Supplement Group Targets Consumer Education
2 January 2002
by Wyn Snow, Managing Editor

Seeking to overcome negative publicity about supplements, an industry coalition called the Dietary Supplement Education Alliance plans to counter media skepticism and win over consumer confidence. With a website already up and running and a major PR campaign under way, the Alliance is the first concerted attempt to systematically brighten the image of an industry that has long been a media whipping boy.

Until now, industry response to negative media coverage has been scattered. According to Elliott Balbert, acting president of DSEA and the chief executive of leading supplement manufacturer, Natrol, the Dietary Supplement Education Alliance (DSEA) is designed to change that. "The media has not been very friendly to the natural products industry, and as a result of that, it has gone from bad to worse to pretty ugly," says Balbert. The DSEA has been organized "to put the E back into DSHEA [the Dietary Supplements Health and Education Act of 1994]," and to publicize the benefits of supplements.

Formed during the spring of 2001 through a collaboration of supplement industry manufacturers, publishers and trade organizations, DSEA by its own estimate has currently raised over $500,000. While DSEA may be long overdue from the perspective of supplement manufacturers, such groups are typical of the American marketplace. Thousands of trade organizations underwrite public relations campaigns -- including trade shows and magazine articles -- that educate public and professional audiences on a host of issues.

The supplement industry's pursuit of this course is as much a sign of maturity as a desire to engage in self-promotion. Given the variety and complexity of supplement products, such an initiative may be no more than good business sense and may well provide useful public service. The medical profession and pharmaceutical industry have long used education-based public relations to enhance their status and marketability. For the supplement industry to follow suit seems only logical.

DSEA taps scientific resources

From its first announcements in the summer of 2001, DSEA has sought to establish its credibility based on scientific expertise. According to press releases, DSEA's scientific advisory board contains nine specialists with ten advanced degrees among them (seven PhDs, two MDs, one DVM, plus a registered pharmacist and registered dietitian). Specialties include nutrition, plant chemistry, pharmacognosy (the analysis and characterization of bioactive elements in natural substances), biochemistry of antioxidants, neuropsychopharmacology, molecular biology, immunology, cancer research, and naturopathic medicine. (See sidebar on DSEA scientific advisory board members and their backgrounds.)

As noted earlier, DSEA claims to have raised more than $500,000 from industry contributors, a sum more than sufficient to ensure that their information is based on the best scientific knowledge available. Whatever information DSEA does seek to distribute will be made available through a number of distribution channels, among them a website as well as a public relations campaign managed by Hill and Knowlton. The latter is the largest public relations organization in the world and a recognized leader in health-related issues management.

Website created as information resource for consumers

One of DSEA's first actions was to create www.SupplementInfo.org. This new website contains information about

• survey results on who takes supplements and why
• areas of supplement research being funded by the federal government
• the nature of health benefit claims that supplements can make
• industry statistics on sales of vitamins, minerals, herbs and specialty supplements

The website also has feature articles -- currently focusing on consumer confidence, the health of seniors, proposed legislation for health plan coverage of supplements, and DSEA-related comments of Senator Tom Harkin, a long-time supporter of supplementation. The website also contains a database of information provided by IntraMedicine.com that covers roughly 180 supplements and 90 health conditions.

Website highlights science-based approach

DSEA's new website contains information reviewed by an advisory board of scientific experts -- according to Joe Betz, PhD, Vice President and Director of Scientific and Technical Affairs of the American Herbal Products Association. Betz is also a member of DSEA's Scientific Advisory Board.

A rigorously scientific approach will be a valuable resource for consumers. Information about supplements on the Web has been tainted with the same kinds of exploitative marketing techniques that pervade radio ads and television infomercials. Identifying reliable, science-based information about supplements on the Web can often be a challenging task.

Quality of website still evolving

In order to assess the quality of the content on the new DSEA website, SupplementQuality.com contacted several independent academics with expertise in both botanical and nutritional supplements. The results suggest that the DSEA website is still in a "dress rehearsal" stage. None considered the site better than others with similar content, and a few offered serious criticism.

Professor Robert Reynolds of the University of Illinois, a leading researcher on vitamin B6, examined the website's entry for B6 -- and says its information "can do real harm."

In particular, in its section on "Toxicities & Precautions" for B6, the DSEA website states, "There are no known toxicities associated with this dietary supplement." But Reynolds observes, "This is wrong, and they know it! Their next sentence [concerning side effects] says, 'Occasional side effects reported with large doses . . . include neurological toxicities' -- so they know there are serious side effects, which they describe later on. That same paragraph sort of pooh-poohs the impact of such side effects when they say, 'It may be necessary to reduce the dose of this dietary supplement. Tell your doctor if these side effects become severe or do not go away.'"

