National Academy of Sciences | 150 Year Anniversary

Questions? Call 800-624-6242

| Items in cart [0]

The National Academies Press

HARDBACK
price:$59.95
add to cart

Rights & Permissions

topleft topright

Dietary Supplements: A Framework for Evaluating Safety (2005)
Institute of Medicine (IOM)

Citation Manager

. "12 Factors Influencing Use of the Safety Framework." Dietary Supplements: A Framework for Evaluating Safety. Washington, DC: The National Academies Press, 2005.

Please select a format:

BibTeX EndNote RefMan


Page
295
bottomleft bottomright

The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy.


Dietary Supplements: A Framework for Evaluating Safety

interactions is difficult to obtain and is currently even more limited than information relevant to evaluating the safety of a single ingredient.

Impact of Formulation and Processing

DSHEA does not distinguish the impact of different processing methods or varied formulations on the subsequent characteristics of dietary supplement ingredients; it allows manufacturers to market products containing ingredients that have been produced using manufacturing methods or in formulations altered without prior FDA review. These changes in product manufacture may lead to significant differences in bioavailability and chemical constituents of the resulting product, suggesting a need for reevaluation of any previous safety evaluations. The lack of this reevaluation, amplified by the increasing complexity of ingredients available for use and the lack of premarket examination, hampers the ability of the FDA to have the data needed to evaluate safety within the context of this Framework; this will continue to be the case until DSHEA is amended to require some type of premarket approval or review of any change in manufacturing process or formulation of a marketed product, thus redefining the point at which an ingredient is required to have an agency review for safety.

Availability of Resources

Another key consideration in the utility of this safety Framework, or any data- or information-driven framework, is the evident limitation in resources available to FDA to operate a framework adequately—particularly resources to support the long-term need for monitoring new information as it becomes available. Without increased availability of resources, any framework developed may have limited impact on protecting the health of the public because of a lack of human and material resources to collect, evaluate, and monitor relevant data. The utility and success of the Framework will ultimately depend on FDA being provided adequate resources to fully implement the goals of DSHEA.

Use of Expert Judgment in the Safety Framework

The Framework, by defining and giving examples of data that may elevate or decrease concern, seeks to explicitly evaluate the different components of the data—considering the evidence of possible risk, seriousness of harm, and the potential public health impact as distinct variables. This approach attempts to guide judgments made to assess when an unreasonable risk of illness or injury is likely to result from use of a dietary supplement ingredient. While the determination of safety can be, at least to some

Page
295
Front Matter (R1-R20)
Executive Summary (1-18)
1 Introduction and Background (19-42)
2 Approaches Used by Others and Existing Safety Frameworks (43-84)
3 The Framework (85-125)
4 Categories of Scientific Evidence--Human Information and Data (126-155)
5 Categories of Scientific Evidence--Animal Data (156-174)
6 Categories of Scientific Evidence--Information About Related Substances (175-216)
7 Categories of Scientific Evidence--In Vitro Data (217-234)
8 Interactions (235-246)
9 Vulnerable Groups and Prevalance of Use (247-252)
10 Scientific Principles for Integrating and Evaluating the Available Data (253-268)
11 Applying the Framework: Case Studies Using the Prototype Safety Monographs (269-291)
12 Factors Influencing Use of the Safety Framework (292-296)
13 Findings and Recommendations (297-306)
Appendix A: Existing Frameworks or Systems for Evaluating the Safety of Other Substances (307-315)
Appendix B: Scope of Work and Comments to Initial July 2002 Framework (316-321)
Appendix C: Plant Family Information (322-355)
Appendix D: Chaparral: Prototype Monograph Summary (356-362)
Appendix E: Glucosamine: Prototype Monograph Summary (363-366)
Appendix F: Melatonin: Prototype Monograph Summary (367-371)
Appendix G: Chromium Picolinate: Prototype Monograph Summary (372-375)
Appendix H: Saw Palmetto: Prototype Monograph Summary (376-379)
Appendix I: Shark Cartilage: Prototype Monograph Summary (380-384)
Appendix J: Prototype Focused Monograph: Review of Liver-Related Risks for Chaparral (385-449)
Appendix K: Protoype Focused Monograph: Review of Anti-Androgenic Risks of Saw Palmetto Ingestion by Women (450-477)
Appendix L: Acknowledgements (478-480)
Appendix M: Biographical Sketches of Commitee Members (481-488)
Index (489-506)