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Vol. 13 No. 6 May 2010 Natural Medicine LawTM VITAMIN A & E CASE UNDER CONSIDERATION Newsletter CFSAN DIRECTOR SUDDENLY LEAVES FDA EFSA ISSUES NEW BRIEFING DOCUMENT As of April 8, 2010, the Alliance Public relations staff at FDA had Concerning for Natural Health US, et al and the U.S. Government have filed their motions and cross motions for the court’s consideration. After the Plaintiffs’ Motion for Summary Judgment was filed on December 30, 2009, the Government’s Cross Motion and Opposition was filed February 22, 2010 in duplicate. The next day the Government filed an Amended Brief because of typographical errors, counsel stated, that came to defendants’ attention after filing the original. Plaintiffs did not oppose the amendments. On April 8, 2010, the Plaintiffs’ filed their Memorandum in Reply and Opposition. No hearing was scheduled or requested on the motions at the time of this update in the first week of May. NML will follow and report what the Court decides at a later update. Here are a few comments from the last pleadings in the file. to refer NML to three people to find someone who could speak about the resignation of Steven Sundlof, DVM, PhD. All they knew at this time was that Commissioner Margaret Hamburg and Deputy Commissioner for Foods, Michael Taylor, issued an “ o p e n letter,” describing the circumstances, but that letter was not easily found on Stephen Sundlof FDA’s or HHS’s main media websites. Sundlof was said, in the “open letter,” to be taking a two-year assignment with a collaborative effort between the VirginiaMaryland Regional College of Veterinary Medicine, the University of Minnesota, and the Ohio State University to develop and establish a regulatory science program. This is a masters level program. Sundlof came to head CFSAN in January of 2008 after being director of the Center for Veterinary Medicine for several years. He spent 16 years with FDA. the evaluation of Article 13.1, 13.5 and 14 health claims on request from EFSA, Question No EFSA-Q-2010-00822 and EFSA-Q-2010-00821, issued for public consultation on 10 May 2010. A copy may be downloaded from www.efsa.europa.eu/en/ ndameetings/docs/nda100601Copyrignrt ax01.pdf. The new 18-page briefing document reviews previous clarifications for stakeholders in the form of meetings and frequently asked questions documents in anticipation of another stakeholder meeting to be held on June 1. Following that meeting this document will be revised. The briefing document is a list of 11 questions with a response formulated by the NDA Panel members. These questions are: See EFSA BRIEFING -- Continued on p. 23... Plaintiffs say that Defendants In This Issue: want the District Court to reverse Vitamin A & E Case Under Consideration.................1 CFSAN Director Suddenly Leaves FDA....................1 the Circuit Court decision in EFSA Issues New Briefing Document.......................1 Selenium Case Reaches Surreply.............................2 Pearson I which “is beyond the New Dietary Ingredients.............................................3 limits of law in our precedentSection 403 Letters....................................................4 Canada Warns About Products.................................5 based system of jurisprudence.” New Zealand Amends Regulations...........................5 Recent Research.......................................................5 Plaintiffs say the Defendants Alliance GMP Case Readies for Review.................10 Consumer Claims Fraud Over Walnut Claims........10 arguments are that Plaintiffs’ Current Status of Walnut Health Claims..................12 science lacks credibility, “thus Selenium NDI Not Posted by FDA..........................13 Lloyd Library Photo Credits.....................................15 Michael Taylor was reemployed deeming it not evidence, and in an Trademarks for Atropha belladonna........................22 ultimate twist of logic, non- by FDA in the summer of 2009 to Interesting Meetings & Programs............................24 Health from the Editor...........................24 implement the food safety laws that Harvesting Special Supplement....................................Centerfold See VITA MIN A & D -- Cont’d on p. 13.. See FDA -- Cont’d on p. 21... NIH Alzheimers Consensus Conference ECJ Rules on Upper Limits of Nutrients Page 2 SELENIUM CASE REACHES SURREPLY TO DEFENDANTS’ REPLY Closing out the arguments before Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside the Court, unless some new issue is belatedly discovered by one of the parties, the Plaintiffs have filed their Surreply, that says, in part, “Defendants characterize Plaintiffs’ argument as a please for special treatment. It is not, but the point reveals irony. While Plaintiffs ask the Court to apply the controlling precedent established in Pearson I and Whitaker I wherein each Court applied Cetnral Hudson (see Pearson I, 164 F.3rd at 659-660; Whitaker I , 248 F. Supp. 2d at 10, the Defendants ask the Court to exempt them from the strictures of those cases, reverse the decisions, and give the agency unprecedented new discretion to censor. Who seeks ‘special treatment?’” Plaintiffs’ Surreply, p. 6 Continuing, the Plaintiffs state that “Defendants admit for the first time in reply that they want this Court to overrule its previous decision in Whitaker. Def. Reply at 7). They present the extraordinary argument on conjecture that Whitaker I conflicts with Pearson I. … The argument is volte face, coming eight years after FDA stated its unreserved acceptance of Whitaker I as governing law (never uttering a peep that it was at odds with Pearson I) (Def. MSJ at 1415.)” May 2010 Plaintiffs restate that they have presented credible scientific evidence to support each of their claims, but FDA eschews the studies on one presumed technical defect or another instead of recognizing them as supportive. Plaintiffs would accept any reasonable disclaimer in order to educate the public of the possible benefits of selenium supplementation. Also Plaintiffs state that “the state of the evidence supporting the selenium/cancer site risk reduction relationships is indistinguishable from the science that existed for every claim at issue in Pearson I. Pearson I and Whitaker I have ordered the FDA to end its legacy of suppression and open the channels of commerce to information indispensable to informed consumer choice….” Plaintiffs’ claims must be allowed, they argue, “unless FDA proves with empirical evidence that the disclaimers are incapable of correcting for misleadingness,” citing the above cited cases. This will be the last word until the Court issues a ruling. The case is Alliance for Natural Health US, et al v. Sebelius, et al, Case No. 1:09-cv-01470, U.S District Court for the District of Columbia, Ellen S. Huvelle, presiding. www.natmedlaw.com is where you can research cases Natural Medicine LawTM Natural Medicine LawTM Newsletter Muscatatuck Publishers, Inc. P.O. Box 741261 Boynton Beach, FL 33474-1261 William J. Skinner Editor and Publisher, Registered Pharmacist and Attorney Copyright 2010 by Muscatatuck Publishers, Inc. Exclusive of U.S. Government document excerpts, photocopying, faxing, and electronic transfer is prohibited without permission. Copies of all documents mentioned in this publication, except copyrighted materials, are available on request for a fee. Telephone (866) 664-2900 or (561) 641-2900 or E-mail at: <[email protected]> for permission. Published six times a year. Subscription price is US$249.00 per year in U.S., Canada, and Mexico. Subscriptions to other countries are an additional US$24.00 per year for postage and handling. Additional copy in same envelope for US$130.00. Natural Medicine Law (ISSN 1095-6336) reports on legal issues. Readers should discuss legal issues with legal counsel before taking action based on information in this publication. 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Display Ads A limited number of display ads may be featured in each issue. Subscribers are attorneys, health care practitioners, company officers, research scientists, university faculty members, and herbalists. Subscribers are located throughout the world. New groups are provided one or more free sample issues per year in promotions at various meetings and through direct mail. Prices are available on the website under Advertising Information. Editorial Correspondence Florida address above Toll-Free Telephone: (866) 664-2900 E-mail: [email protected] NEW DIETARY INGREDIENTS T he following New Dietary Ingredients summaries have not appeared in NML in the past, so these will be new information that allows you to understand how FDA treated these 75-day notices during the first few years of DSHEA. Keep in mind that the DSHEA language requires FDA to post these to the public files. FDA is not doing that regularly, thus flaunting the law. And besides flaunting the specific directions of the law, FDA is entering the data in a haphazard manner with a very jumbled order in the two-year old dockets on www.regulations.gov. U S Botanicals of Mesa, Arizona, wrote FDA on October 14, 1997, to give notice that it would be marketing Sadenosylmethionine (SAM) as a new dietary ingredient in a daily dose of 1200 mg. Certain journal articles were included with relevant information being circled or underlined according to the cover letter. Unfortunately, none of the submission documents were made part of the public file. FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, responded to Dave Brown on November 14, 1997 with a letter stating that the information will be kept confidential until January 20, 1998 and then be placed on display at the Dockets Management Branch. Posted on September 28, 2008 on www.regulations.gov Docket No. FDA-1995-S-00390038. The original FDA Docket was No. 95S-0163, RPT 19. May 2010 Malabar Productos Naturales of Guadalupe, Mexico, wrote to FDA on January 23, 1998 to give notice that it would sell five dietary supplement products – Jointaid, Pancrease, Gastritease, Menstrualaid, and Laxatease. These products will contain five new dietary ingredients — Tecoa mollis, H.B.K. or T. stans Juss., Mexican name Tronadora; Montanoa tormentosa Cerv. Mexican name Zoapatle; Tagetes lucida Cav. or Tagetes florida, SW, Mexican name Pericon; Loeseloa Mexicana (Lam.) Brand, Mexican name Espinosilla; and Cecropia obstusifolia Bert., Mexican name Guarumbo. There were 24 articles mentioned in the letter with at least four for each new dietary ingredient supporting their historical and safety of use. There were English translations for all of the articles. Most of the articles were not part of the public file. FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, responded on April 10, 1998 to Natalia Garza, export manager, in a letter that stated that FDA had carefully considered the information in the submission and has significant concerns about the evidence on which the company relies to supports its conclusion that the five new dietary ingredients will reasonably be expected to be safe. FDA stated that there was not an adequate basis to conclude that Tonadora, Pericon, Espinosilla and Chancarro, when used for the conditions suggested, will reasonably be expected to be safe. Introduction of such products into interstate commerce is prohibited. Based on the submission, FDA disagrees that Page 3 Zoapatle will reasonably be safe. The information submitted states that this botanical contains several terpene compounds that have an adverse affect on fertility, and other interferences in pregnancy including adverse effects associated with consumption of the plant, including abortion and death. Therefore introduction of this product into interstate commerce is prohibited. Posted on September 28, 2008 on www.regulations.gov Docket No. FDA-1995-S-00390039. The original FDA Docket was No. 95S-0163, RPT 20. Humanetics Corporation of St. Louis Park, Minnesota, wrote to FDA on October 21, 1997 to send a NDI for the ingredient alpha-D() Ribofuranose (Ribose), a naturally occurring sugar in all foods. Enclosed were a safety profile summary, ten preclinical pharmacology and toxicology reference reprints on ribose, 15 clinical trial reference reprints on ribose, and two general clinical review reprints on ribose. The documents indicated that studies in humans demonstrate the only safety issue is related to decreased blood sugar. Therefore, the notice proposed that use of up to 5 grams or less than 0.1 gram/kg would be well tolerated and elicit no chronic adverse health effects. There were 27 references listed in the notice. FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, responded to Ronald J. Zenk on November 17, 1997 with a letter stating that the information will be kept confidential until January 20, 1998 and then be www.NatMedLaw.com for Natural Medicine TiesTM See NEW INGREDIENTS -- Cont’d on p. 14... Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside Natural Medicine LawTM Page 4 SECTION 403 LETTERS NML continues reporting on FDA Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside courtesy letters or letters of objection concerning structure/ function claims made on dietary supplement under Section 403(r)(6) of the Dietary Supplement Health and Education Act (DSHEA) of 1994. Remember that you can search for data on the newsletter website on the Volume Index and Search Page. Use ingredient, product name, or manufacturer claims to find out what FDA has said about these forbidden claims. The www.regulations.gov files that contain a second “LET xx” designation within Docket FDA1997-S-0039 appear to be files that were originally filed in FDA Docket No. 97S-0162. These were notices that FDA did not have any question about. NML mentions this in case you are searching www.regulations.gov using only the “LET xx” designation. Be sure to read the name of the company to match the letters. ERRATA – Please note that in the previous issue (March 2010) the www.regulations.gov Docket is FDA-1997-S-0006-xxxx and not FDA-1996-S-0006-xxxx. A corrected copy of the Section 403 Letters for March 2010 can be obtained on www.natmedlaw.com either as a separate article or as part of the March 2010 newsletter. Here are more summaries of files containing courtesy letters or letters of objection. George Eby Research of Austin, Texas, sent a notice to FDA by Fax on February 6, 1996 May 2010 concerning its product Fast Dry™ Zinc Lozenges stating that it would use the claim: “Fast Dry™ Zinc Lozenges release zinc ions. In vitro zinc ions are antirhinoviral agents. T-Cell lymphocyte nutrients, interferon inducers, and antiinflammatory and drying aides.” The letter asks John Gordon, Ph.D. at the Office of Special Nutritionals, CFSAN, if this claim meets the criteria of DSHEA. Gordon also included his book, Handbook for Curing the Common Cold – The Zinc Lozenge Story, and two articles from 1995 concerning the use of zinc. The book and articles are not in the public file. The Gordon letter states that he is seeking a major pharmaceutical manufacturer to license his patent no. 5,409,905 and that this company would be filing a New Drug Application for the product. The Gordon states: “Since the product contains no drugs and can be considered a dietary supplement with drug properties of considerable importance, I want to make the product available to the public now, while we wait for an NDA.” FDA’s John Gordon, Ph.D. responded by letter of March 6, 1996 stating that the proposed claim indicates the product is to treat or prevent a specific disease or class of diseases. The labeling suggests that the product is for other than food use and references state that the lozenges may be used to treat common colds. This means the product is intended for drug use and you should contact FDA’s Center for Drug Evaluation and Research. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S-0163, LET 44 and in www.regulations.gov Docket No. Natural Medicine LawTM Digitalis Photo Courtesy of Lloyd Library and Museum FDA-1997-S-0006-334 posted September 8, 2008. There is also another LET 44 in FDA-1997-S0006-0163 posted October 14, 2008. Optimum Lifestyle, Inc. of Sausalito, California, wrote FDA on March 14, 1997 to give notice that it would use the claim: “Antioxidant Advantage™ combines a powerful array of vitamins, minerals, proanthocyanidins, and herbal extracts that have the ability to help protect our bodies against destructive molecules called free radicals. Many scientists believe that free radicals play a significant role in the development of many diseases and have a profound negative effect on the aging process.” The product name is Lite Bites Antioxidant Ad-vantage™. FDA’s James Tanner, Ph.D. acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, See SECTION 403 -- Continued on page 17... Natural Medicine LawTM May 2010 Page 5 Natural Medicine Law Around the W orld World NEW ZEALAND AMENDS REGULATIONS Three times in March, Health On March 31, 2010 the Dietary Canada warned Canadians about dangerously adulterated products. On March 8, the product was POWER-MAX imported by Cha Health Food. The product contains sildenafil, a prescription medication used to treat erectile dysfunction but should not be used by individuals taking any kind of nitrate drug (e.g. nitroglycerine) as it can cause potentially lifethreatening low blood pressure. Individuals with heart problems are at increased risk of cardiovascular side-effects such as heart attack, stroke, chest pain, high blood pressure and abnormal heart beat. Other side-effects include headache, facial flushing, indigestion, dizziness, abnormal vision, and hearing loss. This product was found in Ontario. Its label says it contains Epimedium macranthum, Polygonum multifonum, Ligatum lucidum, Curcuglio orchiodies, and Panax ginseng. The prescription drug was See CANADA WARNS -- Cont’s on page 11... Big Ben and Parliament in London Supplement Regulations were amended by Regulations 2010(SR1010/5) to introduce a number of changes. The new regulations provide: RECENT RESEARCH Swedish doctors find that use of multivitamins by women increases risk of breast cancer. What went wrong, NML asks? They prospectively examined the association between multivitamin use and the incidence of invasive 1) A new definition of dietary breast cancer in the Swedish supplement. This change Mammography Cohort. In 1997, has the effect of narrowing 35,329 cancer-free women the scope of the DSR so completed a self-administered they now cover only questionnaire that solicited therapeutic-type products. information on multivitamin use as The food-type supplements well as other breast cancer risk previously also regulated factors. Relative risks (RRs) and under the DSR are now 95% CIs were calculated by using regulated as Supplemented Cox proportional hazard models Foods under a new and adjusted for breast cancer risk standard (the New Zealand factors. Food (Supplemented Over a mean period of 9.5 years, Food) Standard 2010 974 of these women were issued under the Food Act 1981 and administered by diagnosed with breast cancer. The the New Zealand Food researchers found that the Safety Authority (NZFSA). multivariable RR of women who reported the use of multivitamins 2) A permission for a was 1.19 (95% CI: 1.04, 1.37). The supplement to contain association did not differ more than a maximum significantly by hormone receptor daily dose of 300mcg of status of the breast tumor. folic acid (but not more NML contacted Susanna C than a maximum daily dose of 500mcg) if the Director- Larsson at the Karolinska General of Health has Institutet, in Stockholm, to ask confirmed that the what the ingredients of the supplement has been multivitamins may have included. prepared in a way that Dr. Larsson responded that accords with the New multivitamins in Sweden contain Zealand Code of Good vitamins and minerals. She quoted Manufacturing Practice for the text of the article which states: Manufacture and Distri- “Because participants were not bution of Therapeutic asked about multivitamin brand Goods (New Zealand Code names, information on nutrient composition of multivitamins was of GMP). See NEW ZEALAND -- Cont’d on p. 8... See RECENT RESEARCH -- Cont’d on p. 6... Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside CANADA WARNS ABOUT PRODUCTS Page 6 RECENT RESEARCH -- Cont’d from p. 5... Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside not available. However, the number of multivitamin brands on the Swedish market is limited. Multivitamins in Sweden generally contain doses of vitamins and minerals close to the recommended daily allowances of vitamin A (0.9mg), vitamin C (60 mg), vitamin D (5 μg), vitamin E (9 mg), thiamine (1.2 mg), riboflavin (1.4 mg), vitamin B-6 (2.1 mg), vitamin B-12 (3μg), and folic acid (300-400 μg). The minerals usually included are iron (10 mg), zinc (12 mg), copper (2 mg), chromium (50 μg), selenium (40μg), and iodine (150 μg).” May 2010 diabetes and a clinical diagnosis of nephropathy who took daily a single tablet of B vitamins containing folic acid (2.5 mg/d), vitamin B6 (25 mg/d), and vitamin B12 (1 mg/d), or matching placebo during the study. While the study took place from May 2001 to July 2007, the report did not say how long the B vitamins were taken. Since the patients were recruited from five medical centers, the outcome was measured by the change in radionuclide glomerular filtration rate (GFR) between baseline and 36 months. Secondary outcomes were dialysis and a composite of myocardial infarction, stroke, revascularThe researchers were Susanna C Larsson, Agneta Åkesson, Leif ization, and all-cause mortality. Bergkvist and Alicja Wolk from Plasma total homocysteine was also the Division of Nutritional measured. Epidemiology, The National The study concluded that among Institute of Environmental Medicine, Karolinska Institutet, patients with diabetic nephropathy, Stockholm, Sweden (SCL, AÅ, high doses of B vitamins compared and AW), and the Department of with placebo resulted in a greater Surgery and Centre for Clinical decrease in GFR and an increase Research, Central Hospital, in vascular events. Västerås, Sweden (LB). The This was a randomized research was supported by research controlled study conducted by grants from the Swedish Cancer Andrew A. House, MD; Misha Foundation and the Swedish Eliasziw, PhD; Daniel C. Cattran, Research Council for MD; David N. Churchill, MD; Infrastructure. More information Matthew J. Oliver, MD; Adrian can be obtained from SC Larsson, Fine, MD; George K. Dresser, MD; Division of Nutritional J. David Spence, MD. Their Epidemiology, National Institute affiliations were: Division of of Environmental Medicine, Nephrology (Dr House), Division Karolinska Institutet, Box 210, SE- of Clinical Pharmacology (Drs 17177 Stockholm, Sweden. E- Dresser and Spence), and Robarts mail: [email protected] Research Institute (Dr Spence), Natural Medicine LawTM Division of Nephrology, University of Toronto, Toronto, Ontario (Drs Cattran and Oliver); Division of Nephrology, McMaster University, Hamilton, Ontario (Dr Churchill); and Division of Nephrology, University of Manitoba, Winnipeg, Manitoba (Dr Fine), Canada. The article above is published in JAMA. 2010;303(16):1603-1609. Researchers compared the efficacy and safety of pyronaridineartesunate with that of artemetherlumefantrine for treatment of uncomplicated Plasmodium falciparum malaria. Intervention tablets contained 180 mg pyronaridine and 60 mg artesunate; control tablets contained 20 mg artemether and 120 mg lumefantrine. Both treatments were given according to bodyweight. The primary efficacy outcome was PCR-corrected adequate clinical and parasitological response (ACPR) rate at day 28 in the per-protocol population. Non-inferiority was shown if the lower limit of the twosided 95% CI for the difference between groups was greater than -5%. When finished the interpretation of the study resulted in the conclusions that the efficacy of pyronaridine-artesunate was non-inferior to that of artemetherlumefantrine for treatment of uncomplicated falciparum malaria. Pyronaridine-artesunate should be considered for inclusion in malaria treatment programs. University of Western Ontario, The above article will be London, Ontario; Department of These medications are derived published in Am J Clin Nutr 91: Community Health Sciences, from relatives of Artemesia annua, 1268-1272, 2010 (May 2010) Clinical Neurosciences, and a common weed in many places, Canadian researchers monitored Oncology, University of Calgary, that was discovered to contain 238 patients with type 1 or 2 Calgary, Alberta (Dr Eliasziw); See RECENT RESEARCH -- Cont’d on p. 7... RECENT RESEARCH -- Continued from p.6... compounds effective against malaria. See Natural Medicine Law™ Newsletter issue of March 2006. The 3:1 ratio product is being investigated for the treatment of P. falciparum and P. vivax malaria to see if it is non-inferior to artemether/lumefantrine combination that is considered a “gold standard.” The researchers concluded that the “study shows that the efficacy of pyronaridineartesunate is non-inferior to that of artemether-lumefantrine for treatment of uncomplicated P falciparum malaria in children and adults, measured by PCR-corrected ACPR rate at day 28. Both treatments were highly efficacious with cure rates of more than 99% and no early clinical failures. Our results accord with the high activity reported for pyronaridine-artesunate against African P falciparum isolates and 100% cure rates shown in the previous clinical study of pyronaridine-artesunate. The efficacy of artemetherlumefantrine was consistent with recent reports from other studies in the African and southeast Asian countries included in our trial.” [footnotes omitted] The researchers were Antoinette K Tshefu MD a, Oumar Gaye MD b, Kassoum Kayentao MD c, Ricardo Thompson PhD d, Kirana M Bhatt MMED e, Sanie SS Sesay MD f, Dorina G Bustos MD g, Emiliana Tjitra MD h, George Bedu-Addo MD i, Dr Isabelle Borghini-Fuhrer PhD j , Stephan Duparc MD j, Chang Sik Shin PhD k, Lawrence Fleckenstein PharmD l, the Pyronaridine-artesunate May 2010 Study Team‡ from the following facilities: a Ecole de Santé Publique, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo; b Service de Parasitologie, Faculté de Médecine, Université Cheikh Anta Diop, Dakar, Senegal; c Malaria Research and Training Centre, Faculté de Médecine de Pharmacie et d’OdontoStomatologie, Bamako, Mali; d Chokwé Health Research and Training Centre, National Institute of Health, Chokwé, Mozambique; e UNITID College of Health Sciences University of Nairobi, Nairobi, Kenya; f Farafenni Field Station, Medical Research Council Laboratories, Fajara, The Gambia; g Research Institute for Tropical Medicine, Manila, Philippines; h National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia; i Komfo Anokye Teaching Hospital, Kumasi, Ghana; j Medicines for Malaria Venture, Geneva, Switzerland; k Shin Poong Pharmaceutical, Seoul, South Korea; l University of Iowa, Iowa City, IA, USA; Correspondence to: Dr Isabelle Borghini-Fuhrer, Medicines for Malaria Venture, International Center Cointrin, Route de Pré-Bois 20, PO Box 1826, CH-1215 Geneva 15, Switzerland Page 7 supplements in patients when they are diagnosed with APOE genotype disclosure done by direct to consumer (DTC) testing companies. Overall, 16% of all participants reported a change in dietary supplement use after AD risk assessment. Participants who learned that they had at least one copy of the risk-increasing e4 allele (e4+) had 4.75 times the odds of reporting a change in dietary supplement use than did their counterparts who had an absence of the risk-increasing e4 allele (e4– ) (95% CI: 2.23, 10.10; P < 0.0001) after adjustment for age, sex, race, baseline supplement use, randomization arm, and educational level. There were no significant differences between APOE e4+ and e4– participants in changes in overall diet, exercise, or medications. In this sample of 272 unaffected first-degree relatives of persons with AD, and who received genetic susceptibility testing for AD, an APOE e4+ genotype status was positively associated with dietary supplement use after risk disclosure. Use of dietary supplements occurred despite the absence of evidence that supplement use reduces the risk of AD. Given the expansion of DTC The Lancet, Volume 375, Issue genetic tests, this study highlights 9724, Pages 1457 - 1467, 24 April the need for future studies in 2010. Elsevier Ltd, the publisher disease risk communication. of The Lancet has made the above article available without charge as The study authors were a public service. To obtain a copy Jacqueline A Vernarelli, J Scott of the complete article, go to Roberts, Susan Hiraki, Clara A www.thelancet.com. Chen, L Adrienne Cupples and Robert C Green from the Alzheimers researchers check See RECENT RESEARCH -- Cont’d on p.8... what happens with dietary Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside Natural Medicine LawTM Page 8 May 2010 Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside in (free text) what supplements they were taking and how often, but were not required to put brand names or dosage. Our interest in this manuscript was the behavioral outcome of supplement use. I hope this helps.” Theobroma cacao, L. Photo Courtesy of Ministry of Agriculture, Kerala State, India RECENT RESEARCH -- Cont’d from page 7... Departments of Neurology (JAV SHRCG) Medicine (Genetics Program) (RCG) Boston University School of Medicine Boston, MA; the Department of Health Behavior Health Education University of Michigan School of Public Health (JCR) Ann Arbor, MI; the Data Coordinating Center (CAC) Departments of Epidemiology (LACRCG) Biostatistics (LCA) Boston University School of Public Health Boston, MA. Natural Medicine LawTM to note, however, that this risk is only relative. Most individuals with ApoE e4 will never develop AD and there are many AD patients who are e4 negative”. ApoE testing was not recommended by this study for Apolipoprotein (Apo) E testing relatives of persons with is done to determine the amount of Alzheimers Disease (AD). So why ApoE e4 that can be found. To are relatives of AD patients getting explain this further, take a look at this test done? The National the website at: Institutes of Health had a w w w . l a b t e s t s o n l i n e . o r g / consensus conference in April on understanding/analytes/apoe/ AD. See a brief report in the special sample.html, where is states, “This supplement in this issue. test looks at a person’s DNA to determine what combination of ApoE forms (genotype) is present. The ApoE gene exists in three NEW ZEALAND -- Cont’d from page. 6... different forms (alleles) – e2, e3, 3) A transfer of responsibility and e4 – with e3 being the most for administration of the common allele, found in 60% of DSR from the NZFSA to the general population. Everyone the Ministry of Health inherits a pair of ApoE genes that (Medsafe). is some combination of these three.” The DSR and the Dietary “ApoE e3/e3 is the most Supplements Amendment Regcommon genotype. ApoE e4 (e4/ ulations 2010 are available from e4 and e4/e3) is found in 25% of www.legislation.govt.nz. The above study is published in Am J Clin Nutr 91: 1402-1407, May 2010. the population and is associated with an increased risk of atherosclerosis. People with these genotypes could be predisposed to an exaggerated elevation of LDLC (“bad cholesterol”) and triglycerides when their diet is high in saturated fat.” [NML asked Dr. Green if he could identify the dietary supplements and amounts that people started taking after testing. Dr. Vernarelli replied, “The supplement information was gathered from survey data, therefore we do not know any exact formulations for the supplements. Participants were allowed to write “ApoE e4 has also been associated with an increased risk of late onset Alzheimer’s disease (AD) – AD that develops after the age of 65. This effect is additive in Dietary Supplements containing that one copy of e4 (e2/e4 or e3/ more than 300mcg of Folic Acid It is only lawful for a dietary e4) carries some increased risk and two copies of e4 (e4/e4) are supplement to contain more than a associated with an even greater risk See NEW ZEALAND -- Continued on p. 9... of developing AD. It is important . Guidance on whether a product is a dietary supplement The categorization of a product is determined by its ingredients, its purpose for use and the manner in which it is presented in the market. The Medsafe guideline Is my product regulated under the Medicines Act or the Food Act can be used to determine whether a product is a dietary supplement. May 2010 New Zealand Regulatory maximum daily dose of 300mcg Guidelines for Medicines. (but not more than a maximum AND daily dose of 500mcg) if the ii. Where the dietary Director-General of Health has supplement is presented as confirmed that the dietary a tablet or capsule, the supplement has been prepared in a finished product way that accords with the New specification for the Zealand Code of Good dietary supplement must Manufacturing Practice (GMP). include a dissolution test for folic acid that either: Confirmation of compliance with · meets the requirements of GMP is not required for dietary the USP monograph for supplements containing up to a folic acid tablets maximum daily dose of 300mcg OR folic acid. It is not permissible to · meets the requirements for supply a product containing more products containing folic than a maximum daily dose of acid specified in TG078 500mcg folic acid as a dietary http://www.tga.gov.au/ supplement. legis/tgo/tgo78.htm The completed application form To obtain confirmation from the and supporting documentation Director-General that a dietary should be sent to: supplement has been prepared in a Manager, Compliance Manageway that accords with the New ment Zealand Code of GMP, a Medsafe prospective supplier must make an P O Box 5013 application to Medsafe using the WELLINGTON 6145 form provided (Microsoft Word document 50kb). The application Following receipt of a completed must be accompanied by copies of: application form and supporting i. Good manufacturing documentation, Medsafe will practice certification check the information supplied. relating to the manufacture When Medsafe is able to confirm of the dietary supplement, the acceptability of the which may be any of the manufacturing arrangements, a signed statement to that effect will following: be added to the form and the form · a Licence to Manufacture will be returned to the prospective Medicines issued by supplier. This document should be Medsafe retained by the supplier as evidence · a Licence to Manufacture that supply of the supplement Therapeutic Goods issued described on the form is lawful. by the Australian TheraThe product cannot lawfully be peutic Goods Adminsupplied as a dietary supplement in istration New Zealand until the Medsafe · a GMP Certificate issued confirmation has been received. Na by Medsafe or by any of the If not satisfied Medsafe will recognised regulators listed contact the supplier to discuss the in Part D Section 5 of the NEW ZEALAND -- Continued from p. 8... Page 9 reason(s) the documentation supplied is inadequate. A prospective supplier who does not hold acceptable GMP certification should contact Medsafe’s Compliance Management Branch if they wish to arrange a GMP audit. A fee for service will apply to such audits in order to recover the time and travel costs associated with the audit. For further information, contact the Compliance Management Branch on 04 819 6800. Export certification Export certification in the form of a Statement to Foreign Governments that explains the regulatory setting for dietary supplements can be obtained on request and on payment of a fee for Service of $120 (GST exclusive). Requests should be addressed to the Manager Product Regulation, Medsafe, P. O. Box 5013, Wellington. Exporters should note that, due to the nature of dietary supplement regulation, it is not possible to attest to the safety or quality of products or their compliance with New Zealand law. Export certificates will therefore include the following statement: Under New Zealand law, dietary supplements are not assessed by a Government agency. This statement cannot therefore provide any assurance that the product(s) listed meet any quality or safety standards, are of New Zealand origin, or meet the regulatory See NEW ZEALAND -- Cont’d on p. 10... Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside Natural Medicine LawTM Page 10 May 2010 Natural Medicine LawTM before June 8, 2010. The parties must also file a Rule 26(f) Report by June 22, 2010 abd meet for an initial In April 2010, the Administrative Record, in the form case management conference on June 29, 2010. of a 52-page index of FDA Docket No. FDA-1996The causes of action are: “Unlawful” Business N-0028 (formerly Docket No. 1996N-0417) was filed Practices in Violation of The Unfair Competition Law, with the Court. The first date in the FDA docket is Bus. & Prof. Code 17200, et seq,; “Unfair” Business Christopher Grell’s comments that reached FDA on Practices in Violation of The Unfair Competition Law, November 20, 1996. The last item in the docket is a Bus. & Prof. Code 17200, et seq,; “Fraudulent” Memo from the FDA Regulations Policy and Business Practices in Violation of The Unfair Management Staff to Dockets Management re OMB Competition Law, Bus. & Prof. Code 17200, et seq,; Review, Executive Order 12866, July 30, 2007, False Advertising in Violation of California Bus. & demonstrating the almost 10-year period of time it Prof. Code 17500, et seq.; Violation of the Consumers took for the Good Manufacturing Practices Legal Remedies Act, Calif. Civ; Code 1750, et seq.; regulations to be formulated. There are three-plus and Restitution Based On Quasi-Contract/Unjust pages of Tab A’s and Tab B’s attached to this Memo. Enrichment. ALLIANCE GMP CASE READIES FOR REVIEW Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside The actual documents are certified to be in the In the opening paragraphs of the complaint Elliot possession of the Food and Drug Administration by Zeisel claims that since March 19, 2006, he has Philip C. Spiller, the Interim Director of the Division purchased Diamond Foods walnuts in packages of Dietary Supplement Programs, CFSAN, FDA. bearing claims that are false and misleading. Zeisel says that Diamond Foods has used express and The 17,000 pages of the Administrative Record was implied statements about positive effects of omega-3 filed on two compact disks and not filed in the District fatty acid consumption on health to entice consumers Court’s electronic filing system due to its size. to purchase its Shelled Walnut products. The phrase “Omega-3 2.5 g per serving” is displayed adjacent to A Motion for Summary Judgment, Opposition, heart symbols, “thereby implying that consumption Cross-Motions for Summary Judgment, and Replies … of walnuts is linked to heart health.” Zeisel also from both sides are to be filed sequentially, under an claims that the packing bears a statement that: “The Order of the Court filed on October 8, 2009, on or omega-3 in walnuts can help you get the proper before October 1, 2010. balance of fatty acids your body needs for promoting heart health. In fact, according to the Food and Drug The case is Alliance for Natural Health US, et al v. Administration, supportive but not conclusive Sebelius, et al, Case No. 1:09-cv-01523, U.S. District research shows that eating 1.5 oz. of walnuts per day, Court for the District of Columbia, Colleen Kollaras part of a low-saturated and low cholesterol diet, Kotelly, presiding. and not resulting in increased caloric intake, may reduce the risk of coronary heart disease.” Then Zeisel claims that FDA advised Diamond Foods in February 2010 there is not sufficient With two attorneys representing him in a class action evidence to identify a biologically active substance lawsuit, Elliot Zeisel of New York, New York is suing in walnuts that reduces the risk of coronary heart Diamond Foods, Inc., makers of Diamond of California Shelled Walnuts, for damages, equitable, See WALNUT CLAIMS FRAUD -- Continued on page 12... declaratory and injunctive relief in the United States District Court for Northern California. The complaint was filed March 22 and contains six causes of action. www.natmedlaw.com CONSUMER CLAIMS FRAUD OVER WALNUT LABEL CLAIMS Now set for Alternative Dispute Resolution by United States Magistrate Judge Elizabeth D. LaPorte Natural Medicine LawTM May 2010 Page 11 ounces of water or other fluid. The risk to Canadians includes choking and/or blockage of the throat, requirements of the importing country. esophagus or intestine. These products should NOT If the product(s) listed comply with the requirements be taken immediately before going to bed. of the New Zealand Dietary Supplements Regulations Health Canada is working with the Canadian (and any other applicable legislation) the product(s) Boarder Services Agency to stop importation of the are legally able to be sold in New Zealand. product into Canada. Any requests for certification that attests to aspects On March 31, Health Canada announced it had of regulation administered by the NZFSA (such as the Animal Products Act 1999 or the Food Hygiene found an unauthorized health product, “West Pharm Regulations 1974) should continue to be sent to the Therma Lean Fat Burner Energizer” was found on the Canadian market. West Pharm Therma Lean Fat NZFSA. Burner Energizer contains ephedrine and caffeine, Please e-mail general inquiries to Medsafe at which combined together, may cause serious and possibly fatal adverse effects. Canadians suffering [email protected]. from heart conditions, high blood pressure and diabetes are among those particularly at risk. The product was distributed across Canada via the internet CANADA WARNS -- Continued from page 5... by Nutrition First (www.nutritionfirst.ca), a company located in Nova Scotia. not included in the list of ingredients. On March 25, Health Canada warned about HERBAL DIET NATURAL that contains an undeclared pharmaceutical ingredient similar to the prescription drug sibutramine, used for obesity treatment. The use of sibutramine may cause serious side-effects, including cardiovascular reactions, such as increased blood pressure, chest pain, and stroke, in addition to dry mouth, difficulty sleeping and constipation. Sibutramine should only be used under the supervision of a healthcare practitioner. Sibutramine should not be taken by people who have had a heart attack, coronary artery disease, heartrelated chest pain, irregular heart beats, congestive heart failure, a stroke or symptoms of a stroke, in individuals with unstable or poorly controlled high blood pressure, or in patients who have clinically diagnosed depression or have a psychiatric illness. Sibutramine is not recommended for women who are pregnant, breastfeeding or planning to become pregnant. Ephedrine taken in combination with caffeine can cause symptoms ranging from dizziness, tremors, headaches and irregularities in heart rate to seizures, psychosis, heart attacks and stroke. Consumers who have purchased “West Pharm Therma Lean Fat Burner Energizer” are advised to consult with a medical professional if they have used the product or have concerns about their health. The use of products containing ephedrine is not recommended in people with heart problems, hypertension, thyroid disease, diabetes, enlarged prostate, anxiety and restlessness, glaucoma (serious eye disorder) and pheochromocytoma (serious gland disorder) because Ephedra/ephedrine aggravates these conditions. In all three cases, once the makers or distributors were notified of violations, the products were recalled and taken off the market. Consumers requiring more information about this advisory can contact Health According to the product label, Herbal Diet Natural Canada’s public inquiries line at (613) 957-2991, or also contains glucomannan used for the treatment of toll free at 1-866-225-0709. weight loss. In January 2010, Health Canada advised Canadians that natural health products containing the ingredient glucomannan in tablet, capsule or powder WWW.NATMEDLAW.COM form, which are currently on the Canadian market, have a potential for harm if taken without at least 8 Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside NEW ZEALAND -- Continued from page 9... Page 12 May 2010 Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside Los Angeles (310) 392-8801 and Michael D. Braun of the Braun Law Group, P.C. in Los Angeles (310) 836-6000. The case is Zeisel v. Diamond Foods, Inc. Case No. 3:10-cv-01192-EDL in the United District Court for the Northern District of California. Watch for more information in the July issue of NML. CURRENT STATUS OF WALNUT HEALTH CLAIMS FDA Photo Courtesy of Lloyd Library and Museum WALNUT CLAIMS FRAUD -- From p.10... has granted and not yet revoked a qualified health claim petition for walnuts and heart disease by issuing a letter of discretion that is summarized on FDA’s website at: www.fda.gov/ Food/LabelingNutrition/ L a b e l C l a i m s / QualifiedHealthClaims/ ucm073992.htm#walnuts, where it stated: “Walnuts & Heart Disease Docket No. 02P-0292 03/09/2004 enforcement discretion letter” disease (“CHD”) or to support the statement that the omega-3 fatty acids found in walnuts promote heart health or reduce the risk of CHD. Continuing, “Defendant’s health claims are therefore unauthorized under federal law and misleading to consumers. As the FDA specifically found in February 2010, Defendant’s Shelled Walnuts “Claim Statement products are ‘in violation of the • (1) Supportive but not Federal Food, Drug, and Cosmetic conclusive research shows Act and applicable regulations … that eating 1.5 ounces per and are misbranded … in that day of walnuts, as part of a [Diamond’s] products bear health low saturated fat and low claims are not authorized by the cholesterol diet and not FDA.’” resulting in increased caloric intake, may reduce The six causes of action are based the risk of coronary heart on the health claims on the disease. See nutrition packaging of Diamond Foods information for fat [and Shelled Walnuts. calorie] content. Diamond Foods is a Delaware Corporation doing business in San Francisco. Attorneys for Zeisel are Janet Lindner Speilberg, Esq, of o Note: The bracketed phrase “and calorie” is optional in that FDA does not Natural Medicine LawTM intend for the presence or absence of such phrase to be a factor in whether it c o n s i d e r s enforcement discretion for the use of the qualified health claim. FDA considered this additional information might be beneficial to consumers to heighten their awareness of the c a l o r i c contribution from walnuts and encourages companies to include it in product labeling.” “Eligible Foods Whole or chopped walnuts” “Factors The claim meets the general requirements for health claims in 21 CFR 101.14, except for the requirement that: (1) the evidence for the claim meet the significant scientific agreement standard; (2) the claim be made in accordance with an authorizing regulation; (3) the food not exceed the disqualifying level for total fat; and (4) the food provide at least 10 percent of the Daily Value of vitamin A, vitamin C, iron, calcium, protein, or dietary fiber per reference amount customarily consumed.” “The disclosure statement about total fat content (i.e., See nutrition information for fat content) is See CURRENT STATUS -- Cont’d on p. 13... Natural Medicine LawTM May 2010 Page 13 The enforcement discretion letter demonstrating consumer deception existent.” FDA believes outright as a condition precedent to claim was issued March 9, 2004 to the California Walnut Commission’s censorship is permitted by Pearson suppression. legal counsel, Sarah E. Taylor, J.D., I because the agency views the R.D., M.P.H., Covington & In Plaintiffs’ Motion for Plaintiffs’ science as unconvincing. FDA believes this because it Summary Judgment they had Burling, in Washington, D.C. and believes the speech suppression is requested the Court rule on all the letter is several pages long and not reviewable under the First causes of action contained in their can be obtained at: www.fda.gov/ Amendment standard of Pearson complaint. These causes included F o o d / L a b e l i n g N u t r i t i o n / I but under the deferential standard a declaration that FDA’s Final L a b e l C l a i m s / of the Administrative Procedure Order in Docket No, FDA-2008- Q u a l i f i e d H e a l t h C l a i m s / Q-0299-0014 violates Plaintiffs’ ucm072910.htm. Act. First Amendment rights and the Plaintiffs argue that Defendants constitutional mandates of the U.S. request to reverse the Court of Court of Appeals in Pearson v. NDI NOT POSTED BY FDA rd Appeals and three other decisions Shalala, 163 F.3 650 (“Pearson of the District Court, after years of I”), and the U.S. District Court in In the January issue of NML, we refusal to abide by the Whitaker v. Thompson, 248 F. reported on a news release on the constitutional mandate in Pearson Supp. 2d 1 (D.D.C. 2002), appeal web site of Sabinsa Corporation dismissed, 2003 U.S. App. LEXIS who announced that FDA had I, is contumacious. 