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Steg A, Oczkowicz M, Smołucha G. Omics as a Tool to Help Determine the Effectiveness of Supplements. Nutrients 2022; 14:nu14245305. [PMID: 36558464 PMCID: PMC9784029 DOI: 10.3390/nu14245305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
There has been considerable interest in dietary supplements in the last two decades. Companies are releasing new specifics at an alarming pace, while dietary supplements are one of the less-studied substances released for public consumption. However, access to state-of-the-art and high-throughput techniques, such as the ones used in omics, make it possible to check the impact of a substance on human transcriptome or proteome and provide answers to whether its use is reasonable and beneficial. In this review, the main domains of omics are briefly introduced. The review focuses on the three most widely used omics techniques: NGS, LC-MS, NMR, and their usefulness in studying dietary supplements. Examples of studies are described for some of the most commonly supplemented substances, such as vitamins: D, E, A, and plant extracts: resveratrol, green tea, ginseng, and curcumin extract. Techniques used in omics have proven to be useful in studying dietary supplements. NGS techniques are helpful in identifying pathways that change upon supplementation and determining polymorphisms or conditions that qualify for the necessity of a given supplementation. LC-MS techniques are used to establish the serum content of supplemented a compound and its effects on metabolites. Both LC-MS and NMR help establish the actual composition of a compound, its primary and secondary metabolites, and its potential toxicity. Moreover, NMR techniques determine what conditions affect the effectiveness of supplementation.
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Lenssen KG, Garcia Fuentes A, van Osch FH, Bast A, de Boer A. Assessing the influence of information on the intention to use dietary supplements: An online questionnaire study. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Borodovsky JT, Sofis MJ, Grucza RA, Budney AJ. The importance of psychology for shaping legal cannabis regulation. Exp Clin Psychopharmacol 2021; 29:99-115. [PMID: 32437193 PMCID: PMC7679279 DOI: 10.1037/pha0000362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Different patterns of cannabis use can be traced directly back to different interactions between 2 types of variables: pharmacological and environmental. As legal cannabis expands in the U.S. and around the world, state and national regulatory agencies are gaining control over these variables. Specifically, regulatory agencies are increasingly capable of altering (a) the pharmacological properties of cannabis products and (b) the way these products are distributed to the population. Consequently, cannabis regulatory agencies are in a unique position to use evidence from psychological science to alter cannabis consumption patterns in ways that mitigate potential harm to public health. However, most state-level legal cannabis regulatory systems in the U.S. are not yet evidence-based or public health-oriented. This applied review and commentary draws on evidence from the psychological science literature to help regulators better understand the types of behaviors they must address and guide empirically supported regulation of THC-laden cannabis, whether used putatively for medical or recreational reasons. This review is organized into 3 parts that correspond to the 3 primary agents within the cannabis regulation ecosystem: (a) the cannabis consumer, (b) the cannabis industry, and (c) the cannabis regulatory agency. Within this structure, the review addresses critical psychological variables that drive cannabis consumer and industry behaviors and discusses how regulatory agencies can use this information to protect public health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Jacob T Borodovsky
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Michael J Sofis
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine
| | - Richard A Grucza
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - Alan J Budney
- Center for Technology and Behavioral Health, Dartmouth Geisel School of Medicine
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Hall MG, Lazard AJ, Grummon AH, Mendel JR, Taillie LS. The impact of front-of-package claims, fruit images, and health warnings on consumers' perceptions of sugar-sweetened fruit drinks: Three randomized experiments. Prev Med 2020; 132:105998. [PMID: 31982477 PMCID: PMC7085890 DOI: 10.1016/j.ypmed.2020.105998] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 12/20/2019] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
Abstract
We aimed to examine the impact of claims, fruit images, and health warnings on consumers' perceptions of fruit-flavored drinks with added sugar (i.e., "fruit drinks"). We conducted three 2x2x2 randomized experiments with online convenience samples of U.S. adults (Study 1 n = 2139 in 2018, current e-cigarette users and smokers; Study 2 n = 670 in 2018, current e-cigarette users; Study 3 n = 1006 in 2019, general sample). Participants viewed a fruit drink that differed in the presence of a "100% Vitamin C" claim, a fruit image, or a health warning. On average across the three studies, consumers who saw a claim on a fruit drink believed that the drink was more healthful than those who did not see the claim (mean average differential effect (ADE) = 0.66, p < .001); they were also more interested in consuming the drink (mean ADE = 0.38, p = .001). The health warning decreased perceived product healthfulness (mean ADE = -0.65, p < .001) and consumption interest (mean ADE = -0.49, p < .001). The fruit image had no effect on perceived product healthfulness (mean ADE = 0.03, p = .81) or purchase intentions (mean ADE = -0.04, p = .77). In Study 1 and Study 2, there were no interactions between claims, images, or warnings (all p > .05). In Study 3, the "100% Vitamin C" nutrition claim only increased perceived product healthfulness when the drink did not also have a health warning (interaction p < .05). These findings suggest that 100% Vitamin C claims increase the appeal of fruit drinks, whereas health warnings decrease the appeal. Together, these studies support policies to restrict marketing and require health warnings on sugar-sweetened beverage packaging.
