1. Dietary Supplements Guidance for Consumers Information Provided To You By: JFHQ Occupational Health Office Nutrition For Everyday Series- Lesson 9

2. Savvy Supplement Users… Making Informed Decisions and Evaluating Information Issues: Abundance of sources and types readily available Information can be conflicting When used properly, supplements can enhance individual health and wellness, but can be detrimental if not taken properly What is in your medicine cabinet? Herbals Vitamin Minerals Other Substances www.fda.gov A global concern for people wanting to improve their health

3. Basics To Know? Example- Coumadin, ginkgo biloba, aspirin and Vitamin E-all can thin the blood and cause increased bleeding risks. Medication interactions with supplements: Trouble in combinations Over the counter medicine can interact just as severely as prescribed medications can. Read the labels, specifically for information on side effects, for timing of doses and combinations to avoid. Check with your Doctor before taking a supplement Think about your Total Diet Some supplements may interfere with your surgery experience.

4. Tips on searching the web Common questionable phrases: This is not a hoax! Send this to everyone you know!!!! RESEARCH HAS PROVEN THIS PRODUCT IS THE BEST IN THE ENTIRE UNIVERSE!!!! Questions to think about- Who operates the site? What is the purpose of the site? What is the source of the information and does it have any references? Is the information current? How reliable is the Internet or e-mail solicitation?

5. More tips and to dos Think twice about chasing the latest headline * Actors endorse things for money and they may not even know exactly what they are selling. Does it sound too good to be true?

6. Check your Assumptions “Even if a product may not help me, it at least won’t hurt me.” “A product is safe when there is no cautionary information on the product label.” “A recall of a harmful product guarantees that all such harmful products will be immediately and completely removed from the marketplace.” “When I see the term ‘natural’, it means that a product is healthful and safe.”

7. Contact the Manufacturer- Ask fact seeking questions Does the firm have a quality control system in place to determine if the product actually contains what is stated on the label and is free of contaminants? Has the firm received any adverse events reports from consumers using their products? Asking questions can save you from adverse events… Does the firm have information to share about tests it has conducted on the safety or efficacy of the ingredients in the product? What information does the firm have to substantiate the claims made for the product?

8. Use References to Understand better- Evaluating Research 10 Things to Know About Evaluating Medical Resources on the Web 5 A short guide developed by the National Cancer Institute, NIH, to help you evaluate medical Web sites. (July, 1999) 10 Things to Know About Evaluating Medical Resources on the Web How to Understand and Interpret Food and Health- Related Scientific Studies 6 This article provides an overview for understanding and interpreting food and health-related scientific studies (from the International Food Information Council, May 2000). How to Understand and Interpret Food and Health- Related Scientific Studies Making Sense of Health and Nutrition News 7 Provides tips for evaluating science.(IFIC, Food Insight. Jan/Feb 2001 Making Sense of Health and Nutrition News Navigating the Internet Medical products and the Internet. A guide to finding reliable information Medical products and the Internet. A guide to finding reliable information 8. Navigating for Health: Finding Accurate Information on the Internet" Navigating for Health: Finding Accurate Information on the Internet" 9. (IFIC Food Insight article, November-December, 2000) Quality of Health Information Quality of Health Information 10.

9. Product Claims and Labeling "Claims That Can Be Made for Conventional Foods and Dietary Supplements" 11 "Claims That Can Be Made for Conventional Foods and Dietary Supplements" FDA Dietary Supplement Overview 12. FDA Dietary Supplement Overview "Improving Public Understanding: Guidelines for Communicating Emerging Science on Nutrition, Food Safety and Health." 13"Improving Public Understanding: Guidelines for Communicating Emerging Science on Nutrition, Food Safety and Health." "Miracle" Health Claims: Add a Dose of Skepticism 14 "Miracle" Health Claims: Add a Dose of Skepticism "Dietary Supplements: An Advertising Guide for Industry" 15. "Dietary Supplements: An Advertising Guide for Industry" MedWatch 16. MedWatch The Food and Nutrition Board 17 The Food and Nutrition Board NUTRITION.GOV 18 NUTRITION.GOV MEDLINE Plus Health Information: Vitamin and Mineral Supplements 19 MEDLINE Plus Health Information: Vitamin and Mineral Supplements International Bibliographic Information on Dietary Supplements (IBIDS) 20 International Bibliographic Information on Dietary Supplements (IBIDS) National Center for Complementary and Alternative Medicine 21, NIH. National Center for Complementary and Alternative Medicine

10. Product Claims and Labeling continued MEDLINE Plus Health Information: Vitamin and Mineral Supplements 19 MEDLINE Plus Health Information: Vitamin and Mineral Supplements International Bibliographic Information on Dietary Supplements (IBIDS) 20 International Bibliographic Information on Dietary Supplements (IBIDS) National Center for Complementary and Alternative Medicine 21, NIH. National Center for Complementary and Alternative Medicine

11. Watch Out!! ALERT!! Aristolochic Acid Colloidal Silver Comfrey Ephedrine Alkaloids Kava LipoKinetix: FDA Warns About Weight Loss Product Liqiang 4 PC SPES and SPES Red Yeast Rice St. John's Wort and Indinavir Tiractricol Triax Metabolic Accelerator Other FDA Alerts Botanical Dietary Supplements

12. Label Requirements information that appears on the product container, including a descriptive name of the product stating that it is a "supplement“ the name and place of business of the manufacturer, packer, or distributor; a complete list of ingredients; and each dietary ingredient contained in the product. Supplements must also include directions for use, nutrition labeling in the form of a Supplement Facts panel that identifies each dietary ingredient contained in the product and the serving size, amount, and active ingredients.

13. Quiz Time 1. A supplement labeled “natural” means that it also is: a. mild b. without any risk of side effects c. safe to use with other medications d.none of the above 2.Since dietary supplements are so easily available — and don’t require a doctor’s prescription — they are much safer than drug products and can be used to self-treat illnesses without a health professional’s advice or supervision. True or False 3.Testimonials in dietary supplement promotions give a good idea of the supplement’s benefits and safety because they’re based on firsthand accounts. True or False Savvy About Supplements

14. Answers Rationale: 1.“Natural” doesn’t always mean “safe”. 2.Some Herbal and Prescribed medications have shown to interact poorly together. 3.Testimonials are not reliable. 1. D 2. False 3. False

15. Quiz Time 4. Many supplements have proven health benefits. True or False 5. Before you start taking a dietary supplement, talk it over with a knowledgeable person like: a. your doctor or health professional b. your pharmacist c. a supplement salesperson d. a friend who takes them Savvy About Supplements

16. Answers Continued Rationale: #4 Don’t forget the reliable source for information. #5 Only take guidance from qualified individuals. 4. True 5. A or B

17. Questions? Please use caution when taking supplements… If you are unsure, ask a professional… Also, make sure the product is legal to use in the Military. It could cost you a career.