Which comes first: supplement safety laws or the power to enforce them? The Durbin-Blumenthal Dietary Supplement Labeling Act

US Senators Dick Durbin (D-IL) and Richard Blumenthal (D-CT) recently introduced the Durbin-Blumenthal Dietary Supplement Labeling Act. This legislation is intended to protect consumers from dangerous supplements by imposing new requirements on supplement manufacturers. While the intentions of this legislation are noble, there are fatal flaws that will prevent this bill from accomplishing any of its goals.  
There are 4 main objectives of the bill, and what follows is the corresponding 4 reasons why this bill won’t work:
The 4 Objectives of the D-B Supplement Labeling Bill (scroll to the bottom of the page)

Requirement #1: Allowing FDA to track how many dietary supplements are on the market and what ingredients they contain. 
Flaw #1: A registration requirement is only as effective as the person/people reviewing the submissions.
The proposed legislation would require dietary supplement manufacturers to register their products with the FDA and to provide a copy of the label as well as information on its ingredients (to prove safety and efficacy).
Theoretically, that would curtail the number of products that are absolute poppycock, with no scientific basis whatsoever. Example: Deer Antler pills (no, this is not a joke).


In reality, it will take a live human being to read through all the paperwork (electronic or hard copy) of all the dietary supplement registration/submissions. And if said FDA Agent finds something bogus, won’t it require another human being (or multiple people) to call or visit this dietary supplement manufacturer and deliver the warning letter or Cease and Desist notification? 
With human resources and manpower already stretched thin, how will the FDA accomplish any of the supplement review goals stipulated in this bill?

Requirement #2: Requiring more information on product labels including warnings associated with specific ingredients.
Flaw #2: This requirement means supplement manufacturers would have to put warnings on the label to call out the hazards for specific ingredients that may cause adverse events for any particular groups. Hmmm, now that sounds like a fantastic idea…but does this sound familiar to anyone else?

Furthermore, the Council for Responsible Nutrition brought up an excellent point in their official response to the proposed bill. As Steve Mister, President and CEO, CRN said in the statement, 

We cannot support legislation that directs FDA to require warning labels for products or ingredients that ‘could cause’ adverse events or potential risks as this is a case of the precautionary principle run amok. While the premise may be well intentioned, in practice this requirement would lead to confusing and unnecessary label instructions likely to deter consumers from using beneficial dietary supplements based on uncommon or miniscule risks. Further, a new law is unnecessary because the Dietary Supplement Health & Education Act (DSHEA) already provides FDA with the authority to mandate warning labels if the agency determines there is an unreasonable risk of injury or illness under the conditions of use provided in the labeling. Other provisions of the legislation likewise create burdensome new mandates for manufacturers who are already complying with DSHEA without addressing the industry’s outliers.     
Requirement #3: Giving FDA the authority to require manufacturers to provide proof for any potential health benefit claims
Flaw #3: Current law already requires a supplement manufacturer to notify the FDA about their structure/function claims (meaning claims that an ingredient with a particular structure elicits a particular function – ex. Calcium builds strong bones). 
One point for the bill: According to this article by Natural Product Insider, a government report has indicated that the FDA needs more authority to compel a manufacturer to submit these kind of documents to prove their structure/function claims. 
HOWEVER: When the FDA is granted more authority to monitor these claims, the argument of Insufficient Manpower comes up again. What good is having the authority to monitor and request these documents if there aren’t actual people and hours to devote to this task? It would be a tough call to have to decide whether to put FDA’s resources toward monitoring supplement claims and monitoring imported foods and resolving food outbreaks (Remember the Cantaloupe Crisis? The Deadly Peanut Butter Salmonella outbreak?)  FDA Resources Spread Thin in Enforcing Food Safety
Furthermore, the FDA and Federal Trade Commission is already responsible for monitoring labels that are misleading. Warning Letters – see how many are due to “misbranding” 
Requirement #4: Directing the FDA to clarify the distinction between dietary supplements and food and beverage products with additives. 
Flaw #4: Beverages are not inherently safer than supplements. 
It’s no secret that Senators Durbin and Blumenthal are anti-energy drinks. 
Oddly enough, one of the biggest complaints against energy drinks is that they are beverages masquerading as supplements. Supposedly, that makes them less accountable for ensuring product safety. As laid out clearly in this article by The Hill Regulation Blog:
“Energy drinks are marketed as dietary supplements instead of beverages, leading them to be regulated more laxly, Senate Democratic Whip Dick Durbin (Ill.) said.” 