18288 (D.C. Cir. 2003). Another accepted its New Dietary notice for Plaintiff say that for FDA to meet cause was for an injunction Ingredient blocking FDA from taking any SelenoForce®, a “seleniumits heavy burden and to censor the garlic product claims, the agency must establish action to prevent their use of the enriched health claims specified herein with manufactured by a patent pending that the Plaintiffs’ science is false, reasonable, “sort, succinct, and soilless culture process. Garlic or disproved, and that empirical evidence proves the disclaimers accurate” disclaimers prescribed bulbs are naturally enriched with a incapable of curing potential by the agency. In Plaintiffs’ unique composition of organic compounds for deceptiveness. FDA has never proposed order, there are six claims selenium set forth that appear in Natural nutritional supplementation, using attempted to do so and does not do Medicine Law™ Newsletter, a proprietary hydroponics method. so in its opposition arguments. September 2009, at page 14. The selenium enriched bulbs are Plaintiffs set forth seven pages of (Readers can view this on the web dried, powdered and standardized, to yield SelenoForce® containing argument why the Administrative at www.natmedlaw.com.) 1000 ppm selenium, in Procedures Act does not apply, and This case is Alliance for Natural bioavailable organic form, in a base 28-pages of argument why FDA’s censorship of Plaintiffs’ qualified Health US, et al v. Kathleen of natural garlic powder.” health claims violate the First Sebelius, et al, Case No. 1:09-cvThe news release states that Amendment. Saying that the First 01546-RJL, U.S. District Court for the District of Columbia. “Low selenium status has been Amendment Standard applies to linked with the occurrence of Qualified Health Claims, that decreased immunity to diseases Plaintiffs’ proposed health claims and the prevalence of various are supported by credible peerforms of cancer.” reviewed scientific evidence, that CURRENT STATUS -- Cont’d from p. 12... FDA must draft reasonable, “sort, At the time, late December or succinct, and accurate” placed immediately following the disclaimers, and that Pearson I and claim, with no intervening early January, the FDA had not Whitaker I established a Per se material, in the same size, typeface, placed this acceptance on the FDA requirement of empirical evidence and contrast as the claim itself.” See SELENIUM NDI -- Continued on p. 14.... Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside VITAMIN A & D -- Cont’d from p.1... Page 14 May 2010 Natural Medicine LawTM Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside SELENIUM NDI GRANTED -- Continued from page 13 ... NEW INGREDIENTS -- Continued from page 3... portion of the www.regulations.gov website as required by law. The statute requires that any accepted new dietary ingredient be placed on file for public view. Apparently the “new” FDA does not consider the website a necessary part of the public view. Prior to 2008, when the FDA Dockets office received the documents from reviewers, the documents would go into the docket with a file number, and shortly thereafter the documents would be placed on the FDA website. placed on display at the Dockets Management Branch. Posted on September 30, 2008 on www.regulations.gov Docket No. FDA-1995-S-00390042. The original FDA Docket was No. 95S-0163, RPT 21. [FDA still has not placed notice of this acceptance on its web site, since discontinuing the Docket No. 95S-0316 in 2008. The new www.regulations.gov Docket No. FDA-1995-S-0039 is not up to date and therefore this company’s claims about acceptance cannot be verified until one or the other of these Federal agencies get around to updating the public files. Normally, NML does not report on the same product twice, but in this case, NML is monitoring FDA’s performance in adhering to the statutory requirements to place the acceptance on public display. Readers will be able to see why when you read the remainder of this summary. – Ed.] NML is now able to confirm that the NDI was accepted because of FDA’s response to a Freedom of Information request, No. F-10-252. The NDI states the product is manufactured in India by Sami Labs Limited in Banglalore. The submission was made September 2, 2009. The draft label contains a warning that states: “Warning: SelenoForce is standardized for Selenium which is toxic in high doses. A daily maximum recommended does of 200 microgram, for adults, of Selenium from dietary supplements should not be exceeded. Selenium intake from all sources should not exceed 400 microgram per day.” The product is being sold in bulk for adding to other products. The intended use of the product is explained in six bulleted statements on page 13 of a 74 page submission. Among these six statements are: “Selenium-enriched garlic contains selenium species that are reported to be more beneficial to health as compared to other forms of selenium supplementation. Selenium is an essential trace mineral nutrient with multiple roles in health maintenance as an antioxidant. Ideally, selenium See SELENIUM NDI GRANTED -- Continued on page 20... Technical Sourcing International, Inc. of Sandy, Utah, wrote FDA on November 19, 1997 as a trade secret: confidential and proprietary information notice for the new dietary ingredients, Isopropoxy isoflavone. Included was a 52 week oral toxicity study on 32 beagle dogs. Also in the file is a letter dated October 9, 2003 from Perrigo of Allergan, Michigan, submitting a notice for Ostivone® containing 100 mg of Isopropoxy Isoflavone, 100 IU Vitamin D and 250 mg calcium per caplet. Suggested use will be for adult women, two tablets per day. With this notice was a safety profile and Technical Sourcing International, Inc’s 75-day notificiation. The 2003 submission contained summaries of a number of human studies and three pharmacokinetic and metabolic modeling studies, plus a list of 19 reference papers. FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, responded to Steve Lee on an unknown date with a letter stating that the information will be kept confidential until February 22, 1998 and then be placed on display at the Dockets Management Branch. Posted on September 28, 2008 on www.regulations.gov Docket No. FDA-1995-S-00390041. The original FDA Docket was No. 95S-0163, RPT 22 after being received in the FDA Dockets Management Branch on October 22, 2003. General Nutrition Corporation, Inc. of Pittsburgh, Pennsylvania, wrote FDA on February 19, 1998, to give notice of an NDI for methyltetrahydrofolate (5MTHF) the active form of folate. The supplement containing the 5-MTHF will consist of 400 mcg of 5MTHF in a tablet or capsule suggested to be taken one time per day. Included were chemical pharmaceutical data, toxicology studies and clinical studies, all in summary form. FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, responded to Dr. John Troup on April 6, 1998 with a letter stating that the information will be kept NEW INGREDIENTS -- Continued on page 15.... Natural Medicine LawTM May 2010 Page 15 serious health risks for oral use of GBL that precludes confidential until May 27, 1998 and then be placed a determination that GBL will reasonably be expected on display at the Dockets Management Branch. to be safe as a dietary ingredient. Tanner stated that Posted on September 30, 2008 on the references to presence in food cannot be compared www.regulations.gov Docket No. FDA-1995-S-0039- to the proposed exposures to GBL and the differences 0043. The original FDA Docket was No. 95S-0163, in bioavailability and absorption of GBL from foods RPT 23 after being received in the FDA Dockets and encapsulated products were not considered. Further FDA disagrees that the two human studies Management Branch on April 9, 1998. show the safety of long-term exposure to GBL. FDA Unique Products Company of Brentwood, cited other safety evidence that was not considered Tennessee, wrote to FDA on February 11, 1998 to in the notice. FDA determined that the product would give notice it would sell a new dietary ingredient, 4- be adulterated a new dietary ingredient for which there butyrolactone also known as gamma-butyrolactone. is inadequate evidence to assure that the ingredient The letter was marked as contaiing trade secret and/ does not present a significant or unreasonable risk of or confidential commercial information. This illness or injury. Introduction of such a product into ingredient is found in numerous foods, References interstate commerce is prohibited. Posted on to this statement were provided. The product will be September 30, 2008 on www.regulations.gov Docket sealed capsules of 325 to 500 mg in a sealed single No. FDA-1995-S-0039-0044. The original FDA pouch of 4 to 5 capsules packaged in cartons five to Docket was No. 95S-0163, RPT 25 after being thirty pouches. The product is intended to support received in the FDA Dockets Management Branch relaxation, normal sleep and the release of growth on May 5, 1998. There is no RPT 24 in the hormone in the body. The maximum dose www.regulations.gov at this time. recommended is five capsules and smaller amounts General Nutrition Corporation, Inc. of for smaller individuals. There will be a warning that the product is not to be used with alcohol or central Pittsburgh, Pennsylvania, wrote FDA on March 2, nervous system depressants. Consumers will be 1998, to give notice of an NDI for Ademetionine, in warned not to use prior to driving or operating a 500 mg capsule or tablet. Included in the notice were machinery. A warning will be listed for persons under chemical pharmaceutical data, toxicology data, and age 18, pregnant or lactating women, persons with clinical studies. This was a 469 page submission. epilepsy, convulsions, seizures, bradycardia, high Ademetionine is the initiator of two important blood pressure or cardiovascular disease, Cushing’s metabolic pathways in humans – transmethylation and syndrome or hyperprolactinemia. A WHO See NEW INGREDIENTS --Continued on page 16... Monograph and two clinical studies were referred to in summary form. FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement PHOTOGRAPHS FROM LLOYD LIBRARY AND MUSEUM Policy, Office of Special Nutritionals, CFSAN, responded to Jay L. Caplan on April 29, 1998 with a Back Cover -- Podophyllum (Podophyllum Peltatum) from AMERIfive-page letter stating that the information had been CAN MEDICINAL PLANTS by Charles F. Millspaugh, M.D, 1887 reviewed carefully and the agency had significant Back Cover --Goldenseal (Hydrastis Canadensis) from AMERICAN concerns. Tanner stated that FDA believes the MEDICINAL PLANTS by Charles F. Millspaugh, M.D, 1887 company did not consider significant limitations of Page 4 - Foxglove (Digitalis purpurea) from MEDICAL BOTANY the evidence cited and the serious, unresolved, health by John Stephenson, M.D. and James Morss Churchill, F.L.S. risks associated with GBL and the submission ignores 1828 unequivocal evidence in the scientific literature of Page 12 - Ginseng (Panax quinquefolium) from THE FAMILY FLORA AND MATERIA MEDICA BOTANICA by Peter P. Good 1845-47 Page 16 - Olive Tree (Olea Europæa) from FLORA GRÆCA by Johannes Sibthorp. M.D. & Jacobus Edvardus Smith, M.D., 1806 www.natmedlaw.com Page 22 -- Cone Flower (Echinacea Intermedia) from PAXTON’S MAGAZINE OF BOTANY, 15th Vol. 1849 Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside NEW INGREDIENTS-- Continued from page 14... Page 16 NEW INGREDIENTS -- Cont’d from p.15 ... Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside transsulfuration. FDA’s Robert J. Moore, Ph.D., Senior Regulatory Scientist, Office of Special Nutritionals, responded to John Troup, Ph.D. by letter of March 13, 1998 stating that the notice was received and that introduction of any dietary supplement containing Ademethionine or katsuobushi oligopeptide into interstate commerce shall not be done until after 75 days. Posted on September 30, 2008 on www.regulations.gov Docket No. FDA-1995-S-00390045. The original FDA Docket was No. 95S-0163, RPT 26 after being received in the FDA Dockets Management Branch on April 9, 1998. General Nutrition Corporation, Inc. of Pittsburgh, Pennsylvania, wrote FDA on March 4, 1998, to give notice of an NDI for Katsuobushi Oligopeptide, a peptide obtained from thermolysin digested Katsuobushi (dreid bonito), in a tablet or powder form that will provide I gm per serving. Suggested use will be three times per day. Included in the notice were product specification and process manufacturing, summary of safety, stability and clinical reports, scientific study describing physiological effect and dosing, cute toxicity and references. FDA’s Robert J. Moore, Ph.D., Senior Regulatory Scientist, Office of Special Nutritionals, responded to John Troup, Ph.D. by letter of March 13, 1998 stating that the notice was received and that introduction of any dietary supplement containing Ademethionine or katsuobushi oligopeptide into interstate commerce shall not be done until after 75 days. Posted on September 30, 2008 on May 2010 Natural Medicine LawTM www.regulations.gov Docket No. FDA-1995-S-0039-0046. The original FDA Docket was No. 95S0163, RPT 27 after being received in the FDA Dockets Management Branch on April 9, 1998. SKW Trostberg AG of Trostberg, Germany, through Robert B. Nicholas, Esq. of McDermott, Will & Emery of Washington, D.C. on March 27, 1998 filed a NDI notice for creatine pyruvate, containing pure pyruvic acid molecularly bonded to pure creatine, in a 40 to 60 percent ratio. The recommended condition for use is 5 to 10 grams per day, taken in two equal doses, mixed with a beverage. Eight documents were listed in the letter as the basis for the company’s expectation that the ingredient will reasonably be expected to be safe under the conditions of use. Copies were appended to the notice letter. However, these documents were not in the public file. FDA’s Robert J. Moore, Ph.D., Senior Regulatory Scientist, Office of Special Nutritionals, responded to Robert B. Nicholas, Esq. by letter of April 6, 1998 stating that the notice was received on March 31, 1998 and that the submission will be kept confidential for 90 days and not placed on public display until after June 28, 1998. Commercial and confidential information in the notification will not be made available to the public. Posted on October 6, 2008 on www.regulations.gov Docket No. FDA-1995-S-0039-0051. The original FDA Docket was No. 95S0163, RPT 28 after being received in the FDA Dockets Management Branch on April 9, 1998. Olive Tree (Olea Europæa) 1806 Photo Courtesy of Lloyd Library and Museum General Nutrition Corporation, Inc. of Pittsburgh, Pennsylvania, wrote FDA on April 20, 1998, to give notice of an NDI for Seaprose-S (Semi-Alkaline Proteinase), a homogeneous crystealline proteinase originated from Aspergillus Melleus. The supplement which contains Seaprose-S will consist of fifteen (15) mg of Seaprose-S in a tablet or powder form that will be suggested for use two times per day. Included in the notice were Development and manufacturing chemistry, toxicity studies, product stability data and physiological studies. FDA’s Robert J. Moore, Ph.D., Senior Regulatory Scientist, Office of Special Nutritionals, responded to John Troup, Ph.D. by letter of April 29, 1998 stating that the notice was received on April 29, 1998 and that the submission will be kept confidential for 90 day until after July 11, 1998 placed on public display. Posted on October See NEW INGREDIENTS -- Cont’d p 17... NEW INGREDIENTS -- Cont’d from p.16 ... 6, 2008 on www.regulations.gov Docket No. FDA-1995-S-00390065. The original FDA Docket was No. 95S-0163, RPT 29 after being received in the FDA Dockets Management Branch on April 30, 1998. Malabar Productos Naturales of Guadalupe, Mexico, wrote to FDA on May 1, 1998 to give notice that it would sell five dietary supplement products – Jointaid, Pancrease, Gastritease, Menstrualaid, and Digestaid. These products will contain the same five new ingredients mentioned in the company letter of January 23, 1998 (See the letter posted on September 28, 2008 on www.regulations.gov Docket No. FDA-1995-S-00390039. The original FDA Docket was No. 95S-0163, RPT 20). The Digestaid contains Loeselia Mexicana (Lam.) Brand. 5%. plus Aloe vera, senna, cassia augustifolia, cascara, and Rhamnus purshiana. . FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, responded on July 15, 1998 to Natalia Garza, export manager, in a letter that stated that FDA considered the information and concludes that “it appears to meet the standard in 21 U.S.C. 350b(a)(2) for the new dietary ingredients Tronadora, Pericon, Espinosilla, and Chancarro. The date received, May 15, 1998, is the filing date for the notification and therefore, the products may not be distributed until July 29, 1998, 75 days after the filing date. Tanner then stated that the submission does not provide an adequate basis May 2010 to conclude that Montanoa tormentosa, when used under the conditions suggested in the labeling, will reasonably be expected to be safe. For the reasons in FDA’s earlier response the product is adulterated because it contains an ingredient for which there is inadequate information to provide reasonable assurance that the ingredient does not present a significant or unreasonable risk of illness or injury. The May 1 submission contains further information confirming the uterotonic effects and induced cervical dilatation and uterine bleeding. Introduction of such a product into interstate commerce is prohibited. Posted on October 6, 2008 on www.regulations.gov Docket No. FDA-1995-S-00390054. The original FDA Docket was No. 95S-0163, RPT 30 after being received in the FDA Dockets Management Branch on July 20, 1998. SECTION 403 -- Continued from p. 4... CFSAN, wrote to Cheryl Radetsky on May 5, 1997 to state that these claim statements are interpreted to mean the product is intended to treat diseases and the product is a drug subject to regulation as a drug under the drug provisions of the Act. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S-0163, LET 45 and in www.regulations.gov Docket No. FDA-1997-S-0006-0335 posted September 8, 2008. Herbs for Kids, Inc. of Bozeman, Montana, wrote to FDA on February 5, 1997 to give notice Page 17 of statements of claims for 35 different products by enclosing labels. FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, on April 15, 1997, wrote to Steve Guettermann stating that two of the products had claims that did not meet the requirements of Section 403(r)(6) because they were claims that the products treat disease. The products and claims were: 1) Echinacea/Golden Root™ Immune Support Blend (Blackberry Flavor and Orange Flavor), “This blend contains herbs which support the body’s ability to resist the onset of infection;” and 2) Vi Blend™ Immune Support Blend, “This blend contains herbs which support the body’s antiviral capabilities.” The FDA letter of April 15, 1997 said that if those claims were used the products would be regulated as drugs under the Act. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S0163, LET 46 and in www.regulations.gov Docket No. FDA-1997-S-0006-336 posted September 8, 2008. There is also a LET 46 for a different product at FDA-1997-S-0039-0164 posted on October 14, 2008. The Health Connection, Limited of Copiague, New York, wrote FDA on March 14, 1997 through Emord & Associates, P.C. of Washington, D.C. to give notice that the company would be using three statements of nutritional support for its product, SPV-30, containing Extract of the See SECTION 403 - Cont’d p. 18... Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside Natural Medicine LawTM Page 18 May 2010 SECTION 403 -- Continued from page 17... Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside Boxwood Evergreen Tree. The statements of support are: “SPV-3- provides nutritional support for the body’s immune system;” “SPV-3- provides nutritional support for the body’s natural defense;” and “SPV30 enhances immune system function by increasing CD4 and CD8 counts.” FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, on April 4, 1997, wrote to Jonathan Emord, Esq. and Claudia A. Lewis, Esq. to state that the claim: “SPV-30 enhances immune system function by increasing CD4 and CD8 counts” is not a Section 403(r)(6) claim, but a claim to treat immune deficiency diseases and therefore it will be regulated as a drug under the Act if used. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S0163, LET 47 and in www.regulations.gov Docket No. FDA-1997-S-0006-337 posted September 8, 2008. There is also a LET 47 for a different product at FDA-1997-S-0039-0165 posted on October 14, 2008. Natural Medicine LawTM notice of claims it was to make for its product, Soy Life, a soy protein isolate. The claims were: “As a result of numerous studies, evidence is mounting that soybeans may inhibit tumor growth. Genistein, an Isoflavone found chiefly in soybeans, has been identified as an angiogensis blocker. Angiogensis is the process by which new blood vessels grow and nourish malignant tumors. Bu blocking angiogenesis (sic), isoflavones may inhibit tumors.” Elizabeth A. Yetley, Ph.D., R.D., Director of the Office of Special Nutritionals at CFSAN, on December 29, 1995, wrote to Ernest Fleming to state that the claims are that the product is intended to prohibit tumor growth and block the growth of malignant tumors. These are not Section 403(r)(6) claims and if the claims are used the product will be regulated as a drug under the Act. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S-0163, LET 49 and in www.regulations.gov Docket No. FDA-1997-S-0006339 posted September 8, 2008. Wakunaga of America Co., Ltd. of Mission Viejo, California, wrote FDA on April 2, 1997 to give notice that labeling for the product, PROBIATA™, containing Lactobacillus acidophilus, would contain the claims: “Replenishes healthy intestinal flora, avoiding disorders such as diarrhea, constipation and yeast discomfort caused by antibiotic usage.” James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, on May 22, 2997 wrote to Mitsuru Takiura at the same address as the company to state that the claims to “ avoiding disorders such as diarrhea, constipation and yeast discomfort caused by antibiotic usage” are not Section 403(r)(6) claims, but rather are claims to treat a special class of diseases. The claims make the product subject to regulation as a drug under the Act. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S0163, LET 50 and in www.regulations.gov Docket No. FDA-1997-S-0006-340 posted September 8, 2008. Paracelsian, Inc. of Ithaca, New York, wrote FDA on February 11, 1997, through Anthony L. Young, Esq. of Piper & Marbury, LLP, in Washington, D.C. concerning a statement of nutritional support for its product, AndroVir™-DS containing the extract of Andrographis paniculata. The statement was: “Helps to support normal immune function.” FDA’s James Tanner, Ph.D., acting director of the Division of Programs and Enforcement Policy, Office of Special Nutritionals, CFSAN, on April 4, 1997, wrote to Anthony Young, Esq. to stated that the statement is not a Section 403(r)(6) claim, but a claim to teat HIVpositive persons and therefore it will be regulated as a drug under the Act if used. The FDA letter also mentions the product, Androcar being marketed to persons with cancer, but there is no such letter in this Docket file. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S-0163, LET 48 and in www.regulations.gov Docket No. FDA-1997-S0006-338 posted September 8, 2008. There is also a Institute for Nutritional Science Limited of San LET 47 for a different product at FDA-1997-S-0039Diego, California, wrote to FDA on December 3, 1996 0166 posted on October 14, 2008. to give notice that it would use certain claims on three Global Marketing International of Richardson, See SECTION 403 -- Continued on page 19... Texas, wrote to FDA on September 11, 1995 to give May 2010 Page 19 SECTION 403 LETTERS -- Continued from page 18...A and Research. FDA also declined to have a meeting of its products, Sugar-Eze, ProFlow, and BioCalcium. since there is no information in the submission that An attachment to the letter provided product labels would lead FDA to change its position in the matter. with a list of ingredients and the claim information. Also in the file was a letter from Paul Hyman, Esq. of For Sugar-Eze, the claim was: “contains chromium Hyman, Phelps & McNamara, P.C. of Washington, and vanadium which have been shown to be essential D.C. commenting on a telephone conversation about for normal glucose metabolism.” For ProFlow the the May 22 letter being addressed personally to claim was: “Contains Saw Palmetto and Pygeum Mitsuru Takiura instead to the same person in his Africanum which have been shown to reduce prostate official capacity as president. Hyman asked for a inflammation.” For BioCalcium the claim was: revised letter, but it does not appear in this docket “Contains the minerals magnesium, manganese, zinc, file. The notice letter and FDA response was received boron, and copper which have been shown to improve in FDA’s Dockets Office on August 12, 1997 and was the uptake of calcium by the bone.” FDA’s James placed in Docket No. 97S-0163, LET 52 and in Tanner, Ph.D., acting director of the Division of www.regulations.gov Docket No. FDA-1997-S-0006Programs and Enforcement Policy, Office of Special 342, posted September 8, 2008. There is also a LET Nutritionals, CFSAN, on January 6, 1997 wrote to 52 for a different product at FDA-1997-S-0039-0170 Dr. Steven E. Whiting, that the claim used on ProFlow posted on October 14, 2008. was not a proper Section 403(r)(6) claim, but a claim to treat a class of diseases – symptoms of Benign Prostatis Hypertrophy or Prostatitis. This claim is subject to regulation under the drug provisions of the Act. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S-0163, LET 51 and in www.regulations.gov Docket No. FDA-1997-S-0006341, posted September 8, 2008. There is also a LET 51 for a different product at FDA-1997-S-0039-0169 posted on October 14, 2008. Wakunaga of America Co., Ltd. of Mission Viejo, California, wrote FDA on June 6, 1997 concerning the letter to Mr. Mitsuru Takiura, dated May 22, 1997 to state that the company was making a change in the claim to: “Replenishes healthy intestinal flora, avoiding disorders such as diarrhea, constipation and yeast discomfort caused by antibiotic usage.” The June 6 letter insisted that the product was intended to help maintain normal body function, that diarrhea and other conditions associated with antibiotics are not diseases, and that the product only affects the structure and function of the digestive tract and is a Section 403(r)(6) claim. FDA’s Robert J. Moore, Ph.D., Senior Regulatory Scientist, Office of Special Nutritionals, CFSAN, wrote to Harunobu Amagase, Ph.D., on June 18, 2007 that the May 22, 1997 letter contains statements that the product is intended to treat, prevent or mitigate a drug-induced disease. If the company intends to make such claims, it should contact the FDA Center for Drug Evaluation Pacific BioLogic of Orinda, California, wrote to FDA on November 11, 1996, to give notice to FDA that it would make revisions in certain product descriptions in light of concerns of Robert Moore of FDA. The letter explained the meaning of the words “heat” and “clear” or “clearing” as applied to a Chinese concept of spiritual balancing. The products RESIST, RESIST 2, PRE COLD PLUS and Cold Free 1 Plus each have lengthy statements made about them and sources of additional information, closing by stating that these changes will sufficiently address your concerns while still communicating the proper use of our products. FDA’s James Tanner, Ph.D. wrote to Randall Wisegarver on January 14, 1997 stating that FDA had no further comment on the claims for RESIST 2 and COLD FREE 1 PLUS. However, for the products RESIST and PRE COLD PLUS, the FDA letter explained again why the claims were making claims to treat diseases and the company should contact the FDA Center for Drug Evaluation and Research if they intended to use the claims. For the product RESIST, the November 15, 1996 letter claims were: Application: To supplement the diet when following a total dietary and lifestyle program which is intended to strengthen and support the body’s own See SECTION 403 LETTERS -- Continued on page 20... www.NatMedLaw.com Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside Natural Medicine LawTM Page 20 May 2010 SECTION 403 LETTERS -- Continued from page 19... Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside defense mechanisms” and “Recommendation: Resist is best used in conjunction with Resist 2 in daily rotation. Reduce or discontinue use of Resist during flare-ups of symptoms or during illnesses such as colds and flus.” For the product PRE COLD PLUS, the November 15, 1996 letter claims were a similar Applications statement followed by: “Pre Cold Plus is a unique design which is considered to be a mild tonic but also contains significant clearing components (as defined by TCM). It is intended to be used to supplement the diet when following total dietary and lifestyle programs which are intended to build the body’s own defense mechanisms when the seasons are changing or during the winter months. Proper nutrition is a key component of insuring the best immune function. The body is best able to combat the woes of the cold and flu season when immune function is optimal. Highly concentrated.” The statement then gives suggested use schedules. FDA says these claims suggest treatment, prevention or mitigation of the symptoms of cold and flu. If these claims are used the company should contact the FDA Center for Drug Evaluation and Research. The notice letter and FDA response was received in FDA’s Dockets Office on August 12, 1997 and was placed in Docket No. 97S-0163, LET 53 and in www.regulations.gov Docket No. FDA-1997-S-0006343, posted September 8, 2008. SELENIUM NDI -- Continued from page. 14... should be supplemented in the form or forms in which it occurs in foods. Garlic grown in selenium rich soil naturally contains organic selenium compounds” and “Selenium may reduce the risk of certain cancers. Some scientific evidence suggests that consumption of selenium may reduce the risk of certain forms of cancer. However, FDA had determined that this evidence is limited and not conclusive. (Qualified Health Claim, CFSAN, 2003).” Numerous safety studies were summarized in the notification, but no copies of these were provided in response to the FoI request. All parts of the file should have been supplied under the request. The only history of use information supplied was contained in the final summary in the notification where it is stated: “There is a long history of traditional food use for garlic, and at the Natural Medicine LawTM recommended levels 50- 200 mcg of SelenoForce™ would be the dose consumed per day, supplying 50200 mcg of supplemental selenium per day.” Also the summary contains the statement: “The organic selenium species in SelenoForce™ have been previously marketed as dietary ingredients in the United States. L-Seleonomethionine was marketed as a dietary supplement prior to 1994 (ã-glutamyl-LSeleonomethionine is broken down to yield LSeleonomethionine in the gastrointestinal tract); SeMethyl-L-selenocysteine was notified as a new ingredient by the manufacturer in 1999 (ã-glutamylL-Seleonomethionine is converted to Se-Methyl-Lselenocysteine in the gastrointestinal tract).” Thirty one pages were redacted from the public file. FDA responded by letter dated November 30, 2009 to Dr. Lakshmi Prakash from Dan D. Levy, Ph.D., Microbiologist, Supervisor, New Dietary Ingredient Review Team, Division of Dietary Supplement Programs, CFSAN stating that this notification is a procedural matter and does not constitute an FDA finding that the ingredient is safe or not adulterated. Also, the letter states FDA is not precluded from taking action in the future if it or any product in which it is placed is found to be unsafe, adulterated or misbranded. No docket numbers are provided on the papers disclosed by the FDA in response to the FoI Request as the 90 days from November 30, 2009 have not been reached. As of May 7, 2010, the place where FDA is supposed to place the information is in the Dockets Management Branch Office, where data is obtained to fulfill FoI Requests, and from which the data is forwarded to the www.regulations.gov staff. Since there was no docket number for the information in the Dockets Office files or in the www.regulations.gov files, and since what was provided under the FoI Request was not complete, it cannot be verified whether the Sabinsa advertising claims in the news release were approved or accepted by FDA. This incompleteness is not fair to Sabinsa or the consumers of the United States. If all of the file were disclosed under the FoI Request there may be a basis for determining whether the advertising is misleading or whether FDA has complied with the law of the land by its actions. Right now the answers are in a dark hole at FDA. Accountability is not possible at FDA under these circumstances. Natural Medicine LawTM May 2010 Page 21 2008, FDA inspected 153 foreign food facilities out Congress was working on at that time. S. 510 was of an estimated 189,000 such facilities registered with reported out of the Senate on March 3, 2009, but has FDA; in 2007, FDA inspected 95 facilities. FDA not gone anywhere since, except to have some estimated that it would conduct 200 inspections in members suggest amendments are needed. The bill 2009 and 600 in 2010. In addition, FDA opened was placed on the General Calendar in the Senate on offices in China, Costa Rica, and India and expects December 19, 2009. In the House, H.R. 1332 has to open offices in Mexico and Chile and to post staff gone nowhere since April 2009. A subcommittee of at European Union agencies.” the Agriculture Committee requested comments from HHS and USDA. “Furthermore, FDA’s testing of a new computer screening system—the Predictive Risk-Based With slow progress on the food safety bill, and a Evaluation for Dynamic Import Compliance Targeting new Deputy Commissioner inserted into the (PREDICT)—indicates that the system could enhance organization chart ahead of you, and closer to the FDA’s risk-based screening efforts at ports of entry, Commissioner, what was Sundlof expected to do, but but the system is not yet fully operational. PREDICT to look around. Sundlof made the choice to develop is to generate a numerical risk score for all FDAprograms that will educate people who are needed at regulated products by analyzing importers’ shipment FDA and USDA. That is a wise choice it seems to information using sets of FDA-developed risk criteria NML. FDA does not have the brain power that is and to target for inspection products that have a high needed, nor does it have the numbers of staff that are risk score.” needed. FDA cannot hire them if they are not available. So Sundlof is attempting to help solve a “GAO previously identified several gaps in big problem by leaving now. Or is he? enforcement that could allow food products that violate safety laws to enter U.S. commerce. For Maybe the Congress knew that “sticker shock” was example, FDA has limited authority to assess penalties coming on the cost of new food safety programs or on importers who introduce such food products, and was waiting on the new Obama Administration to the lack of a unique identifier for firms exporting food figure out what it would support. But in the meantime products may allow contaminated food to evade the Congress asked the General Accountability Office FDA’s review. In addition, FDA’s and CBP’s to do a study. The Subcommittee on Oversight and [Customs and Border Protection] computer systems Investigations, Committee on Energy and Commerce, do not share information. FDA does not always share House of Representatives heard testimony from GAO certain distribution-related information, such as a on May 6, 2010 that put the food inspection program recalling firm’s