Talk:Dietary supplement/Archive 1

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Archive 1 Archive 2

health-supplements-advisor.com

An anonymous editor is linking to health-supplements-advisor.com. This commercial site seems intent on selling arbitrary supplements without any warnings about contra-indications. This is criminally irresponsible. Please do not link to it again.

Take for example Vitamin A (Retinol): According to the BBC, Professor Michael Patton, medical director of BDF Newlife and consultant clinical geneticist at St George's Medical Hospital School in London, said: "Women who are pregnant or likely to become pregnant should avoid supplements of Vitamin A or multivitamin tablets containing Vitamin A, as this may cause damage to the developing baby in the womb." More extremely, see Liver#Liver as food: "Both animal and fish livers are rich in Vitamin A, cod liver oil being commonly used as a supplement. Vitamin A levels can be toxic, particularly in polar animals; the Antarctic explorers Douglas Mawson and Xavier Mertz were both poisoned, the latter fatally, from eating husky liver." Adding multivitamins containing retinol to a diet that already contained "normal" liver would have the same effect. Finall, there is evidence that excess retinol is associated with osteoporosis. A normal balanced diet provided sufficient retinol for most people and supplements should only be taken on personal medical advice. --Red King 23:24, 23 July 2005 (UTC)

More positively, to take controlled amounts of folic acid in the very early stages of pregnancy significantly reduces incidence of spina bifida --Red King 23:24, 23 July 2005 (UTC)

Folic Acid is most important in the first few weeks of pregnancy, when most women don't know they are pregnant. For this reason, all women of child bearing years should supplement folic acid in their diet. Brewwer's Yeast is an excellent whole food source, supplying the matrix of nutrients to help the body utilize the follic acid. --Addie Evans

Actually the link mentioned does discuss contraindictions for Vitamin A, such as:

The Department of Health suggests that women who are pregnant or even planning to become pregnant, limit their consumption of the preformed Vitamin A or retinol, to around 2,500 IU from all sources including food and supplements.

--Dforest 11:38, 28 March 2006 (UTC)

Nice to see that Wiki has some practical effect! --Red King 18:32, 28 March 2006 (UTC)

Format of this article

I doubt you would find a conventional encyclopedia article on nutrional supplements that is arranged in this (23 March 07) fashion, and for good reason. There is a much greater general english language understanding of 'dietary supplement' than this article makes out.

This article is supposed to be about 'nutrional supplements'. It is currently focussed on a selection of regulatory definitions. At the moment the article might as well be called 'regulation of nutrional supplements around the world' (although the choice of bodies is limited - what about Australasia, Asia, South America, or even Switzerland, Canada).

The article comes across as quite USA orientated. Most of the detail is in the United States section, as if the DSHEA was the ultimate pronouncement on supplements. It looks as if someone started from a F&DA perspective, then the EU was added 'for balance', finally Russia chucked in for good measure. I don't like the look and feel of the eventual overall result. Much of what is in the United States section is commonly accepted and should be taken outside this section (eg the first list in the US section; or the last paragraph about lack of double blind testing etc are not unique to the USA).

My view is that the article should start by discussing the common elements of supplements as generally understood (BEFORE any 'US' section). Then review the INTERNATIONALLY claimed benefits for each broad category of ingredients or for supplement packages generally. Then come back with some GENERAL AND INTERNATIONAL scientific criticism of the marketing/claimed benefits, as I'm sure there is lots.

Finally a regulation section at the end would be great, and this is where I would have the regional division. But I think it should be concise and stick just to issues specifically around regulation and legal ramifications.

I think this article needs a complete overhaul, primarily to its format but with tweaks to content too. But I myself don't know enough about supplements to do it. --83.67.127.181 14:50, 23 March 2007 (UTC)

Thank you for your suggestion. When you feel an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the edit this page link at the top. The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes — they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to). WLU 22:28, 25 March 2007 (UTC)

FDA

This article is slanted: The way this entry is written would leave one to believe that the DSHEA is a piece of legislation that the FDA put into action. The DSHEA is actually a product of consumer wishes and the legislative pressure of supplement lobby groups and key political figures such as Senator Orrin Hatch. I have read many articles on this topic and they all say that the FDA wanted more power to 1.) require supplements be tested for safety before entering the market (which they currently cannot do under the DSHEA) and 2.) regulate the health claims that supplements make. Currently the DSHEA only prohibits statements about the cure, mitigation, treatment, or prevention of disease. Health claims about reducing the risk of a disease or health-related condition are allowed although some scientific consensus backing up the validity of that claim is required.

All in all, it was not the FDA's piece of legislation and they do not support it as providing "freedom of choice". That's actually language that the supplement lobbies use. This does not mean, however, that the FDA is not interested in having consumers choose supplements that are right for them. The FDA just wants to make sure that the choices out there are all safe.

Just some thoughts from a student studying health law and policy.

Feel free to modify the page (with references). WLU 11:50, 21 April 2007 (UTC)

Criticisms section

I just noticed that the “Criticisms” section on the Dietary supplement page was largly removed. If you don’t mind me asking, why? Although I can see how one, or even both quotes could be superfluous, the revision also removed one of the sources, and also any mention of the study done by Edgar Miller III (which appeared to show that supplements have a detrimental effect to the immune system.) All in all I feel that the new version really downplays these possible health concerns. I have reverted the changes, however please feel free to point out how I am mistaken with regards to this section. Thanks! S.dedalus 05:04, 25 April 2007 (UTC)

I was the user who re-wrote the section. I don't have a guideline to cite, but I've always felt that placing that much information on a page based on a single study makes the page too heavy, especially with regards to the information from a single study. As an encyclopedia article, there is no need to include lots of details on the study, if people want that, they have the reference. Including quotations adds length to the article without adding much content, and are better of summarized. The second and third links in that section were to the same news article (the Seattle Times, not the Washington Post) and were newspaper summaries of the JAMA article that was the first reference. Rather than have two unneeded citations, I took the prose summaries and condensed it down to the relevant info, using JAMA as a source. I just noticed that the second quote contained in the paragraph did have extra info about another study on just vitamin E, so that could be put back I suppose, though it is really duplicating the info from JAMA. If I were to put it in the article, I'd find the original 2004 journal article, include it as a citation, and have a sentence like "Another study in 2004 similarly found that consuming vitamin E supplements increased the risk of mortality."
Since wikipedia is an encyclopedia and not a journal article or an essay, we don't include too much detail on methodology or other stuff like that, just raw results. Though it was great info to have on the page, it was just too much detail in my opinion. WLU 11:28, 25 April 2007 (UTC)


