Supplement Labeling Fraud is Widespread

The regulation of dietary supplements in the United States has been described as “too little, too late.” “Dietary supplements may be adulterated with dangerous compounds, be contaminated, fail to contain the purported active ingredient, or contain unknown doses of the ingredients stated on the label; be sold at toxic dosages; or produce harmful effects” in other ways. As I discuss in my video Black Raspberry Supplements Put to the Test, “[i]f the composition and quality of ingredients cannot be reliably ensured, the validity of research on dietary supplements is questionable. Moreover, the health of the US public is put at risk.”

A private, third-party company that has independently tested thousands of supplements “identifies approximately 1 in 4 with a quality problem” because it either does not contain what it says it contains, is “of substandard quality,” or is contaminated in some way.

Let’s look at an example. I’ve produced a few videos on the remarkable properties of black raspberries, including one on oral cancer. These berries can’t always be found fresh or frozen, so how about black raspberry supplements, which are available in stores and online? At 0:56 in my video, I show a bottle of Pure Black Raspberry by Pure Health, that says “Fresh – Raw – Pure” right on the label. Sounds good, don’t you think? When we look at the back of the bottle, the label says it contains only seedless black raspberry powder “and absolutely nothing else!” It’s nice to see there are no fillers or artificial ingredients, so why not plunk down $23.77 for a bottle? Well, it turns out we’ve been had.

The first clue is that the image on the front of the label is actually blackberries that had been Photoshopped to look like black raspberries. Pure Health couldn’t even be bothered to put a real image on its fake supplement! The second clue is that the “[d]ark olive-brown-black powder in [the] capsule did not look like berry powder and had a medicinal odor,” according to the researchers. So, it was put it to the test, and, indeed, there was no black raspberry at all. Instead of promoting the fact that the Pure Black Raspberry contains only seedless black raspberry powder “and absolutely nothing else,” the company should have just listed that the bottle contains “absolutely nothing” period—or, at least we hope it contains nothing. Who knows what’s actually in the capsules!

The researchers tested every black raspberry product they could find, and, even of the ones with the correct picture on the front and with powder that actually looked like it came from real black raspberries, more than a third appeared to have no black raspberry fruit at all. “At the moment, a consumer who assumes the US dietary supplement marketplace is free from risk”—or is even honest—“is unfortunately naive.”

How widespread is this deception? Researchers used DNA fingerprinting techniques to test the authenticity of 44 herbal supplements from a dozen different companies. As you can see at 2:33 in my video, less than half of the supplements were authentic and actually contained what they said they did. Most contained plants not listed on the label and product substitution, and many “contained contaminants and or fillers,” also not listed on the label. This isn’t just fraud: Some of this deception could really hurt people. For example, one St. John’s wort supplement contained no St. John’s wort at all. Instead, it was actually senna, which is an herbal laxative that “can cause adverse effects such as chronic diarrhea, cathartic colon, liver damage, abdominal pain, epidermal [skin] breakdown and blistering.” In the video at 3:09, you can see how the 12 companies did. Tested products from only 2 of the 12 companies appeared to be completely authentic, with the remaining 10 companies’ products containing filler, product substitution, and/or contaminents. Herbs only work if they’re actually present. Indeed, this study found that 80 percent of the manufacturers in the supplement “industry suffer[] from unethical activities…”.

“Until US dietary supplement products are better regulated and quality control standards for safety, purity, and dosage are defined and endorsed, the safer source for dietary phenolics,” or phytonutrients, “as a consumer is from food intake.”

For more on supplement company shenanigans, see:

What’s so special about black raspberries? Reversal of cancer progression, for starters! See Black Raspberries vs. Oral Cancer and Best Fruits for Cancer Prevention.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live presentations:

Fennel Seeds vs. Ginger for Menstrual Cramps and PMS

Ninety percent of women report having painful menstrual cramps at least some of the time. Around the Mediterranean, fennel seeds have been traditionally used to relieve painful menstruation. We call them seeds, but they’re actually whole little fruits. I discuss their effectiveness in the treatment of menstrual cramps in my video Fennel Seeds for Menstrual Cramps and PMS. It’s hard to create placebo seeds, so researchers used fennel seed extract to put it to the test. The women started out rating their pain as six out of ten, which then went down to a four within an hour after the taking the fennel seed extract. Fifty-two percent of the women rated the fennel seed treatment as excellent, compared with only 8 percent of those in the placebo group who were just unknowingly given placebo capsules just containing flour.

