The article, published in the April edition of the newsletter Harvard Women’s Health Watch, is titled Why dietary supplements are suspect. The subtitle goes on to say that few are effective, many are useless, and some may actually be harmful.
The article, which was posted without an author attribution, lumps a number of dietary supplement ingredients together, including herbs, omega-3 fatty acids, minerals, vitamins and others. It discounts any evidence of benefit in most cases, and along the way perpetuates errors such as associating cases of liver damage with black cohosh, when this has been shown to be attributable to adulteration with a closely related Chinese species.
Observers noted that the article appeared to have been very poorly researched. The black cohosh information, for example, has been available since at least 2010. In another paragraph supposedly supporting the conclusion that supplements are dangerous, the article cites a New England Journal of Medicine study that concluded that dietary supplements are responsible for an average of 23,000 emergency room visits per year. Michael McGuffin, president of the American Herbal Products Association, wrote a guest article for NutraIngredients-USA showing that that study included some products that are not supplements, such at OTC remedies and topical preparations. He concluded that even if the 23,000 figure were taken at face value, when ranked against the total number of supplement users and against emergency room visits from all causes, that number vanishes into insignificance and is really indicative of the safety of these products rather than the reverse.
Observers are dumbfounded
These omissions and errors led industry observers to conclude that the Harvard posting had been hastily thrown together with perhaps little oversight. Their reactions verged on the incredulous.
“Because it was first published on April 1, 2016, I read it several times to to try ensure that it was not an ‘April Fools’ joke. The author(s) appears to have done very little true research on his/her own, apparently choosing instead to uncritically regurgitate information from various secondary or possibly even tertiary sources,” Mark Blumenthal, founder and executive director of the American Botanical Council, told NutraIngredients-USA.
“This is some of the worst journalism we’ve seen in a long time. It’s utterly uninformed, poorly researched and contains a boatload of errors,” said Frank Lampe, communications director for the United Natural Products Alliance.
“We are embarrassed on the behalf of the Harvard Medical School that they would allow something of this nature to be posted,” he added.
“I think this is a case of unbalanced journalism,” said Duffy MacKay, ND, executive vice president of scientific and regulatory affairs for the Council for Responsible Nutrition. “To try to lump all supplements together and say they are useless is pretty silly because they are such a broad category.”
MacKay did not that even with the strongly negative headline and general negative tone of the article, the author did include some positive information. In the paragraph about melatonin, for example, the article says , “A synthetic copy of a natural hormone, melatonin is used for jet lag, sleep disturbances, and insomnia. Research has determined that it can be effective at doses as low as 0.5 mg.”
“I’m not sure I would write any differently about melatonin,” MacKay said. “And for chamomile, it says it is effective in relieving anxiety, though it’s not as potent as a drug. I think that’s pretty fair.”
The DNA refrain
The article also includes at the end a lengthy discussion of adulteration and quality issues in supplements that relies heavily on DNA analysis conducted by Canadian academicians and by New York Attorney General Eric Schneiderman. It completely misses the boat when it comes to the serious issues raised about whether the tests used in these cases were fit for purpose.
“Where this article really fails is in its apparently blind acceptance of the ‘herbs are adulterated’ premise by uncritically citing the highly-discredited 2013 study by Newmaster et al. at the University of Guelph and its improbable conclusions of the identity of herbal supplements that were inappropriately tested solely by DNA barcoding methods and then the equally questionable and widely-discredited results of the New York Attorney General’s 2015 DNA tests on herbal supplements sold by four major retailers. By ignoring the growing body of published literature — some of it in peer-reviewed publications — by qualified medicinal plant experts that call into serious question the over-reliance on DNA barcoding as a sole determinant of the identity of the herbal ingredients in dietary supplements, this article does a disservice to its readers and raises legitimate questions as to the editorial veracity of the publication in which it appears,” Blumenthal said.
Overall bias?
The ‘unproven’ line in the article seems to be attributable to the fact that supplements are not regulated like drugs and are not studied like them, either. MacKay said he would stop short in saying that Harvard as an institution has a bias against supplements. To do so, he said, would be making the error that article makes.
“If they are looking for the same standard as for an FDA-approved drug, that’s really a non starter position,” MacKay said. “There are lot of reasons why these products are regulated differently than drugs. I know a lot of people from Harvard who understand and appreciate supplements. If you ask, does their public health newsletter possibly have an agenda? Then I would tend to agree.”