A growing market for supplements


He adopted a spiritual name years ago whose Indian translation means "holy man." But to his customers, Sadhu Khalsa is simply the vitamin man.

A vitamin specialist at the Rite Aid store on Martin Luther King Boulevard in the city, Khalsa helps customers navigate the vast array of supplements -- vitamins, minerals, herbs and more -- that line the shelves.

A decade ago, consumers would have been hard-pressed to find much more than a multivitamin in most supermarkets and drugstores, let alone a vitamin specialist. But, as people are looking for ways to live healthier and longer lives, supplements have become big business. The trade publication Nutrition Business Journal listed U.S. sales of supplements at $17.7 billion in 2001. Worldwide, sales approached $150 billion.

But with all those products to choose from, it can be difficult for consumers to get accurate information.

"People come in and they are overwhelmed by all these different products," Khalsa says. "Most have no idea what to buy."

Khalsa, who has worked at Rite Aid for nearly two years, helps customers make sense of supplements -- from the familiar (echinacea) to the unknown (chromium picolinate). Although he is not a doctor and can't "prescribe or diagnose," the former health-food store owner has spent decades studying alternative medicine. "This has always been a lifestyle for me," he says.

At one end of the supplement spectrum are vitamins and minerals. But there are also herbs, botanicals, complex amino acids and sports nutrition products. Meal supplements -- such as weight loss and nutrition products -- also figure in the mix.

The question of whether supplements are effective, or in some cases potentially harmful, depends on whom you ask.

"Vitamins and minerals are essential nutrients, but if you have a reasonable diet and are physically active, you can still maintain good health," says Yank D. Coble Jr., president of the American Medical Association.

"Let's be realistic," counters Judy Blatman, spokeswoman for the Council for Responsible Nutrition, a trade association that represents the supplement industry. "How many people eat right? We're saying you should strive for a well-balanced diet. But supplements can play an important role and fill in the gap."

Coble, an endocrinologist, suggests caution when using supplements. "These are complex chemicals, and entirely different from prescription drugs," he notes. "They can interfere with medications and metabolism."

Some products, he adds, are "marketed effectively without benefit of scientific evidence."

In 1994, Congress passed the Dietary Supplement Health and Education Act, which broadly defined herbs and other botanical products as "dietary supplements."

The legislation prevents makers of supplements from making medical claims: They can't say a product will prevent, treat or cure. But the Food and Drug Administration has little ability to actually oversee the supplement industry. Manufacturers are not, for example, required to prove a product's effectiveness before it is marketed.

"We get into safety issues, but not effectiveness, because we do not have that data," acknowledges FDA spokeswoman Monica Revelle, adding that "the FDA regulates vitamins and supplements differently than drugs."

"Overall, most companies are responsible" when it comes to marketing claims, says Blatman.

Spurred in part by rising health care costs, Blatman says, there is a growing trend toward self-care in the United States. "Consumers are taking more responsibility for their own health," she says.

Supplements seem a natural fit with this way of thinking. It's no wonder, then, that grocery stores, drug chains and specialty retailers are tapping into this lucrative market.

"Vitamin and mineral supplements have always been good business for drugstores," says Gary Kincel, Rite Aid's vice president of merchandising. "In the late '90s, it began rapidly expanding because customers were demanding it."

In 1999, General Nutrition Centers, the nation's largest specialty retailer of supplements, created a "store within a store" concept with Rite Aid. There are now some 900 GNC stores housed within Rite Aid locations, and nearly 50 in the Baltimore region.

As for Sadhu Khalsa, he enjoys passing on his knowledge about supplements. "I love working with people," he says, "giving them information that allows them to make good choices about their health."

Advice for use of vitamin supplements

Do :

* Read labels. By law, labels must identify the product and provide ingredients, directions for use and the name of manufacturers.

* Understand that dietary supplements are not replacements for a nutritious diet.

* See a physician or health professional before taking supplements.

* Watch for any side effects. Report anything unusual to your doctor.

Don't :

* Believe outrageous claims. A product that promises to help diagnose, treat, cure or prevent a disease is being marketed as a drug, which is illegal.

* Mix dietary supplements with prescription drugs without first consulting a physician.

* Forget to do your homework. You can research supplements on the Internet, in books and by consulting professionals.

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