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Health CONSUMER REPORTS INSIGHTS Supplements can be risky We Americans do love our die-


tary supplements. More than half of the adult population has taken them to stay healthy, lose weight, gain an edge in sports or in the bedroom, and avoid using prescription drugs. In 2009, we spent $26.7 billion on them, ac- cording to the Nutrition Busi- ness Journal, a trade publication. What consumers might not re- alize, though, is that supplement manufacturers routinely, and le- gally, sell their products without first having to demonstrate that they are safe and effective. The Food and Drug Administration has not made full use of even the meager authority granted it by the industry-friendly 1994 Die- tary Supplement Health and Education Act. In 2008 and 2009, the FDA said, it received 1,359 reports of serious adverse effects from sup- plement manufacturers and 602 from consumers and health pro- fessionals. But consumers can’t easily find out which products are involved because the FDA doesn’t routinely make those re- ports available to the public. Working with experts from the


Natural Medicines Comprehen- sive Database, an independent research group, Consumer Re- ports recently identified a dozen supplement ingredients that it thinks consumers should avoid because they’ve been linked by clinical research or case reports to serious adverse events. The FDA has warned about the safety of at least eight of them, some as


long ago as 1993. Other factors were also evaluated, including evidence of effectiveness for their purported uses, and the ex- tent to which the ingredients are readily available, either alone or in combination products. Consumer Reports also com- piled a list of 11 supplements that people might want to consider because they have been shown to likely be safe for most people, and because they are possibly or probably effective in appropriate doses for certain conditions.


What you can do Consult your doctor or phar-


macist. Even helpful products can be harmful in some situa- tions, such as when you’re preg- nant or nursing, have a chronic disease or are about to have elec- tive surgery. And some supple- ments might be fine on their own but interact with certain pre- scription drugs. Beware of certain catego-


ries. Supplements for weight loss, sexual enhancement and bodybuilding have been prob- lematic, the FDA said, because some contain steroids and pre- scription drugs. Look for the “USP Verified”


mark. It indicates that the sup- plement manufacturer has vol- untarily asked U.S. Pharmaco- peia, a trusted nonprofit, stan- dards-setting authority, to verify the quality, purity and potency of its raw ingredients or finished products. USP maintains a list of verified products at www.usp


verified.org. Don’t assume more is better.


It’s possible to overdose even on beneficial vitamins and miner- als.


Report problems. Let your


doctor know if you experience any symptoms after you start taking a supplement. And if you end up with a serious side effect, ask your doctor or pharmacist to report it to the FDA, or do it yourself at www.fda.gov/med watch or by calling 800-332- 1088. Research in the right places.


Be skeptical about claims made for supplements in ads, on TV and by sales staff. If a claim sounds too good to be true, it probably is. Instead, try these sources:  The National Institutes of Health’s Office of Dietary Sup- plements, www.ods.od.nih.gov.  The FDA, for alerts, advisories and other actions, www.fda.gov/ food/dietarysupplements.  Consumer Reports Health, www.ConsumerReportsHealth. org, where, for an annual sub- scription fee to the site, you can search for information about di- etary supplements and other natural health products by type, brand or ingredient. You can also view ratings of product effective- ness for various conditions and check interactions between those supplements and certain drugs.


Copyright 2010. Consumers Union of United States Inc.


ALAMY By the numbers


U.S. supplement manufacturers (estimated)


1,500 55


FDA inspections for good manufac- turing practices (estimated)


Supplementsfound to have hidden drugs or steroids since 2008


170+ 33%


Supplements in Natural Medicines Comprehensive Database with scientifi c evidence of effi cacy that are likely safe


12 supplements to avoid


T ese supplement ingredients are among those linked by clinical research or case reports to serious side eff ects. Consumer Reports worked with the Natu- ral Medicines Comprehensive Database, an independent research group, to develop this list. CR thinks it’s wise to avoid all the ingredients on it. Unless otherwise noted, there’s insuffi cient evidence to rate their eff ectiveness for their purported uses. Dangers listed are not meant to be all-inclusive.


