcing regulations is more “catch as catch can,” depending largely on recent news about adverse events from dietary supplements.  We’re doing better in the U.S. than our friends south of the border, but we’re behind Canadians and Europeans, who place the burden of proof of safety on the manufacturer before dietary supplements enter the marketplace.  That’s why in America we often hear representatives of the supplement industry tell us to “just enforce the rules you have” and not to concern ourselves with enacting more rules that might be proposed by the pending FDA Food Modernization Act (S. 510 or Food Safety Act).  

The CR story goes on to do a nice job of illustrating cases where someone has turned blue using colloidal silver or turned yellow after gassing their livers with toxic amounts of an herbal extract.  We have a problem in the U.S. that comes with importing a global supply of ingredients and finished products, and with the behind-the-scenes shell game employed by manufacturers to swap out different ingredients to shave costs.  Even if we tested every product for heavy metals, pesticides and pathogens before they entered the market, it would only ensure safety for that particular batch.  Longitudinal quality checks are not something the supplement industry wants to pay for or cope with, but are required for drugs and some drug-tested populations like those in the NFL and Major League Baseball.  In reality, all athletes deserve a safe pool of dietary supplements where every batch has been tested for safety and proven not to have been adulterated with compounds that could result in a positive doping test (see NSF Certified For Sport  www.nsf.org/consumer/athletic_banned_substances). 

The United States Pharmacopeia Convention (USP) also has a Dietary Supplement Verification Program that companies can use to prove the validity of their products.  LikeNSF, USP’s program does a bang-up job of going to locations where products are manufactured to ensure good manufacturing procedures (GMPs); to confirm what is on the label is actually in the products (label claim); and to oversee safety of the product from a contaminants and dosing standpoint (safety/toxicology).  But unlike NSF, USP is not currently accredited to do testing for banned substances in dietary supplements (www.iso.org/iso/catalogue_detail.htm?csnumber=39883).

There are a couple of labs other than NSF that are accredited to do ISO 17025 analysis for athletic banned substances in dietary supplements, but do not conduct on-site GMP nor look for the toxicological issues, and in some cases don’t even test every batch of products they certify.  This lack of continuity among labs in the dietary supplement certification business is of great concern to food and dietary supplement overseers like members of the Collegiate & Professional Sports Dietitians Association (www.sportsdietitians.org).  CPSDA members are on the front lines ensuring the safety of the foods and dietary supplements put before their athletes.  In today’s environment, one of sports dietitians’ most important responsibilities is to prevent athletes from falling prey to sales pitches by the makers of supplements that could compromise their health…and their eligibility to compete. 

The “Dirty Dozen” that Consumer Reports identified in this article with the help of the Natural Medicines Comprehensive Database are as follows: aconite, bitter orange, chaparral, colloidal silver, coltsfoot, comfrey, country mallow, germanium, greater celandine, kava, lobelia and yohimbe.  The FDA is on record placing warnings about eight of these 12 compounds that date back as far as 1993.  On behalf of those of us who wish we could pick up the phone and ask the FDA or USDA or WADA or USADA for absolute answers on topics of food and dietary supplement safety, be forewarned that these organizations often have their hands tied on going public with information they know.   Anything they write or say could be used against them in a court of law, potentially compromising defense of positions they sometimes take against aggressive legal watchdogs funded by the supplement industry like the Natural Products Association (NPA), the Council for Responsible Nutrition (CRN), and the American Herbal Products Association (AHPA).  These three groups alone represent a $26.7 billion industry in the U.S. market, according to the Nutrition Business Journal.  

A second article in the September issue of Consumer Reports focuses on the $4.7 billion multivitamin (MVI) business in the US.  Here they tested 21 MVI’s to meet label claim and toxicology standards.  They all passed so the story boiled down to what was the best price for multivitamins, but athletes still need to be careful.  Swimmer Kicker Vencil’s story that began in 2005 should serve as a reminder that something as simple as a MVI formulated for aging men can contain a compound that could metabolize into a positive doping test, or so proved Vencil’s attorney, Howard Jacobs, who successfully defended the swimmer’s claim, a process that took two and one-half years (theathleteslawyer.com/cases/swimmer-kicker-vencills-tainted-vitamin-lawsuit).  

In the final analysis, dietary supplements are a minefield for drug-tested athletes and there is no one-stop shop for answers on efficacy to this rapidly expanding industry. Ethical, well-intentioned athletes look over the landscape and all they see is a marketplace littered with supplements basking in the glow of paid endorsements and advertisers’ claims with little to no actual research on the finished products.  The ethical lines get more blurry when everywhere you look in the popular press athletes see advertisements about hormonal therapy for aging males and ads about “male performance” that has grandmothers sleeping out in the camper for protection. 

Sadly, the most notorious stories that have taken center stage in the past decade have had medical doctors squarely in the middle, most of them compromising their ethical vows to help an athlete speed recovery and enhance performance.  When some athletes cannot find or afford medically supervised doping routines, they look instead to loosely regulated anti-aging clinics and even to a handful of people calling themselves “researchers” who do the dietary supplement industry’s bidding.  Many of these “researchers” are gainfully employed by reputable institutions, making it all the more difficult to single them out, yet they show up on editorial boards of supplement industry magazines on a regular basis (Supplement Industry Insider, www.ifmmedia.com).

“Buyer beware” hardly seems strong enough advice in this profit-driven environment.  “Buyer be very very wary.” As health professionals, sports dietitians are in an ethical battle that will rage unabated at least until government steps in to put a lid on the poorly regulated supplement industry.  It’s up to CPSDA Professional Members to stay informed and continually seek better ways to help athletes compete while constantly coaching them to remain on the ethical high ground. CPSDA is already collaborating with the U.S. Anti-Doping Agency to serve as eyes and ears in the athletic arena where we often spot supplement and doping trends in their earliest stages.  For more information about the newly formed CPSDA and the direction it is heading, visit www.sportsdietitians.org.

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