Merging Biologically active dietary supplement into this page

I have proposed merging Biologically active dietary supplement into this page because my understanding is that they are the same thing. This merge would also provide something of an answer to the above question, I think. --JennyRad 20:24, 9 June 2006 (UTC)

First, the BADS guys should provide a verifiable peer-reviewed source instead of Russian regulations and a Russian manufacturer's store website.
Second, the BADS article should be recast in English so we could understand what do they mean.
Third, if and when the above are done, merge it.
Jclerman 08:29, 10 June 2006 (UTC)

I'm not certain about the umbrella term of "biologically active dietary supplements" but there is plenty of clinical evidence in the use of enzymes to support better health and nutrition. More information on enzymes can be viewed on Wikipedia at http://en.wikipedia.org/wiki/Enzymes and another blog about the topic, http://www.enzyme-therapy.at.

I don't know about the term "biologically active dietary supplements either" but if the above issues are taken care of, the merge sounds like a good idea to me too. Romperroom 15:52, 12 June 2007 (UTC)

Scope of article

"A dietary supplement (also known as food supplement) is intended to supply nutrients, (vitamins, minerals, fatty acids or amino acids) that are missing or not consumed in sufficient quantity in a person's diet."

A dietary supplement ought to be anything one eats to supplement one's diet, other than commonly eaten foods. "Nutritional supplement" and "food supplement" suggest things taken to improve nutrition, and perhaps they might fit the category of "nutrients" (in the sense of vitamins, minerals, fatty acids or amino acids), but "dietary supplements", in my opinion, ought to be a broader category, including things taken by mouth (hence supplements to diet), not only to alleviate shortages of nutrients in the narrow sense, but also "nutrients" (in a broader sense) taken to improve mental functioning, fight against free radicals and inflammation, combat chronic and auto-immune disease conditions, promote longevity, strength, endurance, growth, sleep, and so on. There are many such dietary supplements on the market with proven and unproven benefits, and they aren't all "herbal". How are they to be categorized? D021317c (talk) 12:37, 28 November 2007 (UTC)

Food supplements article

The food supplements article should be renamed 'food fortification', in my opinion. It appears to me that its subject matter is partly concerned with food fortification and partly concerned with dietary supplements. As such, I propose that the material in it that deals with dietary supplements should either be deleted or merged into this article, after which it should be retitled 'food fortification'. Vitaminman 10:34, 23 July 2007 (UTC)

Which is the term used in the scientific community or the world at large? From my understanding, a dietary supplement is generally a pill-type thing, food fortification takes palce at the manufacturing point of processed food. WLU 17:40, 23 July 2007 (UTC)
The global standard for dietary supplements/food supplements - the Guidelines for Vitamin and Mineral Food Supplements - was adopted in 2005 by the Codex Alimentarius Commission, a United Nations Commission. To me, the current food supplement article is therefore either: a) unnecessary (in that Wikipedia already has a dietary supplement article), or b) wrongly named (in that some of its content deals with food fortification, which is a separate thing entirely). More to the point, I would therefore suggest that the dietary supplement article should be renamed "food supplement", and the existing food supplement article renamed "food fortification". In the meantime, I have reworded the introduction, as, in the light of the global guidelines, it is clearly overly simplistic to say that the term "food supplement" is merely European terminology. Vitaminman 20:13, 23 July 2007 (UTC)
Agree. I suggest you do a Merge proposal, except that Food additive would be a better target IMO. "Food fortification" is leading the witness. Is Vitamin C an additive or a fortificant? --Red King 19:27, 23 July 2007 (UTC)
This being the first time that I would have made a merge proposal, please run me through what I need to do. Alternatively, I would be more than happy for you to make the proposal, if that would be easier. Btw, in answer to your question, vitamins can be additives or fortificants - the classification essentially depends upon the purpose they are being used for. Vitamin C, as ascorbic acid, for example, is also known as E300. As an additive, ascorbic acid is used as a browning inhibitor in unprocessed cut fruits, fruit pulp and juices; an improving agent for flour; a meat colour preservative; and as an antioxident in the brewing industry. These uses are entirely separate from ascorbic acid's use as a food fortificant, in which cases it is used for its nutritive value. In addition, of course, the food additive category also includes synthetic non-nutrients, such as, say, E129 (Allura Red AC, FD&C Red 40). All in all, therefore, renaming the food supplements article as 'food fortification' (and deleting the material in it that deals with dietary supplements, or merging it into this article) is clearly the way to go. Vitaminman 21:30, 23 July 2007 (UTC)
I have now added a formal merge proposal to the food supplements article. Vitaminman 13:21, 15 December 2007 (UTC) Dietary Supplement is a bad thing.

Sources

I've removed some material which was questionably sourced. The "one million letters" claim was sourced to an email sent to the FDA by a supplement lobbying group. I also removed two other claims referenced to supplement lobby groups. I appreciate the desire for "balance", but the other sources in the section are reliable secondary sources such as Consumer Reports and Time magazine. These cannot be "balanced" by citing lobby-group releases as if they were fact. The quotes from Clinton's signing ceremony are clearly more appropriate and better-sourced, so I left those. MastCell Talk 17:59, 17 December 2007 (UTC)

I take your point here, at least in principle. Given that I took this material from the health freedom movement article, I have therefore edited that article to match your edit here. Vitaminman 21:32, 17 December 2007 (UTC)

Removed section

I removed the section on "Studies of vitamin supplementation". This content may be appropriate, but would be better off in articles on vitamins, vitamin supplementation, etc. Dietary supplements are a much broader category, including (in many jurisdictions) herbals, and it would probably be best to focus this particular article broadly. In any case, a section on "Studies of vitamin supplementation" would have to be quite substantial to accurately represent the volume of sometimes conflicting evidence and opinion on the topic. MastCell Talk 18:00, 14 December 2007 (UTC)

