How spiritual fervor, anti-regulation zealotry laid the groundwork for America’s $36B complement trade
Spend any time watching TV or scrolling through social media and you will inevitably see advertisements for pills, powders, and potions that promise to build muscle, lose body fat, improve your focus, and revitalize your youth.
Most of us have used them. At the last count, the National Center for Health Statistics found that over 50% of all adults in America had consumed a dietary supplement in the past 30 days. The center used data from 2017 and 2018, but recent surveys suggest that this number is closer to over 70%.
Globally, the dietary supplement industry is expected to be worth over $ 140 billion by 2020. In the United States alone, this is estimated to be around $ 36 billion, despite evidence that most of these supplements don’t work.
How did products with questionable benefits and expensive prices become mainstream? Diet supplements are not a new phenomenon. Their history dates back at least 150 years, and they have thrived in the United States thanks to false promises, fanatical followers, and weak regulation.
Make you want alternatives
Given the eccentric claims that supplement labels can adorn, it may not come as a surprise that some of the early supplement enthusiasts were religious figures. Their supplements weren’t pills, they were food alternatives.
Sylvester Graham, born in 1794, was an American Presbyterian who preached salvation through a vegetarian diet.
Part of Graham’s teaching focused on moderation and whole grain foods. Graham’s followers made graham bread, crackers, and flour and marketed them with the promise that these products would promote righteous living and eternal salvation.
Although Graham did not officially endorse these products, his spiritual successor, Dr. John Harvey Kellogg, an avid supporter of his family’s new grocery line. As a doctor, inventor, and businessman in one, Kellogg ran his own Michigan spa – the Battle Creek Sanitarium – in the late 19th and early 20th centuries. Although he didn’t make corn flakes – that was his brother Will – Kellogg was responsible for marketing flour, protein substitutes, cereal, and peanut butter. Like Graham products, Kellogg’s foods have been associated with improved health and virtue.
Graham crackers and granola may seem relatively harmless compared to some health and wellness products sold today, such as detox teas and vitamin-rich water. But they were still important in getting the still strong message behind most of the supplements we see today: this product will improve your health and life.
Fitness supplements are all the rage
In teaching this topic to students, I share a discovery that historians John Fair and Daniel Hall made while researching the history of protein powders.
Sometime in the 1940s, American nutritionist Paul Bragg turned to barbell maker Bob Hoffman.
At the time, Hoffman was making a small fortune selling his York barbell exercise equipment in the United States. Bragg had now firmly established himself as a leading expert on alternative nutrition. Sensing a potentially lucrative partnership, Bragg wrote to Hoffman with an idea.
In the letter, Bragg Hoffman shared the fundamental flaw in his York business: his products were durable. If someone bought a barbell set in the 1930s, it was likely they could still use it in the 1950s. Bragg recommended selling supplements that should be replaced every two weeks or monthly.
Hoffman decided to give up the partnership with Bragg, but soon realized the potential of the idea. In the 1950s, nutritionist and bodybuilding coach Irving Johnson began selling protein supplements in Hoffman’s Strength & Health Magazine. Johnson’s “Hi Protein” powder made from soy was a huge success.
Within a year, Hoffman banned Johnson from his magazine and began selling his own “Hi-Proteen” powder. Protein supplements grew in size and scope as an industry. Soy protein products were eventually replaced with milk protein powder in the 1960s. There were several other derivatives in the late 1990s, ranging from pea protein to collagen powders.
The size and scope of the other offerings grew over time. Vitamin and mineral supplements became popular in the 1950s. Energy drinks and energy boosters like creatine started flying off shelves in the late 1980s and early 1990s. Prohormones – which were supposed to be supposed to build muscle and were eventually banned – were introduced in the early 2000s. Profits skyrocketed every decade, as did creativity in product branding.
Unusual promises were the order of the day. Vitamin manufacturers promised cancer-curing products, protein powders promoted steroid-like effects, while pre-workout dietary supplements – often fortified with methamphetamines – offered limitless energy.
The government agencies did little to stop them.
The struggling FDA
It wasn’t because there was a lack of trying. The dietary supplement industry and federal agencies have long been playing a game of cat and mouse.
When Hoffman and others began selling nutritional supplements, they were technically subject to the guidelines of the Food and Drug Administration. But by the 1950s, the FDA was ill-equipped to regulate dietary supplements. However, some of the outlandish claims and unsanitary practices used by the manufacturers caught the attention of the regulator, which soon sought more scrutiny.
In the 1960s, Hoffman – who routinely claimed his products added pounds of muscle in no time – became a target for the FDA. The secret of his Hi-Proteen powder? A large mixing container in which he mixed Hershey’s chocolate powder with soy protein powder with an oar.
Hoffman was regularly censored but never stopped. During the 1960s and 1970s, the FDA regularly attacked manufacturers for their lax production methods and incredulous claims.
The problem was that the FDA was never able to fully regulate the industry.
From 1968 to 1970, Congress held several public hearings on the FDA’s plans to regulate nutritional supplements. Legislators, trade associations of dietary supplements, manufacturers and citizens discussed restrictions and bans on certain products, such as that the sale of dietary supplements with nutrients that make up more than 150% of the recommended daily intake is illegal.
Public and private outcry stopped such plans. The FDA was forced to agree to a light-touch regulation. In 1975 a court ruling allowed dietary supplements to be advertised as natural. A year later, the Rogers Proxmire Act banned the FDA from limiting vitamin and mineral amounts in dietary supplements.
The FDA reserved the right to pursue unsubstantiated or misleading claims, but this did little to hold back the industry. The number of products continued to grow.
Simply put, it became impossible to see what was going into the products. This also explains why so many supplements contain a statement that they are not FDA approved or recommended.
In the early 1990s, the FDA resumed its efforts to regulate the dietary supplement industry. In particular, the agency wanted to strengthen its own enforcement powers while making the advertising of therapeutic claims on dietary supplement labels illegal. Once again, private lobbying and public outrage diluted the agency’s powers.
In 1994, Congress passed the Health Education Act on Dietary Supplements, which completely changed the food landscape. Dietary supplements were now classified as food, not drugs or food additives. By classifying dietary supplements as food rather than medicine, the law reduced the burden of proof to back up the manufacturers’ claims.
The legislation also expanded which products can be classified as dietary supplements – and therefore do not fall under the FDA’s area of responsibility.
Nowadays, manufacturers are given the responsibility to self-regulate their potentially harmful products. This leaves manufacturers open to lawsuits, but can be a long and drawn-out process for consumers. In fact, nutritional supplements are put on the market before they are thoroughly tested. Many products are sold even though they contain prohibited substances.
A single promise wrapped in a pill
Since the mid-20th century, nutritional supplements have been advertised in a variety of ways in the United States. But given the differences in product, taste, and price, they have generally been marketed on the basis of a single promise: this product will in some ways make your life better.
Whether or not this is the case for the individual product – some supplements actually work, such as creatine – it has become problematic on a broader basis. Federal agencies in the US have been constantly prevented from properly monitoring the market. Private lobbying and public outrage that the government is trying to “take your vitamins away” has sparked malpractice and dangerous news.
A 2018 study found 776 cases of unapproved pharmaceutical ingredients added to dietary supplements between 2007 and 2016 in the United States. Many of these additives were relatively harmless. But some ingredients – from steroid compounds to banned weight loss drugs – weren’t.
Dietary supplements can promise a lot. But in reality most of them are articles of faith.
Conor Heffernan is Assistant Professor of Physical Culture and Exercise Science at the University of Texas at Austin. He wrote this for The Conversation.