This article is from WeChat public account:Back to Park (ID: fanpu2019) author: Shi Jun, cover: vision China
In the article “It’s time to break the myth of multivitamins We talked about the quality of the multivitamins that cannot be guaranteed. The products may not contain all the elements indicated in the instructions, and may also contain harmful substances. So, how to find reliable health products?
With the improvement of living standards, “health” has become a daily topic for Chinese people. In addition to the old methods of the past, taking all kinds of health products has become the best choice for many Chinese, especially the elderly. A study shows that by 2023, China’s nutritional supplement market is expected to reach 40 billion US dollars, will replace the United States to become the world’s largest nutritional supplement market. There are a lot of health products in the Chinese market. There are also domestic and imported products. Many people like to buy “imported” health products, especially in the United States. They feel that the price is affordable and the quality is guaranteed.
However, are American health products really good?
The rise of the US health care market
Since 1994, the US health care market has experienced rapid growth: sales were only $4 billion in 1994, and by 2018 it had reached $42 billion. To a large extent, this growth can be attributed to a federal bill passed in 1994 entitled “Dietary Supplement Health Education Act (Dietary Supplement Health Education Act) [1].
This law was initiated by politicians who are inextricably linked to the health care industry. The protection of health care products manufacturers far outweighs the protection of ordinary consumers. The product does not need to be like a prescription drug, and it can only be listed after strict approval.
This bill relaxes industry regulations that make dietary supplements (Dietary Supplement, which is what we often call health care products, including vitamins, minerals, plants Extracts, etc.) can be sold at pharmacies or supermarkets without prior approval from the US Food and Drug Administration (FDA). After the product enters the market, FDA will intervene if the consumer reports an adverse event after use. The FDA also conducts product sampling inspections from time to time. If it is determined that the supplements are adulterated, the FDA may issue a public warning letter to the manufacturer or recall the merchandise sold.
If you look closely at the regulatory content of health products on the FDA’s website, you can summarize the following important items:
1) Health supplements do not require FDA approval for marketing.
2) US federal law does not require health products to prove to the FDA that the product is safe prior to marketing.
Note: It is not proof that it is “effective”! Even the security does not have to prove!
3) The manufacturer does not have to prove to the FDA that the effect marked on the health care bottle is accurate and true.
4) Generally speaking, the FDA began to officially monitor the product after the health product was launched. Monitoring is only about whether this product will cause great side effects to people and so on.
5) Health product promotion “can cure a specific disease or delay a symptom” is illegal. This is why health care products usually do not cure a specific disease, but only generally can improve “immune” and the like.
There are a large number of health products on the market, some are produced by large companies, and some are from very small companies. The production specifications of different companies vary widely. The number of health supplements is an order of magnitude larger than the drug, but the supervisionThe source is very limited, which means that the quality and safety of these health products can only depend on the conscience of manufacturers and distributors before problems are discovered.
Customer Misunderstanding
01 Made in the USA?
We Chinese people often feel that the quality of health products in foreign (for example, the United States, Australia) is good. However, things are not what we think.
Although most of the health products sold in the United States are produced in the United States, their raw materials are usually from other countries, and more than 60% of the raw materials come from China, and only the final assembly in the United States. The manufacturers will often change the source of raw materials. Different batches of the same vitamin from the same manufacturer are likely to have different raw materials.
The US FDA does not require the country of origin of the ingredient on the bottle of the health product, nor does it require the origin of the label, but only the telephone number or address of the manufacturer or distributor for the consumer to contact. Since the address is not necessarily the place where the product is manufactured, it is impossible to tell where the health care product comes from.
Figure: American-made health supplements. But the raw materials used may come from other countries.
The following three common health care products are mostly produced in China:
1 90% of vitamin C comes from China. Scotland also produces a small amount of vitamin C, but the cost of raw materials is three times that of China, so the price is much more expensive than from China.
2 Currently, there are no biotins in other countries except China.(biotin)Manufacturing Business. Many of the biomolecules known as “Made in the USA” are actually imported from China and then ground and processed into American production.
3 Pure folic acid(folic acid)Mainly from China. Many of the folic acid produced in the United States, like biotin, are also imported from China and then ground in the United States. Only 5-methyltetrahydrofolate (5-MTHF, this form of folic acid is more easily absorbed, bioavailability is better) Exceptionally, this form is usually produced in the United States.
In the United States, the quality of health products is also a big problem.
In 2015, the Office of the Attorney General of the State of New York in the United States accused four major national retailers GNC, Target, Walgreens(Walgreen) and Walmart(Wal-Mart) Sale of fake, even potentially dangerous plant extracts Health care product [2].
