All Prenatal Supplements are Not Created Equally

by Breea Johnson, MS RD LDN, Pulling Down the Moon Nutritionist, April 23, 2010

It’s easy to gloss over ingredient labels. Names such as “potassium bromate” or “hydrolyzed wheat protein” make your eyes glaze over. But what is their purpose in food? Most people trust that they are just there as preservatives or to extend shelf life but have little impact on a person’s health.

As a nutritionist, I understand a lot of the ingredients at a different level – why they are in food and what purpose they serve was part of my education. And examining the potential ill effects they can have on human health was another part. As a result, one thing I always recommend to my clients is to reduce intake of preservatives and additives. As a general rule of thumb, I also recommend avoiding ingredients that you don’t understand as much as possible – because they can have a detrimental effect on your health.

The supplement industry (vitamin and minerals) is also very familiar to me. I search for supplements to help my clients maintain and regain optimal health – especially during the preconception and prenatal stages.

A lot of women who have never taken vitamins (or medication) in their whole life start taking a prenatal (usually at their doctor’s recommendation) as they decide they want to start trying to have a baby. Some women stop by their local drugstore, others get a prescription for one; others might head to the closest health food store and ask the sales clerk for a prenatal recommendation.

The other day, I picked up an advertisement for a pharmaceutical grade prenatal with DHA. I was surprised to see some of the “other ingredients” as “hydrogenated soybean oil,” “sodium aluminum silicate,” “FD&C Blue No 1,” “propylene glycol,” and “mono and diglycerides.” Why are all of these ingredients in your prenatal you ask?

Good question.

Many additives are used in similar ways to how they are used in food: as thickeners or stabilizers or as lubricants so the machines have an easier time “making” the supplements. Like the food industry, there are many additives that need not be included in the supplement (i.e. Blue No. 1) but are added for aesthetic or manufacturing reasons.

Remember the supplement industry is a “self-regulated” industry and supplement companies must decide whether to test individual batches for quality and hold themselves to high standards. No governmental agency tests supplements prior to distribution so it’s extremely important that you buy your supplements from a well-trusted company and remember, that like food, the less “extra” ingredients the better.

Here are some questions to consider when discerning quality in nutritional supplements:

o Is the manufacturer Good Manufacturing Practices (GMP) certified?

o Are products certified under the industry standards &/or certifications of one or more of the following? NNFA (National Nutritional Foods Association, NPA (National Products Association) NSF (National Sanitary Foundation), OTC (Over the Counter Drug GMPs), TGA (Australian Therapeutic Goods Administration) and the FDA Dietary Supplement Good Manufacturing Practices (GMPs). By providing these significant assurances, the practitioner can rely on the safety, quality, effectiveness and guarantee of the products.

o Do they control or operate over 75% of their product manufacturing or are they contract manufactured? If so, do the contract manufacturers have the above certification?

o Do they run DBPCT's (double blind placebo controlled trials) on humans?

o Do they perform safety reviews and safety studies? Is there human efficacy data?

o Do they have a full time scientific staff and advisory board? What are the current credentials and background of these individuals?

o If the product is a meal replacement, is it an FDA-approved medical food (supported by 2 published peer reviewed journal studies and designed for use with a specific health condition) or a "functional food" (regular food supplemented with added nutritional component)?

o Are they USP certified for tablet/capsule disintegration time (under 45 minutes)?

o What kind of liability insurance do they have to protect practitioners, or if they are lay people distributing product - how are the consumers protected?

o Do they do third party independent assays (in addition to internal QA/QC) on raw materials pre and post-production? If so, will they provide such assays for quality and label claim?

o Do credentialed professionals, such as an “RD,” “ND,” or M.D. sell the product? If so, are they available to provide feedback on patient outcomes as a result of using the products?

At Pulling Down the Moon we do recommend nutritional supplements to our patients. We also strive to ensure that any supplement we recommend adheres to the above standards.

Think about it, nutritional supplements are supposed to support optimal health. Poor quality supplements may cost less, but we like to say the most expensive supplement is the one that doesn’t work due to poor quality ingredients. Even more troubling is a supplement that may contain toxic substances. A recent lawsuit filed in California against big name manufacturers (GNC, CVS, RiteAid and Solgar and others) has charged these manufacturers with selling fish oil contaminated with high levels of PCBs, toxic chemicals associated with infertility, birth defects and endocrine disruption.

Unfortunately, until there is a greater level of regulation, it will be up to you (and concerned nutritionists like me) to read labels and research the companies that make the nutritional supplements we put in our bodies.

We hope this information will help.

Be present, be positive…be proactive about what you put in your body!
Breea