But women don’t take flour for cramps; they take drugs such as ibuprofen. Mefenamic acid is in the same class of nonsteroidal anti-inflammatory (NSAID) drugs and may actually work better than ibuprofen, but it is not available over the counter. How did it do against an extract of fennel seeds? In a head-to-head study, most women started out in severe pain but ended up pain-free after treatment, and the fennel worked just as well as the drug class considered the treatment of choice––but without the drug’s side effects, which include diarrhea, rashes, autoimmune anemia, and kidney toxicity.

The drug also doesn’t help with the other symptoms of bad periods. During menstruation, women can feel nauseated, out of sorts, weak, achy, and diarrheic. But when put to the test, fennel seeds seemed to help; however, the control group wasn’t given a placebo, so we don’t know how much of that was a placebo effect.

One downside of taking fennel is that women bleed about 10 percent more. Menstrual cramps are caused by the uterus contracting so hard its blood supply is compromised, and we think fennel works through muscle relaxation. It also helps with infant colic, which is thought to be due to intestinal spasms. The advantage of fennel there, too, is the lack of side effects, unlike the drug commonly used for colic. Indeed, dicyclomine hydrochloride can work a little too well to get your baby to stop crying––by developing side effects like death.

Ginger is effective for cramps and reduces bleeding when an eighth of a teaspoon of ginger powder is taken three times a day during one’s period. This is important since up to 18 million young women in the United States experience iron deficiency anemia due to heavy menstrual bleeding. In a study, the amount of blood loss was estimated using a scoring system that gave points for level of saturation and clot size. On ginger, they went from half a cup per period down to a quarter cup. Ginger appears to be a highly effective treatment for the reduction of menstrual blood loss. It is cheap, at only about 6 cents a month, easy to use, and may have fewer side effects than medications and invasive approaches, even sometimes fewer than placebo! The researchers used lactose (milk sugar) for the sugar pills, which may have caused the reported flatulence.

Ginger may also work better for premenstrual syndrome (PMS). An eighth of a teaspoon twice a day of ginger powder for a week before one’s period yields a significant drop in PMS mood, physical, and behavioral symptoms, whereas fennel may help with PMS anxiety and depression but not with the emotional or physical symptoms.

Other dietary interventions that may help include a reduction in salt and animal fat consumption, which I address in my video Dietary Treatment for Painful Menstrual Periods.

We should use whatever works––because sometimes, evidently, PMS symptoms can lead to death. Case in point: Christine English who, at that time of the month, ran down her husband. Accepting PMS as a defense, the court released her with one year of probation.

For more on treating menstrual pain and PMS, see:

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

How to Prevent Gut Inflammation

When you count all the little folds, the total surface area of our gut is about 3,000 square feet. That’s larger than a tennis court. Yet, only a single layer of cells separates our inner core from the outer chaos. The primary fuel that keeps this critical cell layer alive is a short-chain fatty acid called butyrate, which our good bacteria make from the fiber we eat. We feed the good bacteria in our gut, and they feed us right back. As shown in my video, Prebiotics: Tending Our Inner Garden, our good gut bacteria take the prebiotics we eat, like fiber, and, in return, provide the vital fuel source that feeds the cells that line our colon—a prototypical example of the symbiosis between us and our gut flora.

How important are these compounds that our good bacteria derive from fiber? Researchers have explained that a condition known as diversion colitis “frequently develops in segments of the colorectum after surgical diversion of the fecal stream.” What does that mean? If you skip a segment of the bowel (like with an ileostomy) so food no longer passes through that section, it becomes inflamed and can start bleeding, breaking down, and closing off. How frequently does this happen? It can occur up to 100% of the time, but the inflammation uniformly disappears after you reattach it to the fecal flow.

