Improving Dietary Supplement Studies

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Jeffrey Bland, PhD, chief science officer, Metagenics, San Clemente, CA, gave a keynote address -- “Why the Controversy Concerning the Value of Natural Supplements? -- at the Scripps Center for Integrative Medicine’s Fifth Annual Conference in late January, during which he pondered the most appropriate methods for studying dietary supplements. Dr. Bland reviewed the study design of 98 clinical trials involving natural supplements published in top-ranked peer-reviewed medical journals. In a majority of these studies, the natural supplements did not demonstrate positive outcomes when compared against placebo. Dr. Bland said a potential reason for this is that the traditional “one agent-one outcome” study design used in the clinical study of pharmaceutical compounds, which have a limited number of active molecules, may have limitations for the study of natural supplements. He proposed that a more appropriate clinical study design would recognize that foods and other natural compounds do not impact physiology like pharmaceutical compounds; rather, they work as groups of bioactive molecules to modulate genetic expression. Hence, he suggested a more effective clinical study design would allow for the determination of how specific health outcomes relate to intervention with complex mixtures of bioactive compounds. This conference was attended by healthcare providers and the public, and covered a wide range of issues related to the roles of foods, herbs and supplements in the management of common medical conditions.

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