Legislative Alchemy

Legislative Alchemy

If you were thinking from the title that this might be another facetious SBM post (a la Clay Jones) in which I fabricate an officially-recognized organization within the U.S. Congress devoted to the dietary supplement industry, you would be wrong. There really is an official organization of the U.S. Congress, called the Congressional Dietary Supplement Caucus, and it is devoted, in every sense of the word, to the dietary supplement industry. Its job is feeding your elected representatives a steady diet of industry-friendly talking points and protecting the industry from meaningful regulation, all skillfully orchestrated by the industry itself.

I am not particularly sanguine about the U.S. Congress to begin with, but I must admit that, despite over a decade of dealing with quackery and its many deceits, even I was taken aback to find what is essentially a lobbying arm of the dietary supplement industry imbedded in the institution itself. To be fair, there are other special interests with their own caucuses (beef, bourbon, and cement, for example). I have not investigated the extent to which those and other industries with dedicated caucuses have the same degree of industry control over their message as the Congressional Dietary Supplement Caucus. If they do, don’t expect the beef, bourbon or cement industries to be reformed anytime soon.

Before we put the two together, let’s take a brief look at dietary supplements and caucuses separately.

Just yesterday, Steve Novella’s post reviewed yet another article in the press decrying the lack of effective regulation of dietary supplements and the unfortunate misconception in the public’s mind that supplements are safe and effective, when, in fact, the evidence is to the contrary. (You can find other articles here, here and here.) As he pointed out,

  • Routine supplementation with vitamins and minerals (sometimes sold in dosages far exceeding the recommended daily allowance) is unnecessary for the vast majority of the public.
  • Herbal remedies are essentially unpurified drugs with unfavorable risk-benefit ratios and are not intended to supplement the diet in any event (which is how “dietary supplement” is legally defined).

To this list, I’d add desiccated animal glands, another category of dietary supplement also used as drugs (also here), but (like herbal remedies), without the pre-market testing and post-market level of surveillance pharmaceutical drugs must undergo.

The root cause of the supplement con, as Steve correctly names it, is the Dietary Supplement Health and Education Act of 1994 (DSHEA), which eschews premarket testing for product safety and efficacy in favor of a post-market catch-the-bad-guys-if-you-can regulatory scheme enforced by a severely understaffed and underfunded FDA: 26 government employees and a $5 million budget versus a $41 billion-a-year dietary supplement industry, of which Big Pharma owns a large chunk.

In addition to its own profits, the dietary supplement industry is an economic engine of the vast pseudoscience market. Naturopaths derive significant income from selling patients dietary supplements they prescribe. Gwyneth Paltrow and her apologist, Dr. Aviva Romm, “functional medicine” guru Dr. Mark Hyman, “integrative medicine” inventor Andrew Weil, right wing conspiracy theorist Alex Jones, and President Donald Trump all have (or, in the case of Trump, had) their own branded dietary supplements they want to sell you.

None of these will easily give up their profits. And, if their pals in Congressional Dietary Supplement Caucus have their way, they won’t have to.

A “caucus” is formally known as a Congressional Member Organization (CMO), formed by members of Congress “to pursue common legislative objectives.” CMOs must register with the House Committee on Administration and are governed by its rules. They are not publicly funded per se, although caucus members can use certain publicly-funded resources to carry out the legislative objectives of the caucus, including staff help, communications resources, space on an official website, and preparation of materials for dissemination. Representatives and Senators can use their personal funds to support caucus activities, but the Administration Committee’s rules provide that:

Neither CMOs nor individual Members may accept goods, funds, or services from private organizations or individuals to support the CMO.

As of 2014, according to an article in The Atlantic, there were almost 700 CMOs, up from about 100 in the early 1990s. You can find the current list here. (I didn’t count them, but feel free.)

The Dietary Supplement Caucus

With that background, let’s turn to the Congressional Dietary Supplement Caucus. According to the United Natural Products Alliance (UNPA), an industry trade association, the Dietary Supplement Caucus (DSC) was formed in 2006 and:

serves as a bipartisan congressional group of legislators, who promote discussions among lawmakers about the benefits of dietary supplements; provide tips and insights for better health and wellness; and promote research about the health care savings these products provide. In a recent letter confirming the DSC to the Committee on House Administration, the DSC writes, ‘The caucus seeks to enhance Congressional attention to the role of supplements in health promotion, disease prevention and address the regulation of the supplement industry.’ The DSC sponsors regularly scheduled luncheon briefings on Capitol Hill for members of Congress, their staffers, the media and the public.

Apparently, any consideration of meaningful industry reform via legislation to protect the public from the deleterious health and financial effects of dietary supplements is not on the agenda. Other industry reps were even more blunt in their assessment of the DSC’s purpose. In congratulating Rep. Mia Love (R-UT) on her ascension to co-chair of the DSC following Rep. Jason Chaffetz’s (R-UT) resignation from Congress, here’s what the President of the American Herbal Products Association had to say:

‘We greatly appreciate Rep. Love volunteering her valuable time and expertise to lead this Caucus in representing the regulated dietary supplement industry on Capitol Hill,’ said Michael McGuffin, president of the American Herbal Products Association. ‘Rep. Love’s leadership will help the Caucus continue to educate policymakers about this growing industry’s significant and positive impact on consumer health and the U.S. economy.’

