Guest Post: “Perception is Power: How the Supplement Industry Bought Deregulation” by Tien Nguyen
Today’s guest post is from Tien Nguyen, an organic chemistry grad student at the University of North Carolina, Chapel Hill. Tien is passionate about science outreach through the printed word, social media, and multimedia. On Twitter @mustlovescience and at her blog Must Love Science, she posts about timely chemistry topics and showcases the educational videos about chemistry that she helps create, including “The Fresh Bread of Bel-Air”. She is also a regular contributor to the RSC Catalysis Science & Technology Blog. Here she discusses a chapter of a new book that’s galvanized her views on science communication. Take it away, Tien!
In 2008, more than 200 people were poisoned by massive doses of selenium in liquid multivitamin supplements, Total Body Formula and Total Body Mega Formula. One of the victims was a telephone repairman named John Adams. As reported by the Chicago Tribune, Adams experienced severe loss of hair, fingernails and toenails and fatigue. He eventually became too exhausted to work and was forced to retire.
Other symptoms of selenium poisoning include diarrhea, joint pain, cramps and blistering skin. The FDA found that on average each Total Body serving contained 40,800 micrograms instead of 200 micrograms as planned. Nearly 50,000 supplement related adverse health effects are reported each year. Most supplements, like the Total Body Formula multivitamins, have not undergone any safety testing nor were they required to by law.
That’s because almost 20 years ago, Congress passed the Dietary Supplement Health and Education Act (DSHEA) of 1994, establishing that dietary supplements—vitamins, minerals, herbs, amino acids, enzymes, organ tissues, glandulars (materials from animal organs, glands or tissues) and metabolites—do not have to submit to FDA safety testing before being available to the public.
Referring to the Act’s passage, author Dan Hurley wrote, “So began an unprecedented experiment to test whether the unbridled use of vitamins and other supplements would help or hinder health, with the American public as the guinea pig.”
As long as a supplement is labelled as such and includes a disclaimer stating the lack of approval from the FDA, the bottle is cleared for supermarket shelves. If, after wide circulation, the supplement causes adverse health effects, like organ failure or death, the FDA can step in and pull it off the market.
Say what? Oh, you didn’t know supplements were totally exempt from pre-market safety regulations? Neither did 68 percent of Americans, according to a 2002 Harris poll.
Nor did I, until earlier this year when I reviewed Paul Offit’s new book, “Do you Believe in Magic: The Sense and Nonsense of Alternative Medicine.” He dedicates a chapter to the DSHEA, setting the stage with a quote from prominent philosopher Isaiah Berlin: “Liberty for the wolves is death for the lambs.” He illustrates how a carefully crafted marketing scheme, rooted in manipulation and backed by millions of dollars, could effectively harness public opinion. This kind of branding would make even Mad Men’s advertising king Don Draper wish he had thought of it.
Launched by vitamin industry executives, Offit explains how the campaign took a multi-pronged approach. First, Congress was inundated with letters. Vitamin industry interests sent in pre-printed letters and offered consumers discounts at thousands of health food stores in exchange for writing letters backing the Act. The letters had a unifying message, which was people wanted freedom to choose when it came to their supplements. The messaging was designed to stoke individualistic pride and incite distrust of government regulation.
The book recounts how supplement makers argued that deregulation would give the public access to the widest range of supplements, allowing the American people to decide for ourselves and our families if a supplement was worthy. But, as Offit points out, the Act ensures that supplement makers would not have to provide any safety or efficacy data for us to base that decision on.
According to Offit’s book, the vitamin industry also perpetuated the false dogma that their products are natural, and by default safe, while drugs are man-made and unsafe. This is a fallacy because many drugs are derived from natural sources and either way, any product’s safety can only be determined through testing.
The campaign’s most powerful line, “you have a right to your supplements and the FDA is trying to take one of your basic rights away,” was parroted by highly recognizable celebrities like Mel Gibson and Sissy Spacek in television commercials, gaining widespread traction with the public. Offit describes how opponents of the Act, like Congressman Henry Waxman of California, were dealt with head-on, with hecklers paid to shout over him at public speaking events.
Supporters of the Act believed the FDA was uninterested in safety and just wanted to clear a path for the pharmaceutical industry to profit. Offit suggests that it was actually the vitamin industry that put aside public safety and had the most to gain financially from the legislation. Having successfully rebuffed regulation, the supplement industry pulled in $28 billion in 2007, up from $4 billion in 1994, a tidy return on investment. Since then, about 51,000 new supplements have flooded the market. Only about 170 of those have any documented safety tests.
After reading Offit’s book and many articles supporting his points, I believe the campaign to enact the DSHEA is a stark example of using misinformation to mold public opinion and ultimately influence legislation. Supplement makers realized this goal by investing serious amounts time, money and effort. The scientific community needs to counter these movements with investments of our own.
From translating studies that evaluate the safety and efficacy of certain supplements to clarifying legislative acts like this one, we have to make this information accessible to as many people as possible. Improving science literacy and public opinions of science can feel like an uphill battle, but with human lives at stake, it is one worth fighting.
Editor's Note: If you'd like to read a full review of "Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine", please see the review from C&EN's Nader Heidari in our Sept. 2 issue.