Mainstream media attempts to gain ratings with a hot topic that is mysteriously short on facts.
When CBS anchor Katie Couric conveniently introduced a two-part story on dietary supplements to her January 16 audience with, "Nutritional supplements. So many Americans use them, so why aren't they regulated the way drugs are? You may not like the answer," I should have known better.
I mean these days it seems that the only news stories regarding the dietary supplement industry are sold to the public with fear, and intrigue. This is tragic because health and well being should be important to every person on the planet, and nothing ruins your health faster than lack of hope.
CBS Evening News
The Crux Of The Story
To create this two-part story, Couric relied on the journalistic ability of correspondent Sharyn Alfonsi, author of Natural Causes, Dan Hurley, Steve Mister, President of the Council of Responsible Nutrition and David Seckman of the Natural Products Association. While I am sure Ms. Alfonsi, intended to present both sides respectfully, I believe that the main issue itself was marred with oversight.
While there are several errors in the two-part story, the most glaring is the notion promoted by the shows producers that dietary supplements are unregulated, unproven and unsafe. This is simply untrue, and more suspicious because Ms. Alfonsi appeared to make these issues the central theme of her "investigation".
Ms. Alfonsi stirred up the controversy over footage of actor Mel Gibson from a 1993 ad by stating that, "In 1993, the FDA was on the verge of enforcing a truth-in-labeling regulation for dietary supplements. The industry struck back with commercials like this."
Excuse me, but for those who missed it, the Mel Gibson ad campaign was the first high profile piece that alerted consumers that their right to choose dietary supplements was at risk. Basically, the ad made it clear that if you do not want vitamins, minerals and herbs regulated, then write your congressman.
| Did You Miss It??
The National Health Alliance campaign against the FDA combined Hollywood razzle-dazzle with grassroots anger. One TV advertisement depicted mock FDA agents dressed in riot gear, who raided Mel Gibson's house and confiscated his vitamins. Gibson joined celebrities such as Whoopi Goldberg, Randy Travis, Sissy Spacek, Laura Dern, Mariel Hemingway and Victoria Principal in making public service announcements claiming that the FDA was trying to block consumer access to vitamins.
So are we to believe the dietary supplement industry should not market the benefits offered by the products they sell? Doesn't the same network advertising review process look at drug company ads before they are allowed to run? Of course they do, or at least they should.
Industry Regulation Misunderstood
The result of the dietary supplement 1993 initiative to keep their products available to the public was Congress passing the 1994 Dietary Supplement Health and Education Act (DSHEA).
Evidently, this congressional action was not good enough for Dan Hurley. This seems dubious on two accounts; 1) Hurley argues that most supplements don't work, are not scientifically supported and he says that some can even be harmful and yet 2) Hurley believes congress caved because of the massive written public response, reportedly more than those who were against the Vietnam War. So according to Hurley, a lot of Americans passionately want the right to use dietary supplements, yet they don't get any benefits. Puzzling?
Appearing on camera with Alfonsi in a pharmacy, Hurley insisted that the bill "protects the manufacturers" at the cost of consumers. As a reference; the Dietary Supplement Health and Education Act (DSHEA) set up a regulatory structure for dietary supplements, giving them a different space for regulation by the Food and Drug Administration (FDA).
They are neither foods nor drugs, but a unique area - partially because the FDA has not promulgated specific regulatory guidance. Under the definition of DSHEA, dietary supplements can even be in conventional food form. This has helped increase growth in the market for functional foods.
DSHEA does not, however, allow manufacturers or advertisers to make "false promises" or "bogus claims" about the products they sell. It is simply inconceivable how Alfonsi and CBS could have missed this key piece to the entire argument against supplements.
Congressional Findings On Dietary Supplements
To add insult to injury, not only did CBS fail to mention the details of the FDA's role within the guidelines of DSHEA, they actually produced the type of negative programming that Congress regarded as detrimental when the Act was passed.
Simple fact checking reveals that when Congress passed DSHEA in 1994, lawmakers emphasized the importance of communicating the positive health benefits of supplements to the American public.In Addition Congress Highlighted:
- The importance of nutrition and the benefits of dietary supplements in health promotion and disease prevention, as documented increasingly in scientific studies.
- The link between ingestion of certain nutrients or dietary supplements and the prevention of chronic diseases such as cancer, heart disease, and osteoporosis.
- Education, good nutrition, and the appropriate use of safe nutritional supplements as preventive health measures that limit the incidence of chronic diseases and reduce long-term health care expenditures.
- The importance of informing and empowering consumer choice by disseminating data from scientific studies that demonstrate the health benefits related to particular dietary supplements.
- The growing need to disseminate information linking nutrition and long-term good health.
- DSHEA protects consumers' right of access to safe dietary supplements as necessary in order to promote wellness.
- Dietary supplements are safe within a broad range of intake protocols, and safety problems with supplements are relatively rare.
- The federal government's powers to take swift action against products that are unsafe or adulterated balanced by the understanding it should not impose unreasonable regulatory barriers limiting or slowing the flow of safe products and accurate information to consumers.
- DSHEA provides a rational framework to supersede the ad hoc, patchwork regulatory policy on dietary supplements.
Taking Issue With Hurley
On January 16, the Council for Responsible Nutrition, (CRN), a dietary supplement industry trade group, released a statement attacking Hurley's book, "Natural Causes" as based on hyped personal anecdotes in lieu of empirical data.
The book, "Cannot be considered a credible, scientific work," president Steve Mister was quoted in a CRN press statement. "This is an assortment of extreme anecdotes that exploit rare and tragic misfortunes in an agenda-driven attempt to sell books."
Mister, continues in his press release with, "The book includes more than 200 footnotes, but a cursory examination shows the author repeatedly footnotes his own inquiries, other people's opinions and people who spoke anonymously". This further illuminates the spurious claims made by Hurley who wants more scientific proof validating supplements, yet he offers little if any real science.
Supplements Are Not Scientifically Proven
Even in the controversial area of weight loss supplements, the statistically significant, research studies to support chromium, Conjugated Linoleic Acid (CLA), green tea and Coleus forskohlii to name a few refute the claim that supplements are unproven.
Why CBS chose not to look deeper into this matter is poor journalism at best. Interestingly, this same week on January 21, a well-documented show hosted by Bryant Gumbel, called The National Health Test, made a strong case for the use of dietary supplements. In fact, if you go to http://www.nationalhealthtest.com/nationalhealthtest.html and take the test (which I urge you to do) you will see that their experts give the highest marks for adhering to a comprehensive daily nutritional supplement program.
This show was arguably one sided, but it gave the audience a plan to achieve better health, something that cannot be said for the CBS story. I'd also argue that the panel of experts on the national health test program further demonstrates how CBS intentionally failed to validate their story.
The National Health Test Boasts Experts Such As:
- Vice Admiral Richard H. Carmona, United States Surgeon General
- Margaret Chesney, PhD. Deputy Director, National Center for Complementary and Alternative Medicine
- Mark Filidei, D.O., Medical Director, Whitaker Wellness Institute
- Jonathan E. Fielding, M.D., MPH, Director, Los Angeles Department of Health
- Andrea Giancoli, MP, RD, National Spokesperson, American Dietetic Association
- Ronald Hoffman, M.D. Hoffman Center, New York, NY
- Melissa Johnson, Executive Director, The Presidents Council on Fitness
- Victor Perez, MD, UCLA Center for Healthier Children and Families
- Prediman K. Shah, M.D., Director of Cardiology at Cedars-Sinai and National Spokesperson, American Heart Association
Supplements Are Unsafe
Remarkably, even the subject of adverse event reporting was misconstrued. In the CBS story Alfonsi quotes Hurley that since 1983, 1.5 million cases of adverse events have been reported to the FDA.
What they fail to mention is that anyone can self report to the FDA what they feel may be the cause of a health problem. This is known as an adverse event report (AER). These reports come primarily from consumers, not physicians. Consequently, the self reported AER's are never validated, for accuracy.It is not as if 1.5 million people went to emergency room with their bottle of supplements and said, "Hey, I think this made me sick." So, if someone did not know what "adverse event" really means, as is likely the case with the CBS story, they would be hard pressed not to be alarmed.
Now, I can't say why for sure, but for some reason the FDA's site does not allow visitors to download the actual list of AER's for supplements, something I personally did back in 2001. My hunch is that since many of these reports were suspect, and at times almost silly-like, "It gave me a tummy ache", I suppose they removed the link.
