"...all doctors should be able to diagnose and treat nutritional deficiencies."

Royal College of Physicians. Nutrition and Patients: A Doctor's Responsibility. London 2002

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This page has been printed from the www.stewartnutrition.co.uk web site.


The Response of the UK Supplement Industry to Safety Issues

  • Health Food Manufacturers’ Association
  • Responsible Change is Possible
  • Nutritional Supplements “Safety Statement”
  • Do Doctors Know What Supplements Their Patients are Taking?
  • What the Supplement Industry Could Do Next

The three main reports on safety have each received varying degrees of media attention and a variety of responses from the supplement industry and those associated with it including incredulity and claims of conspiracy theory.  The responsibility for resolving these problems lies with the Food Standards Agency who is guided by the EC Food Supplements Directive (2002/46) which makes provision for setting maximum levels of vitamins and minerals for use in food supplements and further guidance is due in 2008 from the Standing Committee on the Food Chain.  The supplement Industry is represented by the Health Food Manufacturers’ Association.

Health Food Manufacturers’ Association

The majority of the supplement industry in the UK is represented by the Health Food Manufacturers’ Association (www.hfma.co.uk) who were founded in 1965.  In April 2008 issued a statement after the latest Cochrane Review on antioxidants pointing out that, in this meta-analysis, 405 studies that reported no deaths whatsoever were excluded from the study.  Their counter-claim that “Antioxidant supplements cannot be expected to undo a lifetime of unhealthy living ..” is of course true but the remainder of the statement “ but combined with good lifestyle choices, can play an important role in promoting overall health and well-being.” has yet to be proven. 

The Health Food Manufacturers’ Association has taken a number of steps to improve safety including advisory statements relating to pregnancy, vitamin A, vitamin K and iron for use on food supplement packaging.  However the issues of the safety of high dose supplements and contraindications and warnings as to the use of all types of supplements remain. 

The Food Standards Agency produced a report in 2006 of a survey that they commissioned of the food supplement industry.  The survey identified 31 companies that produce 744 products that contain vitamin and mineral substances at or above the Safe Upper Levels or Guidance Levels set by the EVM.  Such products are estimated to be worth £25-33 million per annum.  The FSA commented in their report that “it was disappointing that only a relatively small proportion of the industry took part in the survey.”
www.food.gov.uk/multimedia/pdfs/int060703a.pdf

Responsible Change is Possible

A few major supplement companies have taken steps to make their products safer particularly in relation to retinol (vitamin A) content.  They include:

  • Boots have reformulated their own products so that the formulations do not exceed the Safe Upper Levels and Guidance Levels set by the FSA in May 2003 and have reduced the retinol content of many supplements to reduce the risk of accidental long-term accumulation especially by those who may also wish to take a cod liver oil supplement
  • Seven Seas, who have a long tradition of producing cod liver oil and fish oil preparations, have removed the retinol entirely from some of their cod liver oil formulations and have plans to extend this to other products
  • Solgar, who are a large US-based multinational manufacturer of nutritional supplements with a significant presence in the UK have removed the retinol from most of their high-strength multivitamin preparations.
  • Supplement companies in the US and Scandinavia have reduced the retinol content of common supplements (Centrum in the US and Cod Liver Oil in Norway)

Doubtless a few other companies, who retail in the UK, have made other similar changes and the author would be pleased to hear from them.  For understandable reasons few companies have made much noise about these changes and as time since the publication of the various safety reviews passes and the number of reports of adverse reactions increase it seems likely that few others will.

Companies that wish to act in the best interests of their consumers will need to make a serious in-depth risk/benefit analysis of their current portfolio of products if they have not already done so.   Indeed the Health Food Manufacturers’ Association states in their 2002 constitution that one of their Objects is “in respect of nutrition and health, to be aware of and concerned with the interests of the consumer.”  Unfortunately at present there is no organised way for consumers to express those concerns directly to the health food industry, which is something that will need to be rectified.  



Copyright Dr. Alan Stewart M.B.B.S.M.R.C.P. (UK)M.F. Hom.
47 Priory Street, Lewes, East Sussex. BN7 1HJ
Tel 01273 487003 Fax: 01273 487576