1. In this study, majority of commercial dietary supplements targeting the immune system had inaccurate labels.

2. Significant proportion of commercial dietary supplements had ingredients listed that were not detectable and detected ingredients not listed on label.

Evidence Rating Level: 4 (Below Average)

During the COVID-19 pandemic, supplements boosting or modulating the immune system rose in popularity. Unlike drugs, supplements are not approved by the United States of America Food and Drug administration (FDA) for safety and efficacy. However, the FDA has issued specific regulations in product manufacturing and labeling. How well the dietary supplements currently on the market observe these regulations has not been well studied.

This case-series study examined whether dietary supplements advertised as supporting or boosting the immune system were accurately labeled. The top 30 featured supplements sold through Amazon in May 2021 were purchased and their ingredients were analyzed using liquid chromatography-mass spectrometry. Ingredients were then compared to the product labeling to determine accuracy. Furthermore, claims made on the product label were assessed using the Operation Supplement Safety Scorecard’s set of questions.

Of the 30 products evaluated, only 13 had accurate labels. Of the 17 with inaccurate labels, 13 had ingredients listed on the label that were not detected in mass spectrometry analysis and 9 had detected ingredients not claimed on the label. However, this study was limited by the number of products tested, potential bias due to mass spectrometry being less sensitive for polysaccharides, lipids, enzymes, and proteins, and the binary rather than quantitative nature of analysis performed. Nonetheless, these results highlighted a concerning trend since many of the products tested had inaccurate labels and claims that were inconsistent with FDA’s requirements for dietary supplements. Therefore, further work is needed to improve quality control measures for dietary supplements.

Click to read the study in JAMA Network Open

Image: PD

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