Consumer Health Digest #16-40

Your Weekly Update of News and Reviews
October 30, 2016


Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.


Comprehensive review evaluates calcium supplementation. Calcium is the dominant mineral present in bone and a shortfall nutrient in the American diet. Supplements have been recommended for people who do not consume adequate calcium from their diet as a standard strategy for the prevention of osteoporosis and related fractures. During the past several years, conflicting reports have suggested that calcium intake, particularly from supplements, may have either beneficial or harmful effects on cardiovascular outcomes. Following a thorough review, the National Osteoporosis Foundation and American Society for Preventive Cardiology have concluded, based on current evidence, that (a) calcium with or without vitamin D intake from food or supplements appears to have no relationship (beneficial or harmful) to the risk for cardiovascular and cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults and (b) calcium intake from food and supplements that does not exceed the tolerable upper level of intake (defined by the National Academy of Medicine as 2000 to 2500 mg/day) should be considered safe from a cardiovascular standpoint. [Kopecky SL and others. Lack of evidence linking calcium with or without vitamin D supplementation to cardiovascular disease in generally healthy adults: A clinical guideline from the National Osteoporosis Foundation and the American Society for Preventive Cardiology. Annals of Internal Medicine, Oct 25, 2016] An editorial in the same journal gives this practical advice:

How should clinicians and patients respond to the limited and imperfect evidence regarding the relationship between calcium supplements and cardiovascular risks? Although the preponderance of evidence does not support cardiovascular adverse effects, dietary sources of calcium are preferable to supplements for other reasons. Calcium supplements may increase kidney stone formation, whereas dietary calcium intake reduces the risk for kidney stones, a painful condition that affects 10% to 20% of adults. No evidence exists that consuming more calcium than the recommended dietary allowance will result in better bone health or any other health benefits. The median dietary calcium intake among U.S. adults (across all age and sex groups) is about 700 to 1000 mg/d, which may be attained by consuming 2 to 3 servings of high-calcium foods, including milk, yogurt, cheese, canned oily fish with bones, tofu, calcium-fortified juice, and leafy greens. Supplements may be used to make up but not exceed the gap between dietary intake and the recommended intake level; however, most persons require no more than 500 mg of supplemental calcium to meet their daily needs, if not met by diet alone. Achieving the recommended intakes of vitamin D (600 IU/day for adults up to age 70 and 800 IU/day for those aged 70 or older) also is essential. Based on the totality of evidence for both calcium and vitamin D, more is not better. Calcium supplements and cardiovascular disease Risk: What do clinicians and patients need to know?


Another study finds dietary supplement retailers give poor advice. Consumer Reports has published a list of 15 supplement and herbal ingredients that consumers should always avoid: aconite, caffeine powder, chaparral, coltsfoot, comfrey, germander, greater celandine, green tea extract powder, kava, lobelia, methylsynephrine, pennyroyal oil, red yeast rice, usnic acid, and yohimbe. [15 supplements ingredients to always avoid. Consumer Reports Web site July 27, 2016] The magazine also sent sent 43 secret shoppers to Costco, CVS, GNC, Walgreens, Whole Foods, and the Vitamin Shoppe—60 stores in 17 states—where they asked employees (mostly sales staff but also some pharmacists) about products containing several of the ingredients. Most of the employees didn't warn the shoppers about the risks or ask about pre-existing conditions or medications they might be taking, and many gave information that was either misleading or flat-out wrong. [Supplements can make you sick. Consumer Reports Web site, July 27, 2016] Quackwatch has summarized more than 20 published studies which found that dietary supplement retailers gave improper advice about products.


Texas targeting an MMS distributor. Harris County Attorney Vince Ryan has filed suit to stop a Texas-based distributor from marketing Miracle Mineral Solution (MMS). The chemicals in MMS—sodium chlorite and citric acid—when mixed together become chlorine dioxide, a powerful bleaching agent that can cause nausea, vomiting, diarrhea, and severe dehydration when taken by mouth. Ryan's petition alleges:

The lawsuit contends that Hawkins has violated the state's Deceptive Trade Practices Act because of the fraudulent claims about MMS and by promoting, manufacturing and selling MMS, a drug that is not legally approved as safe and effective for use. Ryan is asking the court to prevent Hawkins from promoting, manufacturing or selling any substance, including MMS, that is offered as a treatment for a disease or condition of the human body unless it has been legally approved by the Texas Food, Drug and Cosmetic Act. Quackwatch has additional information about MMS.


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This page was posted on October 31, 2016.