PAUL MONIZ: I'm Paul Moniz. Thanks for joining us. There is no question about it. Americans are obsessed with dietary supplements. Companies that manufacture these supplements are constantly hawking their products promising more energy, a leaner body, increased mental alertness and even better sexual performance. The problem is that the FDA does not regulate these products. What the companies generally don't want you to know is that the supplements can be dangerous and at times deadly.
Here to assess the effects and risks are two nutritionists. We have Doug Kalman who is a registered dietitian and a Director of Clinical Research at Peak Wellness, which is a private health center in Greenwich, CT. Thanks Doug for being here.
PAUL MONIZ: We also have Heidi Skolnik, who is the team nutritionist for the New York Mets and the Giants, and also the owner of Nutrition Condition, a private company.
Doug, let's begin with you for an overall look at how consumers should go about assessing the safety of some of these products.
DOUG KALMAN, MS, RD, CDN: As with anything, let's say a medicine, you would like to know as a consumer that the product you wish to take has been tested in a scientific setting for both safety and efficacy. Safety always comes first. Before I want to know if it works, I want to know "Is it going to hurt me." So that's why safety becomes first.
HEIDI SKOLNIK MS, CDN, FACSM: One study there were 100 bottles of ginseng that were sent to labs to be tested. In fact, 50 percent didn't have any ginseng in it.
PAUL MONIZ: That's incredible.
HEIDI SKOLNIK MS, CDN, FACSM: That's remarkable. When you think about that, if you open a bag of pretzels and you look inside and there are peanuts, you know that because you can tell the difference between peanuts and pretzels. But this product, you don't know how to assess whether what's in there is really in there. It could either be omitted so that you don't actually have the active ingredients, or what's happening with some of the athletes that I'm working with, they think they're taking something that is safe, over-the-counter, and not banned by their professional organization, but there have been ingredients added that are actually illegal. Since it's not regulated, it was never found out. If they take it, they are still responsible. They're busted.
PAUL MONIZ: Are the added products or added ingredients usually listed, or sometimes they are just not at all?
HEIDI SKOLNIK MS, CDN, FACSM: That's the point. Nobody is tracking that what's on the label is actually in there. So you could say that it's going to have pretzels in the bag and there really aren't any. Or, you could say there are only pretzels in the bag and you open it up and guess what, there are peanuts in there too.
PAUL MONIZ: That's a big problem. What about the studies that the companies say they do? How reliable are these studies and how can you check to see that they actually are real?
DOUG KALMAN, MS, RD, CDN: What's interesting and great about the Internet? You can go to Medline; and you can go through many different websites to get to Medline to type not necessarily the supplement name, but the name of the active ingredient, such as pyruvate or creatine. You would get a recall of all the of the published clinical studies from medical journals, exercise physiology journals, nutrition journals, and that would give you a key whether some safety and efficacy results for that kind of product.
In order to know whether the specific product that you're taking has been tested, you have to do two things. You have to call the company and ask them if this product has ever been tested. If so, "Can you send me a reprint of the paper." The second thing is also to be a good consumer and use the resources that are available to you, such as ConsumerLab.com and Supplementwatch.com, as well as using the Medline that I mentioned earlier.
PAUL MONIZ: The interaction issue is a serious one because so much is unknown.
DOUG KALMAN, MS, RD, CDN: Right. Especially with new herbal, unregulated products that are new to America or the increase of use is just a preponderance. Again, it's really one that you have to check with physician or pharmacists are also educated about what is called drug/nutrient interactions and drug/drug interactions. Now there is the emerging field of drug/herb interactions.
HEIDI SKOLNIK MS, CDN, FACSM: I was going to say, and I think we mentioned this earlier, what are you taking together? Vitamin E and aspirin and what else might you be taking.
DOUG KALMAN, MS, RD, CDN: Coumadin.
HEIDI SKOLNIK MS, CDN, FACSM: Right. You need to be careful what you're taking in that drug/nutrient interaction. You really want to be sure that you inform all of your healthcare providers of what it is you're taking. Those interactions can work against you and not for you.
The other thing that I would want consumers to understand when they are evaluating these claims is that it's not always about studies. Sometimes studies are applied. They are extrapolated.
For example, a study on boron in postmenopausal women increased testosterone. Then they say, "There have been clinical studies done to show increased testosterone" They are marketing it to a young, athletic male population. Yes the study has been done. They are not lying. But it wasn't for that population.
We can talk about getting on the web and checking it out, but it's very confusing. It's confusing to me as a health practitioner. I really also advice that is you are really considering taking some of these, seek out somebody more knowledgeable than you to evaluate it if you're not going to do all of that work.
PAUL MONIZ: But you hit it right on the head. Even for you , and perhaps Doug for you, and you do this for a living, it can be confusing even for professionals. So the consumers are just left really confused. Oftentimes their doctors want to error on the side of caution, so they advise them against taking it. Really, it seems they need to take what one person says, go to the next source and ask their pharmacist and then ultimately make their own decision.
DOUG KALMAN, MS, RD, CDN: Right. What usually happens is that if you listen to everybody and then you get a consensus, that's probably going to be the right decision for you.
PAUL MONIZ: That's some good advice. I appreciate your time. Doug Kalman, than you for being here, and Heidi Skolnik for your time as well.