HOWEVER, as food/beverage/supplement industry lawyer Justin J. Prochnow explains in this interview from BevNet Live, (starting around 3 minute mark) switching from a supplement to a beverage doesn’t mean the product is safer. It means the product has to abide by a different set of rules (What? Supplements have regulations? Yes, and this is the #1 myth regarding supplements because indeed, they DO have regulations to abide by). 

Monster energy, Red Bull and Rockstar are now all marketed as beverages (actually, Red Bull has ALWAYS been marketed as a beverage). Does that mean these products are any less likely to harm someone who consumes too many energy drinks in one day or consumes just one energy drink too fast (meaning consuming over 200mg caffeine under 20minutes)? No. 
The bottom line is regardless of whether the product is marketed as a food/beverage/supplement, there are multiple other factors that determine its safety. 
BOTTOM LINE: Those in the supplement AND food industry know safety is multi-factorial. Hygiene, pest control, ingredient contamination and adulteration – all these factors and many more affect how safe a product truly is. In a world where a supplement or food company can easily falsify a piece of paper stating the composition of their product, the answer is NOT to require companies to file more paperwork. The answer is not to give the FDA and other governing bodies the authority to monitor that paperwork, but to give them the resources (money, manpower, hours, grassroots support etc) to enforce the laws and regulations already in existence. 
 

Impact of AMA’s proposed ban on Energy Drinks for Minors

The American Medical Association has come out in support of a ban on energy drink sales to those under age 18. While it’s true minors and adolescents are more sensitive to caffeine than most adults, I, personally, wish the AMA would recommend the regulations Canada has put in place to address caffeine safety. As someone who’s studied caffeine and energy drinks for years, I see a large gap in AMA’s proposal which would fail to help keep minors safe from caffeine.

Read more

Putting Caffeine in Gum is A BAD IDEA, here’s why…

With new caffeinated foods popping up, the FDA is getting more pressure to reevaluate the safety of caffeine, particularly for adolescents. This is a terrific news story on NutraIngredients-USA.com:

FDA-to-probe-impact-of-caffeine-on-kids-health-following-launch-of-Wrigley-s-Alert-Energy-Caffeine-Gum

Caffeinated jelly beans and gum is not new, but this concept of adding caffeine to anything and everything is a bad idea. Here’s why:

1) Adding caffeine to foods that don’t normally have caffeine will make it harder, not easier, for people to regulate their caffeine intake.  If you don’t believe me, try keeping track of exactly how many grams of sugar you consume in one day. Too much sugar can be just as detrimental to your health as too much caffeine, but like with “too much fiber”, you won’t really notice you’re pushing your body too far until it’s too late to do anything about it.

2) Minors are especially vulnerable to caffeine because for them the safe limit of caffeine intake is so low. It’s unfortunately common for news anchors to completely neglect any reference to the limits of caffeine intake for minors. The truth is, while registered dieticians and pediatricians in the US have adopted an unrealistic “zero tolerance” standpoint, Health Canada has identified safe limits for kids of all different ages.

Ode to Heath Canada – Caffeine Safety

 Health Canada’s limits on safe caffeine intake are as follows:

  • For children:
    • Age 12 and under: no more than 2.5 milligrams of caffeine per kilogram of body weight
    • Age 4-6: 45 mg
    • Age 7-9: 62.5 mg
    • Age 10-12: 85 mg
  • For women of childbearing age: no more than 300 mg caffeine/day.
  • For healthy adults: no more than 400 mg caffeine/day.

 Please note that the 400 mg caffeine per day for healthy adults is based off the same comprehensive scientific review that the US used to set their daily maximum.

Effects of Caffeine on Human Health – Comprehensive Review

3) Putting caffeine in your product is just ASKING for FDA attention, not to mention angry letters from concerned parents. Caffeine is such a hot-button issue right now, and for good reason. Yes, of course caffeine is safe when used appropriately, but the easier your product makes it to abuse/over-consume caffeine, the brighter the target on your back.

As reported by Greenberg Traurig attorney Justin Prochnow:

FDA Deputy Commissioner Michael R. Taylor cited Wrigley’s new Alert gum, which is making its nationwide debut this week, as the catalyst for studying the potential impact that readily-available sources of caffeine could have on the health of minors.

