Bioethics in Practice: Dietary Supplements — Helpful or Harmful?
As I was scrolling through Facebook one night, I came across a meme depicting a scene in which a woman in Whole Foods insisted that her items be entered by the numbers on the barcode, instead of by a scanner, since, as she said, “I don’t want lasers to touch things I am going to eat.” After laughing for a good 30 seconds, I started thinking about the larger trend of health food crazes and fad diets that run in the same vein as this story. Even if this story itself is not factual, it is similar enough to common experiences with health crazes that it is 100% believable.
What exactly are the bioethical implications of health crazes and fad diets? There are several: the first issue is the little to no regulation in the field of “health products” and the second is whether such health products actually work in execution. The second issue is much easier to address. Most experts agree that the modern health crazes and fad diets are bunk and, in fact, are often harmful. Proper nutrition — especially for a growing child — is essential, and when those needs are not met irreparable damage, and perhaps even death, can result.
An example of the effects of this lack of safety regulation can be seen from the Prohibition era in the United States. Jamaica Ginger, colloquially known as “jamaica ginger,” was a medicinal product that contains 80% alcohol by weight and was sold over the counter before Prohibition. During Prohibition, the Federal Government made this variety of ginger available by prescription only, but allowed stores to sell an over-the counter-version that had a much higher ginger to alcohol ratio. Due to the high ginger content, the federal government thought that it would be impossible to be used as a recreational alcohol product. Distributors of the ginger changed the recipe to make it more palatable by adding tricresyl phosphate (TCP). Due to the low level of federal regulation, they were able to get away with it. However, there was an unintended consequence — TCP was actually a slow-acting neurotoxin. Due to the low level of federal regulation, many Americans were paralyzed in their hands and feet.
Similar to Jamaican Ginger, many of today's health products, and “dietary supplements” are not approved by the Federal Drug Administration (FDA). The FDA’s informational website states, “Federal law does not require dietary supplements to be proven safe to FDA's satisfaction before they are marketed.” Additionally, the FDA states that, in general, the first opportunity to take action against a company that produces a harmful product is only “after the product enters the marketplace.” At this point, the product may have caused injury to a consumer. This is shocking! The laws surrounding dietary supplements — everything from protein powder to vitamin supplements — do not ensure that products are safe to consume prior to their distribution, leaving the general population at a huge risk. Additionally, the FDA reports of multiple cases where action has been taken by the FDA due to unsafe products being sold. These products had “to be recalled because of proven or potential harmful effects” only after they were sold on the market and potentially harming people.
Beyond the lack of regulation, there are other unaddressed risks. For instance, the FDA states, “Taking a combination of supplements, using these products together with medicine, or substituting them in place of prescribed medicines could lead to harmful, even life-threatening, results.” Additionally, some supplements can have unwanted effects before, during and after medical procedures. An example is “bleeding” that can be caused by supplements containing “ garlic, ginkgo biloba, ginseng, and Vitamin E.” Additionally, supplements containing kava or valerian “can increase the effects of anesthetics and other medications during surgery.”
Health supplements can be helpful, as many of them provide needed nutrients to people who otherwise would not be able to get them. However, there is a need for much more oversight of the industry, or else a horror story like ginger jake may happen again. Producers should also be required to print clear labels and information on how different supplements react with common supplements and medications. This would hold the producers accountable and ensure that their products are safe. If supplements are truly working like medications to prevent and heal illnesses, then they should be regulated like drugs to ensure the safety of consumers.
Photo Caption: Fish oil capsules
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