Are Herbal Supplements Bogus?

Written by Dr. Steve Chaney on . Posted in Uncategorized

How Can You Be Sure You Are Getting What You Paid For?

Author: Dr. Stephen Chaney

herbal supplementsTwo weeks ago the headlines claimed that most supplements containing grape seed extract were bogus. Just last week the New York Attorney General claimed that four of the largest retailers in the state were selling bogus herbal supplements.

We already knew that it is “buyer beware” in the food supplement industry. Is it really this bad? Are most herbal supplements a waste of money? How can we be sure that we are getting our money’s worth when we buy herbal supplements?

Do Herbal Supplements Work?

Supplements Containing Grape Seed Extract

grape seed supplementThe headlines about supplements containing grape seed extract were based on a recent study by botanical and medicinal chemistry experts at Rutgers University (Villani et al, Food Chemistry, 170, 271-280, 2015). They obtained 21 commercially available supplements containing grape seed extract from vitamin supplement retailers, supermarkets and online vendors.

The scientists used HPLC/UV/MS to analyze the supplements for the polyphenols that should be found in authentic grape seed extracts. (HPLC/UV/MS is an analytic method that is the gold standard for identifying and quantifying the chemical composition of the final product. However, it is a very expensive procedure, and many manufacturers do not use it.)

The results of their analysis were quite alarming.

  • Only 6 of the 21 products tested had the specific polyphenols found in authentic grape seed extract.
  • 9 of the samples had less than 15% of the polyphenols found in grape seed extract.
  • 5 of the samples had less than 3% of the polyphenols found in grape seed extract.
  • One of the samples had no detectable grape seed extract
  • 9 of the samples contained polyphenols that were characteristic of peanut skin extracts rather than grape seed extract. Peanut skin extract is a much cheaper source of polyphenols than grape seed extract. Substitution of peanut skin extract for grape seed extract is a concern because:
    • While polyphenols from peanut skin extract have health benefits, they have not been tested. There is currently no clinical evidence that they are beneficial.
    • There is no label information on the products indicating that peanuts were used in their manufacture. This could be a concern for people with peanut allergies.
  • 3 of the samples contained polyphenols that were more characteristic of pine bark extract than grape seed extract. Again this is a concern because that particular blend of polyphenols has not been shown to provide the same health benefits as grape seed extract.

The authors concluded that “adulteration of grape seed extract in commercial preparations is a significant problem.” They suggested that substitution of much cheaper polyphenol sources such as peanut skin extract or pine bark extract offered significant “economic gain” to the manufacturers.

They went on to say “due to reliance of inferior…assays [or complete lack of quality control assays in some cases] across the value chain, adulteration can go undetected by others in the distribution chain, such as those involved in distribution, packaging, wholesale and retail sales.”

To put that in lay terms it means that suppliers and manufacturers often cheat by substituting cheaper polyphenol sources, primarily for financial gain. Furthermore, because most companies don’t use high cost quality control assays such as HPLC/UV/MS they actually have no idea whether their products actually contain grape seed extract or not.

Supplements Containing Ginko Biloba, St. John’s Wort, Ginseng & Echinacea

The recent headlines about ginko biloba, St. John’s wort, ginseng, echinacea and other herbal products arose from an announcement by the New York Attorney General the he had just ordered GNC, Target, Walmart and Walgreens to take a number of herbal supplements off their shelves because almost 80% of them didn’t contain the ingredients listed on the label or contained non-listed ingredients.

Specifically, the Attorney General claimed that:

  • The ginko biloba and St. John’s wort supplements that they tested from those stores did not test positive for active ingredients.
  • Ginseng and Echinacea supplements also failed their tests.
  • In some cases the supplements contained no organic material. They contained sand instead of active ingredients.

new york attorney generalThe Attorney General claimed that these and other herbal supplements they tested were bogus. Even worse, they were deceptive and could endanger people’s health. For example, people generally use St. John’s wort to relieve depression. If the supplement is bogus, they are not just wasting money. Their mental health is also being compromised.

