Evaluating Dietary Supplements for efficacy and safety
How can you evaluate a dietary supplement for effectiveness (that is delivering on it’s claims) and safety? It ain’t easy. Dietary supplements are regulated more like food than drugs and do not undergo the same level of scrutiny as drugs. Most were classified as GRAS substances (Generally Recognized As Safe) under the Dietary Supplement Health and Education Act of 1994 and are assumed to be safe unless reports of adverse effects demonstrate otherwise. Any new supplement or dietary ingredient introduced by a manufacturer requires that the FDA be notified and provide evidence that a supplement is” reasonably expected to be safe”. When considering a supplement, it is wise to check with your health care provider as well as do some research on your own to examine claims, interactions with medications, and potential adverse effects.
For many semesters, my students completed a project in which they evaluated a dietary supplement of their choosing. The first step was to examine the label for claims, warnings, and dosage instructions. Supplement manufacturers generally use what are called “structure function” claims about how a product might affect the body’s structure and function (not a disease or condition). These use words like “promote”, “helps”, or “maintains” and require a disclaimer that the FDA has not evaluated the claim and that the product is not intended to diagnose, treat, cure, or prevent any disease. I then provided several credible, evidence-based websites where students could read about the supplement and address questions about efficacy of claims, interactions, contraindications, and potential side effects. A few of those sites are listed below.
Finally, students looked at a few scientific abstracts in PubMed – a repository of peer reviewed research and review papers – to gain some insight on the type and quality of research conducted on the supplement they were examining. Here's a helpful guide to "To Find Information About Complementary and Integrative Health Practices on PubMed®" Based on their readings and research students were asked to share their own recommendations and reservations about a supplement – and most concluded that more research was warranted to support claims and safety.