Dietary Supplement Label Database Research Articles

Opportunities and challenges in using NIH’s Dietary Supplement Label Database for research on non-nutrient ingredients: Use case for ingredients in honeybee products

BackgroundNon-nutrient bioactive ingredients of foods such as bee products are often of interest in preclinical and clinical research to explore their possible beneficial effects. The National Institute of Health’s Dietary Supplement Label Database (DSLD) contains over 165,000 labels of dietary supplements marketed in the United States of America (US), including declarations on labels for many ingredients such as those in honeybee products which have been used in foods and traditional medicines for centuries worldwide and are now also appearing in dietary supplements. MethodsThis article presents a use case for honeybee products that describes and tests the utility of the DSLD and other databases available in the US as research tools for identifying and quantifying the prevalence of such ingredients. It focuses on the limitations to the information on product composition in these databases and describes how to code the ingredients using the LanguaL™ and FoodEx2 classification and description systems and the strengths and limitations of information on honeybee product ingredients, including propolis, bee pollen, royal jelly, beeswax. Results and conclusionsCodes for the ingredients are provided for identifying their presence in LanguaL™ and FoodEx2 classification and description systems used in Europe and elsewhere. The prevalence of dietary supplement products containing these ingredients in DSLD and on the US market is low compared to some other products and ingredients. Unfortunately label declarations in DSLD do not provide quantitative information and so the data can be used only to screen for their presence, but cannot be used for quantitative exposure estimates by researchers and regulators.

Hidden sodium in effervescent-tablet dietary supplements and over-the-counter drugs: a comparative cross-sectional study

ObjectiveDietary sodium intake represents a risk factor for cardiovascular disease and mortality. The study sought to analyse the sodium content of effervescent dietary supplements and drugs in Germany and the...

Update of Dietary Supplement Label Database Addressing on Coding in Italy

Harmonized composition data for foods and dietary supplements are needed for research and for policy decision making. For a correct assessment of dietary intake, the categorization and the classification of food products and dietary supplements are necessary. In recent decades, the marketing of dietary supplements has increased. A food supplements-based database has, as a principal feature, an intrinsic dynamism related to the continuous changes in formulations, which consequently leads to the need for constant monitoring of the market and for regular updates of the database. This study presents an update to the Dietary Supplement Label Database in Italy focused on dietary supplements coding. The updated dataset here, presented for the first time, consists of the codes of 216 dietary supplements currently on the market in Italy that have functional foods as their characterizing ingredients, throughout the two commonly most used description and classification systems: LanguaLTM and FoodEx2-. This update represents a unique tool and guideline for other compilers and users for applying classification coding systems to dietary supplements. Moreover, this updated dataset represents a valuable resource for several applications such as epidemiological investigations, exposure studies, and dietary assessment.

Selecting a dietary supplement with appropriate dosing for 6 key nutrients in pregnancy

BackgroundMost pregnant women in the United States (US) are at risk of inadequate intake of key nutrients during pregnancy from foods alone. Current dietary supplement practices reduce risk of inadequacy for only some nutrients and induce excessive intake of other nutrients. ObjectivesOur study aimed to estimate the doses of supplementation needed to help most pregnant women achieve the recommended intake without exceeding upper limits for key prenatal nutrients and to identify US dietary supplements providing these doses. MethodsWe conducted 24-h dietary recalls in 2450 pregnant participants aged 14–50 y from 2007 to 2019. We estimated the usual intake of vitamins A and D, folate, calcium, iron, and ω-3 FAs from foods alone. We calculated the target doses of supplementation needed to shift 90% of participants to consume above the estimated average requirement and keep 90% below the tolerable upper limit. We identified products in the Dietary Supplement Label Database providing these target doses of supplementation. ResultsThe target dose for supplementation was ≥198 mcg retinol activity equivalents of total vitamin A (with ≤2063 mcg preformed retinol); 7–91 mcg vitamin D; 169–720 mcg dietary folate equivalents of folic acid; 383–943 mg calcium; 13–22 mg iron; and ≥59 mg ω-3 FAs. Out of 20,547 dietary supplements (including 421 prenatal products), 69 products (33 prenatal) contained all 6 nutrients; 7 products (2 prenatal) contained target doses for 5 nutrients. Only 1 product (not a prenatal) contained target doses for all 6 nutrients, but it currently costs ∼USD200/mo and requires 7 tablets per daily serving. ConclusionsAlmost no US dietary supplements provide key nutrients in the doses needed for pregnant women. Affordable and convenient products that fill the gap between food-based intake and estimated requirements of pregnancy without inducing excess intake are needed to support pregnant women and their offspring. Am J Clin Nutr 20XX;xx:xx–xx.

