A new study found almost 75% of older Australians take at least one type of dietary supplement or complementary medicine, most of which are not recommended by current medical opinion. The researchers said that the widespread use of complementary medicine in this population raised questions about their marketing and promotion.
- Fears of ‘borderline unethical’ advertising after 75% of older Australians found to be taking supplements
- MJA Podcasts 2021 Episode 2: Complementary medicine use in older Australians, with Dr Alice Owen and A/Prof Ingrid Hopper
Hardly ‘borderline unethical’!
Numerous representative complaints have shown that this discrepancy between use and scientific evidence is largely due to unethical advertising by the complementary medicine industry. For example:
The industry targets vulnerable consumers, with products containing ingredients that lack efficacy and claims that undermine public health messages, such as weight loss, hangover, and lung detox products.
Promotional claims remain unchanged, despite new evidence that has resulted in the products no longer being recommended by current medical opinion. Examples include glucosamine for osteoarthritis and fish oil for ‘heart health’.
Irrational multivitamin / mineral / herbal combinations are extensively promoted for ‘stress, stamina vitality, etc.’, and to fill alleged nutritional gaps caused by busy lifestyles, while Australian Dietary Guidelines (healthy eating) are rarely mentioned.
Claims are extrapolating from a nutrient’s important role in the body to implying that taking this ingredient as a supplement will benefit normal healthy people. Examples include Coenzyme Q10 and nicotinamide riboside chloride (Vitamin B3).
Ingredients such as probiotics and multi-vitamins are added to unhealthy products such as ‘Kids Smart Vita Gummies’ and ‘Probiotic Choc Balls’ to give them a ‘health halo’.
Clinical trial results from specific, well-characterised herbal extracts are extrapolated to generic herbal ingredients, despite only being applicable to the extract used in the trial.
‘Traditional’ rather than ‘scientific’ claims are increasingly used, removing the need for complementary medicines to have a scientific evidence base.
Regrettably, the regulator (the TGA) has failed to address these issues.
Potentially dangerous supplements?
Complementary medicines are regarded by the TGA as low-risk products, but that does not mean they are without risk.
While it’s impossible to overdose on vitamins and minerals in food, it’s certainly possible to consume too much from supplements and experience adverse effects. This is especially so for fat-soluble vitamins that accumulate in the body such as Vitamin A, D & E. Calcium supplementation has also been associated with kidney stones, gastrointestinal side effects, and possibly an increased risk of cardiovascular disease.
Green tea extract supplements used for weight loss have been linked to rare cases of liver damage that needed liver transplants. Herbal supplements can also cause serious adverse effects, such as allergic reactions to Echinacea; they can also interact with prescription drugs, for example St John’s Wort (Hypericum perforatum) interacts with many drugs and can nullify the effect of oral contraceptives.
In short, a healthy diet (Australian Dietary Guidelines) provides all the nutrients most people need and is without risk. However, there can be good reasons to take specific evidence-based complementary medicines for particular purposes. The need for supplements should be discussed with your doctor.