That's quite a radical and, I would say, controversial move, Mastcell. An encyclopedia article on dietary supplements that doesn't make any reference to the science? Personally, I think that you're on very shaky ground there, especially so given that you were previously happy with the section on "Studies of vitamin supplementation" until I added some positive evidence in favour of supplements. But before I revert, let's see what others have to say here. Vitaminman 11:11, 15 December 2007 (UTC)
I think MastCell's larger point is that studies are often on individual supplements, and 'dietary supplements' overall are a very broad group, which encapsulate an enormous number of specific compounds. It would be hard to write an article on 'dietary supplements' overall that didn't basically synthesize a large number of single-topic studies. That's WP:OR, ergo verboten. Pardon my German. The only thing that would really work in my mind would be a table listing specific supplements and any review articles that existed, with pointers to the appropriate {{main}}. But I bow before the admin's greater knowledge in this area, MC knows what s/he is doing. WLU (talk) 13:51, 15 December 2007 (UTC)
My point was only that "dietary supplements" are an incredibly broad category of substances, with a huge and sometimes contradictory body of evidence of dozens if not hundreds of individual supplements. Rather than trying to sum this up by citing a few primary sources (studies), it would probably be better to deal with efficacy of individual supplements in the articles on those supplements. I don't know that I was "happy" with the previous section - I can't remember noticing it particularly before. MastCell Talk 05:58, 17 December 2007 (UTC)
There are currently literally hundreds of Wikipedia articles (some classed as "good" articles) that cite scientific studies. Do you have a problem with them as well? Regardless, the studies that I referenced dealt with multivitamins. I specifically chose them for that reason. You may have a point about "individual" supplements, but I do think that a good encyclopaedic article would reference a small number of scientific studies, both pro and anti, as a means of illustrating the sometimes conflicting scientific evidence on the topic. Alternatively, if you remain convinced that Wikipedia articles shouldn't cite scientific studies, what about using secondary sources (e.g. newspaper and news agency material) instead? Vitaminman 16:08, 17 December 2007 (UTC)

There's no need for strawman arguments - obviously I agree that Wikipedia articles should cite scientific studies. The problem is that your edits focus on multivitamin supplementation. Multivitamins are a tiny fraction of what is covered by the term "dietary supplements". Detailed material on the scientific study of multivitamins would be most appropriate for, well, multivitamin (incidentally, that article could use a lot of work). As far as appropriate sourcing on a topic where many, sometimes conflicting, studies exist, the best sources of scientific opinion would be those of the U.S Preventive Services Task Force, or the Cochrane Library reviews. The JAMA analysis you cited is a good source as well, as a review and meta-analysis from a high-impact journal - but even so, this material belongs in multivitamin rather than dietary supplement. MastCell Talk 17:04, 17 December 2007 (UTC)

I take your point that multivitamins are a tiny fraction of what is covered by the term "dietary supplements". I have therefore deleted the statement that "the purity and quality of individual brands of dietary supplements are unregulated", on the grounds that the reference given related only to "herbal medicines", which are (a) only a tiny fraction of what is covered by the term "dietary supplements", and (b) arguably not even "dietary supplements" anyway, as the United States categorises dietary supplements as foods, not medicines. Vitaminman 21:20, 17 December 2007 (UTC)
Ah. Consider your point made, in that case. I'm really not impressed with your approach - you asked for outside opinions, we got one that went against you, and now you're looking to prove your point experimentally. But OK. The purity and quality of individual brands of all supplements are unregulated in the U.S. - vitamins, herbs, what have you. Your second point is nonsensical, since DSHEA explicitly lumps herbs in with vitamins as "dietary supplements". If you would like to have an actual discussion about how and where to include info on the benefits of multivitamins, we can have that discussion. If you want to seriously object to a well-sourced statement that the purity and dosage of supplements are unregulated in the U.S., then we can have that discussion. MastCell Talk 21:25, 17 December 2007 (UTC)
I can absolutely assure you that it is not my intention to deliberately cause disruption. Far from it, in fact. All I want is for us to agree upon the terms by which this article will edited. Re. my second point, may I politely suggest that editors should actually read and understand DSHEA before they attempt to edit this section of the article. DSHEA specifically states that dietary supplements "may not claim to diagnose, mitigate, treat, cure, or prevent a specific disease or class of diseases." The reason for this is quite simple, as if they did they would be categorised, and regulated, not as dietary supplements, but as medicines. In other words, there is a world of difference between "herbal medicines" and "herbal supplements." Whilst to the uninitiated this difference may seem to be academic, or even "nonsensical", this is in fact the very cornerstone of DSHEA. Moreover, whether or not dietary supplements should or should not be more highly regulated in the U.S. is absolutely irrelevant to this, or any other, encyclopaedia article. Vitaminman 21:53, 17 December 2007 (UTC)
Acutally, there is not a world of difference between herbal "supplements" and "medicines"; though the terms may be used a bit haphazardly, the issues under discussion are very clear. As to DSHEA, the issue of regulation of dietary supplements is notable and relevant, though ideally other aspects of the article will be developed up around it. The material might be spun off into a separate article on DSHEA or regulation of dietary supplements - there are enough good sources, but so far the article is not beefy enough to warrant content forking. Of course my opinion, or yours, about DSHEA is irrelevant, but there is quite a bit of notable, well-sourced discussion, data, and opinion about the effects and level of support for DSHEA and various regulatory thresholds, so I see no reason why it should not be included. MastCell Talk 00:09, 18 December 2007 (UTC)
If you'll slow down in your haste to make a point, you'd see that the sentence you fact-tagged was supported by the reference you removed. The Annals piece states, in its abstract no less, that "The burden of proof is on the U.S. Food and Drug Administration to show a dietary supplement is unsafe, unlike for drugs, which cannot be approved until the manufacturer has demonstrated safety and effectiveness." Deleting a citation and then fact-tagging the preceding sentence is just bad form. I'll assume you didn't read the abstract of the citation before deleting it. MastCell Talk 21:34, 17 December 2007 (UTC)
Frankly, the author of the "Annals" piece doesn't understand the law. (Not surprising, perhaps, given that he/she is a scientist)?? His/her statement that "herbal medicines are regulated as dietary supplements" is absolutely untrue. See my previous entry, above, for an explanation of why. Just because a piece is included in PubMed is not a guarantee of quality. http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=3679247&cmd=showdetailview&indexed=google Vitaminman 22:11, 17 December 2007 (UTC)
It's not just in PubMed. It's a review in Annals, one of the top medical journals in the world. It's possible that the distinction you draw between "herbal medicines" and "herbal supplements" is an entirely semantic one, and that the points under discussion are obvious. In any case, the simple point remains that the article correctly indicates that dietary supplements are not subject to FDA action until they are proven harmful. MastCell Talk 00:09, 18 December 2007 (UTC)
In short, under DSHEA, dietary supplements "may not claim to diagnose, mitigate, treat, cure, or prevent a specific disease or class of diseases." That privilege is reserved solely for products registered as medicines, be they herbal, pharmaceutical, or whatever. Herbal products not registered as medicines are simply not allowed to make these claims. It ain't semantic, I can assure you. There's many a supplement maker will attest to that, as a result of the FDA, at least, understanding the difference. Vitaminman 08:10, 18 December 2007 (UTC)
You're talking about the thin line between structure/function claims and diagnose/treat claims. I think this is covered in the article; if not, it could be. MastCell Talk 09:41, 18 December 2007 (UTC)
Good point. A section dedicated to this question, as international as possible within "western medicine" might be a good idea. For example, the corresponding Swedish article, Kosttillskott, states that the term should only be used for food/nutrient items. The article is still (way too) US-centric in my opinion and such a section could help that. This might require collaboration among people who can check out sources in various, mostly European, languages. --Hordaland (talk) 10:18, 18 December 2007 (UTC)
Yes, the difference between structure/function claims and diagnose/treat claims certainly taps into into this issue, and I agree with Hordaland that a section dedicated to this would be a good idea. I also agree that the article is too US-centric. Vitaminman 19:49, 18 December 2007 (UTC)