The Attorney General’s Office tested the best-selling plant extract health supplements on these retailers’ shelves and found that four-fifths of the products did not contain any botanical ingredients on the label, but only contained cheap fillers such as rice flour. Asparagus and indoor plants (ie, artificially planted ordinary low-cost plants) extract. In some cases, these substances may cause severe allergic reactions.
For example, Walgreens has a very popular self-produced ginseng film that claims to “enhance physical endurance and vitality” and contains only garlic and rice powder. A ginkgo leaf sold by WalmartTake the (ginkgo biloba), the real ingredients are radish, houseplant and wheat flour, although the label claims that the product does not contain wheat and gluten.
One of the six plant extract supplements tested by Target – Ginkgo biloba extract, St. John’s Grass (St. John’s wort) and 缬草根(valerian root)—not containing the ingredients on the label, but containing rice, beans, and wild carrot powder .
The same is true for GNC’s health supplements, which use ingredients not specified on the label as fillers, such as peanuts and soy powder, which is extremely dangerous for people with peanut allergies.
02 Natural = Good?
Many people think that health care products are mostly “natural” ingredients, so there will be no problems. However, even if it is extracted from natural flora and fauna, consider the complexity of the flora and fauna itself (from the content of active ingredients to possible contaminants) ), there are industrial steps to be experienced in purification.
For some health care products made from plants, many different plants can be used to prepare health care products, but plants that look similar and are close in germline may have very different effects. For example, many women take black cohosh (black cohosh) extracts to improve menopausal symptoms, but in the United States and Canada, there have been consumers Because the tablets that are taken contain different substances of similar names and suffer liver damage.
The “natural” ingredients are not good, and many of the natural substances are toxic. The toxic natural substances in food include cyanogenic glycosides in bamboo shoots (cyanogenic glycosiDes), the sugar alkaloid in the potato (glycoalkaloids), citrus (Lemon, lime, grapefruit, bergamot) contains furan coumarin (Furocoumarins), Many beans contain toxins called lectin
The “natural” ingredient is not worthy of superstition.
How to judge the quality of health products?
Because health care products are not subject to rigorous clinical trial testing, there is virtually no way to ensure their effectiveness, safety, or assurance that they will not interact with any medication you may take.
The only thing that can be seen is what is in this health supplement. In other words, does this health supplement contain the ingredients it claims to have, the dose is also in line with the label, no pollution (for example, from lead and other heavy metals, etc. ), and whether the ingredients can be released normally after the tablets are taken.
All the drugs can be tested for purity, and the health products can’t be done right?
The drug is usually a purified product, and the main component may even exceed 99.9%, containing only a small amount of impurities. However, the ingredients of health products can be very complex, sometimes containing dozens or even hundreds of different substances, many of which come from plants or other natural sources, which makes component detection less easy.
The current standard test method is to use chromatography (chromatogrAphy)Assess the composition of the health supplement. However, for complex products, the information obtained by chromatography is limited. Newer technologies, such as new technologies such as liquid chromatography and mass spectrometry, plus other analyses, can yield more accurate results. However, before these technologies are widely used, further verification is required, and the cost must be reduced to be routine.
Therapeutic drugs are regulated by the FDA. Who is willing to test the health products that are being supervised by the “FDA”? How reliable is the quality inspection data released by the manufacturers themselves? The best way to do this is to test it by an independent, non-interested third-party agency, so that the data you get is convincing.
Figure: Certification Marks of the Three Health Quality Inspection Organizations
01 USP certification
Everyone may notice that there are “USP verified” words on the bottle of many health products in the US (pictured above). This means that the product is certified by an independent, non-profit scientist organization called the USP Dietary Supplements Verification Program.
USP sets a quality standard for food ingredients and health products, and then welcomes manufacturers to work with them to test the manufacturer’s production facilities, processes and product quality. If the standard is met, the product can carry the USP verification mark. The organization also updates certified brands on the website in real time, and where to buy these products [3].
But be careful, some companies will put “USP” on the label of the bottle,Instead of the unique black and yellow “USP Verified” seal. These companies claim to be in compliance with USP production standards, but in reality their products have not been reviewed by USP. In fact, only a few health products have the “USP Verified” seal, such as some Kirkland brand health products in Costco.
In addition, strictly speaking, USP is not truly independent third-party testing, it requires voluntary cooperation from manufacturers.
Figure: USP verification mark on health products (from the network)
02 NSF Certification
Another non-profit organization that independently certifies certain health products is NSF International.
This organization will certify health supplements such as fish oil and multivitamins. In addition, it also has a “NSF Sports Certification (eg protein powder, amino acids and creatine) are particularly useful because it has been found that these products sometimes deliberately add stimulants.
The blue-and-white NSF logo means that the product has been reviewed by NSF, including the ingredients listed on its label.