    [House Hearing, 108 Congress]
    [From the U.S. Government Publishing Office]

      DIETARY SUPPLEMENTS: NATURE'S ANSWER TO COST EFFECTIVE PREVENTATIVE
                                    MEDICINE

    =======================================================================

                                    HEARING

                                   before the

                   SUBCOMMITTEE ON HUMAN RIGHTS AND WELLNESS

                                     of the

                                  COMMITTEE ON
                               GOVERNMENT REFORM

                            HOUSE OF REPRESENTATIVES

                          ONE HUNDRED EIGHTH CONGRESS

                                 SECOND SESSION

                                   __________

                               SEPTEMBER 22, 2004

                                   __________

                               Serial No. 108-270

           Printed for the use of the Committee on Government Reform

      Available via the World Wide Web: http://www.gpo.gov/congress/house
                          http://www.house.gov/reform

                                   __________

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                         COMMITTEE ON GOVERNMENT REFORM

                         TOM DAVIS, Virginia, Chairman
    DAN BURTON, Indiana                  HENRY A. WAXMAN, California
    CHRISTOPHER SHAYS, Connecticut       TOM LANTOS, California
    ILEANA ROS-LEHTINEN, Florida         MAJOR R. OWENS, New York
    JOHN M. McHUGH, New York             EDOLPHUS TOWNS, New York
    JOHN L. MICA, Florida                PAUL E. KANJORSKI, Pennsylvania
    MARK E. SOUDER, Indiana              CAROLYN B. MALONEY, New York
    STEVEN C. LaTOURETTE, Ohio           ELIJAH E. CUMMINGS, Maryland
    DOUG OSE, California                 DENNIS J. KUCINICH, Ohio
    RON LEWIS, Kentucky                  DANNY K. DAVIS, Illinois
    TODD RUSSELL PLATTS, Pennsylvania    JOHN F. TIERNEY, Massachusetts
    CHRIS CANNON, Utah                   WM. LACY CLAY, Missouri
    ADAM H. PUTNAM, Florida              DIANE E. WATSON, California
    EDWARD L. SCHROCK, Virginia          STEPHEN F. LYNCH, Massachusetts
    JOHN J. DUNCAN, Jr., Tennessee       CHRIS VAN HOLLEN, Maryland
    NATHAN DEAL, Georgia                 LINDA T. SANCHEZ, California
    CANDICE S. MILLER, Michigan          C.A. ``DUTCH'' RUPPERSBERGER,
    TIM MURPHY, Pennsylvania                 Maryland
    MICHAEL R. TURNER, Ohio              ELEANOR HOLMES NORTON, District of
    JOHN R. CARTER, Texas                    Columbia
    MARSHA BLACKBURN, Tennessee          JIM COOPER, Tennessee
    PATRICK J. TIBERI, Ohio              BETTY McCOLLUM, Minnesota
    KATHERINE HARRIS, Florida                        ------
    ------ ------                        BERNARD SANDERS, Vermont
                                             (Independent)

                        Melissa Wojciak, Staff Director
           David Marin, Deputy Staff Director/Communications Director
                          Rob Borden, Parliamentarian
                           Teresa Austin, Chief Clerk
               Phil Barnet, Minority Chief of Staff/Chief Counsel

                   Subcommittee on Human Rights and Wellness

                         DAN BURTON, Indiana, Chairman
    CHRIS CANNON, Utah                   DIANE E. WATSON, California
    CHRISTOPHER SHAYS, Connecticut       BERNARD SANDERS, Vermont
    ILEANA ROS-LEHTINEN, Florida             (Independent)
                                         ELIJAH E. CUMMINGS, Maryland

                                   Ex Officio

    TOM DAVIS, Virginia                  HENRY A. WAXMAN, California
                          Mark Walker, Chief of Staff
                    Mindi Walker, Professional Staff Member
                            Danielle Perraut, Clerk
              Richard Butcher, Minority Professional Staff Member

