“Perhaps the most tragic way that self-deception harms us is that we start believing our lies and we teach them to others.”
―Cortney S. Warren
We all have that friend who bounces from trend to trend and fad to fad. Very often, the only thing these trends and fads have in common is that our friend never stays with them very long. Like a fish on the line, they are hooked on a promise that was never meant to be delivered; it was meant only to ensnare their wallet.
A recent study examined not the products and trends offered, but our response to them. This study asked the question: “Do statements on nutritional supplement labels affect how consumers perceive the supplement’s health benefits?” In other words, are we easily duped, and do we easily succumb to the old snake oil pitch?
This study examined 4403 US adults who were randomized to see different labels for fish oil and a nonexistent, hypothetical supplement. For both supplements, participants who viewed labels with statements such as “heart health” or “brain health” were more likely to report believing that the supplement prevented or treated cardiac- and neurologic-related conditions. The truth is that such labels have no meaning and carry no weight.
This is no trifling point. The US supplement market was valued at approximately $70 billion in 2024 and is expected to surpass $78 billion in 2025. According to some estimates, it will be worth over $162 billion by 2033. Dietary supplement use is big business, but the claims on their labels are often not intended to legally imply the supplement prevents or treats a disease. They dance in a gray area like a mermaid’s kiss, intended only to entice a purchase.
- The study conducted two online surveys of US adults, evaluating a fish oil supplement and a hypothetical supplement (Viadin H).
- For each survey, participants were randomized to 1 of 4 labels that were otherwise identical but had different health-related label statements (e.g., supports heart health, cognitive function) and then asked about the supplement’s health benefits.
- The study examined the percentage of participants who reported that the supplement was somewhat likely or very likely to prevent or treat a list of diseases.
- Two thousand two hundred thirty-nine participants completed the fish oil survey (1142 [52.6%] women) and 2164 completed the Viadin H survey (1085 [51.2%] women).
- Participants who were shown the fish oil label that claimed “Supports Heart Health” were statistically significantly more likely than those shown a no-claim control to report that it prevents heart attacks (62.5%) and heart failure (59.0%).
- Participants who were shown a fish oil label that claimed “Supports Cognitive Function” were statistically significantly more likely to report that fish oil prevents dementia (47.4%) and improves memory in dementia (48.0%) compared with those shown no-claim labels.
- Participants who were shown a label for Viadin H stating “Heart Health” or “Supports Heart Function” were more likely to report the supplement prevents heart attack (40%) or heart failure (41%), while those shown a label stating “Brain Health” or “Supports Cognitive Function” were more likely to report the supplement prevented dementia (20%) or improved memory (23%).
The Caveat:
Based on this study, the conclusion that can be drawn is that consumers are more likely to report specific disease-related health benefits from supplements when their labels include commonly used statements that imply a non-legally binding promise. Such (mis)perceived benefits often translate into sales. And with 56% of Americans reporting that they take one or more dietary supplements daily, that’s a lot of sales.
Supplement claims fall under the jurisdiction of the FDA; most of us have grown immune to the disclaimer that “this product has not been evaluated by the FDA.” Nonetheless, it appears that the old marketing adage — that if you repeat something often enough, it becomes truth —seems to function well here.
The FDA recognizes three kinds of claims. They are nutrient claims, health claims, and structure/function claims. Nutrient claims refer to the quantity of an ingredient in the dietary supplement, e.g., “only 200 mg of sodium.” Health claims refer to any statement that associates a supplement ingredient with the treatment or prevention of a specific disease based on evidence reviewed by the FDA. These are, as you might expect, as rare as hen’s teeth.
At the heart of the matter are structure/function claims. These are intended to refer to the role of an ingredient in the supplement affecting the normal function of the human body, such as “calcium builds strong bones.” These claims are not intended to describe that taking the supplement itself will prevent or treat a disease. However, when wrapped in nebulous and legally ambiguous language, as exemplified in this study with the use of terms such as “heart health” or “supports cognitive function,” that is often the result. It is similar in practice to claims made for foodstuffs, for example, the fact that Honey Nut Cheerios (an ultra-processed breakfast cereal high in sugar content, with 12 g of added sugar per serving) can help lower cholesterol as part of a heart-healthy diet. This claim is permitted under FDA regulations because of the soluble fiber in oats, an ingredient in the cereal.
The Office of Inspector General and the Government Accountability Office have raised the possibility that these vague structure/function claims could lead to consumer misinformation. However, as of yet, the report’s recommendations to strengthen the FDA’s authority in regulating these specific types of claims have not been implemented. This current study strengthens the argument that such claims, while currently legally permitted, serve only to confuse consumers and boost sales. The proof is in the purchase, “(m)ultiple large randomized clinical trials have found that fish oil supplements do not prevent cardiovascular events and are not recommended for primary or secondary prevention of atherosclerotic cardiovascular disease (ASCVD).” Yet, despite the facts and guidelines, almost 20% of adults in the United States with ASCVD take a fish oil supplement, believing it aids their heart health. Nearly 75% of all fish oil supplements claim at least one health-related structure/function claim. That is a market value of at least $1.6 billion per year.
As noted in the study, “(b)y law, structure/function claims on supplement labels should describe the role of a nutrient in the body and should not state that the supplement prevents or treats any disease.” In practice, as indicated by the study’s results, the implied benefit that a particular supplement or nutrient in food prevents or treats a disease is precisely why, in many cases, someone purchases that product or food. Part of this, no doubt, is a result of an over-reliance on and fixation with individual nutrients; a side effect, as described by Prof. Scrinis, of a singular obsession with Nutritionism. Perhaps it is time to return to simply evaluating whole foods with common sense and a common language.
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