In response to an opinion piece by Pieter A. Cohen, MD, titled “The Supplement Paradox” and published On October 11, 2016 in JAMA1, the Council for Responsible Nutrition (CRN) issued the following statement:
Statement by Steve Mister, president & CEO, CRN:
“More than two-thirds of American adults take dietary supplements for a variety of health reasons, and according to CRN’s annual consumer survey on dietary supplements, they consistently cite doctors as their number one source for trusted information on supplements. We absolutely agree with Dr. Cohen that doctors—in fact, all health care practitioners—should be discussing supplement use with their patients. As consumers are demonstrating an increasing interest in integrative health, they also are seeking a more proactive role in managing their own health, and looking for ways to stay well. Physicians must maintain open minds when discussing supplements and consider all the available evidence surrounding the benefits and risks of supplement use. Cherry-picking research, dismissing patients’ actual experiences with supplements, and relying solely on randomized controlled trials as the only acceptable validation for benefits all alienate their patients and overlook the robust body of evidence for supplement usage.
In addition, the Dietary Supplement Health and Education Act (DSHEA) provides a balance that gives the government ample authority to review safety data for new ingredients before they arrive in the market and to remove unsafe products from the market while still allowing consumer access to the wide variety of products they seek. Doctors can actively help FDA (U.S. Food and Drug Administration) implement and enforce the law by reporting suspected adverse events, objectively evaluating products their patients use, and notifying the agency of illegal ones.
“Given that dietary supplement usage is growing in the United States, and research demonstrates that supplement users are more likely than non-users to engage in healthy habits—including visiting their doctors—we would hope that healthcare practitioners would take their patients’ interest in supplements seriously. Physicians should not only discuss potential interactions, but also potential nutrient depletions that result from some medications. Physicians should recognize that food comes first, but supplements can complement the American diet. The multivitamin serves to fill in the nutrient gaps that government research repeatedly demonstrates exist, as well as provide critical levels of folic acid and iodine for women of childbearing age. Physicians should consider that products ranging from glucosamine/chondroitin, protein and Echinacea to omega 3s and probiotics provide consumers with real-life benefits (even if the actual research is mixed) and do so in safer ways than some of the other non-supplement options on the market. We urge physicians to find ways to foster trust between themselves and their patients when it comes to counseling on dietary supplements.”
For more information, visit www.crnusa.org.
1 Cohen P. The Supplement Paradox. JAMA. 2016;316(14):1453-1454.