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Affiliation(s)
- Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, United States of America; Lineberger Comprehensive Cancer Center, University of North Carolina, United States of America.
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina, United States of America; Hussman School of Media and Journalism, University of North Carolina, United States of America
| | - Anna H Grummon
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, United States of America; Carolina Population Center, University of North Carolina, United States of America
| | - Jennifer R Mendel
- Lineberger Comprehensive Cancer Center, University of North Carolina, United States of America
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina, United States of America; Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, United States of America
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Byron MJ, Hall MG, King JL, Ribisl KM, Brewer NT. Reducing Nicotine Without Misleading the Public: Descriptions of Cigarette Nicotine Level and Accuracy of Perceptions About Nicotine Content, Addictiveness, and Risk. Nicotine Tob Res 2019; 21:S101-S107. [PMID: 31867657 PMCID: PMC6939779 DOI: 10.1093/ntr/ntz161] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 09/05/2019] [Indexed: 01/14/2023]
Abstract
SIGNIFICANCE The public incorrectly believes very low nicotine content (VLNC) cigarettes are less carcinogenic than current cigarettes, a belief associated with lower motivation to quit under a VLNC standard. We examined how different descriptions of the nicotine level in VLNC cigarettes affect the accuracy of the public's perceptions about nicotine content, addictiveness, and cancer risk. METHODS Participants were a national convenience sample of 1353 US adults (22% smokers). In an online experiment, we randomized participants to a VLNC description using (1) concise language; (2) a percentage; (3) an interpretation; (4) a percentage and interpretation; (5) a percentage and a pictograph; or (6) a percentage, interpretation, and pictograph; or to a control description using (7) FDA's "minimally or nonaddictive" phrasing. We assessed accuracy of perceived nicotine content, addictiveness, and cancer risk compared to current cigarettes. RESULTS Compared to control, the percentage description resulted in more accurate perceptions about nicotine content (76% vs. 49% accuracy) and addictiveness (44% vs. 34%), but less accurate perceptions about cancer risk (56% vs. 68%; all ps < .05). Adding interpretation or pictographs to the percentage description did not increase accuracy. The concise language description reduced accuracy of perceived nicotine content and addictiveness but increased accuracy of cancer risk (all ps < .05). CONCLUSIONS Stating that 95% of nicotine would be removed more accurately conveyed the nicotine content and addictiveness of VLNC cigarettes. However, descriptions that better conveyed nicotine content and addictiveness misled people about cancer risk. IMPLICATIONS Implementation of a VLNC standard should include plans for a communication campaign that conveys that VLNC cigarettes will be less addictive but equally toxic to smoke. Stating the percent reduction in nicotine is likely to more clearly communicate reduced addictiveness but may also exacerbate risk misperceptions. VLNC communication requires further study to ensure the public accurately understands a VLNC standard.
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Affiliation(s)
- M Justin Byron
- Department of Family Medicine, University of North Carolina, Chapel Hill, NC
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Jessica L King
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
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Sullivan HW, Aikin KJ, David KT, Berktold J, Stein KL, Hoverman VJ. Consumer understanding of the scope of FDA's prescription drug regulatory oversight: A nationally representative survey. Pharmacoepidemiol Drug Saf 2019; 29:134-140. [PMID: 31833141 DOI: 10.1002/pds.4914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/18/2019] [Accepted: 09/29/2019] [Indexed: 11/08/2022]
Abstract
PURPOSE Misperceptions of how the US Food and Drug Administration (FDA) regulates prescription drugs may affect how consumers assess the safety and efficacy of prescription drugs. The study objective was to survey the public on their knowledge of FDA oversight regarding prescription drug approval and advertising. METHODS In 2017, we conducted a nationally representative mail-push-to-web survey with 1,744 US adults. RESULTS Although most respondents (86%) knew that FDA approves prescription drugs, we found misperceptions about what that approval means. In addition, few respondents understood FDA oversight of prescription drug advertising, with approximately half of respondents reporting that they did not know whether FDA approved these ads or components of the ads, and several mis-reporting that FDA approves these ads (31%) or components of the ads (22%-41%). CONCLUSIONS Enhanced collaboration and communication with the public by key stakeholders in this space could increase public understanding of the roles and responsibilities of FDA.