Abstract 13395: Truth in Advertising? Health Claims and Contents of Fish Oil Supplements

Background: Fish oil supplement use continues to rise. Although prescription eicosapentaenoic acid (EPA) at 4 gm/day did lower cardiovascular risk, the vast majority of randomized trials have shown no benefit to fish oil dietary supplements. Information on health claims and contents of fish oil supplements is limited. Methods: Label information for on-market fish oil supplements was obtained from the National Institute of Health Dietary Supplement Label Database as of February 2022. Label text was analyzed to categorize health claims by type and organ system referenced. The total daily dose of EPA and docosahexaenoic acid (DHA) was evaluated for supplements made by 16 of the leading retailers and manufacturers of fish oil. Results: We evaluated 2,192 fish oil supplement labels, among which 1,647 (75.1%) made at least one health claim. Of these, only 22.0% (n=362) used from the FDA-approved qualified health claim for fish oil. The remaining 78.0% of labels made “structure & function” claims (e.g., “promotes heart health”, “supports brain and vision function”, etc.) across a variety of organ systems (Figure). Heart-health related claims were the most common (n=1,390, 63.4% of labels). Across 16 different brands/manufacturers, 239 product labels were reviewed for dose information. Wide variation in the doses of EPA and DHA was observed (median EPA+DHA dose 600 mg, interquartile range 250-1100 mg). Only 9.2% of supplements reviewed contained at least 2 gm of EPA+DHA, the minimum recommended for triglyceride lowering, and none contained an EPA dose shown to prevent cardiovascular events (≥4 gm/day). Conclusions: Fish oil supplement labels commonly make vaguely worded claims that imply a range of health benefits, almost none of which are supported by randomized trial data. The doses of EPA and DHA available in commonly used fish oil supplements vary substantially, yet none contain levels shown to reduce cardiovascular risk.

Levodopa Content of Mucuna pruriens Supplements in the NIH Dietary Supplement Label Database

This case series assesses the levels of levodopa in Mucuna pruriens supplements available in the US that are included in the National Institutes of Health Dietary Supplement Label Database.

Sampling Plan for a Study of Cranberry Dietary Supplements (DS) for the Dietary Supplement Ingredient Database (DSID)

ObjectivesThe intake of cranberry juice or supplements has been found in several, but not all, clinical studies to reduce the recurrence of urinary tract infections (UTIs). Several studies indicate that cranberry proanthocyanidins (PACs) may have a role in UTI prevention due to their ability to inhibit bacterial adhesion. For cranberry DS products on the US market, the relationship between PAC content and the cranberry source (e.g., powder, juice, extract) used in formulations is largely unknown. Therefore, a sampling plan was developed to identify and purchase DS for PAC testing as part of the Dietary Supplement Ingredient Database project. This will include popular cranberry DS, those used in clinical trials, and products with a variety of label claims and source ingredients. MethodsDS usage data from the National Health and Nutrition Examination Survey and retail sales data were used to identify the most popular cranberry DS in the natural health (NH), mass market (MM), and direct distribution sales channels. Other sources of information were the Dietary Supplement Label Database and web-based DS sellers. Three DS label categories were identified: those with a trademarked cranberry ingredient, those without a trademarked cranberry ingredient, and those with a numeric PAC claim. Some products may fall into two categories. Most products chosen for the study had cranberry as the primary ingredient by weight. Popular products with D-mannose and vitamin C were also included. ResultsIn the first phase of this study, we purchased 41 DSs (18 MM, 11 NH, and 12 direct). Our sample included caplets, capsules, soft gels, tablets, and liquid DSs. Cranberry source materials for the DSs included extracts, concentrates, powder, juice, and whole fruit. Fifteen (15) supplements had trademarked cranberry ingredients and 9 had a specific voluntary claim for PAC content. ConclusionsIn 2020, cranberries were the 6th ranked herbal ingredient sold in the US, according to the Nutrition Business Journal. The range of PAC content in the diverse cranberry DSs on the market is currently not known, since there is no requirement for this information on labels. This study will answer questions about the PAC content in a variety of DSs and whether multiple laboratories testing using the dimethylaminocinnamaldehyde (DMAC) method will yield similar results. Funding SourcesNIH ODS and the USDA.

