First St John's Wort and now vitamins - consumers' right to buy food supplements is being curtailed. Under a controversial EU directive, some vitamins and minerals could be outlawed - such as tablets containing 1,000 mg of vitamin C, writes Sylvia Thompson.
Health stores around Ireland will this week be putting big black Xs across shelves of food supplements that the store owners expect to be outlawed in the next two years, following the passing of an EU directive.
This pre-election stunt is part of a wider campaign by members of the Irish Association of Health Stores to lobby election candidates to take a broader view of healthcare. The passing of the the EU Food Supplements Directive in the European Parliament in Strasbourg last month has added fuel to their fire.
"The European Food Supplements Directive 2002 is likely severely to restrict strengths in which food supplements may be taken, as well as forcing the withdrawal of large numbers of food supplements currently available in Ireland," says Andrew Cape, a spokesperson for the IAHS.
"Restricting the rights of consumers to obtain natural health products to enhance their health is becoming a worrying trend," he adds.
The IAHS, which represents 85 per cent of health store owners in Ireland, claims that more than 50 per cent of Irish adults currently use food supplements.
The EU directive was aimed not only at harmonising national legal provisions on food supplements to ease sale between member state countries but also at establishing an appropriate level of consumer protection in the use of food supplements within the EU. However, many of those who followed the progress of the directive through its preliminary stages believe that the issue of harmonisation has taken precedence.
"Originally, this directive was about extending the single market but in the process of discussion, countries such as Germany, France and Austria, where there are different traditions of the use of vitamins and minerals, fought for restrictions on the availability of higher dose supplements," says Green MEP, Nuala Ahern.
"The traditional availability of high dosage vitamin and mineral supplements in Ireland, Britain and the Netherlands came under threat. It is still unclear what the final outcome will be. It depends on whether the Scientific Committee on Foods (SCF) of the European Commission defines safe upper limits close to the recommended daily allowance (RDAs) or not." The committee has been given 18 months to come to a decision on legal dosage levels for all food supplements.
The varying views on whether supplements should be available in much higher dosage than the recommended daily allowance is central to this debate.
"Vitamin C is currently available in tablets containing 1,500 mg of vitamin C and these levels may be reduced to somewhere between 60 mg and 150 mg per tablet - so consumers will have to buy at least 10 tablets more to get the same dose," says Erica Murray, co-owner of the Hopsack health store in Rathmines, Dublin.
She believes that setting the maximum permitted levels close to the RDAs is of no value whatsoever as the RDAs are recommended daily allowances for healthy people, not certain groups of individuals - such as vegetarians, expectant mothers, children and the elderly - who may need higher dosages of specific vitamins or minerals. The only known side-effect of too much vitamin C, for instance, is diarrhoea, which disappears once the supplementation is stopped.
Murray also believes that the small and medium-sized manufacturers of these higher-dosage vitamin C products will be squeezed out of the market by larger manufacturers that are ready to embrace a harmonised marketplace.
Dr John Fleetwood, a GP in Blackrock, Co Dublin agrees.
"The RDA for vitamin C is 60 mg a day yet you can need up to 6,000 mg a day if you are sick. The RDAs are for healthy people. I've seen people make great improvements taking 10 times the RDAs of specific vitamins and minerals.
"This isn't alternative woolly stuff. Some vitamins and minerals can be used instead of expensive medication and from the preventative health point of view, they can be very effective. For example, folic acid was recommended for years by the alternative healthcare sector but it wasn't ever accepted until orthodox medicine researched its value. The problem with many orthodox doctors is that we don't want to see someone having a go at curing somebody where we've failed."
Aideen McGuinness is a dietician working in the Adelaide, Meath and National Children's Hospital in Tallaght. In contrast to Dr Fleetwood and members of the IAHS, she believes that only dosages close to the RDAs should be available.
