April 20, 2024

40% of Sports Supplements Don’t Have On-Label Ingredients, US Study Finds : ScienceAlert

“You get what you pay for” is not an adage we can always count on. A US study found that more than one third of a selection of sports supplements bought online do not contain key ingredients that the label says they should have.

Pieter Cohen, a clinician-researcher at Cambridge Health Alliance and Harvard Medical School in Cambridge, Massachusetts, and colleagues ordered 57 sports supplements to analyze their contents.

Each product’s label claimed that the supplement contained one of five botanical compounds with purported performance-enhancing properties. The substances included in supplements from stimulants are called ephedra banned in 2004.

“The FDA does not pre-approve these ingredients, or any supplement ingredients, for efficacy or safety prior to introduction,” Cohen and colleagues write in their paper.

“But FDA inspections have found that supplement manufacturers often fail to adhere to basic manufacturing standards, such as establishing the identity, purity or composition of the final product.”

Their analysis found that about 40 percent of the 57 supplements purchased online (an admittedly small sample) did not have a detectable amount of the listed ingredient. Half indicated the wrong amount, and 12 percent were found to contain illegal additives.

“Only 11 percent of the products were accurately labeled and 5 different FDA-prohibited ingredients were found, including an unapproved drug available in Russia, 3 drugs previously available in Europe, and one drug never approved in any country,” Cohen and colleagues report.

Although amounts may vary in batches within a given brand, the study found that a recommended serving of a supplement contained more than three times the mass of one of the stimulants listed on the label.

Although the results of the study are alarming, they are not surprising when you understand how supplements are regulated in the United States and other countries such as Australia.

Since they are health products, you might think that supplements fall into a subcategory of medications. But in reality, the FDA regulates them as a subcategory of food, Cohen explains.

“This has huge consequences for the whole category of dietary supplements, from vitamins, minerals, probiotics and all kinds of new ingredients,” Cohen tell the American Medical Association (AMA) in 2021, because “what it means that the manufacturer can bring anything into the [US] a market they believe is safe.”

The FDA’s job then is to keep tabs on new products, identify if they are causing any harm, and remove them from store shelves if so.

In 2004, for example, the FDA banned the sale of herbal supplements containing ephedrine alkaloids “because they present[ed] unreasonable risk of illness or injury” to consumers.

Ephedrine alkaloids, or ephedrawhich are removed from stimulants Ephedra sinica and other plants, touted to increase energy and improve athletic performance. Since they are transferred, there is ephedra poisoning in the USA fell sharplyno ephedra-related deaths since 2008 have been reported.

Australia’s drug regulator, the Therapeutic Goods Administration (TGA), is the same crack down on supplementswhich is possible endanger health by interfering with prescription medications or causing severe allergic reactions.

At the end of 2020, the TGA now regulates high-risk sports supplements as medicines other than ‘sports foods’ after some people die.

But there are drug regulators playing catch up to a fast moving market. Cohen say there has been an “explosion of new ingredients” in supplements in recent years, with more than 75,000 dietary supplement products sold in the US, he estimates.

“Today we are seeing so many new innovations or brand-new ingredients being introduced with supplements,” Cohen said in his AMA interview.

“Again, because the FDA is not checking these products before they appear on store shelves or on the internet, what happens is that they may pose unpredictable risks.”

More research is needed to see how many other sports supplements and health products are mislabeled before we know the extent of this problem.

However, recent studies have found that melatonin gums sold in the US and Canada may be giving children much higher doses than the labels suggest.

The the Australian study of 135 dietary supplements purchased between 2014 and 2017 also found that only 20 percent had at least one ingredient confirmed on laboratory testing.

The study is published in JAMA Open Network.

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