The Supplement Industry: Exposing The Dark Side

Written by Dr. Steve Chaney on . Posted in Supplement Industry

It Is Buyer Beware

Author: Dr. Stephen Chaney

 

the supplement industryEvery once in a while, the professor needs to clear out his desk. This week was a perfect time for a little early Spring cleaning. I have been accumulating articles about the dark side of the supplement industry. None of them are sufficient for a whole issue of “Health Tips From the Professor” by themselves, so I have combined the top three in this issue.

I don’t want to unduly alarm you. Most supplement companies are ethical. They are doing their best to provide you with supplements that will improve your health. However, there are a few bad apples in every barrel.

 

The Supplement Industry:  Exposing The Dark Side

 

the supplement industry the dark sidePerhaps the question we should be asking is “Why do supplement companies “Go over to the Dark Side” in the first place? It almost always involves the almighty dollar. Simply put, some companies are more interested in making money than they are about improving your health.

Let me give you some examples where companies cut corners to save money:

  • They substitute cheaper ingredients to save money. This practice is referred to as adulteration. There is, in fact, no evidence that the cheaper ingredients will provide the same benefit as the ingredient listed on the label. I give an example of adulteration below.
  • They don’t do quality controls. That saves a lot of money. However, it means that neither you or the company knows what is in the product. The FDA inspects as many manufacturing facilities as the can. Each year they shut down a few manufacturers for lack of quality controls, but two spring up for every one they shut down. I call it “Whack-A-Mole”, after that popular carnival game.
  • They don’t do clinical studies on their products. That also saves a lot of money. However, it means that neither you or the company knows whether their product is safe and effective. The FDA doesn’t require clinical studies, so many companies don’t do them.

the supplement industry bustedHowever, the worst abuses of the industry arise because of our own human frailties. When it comes to weight loss, muscle gain, sexual arousal, and energy,  many people don’t care about safety. They just want instant results.

The unscrupulous companies in the supplement industry are only too happy to oblige. They manufacture products containing illegal stimulants and pharmaceuticals. These products work. They also kill people. These companies are the really “bad apples” that give the whole industry a black eye. I will give some examples of products containing illegal stimulants and pharmaceuticals below.

 

The Adulteration Of Cranberry Supplements

 

the supplement industry cranberryIs nothing sacred? Is even something as wholesome and natural as cranberry supplements not safe from adulteration? Apparently, the answer is: “No”.

Part of the problem is that cranberry supplements have become very popular. They used to just be for urinary tract infections. However, a quick scan of the internet showed they are now also recommended for detoxification, for reducing inflammation, for reducing heart disease and preventing kidney stone formation.

With the increased interest in the benefits of cranberry supplements, it is no surprise that sales of cranberry supplements almost doubled between 2013 and 2016. That created a huge problem for manufacturers. Cranberry extract is very expensive, and there just wasn’t enough to meet demand. Plus, for new companies to gain traction in an increasingly crowded market, they needed to come in at a lower price than the established supplement companies.

You might suspect unscrupulous companies would be tempted to substitute cheaper ingredients for authentic cranberry extract. In fact, because of a recent bulletin released by the Botanical Adulterants Program of the American Botanical Council, we know that is exactly what is happening. The bulletin reported that many ingredient suppliers are adulterating cranberry extract with cheaper ingredients such as peanut skin, grape seed, mulberry fruit, hibiscus calyx, black bean skin, or black rice. In fact, they are using almost any ingredient that can impart the same red color found in authentic cranberry extracts.

Unfortunately, most supplement companies don’t have the kind of sophisticated equipment that is required to test for adulteration. They simply believe the lies of their suppliers and pass on these worthless “cranberry supplements” to you.

 

The FDA Warns Against Kratom Supplements

 

the supplement industry too good to be trueKratom supplements have also gained widespread popularity in recent years. A quick scan of claims on the internet show why. If you believe the hype, kratom will:

  • Relieve anxiety, stress, and depression.
  • Relieve pain & inflammation.
  • Improve mental acuity & focus.
  • Increase your metabolic rate & burn off excess pounds.
  • Improve your sexual prowess.
  • Induce healthy sleep.
  • Strengthen your immune system.
  • Prevent diabetes.
  • Help with opioid withdrawal.