Databases of Iodine Content of Foods and Dietary Supplements–Availability of New and Updated Resources

The iodine status of the U.S. population is adequate overall, but some people might have insufficient or overly high iodine intakes and would benefit from certain dietary changes. Identifying these individuals can be challenging, however, due to a lack of data on the iodine content of foods and dietary supplements. To fill this gap, a new online database--the USDA, FDA, and ODS-NIH Database for the Iodine Content of Common Foods--was released in 2020. It contains about 430 foods and beverages, such as dairy products and eggs, baby foods, vegetables, meats, mixed dishes, juices, seafood, various types of salt, restaurant foods, and baked goods, including breads made with and without iodate-containing dough conditioners. Data are presented as mean iodine content for both standard serving sizes and per 100 g of food, along with standard deviations, value ranges, and sample sizes. The new database, combined with the existing Dietary Supplement Ingredient Database, which contains chemically analyzed values for the iodine content of dietary supplements, and the newly updated Dietary Supplement Label Database, which contains label information from thousands of dietary supplements on the market, provides comprehensive data to help assess the iodine intakes of individuals and populations.

Iodine in foods and dietary supplements: A collaborative database developed by NIH, FDA and USDA

Data on the iodine content of foods and dietary supplements are needed to develop general population intake estimates and identify major contributors to intake. Samples of seafood, dairy products, eggs, baked products, salts, tap water, other foods and beverages, and dietary supplements were collected according to established sampling plans of the U.S. Department of Agriculture (USDA) and the U.S. Food and Drug Administration (FDA). Samples were assayed for iodine content using inductively coupled plasma mass spectrometry with rigorous quality control measures. The food data were released through a collaboration of USDA, FDA, and the Office of Dietary Supplements-National Institutes of Health (ODS-NIH) as the USDA, FDA, and ODS-NIH Database for the Iodine Content of Common Foods at www.ars.usda.gov/mafcl. Iodine data for dietary supplements are available in the ODS-USDA Dietary Supplement Ingredient Database and the ODS Dietary Supplement Label Database. Data from the iodine databases linked to national dietary survey data can provide needed information to monitor iodine status and develop dietary guidance for the general U.S. population and vulnerable subgroups. This iodine information is critical for dietary guidance development, especially for those at risk for iodine deficiency (i.e., women of reproductive age and young children).

Do Multivitamin/Mineral Dietary Supplements for Young Children Fill Critical Nutrient Gaps?

