Food, Nutrition and dietary supplements: Guarding the health of the public

The food industry represents a potent political force. The AMA has recommended changes in the Dietary Supplement Health and Education Act, which regulates dietary supplements and herbal remedies, insisting that manufacturers be required to provide evidence of safety and efficacy prior to marketing, establish good manufacturing practices, and report adverse reactions associated with their products. Mandatory adverse event reporting was enacted into federal law in 2006, and the AMA was also successful in removing from the marketplace dietary supplements containing ephedra or anabolic steroid precursors. The AMA also opposed the use of qualified health claims for conventional foods, and the creation of a new category of “functional foods.” The AMA's Council on Science and Public Health recently issued a report calling for strong measures to reduce the amount of salt added to the food supply, thereby reducing the public health burden from cardiovascular diseases. Measures include a stepwise, minimum 50% reduction in sodium in processed foods, fast foods, and restaurant meals; revoking the GRAS status of salt, and changing food labels to improve consumers' understanding of the amount of sodium in processed food products, including warnings for foods high in sodium. The report received huge exposure in the mass media. Through promulgation of this report, and creation of a Healthy Lifestyles Division, a series of meetings with the food industry and the FDA have been convened focusing on sodium content, portion size, trans fats, and saturated fats intended to bring about healthful changes in the food supply.