DSHEA Section

The assertion that FDA now regulates supplements as foods is incorrect. From:

http://www.cfsan.fda.gov/~dms/dietsupp.html

The FDA says:

As a result of these provisions, dietary ingredients used in dietary supplements are no longer subject to the premarket safety evaluations required of other new food ingredients or for new uses of old food ingredients. They must, however, meet the requirements of other safety provisions.

In other words, new food ingredients have more regulation than new supplements, because they must undergo safety evaluations. —Preceding unsigned comment added by Eric.Gunnerson (talk • contribs) 17:57, 26 March 2008 (UTC)

Missing material?

This excess material was on the Dab Supplement:

taken by people to enhance their diets; it can include vitamins, minerals, fiber, and/or protein, among other additives;
  • the pet or livestock equivalent of the nutritional supplement, added to pet foods or fodder, which in addition to the types of additives found in the human equivalent can also include antibiotics or other drugs to improve their resistance to common ailments;
  • premixes can be used in supplements; or

It's probably already covered in the accompanying article, but someone may want to check.
--Jerzy•t 19:15, 29 April 2008 (UTC)

Flawed and biased analysis published in JAMA

I removed this silly meta-analysis. For more info, read [1]. --Bork (talk) 17:01, 17 April 2008 (UTC)

Hmm... JAMA vs. the Life Extension Foundation. JAMA is an undoubtedly reliable source by Wikipedia's definition. The Life Extension Foundation, not so much. MastCell Talk 22:36, 29 April 2008 (UTC)
The meta-analysis did what it was designed to do. Spread FUD. Therefore JAMA was reliable source of FUD.
Which of the referenced articles at that LEF page are unreliable in your opinion?
--Bork (talk) 22:07, 30 April 2008 (UTC)
If you're proceeding from the belief that the JAMA article was "designed to spread FUD", then I don't know how much common ground we're likely to find. I'm not talking about my opinion of the LEF's reliability; I'm talking about whether their website meets Wikipedia's criteria for appropriate sourcing, as in WP:V and WP:RS. "Articles should rely on reliable, third-party published sources with a reputation for fact-checking and accuracy." Or: "In general, the most reliable sources are peer-reviewed journals and books published in university presses; university-level textbooks; magazines, journals, and books published by respected publishing houses; and mainstream newspapers. As a rule of thumb, the greater the degree of scrutiny involved in checking facts, analyzing legal issues, and scrutinizing the evidence and arguments of a particular work, the more reliable it is." And so on. MastCell Talk 23:22, 30 April 2008 (UTC)
Well that LEF page scrutinized the evidence and arguments of a particular work, in this case the cherry-picked meta-analysis.
--Bork (talk) 23:49, 30 April 2008 (UTC)
What I'm getting at is that the LEF website is a reasonable source for the LEF's opinion of the study, but not to "debunk" the study in a conclusive sense. If we go into depth on the JAMA study, then we could consider saying something along the lines of: "Some groups which advocate the use of vitamin supplements, such as the Life Extension Foundation, have criticized the JAMA study, arguing that... etc etc etc." MastCell Talk 15:58, 1 May 2008 (UTC)

JAMA errata

The February 2008 errata to the Bjelakovic (2007) JAMA article indicates a number of what appear to be rounding errors or an early mistake/omission which propagated (embarrassing but common), and one instance of an extra "not" ("Heterogeneity was not significant (I2=18.6%, P=.10)"; i.e. the results of the different trials disagreed with each other). The next section breaks this down into "low" and "high" risk of bias (according to methodological quality), where the point is made clear that the low-risk studies trend together and the high-risk studies trend together, but the two trends are not the same. The authors state that "None of the data errors altered the overall results of the study."

More details available upon request. - Eldereft ~(s)talk~ 05:01, 1 May 2008 (UTC)

Thanks. The whole discussion may be dated just now, but such things have a tendency to reappear, so it's good to have this documented here. --Hordaland (talk) 18:18, 1 May 2008 (UTC)

Citation for St.John's Wort being poisonous

Is there a citation for St. John's wort being poisonous when combined with certain prescription meds? -User:70.225.185.47 04:25, 1 December 2005 (UTC)

St. John's wort can interact with many medications owing to induction of cytochrome P-450 3A4 and other mechanisms. "About the cover: St. John's wort". J Soc Integr Oncol. 4 (1): 52–5. 2006. PMID 16737673.
Bork (talk) 11:45, 9 June 2008 (UTC)

"New" FDA rules

Someone more familiar than I with this topic and this article's history may want to double-check the changes I just made. I've cited an FDA press release (June 2007, [2]) about changes to requirements in manufacture and labeling of dietary supplements. (Also added same ref to Melatonin.) --Hordaland (talk) 11:13, 10 September 2008 (UTC)

Food additives etc. ==> need merging.