BackgroundNearly a third of young US children take multivitamin/mineral (MVM) dietary supplements, yet it is unclear how formulations compare with requirements. ObjectiveDescribe the number and amounts of micronutrients contained in MVMs for young children and compare suggested amounts on product labels to micronutrient requirements. DesignCross-sectional. SettingAll 288 MVMs on the market in the United States in the National Institutes of Health’s Dietary Supplement Label Database in 2018 labeled for children 1 to <4 years old. Main outcome measuresNumber of MVM products and amounts per day of micronutrients in each product suggested on labels compared with requirements represented by age-appropriate Daily Values (DV). Micronutrients of public health concern identified by the Dietary Guidelines for Americans (DGA) 2015-2020 (DGA 2015) and DGA 2020-2025 (DGA 2020) or those of concern for exceeding the upper tolerable intake levels. Statistical analysesNumber of products and percent DV per day provided by each micronutrient in each product. ResultsThe 288 MVMs contained a mean of 10.1 ± 2.27 vitamins and 4.59 ± 2.27 minerals. The most common were, in rank order, vitamins C, A, D, E, B6, B12; zinc, biotin, pantothenic acid, iodine, and folic acid. For micronutrients denoted by the DGA 2015 and DGA 2020 of public health concern, 56% of the 281 products containing vitamin D, 4% of the 144 with calcium, and none of the 60 containing potassium provided at least half of the DV. The upper tolerable intake level was exceeded by 49% of 197 products with folic acid, 17% of 283 with vitamin A, and 14% of 264 with zinc. Most MVMs contained many of 16 other vitamins and minerals identified in national surveys as already abundant in children’s diets. ConclusionsA reexamination of the amounts and types of micronutrients in MVMs might consider formulations that better fill critical gaps in intakes and avoid excess.

Analysis of Omega-3 Fatty Acid Content in Fish Oil Products

Background: Omega-3 fatty acids eicosapentaenoic acid (EPA) and docosehexaenoic acid (DHA), often found in fish oil supplements, have been linked to cardiovascular benefits in proper doses. Objectives: Quantify serving sizes and EPA and DHA content of fish oil products and determine which products contain appropriate amounts of EPA and DHA per serving to lower cholesterol. Methods: Products were identified through the National Institutes of Health’s Dietary Supplement Label Database using the search term “fish oil.” Product labels were reviewed for EPA and DHA content. The number of units, such as capsules, gummies, or milliliters, necessary to obtain a total of at least 2,000 mg of EPA and DHA was also evaluated. Descriptive statistics were used to report findings. Results: Of 493 products identified, 231 products were analyzed. Two (0.9%) products, both of which were liquid formulations, contained at least 2,000 mg of EPA and DHA in the standard serving size listed on the labeling. The total amount of EPA and DHA per serving ranged from 60.2 mg to 2684 mg with an average of 697 mg. The number of servings necessary to achieve 2,000 mg of EPA and DHA ranged from 1 to 34 servings with an average of 5 servings. Conclusions: Serving sizes of fish oil products rarely result in adequate EPA and DHA intake to provide cholesterol-lowering benefit. Instruction by a trained healthcare professional, such as a pharmacist, is important to ensure patients are taking an appropriate serving of fish oil to obtain cardiovascular benefit.

Perspective: Characterization of Dietary Supplements Containing Calcium and Magnesium and Their Respective Ratio—Is a Rising Ratio a Cause for Concern?

Low magnesium intakes coupled with high calcium intakes and high calcium-to-magnesium (Ca:Mg) intake ratios have been associated with increased risk for multiple chronic conditions such as cardiovascular disease and metabolic syndrome, as well as some cancers (colorectal, prostate, esophageal), and total mortality. A high dietary Ca:Mg ratio (>2.60) may affect body magnesium status while, on the other hand, high intakes of magnesium could adversely impact individuals with an exceedingly low dietary Ca:Mg ratio (<1.70). Thus, a Ca:Mg ratio range of 1.70-2.60 (weight to weight) has been proposed as an optimum range. Data from NHANES surveys have shown the mean Ca:Mg intake ratio from foods alone for US adults has been >3.00 since 2000. One-third of Americans consume a magnesium supplement with a mean dose of 146mg/d, and 35% of Americans consume a calcium supplement with a mean dose of 479mg/d. Our review of Ca:Mg ratios in dietary supplements sold in the United States and listed in NIH's Dietary Supplement Label Database (DSLD) found a mean ratio of 2.90 across all calcium- and magnesium-containing products, with differences by product form. The ratios ranged from a low of 0.10 in liquid products to a high of 48.5 in powder products. Thirty-one percent of products fell below, 40.5% fell within, and 28.3% fell above the ratio range of 1.70-2.60. Our findings of calculated Ca:Mg ratios from dietary supplements coupled with food-intake data suggest that, in individuals with high calcium intakes from diet and/or supplements, magnesium supplementation may be warranted to establish a more favorable dietary Ca:Mg ratio in their total diet. Additional research may provide greater insight into whether the Ca:Mg ratio is a biomarker of interest for moderating chronic disease and which population groups may derive benefit from moderating that ratio.

