Academic comes down on vitamins and current regulation

An American Journal of Clinical Nutrition article, based on last year's NIH State of the Science conference, has suggested that building scientific standards into supplements legislation could be a way to reward companies making science-based marketing.

The article, appearing in the journal's January supplement, is written by Dr. Irwin Rosenberg, director of the nutrition and neurocognition laboratory at Tufts University. The article is based on Rosenberg's presentation at the National Institutes of Health (NIH) State-of-the-Science Conference in May 2006. This 13-member independent panel reviewed literature of both single and multivitamin/mineral randomized clinical trials (RCT).

"We really need to encourage good study design and to establish indicators of efficacy and safety in vitamin research," wrote Rosenberg. "At best, the research needed to translate scientific knowledge into policy will require a robust interaction between the public and private sectors in a regulatory framework that supports and rewards investment in good science."

This standpoint is not wildly different to that put forward by the respectable side of the supplements industry, which has placed great emphasis on science in recent years.

In a response to the panel report CRN president Steve Mister said:

"CRN agrees that more research examining the effects of multivitamins on the prevention of chronic diseases could provide valuable insights for consumers. However, consideration should also be given as to whether the drug model for clinical research is the appropriate way to assess the preventative benefits of nutrients."

In the meantime, he said, consumers should be encouraged to eat a well-balanced diet, get plenty of exercise, and take a multivitamin every day.

But according to a communique from Tufts University, Rosenberg departs from industry thinking on the adequancy of current regulation. He is said to believe that supplements are "currently subject to very little federal regulation".

The dietary supplement industry propones that current regulations under DSHEA (the 1994 Dietary Supplement Health and Education Act) are a sufficient framework for companies to work and self-regulate within. As well, the industry works within a set of credibility gages, such as such as aspiring to publication in peer reviewed journals and securing patents.

Rosenberg suggests that a set of standards would be helpful to both consumers and industry by rewarding those companies that do science-based marketing, rather than those that make unjustified health claims.

Rosenberg also questions the validity of the scientific evidence specifically behind vitamins.

"The evidence regarding vitamin use for prevention of chronic disease is still quite rudimentary, especially for multivitamins," said Rosenberg. "Since multivitamin-users are generally healthier, it might not be feasible to attribute health outcomes to vitamin use until we have more information. The best source of vitamins is food."

The State-of-the-Science conference put forth in its final conclusion:

"The uncertainty resulting from these trials suggests that multivitamin trials are unlikely to lead to generalizable knowledge."

The panel said it did find some evidence pointing to possible benefit of selenium, vitamin E, or both in cancer prevention, especially in men. However, it also said studies have also pinpointed subgroups of the population whose cancer risk might increase with such supplementation.

In May, the Council for Responsible Nutrition urged the panel to pay careful attention to the language used in its conclusions in order to avoid inadvertently undermining public confidence in"one of the easiest and most affordable ways for people to improve their nutrient intake and their health-namely, the consistent long-term use of a multivitamin."

Rosenberg has held positions on committees for the Food and Drug Administration and the Institute of Medicine. He also served as dean of the Friedman School of Nutrition Science and Policy at Tufts and as director of the USDA HNRCA (USDA Human Nutrition Research on Aging).

Rosenberg has played an active role in national and international nutrition policy efforts and endorses increased regulation of dietary supplements.

The article is based on Rosenberg's presentation at the National Institutes of Health State-of-the- Science Conference "Multivitamin/Mineral Supplements and Chronic Disease Prevention" in 2006.

Reference:

Rosenberg IH. "Challenges and opportunities in the translation of the science of vitamins." American Journal of Clinical Nutrition. 2007 (January);85(supplement):325S-327S.