While the Attorney General’s announcement is alarming, it is also a bit misleading. It is based on an analytic method called “DNA barcoding”. In simple terms, DNA barcoding means that DNA is extracted from the sample and the genetic information in that DNA is compared with the genetic information characteristic of the herbal ingredient.

DNA barcoding is an important analytic test that every manufacturer should use to validate the identity of their herbal raw ingredients. However, DNA is often removed in the process of preparing an herbal extract, so DNA barcoding is an inappropriate assay to use for validating the quality of the finished product. Assays such as the HPLC/UV/MS are more appropriate or the final product.

In short, the Attorney General identified a potential problem with the herbal supplement industry, but further tests are required before we know how significant the problem actually is. The most troubling aspect of the whole incident is that some of the retailers had not run their own quality controls on the products, so they actually had no idea whether the products they were selling were bogus or not.

How Can you Make Sure the Supplements you Buy Aren’t Bogus?

Now that you know that many herbal supplements may be bogus, how do you protect yourself? How do you make sure that you are not wasting your money and jeopardizing your health?

The answer is actually pretty simply.

  • Ignore the slick marketing.
  • Don’t base your decision on price alone.
  • Do your research. Only choose reputable companies that do quality controls on both the raw ingredients and the finished product.

The Bottom Line

Herbal supplements have been in the headlines lately, and the news isn’t good.

  • One study (Villani et al, Food Chemistry, 170, 271-280, 2015) reported that only 6 out of 21 supplements listing grape seed extract on their label actually contained pure grape seed extract. The rest were adulterated with less expensive polyphenol sources which may not provide the same health benefits, such as peanut skin extracts and pine bark extracts. That report was based on HPL/UV/MS, which is the gold standard of quality controls assays for herbal supplements.
  • Two weeks later the New York Attorney General ordered GNC, Target, Walmart and Walgreens to stop selling herbal supplements containing ginko biloba, St. John’s wort, ginseng, echinacea and other herbal ingredients. He claimed that 80% of the supplements tested didn’t contain the ingredients on the label and some contained sand instead of any active ingredients. His claim was based on DNA barcoding, an assay that is appropriate for identifying the herbs used in manufacturing the supplements, but is not valid for determining whether the finished product contains extracts prepared from those herbs. In short the Attorney General’s report identified a potential problem with those supplements, but further tests will be required to determine how significant that problem is.
  • Both reports serve to remind us that many supplement manufacturers fail to run adequate quality control tests on their products. Neither they nor you know whether their products actually contain any active ingredients. Your best bet is to choose food supplement companies that run appropriate quality controls on both their raw ingredients and on their final products.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

A Low Carb Diet and Weight Loss

Posted January 15, 2019 by Dr. Steve Chaney

Do Low-Carb Diets Help Maintain Weight Loss?

Author: Dr. Stephen Chaney

 

low carb dietTraditional diets have been based on counting calories, but are all calories equal? Low-carb enthusiasts have long claimed that diets high in sugar and refined carbs cause obesity. Their hypothesis is based on the fact that high blood sugar levels cause a spike in insulin levels, and insulin promotes fat storage.

The problem is that there has been scant evidence to support that hypothesis. In fact, a recent meta-analysis of 32 published clinical studies (KD Hall and J Guo, Gastroenterology, 152: 1718-1727, 2017 ) concluded that low-fat diets resulted in a higher metabolic rate and greater fat loss than isocaloric low-carbohydrate diets.

However, low-carb enthusiasts persisted. They argued that the studies included in the meta-analysis were too short to adequately measure the metabolic effects of a low-carb diet. Recently, a study has been published in the British Medical Journal (CB Ebbeling et al, BMJ 2018, 363:k4583 ) that appears to vindicate their position.

Are low carb diets best for long term weight loss?

Low-carb enthusiasts claim the study conclusively shows that low-carb diets are best for losing weight and for keeping it off once you have lost it. They are saying that it is time to shift away from counting calories and from promoting low-fat diets and focus on low-carb diets instead if we wish to solve the obesity epidemic. In this article I will focus on three issues:

  • How good was the study?
  • What were its limitations?
  • Are the claims justified?