 

I didn’t come across “leaping tall buildings in a single bound”, but I might have missed something. With all this hype, it’s no wonder kratom is becoming so popular.

However, the FDA is not impressed. They recently issued an FDA advisory  “about the deadly risks associated with kratom.”

The FDA advisory states: “Proponents argue that it is a safe substance because it is a plant-based product…Evidence shows that kratom has similar effects to narcotics like opioids, and carries similar risks of abuse, addiction and in some cases, death.”

It goes on to say: “Calls to US poison control centers regarding kratom have increased 10-fold from 2010 to 2015, with hundreds of calls made each year. The FDA is aware of 36 deaths associated with kratom-containing products…The use of kratom is also associated with serious side effects like seizures, liver damage, and withdrawal symptoms.”

The FDA is currently doing its best to seize and destroy shipments of kratom entering the country, but some is still making it in. The kratom manufacturers have disputed the FDA claims, but my advice would be to avoid kratom supplements until this issue is resolved.

 

Illegal Stimulants Can Still Be Found In Supplements

the supplement industry illegal ingredientsAmphetamine-like stimulants are very popular for weight loss and muscle building supplements. This is because they increase metabolic rate, which “burns fat effortlessly”, and increase energy, which “improves workouts and maximizes muscle gain.” You can sense the allure of these kinds of products.

There is only one problem. They cause high blood pressure and irregular heartbeat. They kill people. In previous issues of “Health Tips From the Professor” I have warned you about the amphetamine-like stimulants DMAA and DMBA. They are both quite dangerous. The FDA has ruled that both are illegal dietary ingredients. That means they should not be present in any supplements. Period.

Octodrine is another amphetamine-like stimulant. It was approved as a drug to treat bronchitis in the 1940s. As a pharmaceutical ingredient, it also should not be present in any supplement.

Unfortunately, a recent study (PA Cohen et al, Clinical Toxicology doi.org/10.1080/15563650.2017.1398328 shows that they are still present in supplements you can easily buy online. The investigators searched online for weight loss and sports supplements which had natural sounding ingredients on their labels that might be analogs of DMAA.

They selected two weight loss products and four sports supplements, purchased the products, and tested them in their laboratory. All of them contained illegal stimulants. In addition to DMAA, the investigators found DMBA, octodrine, and several other stimulants in the products they tested.

There is no way to whitewash this. These are all illegal stimulants. They could not have ended up in the products by chance. These manufacturers were knowingly adding illegal ingredients to their products. I’m sure they felt adding those ingredients would allow them to make exaggerated claims about how their products could “make your weight disappear without any effort” and “turn Clark Kent into Superman.” They were thinking about all the money they could make. But, they had to know their products might just kill someone.

 

How Can You Protect Yourself From The Dark Side of The Supplement Industry?

How can you protect yourself from unscrupulous supplement manufactures? How can you make sure the supplements you use are safe and effective, that they build your health rather than destroy your health? I have covered this in previous issues of “Health Tips From the Professor”. Here is a brief summary:

  • Choose an established company, with a reputation for integrity.
  • Ignore alluring claims about cures, boundless energy, and the like. Use your common sense. If it sounds too good to be true, it probably is too good to be true.
  • Ignore testimonials. They are often made up. Ignore endorsements. They are bought and sold.
  • Insist on rigorous quality controls
  • Insist on published clinical studies that show their products are safe and effective.

 

The Bottom Line

 

In this week’s issue of “Health Tips From the Professor” I explored the dark side of the supplement industry. For example:

  • A recent bulletin by the Botanical Adulterants Program of the American Botanical Council reported that many cranberry supplements were adulterated with cheaper ingredients with no proven effectiveness.
  • The FDA has recently issued an official advisory about the deadly risks associated with kratom products.
  • A recent study showed that some weight loss and sports supplements contain illegal stimulants that have the potential to kill people.

For more details about these reports and how you can protect yourself from the dark side of the supplement industry, 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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Do Omega-3s Lower Blood Pressure in Young, Healthy Adults?

Posted August 14, 2018 by Dr. Steve Chaney

What Is The Omega-3 Index And Why Is It Important?