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Lubowiecki-Vikuk A, Król-Zielińska M, Kantanista A. Consumption of dietary supplements to support weight reduction in adults according to sociodemographic background, body mass index, waist-hip ratio, body fat and physical activity. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2019; 38:31. [PMID: 31690346 PMCID: PMC6833227 DOI: 10.1186/s41043-019-0191-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this study was to analyse the use of dietary supplements to support weight reduction (DSSWR) in adults according to sociodemographic background, body mass index (BMI), waist-hip ratio (WHR), body fat percentage (%BF) and level of physical activity (PA). METHOD Participants (n = 1130) were recruited from a region of Poland with a high rate of adult overweight and obesity. Based on anthropometric data, BMI and WHR were calculated. %BF was assessed using a bioimpedance method. To examine the association between DSSWR use and sociodemographic factors, BMI, WHR, %BF and PA multiple logistic regression were conducted. RESULTS The rate of DSSWR use in the group studied was high (69.5%). A higher proportion of women, individuals aged 18-35 years, those who had completed higher education, those who did not report financial status as "poor", with a BMI < 18.5, normal %BF and individuals with a high level of PA used DSSWR. In complete case analysis (n = 1108), primarily financial status reported as "good" (OR = 2.18, 95% CI: 1.69, 2.81) or "hard to say" (OR = 2.41, 95% CI: 1.86, 3.12) (vs. "poor") and female sex (OR = 2.59, 95% CI: 2.17, 3.08) were associated with DSSWR intake. CONCLUSION It seems that primarily financial status and sex, but also age, education, and level of PA, have significance in DSSWR use in adults and may be considered when developing appropriate strategies for body weight management and health promotion.
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Affiliation(s)
- Adrian Lubowiecki-Vikuk
- Department of Consumer Behaviour Research, Collegium of Management and Finance, Warsaw School of Economics, Al. Niepodległości 162, 02-554 Warsaw, Poland
| | - Magdalena Król-Zielińska
- Department of Physical Education and Lifelong Sports, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871 Poznań, Poland
| | - Adam Kantanista
- Department of Physical Education and Lifelong Sports, Poznan University of Physical Education, Królowej Jadwigi 27/39, 61-871 Poznań, Poland
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Baig SA, Byron MJ, Lazard AJ, Brewer NT. "Organic," "Natural," and "Additive-Free" Cigarettes: Comparing the Effects of Advertising Claims and Disclaimers on Perceptions of Harm. Nicotine Tob Res 2019; 21:933-939. [PMID: 29529277 PMCID: PMC6588395 DOI: 10.1093/ntr/nty036] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/25/2018] [Indexed: 11/14/2022]
Abstract
INTRODUCTION The US Tobacco Control Act restricts advertising or labeling that suggests one tobacco product is less harmful than another. We sought to examine how "organic," "natural," and "additive-free" advertising claims and corresponding disclaimers affect perceptions of cigarettes' harm. METHODS Participants were a national probability sample of adults in the United States (n = 1114, including 344 smokers). We conducted a 5 (claim) × 2 (disclaimer) between-subjects factorial experiment. Participants viewed a Natural American Spirit cigarettes ad claiming they were "organic," "natural," "additive-free," "light," or "regular;" and with or without a corresponding disclaimer. The outcome was perceived harm of the advertised cigarettes. Among smokers, we also assessed interest in switching within their current brand to cigarettes with this characteristic (eg, "additive-free"). RESULTS Claims in the ad had a large effect on perceived harm (Cohen's d = 0.87, 95% CI = 0.47 to 1.29). Claims of cigarettes being "organic," "natural," or "additive-free" reduced perceived harm from the advertised cigarettes, as compared with "regular" and "light" claims. Disclaimers had a small effect, increasing perceived harm (d = 0.25, 95% CI = 0.08 to 0.41). The problematic claims also increased smokers' interest in switching. Disclaimers had no effect on smokers' interest in switching. CONCLUSIONS "Organic," "natural," and "additive-free" claims may mislead people into thinking that the advertised cigarettes are less harmful than other cigarettes. Disclaimers did not offset misperceptions of harm created by false claims. The US Food and Drug Administration should restrict the use of these misleading claims in tobacco advertising. IMPLICATIONS "Organic," "natural," and "additive-free" cigarette advertising claims decrease perceptions of harm among the public and increase interest in switching to such cigarettes among smokers. Disclaimers do not counteract the reduced perceptions of harm or increased interest in switching to these cigarettes. The US Food and Drug Administration should restrict the use of "organic," "natural," and "additive-free" claims in tobacco marketing.
