Herbal Supplements Face New Scrutiny

[Guest guest]

Elderberry extract and acai to boost the immune system. Black cohosh to

lessen the discomforts of menopause. Soy capsules to prevent bone loss and

prostate cancer.

Many botanical supplements—made from the seeds, bark, leaves, flowers and

stems of a wide range of plants—have been widely used as folk remedies for

centuries. Americans have been consuming growing quantities of the

supplements in hopes of warding off disease and easing symptoms of various

conditions. But there is scant scientific evidence to support their health

benefits.

Now, the federal government is stepping up research into the safety and

effectiveness of a wide range of over-the-counter supplements, including

plant oils, garlic, soy, elderberry, licorice, black cohosh, St. 's wort

and the Asian herb dong quai. The aim is to better understand how compounds

in the plants affect health and to help consumers make more informed choices

about supplements, which can interact with prescription drugs, cause side

effects or lead to new health risks. Sales of botanical supplements in the

U.S. topped $5 billion last year, up 17% from five years earlier, according

to the non-profit American Botanical Council.

" Sometimes people assume because a product is natural, it is also safer. But

these compounds can have both benefits and potential side effects and we

need to understand both of those, " says Floyd Chilton III, director of the

Center for Botanical Lipids and Inflammatory Disease Prevention at Wake

Forest University Baptist Medical Center in Winston-Salem, N.C. Dr.

Chilton's center received a $7.5 million federal grant to study botanicals,

including whether plant oils such as echium and borage can help play a role

in preventing cardiovascular disease, asthma and diabetes.

" People are using supplements for purposes for which they were not

intended, " such as treating health conditions they have self-diagnosed, or

using multiple supplements in combination with prescription medications,

says Marguerite Klein, director of the Botanical Centers Research program at

the National Institutes of Health. One concern, she says is the heavy use by

women of black cohosh to treat menopause symptoms, such as hot flashes.

Limited research seems to support the black cohosh's benefit. But it isn't

known how the botanical works. Black cohosh has been linked in some patients

to liver damage, and breast-cancer patients are often advised to avoid using

it because its effects on breast tissue are unknown.

Helping to spur the research initiative are the Office of Dietary

Supplements and the National Center for Complementary and Alternative

Medicine, both part of the National Institutes of Health. The agencies last

month awarded grants totaling about $37 million to five dietary supplement

research centers, expanding a program that has already awarded more than

$250 million in research grants for herbs and botanicals since 2002. The NIH

is also funding research into botanical products through the National Cancer

Institute, which is interested in how components in botanicals might

influence cancer risk and tumor growth.

Studies funded by the federal grants have so far shown that chamomile

capsules may help reduce anxiety compared to a placebo and that an extract

from the milk thistle plant can interfere with the life cycle of the

hepatitis C virus. They also have refuted some purported benefits of

botanicals, showing, for instance, that ginkgo biloba does not prevent heart

attack, stroke, or cancer, or stem memory loss and that St. 's wort was

no better than a placebo in treating symptoms of attention deficit

hyperactivity disorder in children and teens.

Unlike drugs, which must be tested in clinical trials and approved by the

Food and Drug Administration before they can be marketed, botanicals and

other supplements don't require regulatory approval. The FDA in June began

requiring all supplement makers to follow strict quality manufacturing

standards, but the agency only periodically inspects plants.

An investigation published in May by the General Accounting Office found

deceptive marketing practices at a number of online retailers, including

claims that supplements could prevent or cure conditions such as diabetes,

cancer, or cardiovascular disease. The investigation also found trace

amounts of potentially hazardous contaminants, such as lead or bacteria, in

37 of 40 herbal dietary supplement products it tested.

Tod man, president of ConsumerLab.com, which tests supplement brands

for quality, says the group finds problems with about 25% of all

supplements, and especially with herbal products, many with ingredients from

overseas. A recent review of supplements made from ginseng—commonly taken to

boost energy and vitality—found that 45% failed quality tests because they

didn't contain the advertised amount of ginseng or were contaminated with

lead. Test results and other information are available to members, who pay

$30 annually.

Consumers also can find information about potential uses, benefits and risks

of dietary supplements at federal websites ods.gov and nccam.gov. Another

government site, Medlineplus.gov, grades scientific evidence on a variety of

supplements.

Cefalu, director of the Pennington Biomedical Research Center at

Louisiana State University in Baton Rouge, says researchers are only

beginning to understand how thousands of different compounds in a single

plant may interact, and how the concentration of a particular plant chemical

affects its potency. For example, peppermint tea is considered safe to

drink, but peppermint oil, often taken for irritable bowel syndrome or

indigestion, is much more concentrated and can be toxic if used in high

doses.

Because the potency of wild plants can vary, some researchers are

cultivating their own. At the Center for Botanical Interaction Studies at

the University of Missouri in Columbia, 600 types of soybean seeds are being

cultivated to study different concentrations of the same compounds in the

plants and how they might work to prevent prostate cancer. The center is

also growing 60 types of elderberries to study the plant's possible role in

boosting the immune system against infection and fighting cancer and

inflammation in the body. Center director Dennis Lubahn says there may be

variations in individual plants that will make a difference in how well they

fight disease. " We've come a long way from the traditional medicine woman

sampling leaves in the forest, " he says.

http://online.wsj.com/article/SB10001424052748704190704575489812916405630.html

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Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

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