Author: Dr. Stephen Chaney

 

Do omega-3s lower blood pressure in healthy adults?

omega-3s lower blood pressure young adultsThe literature on the potential health benefits of omega-3s is very confusing. That’s because a lot of bad studies have been published. Many of them never determined the omega-3 status of their subjects prior to omega-3 supplementation. Others relied on dietary recalls of fish consumption, which can be inaccurate.

Fortunately, a much more accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes. Using modern technology, it can be determined from a single finger prick blood sample. It is a very accurate reflection of omega-3 intake relative to other fats in the diet over the past few months. More importantly, it is a measure of the omega-3 content of your cell membranes, which is a direct measure of your omega-3 nutritional status.

A recent extension of the Framingham Heart Study reported that participants with an Omega-3 Index >6.8% had a 39% lower risk of cardiovascular disease than those with an Omega-3 Index <4.2% (WS Harris et al, Journal of Clinical Lipidology, 12: 718-724, 2018 ). Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk, while 8% or better is considered indicative of low cardiovascular risk. For reference, the average American has an Omega-3 Index in the 4-5% range. In Japan, where fish consumption is much higher and cardiovascular risk much lower, the Omega-3 Index is in the 9-11% range.

Previous studies have suggested that omega-3 fatty acids lower blood pressure to a modest extent. Thus, it is not surprising that more recent studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, those studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Unfortunately, there were no studies looking at that population. The current study was designed to fill that gap.

 

How Was The Study Done?

omega-3s lower blood pressure young healthy adultsThe current study (M.G. Filipovic et al, Journal of Hypertension, 36: 1548-1554, 2018 ) was based on data collected from 2036 healthy adults, aged 25-41, from Liechtenstein. They were participants in the GAPP (Genetic and Phenotypic Determinants of Blood Pressure) study. Participants were excluded from the study if they had been diagnosed with high blood pressure and were taking medication to lower their blood pressure. They were also excluded if they had heart disease, chronic kidney disease, other severe illnesses, obesity, sleep apnea, or daily use of non-steroidal anti-inflammatory medications.

Blood samples were collected at the time of their enrollment in the study and frozen for subsequent determination of Omega-3 Index. Blood pressure was also measured at their time of enrollment in two different ways. The first was a standard blood pressure measurement in a doctor’s office.

For the second measurement they were given a wearable blood pressure monitor that recorded their blood pressure over 24 hours every 15 minutes during the day and every 30 minutes while they were sleeping. This is considered more accurate than a resting blood pressure measurement in a doctor’s office because it records the variation in blood pressure, while you are sleeping, while you are exercising, and while you go about your everyday activities.

 

Do Omega-3s Lower Blood Pressure In Young, Healthy Adults?

omega-3s lower blood pressure young adults equipmentNone of the participants in the study had significantly elevated blood pressure. The mean systolic and diastolic office blood pressures were 120±13 and 78±9 respectively. The average Omega-3 Index in this population was 4.6%, which is similar to the average Omega-3 Index in the United States.

When they compared the group with the highest Omega-3 Index (average = 5.8%) with the group with the lowest Omega-3 Index (average = 4.6%):

  • The office measurement of systolic and diastolic blood pressure was decreased by 3.3% and 2.6% respectively
  • While those numbers appear small, the differences were highly significant.
  • The 24-hour blood pressure measurements showed a similar decrease.
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index. [In studies of this kind, a linear dose-response is considered an internal validation of the differences observed between the group with the highest Omega-3 Index and the group with the lowest Omega-3 Index.]

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

 

What Does This Mean For You?

omega-3s lower blood pressure young adults questionPerhaps I should first comment on the significance of the relatively small decrease in blood pressure observed in this study.

  • These were young adults, all of whom had normal or near normal blood pressure.
  • The difference in Omega-3 Index was rather small (5.8% to 4.6%). None of the participants in the study were at the 8% or above that is considered optimal.
  • Liechtenstein is a small country located between Switzerland and Spain. Fish consumption is low and omega-3 supplement consumption is rare.

Under these conditions, even a small, but statistically significant, decrease in blood pressure is remarkable.

