Are There Any Honest Nutritional Supplement Companies?

Written by Dr. Steve Chaney on . Posted in Uncategorized

Do They “Cherry Pick” Scientific Studies?

Author: Dr. Stephen Chaney

cherry picking studiesWhen we buy a food supplement from a company we assume that it will provide a benefit. We are trusting that company to be honest in their product claims. But, are there any honest nutritional supplement companies?

  • What if they were lying to us?
  • What if they had no clinical studies done with their product?
  • What if they were just quoting studies done with ingredients found in their product?
  • What if they were “cherry picking” the studies they listed to support the claims they wanted to make?

Unfortunately, that happens far too often in the nutraceutical industry. As an example, I came across an article in a recent issue of www.nutraingredients.com about a FDA warning letter (http://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2016/ucm518533.htm) to a noni juice company.  In case you are wondering, noni fruit is the latest in a long line of “magical fruits” that is going to cure everything that ails you.

The thing that brought this company to the FDA’s attention in the first place was the health claims the company made on their website. The company claimed or implied that their product would cure cancer, cure gout, cure arthritis, lower cholesterol, and help fight infections. Claims like that always invite FDA scrutiny.

What caught my attention, however, was the quote by an attorney specializing in FDA compliance issues that the studies cited on their website were “cherry picked” to support their claims. He said that the studies they cited “…do not meet the standards of third party literature…You have to include a full range [of published studies], and not just cherry pick the positive studies. It has to be a balanced presentation. It looks like they just did a literature search on noni and included only the positive studies.”

That statement caught my attention because it doesn’t just apply to just this one company. It is a practice that is common in the nutraceutical industry.  Many supplement companies cherry pick studies from third party literature. They list only the studies that support their product claims and ignore the rest. That is misleading because it implies a level of proof for their product claims that does not exist.  It is fundamentally dishonest. These are certainly not honest nutritional supplement companies.

Using Borrowed Science

honest nutritional supplement companiesThe noni juice company cited in the FDA letter had no clinical studies to support their claims. Instead they quoted studies done with ingredients found in their product. This is what I call “borrowed science.”

I call this “borrowed science” because the studies were not actually done with their products. They were simply trying to “borrow” results done with individual ingredients and pretend that they applied them to their product.

Let me be clear. Third party studies done with ingredients found in a company’s product are of little value in predicting whether that product will provide any benefit to you. To claim otherwise is dishonest.  Again, these are not honest nutritional supplement companies.

There are several reasons this is true.

  • In many cases, the amount of that ingredient provided by the supplement does not match the amount actually used in the clinical study they quote. The ingredient may or may not be effective at the dose provided in the supplement.
  • More importantly, a supplement usually contains multiple other components that may influence how a single ingredient works in your body. The other components may enhance the effectiveness of the ingredient in question, or they may inhibit it.
  • Without clinical trials done with their product, companies actually have no idea whether their product works or not.

Unfortunately, I see this practice all too frequently in the nutraceutical industry. Clinical trials are expensive. It’s cheaper and easier to search the literature for published studies you can “borrow” to support your product.

 

Honest Nutritional Supplement Companies Do Not“Cherry Pick” Studies

dishonest supplement companiesEven worse, many companies cherry pick studies from the literature to support the product claims they want to make.

To understand what that statement means you need to know a little bit about the scientific method. Most scientists design their experiments to disprove what other scientists have published. This is a self-correcting process that is a strength of the scientific method.

However, it also means that you will find articles in the literature supporting and refuting the benefits of almost every nutraceutical ingredient. The scientific community waits until enough studies have accumulated and then relies on the weight of evidence before drawing any conclusions.

Unfortunately, unscrupulous supplement companies decide first on what claims they want to make and quote only the studies that support those claims. This is what is referred to as “cherry picking” the studies.

The Dietary Supplement Health and Education Act of 1994 (otherwise known as DSHEA) is very clear about that. Section 5 of DSHEA states “…scientific journal articles, books and other publications can be used in the sale of dietary supplements provided…[they] are presented with other materials to create a balanced view of the scientific information…”

In plain words this legalese simply means that you can’t cherry pick studies. You can’t select only the studies that support your product claims and ignore those that don’t.  Honest nutritional supplement companies would not use these deceitful practices.

However, this is a practice that I see all too often in the nutraceutical industry. It is dishonest. It is disgraceful

 

Are There Any Honest Nutritional Supplement Companies?

The bad news is that there are lots of supplement companies that do no clinical studies of their own. Instead they rely on borrowed science from studies that really do not provide proof that their products are either safe or effective. Even worse, many of those companies cherry pick only the studies that support their product claims and ignore studies that do not. This is a practice I regard as clearly dishonest. Those are companies I would avoid.

The good news is that there are a few companies that actually support clinical studies on their key products and publish those studies in peer reviewed scientific journals. Those are companies worthy of your consideration.