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Affiliation(s)
- Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - M Justin Byron
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Allison J Lazard
- School of Media and Journalism, University of North Carolina, Chapel Hill, NC
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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Abstract
In a Guest Editorial, Aaron S. Kesselheim and Michael S. Sinha show how federal and state legislation to allow promotion of drugs for non-approved uses threatens to undermine the FDA's public health mission.
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Affiliation(s)
- Michael S. Sinha
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Aaron S. Kesselheim
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
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Abstract
The idea that the degree of infringement public health interventions have on individual rights should be proportional to the degree of expected benefits has emerged as an influential principle in public health ethics and policy. While proportionality makes sense in theory, it may be difficult to implement in practice, due to the inherent conflict between individual rights and the common good underlying the principle. To apply the proportionality principle to a decision of policy, one must still find a reasonable way of balancing these competing values in light of the available options and empirical evidence. In this article, I consider how the proportionality principle applies to the regulation of dietary supplements and examine some critiques of the current oversight system. I argue that it may be difficult maintain proportional oversight because the risks of dietary supplements vary considerably. Strengthening the regulations may therefore promote an appropriate level of regulation in some cases but lead to overregulation in others.
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Affiliation(s)
- David B Resnik
- National Institute of Environmental Health Sciences, National Institutes of Health, 111 Alexander Drive, Box 12233, Mail Drop E1-06, Research Triangle Park, NC, 27709, USA
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Gratale SK, Maloney EK, Sangalang A, Cappella JN. Influence of Natural American Spirit advertising on current and former smokers’ perceptions and intentions. Tob Control 2017; 27:498-504. [DOI: 10.1136/tobaccocontrol-2017-053881] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/23/2017] [Accepted: 09/25/2017] [Indexed: 11/04/2022]
Abstract
ObjectiveThis study sought to demonstrate causal effects of exposure to Natural American Spirit (NAS) advertising content on misinformed beliefs of current and former smokers, and to empirically establish these beliefs as a mechanism driving intentions to use NAS.MethodsOur study employed a randomised experimental design with 1128 adult daily, intermittent and former smokers. We compared participants who were exposed to NAS advertisements or claims made in the advertisements with those in a no-message control group to test the effects of NAS advertising content on inaccurate beliefs about NAS and attitudes and intentions towards the product.ResultsOne-way analysis of variance revealed that exposure to NAS advertisements produced inaccurate beliefs about the composition of NAS cigarettes among current and former smokers (p<0.05). Planned contrasts indicated a compilation of arguments taken directly from NAS advertisements resulted in significantly greater beliefs that NAS cigarettes are healthier/safer than other cigarettes (for former smokers, t(472)=3.63, p<0.001; for current smokers, t(644)=2.86, p=0.004), demonstrating that suggestive claims used in the brand’s marketing have effects on beliefs not directly addressed in the advertisements. Regression and mediation analyses showed that health-related beliefs predict attitudes towards NAS for current and former smokers, and mediate intentions to use NAS.ConclusionsThe findings of this study provide causal support for the need for further regulatory action to address the potentially harmful ramifications of claims used in NAS advertising.