NAME (ALSO KNOWN AS)


ACONITE (aconiti tuber, aconitum, radix aconiti)


BITTER ORANGE (aurantii fructus, Citrus aurantium, zhi shi)


CHAPARRAL (creosote bush, Larrea divaricata, larreastat)


COLLOIDAL SILVER (ionic silver, native silver, silver in suspending agent)


COLTSFOOT (coughwort, farfarae folium leaf, foalswort)


COMFREY (blackwort, common comfrey, slippery root)


COUNTRY MALLOW (heartleaf, Sida cordifolia, silky white mallow)


GERMANIUM (Ge, Ge-132, germanium-132)


GREATER CELANDINE (celandine, chelidonii herba, Chelidonium majus)


KAVA (awa, Piper methysticum, kava-kava)


LOBELIA (asthma weed, Lobelia infl ata, pukeweed, vomit wort)


YOHIMBE (yohimbine, Corynanthe yohimbi, Corynanthe johimbi)


PURPORTED USES


Infl ammation, joint pain, wounds, gout


Weight loss, nasal congestion, allergies


Colds, weight loss, infections, infl ammation, cancer, detoxifi cation


Fungal and other infections, Lyme disease, rosacea, psoriasis, food poisoning, chronic fatigue syndrome, HIV/AIDS


Cough, sore throat, laryngitis, bronchitis, asthma


Cough, heavy menstrual periods, chest pain, cancer


Nasal congestion, allgeries, asthma, weight loss, bronchitis


Pain, infections, glaucoma, liver problems, arthritis, osteoporosis, heart disease, HIV/AIDS, cancer


Upset stomach, irritable bowel syndrome, liver disorders, detoxifi cation, cancer


Anxiety (possibly eff ective)


Coughing, bronchitis, asthma, smoking cessation (possibly ineff ective)


Aphrodisiac, chest pain, diabetic complications, depression, erectile dysfunction (possibly eff ective)


RCE: NATURAL MEDICINES COMPREHENSIVE DATABASE, PROFESSIONAL VERSION, JUNE 2010 POSSIBLE DANGERS


Toxicity, nausea, vomiting, low blood pressure, respiratory-system paralysis, heart-rhythm disorders, death


Fainting, heart-rhythm disorders, heart attack, stroke, death


Liver damage, kidney problems


Bluish skin, mucous-membrane discoloration, neurological problems, kidney damage


Liver damage, cancer Liver damage, cancer


Heart attack, heart arrhythmia, stroke, death


Kidney damage, death Liver damage Liver damage


Toxicity; overdose can cause fast heartbeat, very low blood pressure, coma, possibly death.


Usual doses can cause high blood pressure, rapid heart rate; high doses can cause severe low blood pressure, heart problems, death.


COMMENTS


UNSAFE. Aconite is the most common cause of severe herbal poisoning in Hong Kong.


POSSIBLY UNSAFE. Has synephrine, which is similar to ephedrine, banned by the FDA in 2004. Risks might be higher when taken with herbs that contain caff eine.


LIKELY UNSAFE. T e FDA advises people not to take chaparral.


LIKELY UNSAFE. T e FDA advised consumers about the risk of discoloration on Oct. 6, 2009.


LIKELY UNSAFE.


LIKELY UNSAFE. T e FDA advised manufacturers to remove comfrey products from the market in July 2001.


LIKELY UNSAFE. Possible dangers linked with its ephedrine alkaloids banned by the FDA in 2004.


LIKELY UNSAFE. T e FDA warned in 1993 that it was linked to serious adverse events.


POSSIBLY UNSAFE.


POSSIBLY UNSAFE. T e FDA issued a warning to consumers in 2002. Banned in Germany, Canada and Switzerland.


LIKELY UNSAFE. T e FDA warned in 1993 that it was linked to serious adverse eff ects.


POSSIBLY UNSAFE for use without medical supervision because it contains a prescription drug, yohimbine. T e FDA warned in 1993 that reports of serious adverse events were under investigation.


GRAPHIC BY THE WASHINGTON POST BIGSTOCK


“Buy me some peanuts and . . . ” On second thought, maybe you’d be wiser to bring your own food to a sporting event.


Adapted from the Post’s daily health blog.