There are other things to take into account in selecting the best of the best – things like the number of studies and the quality of the studies. However, that’s a topic for another day.

 

Many Blogs Cherry Pick As Well

deceitful supplement companiesI can’t leave this topic without pointing out that many popular health and nutrition blogs, including those written by some well-known doctors, do exactly the same thing.

The pressures that lead to this behavior are obvious. The very popularity of these blogs depends on them being sensational week after week.

Unfortunately, true science is rarely sensational. It’s usually pretty wishy-washy. If you do a complete search of the literature, you usually find articles that are both for and against any point of view you wish to express. Occasionally, enough evidence accumulates on one side of an issue that scientists are willing to come to a definitive conclusion, but that conclusion is hardly ever sensational.

The only way that the authors of these popular blogs can make sensational claims each week is to cherry pick only the studies that support their point of view and ignore everything else.

Unfortunately, the average reader doesn’t realize this. They see the list of references supporting the claims and believe what they read. Then these bizarre claims get reposted over and over until the general public actually starts believing that they are true.

It really is a shame that DSHEA doesn’t apply to blogs. If it did, they wouldn’t be nearly as sensational, but they would be much more accurate. They would have to report on the whole body of scientific literature, rather than cherry picking just the studies that support their point of view.

In conclusion, there are some honest nutritional supplement companies, but be sure the company you choose to believe is citing studies on their actual products and not just ingredients in their products.  Also, watch out for “cherry picking.”

 

The Bottom Line

 

  • The FDA recently sent a warning letter to a noni juice company for making unsupported health claims for their product. The company was claiming their product could cure things like cancer, gout and arthritis. Whenever a company makes claims like that, they can expect to draw the attention of the FDA.
  • An outside attorney specializing in FDA compliance pointed out that the company also had no good evidence to support their product claims. The company had done no clinical studies on the products. Instead they had “borrowed” the results of third party studies done with ingredients found in their product. Even worse, they had cherry picked only the studies that supported their product claims and ignored the studies that did not.
  • Third party studies done with ingredients found in a company’s product are often worthless in predicting whether that product will provide any benefit to you. I discuss the reasons for that in the article above.
  • Cherry picking only the studies that support a company’s product claims runs afoul of the Dietary Supplement Health and Education Act of 1994 (DSHEA) requirement that companies provide a balanced view of the scientific literature relating to their products. It is also misleading and dishonest.
  • Unfortunately, the practice of using “borrowed science” from third party studies and cherry picking only the studies that support their product claims is common in the nutraceutical industry. Supplement companies that rely on this kind of evidence to support their product claims are dishonest and should be avoided.
  • For products you can trust, choose companies that support clinical studies on their key products and published those studies in peer-reviewed journals. You should also look at the number and quality of studies, but that is a topic for another day.

 

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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Can Plant-based Diets Be Unhealthy?

Posted September 10, 2019 by Dr. Steve Chaney

Do Plant-Based Diets Reduce Heart Disease Deaths?

Author: Dr. Stephen Chaney

 

plant-based diets vegetablesPlant-based diets have become the “Golden Boys” of the diet world. They are the diets most often recommended by knowledgeable health and nutrition professionals. I’m not talking about all the “Dr. Strangeloves” who pitch weird diets in books and the internet. I am talking legitimate experts who have spent their life studying the impact of nutrition on our health.

Certainly, there is an overwhelming body of evidence supporting the claim that plant-based diets are healthy. Going on a plant-based diet can help you lower blood pressure, inflammation, cholesterol and triglycerides. People who consume a plant-based diet for a lifetime weigh less and have decreased risk of heart disease, diabetes, and cancer.

But, can a plant-based diet be unhealthy? Some people consider a plant-based diet to simply be the absence of meat and other animal foods. Is just replacing animal foods with plant-based foods enough to make a diet healthy?

Maybe not. After all, sugar and white flour are plant-based food ingredients. Fake meats of all kinds abound in our grocery stores. Some are very wholesome, but others are little more than vegetarian junk food. If you replace animal foods with plant-based sweets, desserts, and junk food, is your diet really healthier?

While the answer to that question seems obvious, very few studies have asked that question. Most studies on the benefits of plant-based diets have compared population groups that eat a strictly plant-based diet (Seventh-Day Adventists, vegans, or vegetarians) with the general public. They have not looked at variations in plant food consumption within the general public. Nor have they compared people who consume healthy and unhealthy plant foods.

This study (H Kim et al, Journal of the American Heart Association, 8:e012865, 2019) was designed to fill that void.

 

How Was The Study Done?

plant-based diets studyThis study used data collected from 12,168 middle aged adults in the ARIC (Atherosclerosis Risk in Communities) study between 1987 and 2016.

The participant’s usual intake of foods and beverages was assessed by trained interviewers using a food frequency questionnaire at the time of entry into the study and again 6 years later.

Participants were asked to indicate the frequency with which they consumed 66 foods and beverages of a defined serving size in the previous year. Visual guides were provided to help participants estimate portion sizes.

