On September 22, the House Government Reform Subcommittee on Human Rights and Wellness held a hearing entitled, “Dietary Supplements: Nature’s Answer to Cost Effective Preventative Medicine.”
In his opening remarks, Chair Dan Burton (R-IN) stated, “I, along with millions of Americans, firmly believe that dietary supplements have been shown through credible research and historical use to be of immeasurable benefit to human health,” adding, “In addition to the scientifically proven health benefits of using dietary supplements correctly to promote a healthier lifestyle and curb disease, these products can also offer substantial cost savings for our long-term National health care expenditures.”
Paul Coates, director of the Office of Dietary Supplements at the National Institutes of Health (NIH), highlighted the proven scientific benefits of dietary supplements for the improvement of health and prevention of disease, including folic acid to reduce the most common birth defects, calcium to reduce the risk of osteoporosis, and iron supplements during pregnancy to prevent maternal anemia and premature delivery. He explained that the Centers for Disease Control and Prevention has implemented a National Folic Acid Campaign “to educate all women of childbearing age to consume 400 micrograms of synthetic folic acid daily from vitamin supplements and/or fortified foods in addition to eating food folate in a healthful diet.” Dr. Coates also noted that the NIH is actively investigating a number of dietary supplements that have not undergone scientific testing, including dietary phytoestrogens, which may prevent bone loss in postmenopausal women.
Senior Vice President Al Dobson of the Lewin Group explained that the Lewin Group “developed estimates of potential cost savings that could result from daily use of…those supplements for which the highest standard of evidence exists at this time, and for which the Food and Drug Administration (FDA) has approved health claims.” Noting that there are 64 million women of childbearing years in the United States, he said that “if an additional 10.5 million, or 25 percent of those not currently taking folic acid, began taking 400 mcg of folic acid on a daily basis prior to conception, the Lewin Group estimates that at least 600 babies would be born without Neural Tube Defects with an associated annual lifetime saving of as much as $321.9 million…The estimated five-year (2005-2009) savings, taking into account the very low cost of the supplement, is $1.3 billion in lifetime costs of caring for babies born with neural tube defects.”
Jeffrey Blumberg, a professor of nutrition at the Friedman School of Nutrition Science and Policy, said that inadequate intake of folic acid “has been associated with anemia, some forms of cancer, heart disease, poor pregnancy outcomes (including preterm delivery, infant low birth weight, fetal growth retardation), and birth defects, most notably, neural tube defects (NTD) leading to spina bifida and anencephaly but also including cleft lip and palate, limb deficiencies, conotruncal defects of the heart and Down syndrome.” Explaining that the recommended daily allowance for folic acid is 400 mcg daily, he pointed out that pregnant women, women who are breastfeeding, and people who consume alcoholic beverages or take aspirin have a greater need for folic acid. In addition, Dr. Blumberg said that scientific studies “have also suggested that the increased risk of breast cancer associated with regular alcohol consumption may be reduced by an increased intake of folic acid from dietary supplements.”
Testifying on behalf of the Scientific Advisory Board of the Dietary Supplement Education Alliance, Dr. Barbara Levine focused her comments on omega-3 fatty acids and calcium, which “are essential from the very beginning of life and even before because a woman needs to be replete in these nutrients before entering pregnancy to ensure that the fetus will derive what is essential for proper growth and development from the mother. And they are also essential to maintaining the mother’s health and a successful outcome in the birth of her child.” She explained that one of the omega-3 fatty acids, docosahexaenoic acid (DHA), is “vital” for pregnant and lactating women: “DHA plays a critical role in supporting brain and retina development in infants. A mother provides DHA to her baby in-utero and via breast milk. Throughout pregnancy, a developing fetus will receive DHA from the mother, particularly during the last trimester when there is significant brain growth.” Dr. Levine noted that most pregnant women do not eat enough cold-water fish, which is the principle dietary source of DHA, and recommended supplements produced from marine algae. “Supplements derived from fish oil are not recommended for pregnant women and children 5 years and younger because of the potential contamination with organic toxins such as pesticides and methyl mercury,” she added.
Dr. Levine also stated that low calcium intake has been linked to a number of chronic diseases, including osteoporosis, colon cancer, and hypertension. She explained that, “each year, osteoporosis causes more than 1.5 million bone fractures of the hip, spine, wrist or other site, draining more than $14 billion from the U.S. healthcare system. It is a painful, debilitating, and in some cases, life-threatening disease.” Noting that the National Health and Nutrition Examination Survey recommends that women over age 40 should get at least 1,500 mgc of calcium per day, Dr. Levin said that most women only get 698 mcg per day. She concluded, “In those who are unable or unwilling to change their dietary habits to include enough calcium-containing foods to meet the daily recommended intake of calcium, calcium supplements are and should continue to be strongly encouraged. These dietary supplements are available in the forms of various calcium salts. Not only can supplements help to increase the intake of calcium among our population but also the resultant disease prevention can help cut health care costs.”
