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Guest Editorial: Supplements and Cancer Risk

Posted By Daniel Breeman, Editor-in-Chief, Natural Practitioner Magazine, Monday, June 15, 2015
Updated: Wednesday, June 3, 2015
Do you recommend supplements to your patients? If so, the news that taking too many supplements actually increases the risk of cancer likely stopped you in your tracks and possibly even made you reconsider the health benefits of supplements vs. the risk factors for your patients and what this could mean for your practice long term.

For years, supplements have been touted for their health benefits, including those thought to have anti-cancer properties, such as curcurmin and boswellic acids, which are well-established dietary botanicals with potent anti-cancer properties. In fact, a new study actually suggests that there is a synergistic benefit to taking both together, as stated by Ajay Goel, PhD, director of epigenetics, cancer prevention, and cancer genomics, Baylor Research Institute, Baylor University Medical Center in Dallas, TX, who authored a related study.

But on the other side of the argument sits Dr. Tim Byers, director for cancer prevention and control at the University of Colorado Cancer Center, who, last month, conducted a meta-analysis of two decades worth of research, including 12 trials that involved more than 300,000 people, and found a number of the supplements tested actually made individuals more likely to develop certain types of cancer.

Dr. Byers' findings suggest that while eating certain fruits and vegetables can reduce an individual's risk for cancer, taking supplements that provide the same vitamins and minerals as those fruits and vegetables not only failed to provide similar protection, but actually increased a person's cancer risk.

This, of course, is not the first time this has been suggested. Past studies have pointed to an increased cancer risk for patients who took high doses of dietary supplements. In a 2011 study, for example, researchers found that taking high-dose vitamin E supplements was linked to a 17 percent increase in cancer risk over a sever to 12-year period. Other similar studies have linked women's increased risk of breast cancer to high intake of folic acid supplements.

But not so fast. Did the meta-analysis method used by Dr. Byers do justice to the evidence at hand? Not according to Natural Products Association (NPA) Senior Vice President of Scientific and Regulatory Affairs Corey Hilmas, MD, PhD, and former Chief of the Dietary Supplement Regulation Implementation Branch within the Division of Dietary Supplement Programs at the Food and Drug Administration (FDA), who questioned the research that linked supplement intake with an increased risk of cancer.

In his argument, Dr. Hilmas points out that dietary supplements are designed to "supplement the diet because consumers do not eat enough of the critical phytochemicals and constituents found in fresh fruits, vegetables and other foods, including fish, on a daily basis. Dietary supplements should be taken as part of a healthy lifestyle and after consulting with one's health care provider."

So perhaps this is where Dr. Byers and his meta-analysis goes awry. Should the study compare the health benefits of eating fruits and vegetables to gain the needed nutrients to taking comparable dietary supplements or should it look at both with the need for a healthy lifestyle a must?

There are some other questions surrounding Dr. Byers' methods, according to Dr. Hilmas, like why the 12 "cherry-picked" trials for the meta-analysis failed to include other studies that may have evaluated negative outcomes in a long-term prospective study.

NPA says it welcomes the opportunity to review the finalized manuscript once it is published, and reminds consumers that they "should remain confident that their dietary supplements are safe and effective and can contribute to one's overall health and wellness." This, of course, should also hold true for both your practice and your patients.


Tags:  Corey Hilmas  dietary supplements  Dr Time Byers  MD  nutrition 

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Nutritional Supplements

Posted By Carol L Hunter, PhD, PMHCNS, CNP, Friday, June 5, 2015
Updated: Wednesday, June 3, 2015

Recently, I subscribed to consumerlabs.com, an independent testing lab for nutritional supplements and natural products. There is a subscription fee but the information on laboratory testing results is very interesting. In addition, consumers can write in with their personal questions and get them answered. One recent query was in regard to the side effect of nausea from various multi vitamin/mineral supplements. I could easily relate and remembered years ago being hit with a bout of severe nausea while in the middle of a therapy session. I felt like I would fall off my chair, but as horrible as it was, it rapidly passed and I was able to continue. My resolution after that experience was to find a new supplement. Today the problem isn’t as difficult to remedy because the new food based multis are tolerated much better and can be taken with or without food. We’ll look at the ingredients in some of these multiple vitamin/mineral preparations shortly. But first should we even be bothered with them at all?

For decades physicians and registered dieticians proclaimed that nutritional products were a waste of money, producing “expensive urine.” The message was always “you can get everything you need in your food.” Oh, but how I laughed when many health food store owners told me that physicians were buying their own supplements by the boatload. Even though they were personally convinced of the benefit, they were not ready to publicly say so. Let’s consider the logic here. First of all, as a scientist, I know that nothing is a 100% iron clad truth; there are simply too many variables in life. And even when those variables are controlled in research study designs, there are always more that remain; hence, the “limitations of the study.” Therefore, as a consumer, waiting for the final “evidence based” word on a topic of interest may be unwise, especially since in a decade, evidence will have changed. I’ve been around long enough to see the trending of health issues, from pediatric to dietary and exercise advice. I started taking nutritional supplements decades before any awareness had surfaced among the public. Many years ago I was given a book written by Robert Rodale on vitamin E and pregnancy that became my compelling introduction to nutritional supplementation.  Shortly afterwards, it was vitamin C and the work of Linus Pauling. When I was in nursing school, I secretly read Prevention Magazine and knew better than to talk about it. I would have been laughed out of class! Back in the 1970s Prevention presented useful information in a professional manner. The Prevention Magazine of today, which seems to harp on blasting belly fat, is unrecognizable as a distant cousin of that early publication. Evidence was slowly building by such pioneers as Ewan Cameron, Irwin Stone and Carl Pfeiffer, to name just of a few of my early heroes. One must think of supplements as a form of health insurance and why not err on the side of prevention? It just makes common sense as few of us have perfect dietary habits.

It is difficult for professionals to sort out the value of the various studies on the subject of supplementation, let alone the public consumer. It’s confusing enough just wondering through a health food store and pondering the many products and brands. And certain compounds like co enzyme Q-10 is pricey. Fortunately, most of the ACAM members have an affiliation with Emerson Ecologics, a clearing house for high quality nutritional products. Professionals receive a discount on products and the savings can now be passed on to the consumer by way of a virtual pharmacy online. This is fairly new so not all the providers have set up their programs yet, myself included. You can find an ACAM provider near you by going into the directory and entering your location. Even if there is no provider in your own town, you can still contact one by phone or online to arrange for a consultation and advice on the best choices for your particular health issues. You can be directed to the provider’s online virtual pharmacy to order your products along with a discount which varies from provider to provider.

Multi vitamin/mineral products are a good place to begin if you’ve never taken supplements before. Let’s look at a couple brands I just happen to have in my cupboard at the moment, good examples of “whole food” based products. Alive and New Chapter are two brands that are well tolerated. I also like Vitamin Code by Garden of Life for the 50 and wiser women. They are capsules and the serving size is 4 caps per day, easy enough to handle. It is best to spread dosing throughout the day to replenish nutrient supplies. We are constantly metabolizing, absorbing, utilizing and excreting the compounds so more frequent replacement is more desirable. One a day multis are plentiful but I personally do not recommend them for the above reasoning. However, if convenience is an important issue, a one a day is better than nothing.  Another brand I like is Bluebonnet’s super earth multi nutrient, which comes in tablets with a daily dose of three per day. Some of the categories you can expect to see in whole food based supplements are the following:  vitamins, minerals, phytonutrient sprouts, super fruit antioxidants, plant source minerals, plant source enzymes and herbs. Most also include probiotics.  I have only mentioned a handful and there are many other high quality brands from which to choose. They even have a brand of “minis” for seniors that are easy to swallow. After starting on a multi, then you can more closely examine specific nutrients to target your own personal health issues and add them in, preferably one at a time just in case there is a problem.

Nutritional supplements have subtle effects upon the body, comparing them to prescription drugs like antibiotics and allergy medications, so don’t be alarmed. I have had many patients tell me they stopped “because I couldn’t tell any difference.” Most did not give the supplements a fair trial and stopped prematurely. When you have taken them long enough you can detect a difference between days they are taken and days they are not, particularly in terms of energy production. Just be assured you are giving your body extra nutrients that are sometimes difficult to consume in the typical daily diet.

If you’ve never been in a health food store before, it’s an interesting experience. Try to go with a knowledgeable person who can show you the ropes. Staff can be helpful and some are experts in their knowledge base, so don’t hesitate to ask.  While you’re there pick up a bag of PureVia, a natural raw cane sugar and stevia blend sweetener with half the calories of sugar but with the same great taste.

Tags:  Carol Hunter  dietary supplements  nutrition  PhD 

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GNC Makes Deal with NY Attorney General

Posted By Reprinted with permission from Vitamin Retailer, Friday, May 15, 2015
On March 30, GNC (Pittsburgh, PA) announced that it had reached an agreement with the New York Attorney General (NYAG) that affirms the company's Herbal Plus products were in full compliance with the federal U.S. Food and Drug Administration (FDA) current good manufacturing practice (cGMP) requirements and acknowledges GNC's full cooperation with the AG's inquiries.

In its response to the NYAG's inquiry, GNC provided the results of rigorous tests conducted both internally and by independent third parties. These tests provided conclusive evidence that GNC's products are safe, pure, properly labeled and in full compliance with all regulatory requirements. The testing also demonstrated that the company's products contain all herbal extracts listed on their respective labels.

In addition, a former senior FDA cGMP expert performed a comprehensive review of GNC's manufacturing processes for the products at issue and found them to be in compliance with all applicable requirements. Accordingly, GNC has restored its full assortment of Herbal Plus products to all GNC stores in New York State.

GNC also announced that it will expand its testing processes deeper into its supply chain by leading ongoing industry efforts to integrate source material traceability standards including DNA barcoding where appropriate(prior to extraction processes) and enhance certain other aspects of its operations to provide consumers even greater confidence in its products.

GNC said that it believe these measures, which would not have impacted availability of the products subject to this review, will result in the adoption of stricter minimum standards across the broader industry.
"As our testing demonstrated, and this agreement affirms beyond any doubt, our products are not only safe and pure but are in full copliance with all regulatory rewquirements," said Michael G. Archbold, CEO, GNC. "A robust testing regime, careful sourcing regimen and detailed manufacturing specifications have always been cor elements to ensuring that we provide our customers with high-quality products. Our customers trust and value our products, and we are steadfastly committed to maintaining that trust and confidence. As an industry leader we have always gone above and beyond the minim requirements in pursuing quality for our consumers, and we will continue to lead the efforts for higher standards. This is good for consumers, good for the industry and good for GNC.

GNC has preserved the specific product lots of the five products that were the subject of the NYAG inquiry for us in defending the Company against the lawsuits that have been filed subsequent to the NYAG's February 2 letter, despite the fact that there is no prohibition against the sale of such products. GNC believes these lawsuits are completely without merit and will defend itself aggressively. Identical products to those that have been preserved remain available for sale to consumers at GNC stores in New York State. For more information, visit www.gnc.com.

Tags:  dietary supplements  FDA  GNC  Target  Walgreens  Walmart 

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Guest Editorial: The Beat Goes On

Posted By Daniel Breeman, Editor-in-Chief, Natural Practitioner Magazine, Friday, May 15, 2015

Just how much longer will the dietary supplement industry continue to be under attack? And more importantly, has the damage already been done?

It's been nearly three months since New York Attorney General Eric Schneiderman launched his investigation into the dietary supplements industry by issuing cease-and-desist letters to four major retailers - GNC, Target, Walgreens and Walmart - calling on them to pull their own brands of herbal supplements from their shelves, following an investigation by his office that found nearly 80 percent of the products tested from those stores contained none of the plants listed on the products' labels. GNC, as you may know, reached an agreement with the attorney general's office in late March whereby the company will use DNA tests to authenticate the plants that will be used as ingredients in its herbal supplements. Some industry experts applauded the agreement, while others said it set a dangerous precedent going forward.

Of course, the questionable DNA testing methods used have come under hard scrutiny by the likes of the Natural Products Association (NPA), the Council for Responsible Nutrition (CRN) and other industry groups, but that didn't prevent Schnedierman and 13 other state attorneys general from sending a letter to Congress requesting an investigation into herbal supplements and calling for more regulatory oversight of the industry by the Food and Drug Administration (FDA). Schneiderman and his counterparts, despite admitting that the federal good manufacturing practices currently in place for dietary supplements are sufficient, continues to push forward in what is seemingly becoming a "witch hunt" at the expense of taxpayer dollars.

While the two sides continue to slug it out and the NPA calling for a grassroots campaign to attempt to prevent Schneiderman from taking further action, a larger question for the industry at-large may be, "Has the damage already been done?" While little has yet to be determined legally regarding the outcome of the dispute, the danger here for the dietary supplement industry is that in the court of public opinion, they may have already lost.

Of course, a Harvard-led study early last month that indicated that a handful of weight-loss and sports supplements contained amphetamine-like ingredients, not the plant extract listed on the label of the product, didn't help the cause.