I'm Paul Moniz. Thanks for joining us. Remember these products are not regulated by the FDA, but as our guests mentioned if you talk to your doctor and other health professionals, you should be able to come to some reasonable determination about how they should used.
Thanks for joining us.
Here to assess the effects and risks are two nutritionists. We have Doug Kalman who is a registered dietitian and a Director of Clinical Research at Peak Wellness, which is a private health center in Greenwich, CT. Thanks Doug for being here.
PAUL MONIZ: We also have Heidi Skolnik, who is the team nutritionist for the New York Mets and the Giants, and also the owner of Nutrition Condition, a private company.
Doug, let's begin with you for an overall look at how consumers should go about assessing the safety of some of these products.
DOUG KALMAN, MS, RD, CDN: As with anything, let's say a medicine, you would like to know as a consumer that the product you wish to take has been tested in a scientific setting for both safety and efficacy. Safety always comes first. Before I want to know if it works, I want to know "Is it going to hurt me." So that's why safety becomes first.
HEIDI SKOLNIK MS, CDN, FACSM: One study there were 100 bottles of ginseng that were sent to labs to be tested. In fact, 50 percent didn't have any ginseng in it.
PAUL MONIZ: That's incredible.
HEIDI SKOLNIK MS, CDN, FACSM: That's remarkable. When you think about that, if you open a bag of pretzels and you look inside and there are peanuts, you know that because you can tell the difference between peanuts and pretzels. But this product, you don't know how to assess whether what's in there is really in there. It could either be omitted so that you don't actually have the active ingredients, or what's happening with some of the athletes that I'm working with, they think they're taking something that is safe, over-the-counter, and not banned by their professional organization, but there have been ingredients added that are actually illegal. Since it's not regulated, it was never found out. If they take it, they are still responsible. They're busted.
PAUL MONIZ: Are the added products or added ingredients usually listed, or sometimes they are just not at all?
HEIDI SKOLNIK MS, CDN, FACSM: That's the point. Nobody is tracking that what's on the label is actually in there. So you could say that it's going to have pretzels in the bag and there really aren't any. Or, you could say there are only pretzels in the bag and you open it up and guess what, there are peanuts in there too.
PAUL MONIZ: That's a big problem. What about the studies that the companies say they do? How reliable are these studies and how can you check to see that they actually are real?
DOUG KALMAN, MS, RD, CDN: What's interesting and great about the Internet? You can go to Medline; and you can go through many different websites to get to Medline to type not necessarily the supplement name, but the name of the active ingredient, such as pyruvate or creatine. You would get a recall of all the of the published clinical studies from medical journals, exercise physiology journals, nutrition journals, and that would give you a key whether some safety and efficacy results for that kind of product.
In order to know whether the specific product that you're taking has been tested, you have to do two things. You have to call the company and ask them if this product has ever been tested. If so, "Can you send me a reprint of the paper." The second thing is also to be a good consumer and use the resources that are available to you, such as ConsumerLab.com and Supplementwatch.com, as well as using the Medline that I mentioned earlier.
PAUL MONIZ: The interaction issue is a serious one because so much is unknown.
DOUG KALMAN, MS, RD, CDN: Right. Especially with new herbal, unregulated products that are new to America or the increase of use is just a preponderance. Again, it's really one that you have to check with physician or pharmacists are also educated about what is called drug/nutrient interactions and drug/drug interactions. Now there is the emerging field of drug/herb interactions.
HEIDI SKOLNIK MS, CDN, FACSM: I was going to say, and I think we mentioned this earlier, what are you taking together? Vitamin E and aspirin and what else might you be taking.
DOUG KALMAN, MS, RD, CDN: Coumadin.
HEIDI SKOLNIK MS, CDN, FACSM: Right. You need to be careful what you're taking in that drug/nutrient interaction. You really want to be sure that you inform all of your healthcare providers of what it is you're taking. Those interactions can work against you and not for you.
The other thing that I would want consumers to understand when they are evaluating these claims is that it's not always about studies. Sometimes studies are applied. They are extrapolated.
For example, a study on boron in postmenopausal women increased testosterone. Then they say, "There have been clinical studies done to show increased testosterone" They are marketing it to a young, athletic male population. Yes the study has been done. They are not lying. But it wasn't for that population.
We can talk about getting on the web and checking it out, but it's very confusing. It's confusing to me as a health practitioner. I really also advice that is you are really considering taking some of these, seek out somebody more knowledgeable than you to evaluate it if you're not going to do all of that work.
PAUL MONIZ: But you hit it right on the head. Even for you , and perhaps Doug for you, and you do this for a living, it can be confusing even for professionals. So the consumers are just left really confused. Oftentimes their doctors want to error on the side of caution, so they advise them against taking it. Really, it seems they need to take what one person says, go to the next source and ask their pharmacist and then ultimately make their own decision.
DOUG KALMAN, MS, RD, CDN: Right. What usually happens is that if you listen to everybody and then you get a consensus, that's probably going to be the right decision for you.
PAUL MONIZ: That's some good advice. I appreciate your time. Doug Kalman, than you for being here, and Heidi Skolnik for your time as well.
I'm Paul Moniz. Thanks for joining us. Remember these products are not regulated by the FDA, but as our guests mentioned if you talk to your doctor and other health professionals, you should be able to come to some reasonable determination about how they should used.
Thanks for joining us.