Time to tame the dietary supplement industry

Once upon a time, traveling salesmen went from town to town selling tonics bubbling with opiates, cocaine and knockout quantities of grain alcohol. The Pure Food and Drug Act shut them down in 1906.

The hucksters are back. The vitamin, mineral and herbal supplement industry — now a $23-billion-a-year business — is hawking wares with dubious claims and unproven safety records to an unsuspecting public. Whether you shop at Wal-Mart or high-priced organic-food stores, you will find shelves of supplements that claim to be as basic to personal health as whole grains and toothpaste.

Industry executives claim that they are promoting "health freedom." But they are actually exploiting people's genuine health concerns and anxieties over the skyrocketing cost of traditional medical care. The supplement moguls — along with their retinue of lobbyists, political allies, celebrity endorsers, media promoters and alternative-medicine gurus — are fighting off government oversight so that they can continue bamboozling the public into thinking that good health comes in a bottle. The Food and Drug Administration needs to intercede.

According to Consumer Reports, only a third of 54,000 supplements in the Natural Medicines Comprehensive Database have any scientifically supported level of safety and effectiveness, and 12 percent are linked to safety concerns or quality issues. Mounting evidence suggests that most vitamin supplements, including the popular daily multivitamin, may be useless — and some could even increase the risk of disease.  

Quality control is also a concern. Many vitamins that appear in the U.S. — in everything from soft drinks to breakfast cereal — are made in China, where standards are lax. When consumers buy children's chewables, they fail to realize that the lack of uniform manufacturing rules can result in mislabeling or contamination. A recent New York Times report on herbal supplements reveals that popular products like echinacea may be diluted or contain nothing more than cheap fillers like rice.

Supplement promoters sell themselves as an alternative to big pharma, but giant pharmaceutical firms actually own the bulk of the industry. Pfizer owns Centrum, Bayer owns One a Day, and Procter & Gamble owns supplement maker New Chapter. Even Wall Street is getting in on the action. The Carlyle Group, a private-equity giant, owns NBTY (formerly Nature's Bounty), and hedge funds are trading on industry players like the Vitamin Shoppe, betting that health-conscious baby boomers and other promising demographics will keep buying.

To be sure, humans need vitamins and minerals, but outside of a few specific cases of diagnosed deficiencies, like folic acid for pregnancy, there is little evidence that consuming them in supplement form is generally beneficial. Most major health bodies — including the National Institutes of Health, the American Academy of Pediatrics, the American Dietetic Association, the Mayo Clinic and Harvard Medical School — do not recommend supplements because their alleged benefits have failed to withstand scientific scrutiny.

Paul Offit, the chief of the infectious-disease unit at Children's Hospital of Philadelphia and a critic of the supplement industry, lays out the scientific case against high doses of vitamins in his book "Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine." Steven Novella, a clinical neurologist at the Yale School of Medicine, co-founded a website that investigates the myriad false claims made by the supplement industry.

Yet the U.S. government has failed to catch up with the science. Under current law, dietary supplements are considered neither food nor drugs and exist in an unregulated gray area. You can put supplements in a shake, stick them in a pill or add them to water without testing their safety.