We didn’t know what caused this. Perhaps it was some kind of bacterial overgrowth or bad bacteria? No, it was a nutritional deficiency of the lining of the colon due to the absence of the fiber needed to create the short-chain fatty acids. This was proven in a study wherein researchers cured the inflammation by bathing the lining in what it so desperately needed: fiber breakdown products. Severe inflammation was gone in just a few weeks, demonstrating that when we feed the good bacteria in our gut, they feed us right back.

It makes sense that we have good bacteria in our gut that feed us and try to keep us healthy—they have a pretty good thing going. Our guts are warm and moist, and food just keeps magically coming down the pipe. But if we die, they lose out on all of that. If we die, they die, so it’s in their best evolutionary interest to keep us happy.

But, there are bad bugs, too, like cholera that cause diarrhea. These have a different strategy: The sicker they can make us, the more explosive the diarrhea, and the better their chances of spreading to other people and into other colons. They don’t care if we die, because they don’t intend on going down with the ship.

So, how does the body keep the good bacteria around while getting rid of the bad? Think about it. We have literally trillions of bacteria in our gut, so our immune system must constantly maintain a balance between tolerating good bacteria while attacking bad bacteria. If we mess up this fine balance and start attacking harmless bacteria, it could lead to inflammatory bowel disease, where we’re in constant red-alert attack mode. Researchers explained, “The mechanisms by which the immune system maintains this critical balance remain largely undefined.” That was true…until now.

If you think about it, there has to be a way for our good bacteria to signal to our immune system that they’re the good guys. There is. And that signal is butyrate. Researchers found that butyrate suppresses the inflammatory reaction and tells our immune system to stand down, so butyrate “may behave as a microbial signal to inform [our] immune system that the relative levels of [good] bacteria are within the desired range.” Butyrate calms the immune system down, saying in effect, “All’s well. You’ve got the good guys on board.” This ultimately renders the intestinal immune system hyporesponsive, (i.e., accommodating) to the beneficial bacteria. But, in the absence of the calming effect of butyrate, our immune system is back in full force, attacking the bacteria within our gut under the assumption that those are obviously not the good ones since butyrate levels are so low.

We evolved to have butyrate suppress our immune reaction, so should our good bacteria ever get wiped out and bad bacteria take over, our immune system would be able to sense this and go on a rampage to destroy the invaders and continue rampaging until there were only good bacteria creating butyrate to put the immune system back to sleep.

But what if we don’t eat enough fiber? Remember, our good bacteria use fiber to create butyrate. So, if we don’t eat enough fiber, we can’t make enough butyrate. We could have lots of good bacteria, but if we don’t feed them fiber, they can’t make butyrate. And when our body senses low levels of butyrate, it thinks our gut must be filled with bad bacteria and reacts accordingly. In other words, our body can mistake low fiber intake for having a population of bad bacteria in our gut.

Our body doesn’t know about processed food—it evolved over millions of years getting massive fiber intake. Even during the Paleolithic period, humans ingested 100 grams of fiber a day. So, on fiber-deficient Western diets (Spam on Wonder Bread, anyone?), when our body detects low butyrate levels in the gut, it doesn’t think low fiber. As far as our body is concerned, there’s no such thing as low fiber. So, instead, it thinks bad bacteria. For millions of years, low butyrate has meant bad bacteria, so that’s the signal for our body to go on the inflammatory offensive. That’s one reason why fiber can be so anti-inflammatory and one of the reasons it’s said that “[f]iber intake is critical for optimal health.”

It’s important to note that we’re not referring to fiber supplements here, but whole plant foods. Fiber supplementation with something like Metamucil may “not replicate the results seen with a diet naturally high in fiber.”

For additional background on the advantages of fiber-rich whole foods over fiber supplements, watch my video entitled Is the Fiber Theory Wrong?

There is plenty more evidence supporting the role a fiber-rich diet—that is, a whole plant diet—plays in maintaining optimal health, which you can learn about in these videos:

For even more on gut flora, see:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: