Terra Sigillata

Quick picks

Time is short today so here are two quick picks of blog posts well worth reading on topics related to our normal discussions:

Joseph at The Corpus Callosum discusses a paper and a news report on putting drug safety risks in objective perspective relative to other risk behaviors we encounter daily, like driving a car. Depending on one’s aversion to risk, some drugs can be considered relatively safe or dangerous, but Joseph points out that one must also consider the benefits of drugs in these risk assessment. But safety is not absolute: all beneficial activities and behaviors carry some risk.

Second is a post from the WSJ Health Blog on a paper in Archives of Internal Medicine reporting on a survey of internal medicine residents about their knowledge of dietary supplements (defined as “vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites”).

More than a third of those who took the quiz wrongly believed that dietary supplements had to be approved by the FDA before being sold. Attending physicians fared better than the overall group, though 15% still thought supplements required FDA approval. And roughly 60% of both residents and attending physicians were unaware that serious side effects of dietary supplements are supposed to be reported to the FDA.

The authors then tested whether an online interactive curriculum they developed could improve supplement knowledge.

The total average pretest score was only 59% (986/1675). The average score rose to 91% (1526/1675) after completion of the curriculum (P<.001).

The bottom line seemed to be that if young docs and attending physicians had poor knowledge of supplement regulation and adverse event reporting, patients and consumers must really be in a fog.


  1. #1 Joe
    May 16, 2007

    This is an interesting item. Although there was a substantial improvement, I remain a tad dismayed that the post-tutorial score did not rise to 100% on a 5-question test.

  2. #2 Lab Cat
    May 16, 2007

    I can confirm that few consumers are aware of how dietary supplements are regulated. The regulations covering dietary supplements are confusing even for food science professionals to understand.

  3. #3 Joseph j7uy5
    May 16, 2007

    There are certain local outlets in town (a college town) that have a reputation for selling high-quality supplements and having knowledgeable staff. I find that even they are misinformed about the role of the FDA.

    Apparently, the FDA does occasionally send people to these stores to be sure the products are not being misrepresented. This gives the people in the store the impression that the FDA is closely regulating the products. The FDA is doing no such thing; they are merely regulating the marketing of the products. As long as there is nothing toxic in the product, they don’t care what is in it. They don’t even care if the product contains what the label says.

  4. #4 Joe
    May 17, 2007

    @ Joseph j7uy5, I think you are being sold a bill of goods about FDA inspections of stores. I can’t be sure; however, I have never heard of such a thing (absent a serious complaint). Even then, marketing complaints are usually the province of the Federal Trade Commission.

    The FDA certainly does care if the contents match the label. And a store visit doesn’t tell them there is nothing toxic in the products (unless there are bottles labelled “ephedra”). I suspect these people simply want you to think they are regulated.

    I recommend reading Dan Hurley’s new book “Natural Causes.”

  5. #5 Joseph j7uy5
    May 17, 2007

    Well, the person who told me about the FDA inspecting stores has no reason to be dishonest, but she could misunderstand the distinction between the FDA and the FTC.

    But I do think that the proprietors of the store do want us to think there is more oversight than there really is. They may even believe it themselves.

  6. #6 S.H.A.M. Scam Sam
    June 23, 2007

    When informed about the “remedies” being sold in a health food store, a visitor declared the particular store owners were “benevolent con men” and, pleased with herself, let it go at that. My feelings are that, when the owners (and the clients) have no standards, there’s (apparently) nothing you can do but wait for some horrible thing to happen to them.

    BTW, “Natural Causes” is a great read.

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