The Nutritional Adequacy of Prescription Versus Nonprescription Prenatal Vitamins [33K

INTRODUCTION: To descriptively compare nutritional content of prescription to nonprescription prenatal vitamins (PNVs) through consideration of the American College of Obstetricians and Gynecologists (ACOG) recommendations for a healthy pregnancy. METHODS: We utilized 2 publicly available online databases, Dietary Supplement Label Database and DailyMed, to obtain a list of all currently available PNVs. Inclusion criteria was based on initial search results from keyword “prenatal.” Exclusion criteria were single ingredient supplements, or duplicates. Duplicates were supplements listed separately because of different package forms for sales purposes, but were identical (i.e. same manufacturer, nutritional label/content), or those present in both databases. PNV ingredients were recorded from nutritional labels and compared to ACOG micro-nutrient guidelines. RESULTS: We obtained a total sample of 307 PNVs (110 prescription, 197 nonprescription). Of the prescription PNVs, 0% met calcium requirements, 100% met folic acid requirements, 82% met iron requirements, and 16% met vitamin D requirements. Of the nonprescription PNVs, 8% met calcium requirements, 98% met folic acid requirements, 11% met iron requirements, and 33% met vitamin D requirements. Each PNV was assigned a score from 0-4, based on the number of the 4 ACOG supplementation recommendations they met. Of the prescription PNVs, 12% scored ≥3, and 20% of the nonprescription PNVs scored ≥3. No single prescription PNV met all 4 ACOG recommendations, and 2 nonprescription PNVs did. CONCLUSION: We found no meaningful difference in nutritional adequacy of prescription versus nonprescription PNVs with respect to ACOG recommendations. Tailored supplementation should be considered as an alternative to PNVs.

IDISK: the integrated DIetary Supplements Knowledge base.

To build a knowledge base of dietary supplement (DS) information, called the integrated DIetary Supplement Knowledge base (iDISK), which integrates and standardizes DS-related information from 4 existing resources. iDISK was built through an iterative process comprising 3 phases: 1) establishment of the content scope, 2) development of the data model, and 3) integration of existing resources. Four well-regarded DS resources were integrated into iDISK: The Natural Medicines Comprehensive Database, the "About Herbs" page on the Memorial Sloan Kettering Cancer Center website, the Dietary Supplement Label Database, and the Natural Health Products Database. We evaluated the iDISK build process by manually checking that the data elements associated with 50 randomly selected ingredients were correctly extracted and integrated from their respective sources. iDISK encompasses a terminology of 4208 DS ingredient concepts, which are linked via 6 relationship types to 495 drugs, 776 diseases, 985 symptoms, 605 therapeutic classes, 17 system organ classes, and 137568 DS products. iDISK also contains 7 concept attribute types and 3 relationship attribute types. Evaluation of the data extraction and integration process showed average errors of 0.3%, 2.6%, and 0.4% for concepts, relationships and attributes, respectively. We developed iDISK, a publicly available standardized DS knowledge base that can facilitate more efficient and meaningful dissemination of DS knowledge.

Development of Dietary Supplement Label Database in Italy: Focus of FoodEx2 Coding.

