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

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321
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Dietary Supplements: A Framework for Evaluating Safety

expert committee. It was suggested that a representative for consumers and an expert on evidence-based analysis be included in the advisory group. It was also suggested that pharmacognosists and others with experience with botanical products also be included.

Regulatory Situation of Dietary Supplements

Several comments received applied more to the appropriateness of the current regulatory situation that to the report itself, an issue that the committee did not specifically address in the first report.

Comments were received stating that the risks and benefits of dietary supplements should be considered in evaluating the safety of dietary supplements.

A few comments were also received questioning whether FDA had the legal authority under the Dietary Supplement Health Education Act to develop monographs on dietary supplements and whether the study commissioned is scientifically valid.

One comment was also received suggesting that the description for the 75-day advanced notice for new dietary supplements should be compared with the self-declaration of “generally recognized as safe” used for conventional food ingredients.

Testing the Framework

A few comments called for a description on how the six supplements chosen for monograph development as part of this report came through each of the steps of the proposed framework.

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321
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)