"There are certainly safety issues with a lot of vitamins and minerals. People believe that you can't overdose on vitamins and they take high-dosage supplements because they have the idea that more is better. But, if I recommend usage of a supplement, I'd recommend a dosage close to the RDA.
"Studies have shown that those who use supplements are generally those who have the best diets and are more health conscious while those with poor diets which might need them often don't use supplements at all."
McGuinness points out that many products don't say what percentage of the RDA the supplement is, so if healthy individuals are already getting a high percentage of their RDA of a specific vitamin or mineral from their diet, the added supplement is of little value.
"It's like self-dosing with drugs for some people. We know not to take somebody else's antibiotic, yet with vitamins and mineral supplements, just because it works for one person, many believe it will also work for them."
The directive also contains two key annexes which are causing concern among those keen to have a more liberalised food supplements market. The first is a list of the vitamins and minerals that may be used in the manufacture of food supplements and the second is a list of the vitamin and mineral substances which may be used in the manufacture of food supplements. Up to 300 of the nutrient forms currently used in supplements here are not on the directive's list of permitted substances.
For example, boron, a mineral which helps the synthesis of calcium in the body, is not on the list. Also, while selenium, dubbed the "anti-cancer mineral" and valued as an antioxidant, is a permitted mineral, there are many different selenium salts on the market which are not on the second list of permitted vitamin and mineral substances.
"Also, chelates are not on the positive substance list yet this is the form many people are taking minerals such as iron, calcium and zinc," says Cape. He is also concerned about some substances which have made it onto the positive list, such as calcium carbonate: "This isn't a particularly good form of calcium but it has made it on the list because it is widely sold and has a long history of use".
Jonathan Griffith, managing director of the Natural Medicine Company in Blessington, Co Wicklow, and technical adviser to the Irish Health Trade Association, believes that this directive is against consumer interests and against the interests of the natural food industry.
"I'm particularly concerned about non-essential nutrients such as glucosulphate (which is good for healthy joints) and chondroitin (which is good for building tissue and cartilage) which are not on the positive substances list."
Those campaigning against the directive in its current form also believe that having restricted lists of mineral and vitamin substances might prevent new and better formulas from being developed. "Some manufacturers are currently researching new bio-available forms of supplements [supplements in which a higher percentage of the vitamin or mineral will be absorbed into the body]. The admission of new forms will go through the Scientific Committee on Foods via research dossiers presented by manufacturers but we don't yet know how quickly this committee will have to give a response and whether they will have to publish their findings," says Cape.
The onus of proof of the efficacy of a vitamin or mineral currently lies with the manufacturers and not with a health authority. The IAHS would like to see the establishment of a new state regulatory system for natural healthcare products as currently exists in Canada. Such a natural healthcare authority should, according to the IAHS, take over the functions which at present are the responsibility of the Irish Medicines Board or the Food Safety Authority with regard to natural health products.
One thing is certain in all of this: if the directive goes through parliament unamended, those who will no longer be able to buy their preferred vitamin and mineral supplements over the counter in health stores will look elsewhere. More than likely, they will turn to the completely unregulated marketplace on the Internet where bogus products can attract the unwary, with potentially more serious consequences.
The website of the Canadian Office of Natural Health Products is at www.hc-sc.gc.ca/hpb/onhp
Supplements heading for the banned list
Some of the popular food supplements which face being outlawed by the Food Supplements Directive:
Boron: a mineral which helps the synthesis of calcium in the body.
Calcium amino acid chelate: a popular form in which calcium is taken to maintain healthy bones and teeth. Up to 30 other forms of calcium are also excluded.
Iron: up to 20 forms of iron including the popular amino acid chelate form. Iron is deemed essential for a healthy red-blood cell count.
Magnesium: up to 30 forms of this mineral are deemed valuable for healthy bones and teeth.
Potassium: up to 20 forms of this mineral are deemed valuable for maintaining blood pressure.
Selenium: over 10 forms of this mineral are deemed valuable for their antioxidant properties.