For those who have long supported the dietary supplement industry, not much will change. Natural products manufacturers, suppliers and retailers alike will strongly defend the methods used to test and regulate their industry and will continue to fight for its survival. On the other hand, those who have long opposed or questioned the industry now have more ammunition at their disposal to challenge every move the industry makes. And finally, the real danger here is in convincing those consumers who have long been considering walking into your store to try a natural remedy or supplement might now be turned off by the ongoing negative press.

So what's the next step? Will the letter to Congress sent by Schneiderman and the 13 other state attorneys general be enough to eventually push the industry under regulation by the federal government? Does DSHEA carry no weight here?

For now, the smart move for the dietary supplement industry is to continue to provide the quality products that it's always provided. I also encourage you to take part in NPA's grassroots campaign and to join in fighting the good fight.

Tags:  dietary supplements  DNA testing methods  FDA  GNC  Target  Walgreens  Walmart 

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Cancer Center Leaps to Wrong Conclusions After Reviewing Faulty Supplement Studies

Posted By Tim Reihm, Director of Communications & Outreach - Alliance for Natural Health, USA, Tuesday, May 5, 2015
Health advocacy group calls the University of Colorado’s analysis “grievously flawed” and “premature”

April 22, 2015 — The Alliance for Natural Health USA (ANH-USA) today recommended caution regarding the University of Colorado Cancer Center’s claim that dietary supplements have been “shown to increase cancer risk.” According to Gretchen DuBeau, ANH-USA’s legal and executive director, the center’s conclusions, which were presented at a forum at the American Association for Cancer Research (AACR) Annual Meeting 2015, are based in part on studies that have been largely discredited.

“Leaving aside the hysteria with which media outlets have been reporting this very minor story, with headlines like ‘Too many vitamins can give you CANCER, major new study warns the millions who take them,’” DuBeau said, “the research on which these dire conclusions are based is not new, by any means. This was a meta-analysis of twelve trials conducted with wildly varying parameters, inputs, and controls over two decades, and some of those studies were grievously flawed. This reduces the significance of any findings tremendously, since one study cannot be directly compared to another. And because this new analysis has not yet been published, it hasn’t been subjected to any peer review process, so any real conclusions are premature at best.”

According to scientists and reviewers familiar with the analysis, one of the trials was the SELECT study, the Selenium and Vitamin E Cancer Prevention Trial of 2008. In it, participants were given vitamin E in the form of synthetic alpha-tocopherol—an incomplete form of the vitamin not found in nature. “Vitamin E is comprised of mixed tocopherols and tocotrienols,” DuBeau explained. “Too much alpha-tocopherol can interfere with your body’s use of the arguably more important gamma form. No information was kept on the participants’ dietary or exercise habits or other lifestyle considerations. And a peer-reviewed study published in the respected Journal of the National Cancer Institute demonstrated a 32% reduction in prostate cancer incidence in response to daily vitamin E supplementation! Studies in other scientific journals tell a similar story.”

The current meta-analysis also noted concerns over vitamin B and a risk of colon cancer. “But once again, the researchers tested the wrong stuff,” says DuBeau. “They used folic acid, a synthetically produced form that is widely used to fortify processed foods. The important thing to remember is that folic acid is not itself biologically active, and 30% to 40% of the population can’t efficiently convert synthetic folic acid into folate, the naturally occurring form of the vitamin that the body can actually use. So of course these people would never see any benefits from supplementing with folic acid.”
DuBeau has some sound advice for consumers worried about all the contradictory, frightening warnings about supplements being disseminated by the media: talk to an integrative physician or other healthcare professional who understands things like co-factors (which supplements need to be taken together), take appropriate therapeutic doses, and choose the highest quality supplements possible.

# # #

About the Alliance for Natural Health USA (ANH-USA)  http://anh-usa.org
The Alliance for Natural Health USA is part of an international organization dedicated to promoting natural, sustainable healthcare through good science and good law. We protect the right of natural health practitioners to practice, and the right of consumers to choose the healthcare options and treatment modalities they prefer, including complementary and alternative medicine. As a membership-based organization, we unite consumers, practitioners, and industry to speak with a common voice and have worked since 1992 to shift the medical paradigm from an exclusive focus on surgery, drugs and other conventional techniques to an “integrative” approach incorporating food, dietary supplements, and lifestyle changes.

Tags:  cancer  dietary supplements  university of colorado 

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