At WikiProject Food and Drink I've started the thread Food additives etc. ==> need merging. in hopes that some of the pages:

can be merged/eliminated. I hope that that thread will be a central place to discuss this somewhat messy situation. I'll be adding this comment to each of the articles' Talk pages. --Hordaland (talk) 11:57, 6 October 2008 (UTC)

Natural vs Artificial?

Can anyone add the difference between (or lack thereof) natural dietary supplement and artificial dietary supplement? I've seen alot of claims from many companies that natural(or organic) ones are supposedly better than artificial one. It would be nice if someone can supplement (or debunk) this claim and show them in this article since many people question about it. Thanks. Mrlie3 —Preceding comment was added at 04:02, 15 April 2008 (UTC)

Good point, someone who knows how best to formulate it, should add such a section. The so-called dietary supplement I'm most familiar with, the hormone melatonin, should NOT be available in its organic form, as it used to be. It was made from the pineal glands in cows' brains, and might transmit Mad Cow disease. I think that only the synthetic version is available now. Some health food fanatics and shops continually confuse the issue, claiming that synthetic = inferior. --Hordaland (talk) 21:07, 29 April 2008 (UTC)
"Natural" in that sense is a marketing term, not a scientific one. I suppose we can look for sources dealing with this. MastCell Talk 22:37, 29 April 2008 (UTC)
Natural sources are those that exist in nature. Synthetic sources are those that do not exist in nature but are created in a laboratory. The peer-reviewed literature recognizes this difference, see for example Interaction between antioxidant vitamin supplementation and cigarette smoking during radiation therapy in relation to long-term effects on recurrence and mortality: A randomized trial among head and neck cancer patients - the full text of which acknowledges that "It is possible that vitamins of natural rather than synthetic origin....would not yield results similar to those observed in our trial." That said, the researchers qualify this statement by stating that to date there is no human data to support such claims.Vitaminman (talk) 20:59, 30 April 2008 (UTC)
Yes, that lack of supporting data is the reason I characterized the distinction as largely a marketing tactic. I think the distinction between vitamins obtained "naturally" through the diet and those created synthetically in the lab is fairly intuitive, but are there sources drawing an exact distinction between "natural" and "synthetic" for the wider class of dietary and herbal supplements? I'm curious about definitions here. MastCell Talk 21:21, 30 April 2008 (UTC
Well, to cite the example of vitamin B12, and to quote good ol' Wikipedia: "Cyanocobalamin usually does not even occur in nature, and is not one of the forms of this vitamin which is directly used in the human body (or that of any other animal). However, animals and humans can convert it to active (cofactor) forms of the vitamin, such as methylcobalamin." In other words, and to clarify, methylcobalamin - the active (cofactor) form of B12 - occurs naturally in the body, unlike cyanocobalamin, which does not even occur in nature. Both forms however are found in supplements.Vitaminman (talk) 21:52, 30 April 2008 (UTC)
Yes, that's fine, and as I said a reasonable distinction can be drawn for many vitamins, B12 included. I was more curious about other dietary supplements and so forth. MastCell Talk 23:17, 30 April 2008 (UTC)
Ah right, I see what you mean, sorry. As you're probably aware, this has been something of a hot issue in the food industry for at least a couple of years now.[3] You might want to check out the Naturally Occurring Standards Group website which, whilst it might not necessarily qualify as a reliable source, focuses very strongly on this issue.Vitaminman (talk) 15:40, 1 May 2008 (UTC)
Thanks, I'll do that. I was mostly asking out of personal curiosity, since the term "natural" is bandied about and I was interested in how various groups have defined it. Thanks for the links. MastCell Talk 15:56, 1 May 2008 (UTC)

Artifical is made in a laboratory, natural is a whole food supplement that contains concentrated food products of what is needed. It has all the co-factors necessary for the body to use it. I'm not certain if everyone uses the word "natural" with the same definition though. WSNRFN (talk) 23:20, 17 December 2008 (UTC)

If one could figure out what to call it, this topic would deserve its own article. This article can never be international enough, I think, as it's essentially American, maybe North American. Translations of the words dietary supplement can be found in other languages, of course, but what's included varies widely.
Melatonin, which I mentioned above, is one of the hormones included in the US definition of dietary supplements; absurd! It's found naturally in the brains of mammals. Traces are found in a few foodstuffs, such as grapes and rice. Brains of mammals can also be called foodstuffs, of course.
An article on natural vs. artificial should include also medications and even illegal drugs. Probably also additives. - Hordaland (talk) 15:39, 18 December 2008 (UTC)

Dietary supplement controversy

Dietary supplements do not have to be proved safe or effective before they can be sold. Some contain natural things you might not want, such as lead and arsenic. Some interfere with other things you may be taking, such as birth control pills.[4] QuackGuru (talk) 21:03, 8 June 2009 (UTC)

QuackGuru, regarding the first sentence of your comment above, that might be the case in some countries, but it most certainly doesn't apply throughout the world. In some European countries, for example, the sale of dietary supplements is very highly regulated. This article should reflect a proper worldview, rather than merely the countries of origin of its authors.Vitaminman (talk) 05:05, 9 June 2009 (UTC)
Good point. We can add it to Dietary supplement#United States. QuackGuru (talk) 05:09, 9 June 2009 (UTC)

An "old" saying? I can't find anyone else using the expression "anyone with a printer..."

