What unethical marketing practices were discovered?

Posing as elderly people calling in to 22 online and store-front retailers, the GAO report describes 10 instances of questionable marketing practices, including store associates advising people to take dietary supplements in place of their prescription medications. The GAO also identified multiple instances of suspect labeling practices, including claims that a dietary supplement can cure or prevent diseases such as cancer, Alzheimer’s disease, or high cholesterol.

It is unquestionably unethical to overpromise supplement effects (especially to people managing serious diseases) or to encourage anyone to discontinue using medication or adding a new supplement to a treatment regimen without consulting their healthcare provider. Fortunately, the report does not demonstrate a pattern that gives reason to believe that the transgressions are widespread. It describes the sample of retailers investigated as “non-representative,” which presumably means that they did not look objectively across the thousands of supplement retailers nationwide and select a group that somehow represents the industry. The names of the retailers were not included in the report, nor was it clear whether the instances of illegal marketing were discovered by a single retailer or across the group.

Since 1994, the Dietary Supplement Health and Education Act has expressly forbidden these types of marketing practices, and it seems reasonable to expect that responsible supplement manufacturers observe the laws.

What impurities were found in the tested supplements?

Though none of the contaminant levels exceeded those thought to cause acute toxicity, the GAO found that 93% of the 40 supplements tested contained at least one contaminant and that 18 of them contained at least one pesticide residue. All of the contaminated supplements contained lead and others contained the heavy metals, mercury, arsenic, or cadmium. While the Environmental Protection Agency and FDA did not express concern over the immediate negative health consequences of taking any of the supplements that were tested, since conscientious consumers are increasingly interested in organic foods and knowing where their foods come from, extending that awareness to include the source and purity of supplements is the next logical step. In a statement to the New York Times, Steve Mister, spokesperson for the Council for Responsible Nutrition, pointed out that it was “not surprising that herbal supplements contained trace amounts of heavy metals, because these are routinely found in soil and plants.”

Buyer be…smart

Alan R. Gaby, MD, chief science editor at Aisle7 believes that, “while it is important to identify the purest sources of vitamins, minerals, herbs, and other natural substances, the majority of the evidence indicates that the benefits of taking recommended amounts of dietary supplements for proven benefits outweighs the risks.”

The concerns raised by the GAO report certainly warrant further investigation, but before action is taken, it is preferable that regulatory agencies put the findings into context and support the efforts of reputable manufacturers and retailers, many of which go out of their way to provide meaningful, science-based information and high-quality products. Until more is known, there are plenty of things that you can do to choose your supplements safely:

• Research before you buy. Avoid “miracle cures” by learning what you should realistically expect from supplements. Look for unbiased, science-based resources (online and in-store, such as those provided by Aisle7) that can help you make informed decisions on whether supplements are right for you and what is safe to take with your medications.
• Do not trust anyone that recommends you take a supplement in place of your medication. (“Take red yeast rice instead of your cholesterol medication.”)
• Read product labels carefully and rely on credible third-party information to help you sales staff to interpret the message. “This product helps lower blood pressure” does not mean the same thing as “This product supports heart and vascular health.”
• Ask retailers for documentation of supplement claims. For example, an abstract from peer-reviewed journal can help lend support to the “suggested uses” of the supplement. Look out for studies funded by the supplement’s manufacturer.
• Consider the source. Check labels and websites if you are interested in finding the purest supplements. Many companies use organically produced ingredients in their supplements. Look for labels stating that the herbs are “certified organically grown” to ensure that no pesticides have been used in the manufacturing of the supplement.
• Ask a professional. Make an appointment to speak with someone trained in the proper use of dietary supplements and knowledgeable about drug-herb-nutrient interactions, such as a licensed naturopathic doctor, a holistic medical doctor, or a certified nutritionist.

“A closer look into the findings of the GAO reveal a chance for enhancing consumer awareness and empowerment through informed decision making,” says Gaby. “This is the time to bring to light the reams of studies supporting the use of traditional remedies for common ailments. With enhanced access to decision-making tools and properly trained medical professionals, people will be able to safely utilize alternatives or adjuncts to over-the-counter and prescription drugs. In the end, access to truthful scientific information regarding dietary supplements is more helpful to the public than basing policy on questionable claims made by a handful overzealous or unscrupulous supplement manufacturers.”

(GAO Testimony Before the Special Committee on Aging, US Senate; Herbal Dietary Supplements, Examples of Deceptive or Questionable Marketing Practices and Potentially Dangerous Advice; http://aging.senate.gov/minority/_files/hr221gk.pdf)