                                C O N T E N T S

                                  ----------
                                                                       Page
    Hearing held on September 22, 2004...............................     1
    Statement of:
        Coates, Paul, Ph.D., Director, Office of Dietary Supplements,
          National Institutes of Health, U.S. Department of Health
          and Human Services.........................................     9
        Dobson, Allen, Ph.D., senior vice president, the Lewin Group;
          Jeffrey Blumberg, Ph.D., professor, Friedman School of
          Nutrition Science and Policy, Tufts University; Barbara
          Levine, R.D, Ph.D., associate professor of nutrition in
          medicine, Weill College of Medicine; Elliott Balbert,
          president, Dietary Supplements Education Alliance; and
          Marilu Henner, actress, nutrition and diet expert..........    22
    Letters, statements, etc., submitted for the record by:
        Balbert, Elliott, president, Dietary Supplements Education
          Alliance, prepared statement of............................    59
        Blumberg, Jeffrey, Ph.D., professor, Friedman School of
          Nutrition Science and Policy, Tufts University, prepared
          statement of...............................................    42
        Burton, Hon. Dan, a Representative in Congress from the State
          of Indiana, prepared statement of..........................     4
        Coates, Paul, Ph.D., Director, Office of Dietary Supplements,
          National Institutes of Health, U.S. Department of Health
          and Human Services, prepared statement of..................    12
        Dobson, Allen, Ph.D., senior vice president, the Lewin Group,
          prepared statement of......................................    24
        Henner, Marilu, actress, nutrition and diet expert, prepared
          statement of...............................................    65
        Levine, Barbara, R.D, Ph.D., associate professor of nutrition
          in medicine, Weill College of Medicine, prepared statement
          of.........................................................    50