The participant’s adherence to a plant-based diet was assessed using four different well-established plant-based diet scores. For the sake of simplicity, I will include 3 of them in this review.

  • The PDI (Plant-Based Diet Index) categorizes foods as either plant foods or animal foods. A high PDI score means that the participant’s diet contains more plant foods than animal foods. A low PDI score means the participant’s diet contains more animal foods than plant foods.
  • The hPDI (healthy plant-based diet index) is based on the PDI but emphasizes “healthy” plant foods. A high hPDI score means that the participant’s diet is high in healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) and low in animal foods.
  • The uPDI (unhealthy plant-based diet index) is based on the PDI but emphasizes “unhealthy” plant foods. A high uPDI score means that the participant’s diet is high in unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) and low in animal foods.

For statistical analysis the scores from the various plant-based diet indices were divided into 5 equal groups. In each case, the group with the highest score consumed the most plant foods and least animal foods. The group with the lowest score consumed the least plant foods and the most animal foods.

The health outcomes measured in this study were heart disease events, heart disease deaths, and all-cause deaths. Again, for the sake of simplicity, I will only include 2 of these outcomes (heart disease deaths and all-cause deaths) in this review. The data on deaths were obtained from state death records and the National Death Index. (Yes, your personal information is available on the web even after you die.)

 

Do Plant-Based Diets Reduce Heart Disease Deaths?

plant-based diets reduce heart deathsThe participants in this study were followed for an average of 25 years.

The investigators looked at heart disease deaths over the 25 years and compared people with the highest intake of plant foods to people with the highest intake of red meat and other animal foods. The results were:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods (whole grains, fruits, vegetables, nuts, legumes, coffee and tea) had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods (refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts) had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

What Else Did The Study Show?

The investigators made a couple of other interesting observations:

  • The association of the overall diet with heart disease and all-cause deaths was stronger than the association of individual food components. This underscores the importance of looking at the effect of the whole diet on health outcomes rather than the “magic” foods you hear about on Dr. Strangelove’s Health Blog.
  • Diets with the highest amount of healthy plant foods were associated with higher intake of carbohydrates, plant protein, fiber, and micronutrients, including potassium, magnesium, iron, vitamin A, vitamin C, folate, and lower intake of saturated fat and cholesterol.
  • Diets with the highest amount of unhealthy plant foods were associated with higher intake of calories and carbohydrates and lower intake of fiber and micronutrients.

The last two observations may help explain some of the health benefits of plant-based diets.

 

Can Plant-Based Diets Be Unhealthy?

plant-based diets unhealthy cookiesNow, let’s return to the question I asked at the beginning of this article: “Can plant-based diets be unhealthy?” Although some previous studies have suggested that unhealthy plant-based diets might increase the risk of heart disease, this study did not show that.

What this study did show was that an unhealthy plant-based diet was no better for you than a diet containing lots of red meat and other animal foods.

If this were the only conclusion from this study, it might be considered a neutral result. However, this result clearly contrasts with the data from this study and many others showing that both plant-based diets in general and healthy plant-based diets reduce the risk of heart disease deaths and all-cause deaths compared to animal-based diets.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

There is one other subtle message from this study. This study did not compare vegans with the general public. Everyone in the study was the general public. Nobody in the study was consuming a 100% plant-based diet.

For example:

  • The group with the highest intake of plant foods consumed 9 servings per day of plant foods and 3.6 servings per day of animal foods.
  • The group with the lowest intake of plant foods consumed 5.4 servings per day of plant foods and 5.6 servings per day of animal foods.

In other words, you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet.

 

The Bottom Line

A recent study analyzed the effect of consuming plant foods on heart disease deaths and all-cause deaths over a 25-year period.

When the investigators looked at heart disease deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had a 19-32% lower risk of dying from heart disease than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

When the investigators looked at all-cause deaths over the 25 years:

  • People with the highest intake of plant foods and the highest intake of healthy plant foods had an 11-25% lower risk of dying from any cause than people with the highest intake of red meat and other animal foods.
  • People with the highest intake of unhealthy plant foods had the same risk of dying from heart disease as people with the highest intake of red meat and other animal foods.

The main message from this study is clear.

  • Replacing red meat and other animal foods with plant foods can be a healthier choice, but only if they are whole, minimally processed plant foods like whole grains, fruits, vegetables, nuts, legumes, coffee and tea.
  • If the plant foods are refined grains, fruit juices, French fries and chips, sugar sweetened and artificially sweetened beverages, sweets and desserts, all bets are off. You may be just as unhealthy as if you kept eating a diet high in red meat and other animal foods.

A more subtle message from the study is that you don’t need to be a vegan purist to experience health benefits from adding more whole, minimally processed plant foods to your diet. The people in this study were not following some special diet. The only difference was that some of the people in this study ate more plant foods and others more animal foods.

For more details on the study, 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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