To give consumers a higher level of confidence in the safety of dietary supplements, the US Food and Drug Administration (FDA) plans to strengthen guidelines on the manufacture and use of these products. The FDA?s Center for Food Safety and Applied Nutrition has developed an overall dietary supplement strategy, with plans of putting it in place by 2010.

The goal of the plan is to form a science-based regulatory program to fully implement the Dietary Supplement and Health Education Act (DSHEA) of 1994. DSHEA states that manufacturers of dietary supplements can claim a product affects the structure or functioning of the body so long as they do not claim it can treat, diagnose, cure or prevent disease when no scientific proof exists to support such claims.

Labels list ingredients

Last year, the FDA required labels on all dietary supplements to include a list of ingredients and a breakdown of nutritional information. The guidelines for 2010 add a variety of safety features to that requirement ? including a system for reporting drug interactions in people taking dietary supplements, the publication of "good manufacturing practices" for supplements, stricter labeling guidelines and enforcement mechanisms and enhanced scientific oversight of research into supplements.

"Consumers need to know the risks and possible adverse reactions certain dietary supplements can have, whether because of a preexisting condition, dosage issues or adverse reactions with other medications," said Joseph A. Levitt, director of the FDA?s Center for Food Safety and Applied Nutrition.

Unlike makers of prescription or over-the-counter medicines, dietary supplement manufacturers are now relatively free of government regulation. Dietary supplements can be sold without FDA approval. Currently, the burden is on the FDA to prove a product poses an unreasonable health risk or is being marketed as a drug before it can restrict its use.

A few companies have been willing to conduct scientific testing of their products to prove they work. A manufacturer of saw palmetto, which is said to support prostate health, is conducting the same rigorous clinical trials the FDA requires of prescription drugs. However, most supplement makers are not doing this kind of research.

More research should be done

"Nutritional research is in its infancy," says David Rosenthal, MD, professor of medicine at Harvard University Medical School and director of Harvard?s University Health Services. "While many supplements are probably benign, some herbs and minerals might be potentially harmful. [Manufacturers of these] products are making claims that need to be monitored and under better scrutiny, particularly in the area of interactions with other drugs."

Dietary supplements cannot prevent or cure cancer. Scientific studies continue to show that virtually all nutrients needed for good health can be obtained by eating a balanced diet, according to Alexis Williams, project assistant in nutrition and physical activity promotion for the American Cancer Society (ACS).

"Most people can get all the nutrients they need from eating a balanced diet ? one that includes five or more servings of vegetables and fruit each day. Research on supplements and cancer risk reduction have not shown the same benefits as whole foods," Williams said. "It?s also important for good health to get regular physical activity. The American Cancer Society recommends at least 30 minutes on most days."

Only a few special groups of people need dietary supplements in addition to a balanced diet. They are pregnant and breast-feeding women, young children, vegans (people who eliminate all meat and dairy from their diets), alcoholics and people who are frail or ill and unable to eat normally. Women after menopause may benefit from taking calcium supplements to help prevent osteoporosis and folic acid supplements (during child-bearing years) to help prevent birth defects.