“The only time that FDA explicitly approved the added use of caffeine in a food was for cola, and that was in the 1950s,” Taylor said. “Today, the environment has changed. Children and adolescents may be exposed to caffeine beyond those foods in which caffeine is naturally found and beyond anything FDA envisioned when it made the determination regarding caffeine in cola.”

Taylor said that the FDA will take “appropriate action” it deems necessary to regulate caffeinated products following the investigation.

BOTTOM LINE: Caffeine is safe in moderation, and for kids and teens “moderation” means “almost no caffeine at all”. Putting caffeine in normally caffeine-free foods creates a potentially hazardous situation because it makes it easier for someone to consume more than their body can handle.
(think multi-vitamins that look exactly like gummy bears in a jar without a child-safe lid
)

NY Bans marketing of Red Bull but misses the bull’s eye

Suffolk County in New York recently passed legislation that limits the marketing of energy drinks* to minors, and while this sounds like a brilliant demonstration of the movement to protect children from over-caffeinating themselves, I have several huge concerns.

First of all, notice I put an asterisk by the words “energy drink”, above. The US Food and Drug Administration considers a product with the word “drink” to be a beverage, as opposed to a supplement. Beverages and supplements have different regulations regarding their label and how product safety is monitored. [For the full discussion, see my previous blog: Beverage Vs Supplement]

Does this regulation apply only to energy drinks, meaning caffeinated products with a Nutrition Facts panel, or does it also apply to caffeinated products with a Supplement Facts panel? Monster energy drinks have a supplement facts panel (for now), but Red Bull has a Nutrition Facts panel. Rockstar products are split: some are supplements, some are beverages. Are we limiting marketing of ALL CAFFEINATED PRODUCTS and does this legislation include measures to prevent minors from ordering a Venti coffee with over 5 expresso shots?
  

And what about these caffeinated products, Starbucks Refreshers, will these be included in the legislation? They have caffeine, and if you consume more than 3 in one hour you’re bound to get jitters.

 
Second of all, the bill’s sponsor, Willam Spencer, highlighted THE WRONG PROBLEM in his letter to the media. According to an article in Food Product Design, “William Spencer said energy drinks consumed by kids may contain up to 800 milligrams of caffeine” (Food Product Design article).

In my life, I have examined over 100 caffeinated product labels–beverages, supplements, shots and coffees from several different states and from quite a few different countries. IN MY LIFE, I have never seen a product with 800 milligrams of caffeine. I am not denying that there is a product somewhere in the world with over 800 mg caffeine in one container, but the most popular energy products–Rockstar, RedBull, Amp, 5-Hour Energy, Monster, NOS, Full Throttle, RedLine–do not have 800 mg of caffeine in one container.  

Check it out for yourself on this brilliant site from Energyfiend.com: The 15 top energy drink brands (and their caffeine content – click on the brand name)

Notice I said above, “…in one container.”

Alas – the true problem: minors (and adults as well) are consuming too many caffeinated products in a 24-hour window. Where is this issue addressed in the legislation? According to the NBC New York report, “The law prohibits the marketing of energy drinks to minors, prohibits the sale of the drinks in county parks and sets up an extensive public education campaign on the side effects associated with the beverages.” NBC New York report

I will be very interested in reading what this “extensive public education campaign” entails. Is it led by physicians? Does it include information on the maximum daily dosage of caffeine considered safe? (400mg – see previous blogs) Does it carry a strong message that the AMOUNT OF CAFFEINE ONE CONSUMES is dependent on the product as well as THE NUMBER OF SERVINGS ONE CHOOSES TO CONSUME IN ONE HOUR?

For the sake of everyone, I sincerely hope this public education campaign includes a lesson on reading labels, and on the importance of NOT mixing energy drinks with alcohol. If we don’t address these issues, this bold piece of legislation will be ineffective at protecting people from the true hazards of caffeinated products.

 

Beverage vs Supplement: What Monster Energy’s switch from supplement to beverage means to the consumer

Next time you pick up an energy drink, take a peek at the label – does it say “Nutrition Facts” or “Supplement Facts”? What difference does one word make? Well, in this case, it’s kind of a big deal.

Monster Energy announces plans to move many of its products from the supplement category to the beverage category. While this may seem like changing one word, this move involves significant changes to how Monster energy drinks are regulated, labeled, and monitored for safety.

