Friday, October 20, 2017

The Liver Meeting® 2017 - The Frequency of Herbal and Dietary Supplement Mislabeling

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The Liver Meeting® 2017

Herbal and dietary supplements often mislabeled
Last Updated: 2017-10-24
By Megan Brooks
NEW YORK (Reuters Health) - Product information on labels of most herbal and dietary supplements are inaccurate, according to research presented at The Liver Meeting, held by the American Association for the Study of Liver Diseases.

Products used for body building and weight loss are most apt to be mislabeled, Dr. Victor Navarro from Einstein Healthcare Network in Philadelphia, and his colleagues found.

They did a chemical analysis of 203 herbal and dietary supplements (HDS) and compared the results to ingredients listed on the product labels.

Fewer than half of the products (90 of 203, 44%) had labels that accurately reflected their contents.
Based on the composition of the product, mislabeling occurred in 80% of products made principally of steroidal ingredients, 54% of those made principally of vitamin ingredients, and 48% of those made largely of botanical ingredients, the researchers say.

Products intended for bodybuilding, weight loss, energy boosters and general health/well-being had mislabeling rates of 79%, 72%, 60% and 51%, respectively.

Similar mislabeling rates were found the 166 HDS products judged to be responsible for liver injury by investigators with the Drug Induced Liver Injury Network (DILIN).

"What is novel in terms of actually testing products, is the extent of the mislabeling of over-the-counter supplements, which translates into significant health risks for consumers taking them," Samantha Heller, registered dietitian and senior clinical nutritionist, NYU Langone Health, told Reuters Health by email.

"There are a high number of cases of liver injury due to dietary supplements that include hepatotoxicity, acute liver failure and subsequent death or transplantation, as well as nephrotoxicity," said Heller, who was not involved in the study.

Heller said the message is clear. "Don't bother taking any dietary supplement that claims to promote fast weight loss, build muscle, detox or cleanse the body, boost brain power, cure disease or offer other miraculous results. At this time there is no scientific evidence to support any of these claims. Consumers' money is better spent on a fitness center membership, seeing a registered dietitian for evidence-based nutritional guidance, adopting healthy lifestyle habits, and getting a massage."
The study had no funding, and the authors have no relevant disclosures.
American Association for the Study of Liver Diseases 2017.
Reuters Health - Read the article (LINK)

Most dietary supplements mislabeled, may cause liver injury
October 22, 2017
WASHINGTON — Mislabeling or omission of ingredients occurs frequently in herbal and dietary supplements, especially among bodybuilding and weight loss products, according to a presentation at The Liver Meeting 2017. “We have found that the dietary supplements are a common cause of liver injury,” Victor J. Navarro, MD, from the department of transplantation at the Einstein Healthcare Network, Philadelphia, said in his presentation. “In looking at those cases, we find that there are a lot of products that are difficult to identify exactly what they are and what they’re used for. There has been a lot of literature that tells us that dietary supplements in the market can be mislabeled and can be adulterated.”
Article available @ Healio

The Frequency of Herbal and Dietary Supplement Mislabeling
Washington, D.C. – Herbal and dietary supplement mislabeling is common and should be evaluated as a potential cause for liver damage, according to research presented this week at The Liver Meeting® — held by the American Association for the Study of Liver Diseases.

The herbal and dietary supplements industry is a multi‐billion‐dollar‐per‐year enterprise in the United States. Over 20 percent of cases of liver injury reported to the U.S. Drug Induced Liver Injury Network (called DILIN) are attributed to herbal and dietary supplements.

“Since herbal and dietary supplements are not required by the FDA to be tested for safety or effectiveness, the DILIN has focused on various factors that could explain their potential for harm,” says Victor Navarro, MD, chair of Hepatology for Einstein Medical Center in Philadelphia.

There is a growing concern that potentially mislabeled products may contain ingredients that can be highly toxic, and damaging, to the liver. To assess this, Dr. Navarro’s team of researchers used samples of herbal and dietary supplements collected by DILIN to analyze the contents of these products and determine the frequency of mislabeling.

Between 2003 and March 2016, DILIN collected 341 herbal and dietary supplement products from 1,268 patients enrolled in DILIN. The National Center for Natural Products Research at the University of Mississippi conducted a chemical analysis on 229 of these products. The ingredients, as they were determined by the chemical analysis, where then compared to the ingredients listed on the 203 analyzed products that contained a label.

As determined through the chemical analysis, Dr. Navarro’s team found only 90 of 203 products contained labels that accurately reflected their contents. Mislabeling – defined by the researchers as when the chemical analysis did not confirm the ingredients listed on the label – occurred in 80 percent of products used for body building and performance enhancement, and 72 percent of products used for weight loss. “Based on these findings, the DILIN will embark upon a more detailed analysis of the chemical ingredients, to determine the precise cause of the liver injury”.

Dr. Navarro will present these findings at AASLD’s press conference in Room 103B at the Walter E. Washington Convention Center in Washington, D.C on Saturday, October 21 at 4 PM. Dr. Navarro will present the study entitled “The Frequency of Herbal and Dietary Supplement Mislabeling: Experience of the Drug Induced Liver Injury Network” on Tuesday, October 24 at 10:15 AM in the Ballroom. The corresponding abstract (264) can be found in the journal, HEPATOLOGY (link is external).

AASLD is a medical subspecialty society representing clinicians and researchers in liver disease. The work of our members has laid the foundation for the development of drugs used to treat patients with viral hepatitis. Access to care and support of liver disease research are at the center of AASLD’s advocacy efforts.

AASLD is the leading organization of scientists and healthcare professionals committed to preventing and curing liver disease. AASLD was founded in 1950 by a small group of leading liver specialists and has grown to an international society responsible for all aspects of hepatology.

Press releases and additional information about AASLD are available online at

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