It currently reads: but as an old saying goes, anyone with a printer can create a certificate of analysis I Googled for that expression, and found it only in this wikipedia article, and a few places that copied everything word for word from the article. I'm going to change that. Dream Focus 21:07, 17 May 2009 (UTC)

The statement was in the reference after it, as you could have noticed: Beyond Balco The untold dietary-supplement scandal. "'There's an old saying: Anyone with a printer can produce a certificate of analysis,' says Warren Majerus, an auditor with a nonprofit organization that inspects supplement plants worldwide." II | (t - c) 16:19, 9 June 2009 (UTC)
If it had been a quote of the person saying it, the only one in history who has apparently, then it might've been acceptable. But you can't just say its an old saying, when not a single person ever used it until a few years back, so it isn't that old at all. Dream Focus 02:23, 9 June 2009 (UTC)
It's an industry saying. Most industry correspondence does not end up on the internet. It's in intranets, emails, and file cabinets. II | (t - c) 16:19, 9 June 2009 (UTC)
How old can a saying be? Are we talking about computer printers, which haven't been around but a few decades? Of course early on you could only print things on paper that had the holes in the side that the machine could turn, so perhaps it wasn't the earliest of printers that could make believable certificates(hold up dot matrix to the light and look close, and you can see how many black dots make up each letter). I doubt many people have their own printing press, so its probably just a computer printer the guy is referring to. Have you personally ever seen this expression in intranets, email, or file cabinets? Has it actually managed to someone circulated around, that significant numbers of people have seen it? I find it unlikely the expression existed before this one writer decided to put it in his book. If anyone actually heard of it before then, by all means, chime in, I'd love to hear about it. Dream Focus 22:55, 9 June 2009 (UTC)
I'm sorry; we're talking about a quote from a source. Let's either include it or not, based on its relevance. I understand that you disagree with the saying, and are attempting to poke what you no doubt consider very clever holes in it, but that's not really a useful exercise here. MastCell Talk 03:11, 10 June 2009 (UTC)

Two sources on certification

Resveratrol

How is Resveratrol extracted, and processed into a nutritional supplement, from Japanese knotweed?

Bruce —Preceding unsigned comment added by 124.180.215.178 (talk) 01:08, 7 September 2009 (UTC)

A Graph showing Nutritional supplements efficacy score – based on current studies results

Hello dear editors.

I just created (for fun) an image (as the title stated) in this link:

http://www.r-statistics.com/2010/02/nutritional-supplements-efficacy-score-graphing-a-bar-plot-of-current-studies-results-using-r/

based on the research given here:

http://spreadsheets.google.com/ccc?key=0Aqe2P9sYhZ2ndFRKaU1FaWVvOEJiV2NwZ0JHck12X1E&hl=en_GB

I was wondering if it might be interesting to include this image in the article, or to even just link to the Article at the end.

But I wasn't sure if this image is fitting, or if it is a good link to put in the article.

What do you think?

Talgalili (talk) 09:34, 26 February 2010 (UTC)

Sorry, but this is not suitable for Wikipedia as it contravenes WP:NOR. Vitaminman (talk) 13:15, 26 February 2010 (UTC)
I read and understood. good to know, Thanks. Talgalili (talk) 13:55, 26 February 2010 (UTC)
After a second thought - this is not original research. But a research of meta-research of research. (or an original meta meta research) please see here it reads:
This piece was doggedly researched by myself, and researchers Pearl Doughty-White and Alexia Wdowski. We looked at the abstracts of over 1500 studies on PubMed (run by US National Library Of Medicine) and Cochrane.org (which hosts meta-studies of scientific research). It took us several months to seek out the evidence – or lack of.
Does it make a difference ? Talgalili (talk) 13:09, 10 April 2010 (UTC)
No, because it's still your own analysis. It would only be appropriate for inclusion if it was published in a publication or on a website that conforms to Wikipedia's guidelines on reliable sources. See: WP:RS. Vitaminman (talk) 16:22, 10 April 2010 (UTC)
Hi Vitaminman,
It is not my analysis. All that I did was to give a visualization of someone else's research. I understand though that their research is a "Self-published sources (online)" and therefore doesn't fit (unless I would show the importance of the original researchers, which I won't go about doing for now, if I will - I would repost here).
Cheers, Talgalili (talk) 16:49, 10 April 2010 (UTC)

How are vitamin and mineral supplements made?

It would be nice if this article explained how vitamin and mineral supplements were made. Anyone know the answer to this? -Christiaan 14:27, 18 March 2006 (UTC)

I agree with you. Most vitamin and mineral products are synthetically isolated, sometimes using unnatural or non-food sources. The Dietary supplement section here should cover and compare different ingredients, their sources and how they are processed. --Addie Evans

A discussion of how these products are made is a rather lengthy undertaking. Looking at the first points identified in this disussion, here are some amplifications:

A good number of nutrients (starting with those that are recognized as essential) are presented in dietary supplements in a manufactured form. (Call this synthetic since that is the process that typically is involved in manufacturing them). The reality is that the specifics of the nutrient itself from a chemical erspective is nearly always identical to the chemical found in nature. In other words: Riboflavin is Riboflavin whether it is found in yeast or found in a dietary supplement. There are "natural" forms of some vitamins (vitamin E is a good example) where the nutrient is isolated or extracted from a food source (soy) and then used in the manufacture of dietary supplements. To be fair and clear -- there are sometimes differences between some nutrients found in nature and those that are synthesized for use in food products. The best example of this is beta carotene (a source of vitamin A). synthesized beta carotene is consistenly presented (chemicallyl) as "all-trans" beta carotene. That's the nature of the synthesizing process. When derived from natural sources (say an algae that produces this nutrient naturally) you get other isomers of beta carotene (including 9-cis and 13-cis). It's still beta carotene. Still has the same chemical structure but is different. Does this make a difference? There aren't data available to definitively say yes or no.

And this is just the tip of the iceberg of discussing natural versus synthetic nutrients. Sure, it would be nice to get all the nutrition you need from the foods you eat, but there are many complicating factors. Not the least of which is the fact that many foods we purchase and consume are fortified with the same synthetic nutrients of discussion here. The concern relative to natural versus synthetic nutrients is clearly a debate and a discussion worth having if you are particularly concerned about it. The first step is to identify why the concern (with some background of science serving as the foundation for the discussion) and then inquire on an individual nutrient basis whether there are benefits to obtaining, locating and consuming a natural form of the nutrient.