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Krishnareddy S, Stier K, Recanati M, Lebwohl B, Green PHR. Commercially available glutenases: a potential hazard in coeliac disease. Therap Adv Gastroenterol 2017; 10:473-481. [PMID: 28567117 PMCID: PMC5424869 DOI: 10.1177/1756283x17690991] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/01/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The only treatment for celiac disease (CD) is a gluten-free diet (GFD). However, there is interest among patients in a medical therapy to replace or help with a GFD. Therapies include gluten-degrading enzymes (glutenases). There are glutenases available marketed as dietary supplements that have not been demonstrated to digest the toxic epitopes of gluten. METHODS We investigated the contents, claims, and disclaimers of glutenase products and assessed patient interest using Google AdWords to obtain Google search frequencies. RESULTS Among 14 glutenase product, all contained proteases, eight contained X-prolyl exopeptidase dipeptidyl peptidase IV, two did not state the protease contents, and eight failed to specify the name or origin of all proteases. Eleven contained carbohydrases and lipases and three probiotics. One declared wheat and milk as allergens, two contained herbal products (type not stated) and one Carica papaya. Thirteen claimed to degrade immunogenic gluten fragments, four claimed to help alleviate gastrointestinal symptoms associated with eating gluten. Disclaimers included not being evaluated by the US Food and Drug Administration and products not intended to diagnose, treat, cure, or prevent any disease. On Google AdWords, the search frequency for the product names and the search terms was 3173 searches per month. CONCLUSIONS The names of these products make implicit claims that appear to be supported by the claims on the labels and websites for which there is no scientific basis. Google search data suggest great interest and therefore possible use by patients with CD. There needs to be greater oversight of these 'drugs'.
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Affiliation(s)
- Suneeta Krishnareddy
- Celiac Disease Center at Columbia University, Columbia University, New York, USA
| | - Kenneth Stier
- Celiac Disease Center at Columbia University, Columbia University, New York, USA
| | - Maya Recanati
- Celiac Disease Center at Columbia University, Columbia University, New York, USA
| | - Benjamin Lebwohl
- Celiac Disease Center at Columbia University, Columbia University, New York, USA
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Herriman M, Fletcher L, Tchaconas A, Adesman A, Milanaik R. Dietary Supplements and Young Teens: Misinformation and Access Provided by Retailers. Pediatrics 2017; 139:peds.2016-1257. [PMID: 28044048 DOI: 10.1542/peds.2016-1257] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Despite the American Academy of Pediatrics' recommendations against pediatric use of creatine and testosterone boosters, research suggests that many young teenagers take these dietary supplements. Our objective was to determine to what extent health food stores would recommend and/or sell creatine and testosterone boosters to a 15-year-old boy customer. METHODS Research personnel posing as 15-year-old high school athletes seeking to increase muscle strength contacted 244 health food stores in the United States via telephone. Researchers asked the sales attendant what supplements he/she would recommend. If a sales attendant did not mention creatine or testosterone boosters initially, each of these supplements was then specifically asked about. Supplement recommendations were recorded. Sales attendants were also asked if a 15-year-old could purchase these products on his own in the store. RESULTS A total of 67.2% (164/244) of sales attendants recommended creatine: 38.5% (94/244) recommended creatine without prompting, and an additional 28.7% (70/244) recommended creatine after being asked specifically about it. A total of 9.8% (24/244) of sales attendants recommended a testosterone booster. Regarding availability for sale, 74.2% (181/244) of sales attendants stated a 15-year-old was allowed to purchase creatine, whereas 41.4% (101/244) stated one could purchase a testosterone booster. CONCLUSIONS Health food store employees frequently recommend creatine and testosterone boosters for boy high school athletes. In response to these findings, pediatricians should inform their teenage patients, especially athletes, about safe, healthy methods to improve athletic performance and discourage them from using creatine or testosterone boosters. Retailers and state legislatures should also consider banning the sale of these products to minors.
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Affiliation(s)
- Maguire Herriman
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, North Shore-Long Island Jewish Health System, Lake Success, New York
| | - Laura Fletcher
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, North Shore-Long Island Jewish Health System, Lake Success, New York
| | - Alexis Tchaconas
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, North Shore-Long Island Jewish Health System, Lake Success, New York
| | - Andrew Adesman
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, North Shore-Long Island Jewish Health System, Lake Success, New York
| | - Ruth Milanaik
- Division of Developmental and Behavioral Pediatrics, Steven and Alexandra Cohen Children's Medical Center of New York, North Shore-Long Island Jewish Health System, Lake Success, New York
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15
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Akabas SR, Vannice G, Atwater JB, Cooperman T, Cotter R, Thomas L. Quality Certification Programs for Dietary Supplements. J Acad Nutr Diet 2016; 116:1370-1379. [PMID: 26795259 DOI: 10.1016/j.jand.2015.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Indexed: 11/16/2022]
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Byron MJ, Baig SA, Moracco KE, Brewer NT. Adolescents' and adults' perceptions of 'natural', 'organic' and 'additive-free' cigarettes, and the required disclaimers. Tob Control 2015; 25:517-20. [PMID: 26628496 DOI: 10.1136/tobaccocontrol-2015-052560] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/30/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We sought to investigate adolescents' and adults' perceptions of an American Spirit advertisement with 'natural', 'organic' and 'additive-free' descriptors and related disclaimers. METHODS We conducted nine focus group discussions in the Southern USA, with 59 participants aged 13-64 years (30 male, 29 female), stratified by age, smoking status and susceptibility to smoking. We conducted thematic content analysis of the transcripts. RESULTS Many participants were sceptical or confused about the 'natural', 'organic' and 'additive-free' descriptors. Many participants viewed American Spirit cigarettes as being less, or possibly less harmful than other cigarettes, even though the ad contained disclaimers explicitly stating that these cigarettes are not safer. Some participants said that people tend to ignore disclaimers, a few expressed doubt that the disclaimers were fully true, and others did not notice the disclaimers. A few smokers said they smoke American Spirit cigarettes because they think they are not as bad for them as other cigarettes. CONCLUSIONS Disclaimers intended to prevent consumers from attributing a health benefit to cigarettes labelled as 'natural', 'additive-free', or 'organic' may be insufficient. A ban on these descriptors may be a more appropriate remedy than disclaimers.