We should think of this study as the start of the investigation of the relationship between omega-3 status and blood pressure. Its weakness is that it only shows an association between high Omega-3 Index and low blood pressure. It does not prove cause and effect.

Its strength is that it is consistent with many other studies showing omega-3 fatty acids lower blood pressure. Furthermore, it suggests that the effect of omega-3s on blood pressure may also be seen in young, healthy adults who have not yet developed high blood pressure.

Finally, the authors suggested that a diet rich in omega-3s might reduce the incidence of high blood pressure by slowing the age-related increase in blood pressure that most Americans experience. This idea is logical, but speculative at present.

However, the GAPP study is designed to provide the answer to that question. It is a long-term study with follow-up examinations scheduled every 3-5 years. It will be interesting to see whether the author’s prediction holds true, and a higher Omega-3 Index is associated with a slower increase in blood pressure as the participants age.

 

Why Is The Omega-3 Index Important?

 

The authors of this study said: “The Omega-3 Index is very robust to short-term intake of omega-3 fatty acids and reliably reflects an individual’s long-term omega-3 status and tissue omega-3 content. Therefore, the Omega-3 Index has the potential to become a cardiovascular risk factor as much as the HbA1c is for people with diabetes…” That is a bit of an overstatement. HbA1c is a measure of disease progression for diabetes because it is a direct measure of blood sugar control.

In contrast, Omega-3 Index is merely a risk factor for cardiovascular disease. However, if it is further validated by future studies, it is likely to be as important for predicting cardiovascular risk as are cholesterol levels and markers of inflammation.

However, to me the most important role of Omega-3 Index is in the design of future clinical studies. If anyone really wants to determine whether omega-3 supplementation reduces cardiovascular risk, high blood pressure, diabetes or any other health outcome they should:

  • Start with a population group with an Omega-3 Index in the deficient (4-5%) range.
  • Supplement with omega-3 fatty acids in a double blind, placebo-controlled manner.
  • Show that supplementation brought participants up to an optimal Omega-3 Index of 8% or greater.
  • Look at health outcomes such as heart attacks, cardiovascular deaths, hypertension, stroke, or depression.
  • Continue the study long enough for the beneficial effects of omega-3 supplementation to be measurable. For cardiovascular outcomes the American Heart Association has stated that at least two years are required to obtain meaningful results.

These are the kind of experiments that will be required to give definitive, reproducible results and resolve the confusion about the health effects of omega-3 fatty acids.

 

The Bottom Line

 

An accurate measure of omega-3 status has been developed and validated in recent years. It’s called the Omega-3 Index. Simply put, the Omega-3 Index is the percentage of EPA and DHA compared to 26 other fatty acids found in cellular membranes.

Although more work needs to be done, an Omega-3 Index of 4% or less is generally considered indicative of high cardiovascular risk while 8% or better is considered indicative of low cardiovascular risk.

Previous studies have shown an inverse correlation between Omega-3 Index and blood pressure. However, these studies have been done with older populations, many of whom had already developed high blood pressure.

From a public health point of view, it is much more interesting to investigate whether it might be possible to prevent high blood pressure in older adults by optimizing omega-3 intake in a young, healthy population, most of whom had not yet developed high blood pressure. Until now, there have been no studies looking at that population.

The study described in this article was designed to fill that gap. The participants in this study were ages 25-41, were healthy, and none of them had elevated blood pressure.

When the group with the highest Omega-3 Index (average = 5.8%) was compared with the group with the lowest Omega-3 Index (average = 4.6%):

  • Both systolic and diastolic blood pressure were decreased
  • Blood pressure measurements decreased linearly with increasing Omega-3 Index.

The authors concluded: “A higher Omega-3 Index is associated with statistically significant, clinically relevant, lower systolic and diastolic blood pressure in normotensive, young and healthy individuals. Diets rich omega-3 fatty acids may be a strategy for primary prevention of hypertension.”

Let me translate that last sentence into plain English for you. The authors were saying that optimizing omega-3 intake in young adults may slow the age-related increase in blood pressure and reduce the risk of them developing high blood pressure as they age. This may begin to answer the question “Do omega-3s lower blood pressure in young, healthy adults?”

Or even more simply put: Aging is inevitable. Becoming unhealthy is not.

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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