In a conversation with NutraIngredients-USA, Gelbert, who came on as CSO in October 2017, highlighted the company’s recent research into the micronutrient deficiencies that are caused by or potentially could be caused by certain common therapies for chronic disease. As the chronic disease burden continues to be a pressing public health concern in the United States, the research points to the partly hidden role deficiencies might play in these cases.
“This wasn’t primary research. But it was a comprehensive review of the data that is out there,” Gelbert said.
Many deficiencies poorly understood
Titled “Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update,” the research was published in March in the journal Pharmaceutics. It was conducted by a team of researchers from Tufts University in Boston as well as from Nature’s Bounty.
The researchers looked at the data showing what micronutrient deficiencies might arise from common therapies to manage chronic disease. The depletion of CoQ10 among statin users is one well-known and well-supported example.
But there are a plethora of others. These include deficiencies associated with hypertension drugs, antidepressants, some steroids and other classes of drugs. The deficiencies include low levels of vitamins B12, C, D and E and insufficient amounts of minerals such as calcium, potassium and zinc. Low levels of the nutrient folate have been observed as well.
The researchers noted that this area of nutrition research has been little studied. Complicating factors include the fact that many prescribing physicians don’t fully appreciate the role of nutrition in supporting their patients’ health as well as the lack of baseline nutritional status data on patients in many cases.
“A number of these studies have identified potential risk factors that may make certain populations more susceptible, but guidelines on how to best manage and/or prevent drug-induced nutrient inadequacies are lacking. Although widespread supplementation is not currently recommended, it is important to ensure at-risk patients reach their recommended intakes for vitamins and minerals,” the researchers noted.
More research needed to describe mechanisms
The paper noted that much research still needs to be done to identify what deficiencies exist and how best to manage them. For example, cases of critically low magnesium levels have been observed with some patients using proton pump inhibitors, a class of drugs that treat chronic acid reflux. But the underlying mechanism is unknown. Similarly, the mechanism by which corticosteroids can cause excessive potassium excretion thus raising the risk of hypertension has also not yet been described
“For the majority of the interactions described in this paper, more high-quality intervention trials are needed to better understand their clinical importance and potential consequences,” the researchers wrote.
Renewed emphasis on research
Gelbert said the research is indicative of a renewed vigor at Nature’s Bounty that came in with the purchase of the company by investment firm KKR a little more than a year ago. Gelbert was part of a changeover in the management suite at the company which includes Don Kerrigan, the new president for North American operations. (An interview with Kerrigan will appear in an upcoming edition of NutraIngredients-USA.)
Gelbert, who has advanced degrees in chemistry as well as a law degree, had spent hears in the prescription and OTC drug world during previous stints at Pfizer and Johnson & Johnson. But Gelbert said his real roots are in dietary supplements.
“I have been involved with dietary supplements for more than 25 years. I interacted with the staff at Sen. Hatch’s office around the time that DSHEA was being written,” Gelbert said.
“I think this industry has come such an incredible way in a short time,” he said.
Gelbert said his multifaceted background will help in the mission to reestablish Nature’s Bounty as a leader in the industry, both from a regulatory and compliance standpoint as well as leading on the research end.
“I think that’s why I was brought on board,” he said. “What I bring is a renewed focus on innovation, especially as regards to our approach to science and technology.”
“Our interest is in delivering high quality products to our consumers. We stand behind the quality of our products in our manufacturing and testing. It’s a responsibility we take incredibly seriously,” Gelbert said.
2018, 10(1), 36; doi:10.3390/pharmaceutics10010036
“Evidence of Drug–Nutrient Interactions with Chronic Use of Commonly Prescribed Medications: An Update”
Authors: Mohn, ES, Kern HJ, Saltzman E, Mitmesser SH, McKay DL