Reynolds continues, "If you have these side effects, reduce the dose immediately! If the side effects do become severe or do not go away, it is too late. Permanent neurological damage has already been done."

Reynolds criticizes several other points of this website's information about B6 (see sidebar of Reynolds' detailed critique) including the website's use of recommended daily allowance instead of recommended dietary allowance (RDA). Use of this obsolete term for RDA suggests either ignorance on the part of the writer, use of information written before the change in terminology several years ago, or an attempt to "laymanize" information about supplements for a consumer audience.

Another independent voice

Paul Thomas, EdD and a registered dietitian, devoted a full page to DSEA's SupplementInfo.org website in the July-Sept 2001 edition of his newsletter, The Dietary Supplement. Thomas says, "The website's information is useful, but emphasizes the positive potential of supplements, ignores controversy, and downplays information that a supplement may be of no benefit."

Thomas believes the website has two incompatible goals: to provide "the complete facts" about supplements, and to promote their benefits and use. Thomas finds that "A look at DSEA's website quickly reveals that conveying positive and reassuring feelings about supplements is its major purpose." He concludes, "The website is basically hype and propaganda."

Supplement information being updated

Flaws in the supplement database are being remedied -- according to David Seckman, a member of DSEA's steering committee and Executive Director of the National Nutritional Foods Association (NNFA). NNFA is the nation's oldest and largest trade association for natural products.

Seckman says, "DSEA members are now finalizing a review of the information in the IntraMedicine database. There have already been some changes, and there will be more. IntraMedicine has been very appreciative of our review. We feel very good about the quality of information that will be available. For consumers, it will enable people to get essential information."

Phillip Harvey, PhD, Director of Science and Quality Assurance for NNFA, is one of the site reviewers. Says Harvey, "The process has been slow because there are so many monographs (to review). However, the monographs are dynamic and will be updated and improved as new information appears in the scientific literature."

Site intended to inform consumers

Concerning drug/supplement interactions and the explicit benefits of supplementation, both controversial topics in the media, Seckman says, "A story came out today that garlic can interfere with medications for HIV and other conditions. And when a supplement has interactions, we all need to know about it. Whether it's garlic or St. John's wort or whatever. But these stories imply that supplements are not good for you. Even though a lot of new research shows they are good for you, information like that tends not to appear in the news. I just came from my ophthalmologist, where I heard about zinc being good for the eyes. I think people need and can use that kind of news. That's why the DSEA website focuses on benefits. It gives valuable information that consumers need to know."

Seckman believes it's important to make sure people use supplements properly. He says, "If I'm interested in garlic, what concerns should I have? I can go to SupplementInfo.org and see the positives and the potential for interaction. We always advise everyone to look at all sides. What is it used for? What are the possible interactions? It doesn't do any good for industry or the consumer when people use a supplement in ways it's not intended for."

Potential for consumer education

Seckman's concerns about media coverage raise a valid point. Mainstream media such as the Journal of the American Medical Association (JAMA) and The New York Times are dismissive in their coverage of supplements, and often give inaccurate information about them (such as claims that supplements are untested and unregulated). Invariably, such coverage is accompanied by sensationalism (at least in the case of the daily and broadcast media) and reveals a painful lack of knowledge about supplements in general.

It is also important to recognize the economic and cultural biases against supplements, which DSEA can play a role in overcoming. The reasons for such biases are numerous and go far beyond the scope of this editorial, but are worth observing. If DSEA can educate consumers about the rationale behind prevention-based health care and link such strategies to reduced costs and enhanced well being, its resources will be well utilized for the public good.

Providing consumers and the media with solid, science-based information is an important and laudable goal. DSEA has launched a campaign with excellent potential for educating both the public and the media about the very real health benefits of supplements and for encouraging more balanced media attention.

Website a litmus test for industry

However, the last thing consumers need from the producers of dietary supplements is incorrect information. Like Caesar's wife, the industry must be above reproach. Consumers cannot determine for themselves which parts of the supplement database are accurate and which are not. Thus, the presence of any single piece of incorrect information casts doubt upon the whole.

If DSEA is to play a leadership role, it must do so first by example, including adherence to the highest quality standards in its content. We look forward to viewing revised information on the DSEA site after it has undergone a complete and rigorous scientific review. Until then, we view SupplementInfo.org for what it is -- a litmus test for an industry yet to rise above the contention in which it is still embroiled.