However, I thought I better check my facts again regarding the FDA's position on analyzing AER's, this time all I could find was a statement for drugs. Here it is:
There are some important things to keep in mind when reviewing or analyzing AERS data:
For any given report, there is no certainty that a suspected drug caused the reaction. This is because physicians are encouraged to report suspected reactions; however, the event may have been related to the underlying disease being treated, or caused by some other drug being taken concurrently, or simply occurred by chance at that time.
Accumulated reports cannot be used to calculate incidence (occurrence rates) or to estimate drug risk. Comparisons between drugs cannot be made from these data."
For the record this is why self-reporting is an even weaker instrument for analyzing problems with dietary supplements.
CBS Fact Checking Feeble At Best Or Worse Slanted
However, not only did Alfonsi give little air time to Mister's complaints, she parroted a horror story from Hurley's book that critics say more regulation would do little if anything to prevent her injury. In her January 15 "Evening News" story, Alfonsi told viewers about Sue Gilliatt, a woman whose "nose was burned off" by "an herbal paste called bloodroot to treat a pink area on her nose she thought might be cancer."
Once again, by doing a bit of legwork to check facts, Alfonsi would have been able discern that this tragic story did not fit the story criteria. That is, the guidelines of DSHEA do not apply to cosmetics or topical products, as these items are the jurisdiction of the FDA, and not considered dietary supplements. Further, the FDA issued a warning letter on April 6, 2006 making marketing bloodroot as a cancer cure illegal in the United States.
An expert in food and drug law agreed, critiquing Hurley in his Amazon.com book review posted on January 16:"The real problem is that any topical product such as the one described in this section of Mr. Hurley's book is not a dietary supplement, and cannot be legally sold as one in the United States. By law such products are drugs.
If either Mr. Hurley or his editors had bothered to look at the Federal Food Drug and Cosmetic Act, they could have avoided this fundamental mistake," wrote Marc S. Ullman, a New York attorney who represents clients "in the dietary supplement/natural products industry."
Comparing The Risks Of Dietary Supplements Versus Drugs
In light of the deliberate "consumer beware" promotional pieces leading up to the story, is it just a coincidence that CBS chose not compare the risks of dietary supplements versus that of prescription drugs or calculated. You can judge that for yourself, but here are some numbers you can use for your own comparison. Of course, you can argue the numbers, but they come from the same governing body that regulates prescription drugs in this country, the FDA.
For those who watched the CBS story it might be revealing to know that in 2001, the FDA received 1,214 reports of adverse events regarding dietary supplements. That same year, it received more than 300,000 adverse reports about drugs. No mention of this in either segment, but in essence supplements represent less than half-of-one percent of drug adverse events using current FDA data.
For The Real Skeptics, here Are Some More Sobering Facts:
- Prescription drugs, even with all the testing they go through and profuse usage directions/contraindications that are issued with them, are estimated to be one of the top five leading causes of death in the U.S. at more than 106,000 annually (Journal of the American Medical Association).
- According to reports from poison control centers throughout the United States, adverse reactions to drugs are more than 800 percent higher than those to dietary supplements (American Association of Poison Control Centers).
| What Does Contraindication Mean?
Used with drugs, chemicals, and biological or physical agents in any disease or physical state that might render their use improper, undesirable, or inadvisable.
For those interested the above information and more can be found by searching safety at: http://www.naturalproductsassoc.org.
In my mind, the best journalists wind up voicing their opinion. At least that's what I do. Isn't that why we eventually tune into what someone has to say? So the idea of "balanced and fair" is usually a ploy to actually create an unfair argument.
Another problem is that when the press gives its audience two opposing perspectives, the subject matter can become more, not less confusing. Sure it is the responsibility of consumers to sort through the information and make up their own mind. This assumes that the information is good enough to make an informed decision; otherwise one is left not really knowing what to believe.
For this reason I'd like to see more journalists take the initiative to step in and sort things out - even if that means suggesting that one side or the other has it wrong. If a journalist wants to open up an argument, they need to be able to put on those that are capable of defending their point of view.
In my opinion, the National Health Test program took the risk of presenting a very convincing story for taking better care of you. Taking the initiative to help improve the health of our nation-at the expense of ratings, or bias, is a lesson for all media to learn. In the end, the CBS supplement segments fall apart by trying to appear balanced, when it is easy to see they didn't play fair.