      DIETARY SUPPLEMENTS: NATURE'S ANSWER TO COST EFFECTIVE PREVENTATIVE
                                    MEDICINE

                                  ----------

                         WEDNESDAY, SEPTEMBER 22, 2004

                      House of Representatives,
             Subcommittee on Human Rights and Wellness,
                                Committee on Government Reform,
                                                        Washington, DC.
        The subcommittee met, pursuant to notice, at 10:10 a.m., in
    room 2154, Rayburn House Office Building, Hon. Dan Burton
    (chairman of the subcommittee) presiding.
        Present: Representatives Burton and Watson.
        Staff present: Mark Walker, chief of staff; Mindi Walker,
    Brian Fauls, and Dan Getz, professional staff members; Nick
    Mutton, press secretary; Danielle Perraut, clerk; Sarah
    Despres, minority counsel; Richard Butcher, minority
    professional staff member; and Cecelia Morton, minority office
    manager.
        Mr. Burton. Good morning. A quorum being present, the
    Subcommittee on Human Rights and Wellness will come to order. I
    ask unanimous consent that all Members and witnesses' written
    and opening statements be included in the record. And without
    objection, so ordered.
        I ask unanimous consent that all articles, exhibits, and
    extraneous or tabular materials referred to be included in the
    record. Without objection, so ordered.
        In the event of other Members attending the hearing, I ask
    unanimous consent that they be permitted to serve as a member
    of the subcommittee for today's hearing. And without objection,
    so ordered.
        We have other Members that will be coming very shortly, Ms.
    Watson in particular. And for those who aren't here, they will
    get transcripts of the hearing.
        I, along with millions of Americans, firmly believe that
    dietary supplements have been shown through credible scientific
    research and historical use to be of immeasurable benefit to
    human health.
        As a regular consumer, I know firsthand the health benefits
    of using dietary supplements on a daily basis. Consequently I
    proudly serve as cochairman of the Congressional Complementary
    and Alternative Medicine Caucus, the CAM Caucus, along with my
    colleague, Representative Dennis Kucinich of Ohio, in the
    House, and Senators Orrin Hatch of Utah in the Senate, and Tom
    Harkin of Iowa in the Senate. They have been true champions on
    these issues for some time.
        Together we have worked hard, in a bipartisan fashion, for
    the continued research and safety of all dietary supplements
    manufactured and sold in the United States. It remains our top
    priority to ensure that only the highest quality of products
    are made available to the American consumers.
        Given my role as cochairman of the CAM Caucus, as well as
    my duties as chairman of the Subcommittee on Human Rights and
    Wellness, I am particularly concerned about how these products
    can be used as preventatives, and preventative measures, to
    combat the multitude of life-threatening and debilitating
    medical conditions like cardiovascular disease, cancer,
    osteoporosis, and even preventable birth defects in infants.
        The subcommittee has invited some of the foremost experts
    on nutrition to discuss the proven health benefits of regular
    supplement usage. Dr. Jeffrey Blumberg, professor at the
    Friedman School of Nutrition Science and Policy at Tufts
    University is with us today to explain the role of folic acid
    and other dietary supplements in the promotion of health and
    prevention of chronic diseases.
        The subcommittee also has the pleasure of hearing testimony
    from Dr. Barbara Levine, an associate professor of nutrition
    and medicine at the Weill College of Medicine at Cornell
    University, who will discuss two of the nutrients she has
    studied for a majority of her career, Omega-3 fatty acids and
    calcium. Dr. Levine will also explain how those two nutrients
    are needed throughout the entire life cycle in the development
    and growth of the human body, in addition to their use for
    prevention and treatment of a variety of diseases.
        In addition to the scientifically proven health benefits of
    using dietary supplements correctly to promote a healthier
    lifestyle and curb disease, these products can also offer
    substantial cost savings for our long-term national health care
    expenditures. And that is one of the things that isn't talked
    about enough.
        During our hearing today a new study will be released
    regarding the cost savings of dietary supplements on the U.S.
    health care system. Dr. Allen Dobson, senior vice president of
    the Levin Group, an independent health care consulting firm, is
    here with us today to discuss the conclusions of his study,
    which demonstrates that certain supplements provide an
    inexpensive and safe way to improve overall personal health and
    reduce health care expenditures.
        A recent report published by the Institute of Medicine
    [IOM], estimates that American consumers spend over $18 billion
    annually on the over 29,000 supplements sold in the United
    States. In 1994, Congress passed, and the President signed into
    law, the Dietary Supplement Health Education Act [DSHEA]. DSHEA
    prescribes the framework for how the Federal Government ensures
    the safety and the efficacy of dietary supplements sold in the
    United States.
        Prior to DSHEA, dietary supplements were treated and
    regulated as traditional food products. Seeing a need for the
    Federal Government to address the American consumer's growing
    interest in dietary products, in conjunction with public
    safety, Congress overwhelming passed this legislation to make
    certain that all dietary health products sold in the United
    States are held to the highest and most stringent quality
    standards.
        DSHEA ensures the safety of dietary supplements by
    requiring manufactures to follow standards called good
    manufacturing practices [GMPs]. Essentially all ingredients in
    supplements sold in the United States must be previously
    approved by the Food and Drug Administration and listed on the
    products bottle label. In addition, distributors must follow
    strict guidelines on all claims that are made in regard to a
    particular product. This ensures consumers are equipped with
    the most accurate information regarding their supplements.
        Dr. Paul Coates, the Director of the Office of Dietary
    Supplements at the National Institutes of Health [NIH], is here
    to talk about the Federal Government's research into dietary
    supplements and how these products have been shown to provide
    for a healthier lifestyle both in children and in adults.
        In addition, Mr. Elliott Balbert, the president of the
    Dietary Supplement Education Alliance, will be testifying
    before the subcommittee to discuss the supplement industry's
    efforts and continued support for the overwhelming need to
    ensure that consumers have access to balanced, science-based
    facts about dietary supplements.
        And, finally, we have the distinct pleasure of having a
    distinguished star of the stage and screen, whom I think is
    beautiful and have admired her for a long, long time,
    testifying before our subcommittee today. I saw her in Taxi a
    long time ago, and she looks so young, it just doesn't seem
    possible. Marilu Henner is here to talk about her personal
    experiences using dietary supplements in attaining and
    maintaining optimal health. Ms. Henner has not only personally
    benefited from supplement usage, but has also served as a
    health advocate, and is the author of six books on how to live
    a healthier lifestyle.
        Whether taking a multivitamin, herbal product or a
    specialty supplement, people can and do live healthier lives
    and save money in long-term health care costs by supplementing
    their diets.
        I would like to thank all of our witnesses for their
    participation in this hearing, and I look forward to hearing
    their testimony.
        [The prepared statement of Hon. Dan Burton follows:]

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        Mr. Burton. With that, we will start with Dr. Coates.
        Dr. Coates, if you would come forward and stand so I can
    swear you in, please.
        [Witness sworn.]
        Mr. Burton. Do you have an opening statement, Doctor?
        Mr. Coates. I do.
        Mr. Burton. If we could, I would like to try to admonish
    the witnesses to try to keep their statements to 5 minutes so
    we would have more time for questions if possible.

     STATEMENT OF PAUL COATES, Ph.D., DIRECTOR, OFFICE OF DIETARY
    SUPPLEMENTS, NATIONAL INSTITUTES OF HEALTH, U.S. DEPARTMENT OF
                       HEALTH AND HUMAN SERVICES