The manufacturers of dietary supplements should use the finest sources of nutrients available in order to provide products that meet the needs of the millions of consumers who use them. This is the primary obligation and one that supercedes the distinction bethween natural versus synthetic. A discussion of how these products are made would include this discussion as well. Until then, its place in an encyclopedia is one that perhaps should be deferred. JL

US Vitamin supplements and some herbal teas might be fine but otherwise my advice is. Keep your finger off US-made dietary supplements! They do not have any product registration and everything can be in there. Most companies do operate under very poor conditions. Hardly any materials are chromatographically assayed anymore, with some exceptions out of Sebastopol or Oregon. But generally, keep your hands of herbal extracts made in the US. Usually, stick with preparations that have OTC-drug status in Europe or Canada. Osterluzei (talk) 06:47, 14 February 2011 (UTC)

Ask an MD in the US, what he/she thinks of dietary supplement or a pharmacist behind the counter? Other than vitamins and herbal teas, they would not recommend anything, and even these, are only recommended very timidly. That is just a fact. Any tryptophan? No thanks. When I was there, I always wanted my wife to take supplements, with good intentions. She never did. I wonder why until I figured it out myself. Why don't they at least register their products like everywhere else in the world? Osterluzei (talk) 07:05, 14 February 2011 (UTC)

Logical Fallacies

The article contains logical fallacies. Example: "Another common supplement is omega-3 fatty acids which are naturally found in fatty fish, such as salmon, however no studies show that taking a supplement has any benefit for healthy individuals, so again only a small population has a need for this sort of addition to their diet." This sentence uses "no studies show ... any benefit" as a proof that "again ony a small population has a need for [it]." That conclusion is not valid. The absence of a proof for a hypothesis is not proof that the hypothesis is wrong. --92.224.55.188 (talk) 15:38, 27 December 2012 (UTC)

Both grammatically and in the encyclopedic sense, the sentence is truly awful and should be removed.Vitaminman (talk) 17:11, 27 December 2012 (UTC)

Melatonin

Melatonin is a hormone produced by all (nearly all?) animals, plants and many other organisms, possibly even "all living things" as it says in the article about it. It is important in the regulation of circadian rhythms and, for many animals, seasonal behavior such as migration and reproduction. It is known as an antioxydant.

According to the Wikipedia article on Melatonin, it "was released into the general health supplement market in the United States in 1993." My first question is: released by whom? The DSHEA first appeared in 1994. Melatonin packaging refers to it as a dietary supplement. Are there other hormones so freely available in some countries?

My second question regards the rationale for considering a hormone to be not-a-drug. The list of substances regulated by DSHEA in the states includes vitamins etc, but not hormones. AFAIK you can't get insulin over-the-counter. How can melatonin be freely available in the USA and Canada (and possibly other countries?), while it requires at least an ordinary prescription, or a restricted prescription, in many other countries and is totally unavailable in some.

I hope that someone can shed some light on these questions. Hordaland (talk) 13:15, 25 November 2007 (UTC)

Hormones such as melatonin, DHEA and pregnenolone are sold over the counter in the United States and are regulated as dietary supplments under DSHEA. With regard to your first question, I would say that "released into" is probably the wrong phrase to use in this context. "First sold in" would probably be a better way to go. --Vitaminman 23:10, 26 November 2007 (UTC)
Thanks for answering. Interesting that more than one hormone is OTC in the US. I don't understand why they should be nor why they're not included in the DSHEA's list (if it's complete here). I happen to live in a country where melatonin is available only on a specialist's named-patient application, and it requires both red tape and wait time to get it. (Not very expensive, though.) It's weird that two Western, otherwise similar, countries have such extremely different policies on this. Hordaland (talk) 23:32, 26 November 2007 (UTC)
The regulation and definition of dietary supplements varies widely from country to country. The U.S. is among the more lenient/unregulated markets in this regard at present. MastCell Talk 00:32, 27 November 2007 (UTC)
The relatively liberal regulation in the US is the result of citizen activity and public outcry. In countries where citizens are more docile and do not protest restrictive regulation, the supplement regulations are very tight. In my country most common supplements and herbs are unavailable and also illegal to order from overseas. Melatonin is available here but prescription-only and costs about 50 times more than in the liberal US (+ doctor visits and the high probability that you will not be able to even persuade the doc to give you a prescription because docs always love to think they know better than you). --Bstard12 (talk) 23:48, 1 February 2013 (UTC)

How can a dietary supplement be patented?

If one looks at the list of items that the FDA qualifies as dietary supplements, it seems clear that they are naturally occurring compounds that could not possibly be invented by man. Any compound that is patented would necessarily need to identify a medical effect in order to receive a patent, and hence by claiming a medical effect would lose the ability to be marketed as a dietary supplement (I would think). I submit the dietary supplement known as Beano as an example of this conundrum. Discuss. — Preceding unsigned comment added by 64.231.81.147 (talk) 01:17, 28 September 2011 (UTC)

You can patent formulations or mixtures, and you can also patent "methods to use". If you have a patent on, "methods to use to treat a disease or condition" (for example, "a method to use curcumin to treat cancer") then that patent would have no value in the dietary supplement market because dietary supplements cannot be marketed to treat a disease or condition. however if you have a method to use that is something like "a method to use glucosamine to support bone health" then that could have a lot of value since dietary supplements can only be marketed for things like that -- supporting the structure of function of the bo.dy. hope that answers your question. are you thinking that it would be useful to have content in the article on this?Jytdog (talk) 23:59, 1 February 2013 (UTC)

Potential resources for globalizing

Going through some of my old lists, I found Regulation of functional foods and nutraceuticals: a global perspective which I had been considering receiving through interlibrary loan. Unfortunately I don't think I was successful; if anyone has this, let me know. Otherwise it's a potential resource on some of the less well-covered areas of the world. II | (t - c) 18:04, 8 April 2013 (UTC)

Reality check

The consensus of medical science is that essentially all "supplements" are of no actual value-- other than as placebo. I added a sentence near top alluding to this, with reference to a book review in today's NYT. 81.189.26.77 (talk) 17:07, 6 July 2013 (UTC)

People with specific medical conditions are frequently prescribed dietary supplements, such as people who are anemic being prescribed iron supplements. A variety of genetic disorders that hinder the absorption of specific nutrients and conditions resulting from chronic malnutrition are also often treated with dietary supplements. Although in healthy individuals dietary supplements are not needed, and while many dietary supplements advertise unproven/unrealistic claims, are supplied in a form that greatly reduces their bioavailibility, and are potentially harmful, that does not ignore the fact that many dietary supplements do have legitimate purposes.AioftheStorm (talk) 01:22, 7 July 2013 (UTC)
A clear statement of the mainstream "big picture" medical view on dietary supplements is important for article's lead. (An MD recently reviewing for NYT a book on this topic authored by prominent mainstream doctor is excellent source for general audience).
Lacking explanation to contrary, I propose restoring this brief but important reference.