Yep. That’s Job #1 of the DSC: “representing the dietary supplement industry on Capitol Hill.”

And this from the head of the Council for Responsible Nutrition, another industry trade group:

As more than 170 million Americans take dietary supplements each year, the Dietary Supplement Caucus serves as an important resource to ensure legislators and their staff learn more about the wellness benefits of dietary supplements and the regulatory complexities of our booming industry . . .

Of course, as mentioned, the “wellness benefits” of dietary supplements overall are extraordinarily modest compared to their risks, so much so that major health institutions advise against their use. The actual research demonstrates that:

Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided. This message is especially true for the general population with no clear evidence of micronutrient deficiencies, who represent most supplement users in the United States and in other countries.

Yet, according to a rep from the UNPA, the DSC has its work cut out for it: making sure Americans take even more unnecessary and potentially dangerous dietary supplements.

Loren Israelsen, president of the United Natural Products Alliance, which is based in Salt Lake City, said, ‘UNPA is thrilled that Rep. Love is taking on this important new leadership role. We look forward to working with her to help grow the $41 billion national dietary supplement industry, which includes more than $13 billion in supplement business activity in Utah. The dietary supplement industry is a positive and powerful economic engine that creates thousands of jobs while helping Americans support their healthy lifestyles.’

Rep. Love, for her part, is all in:

‘I’m excited to begin work on behalf of the more 68 percent of Americans who take dietary supplements every year, ‘ Love said. ‘The industry is also a crucial part of Utah’s economy. Not only do dietary supplement companies provide jobs and opportunities in my state, they give consumers the opportunity to make educated choices to fill critical nutrient gaps and achieve better health.’

(Once again, no, they don’t.)

In fact, when the DSC reauthorized itself with the House Committee on Administration this year, a Senior VP of the Council for Responsible Nutrition, Mike Greene, made it clear just who was behind the effort:

In the past, it used to take us months to reform the caucus, which has to be done each two years. This year was relatively quick.

And:

Normally at the beginning of every Congress we refile the caucus. It used to be that we had to reach out to each individual to see if they wanted to continue to be a member; now we tell participants they will continue to be carried as members unless they affirmatively opt out.

“Us?” “We?” In other words, the supplement industry isn’t just getting its messaging out via the DSC, it’s dictating the terms of membership in the caucus and taking a proprietary role in its administration.

The Dietary Supplement Caucus seems to have taken a liberal view of the rule against accepting “goods, funds, or services from private organizations or individuals.” An announcement imploring other members of Congress to join the DSC, sent out by the Council for Responsible Nutrition, conveniently provides the names and contact information of Congressional staffers for those wanting more information. Or, your elected representative was told, he or she could just contact the CRN’s own “DSC industry liaison” for more information on joining the DSC. That seems a bit cozy, as well as a clear indication that the industry has no reason to fear that the DSC might present anything other than pro-supplement fodder to its members. (Current members of the Dietary Supplement Caucus are listed on the announcement. If you see one of your elected officials there, you might want to contact him or her and give them your thoughts on belonging to this group.)

The DSC has co-hosted a number of luncheons and briefings for members of Congress and their staffs “in cooperation with” (also here, here, here, here, here, and here) the four major industry associations: the American Herbal Products Association, the Council for Responsible Nutrition, the Natural Products Association and the United Natural Products Alliance. One can guess who picked up the tab.

In fact, Daniel Fabricant, executive director of the Natural Products Association (and former director of the FDA’s Division of Dietary Supplement Programs), has been remarkably frank about the industry’s role in running the show:

If you look at the history of the caucus, it has been the best way to educate Congress about dietary supplement issues. At these meetings, we can bring in speakers . . .

Yes, “we” can and “we” do.

You’ll not be surprised, by the way, to learn that Sen. Orrin Hatch (R-UT) is a member of the Dietary Supplement Caucus, nor that he is again sponsoring a bill to permit people with Health Savings Accounts to purchase dietary supplements and homeopathic remedies with their triply-tax-exempt funds. (A companion bill has been filed in the House.) We at SBM have criticized Sen. Hatch for blocking needed reforms in dietary supplement regulation. Perhaps we have been remiss in giving him too much credit. Looks like he’s got plenty of help from his fellow DSC members.

Any organization that is essentially part of Congress and operated with taxpayer-funded resources should not function as the in-house lobbying arm of an industry special interest group, nor should Congressional rules allow this to happen. As presently constituted, the Congressional Dietary Supplement Office is simply a shill for Big Supp. Both the caucus and the rules should be reformed to prevent this.

Posted by Jann Bellamy

Jann J. Bellamy is a Florida attorney and lives in Tallahassee. She is one of the founders and Board members of the Society for Science-Based Medicine (SfSBM) dedicated to providing accurate information about CAM and advocating for state and federal laws that incorporate a science-based standard for all health care practitioners. She tracks state and federal bills that would allow pseudoscience in health care for the SfSBM website. 

Her posts are archived here.