The Department of Health’s Food and Drug Administration issued an advisory last week warning about “the massive advertisement, promotion of food/dietary supplements which may have often misled some consumers to buy them as drugs or medicines,” and providing some advice on checking product labels and using the FDA website for more information.
The advisory reminded me of an incident a few months back. I was at the Legaspi Sunday market in Makati looking at some less-known vegetable—I can’t even remember what it was now—when the woman next to me asked, “What is it good for?” I asked back, “You mean dishes you can prepare with it?” and she shook her head, saying: “No, what are its health benefits?”
I was initially startled at how people’s concerns over food now extend into this “what is it good for,” and then remembered that a year or two ago at Farmers’ Market, one of the vendors had a vegetable with a little cardboard sign that identified it—French beans—followed by, and I’m paraphrasing that it’s supposed to beautify the skin and strengthen the blood (how I regret not having a camera then): “Pampaganda ng kutis, pampalakas ng dugo.”
There was a time when food was food, something you ate (kinakain). In schools we would get dry lectures on nutrition; in my time it was about “go (carbohydrates), grow (protein) and glow (vitamins)” foods, emphasis on foods, rather than on individual nutrients.
And then there were medicines, which you usually drink (iniinom) for an illness. Then vitamin awareness grew, and people began to associate medicines with maintaining health, albeit with all kinds of misconceptions, like vitamins seen as sources of energy, or as a growth stimulant in children.
People began to be more conscious about the nutritional content of foods, especially after the United States, followed by other countries including the Philippines, began to require labels on all food products listing its nutritional content, mainly protein, carbohydrates (calories), fat and various minerals like sodium.
Our DOH began to certify instant noodles that were “fortified” with vitamin A, intended to encourage mothers to buy products that would give their children more of that vitamin but might have inadvertently ended up promoting instant noodles.
And then, the craze over “herbals” exploded. The term is generically used now for all kinds of products, many of which are not at all herbal (i.e., plants), with presumed health benefits. The technical term for these products is “food supplements,” coming from the US FDA. They’re not food in the sense of fresh foods we find in wet markets, but they’re not medicines either. If the manufacturers bother to register their products at all, they have to be cleared for safety—that is, certified to be prepared hygienically.
In contrast, for a medicine to be registered, there have to be clinical trials showing the drug is both safe (not just hygienically, but also in terms of tolerable side effects) and effective for certain conditions. Food supplements in the United States and the Philippines need to have a disclaimer “No therapeutic claims approved,” but even with the label on, the advertising for these products will make all kinds of wild claims. This was why then Health Secretary Esperanza Cabral issued an order requiring a new label that would read “Hindi ito gamot” (This is not medicine), but the supplements manufacturers sued her and were able to get a temporary restraining order which seems to have become permanent.
We now have a situation where the distinctions between food and medicine are becoming very blurred, with all kinds of adverse “side effects.”
First, people end up spending hard-earned money for products of dubious quality. My physician-friends complain all the time about patients who whine about a medicine that might cost P30 a tablet, and yet are willing to spend P9,000 a month (or P300 a day) for some food supplement package.
It would be better if consumers understand that yes, foods can have beneficial health benefits because of various nutrients, and that the nutrients are at their best levels if the food is fresh and, we hope, without pesticides or, with animals, without antibiotics and hormones.
Second, supplements usually involve very high doses of vitamins and minerals, which can be problematic. Vitamins A, D, E and K, for example, remain in the body for long periods and can become toxic.
Third, the claims of food supplements and, in groceries and supermarkets, of so-called “natural foods,” are often deceptive. You can have foods high in sodium or salt, which isn’t healthy for people with hypertension and kidney problems, but such foods are still considered “natural” because salt is found in nature. Read some of the labels of food packages in your house, including those claiming to be “natural,” and you’ll see what I mean with the foods processed with salt, sulfur, sugar and all kinds of other “natural” substances.
What protection then do consumers have?
At this point, not too much. Our FDA has at least put up a website (fda.gov.ph) where you can use a search engine to check if the product you bought is registered, and whether it is a drug (medicine), a food/dietary supplement, or even a cosmetic. If the product is registered as a food supplement but is being marketed with therapeutic claims, then the manufacturers are violating our laws and the FDA is seeking information about them. The site also has many important announcements on bans and withdrawals of unsafe medicines, food supplements, cosmetics and chemicals used in households.
Our FDA has its hands full checking out what’s on the market, so its website has no information on specific medicines and food supplements. To get that kind of information you’d have to go into the jungle that is the Internet. You can try the US FDA, which has a very similar website address to our FDA: www.fda.gov (not to be confused with fda.com, which is an information portal of Food and Drug Assistance, a private company).
The US FDA site is not easy to navigate but you may still want to browse through to see what it has. The home page has an interesting call to the public to send in their opinions on the US FDA’s plans to regulate menthol in cigarettes, after findings that the menthol increases the chances of young people starting, and getting hooked, on cigarettes. I’m mentioning this new development to highlight how the US FDA now considers cigarettes as part of its regulatory jurisdiction, because cigarettes aren’t just tobacco products but also delivery agents for a drug: nicotine. In other words, cigarette smokers are, in a sense, drug dependents. Meanwhile, the “drug” (as in drugs like shabu) marijuana is now legal in several American states as a medicine.
If you’re still interested in knowing what that vegetable or fruit or cereal is good for, you can try whfoods.org, which claims to have information on the “world’s healthiest foods,” complete with a breakdown of nutritional content for each food, and recipes. It does not carry commercials except for products from the website owner.
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