81.189.26.53 (talk) 09:23, 7 July 2013 (UTC)

I'm sorry but there are few generalizations you can make that apply to all dietary supplements, and as far as sources go a book review is insufficient to represent medical consensus irrespective of its author. Dietary supplements are not obscure, you should be able to find high-quality sources that discusses them, preferably peer-reviewed review articles appearing in reputable journals or position statements by notable medical organizations such as the WHO or the CDC.AioftheStorm (talk) 15:32, 7 July 2013 (UTC)
Only two of the 51,000 retail dietary supplements on U.S. market have proven value beyond placebo, according to the MD reviewer in NYT. Highly credible author of book under review looked at multiple meta analyses, and the MD reviewer looked at further meta analyses, and then presented the above view as the current medical consensus. Most doctors I know carefully read and deeply respect the NYT. What -- if anything-- is available to contradict this view?

81.189.26.53 (talk) 21:04, 7 July 2013 (UTC)

ummm, the article actually says four, not 2 (omega-3 fatty acids, calcium + vitamin D, and folic acid) ... http://www.nytimes.com/2013/07/02/health/mind-over-matter-debunking-alternative-medicines.html?ref=science&_r=0 More importantly, please see WP:MEDRS for how we source health related information. A NY Times book review is not a MEDRS compliant source. As AotS said, please bring a MEDRS compliant secondary or tertiary source. It is more work but it is the Wikipedia way. I doubt you are going to be able to find one that is this broadly dismissive. I also think the statement you wanted to insert conflated the use of dietary supplements as drug-like interventions (which is where the big $ and oversold hoopla is) with their use as intended, which is as a supplement to provide nutrients otherwise lacking, where they can indeed play an important role. Jytdog (talk) 21:23, 7 July 2013 (UTC)
You are misreading what the NYT reviewer said IP. He says that Dr. Offits only gives credence to 4 dietary supplements on the US market, that does not mean that is what the majority of health community believes. For instance, the Centers for Disease Control and Prevention, and the American College of Obstetricians and Gynecologists both support universal iron supplementation in pregnant women. Although use of iron supplementation in pregnant women as a prophylactic is controversial and not everyone supports that belief, there are many reputable organizations that do. Also, Dr. Offits only addresses supplements in the US, not the whole world, and I could bring up dozens of supplements which are prescribed for certain conditions if I really wanted to. And lastly, no doctor should turn to the NYT or any news publication for medical info.AioftheStorm (talk) 21:35, 7 July 2013 (UTC)
"Umm" the author of the article says two, not four, but we needn't quibble. The editors that I know at the NYT take very seriously their employer's self-identified role as the "paper of record" and when something appears there, it's not generally a matter of somebody's whim but results from an elaborate bureaucratic system designed to protect that stated role.

Anyway, perhaps you'd accept the NIH as an arbiter of medical consensus? I've recast the whole thing, while keeping an important thrust. Dietary supplements are taken by something like half the public -- almost universally based on misconceptions which this article does little to correct. 81.189.26.53 (talk) 11:44, 8 July 2013 (UTC)

I see, because the national task force took out calcium+vitamin D the author says we are down to 2. Good point. Your final version is pretty good, but do you realize that you have turned the lede from have an appropriate globalized focus, to a narrow, US focus? Please see this page http://apps.who.int/medicinedocs/en/d/Jwhozip57e/4.4.10.html for more information (Germany is highlighted, which treats what we call "dietary supplements" as medicine. Please know that based on your edits, you and I view the marketing claims of the dietary supplement industry with the same very skeptical eye. I've spent a lot of time working on various articles covering herbal extracts etc to get rid of absurd medical claims and bring them into line with MEDRS. But at the same time unless we want to change the title of the article to "Dietary Supplements in the US" we need to avoid having it focus on the US stance. Jytdog (talk) 13:07, 8 July 2013 (UTC)

Regulation edits

I reorganized a lot and re-wrote a little, for what I consider clarity. I also cut a little of what I considered excessive detail. The section could probably use a statement from the supplements lobby for "balance."

On the other hand, I personally doubt credibility of this material, and won't be looking for it.

If somebody wants to restore stuff, please do so ---but don't mindlessly and merely hit "revert," as I was careful to remove a lot of maladroitly used acronyms and other obviously bad writing.

As for concerns about "international" perspective. I don't care. The U.S. is locus of medical research and its market is what drives the supplements industry. Bolivia may have a different take on subject... etc. 81.189.26.53 (talk) 16:41, 8 July 2013 (UTC)

There is a wiki-wide project on countering North American bias and ignoring it is not optional. We need to put back the international perspective or change the title of the article to focus on the US. I am not sure there will be consensus for this. Blowing off the issue is just ugly. As in Ugly American.Jytdog (talk) 17:13, 8 July 2013 (UTC)
As I said, either way I don't care.

I moved U.S. segment up because the U.S., as of the moment, accounts for more than half of the $50 billion world market. Moreover its influence on the cultural, business, legal and research aspects of the topic has, I believe, been much greater than its market share suggests.

(Although I must say that here in Europe, one encounters noticeably less dubious advertising for dietary supplements than in the Good Ole USA).
81.189.26.53 (talk) 06:45, 9 July 2013 (UTC)

International

I see you touched it up slightly. I added a little touch-up too. Sure it doesn't meet whatever standard one strives for.

I hate the use of acronyms (HUA) unless (U) absolutely (A) necessary (UAN), so I took that out (SITTO) (OMG!) 81.189.26.53 (talk) 10:06, 9 July 2013 (UTC)

More on International & etc.

I notice that the "international" segment is solely about the EU. I made it into a number of paragraphs for easier reading, which just makes it easier to see that it's difficult to comprehend and that much of it is perhaps of little value. But I certainly won't cut any of it. Heaven knows, the article does need a more "international" perspective.
More generally, I've now done a lot of editing on this article & cut only very minimal content that I thought was excessive or redundant or meaningless (depending on specifics). I have, however, rephrased many segments in a manner which I think makes them more concise. I've also relocated to different IP address.

108.204.142.171 (talk) 17:37, 11 July 2013 (UTC)

Moved "Need" segment up

I didn't contribute to "Need" segment, other than

through copy edits, and I don't believe its content, or even its subtitle "Need," is extremely strong. But logically, it seems to me a more significant category of information than the material on regulation. So I moved it above these segments. 108.204.142.171 (talk) 23:23, 11 July 2013 (UTC)

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