 

How Was The Study Designed?

low carb diet studyThe investigators started with 234 overweight adults (30% male, 78% white, average age 40, BMI 32) recruited from the campus of Framingham State University in Massachusetts. All participants were put on a diet that restricted calories to 60% of estimated needs for 10 weeks. The diet consisted of 45% of calories from carbohydrate, 30% from fat, and 25% from protein. [So much for the claim that the study showed low-carb diets were more effective for weight loss. The diet used for the weight loss portion of the diet was not low-carb.]

During the initial phase of the study 161 of the participants achieved 10% weight loss. These participants were randomly divided into 3 groups for the weight maintenance phase of the study.

  • The diet composition of the high-carb group was 60% carbohydrate, 20% fat, and 20% protein.
  • The diet composition of the moderate-carb group was 40% carbohydrate, 40% fat, and 20% protein.
  • The diet composition of the low-carb group was 20% carbohydrate, 60% fat, and 20% protein.

Other important characteristics of the study were:

  • The weight maintenance portion of the study lasted 5 months – much longer than any previous study.
  • All meals were designed by dietitians and prepared by a commercial food service. The meals were either served in a cafeteria or packaged to be taken home by the participants.
  • The caloric content of the meals was individually adjusted on a weekly basis so that weight was kept within a ± 4-pound range during the 5-month maintenance phase.
  • Sugar, saturated fat, and sodium were limited and kept relatively constant among the 3 diets.

120 participants made it through the 5-month maintenance phase.

 

Do Low-Carb Diets Help Maintain Weight Loss?

low carb diet maintain weight lossThe results were striking:

  • The low-carb group burned an additional 278 calories/day compared to the high-carb group and 131 calories/day more than the moderate-carbohydrate group.
  • These differences were even higher for those individuals with higher insulin secretion at the beginning of the maintenance phase of the study.
  • These differences lead the authors to hypothesize that low-carb diets might be more effective for weight maintenance than other diets.

 

What Are The Pros And Cons Of This Study?

low carb diet pros and consThis was a very well-done study. In fact, it is the most ambitious and well-controlled study of its kind. However, like any other clinical study, it has its limitations. It also needs to be repeated.

The pros of the study are obvious. It was a long study and the dietary intake of the participants was tightly controlled.

As for cons, here are the three limitations of the study listed by the authors:

#1: Potential Measurement Error: This section of the paper was a highly technical consideration of the method used to measure energy expenditure. Suffice it to say that the method they used to measure calories burned per day may overestimate calories burned in the low-carb group. That, of course, would invalidate the major findings of the study. It is unlikely, but it is why the study needs to be repeated using a different measure of energy expenditure.

#2: Compliance: Although the participants were provided with all their meals, there was no way of being sure they ate them. There was also no way of knowing whether they may have eaten other foods in addition to the food they were provided. Again, this is unlikely, but cannot be eliminated from consideration.

#3: Generalizability: This is simply an acknowledgement that the greatest strength of this study is also its greatest weakness. The authors acknowledged that their study was conducted in such a tightly controlled manner it is difficult to translate their findings to the real world. For example:

  • Sugar and saturated fat were restricted and were at very similar levels in all 3 diets. In the real world, people consuming a high-carb diet are likely to consume more sugar than people in the other diet groups. Similarly, people consuming the low-carb diet are likely to consume more saturated fat than people in the other diet groups.
  • Weight was kept constant in the weight maintenance phase by constantly adjusting caloric intake. Unfortunately, this seldom happens in the real world. Most people gain weight once they go off their diet – and this is just as true with low-carb diets as with other diets.
  • The participants had access to dietitian-designed prepared meals 3 times a day for 5 months. This almost never happens in the real world. The authors said “…these results [their data] must be reconciled with the long-term weight loss trials relying on nutrition education and behavioral counseling that find only a small advantage for low carbohydrate compared with low fat diets according to several recent meta-analyses.” [I would add that in the real world, people do not even have access to nutritional education and behavioral modification.]

 

low carb diet and youWhat Does This Study Mean For You?