The sector of food supplements is certainly varied and growing: an ever wider offer of new products is launched on the market every year. This is reflected in new reorganization of drug companies and new marketing strategies, in the adoption of new production technologies with resulting changes in dietary supplements regulation. In this context, information on composition reported in labels of selected dietary supplements was collected and updated for the development of a Dietary Supplement Label Database according to products’ availability on the Italian market and also including items consumed in the last Italian Dietary Survey. For each item, a code was assigned following the food classification and description system FoodEx2, revision 2. A total of 558 products have been entered into the database at present, trying to give a uniform image and representation of the major classes of food supplements, and 82 descriptors have been compiled. Various suggestions on how the number of FoodEx2 system descriptors could be expanded were noted during the compilation of the database and the coding procedure, which are presented in this article. Limits encountered in compiling the database are represented by the changes in the formulation of products on the market and therefore by the need for a constant database update. The database here presented can be a useful tool in clinical trials, dietary plans, and pharmacological programs.

Normalizing Dietary Supplement Product Names Using the RxNorm Model.

The use of dietary supplements (DSs) is increasing in the U.S. As such, it is crucial for consumers, clinicians, and researchers to be able to find information about DS products. However, labeling regulations allow great variability in DS product names, which makes searching for this information difficult. Following the RxNorm drug name normalization model, we developed a rule-based natural language processing system to normalize DS product names using pattern templates. We evaluated the system on product names extracted from the Dietary Supplement Label Database. Our system generated 136 unique templates and obtained a coverage of 72%, a 32% increase over the existing RxNorm model. Manual review showed that our system achieved a normalization accuracy of 0.86. We found that the normalization of DS product names is feasible, but more work is required to improve the generalizability of the system.

Dietary Supplements Containing the Upper Tolerable Limit Amount or More of Pyridoxine (P24-034-19)

ObjectivesTo estimate what proportion of pyridoxine containing-dietary supplements available in the USA contain higher than the upper tolerable limit of pyridoxine. MethodsThe Dietary Supplement Label Database (DSLD) from the National Institutes of Health was chosen as the data source to characterize how many supplements contain an amount of pyridoxine (vitamin B6) that is at the upper tolerable limit (UL) or above. DSLD was searched for all dietary supplement labels that contain pyridoxine. Label data was downloaded into an excel spreadsheet and characterized based on target age group and amount of pyridoxine contained per serving size. ResultsA total of 5615 pyridoxine-containing dietary supplement label entries were reviewed. Of these labels, 4871 were for patients 4 years and older, 106 were for pregnant or lactating women, 148 were for toddlers ages 1–4 years, 8 were for infants less than 1 year of age, and the rest did not specify a target age group. From the dietary supplements targeting people 4 years and older, 288/4871 (5.9%) contained 100 mg of pyridoxine or more per serving, which is the UL for adults 19 years and older; 330/4871 (6.8%) contained 80 mg of pyridoxine or more, the UL for children 14–18 years; 449/4871 (9.2%) contained 60 mg of pyridoxine or more, the UL for children 9–13 years; 1031/4871 (21.1%) contained 40 mg of pyridoxine or more, the UL for children 4–8 years old. From the dietary supplements targeting pregnant or lactating women, 2/106 (1.8%) contained 100 mg pyridoxine per serving which is the UL for this patient population. From dietary supplements targeting toddlers ages 1–4 years, 1/148 (0.6%) contained 30 mg of pyridoxine which is the UL for this target group. Finally, because there is not an established UL for infants 12 months or less of age, those labels could not be characterized. ConclusionsIn spite of the ULs set by the Institute of Medicine’s Food & Nutrition Board, an alarming number of manufactures produce dietary supplements that contain pyridoxine at the UL level or higher per serving size. This poses a significant safety risk to patients consuming dietary supplements. Funding SourcesNone.