        Mr. Coates. Thank you very much. Mr. Chairman, I am Paul
    Coates. I direct the Office of Dietary Supplements at the
    National Institutes of Health. I appreciate the opportunity to
    appear before you today to talk about NIH efforts and research
    on dietary supplements.
        I appeared before this committee 2 years ago to give you
    details about some key NIH initiatives and to highlight the
    opportunities as well as the challenges associated with
    developing strong science in the field of dietary supplements.
    These are products that are used widely by American consumers
    for their potential health benefits, often in combination with
    other lifestyle measures such as diet and physical activity.
    Their potential to improve health and to prevent disease has
    been realized when some have been put to modern scientific
    testing. Clear examples of this are folic acid, in the
    prevention of neural tube defects, and calcium to reduce the
    risk of osteoporosis.
        It is important to keep in mind, though, that others have
    not undergone rigorous scientific testing to establish their
    efficacy and safety. Some are currently under active
    investigation at the NIH, as I will mention in a moment.
        In the preamble, or in the invitation, you identified five
    supplements as being of particular interest today: folate,
    calcium, omega-3 fatty acids, glucosamine, and saw palmetto. I
    would like to give you a snapshot of some ongoing NIH-funded
    research efforts related to these ingredients.
        With respect to folate, NIH has funded and continues to
    fund considerable research examining its role in the prevention
    of chronic diseases such as cancer and heart disease. In
    addition to these many projects, which I would be pleased to
    share with you in more detail, I draw your attention to another
    current trial that looks at the impact of folate and other B
    vitamins on slowing the rate of cognitive decline in
    Alzheimer's disease.
        With respect to calcium, the NIH has a considerable
    investment in clinical research. In addition to the many
    studies supported by NIH over the years on calcium and bone
    health, one current trial that I would like to draw to your
    attention is a trial called supplemental calcium in overweight
    people, currently under way at the NIH to examine the effects
    of calcium supplementation on weight reduction.
        With respect to omega-3 fatty acids, the Office of Dietary
    Supplements has sponsored a series of evidence reports in
    collaboration with the Agency for Health Care Research and
    Quality, on the health effects of omega-3s for a number of
    conditions. One report in particular, the one on cardiovascular
    disease, concluded that there was substantial evidence for
    benefit of omega-3 fatty acids in the secondary prevention of
    heart disease, but that there was considerably less evidence
    for an effect on primary prevention; that is, in the general
    population.
        We view that as an opportunity, not a barrier, and as a
    result of this report, the National Heart-Lung and Blood
    Institute, along with the Office of Dietary Supplements,
    convened a working group earlier this year to assess future
    research needs related to coronary disease prevention with
    omega-3s. The working group recently made its recommendations,
    which are currently being pursued at the NIH.
        With respect to glucosamine, a clinical trial is currently
    under way looking at the effect of glucosamine and chondroitin
    sulfate for knee osteoarthritis. It has now met its recruitment
    goals of nearly 1,600 participants and scheduled to be
    completed within a year.
        Finally, a clinical trial of saw palmetto and African plum
    for urinary symptoms in men was recently funded and should
    provide some very informative results.
        I would like to comment at this point that the evidence for
    benefit is stronger for some of these supplements than it is
    for others. I would also like to point out that research
    efforts need to continue apace in all of these areas, and that
    NIH remains committed to encouraging and supporting the best
    science in this area.
        Between 1999 and 2003, the years for which we have these
    data, NIH invested roughly $770 million to support research
    related to dietary supplements. About a quarter of that was
    devoted to studies of the five supplement ingredients that I
    have cited above.
        Let me briefly tell you a little about the Office of
    Dietary Supplements. We were authorized by the Dietary
    Supplement Health and Education Act of 1994, and came into
    existence at the NIH in 1995. Our mission is to identify and
    foster research on the health benefits and the risks of
    supplements.
        We have a strategic plan in place, and I am pleased to
    announce that the strategic plan for the next 5 years has now
    been published, and it can be found on the Office of Dietary
    Supplements' Web site.
        As a result of increases in funding for the Office by
    Congress, from $3.5 million in 1999 to about $26 million year,
    we have expanded our role in a number of important activities.
    This year we cofund 90 research grants with other institutes at
    the NIH, and among those a number of dietary supplement
    research centers that we fund across the country that
    specialize in botanical dietary supplements.
        Let me give you four brief examples of other efforts that
    we do in collaboration with other agencies, both within and
    outside the NIH. The National Health and Nutrition Examination
    Survey looks at supplement use in a health context, and is
    conducted by the CDC. We significantly support that, along with
    collaborators at the FDA, the National Institute of Standards
    and Technology, and a number of private sector organizations,
    including the dietary supplement industry. We administer a
    program to develop, validate and disseminate analytical methods
    and reference materials for dietary supplements.
        And, finally, I wanted to mention that as part of our
    evidence-based review program, which we conduct in
    collaboration with the Agency for Healthcare Research and
    Quality, we have two others that are currently under way, two
    evidence reports, in addition to the omega-3 ones I cited. One
    is on vitamin D adequacy in health, and the other is on the
    role of antioxidants and B vitamins in the age-related
    neurodegenerative disorders. These are all collaborative
    efforts. It is a key way in which to get research done in this
    area, in my opinion.
        Mr. Chairman, I thank you for the opportunity to review the
    status of dietary supplement research at the NIH, and I would
    be happy to answer your questions.
        [The prepared statement of Mr. Coates follows:]