But first, let’s clear up one thing…

First of all, “energy drink” is a term used to refer to both beverages and supplements, but these are two different categories of products, each with their own set of regulations. Second of all, both beverages and supplements are indeed regulated by the FDA.

[Henceforth, the term “energy drink” will be used to specifically refer to products in the supplement category, whereas “energy beverage” will be used to refer to products in the food and beverage category]

1) Food/Bev vs Supplement Regulations:

Beverages are considered conventional foods; supplements are not food or beverages…or drugs (hence the supplement disclaimers “not intended to treat or cure disease”)

·      Ingredients added to FOOD must be approved food additives OR be classified as Generally Recognized as Safe (GRAS)

o   Example: Ginko biloba is acceptable in supplements, but not permitted in food because it’s not GRAS or covered by any food additive regulation

·      Ingredients added to SUPPLEMENTS must meet these two requirements:

1)   The ingredient must be a dietary ingredient* and

2)   If the ingredient was not sold in the US as a dietary supplement before October 15, 1994 (I’ll explain this date in a second), the manufacturer must file a special report that notifies the FDA of the intention to use this ingredient and must provide scientific evidence of its safety

*A “dietary ingredient” is defined by the Dietary Supplement Health and Education Act (DSHEA) as a vitamin, mineral, herb/botanical, amino acid, metabolite/extract or some other substance intended to boost (or supplement) the level man already consumes.

A blueberry would be a food ingredient


Blueberry extracts would be a dietary ingredient

Why October 15, 1994?


Because that’s when DSHEA was signed into law. Before this time, dietary supplements were subject to the same regulatory requirements as food products. Now, dietary supplements are just “under the umbrella” of food, which is why their safety is monitored by the FDA’s Center for FOOD Safety and Applied Nutrition (CFSAN).

2) Food Labels vs Supplement Labels

Food products and supplements are BOTH required to list all the components added to make the final formula

·      Food labels are required to list the ingredients by descending order, meaning the ingredient used the most comes first in the list while the ingredients that make up less than 2% of the total formula go last

o   NOTE: only certain ingredients (Calories, Total Fat, vitamins A and C to name a few) are required to be itemized with the amounts, other ingredients are only required to be mentioned in the list of ingredients

·      Supplements are required to list every ingredient in the formula, either in the “Supplement Facts” panel or in the “Other Ingredients” section

o   NOTE: the supplement label may group “proprietary blends” and list only the total amount of the blend, as long as there are no ingredients added to the supplement that are omitted entirely from the label

Special Circumstances with Caffeine:  caffeine is only required on the food label when it is added, not inherent—this is why dark chocolate does not mention caffeine in the ingredients list, but it is included within the product. When it is added, the word “caffeine” must appear in the ingredients list, but the amount of caffeine is not required to be listed.

3) Food Safety vs Supplement Safety

·      The FDA limited the amount of caffeine in cola-type drinks to 0.02% (71 mg per 12 oz serving)

·       Neither coffee nor energy drinks are held to this limit (and BOTH have been found to exceed this limit)

·      SUPPLEMENT manufacturers, packers, and distributors are required by the Federal Food, Drug, and Cosmetic Act (the FFDCA) to report any serious adverse events to the FDA

·      FOOD manufacturers, packers, or distributors are NOT required by the FFDCA to report serious adverse events to FDA

By definition, a serious adverse event is a health-related incident that results in death, a life-threatening experience, inpatient hospitalization, a persistent or significant disability or incapacity, a congenital anomaly or birth defect, or medical or surgical intervention to prevent any of the preceding outcomes.

Want to know more about AERs? See Question #5.

BOTTOM LINE:  
Marketing energy drinks as beverages instead of supplements will theoretically prevent a manufacturer from using questionable ingredients in the product (no unpronounceable plant extracts from different planets allowed). But will this change make the product safer? That remains to be seen. True, the levels of caffeine in the drink may be cut, but only the word caffeine, not the level, is required to be listed on the label. With any supplement, such as a vitamin, reading the directions for how much to consume at once is crucial. However, energy drinks usually look like beverages, and the reports of people experiencing symptoms of caffeine overdose is a clear indication that the directions on the energy drink label are not being followed. With the move to the beverage category, it’s still possible for people to consume more servings than they should, just as some people enjoy more than 3 sodas per day.

Remember to read the labels – with caffeinated beverages of any kind, personal responsibility is a key ingredient.
-Green-Eyed Guide