The Chemical Forms of Iron in Commercial Prenatal Supplements Are Not Always the Same as Those Tested in Clinical Trials

In the US, 70% of pregnant women use an iron-containing prenatal supplement product; however, only 2.6% of pregnant women have iron-deficiency anemia and 16.3% are iron deficient. Yet, published data on the amounts and chemical forms of iron used in formulating these products are not available, although they are known to affect bioavailability. This information is especially important in comparing commercially available products with those that were tested in clinical trials. Our examination of nonprescription and prescription iron-containing prenatal supplement products in NIH's Dietary Supplement Label Database (DSLD) and DailyMed found the labeled amount of elemental iron ranged between 9 and 60 mg/serving in 148 nonprescription supplements and between 4.5 and 106 mg/serving in 101 prescription supplements. Ferrous fumarate was the preferred chemical form used in these products. In contrast, ferrous sulfate was the preferred chemical form of iron reported in the clinical trials summarized in a 2015 Cochrane Systematic review assessing the effects of daily oral iron supplements for pregnant women. Ferrous sulfate was not found on any prenatal supplement product label in the DSLD or DailyMed. The chemical forms of products on the market and those tested in clinical trials are dissimilar, and we believe this may have clinical implications. The findings raise several questions. Do outcomes in clinical trials correlate with the benefits and risks that might adhere to iron supplements with different iron formulations? Should the differences in chemical forms, their bioavailability, and safety profiles, be considered in greater depth when evaluating the effect of the various formulations on maternal iron nutriture? Should new clinical trials for pregnant and lactating women in the US use a form of iron not found in prenatal supplements sold in the US or should a more common form be used?

Using the Dietary Supplement Label Database to Identify Potentially Harmful Dietary Supplement Ingredients

Over half of young adults, athletes, and Military Service Members self-report using at least one dietary supplement (DS) 1 or more times per week. DS may be consumed to improve health, provide more energy, increase muscle strength, and/or enhance performance. The United States Food and Drug Administration (FDA) has raised concerns regarding adulteration, safety, and adverse events associated with DS marketed for brain health and bodybuilding. Some DS products may compromise health as well as lead to a serious adverse event. The National Institutes of Health (NIH) Dietary Supplement Label Database (DSLD), available at https://dsld.nlm.nih.gov/, can be freely accessed and used by researchers, providers, and consumers alike to screen for potentially harmful DS. It was developed to serve the research community and as a resource for health care providers and the public. Herein we provide two examples of how the database can be used to identify DS ingredients of concern in products marketed for brain health and bodybuilding. The search for DS marketed for brain health returned 49 unique DS, and the search on DS marketed for bodybuilding returned 18 unique DS. Search results were cross-referenced with the Operation Supplement Safety High-Risk Supplement List, the FDA Tainted Products Marketed as Dietary Supplements list, the Natural Medicines database, and NIH Office of Dietary Supplements Fact Sheets. Three ingredients found in DS marketed for brain health and two ingredients in DS marketed for bodybuilding were identified as "of concern". Educational tools, including the DSLD, can help consumers and providers make informed decisions regarding DS.

The Dietary Supplement Label Database: Recent Developments and Applications

To describe the history, key features, recent enhancements, and common applications of the Dietary Supplement Label Database (DSLD). Although many Americans use dietary supplements, databases of dietary supplements sold in the United States have not been widely available. The DSLD, an easily accessible public-use database was created in 2008 to provide information on dietary supplement composition for use by researchers and consumers. Accessing current information easily and quickly is crucial for documenting exposures to dietary supplements because they contain nutrients and other bioactive ingredients that may have beneficial or adverse effects on human health. This manuscript details recent developments with the DSLD to achieve this goal and provides examples of how the DSLD has been used. With periodic updates to track changes in product composition and capture new products entering the market, the DSLD currently contains more than 71,000 dietary supplement labels. Following usability testing with consumer and researcher user groups completed in 2016, improvements to the DSLD interface were made. As of 2017, both a desktop and mobile device version are now available. Since its inception in 2008, the use of the DSLD has included research, exposure monitoring, and other purposes by users in the public and private sectors. Further refinement of the user interface and search features to facilitate ease of use for stakeholders is planned. The DSLD can be used to track changes in product composition and capture new products entering the market. With over 71,000 DS labels it is a unique resource that policymakers, researchers, clinicians, and consumers may find valuable for multiple applications.