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Affiliation(s)
- M Justin Byron
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sabeeh A Baig
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kathryn E Moracco
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Dodge T. Consumers' perceptions of the dietary supplement health and education act: implications and recommendations. Drug Test Anal 2015; 8:407-9. [PMID: 27072844 DOI: 10.1002/dta.1857] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 07/21/2015] [Accepted: 07/21/2015] [Indexed: 11/09/2022]
Abstract
In 1994, the United States Congress passed the Dietary Supplement Health and Education Act (DSHEA). The regulatory framework for dietary supplements created by DSHEA has led to significant misperceptions regarding consumers' understanding of the safety and efficacy of supplements. Research shows that consumers erroneously believe that: (1) supplements are approved by the government, (2) supplements have been tested for safety and effectiveness, (3) the content of supplements is analyzed, and (4) manufacturers are required to disclose known adverse effects to consumers. Furthermore, labelling requirements that are intended to provide transparency to consumers are relatively ineffective. The following four recommendations are offered for reforming DSHEA: (1) only allow structure-function claims that are supported by research evidence, (2) require manufacturers to list known adverse effects on the labels of dietary supplements, (3) require that the Food and Drug Administration analyzes the content of dietary supplements and (4) restrict the definition of dietary ingredients. These recommendations would bring DSHEA to more closely align with consumer expectations regarding the regulation of dietary supplements and would likely provide a safer landscape for the use of supplements. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Tonya Dodge
- Department of Psychology, George Washington University
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Kapoor A, Sharfstein JM. Breaking the gridlock: Regulation of dietary supplements in the United States. Drug Test Anal 2015; 8:424-30. [PMID: 27072846 DOI: 10.1002/dta.1892] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Revised: 08/16/2015] [Accepted: 09/07/2015] [Indexed: 12/29/2022]
Abstract
Despite increasing use of dietary supplements by millions of consumers, regulation of these products has not kept pace with changes and risks in the market. A major reason for this policy gridlock is the inability of different parties to come to an agreement on a path forward. The purpose of this paper is to set out a new framework for regulation in which consumers, industry, and regulators can all find common ground. This framework is based on a conceptual shift from 'benefit versus risk', the model for prescription drugs, to 'access with safety'. Steps should include registration of all dietary supplements to permit easier enforcement against rogue products, a stronger disclaimer explaining the limited role of FDA in evaluating structure/function product claims, the establishment of standard laboratory techniques for characterization of products, and more clear authority for the agency when safety concerns arise. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Akshay Kapoor
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Joshua M Sharfstein
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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Sarpatwari A, Kesselheim AS. The 21st century cures act: Opportunities and challenges. Clin Pharmacol Ther 2015; 98:575-7. [DOI: 10.1002/cpt.208] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A Sarpatwari
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine; Brigham and Women's Hospital and Harvard Medical School; Boston Massachusetts USA
| | - AS Kesselheim
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine; Brigham and Women's Hospital and Harvard Medical School; Boston Massachusetts USA
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Avorn J, Sarpatwari A, Kesselheim AS. Forbidden and Permitted Statements about Medications--Loosening the Rules. N Engl J Med 2015; 373:967-73. [PMID: 26332553 DOI: 10.1056/nejmhle1506365] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hwang TJ, Powers JH, Carpenter D, Kesselheim AS. Accelerating innovation in rapid diagnostics and targeted antibacterials. Nat Biotechnol 2015; 33:589-90. [DOI: 10.1038/nbt.3251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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