The Dietary Supplement Health and Education Act of

Dietary supplement usage in the United States has increased significantly since the passage in 1994 of the Dietary Supplement Health and Education Act (DSHEA, pronounced Dee-shay). This legislation defined dietary supplements as distinct from food and drugs, and it allowed them to be sold without a prescription. The passage of DSHEA provided consumers with the right to purchase dietary supplements that they felt would help them attain their personal health goals. At the same time, DSHEA transferred to consumers the responsibility for making informed choices about the supplements that they used. In contrast to prescription and over-the-counter drugs, where effectiveness and safety must be demonstrated prior to marketing of the drugs, premarket approval is not required of manufacturers of dietary supplements. As a result, there is a greater potential risk that dietary supplements may be ineffective, or even harmful, as compared with drugs.

The dietary supplements industry is not unregulated, it is just not regulated to the extent that U.S. consumers have come to expect for prescrip-

macrobiotic: related to a specific dietary regimen based on balancing of vital principles diet: the total daily food intake, or the types of foods eaten botanical: related to plants herbal: related to plants vitamin: necessary complex nutrient used to aid enzymes or other metabolic processes in the cell mineral: an inorganic (non-carbon-containing) element, ion, or compound antioxidant: substance that prevents oxidation, a damaging reaction with oxygen enzyme: protein responsible for carrying out reactions in a cell metabolite: the product of metabolism, or nutrient processing within the cell hormone: molecules produced by one set of cells that influence the function of another set of cells amino acid: building block of proteins, necessary dietary nutrient fatty acids: molecules rich in carbon and hydrogen; a component of fats nutrient: dietary substance necessary for health over-the-counter: available without a prescription

The rising popularity of alternative medicine has revived ancient techniques such as acupuncture. In the United States, the requirements for acupuncture licensure may vary from state to state. [Photograph by Yoav Levy. Phototake NYC. Reproduced by permission.]

tion drugs. Instead of the drug manufacturer and the physician working to insure that a drug meets the needs of the patient and that it is both safe and effective, consumers must provide these services for themselves with dietary supplements. It is, therefore, important to know the appropriate use of a dietary supplement, the dose at which it is effective, and whether it is likely to interfere with other medications or dietary supplements being taken. It is also important to know that the manufacturer adheres to high quality standards in the preparation of its products.

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