product distribution lists with states, in perspective. See GAO 10-699T testimony report which impedes states’ efforts to quickly remove that is available at www.gao.gov. contaminated products from grocery stores and warehouses.” Lisa Shames, director of Natural Resources and Environment for GAO testified that FDA could “GAO identified certain statutory authorities that strengthen oversight of imported food by improving could help FDA in its oversight of food safety. enforcement and seeking additional authorities. But Specifically, GAO previously reported that FDA GAO is independent of the Obama Administration, currently lacks mandatory recall authority for so this testimony does not necessarily fit with the companies that do not voluntarily recall food products Administration’s plans, unless it is more spending and identified as unsafe. Limitations in FDA’s food recall more programs that they want. See FDA -- Continued on page 22... FDA has attempted to get money to protect American citizens, who pay the bills from foreign foods that are unsafe by inspecting foreign food sources, but this is a larger problem than most people understand. From the testimony we learn that “in www.NatMedLaw.com to search past issues Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside FDA -- Continued from page 1... Page 22 May 2010 “atropa,” but “belladonna” is different. There are eleven marks authorities heighten the risk that containing the word “belladonna,” unsafe food will remain in the food and five are still alive. supply. In addition, under current FDA regulations, companies may Belladonna is a word mark in conclude a food ingredient is International Class 032 for generally recognized as safe concentrates, syrups or powders without FDA’s approval or used in the preparation of soft knowledge. GAO recommended drinks and other beverages. It was that if FDA determines that it does first used on June 30, 2005 by Jusnot have the authority to implement Made, LP of Dallas, Texas and filed one or more recommendations, the on May 3, 2010 under Serial No. agency should seek the authority 85/029088. The application states from Congress. Finally, GAO that the English translation of reported that FDA has identified a belladonna is pretty woman. need for explicit authority from Congress to issue regulations Belladonna is a word mark in requiring preventive controls by International Class 031 for firms producing foods that have chocolate syrup; Coffee flavored been associated with repeated syrup for making food beverages, instances of serious health flavoring syrup as well as tea based problems or death. FDA already beverages and as a topping syrup. has preventive regulations for It was first used on June 30, 2005 seafood and juice, which require by Jus-Made, LP of Dallas, Texas firms to analyze safety hazards and and filed on May 3, 2010 under implement plans to address those Serial No. 85/029077. The hazards.” application states that the English translation of belladonna is pretty NML contacted Frank Pearsall, woman. Director of Development at the Virginia-Maryland Regional Intima Belladonna is a word College of Veterinary Medicine to mark in International Class 025 for obtain comments on the new apparel and accessories, namely regulatory program. Pearsall just lingerie, sleepwear, chemises, took over media relations in wraps, gowns and other clothing addition to development at the items. It was first used October 1, school. Pearsall had not heard 2001 and is Registration No. about this new masters program 3731357 since December 29, 2009. but offered to let NML know what The Owner is Ray Quinones of he could find out. At the time this Gardena, California. The word issue was printed, coments had not Intima is disclaimed apart from the been received. mark as shown, and the English meaning is Intimate Beautiful Woman. TRADEMARKS FOR Belladonna, Pocket Full of ATROPA BELLADONNA WWW.NATMEDLAW.COM Posiez is a word and design mark Surprise – there are no trademarks in International Class 016 for for “atropa belladonna” or stickers. The mark was first used Natural Medicine LawTM FDA -- Continued from p.21... Copyright 2010 by Muscatatuck Publishers, Inc. For Information on photocopying, see Page 2 Inside CONE FLOWER (E. Intermedia) Photo Courtesy of Lloyd Library & Museum on October 1, 2001 and is Registration No. 2955032 as of May 24, 2005. The owner is Patricia M. Gravning of Encino, California. Belladonna Entertainment is a word and design mark in International Class 009 for prerecorded videotapes and Digital Video Disks featuring adult oriented entertainment. The mark was first used August 29, 2002 and is Registration No. 2899071 as of November 2, 2004. The owner is Belladonna Entertainment, LCC, LTD of Woodland Hills, California. One of the common names, Deadly Nightshade, is also a trademark in International Class 003 for cosmetics, hair care products and fragrances, namely make-up, lipstick, hair dyes, hair colors and perfume. This mark was first used July 1, 1994 and is Registration No. 2006413 as of October 8, 1996. The owner is Tish See TRADEMARKS -- Cont’d p. 23... . TRADEMARKS -- Cont’d from p. 22... & Snooky’s N.Y.C, Inc of Long Island City, New York. The Section 15 and Section 8 affidavits and first renewal were accepted November 15, 2006. Nightshade is also a mark in five other live filings and thirteen other dead filings, including Nicotiana Solanaceae Nightshade Extract. None of those marks are in International Class 005 that might be used for dietary supplements. Proceed with experienced counsel to register a Belladonna mark under these circumstances. EFSA BRIEFING -- Cont’d from p. 1... 1. Overview of main issues addressed by the NDA Panel in evaluation of Article 13.1, 13.5 and 14 health claims 2. How does the NDA Panel decide whether a health claim is substantiated? 3. What is the totality of the available scientific data? 4. What are pertinent studies for substantiation of a health claim? 5. On what basis does the NDA Panel propose wordings of health claims? 6. To what extent should a food/ constituent be characterised? May 2010 Page 23 related to children and disease risk reduction health claim applications 10. Procedural aspects for (Article 14 health claims) and 22 Article 13.5 and 14 health claims opinions related to health claim applications based on newly 11. Procedural aspects for Article developed science and/or 13.1 health claims proprietary data (Article 13.5 health Although the notice of the claims). Out of the over 4,600 meeting includes a list of persons general function health claims who should attend the notice also (Article 13.1 health claims) states that registration is closed. submitted to EFSA via the Member The meeting will be held in an States/European Commission, the auditorium in a public park in NDA Panel has evaluated 937 Parma, Italy from 9:00 AM to 5:00 claims and published them in PM and there is no charge to attend respective opinions. if you were invited. For more information, contact: meeting On April 30, 2010 European secretary, Cinzia Percivaldi, Health Product Manufacturers European Food Safety Authority (EHPM) called on Members of the (EFSA), Tel. +39 0521 036 689 European Parliament to review [email protected] what was described as the “devastating impact” of the current apThe NDA Panel (Dietetic proach to regulation of Generic products, nutrition and allergies) Health Claims on the industry and has treated all health claims with consumer choice. the same scientific standards and this is the main problem faced by Since the claims have been apsubmitters. Many manufacturers proved in batches, this distorts the and consultants had not expected competition in the market. Peter this would be the case and Van Doorn, chairman of the EHPM therefore were submitting claims called for a stop to the piecemeal with less stringent proof in some adoption of Article 13 lists and a cases for products used for years. review of the impact of the legislaSome Panel rejections caused tion. some manufacturers to withdraw claims from the approval process To contact EHPM email so as not to damage their [email protected]. tele marketing of well-known products +(32) 2 209 11 45 or visit ehpm.org. in Europe. for health claims Regulation (EC) No 1924/ 2006[1] harmonises the provisions 7. How should the claimed effect that relate to nutrition and health be shown to be beneficial? claims and establishes rules 8. What is a risk factor for the governing the Community development of a human authorisation of health claims made on foods. Up to now the disease? EFSA NDA Panel has adopted and 9. Compliance/eligibility issues published 63 scientific opinions [1] European Parliament and Council (2006). Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods. Official Journal of the European Union OJ L 404, 30.12.2006. Corrigendum OJ L 12, 18.1.2007, p. 3–18 Copyright, 2010 by Muscatatuck Publishers, Inc. For Information on Photocopying, see Page 2 Inside Natural Medicine LawTM Page 24 MEDICINES FROM THE EARTH June 4 to 7 Blud Ridge Assembly Black Mountain, NC Influential Herbal Practitioners will teach their skills www.botanicalmedicine.org Copyright 2010, Muscatatuck Publishers, Inc. For Information on Photocopying see Inside Cover Society of Economic Botany Xalapa, Veracruz, Mexico June 6 - 10, 2010 https://payments.botany.org/ seb2010/ login.php?next_registration May 2010 AMERICAN SOCIETY OF PHARMACOGNOSY Trade Winds Island Resort, St. December 15-20, 2010 in Hono- AMERICAN HERBALISTS GUILD NEW ENGLAND WOMEN’S HERBAL CONFERENCE August 20 - 22, 2010 October 1-3, 2010 at the Registration limited to 500 Hyatt Regency, Austin, Texas. Early registration begins May 30 http://americanherbalistsguild.com/ www.womensherbalconference.com symposium_2009 across Europe are strapped for income and being barraged by tax nel have taken a back seat to payers for their spending programs. Obamacare plans in the American Take Greece, for example, that is Congress. For more than a year Congress wanted to respond to having riots in the streets because amendments to establish better the county has to stop spending food safety, but the legislation is money it does not have. This conset aside to deal with other issues. tagion may spread to other places where people are seeking a governThis month, the GAO testified ment paid vacation every year. that FDA should ask for more auIn the United States, the money thority, but FDA cannot do more problems are tremendous after with current budgets and staff. bailing out banking, autos, insurAcross the pond, the EU health ance, and other sectors. This week claims approval process is tearing the government-backed housing down businesses with long-time mortgage companies asked for anrecognized health claims on prod- other $20 Billion that the USA does ucts by applying new and unex- not have coming in. The taxpaypected scientific standards to prod- ers have spent about $145 Billion bailing out the housing sector. ucts. Food safety programs and person- At the same time, governments PACIFICHEM 2010 lulu, Hawaii. For registration, hoPetersburg Beach, Florida tel and other information go to: July 10-14, 2010 www.pacifichem.org. Registration opens in June. www.phcog.org/FutureASP.html HARVESTING HEALTH The industry is balking at these actions, seeking modifications. When the products come off the market, unemployment will increase. Natural Medicine LawTM Unemployment is hovering around 10% nationwide in the U.S. and higher in some of the states. Housing markets are down another 10% or more in some states. And at the same time, people seem to want safer food and less spending, if you believe what some people are saying. Liberal government politicians cannot resist giving people what they want, knowing that this has bought them votes for years. What will we do now? Trust the farmers? Grow our own? Learn how to do our own food inspections before we pay our money. Use common sense and read the labels. Rely on grocers to do the inspections for us? The U.S. is not capable of being the food safety inspector for the world’s food market. And many Americans are saying money does not grow on trees. Who is correct? William J. Skinner, R.Ph., Attorney at Law, Editor