Tougher rules urged for dietary supplements

WASHINGTON -- With nearly one-fifth of Americans taking dietary supplements, the Institute of Medicine yesterday called for tougher regulations to make sure the products are safe and do what they claim.

The institute expressed concern about the quality of dietary supplements, saying ''there is little product reliability."

This makes it difficult for health professionals to guide patients in use of supplements, the report said. The panel urged that Congress take steps to require improved quality control of supplements and to provide incentives to study the efficacy of the products.

''Reliable and standardized products are needed," Dr. Stuart Bondurant, chairman of the committee that prepared the report, said at a briefing.

In a 327-page report, the institute also urged that complimentary and alternative medical procedures, such as herbal remedies and acupuncture, be required to meet the same standards of effectiveness as conventional medical treatments.

Unlike drugs, which must be proven safe before they can be sold, the Dietary Supplement Health and Education Act allows sale of supplements unless the Food and Drug Administration can prove them harmful. The law also does not require manufacturers to report adverse reactions, as drug companies must.

The Institute of Medicine report said 19 percent of Americans reported in 2004 that they had taken a dietary supplement in the past year. The industry was responsible for $18.7 billion in sales in 2002.

A study by researchers at Harvard Medical School, also released yesterday, found that about 35 percent of Americans have used some form of alternative medicine.

Dr. Hilary Tindle, lead author of that report, said such widespread use shows the necessity of studying the safety, efficacy, and cost of these approaches.

The biggest change was an increase in use of herbal supplements over the five years, the study said. The practice of yoga also increased.

The Harvard report, published in the journal Alternative Therapies in Health and Medicine, said use of therapies such as acupuncture, biofeedback, energy healing, and hypnosis remained essentially unchanged between 1997 and 2002, while the use of homeopathy, high-dose vitamins, and chiropractic and massage therapy declined slightly.

Both the Harvard and IOM reports cited a failure of a majority of consumers using supplements to tell their doctors.

The Institute of Medicine is a part of the National Academy of Sciences, an independent organization chartered by Congress to advise the government.