By Dr. Ronald Hoffman
The January 19 broadcast of PBS Frontline's "investigative report" on supplements was so dreaded that it sent stock prices of major vitamin retailers like GNC and Vitamin Shoppe plummeting days before it aired.
Accustomed to hard-hitting Frontline exposes of villains like Wall Street manipulators, corrupt politicians, greedy military contractors, industrial polluters, and Middle Eastern terrorist groups, viewers knew what to expect. It wasn't pretty.
Daniel Fabricant did his best. He's the head of the Nutritional Products Association (NPA). We interviewed him this Wednesday for Intelligent Medicine. But clearly, the Frontline producers had their minds made up already. They lacerated him with insinuations that, as a former head of the FDA supplements division, he was a "revolving door" hire. You know, the ex-regulator helping the regulated to evade regulation.
But Fabricant has a reputation as the tough new sheriff in town for the supplement industry. He has sternly admonished manufacturers to clean up their acts, or else invite a government clampdown.
Frontline accused Fabricant of responding too slowly to supplement hazards during his tenure at the FDA, citing several incidents where supplements caused harm. Fabricant called Frontline's TV segment bashing supplements "patently dishonest." Gretchen Dubeau of the Alliance for Natural Health echoed Fabricant's argument that the very fact that the implicated supplements were successfully removed from the marketplace attests to the adequacy of existing regulations.
That's the crux of the anti-supplement agitators' argument in the Frontline hit piece. They've never been happy with compromise legislation enacted in 1994-the Dietary Supplement Health and Education Act (DSHEA)-which allowed supplement manufacturers freedom to continue making products without FDA pre-approval, in exchange for not making medical claims-even if truthful-about supplement benefits.
The Frontline producers want supplements to be regulated like drugs. "Drug makers have to prove their products are safe and effective before they send them to the market," says one pro-regulatory interviewee. "Supplement manufacturers do not." While superficially this might seem to make sense from a public health standpoint, it would kill the wonderful innovation and choice now available to supplement consumers. The supplement industry has thrived under DSHEA despite limitations on truthful free speech about research validating supplements. Consumers who use supplements have been the beneficiaries. Compared to drugs, side effects of supplements are minuscule.
Frontline ominously intoned that supplement advocates like Drs. Oz, Weil, and Mercola were invited to comment, but "declined to be interviewed." I don't blame them one bit! They realized they were walking into an ambush, and prudently avoided it.
Who did Frontline rely upon for expert opinion? For one, Paul Offit, an avowed supplement skeptic, author of the snarky book "Do You Believe in Magic?" which pans everything from acupuncture to homeopathy to vaccine skeptics. When it comes to supplements, Offit has no expertise-he is a vaccine developer, responsible for the Rotavirus vaccine. Yet, he opines that there's no evidence that supplements-beyond the ridiculously low RDA-have any benefit whatsoever. "It's a complete unknown when you buy a dietary supplement," he asserts to Frontline.
Then there's Pieter Cohen, a Harvard Professor who's an arch-foe of supplementation. He has called for every supplement ingredient to be submitted to FDA for testing for safety and efficacy, a process that would throttle supplement innovation. "There's no effective system to detect harmful supplements," he claims.
Former FDA chief David Kessler makes an appearance as well, decrying the political power of vitamin advocates: "The supplement industry unleashes lobbying campaigns that are second to none." Indeed, public outcry in response to calls-to-action over restrictive legislative or regulatory proposals that limit free access to supplements is second only in vociferousness to that of 2nd Amendment zealots. Regulators think the public is just gullible, not capable of making informed judgments about the supplements they take
But perhaps the most disingenuous of all of Frontline's experts is Preston Mason, PhD, who cuts open some fish oil capsules to demonstrate how inferior they are to a pharmaceutical version of Omega 3 called Vascepa. But Mason has skin in the game, as an unabashed promoter of Vascepa. Records show that his fellow Vascepa advocate, Dr. Eliot Brinton, received $366,698.68 from pharmaceutical companies. Mason, as a PhD, is not a medical doctor so he's not legally required to make his compensation public.
Conveniently timed to coincide with the Frontline expose, Amarin Pharmaceuticals, the maker of Vascepa, was ready with a website touting the benefits of its fish oil, in a media campaign that features Dr. Mason and Dr. Brinton highlighting the issue of rancidity in over-the-counter supplements.
But rancidity simply is not an issue in high-quality, premium fish oil supplements made by reputable manufacturers. Molecular distillation and scrupulous quality control implemented by big companies like Nordic Naturals assure customers of safety and efficacy. Vascepa retails for $256.39 for a bottle of 120 on drugs.com; by contrast, an equivalent pill-Nordic Naturals Ultimate Omega-costs just $59.46 for a bottle of 180!
The Frontline special goes on to repeat additional canards, like the contention that the majority of supplements are adulterated, or contain fraudulent ingredients. They invoke a testing methodology called DNA barcoding to support this contention. But this way of testing for supplement potency and genuineness has been thoroughly discredited; purified plant extracts often contain little genetic residue of the herbs from which they are derived. Andrea Wong of the Council for Responsible Nutrition and Mark Blumenthal of the American Botanical Council, acknowledged experts in botanical science and pharmacognosy, debunk the arguments against DNA barcoding in podcasts I recorded with them last year.
Anti-supplement crusading New York Attorney General Eric Schneiderman makes an appearance in the Frontline special decrying "massive fraud" in the supplement industry, but his investigation relies on the selfsame dubious DNA barcoding methodology, results of which have not even yet been made public. He has been accused of grandstanding for votes in the guise of consumer protection; in New York, AG stands for "almost governor".
Frontline even trots out the scurrilous 2013 Annals of Internal Medicine editorial "Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements" which stridently declares "we believe that the case is closed- supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful." For a reasoned critique, listen to this podcast with eminent antioxidant researcher Dr. Balz Frei of the Linus Pauling Institute.
The shame of it is that PBS offers this slanted reporting in lieu of balanced journalism. But perhaps it's not surprising, in view of the fact that PBS derives a considerable proportion of its funding from the Federal government, whose clear-cut agenda is to tighten strictures on supplements. Maybe that's why some critics of PBS' bias have dubbed it GBS-Government Broadcasting System.
Don't get me wrong. Problems do exist in the supplement industry, and we need to do better. Cheap, discount brands abound, often with lesser-quality ingredients, like rancid fish oil. And I have often warned against quick-fix energy, weight loss, male potency, and muscle-building supplements with extravagant claims. Read my take on 14 Supplements You Should Never Take for my latest list of duds.
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