A sickening stadium-food scorecard Before you order your next ballgame snack, you might want to read this report from ESPN on stadium concessions. Then again, you might not. The cable sports network reviewed health department


inspection reports for the 107 North American stadiums and arenas at which major league sporting events were held in 2009 and found . . . well, a lot of yucky stuff. At 30 percent of those venues, more than half of the vendors had been cited for “critical” or “major” violations of food-handling standards. These included storing or serving foods at improper temperatures, cross-contamination (e.g., using a cutting board to chop chicken, then using it to cut tomatoes without first cleansing it), poor employee hygiene and the presence of insects or rodents. If you’re about to gag, bear in mind that there has not been


In partnership with


For further guidance, go to ConsumerReportsHealth.org. More-detailed information — including CR’s ratings of prescription drugs, treatments, hospitals and healthy-living products — is available to subscribers to that site.


a documented outbreak of widespread food-borne illness associated with a sporting arena or stadium. Yet. But the ESPN report cites individual cases in which people believe they’ve been sickened by stadium food. (Such illnesses can be hard to trace to a source, however, as food-borne illness can take days to set in after the contaminated food is eaten.) In terms of food safety, local sports fans may be better off seeing a Baltimore Ravens game at M&T Bank Stadium, where just 4 percent of vendors had received critical citations, than a Redskins game at FedEx Field, where 36 percent of vendors had received such citations. If you’re seeing a Wizards or Capitals game at Verizon Center, you might want to eat before you go: Fully 100 percent of that venue’s vendors had received critical citations. Responding in his blog, Ted Leonsis, owner of the Wizards, the Capitals and Verizon Center, wrote, “Any issues that were reported back in 2009 we have taken care of already, and now we as a new team are working to make sure we get zero citations ever again.”


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Give your brain a hand AARP MAGAZINE AND AARP BULLETIN, JULY/AUGUST ISSUES


The current issue of AARP magazine explores how folks over 50 can cope with information overload. “May I Have My Atten- tion, Please?” asserts that normal brain changes that accompa- ny aging — such as small blockages to the brain’s blood supply and a decline in working memory — make it harder for the AARP demographic to tune out distractions. A sidebar to that article, “Tame Your Info Appetite,” offers six tips that might be helpful to anybody who has caught himself or herself with 25 Internet browser tabs open at the same time. These hints in- clude making a to-do list rather than jumping right into tasks, avoiding open-ended surfing online or on TV, and “exercising your concentration muscles” with books or meditation. “Iranian Cure for the Delta’s Blues,” in AARP’s newsier publi-


cation, AARP Bulletin, prompts readers to wonder if an Irani- an model of health-care delivery could work in Baptist Town, Miss. Two doctors there, one Iranian and one American, are hoping that it could, though their unusual partnership is still in the early stages. A 77-year-old Mississippi pediatrician, Aar- on Shirley, and Jackson State University’s Mohammad Shah- bazi are planning to deliver primary care in a setting that’s sim- ilar to an Iranian “health house.” (In rural parts of Iran, health houses provide basic services such as vaccinations and prena- tal care; the staff refers patients with more-complicated health conditions to a regional health center.) Mississippi has some of the country’s highest rates of obesity, diabetes, hypertension and infant mortality.


—Rachel Saslow QUICK STUDY INACTIVITY


Too much sitting may hasten death THE QUESTION People who are physically active tend to live longer. Might being inactive, specifically spending a lot of time simply sitting, have the opposite effect? THIS STUDY analyzed data on 123,216 adults, who averaged in their early 60s and were disease-free at the start of the study. In a 14-year span, 19,230 of them died. The more of their leisure time they spent sitting — doing such things as watching television, reading and driving — the more likely people were to have died, especially from cardiovascular dis- ease, even if they also exercised. Women who sat six or more hours a day were 37 percent more likely to have died than were women who spent fewer than three hours a day sitting. Men’s risk was 18 percent higher. Women who sat the longest and exercised the least increased their chances of dying by 94 percent compared with those who sat the least and were the most active. Risk was 48 percent higher for men. WHO MAY BE AFFECTED? People who are inactive. Research has shown that inactivity is a prime contributor to excessive weight gain, which can lead to cardiovascular disease and diabetes and increase the risk for premature death. CAVEATS Information on the participants’ activity levels was based on their answers to questionnaires. Data and analysis did not include whether people sat or were physically active at work, although most people in the study were retired. The study showed an association but not an absolute cause-and- effect between sitting and death. FIND THIS STUDY July 22 online issue of the American Jour- nal of Epidemiology. LEARN MORE ABOUT the health benefits of physical activity at www.cdc.gov (click “P” in A-Z Index) and www.mayoclinic. com (search for “7 benefits”).


—Linda Searing


The research described in Quick Study comes from credible, peer-reviewed journals. Nonetheless, conclusive evidence about a treatment’s effectiveness is rarely found in a single study. Anyone considering changing or beginning treatment of any kind should consult with a physician.


The Checkup 6voices.washingtonpost.com/checkup


KLMNO


V1 V2 V3 V4


TUESDAY, AUGUST 3, 2010


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