Supplement ads — can they be trusted?

Aim of the study: Background: Dietary supplements promoted for brain health and enhanced cognitive performance are widely available. Claims made for these products are directed not only to older people wishing to prevent or reduce cognitive decline, but also to young, healthy people looking to boost their cognitive performance.

Results: The ingredients evaluated included Bacopa monnieri, choline, creatine, omega-3 fatty acids, Ginkgo biloba, ginseng, Rhodiola rosea, tyrosine and valerian root, all in supplement form and compared with a placebo, at various serving sizes and durations of use. Conclusions: The low level of certainty in the current scientific evidence, together with the fact that we do not always know what a dietary supplement contains, makes it difficult to weigh the risks and benefits. These data make it harder to develop recommendations for consumers interested in using these ingredients to boost cognitive performance. Although this synthesis points to certain promising trends in serving sizes or duration of use, the studies taken together are inconsistent and imprecise, and many have methodological flaws. Possible solutions to address gaps in the research are offered as next steps for future research, which is needed to strengthen the evidence and inform decisions.

Aim of the study: Omega-3 polyunsaturated fatty acids (n-3 PUFAs) are promoted as cognitive enhancers, and their use is recommended for the general population and for people with neurocognitive conditions such as attention deficit hyperactivity disorder (ADHD). However, evidence from randomised placebo-controlled trials is inconclusive.

Results: In the 24 studies included, n-3 PUFA supplementation did not improve any measure of cognitive performance in the full sample or in the TD and ADHD+RD subgroups. In participants with low n-3 PUFA status, supplementation improved short-term memory. There is limited evidence that n-3 PUFA supplementation affects cognition in people who are deficient in n-3 PUFAs. However, there is no evidence of an effect in the general population or in people with neurodevelopmental disorders. This has important implications given the widespread advertising and consumption of n-3 PUFA; claims of cognitive benefits should be more limited.

Aim of the study: To analyse the scientific evidence available for the advertising claims made for two products containing Lactobacillus casei and Bifidobacterium lactis, and to compare the published literature with the information presented on the companies’ website.

Results: Of the 440 articles identified, 16 met the inclusion criteria. Only four (25%) had a level of evidence of 1b and a recommendation grade of A; all related to studies of a product containing Bifidobacterium lactis. Only 12 of the 16 studies were published on the corporate website (47). There is insufficient scientific evidence to support the health claims made for these products, especially for the product containing Lactobacillus casei.

Aim of the study: Prevagen® is a dietary supplement marketed to help with mild memory loss associated with aging. The manufacturer says that clinical evidence supports this use.

Results: Prevagen®’s designation as a “#1 Pharmacist Recommended Brand” is based on a survey conducted by Pharmacy Times® to identify the over-the-counter brands that pharmacists recommend most often. Given the limited clinical data supporting Prevagen®’s effectiveness, the survey results likely reflect pharmacists’ familiarity with this product, which may be influenced by extensive advertising. As practitioners of evidence-based medicine, pharmacists should not recommend a product when there is limited evidence to support its use. Furthermore, pharmacists should proactively educate their patients, especially those who are most vulnerable, about the rational use of all pharmacologically active substances, including dietary supplements.

Aim of the study: Background: Dietary supplements targeting brain health have quickly emerged on the market as cognitive performance has become an important public health issue.

Results: Conclusions: Dietary supplements targeting brain health are being marketed to consumers, and some should be considered adulterated and mislabelled. Advertisements and product labels may be deceptive and could put the public at risk. The public needs education to recognize red flags while the U.S. Food and Drug Administration works to “modernize” current regulations for dietary supplements.

Aim of the study: Public health institutions have alerted consumers about dietary supplement advertising that makes false claims about preventing or treating COVID-19. We quantitatively and qualitatively examined newspaper advertisements for dietary supplements before and after the spread of COVID-19.

Results: The number of dietary supplement advertisements claiming to prevent infections (p=0.009) or improve joint (p=0.002) and digestive (p=0.002) function increased significantly after the spread of COVID-19 compared with before. Dietary supplements claimed to prevent infection were advertised alongside recommendations to gargle and wash hands. Terms such as “defence” and “prevent” were used to promote preventive effects. False and misleading claims in dietary supplement advertising may harm consumers, for example through overdosing or failure to take preventive measures. While the pandemic continues, there will be a growing need to share accessible information about the appropriate use of dietary supplements, educate consumers and warn manufacturers.

Aim of the study: Dietary supplements may have beneficial value but, by definition, they have no therapeutic effect. However, their labels and especially their media advertisements often make unsubstantiated health claims.

Results: Supplement advertisements broadcast on six TV and radio stations from 9–15 March 2020 were analysed. Most of the advertisements analysed complied with legal requirements and included terms such as “supports” or “facilitates” body functions, which are less definite. Almost 30% of the advertised supplements made unproven claims about their effectiveness in various health situations, such as effective weight loss, thereby assuring viewers of their benefits in a particular health context. Agreement on the rules and regulations governing supplement advertising led to a noticeable improvement in the content of advertisements, which will hopefully increase consumer awareness that dietary supplements do not have therapeutic properties.

Aim of the study: Background: Excessive use of dietary supplements is widespread, and their advertising is often misleading and suggests therapeutic properties. The study aimed to assess consumers’ perceptions of advertising, their expectations about the effects of dietary supplements, and their overall knowledge of these products.

Results: The proportion of respondents expressing the highest level of scepticism also increased as their knowledge of dietary supplements increased. Despite this, 60.6% of respondents said that if they experienced the health problems mentioned in an advertisement, it could encourage them to start using the advertised products. Factors that significantly increased the likelihood of using dietary supplements included high expectations of their effectiveness (OR = 11.1), little knowledge about dietary supplements (OR = 2.9), believing that their effectiveness had been proven in scientific studies (OR = 1.9), and living in a rural area (OR = 1.9). Conclusions: Given forecasts of continued growth in the dietary supplement market, and the belief among many consumers that the effects of these products have been proven, educational campaigns are needed to prevent confusion between supplements and medicines.

Aim of the study: Consumers who are unable to obtain semaglutide or tirzepatide from clinicians or insurers are turning to natural “GLP-1” transdermal patches. The Dietary Supplement Health and Education Act specifies that dietary supplement products must be swallowed, so all these products are illegal.

Results: The Dietary Supplement Health and Education Act specifies that dietary supplement products must be swallowed, so all these products are illegal. We identified 24 transdermal patch dietary supplement products and one transdermal gel product, with an average of 7 ± 4 natural ingredients (berberine, glutamine/glutamate, cinnamon and pomegranate were listed most often). No certificates of analysis were posted, many products lacked the Food and Drug Administration disclaimer, and many used deceptive advertising. Several products had 1- to 2-star reviews and consumer comments suggesting a lack of effectiveness or adverse events.

Aim of the study: Dietary supplements are commonly used, and many are effective or show promise for treating various conditions. However, they do not require approval from the Food and Drug Administration (FDA).

Results: Impurities and adulterants have been found in these products, mostly because there are no requirements for good manufacturing practices. In addition, because standardization is not required, the active ingredient may be absent or vary greatly between manufacturers. The FDA published its 10-year plan for dietary supplements, which addresses safety, labeling, boundaries, enforcement, research and outreach. If implemented, this effort will be instrumental in giving consumers greater confidence in the safety, composition and labelling of dietary supplements.