so this week we are going to um wrap up by talking about supplements so um when used correctly most dietary supplements can support Health Training and athletic performance um but there are some stipulations to that and although some dietary supplements are beneficial others are not and some could even be harmful to a person's health so we want to make sure that we're um looking at legitimate substances and things like that for athletic considerations specifically poor manufacturing practices or intentional spiking of a supplement with a prescription or illegal substance could result in a positive drug test the prevalence of dietary supplement use excuse me among athletes um it's difficult to quantify because there's very limited research um but trying to determine the prevalence is exacerbated by inconsistent methodology poor science poor research design um lack of homogenity among studies and so we can take a minute here just to like clarify some um some terms the FDA refers to the Food and Drug administ ation FTC refers to the Federal Trade Commission and dsha refers to dietary supplement health and Education Act of 94 so this terminology becomes really important when discussing legality and federal regulations of nutrition supplements so the legal definition of a supplement is a product taken by a mouth that contains a dietary ingredient to supplement the diet legally a dietary ingredient may include vitamins minerals herbs Botanicals amino acids enzymes organ tissues glandulars and metabolites um the legalized the legally recognized term for dietary supplements are tablets capsules liquids and powders and in any other form like a sports bar or a shake the information on the label it can't imply that the product should replace a meal or substitute a diet comprised of food okay so notice that the FDA does not approve dietary supplements for safety or Effectiveness this is really really important um so there's no approval process to get them on the market anybody can put it on the market um but you'll we'll talk about in a minute it is the fda's job to prove that it's harmful before they're able to remove it and because there's no checks and balances in place this rarely happens so under dsha the dietary supplements are regulated separately and under a different set of regulations from food or drugs the FDA does not need to approve dietary supplements before they reach the consumer um but and the FDA doesn't have Financial Resources to analyze the contents of supplements before being sold so it's the manufacturer's responsibility to ensure the supplement facts label ingredient lists are accurate and that the content matches what's declared on the label which I can tell you is very rare happens so for example there have been many studies done specifically on prenatal vitamins and non-prescription prenatal vitamins what is on the label versus what is actually in them generally speaking what is actually in the supplement is about 50% of what's on the label um which is honestly that's a good case scenario in other instances that we have found um lead in these and so it can get really it can get very very dangerous so we'll talk about some stop gaps here in a minute so once a product is marked marketed and sold it's fda's responsibility to demonstrate that it's harmful before they're able to take action on it or restrict the use to the public and then once the product is ready for sale it's the manufacturer and distributor's responsibility to ensure that product is safe meaning doesn't contain lead um meaning um you know doesn't con doesn't have adverse side effects a manufacturer does not need to provide the FDA with evidence used to substantiate the safety or efficacy of the product and it's not required to disclose the FDA um or consumers the information they have about the safety um or proposed benefits of the product so very very under regulated so the FDA has published comprehensive regulations for gold manufacturing practices I'm sorry good manufacturing P practices gmps for those manufacture package um and distribute products related to dietary supplements and these regulations really focus on practices to ensure the identity the Purity the quality the strength and the composition of these dietary supplements um and then the FDA does not create a list of dietary supplement manufacturers distributors or product sold like literally they just don't touch this area at all all it's really the consumer's responsibility to contact the manufacturer If the product um if you know you need more information on the product so the FDA does require most dietary supplements to have a supplement fact panel is just not ensure that it's correct and this panel has to list each dietary ingredient and um any ingredients not included on the panel have to be listed under other ingredients printed beneath the panel um and then the recommended serving size is determined by the manufacturer once again does not require FDA approval so the nutrient content claims describe the quantity of a nutrient in a product um and have been authorized for use by the FDA on foods and dietary supplements so if there are content claims then those are different those do need to be approved Health claims describe a relationship between a nutrient or ingredient and reduced risk of a health related condition or disease so really good example of this would be Cheerios a lot of times the Cheerio box says may reduce cholesterol and that's just because it's a whole grain pulling that cholesterol out of the body um in order to have the FDA approve a health claim on a food or a supplement there has to be significant scientific agreement supporting that proposed claim so Cheerios are significant scientific agreement that whole grain can reduce um the risk of heart disease and lower cholesterol and so that's what you'll often see on the Cheerios label structure and function claims are about General well-being so these claims might State how the product nutrient or inred inent and tends to affect the normal structure or function within the body um I for example calcium helps build strong bones or how it acts to maintain a particular structure or function fiber helps um helps keep you regular antioxidants maintain cell Integrity uh but they can't explicitly or implicitly link or associate the claim effect of the nutrient um component or ingredient to a specific disease so it's just like it's overall health not disease specific and the first step in valuating up dietary supplement is to just view the product the brand the product name the claims if there's a million claims on it that might be a red flag um the name the quantity of key ingredients should all be listed um National Brands T to be a little bit more reputable in this case but overall what I really really look for are these voluntary certifications so although the FDA doesn't regulate them supplements can say I want a USP that's a very common or an NSF um stamp of approval and what that is is they pay a third party USP NSF um something like that to put their stamp of approval on the process to say what you say what I'm saying in here claims and ingredients um quantity otherwise and they put the product through testing and then the result of that is they get this stamp of approval that they can put on the label um and this just can minimize a chance of purchasing a supplement that's altered or contaminated um something like that there's also the fda's medication Health fraud website and that lists a small fraction of the potentially hazardous products with his hidden ingredients um that are sold to Consumers NSF is a third party certification that I just talked about um and products that carry the informed choice they um they certify that the nutrition supplements and ingredients in the product have been tested for band substances specifically um related to sports um and substances by LGC and the World Class Sports anti-doping um so that that one's very important for sports the others are very important for quantity and quality so when um people are taking supplements always say look for a USP or an NSF um or an informed Choice um look for one of these stamps of approvals that way you know what's their saying is in there is actually in there it doesn't contain lead and other things so supplements might contain prohibited substances not declared on the label we did touch on this um but the product could be contaminated due to poor manufacturing processes so nobody's intentionally putting lead in their products generally it's from older machinery and and things like that same thing that's how our L gets in our food um from contaminated soils or really old machinery and this happens in the US more than I feel like disproportionately more than other places because we're still using the same machinery um most sports organizations with baned substances policies have strict liability this means that even if athletes innocently or unknowingly inest demand substance and then test positive they lose the ability to compete um and they lose any awards if the completion has already started so the US anti-doping agency manages the um manages a program and it is included in competition or out of competition testing and um it results in the management of these processes and the drug reference resources okay so that's it for supplements I'm going to do actually we have one more on supplements um and then that will be it for this week let me know if you have any questions