There is a continued gap in the perception of dietary supplements between those who make them and the organizations that regulate their use in sports. The latest example comes in the form of comments from a U.S. anti-doping official.
Amy Eichner, PhD, special adviser on drugs and supplements for the United States Anti-Doping Agency, spoke with NutraIngredients-USA in response the comments made by Jiri Dvorak, MD, an official of FIFA, the international soccer sanctioning body. Dr. Eichner echoed many of Dr. Dvorak’s cautionary comments about dietary supplements.
“When it all is said and done we here at USADA have a responsibility to protect the clean athlete. No matter how you dress it up, there are problems in the dietary supplement industry,” she said.
"We don't have a choice but to warn athletes about supplements."
Dr. Dvorak had called the efficacy of many sports supplements into question. Dr. Eichner said much the same:
“Claims of performance enhancement are common among products marketed as supplements to athletes. While some claims are supported for some ingredients (e.g. calcium helps build strong bones) in a study published in BMJ Open, it was noted that ‘There is a striking lack of evidence to support the vast majority of sports-related products that make claims related to enhanced performance or recovery, including drinks, supplements and footwear.’ ”
Dr. Eichner cautioned about supplements that promise effects on the label such as ‘boosts testosterone’ or ‘increases growth hormone.’ If a product really does these things, she said, it would fall into the World Anti Doping Agency prohibited list. If they don’t, she said, “the product is making false and misleading claims. Either way it’s a lose-lose situation for athletes.”
Supplements, or drugs?
John Shaw, executive director and CEO of the Natural Products Association stated what many in industry have long maintained, namely that products that include banned or controlled substances aren’t dietary supplements at all, but illegal drugs in disguise.
“We’re all for quality control. People who sell potentially adulterated products should be prosecuted to the full extent of the law,” he said.
Dr. Eichner agrees to some extent, but said there are issues of confusing packaging, marketing and labeling.
“When you say ‘dietary supplement’ many athletes think of the heavy duty performance-enhancing products, many of which are not dietary supplements at all. The problem is that since packaging often looks alike and they all have a supplement facts panel, it is difficult to know what is actually in the product,” she said.
“There is no way an athlete can tell which ones are legitimate high-quality supplements and which ones are illegal. Given that young athletes encounter myriad products marketed as supplements that are in fact illegal steroids, stimulants, or prescription drugs, there is a risk factor associated with ‘dietary supplements’ as a category of health products.”
Quality control problems cited
Many in industry point to the strides that have been made recently with the advent of GMP regulations and attendant inspections as evidence that whatever shortcomings the industry might have with quality control are being dealt with. On this score, Dr. Eichner is far from sold.
“An increase in GMP audits by the FDA is certainly a step in the right direction, but the fact that roughly half of the audited companies have failed such inspections speaks to poor quality-control across the industry. Hopefully improved compliance with GMP regulations will help,” she said.
But, she said, enforcement of these regulations has a long way to go, pointing to an incident just in the past few days in which she was able to buy a supplement that supposedly had been recalled by FDA weeks ago.
Dr. Eichner cautions young athletes to go slow if they decide to try using a dietary supplement.
"Choose a simple supplement that contains only the ingredients that you have a demonstrated need for. Ask the company to show that they are compliant with Good Manufacturing Practices, and seek a product that has been thoroughly evaluated and tested by an accredited independent third party." she said.
Part of the issue, Dr. Eichner said, is the nature of the marketplace, and the competitive nature of human beings, whether trying to make a sale or set a world record.
“When the stakes are high there is an incentive to take shortcuts, exploit gaps, and even cheat. This is true among athletes, and among some companies that market products as dietary supplements. Just as USADA works to level the playing field amongst athletes, so should the industry work to level the playing field among dietary supplement companies,” she said.