Earlier this week, the Council for Responsible Nutrition (CRN; Washington, DC) testified in opposition to HB 1195, a bill that would prohibit minors from purchasing “weight-loss and muscle-building dietary supplements” in Massachusetts. The proposed legislation, introduced by State Representative Kay Khan earlier this year, is an updated version of a bill first introduced in 2015. CRN says that it was the “only industry voice” that testified in opposition to the 2015 legislation when it was introduced.
The bill would prohibit the sale of over-the-counter diet pills or dietary supplements intended for weight-loss or muscle-building to consumers under 18 years of age. In addition, the proposed legislation would require that retailers place such products behind the counter or made “not directly accessible by customers,” and make conspicuous notices developed by the Department of Public Health communicating that such products “are known to cause gastrointestinal impairment tachycardia, hypertension, myocardial infarction, stroke, severe liver injury sometimes requiring transplant or leading to death, organ failure, other serious injury, and death.” Furthermore, the bill proposes that violations would result in fines as much as $2,000.
After the bill was reintroduced, CRN developed a coalition to oppose the legislation. At a hearing held on October 17, 2017, Ingrid Lebert, senior director of government relations, CRN, and Rick Kreider, PhD, director of the Exercise and Sports Nutrition Lab at Texas A&M University (College Station, TX), testified before the Joint Committee on Public Health. In her testimony, Lebert stated: “While we recognize the potential concern about misuse and abuse of such products, CRN is alarmed with this legislation because the bill attempts to restrict safe, legal and regulated products.”
Lebert expressed concern that the bill would not only restrict access to muscle-building and weight-loss supplements to minors, but would also hamper access for adults and hurt legal Massachusetts businesses. She noted that, in addition to regulatory structure established by the Dietary Supplement Health and Education Act (DSHEA) in 1994, other federal regulations are in place for dietary supplements sold in Massachusetts. According to Lebert, the dietary supplement industry has helped to pass such regulatory acts as the Designer Anabolic Steroid Control Act, which allows federal agencies to ban steroid-containing products illegally “masquerading as dietary supplements,” and the Dietary Supplement and Non-Prescription Consumer Protection Act, “regulation that set up a post-market surveillance program by creating a system for submitting and monitoring serious adverse events to FDA.”
In her testimony, Lebert addressed three specific areas of concern. First, she said, the bill casts too broad a net for the products it would restrict, which would include popular supplements such as protein and protein powders, creatine, and fiber, among others. Lebert also argued that proponents of the bill are using “broad and unproven arguments that don’t apply to dietary supplements”—namely, that eating disorders may arise from the use or misuse of dietary supplements, an assertion that Lebert said is “not based in fact.” She continued: “If you’re going to ban dietary supplements because of concerns regarding eating disorders, then you will also need to ban fashion magazines, youth culture perpetuated by commercial interests, societal expectations, the media and its messages about self-esteem and body image, genetic predisposition, and so forth.”
Finally, Lebert said, the bill would negatively impact legitimate retail business by encouraging retailers to discontinue selling weight-loss and muscle-building dietary supplements out of liability concerns. She noted that, in Massachusetts, the dietary supplements industry has a total direct economic impact of $298 million, and said that the supplements industry generates $52 million in tax revenue for the state annually. Ultimately, she argued, the bill would not achieve “any clear public health objectives.”
Kreider, meanwhile, appeared before the committee to answer questions regarding the safety and efficacy of muscle-building and weight loss supplements. Kreider is a co-founder of the International Society of Sports Nutrition (ISSN) and served as the founding editor-in-chief of theJournal of the International Society of Sports Nutrition. At the hearing, Kreider agreed with CRN’s position that the bill is “too broad as it is unclear what is meant by muscle building and weight loss supplements.” He noted that common dietary supplements, including sports and energy drinks, protein bars, and ready-to-drink beverage products, are used by both athletes and the general public for a variety of reasons. The bill’s lack of specificity, then, would throw the sale of such products into question.
In addition, Kreider asked the committee whether “similar foods and/or beverages that contain nutrients at or above levels found in dietary supplements” would be included in the ban. “For example,” he said, “would you need to purchase a low-calorie energy drink that contains 200 mg of caffeine behind the counter while being able to buy a cup of premium coffee at the neighborhood coffee shop or large high sugar soda at a convenience store that has much more caffeine and calories?” The proposed legislation, he said, would ultimately create “significant confusion” about whether food and beverage products containing similar nutritional profiles would be banned or not. Kreider also echoed Lebert’s testimony that there is no “compelling evidence” that dietary supplementation is linked to eating disorders, while there is ample scientific backing for the efficacy and safety of muscle-building and weight-loss supplements.
Both Kreider and Lebert agreed, however, that proper education about dietary supplement use and existing structures for regulating these products is important. Restricting or banning such supplements, they said, would do more harm than good.
“If you are concerned about inappropriate use of dietary supplements among minors, Kreider said, “my recommendation is that the State of Massachusetts invest in hiring certified athletic trainers, strength and conditioning coaches, sport nutrition professionals, and registered dietitians at local schools to provide guidance about proper diet, exercise, and nutritional supplementation guidelines.”
HB 1195 is not the first bill seeking to restrict sale of certain dietary supplement ingredients to minors. Earlier this year, the Honorable Linda Rosenthal, assemblywoman in the New York State Assembly, iintroduced a bill (AB 4712) that would prohibit the sale or distribution of the dietary-supplement ingredient creatine to minors. CRN challenged that bill as well, citing creatine’s “strong and proven safety record.”