  • This study shows that under very tightly controlled conditions (dietitian-prepared meals, sugar and saturated fat limited to healthy levels, calories continually adjusted so that weight remains constant) a low-carb diet burns more calories per day than a moderate-carb or high-carb diet. These findings show that it is theoretically possible to increase your metabolic weight and successfully maintain a healthy weight on a low-carb diet. These are the headlines you probably saw. However, a careful reading of the study provides a much more nuanced viewpoint. For example, the fact that the study conditions were so tightly controlled makes it difficult to translate these findings to the real world.
  • In fact, the authors of the study acknowledged that multiple clinical studies show this almost never happens in the real world. These studies show that most people regain the weight they have lost on low-carb diets. More importantly, the rate of weight regain is virtually identical on low-carb and low-fat diets. Consequently, the authors of the current study concluded “…translation [of their results to the real world] requires exploration in future mechanistic oriented research.” Simply put, the authors are saying that more research is needed to provide a mechanistic explanation for this discrepancy before one can make recommendations that are relevant to weight loss and weight maintenance in the real world.
  • The authors also discussed the results of their study in light of a recent, well-designed 12-month study (CD Gardener et al, JAMA, 319: 667-669, 2018 ) that showed no difference in weight change between a healthy low-fat versus a healthy low-carbohydrate diet. That study also reported that the results were unaffected by insulin secretion at baseline. The authors of the current study noted that “…[in the previous study] participants were instructed to minimize or eliminate refined grains and added sugars and maximize intake of vegetables. Probably for this reason, the reported glycemic load [effect of the diet on blood sugar levels] of the low-fat diet was very low…and similar to [the low-carb diet].” In short, the authors of the current study were acknowledging that diets which focus on healthy, plant-based carbohydrates and eliminate sugar, refined grains, and processed foods may be as effective as low-carb diets for helping maintain a healthy weight.
  • This would also be consistent with previous studies showing that primarily plant-based, low-carb diets are more effective at maintaining a healthy weight and better health outcomes long-term than the typical American version of the low-fat diet, which is high in sugar and refined grains. In contrast, meat-based, low-carb diets are no more effective than the American version of the low-fat diet at preventing weight gain and poor health outcomes. I have covered these studies in detail in my book “Slaying The Food Myths.”

Consequently, the lead author of the most recent study has said: “The findings [of this study] do not impugn whole fruits, beans and other unprocessed carbohydrates. Rather, the study suggests that reducing foods with added sugar, flour, and other refined carbohydrates could help people maintain weight loss….” This is something we all can agree on, but strangely this is not reflected in the headlines you may have seen in the media.

The Bottom Line

 

  • A recent study compared the calories burned per day on a low-carb, moderate-carb, and high-carb diet. The study concluded that the low-carb diet burned significantly more calories per day than the other two diets and might be suitable for long-term weight control. If confirmed by subsequent studies, this would be the first real evidence that low-carb diets are superior for maintaining a healthy weight.
  • However, the study has some major limitations. For example, it used a methodology that may overestimate the benefits of a low-carb diet, and it was performed under tightly controlled conditions that can never be duplicated in the real world. As acknowledged by the authors, this study is also contradicted by multiple previous studies. Further studies will be required to confirm the results of this study and show how it can be applied in the real world.
  • In addition, the kind of carbohydrate in the diet is every bit as important as the amount of carbohydrate. The authors acknowledge that the differences seen in their study apply mainly to carbohydrates from sugar, refined grains, and processed foods. They advocate diets with low glycemic load (small effects on blood sugar and insulin levels) and acknowledge this can also be achieved by incorporating low-glycemic load, plant-based carbohydrates into your diet. This is something we all can agree on, but strangely this is not reflected in the headlines you may have seen in the media.
  • Finally, clinical studies report averages, but none of us are average. When you examine the data from the current study, it is evident that some participants burned more calories per hour on the high-carb diet than other participants did on the low carb diet. That reinforces the observation that some people lose weight more effectively on low-carb diets while others lose weight more effectively on low-fat diets. If you are someone who does better on a low-carb diet, the best available evidence suggests you will have better long-term health outcomes on a primarily plant-based, low-carb diet such as the low-carb version of the Mediterranean diet.

For more details read the article above.

 

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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