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        Mr. Burton. Do you take supplements?
        Mr. Coates. That is a personal decision, and I do. But that
    doesn't extend beyond by personal decision.
        Mr. Burton. What does that mean?
        Mr. Coates. I am not in a position to make recommendations
    to others.
        Mr. Burton. I see. But you do take supplements.
        Mr. Coates. I take a multivitamin.
        Mr. Burton. Can you tell us a little bit about the risks
    associated by using dietary supplements, from your point of
    view?
        Mr. Coates. I can tell you some of the issues that are
    raised. One in particular is the possible interaction of
    certain dietary supplement ingredients and other bioactive
    ingredients that people take, either other supplements or
    drugs. Occasionally there have been identified risks associated
    with that. People need to know about the possible interaction
    among these biologically active constituents.
        Mr. Burton. But the labeling on the bottles pretty much
    tells people who are taking those to be careful or consult a
    physician in the event that they think that there might be some
    counteractive----
        Mr. Coates. Yes. That is certainly a goal for all of the
    potentially harmful interactions. I venture to say that we
    don't know everything that we need to know either about the
    benefits or the risks of dietary supplements, and our job is to
    try to identify those so that the best information can be made
    available to consumers.
        Mr. Burton. I see. But you don't see the need for the
    health agencies to take over complete control over supplements
    and all of that?
        Mr. Coates. I am not sure I understand that question.
        Mr. Burton. Well, there have been some people who thought
    that DSHEA was something that we should not have passed in the
    Congress, and some of our health agencies say that all
    supplements should be regulated. You don't agree with that?
        Mr. Coates. They are regulated.
        Mr. Burton. No. What I mean is they are not reviewed on a
    regular basis by the health agencies; i.e., Health and Human
    Services and FDA.
        Mr. Coates. I think it is the FDA's responsibility to
    regulate dietary supplements using the existing law.
        Mr. Burton. Using the existing law. But you don't think
    there needs to be any changes in that?
        Mr. Coates. The last time I testified here, Mr. Chairman, I
    think you asked me the same question, and I said that at the
    time that DSHEA was passed, that it was an effective and
    appropriate way to look at dietary supplements.
        Sometimes things change. I think we have learned a lot
    about dietary supplements, and I am not advocating that there
    be any change. But I do think that it is appropriate for people
    to examine periodically what they are doing.
        Mr. Burton. But you are not advocating any change right
    now?
        Mr. Coates. That is not my position.
        Mr. Burton. Good.
        In your opinion, how has the passage of the dietary
    supplement--or DSHEA affected the FDA's enforcement powers over
    dietary supplements?
        Mr. Coates. This is a tricky question for me to answer,
    since I am not in the FDA, and I am in a sister agency, and I
    don't know that I have any information that I can bring to bear
    on your question.
        Mr. Burton. OK. Could you please inform the subcommittee
    where you believe the issue of dietary supplements will be in 5
    years if the funding for these research initiatives remain
    consistent or constant?
        Mr. Coates. Thank you for--there is a question that I am in
    a much better position to be able to answer, since it relates
    to the research efforts, which really is what I do.
        I think we are in a position where we can provide an
    enormous amount of information to American consumers about
    dietary supplements. There is a lot that still needs to be
    done.
        What we understand about dietary supplements is quite
    variable. For some, we have very clear evidence of benefits. We
    also understand those circumstances in which individuals may be
    at risk, given exposure to certain supplements under some
    conditions. It is such a large body of knowledge that needs to
    be addressed. I think you alluded to the idea that there are
    29,000 or so products in the marketplace. They are not, of
    course, all different from one another in terms of the
    ingredients.
        But there is a lot that remains to be done, and I think it
    is incumbent upon us as a research agency to invest as much as
    we can in developing the right data set to inform consumers.
        Mr. Burton. Ms. Watson, I am sure, has questions. Would you
    be willing to have her submit those to you for the record,
    because she is not here. She had to go to a Democrat get-
    together, I guess, and she is in the front row, and she can't
    leave right now. But she will be here shortly, so we will have
    her submit those to you.
        Mr. Coates. Thank you. I will be here for the rest of the
    hearing.
        Mr. Burton. Oh, good. Thank you. I am glad you decided to
    stay. I wish we had more government agencies that were willing
    to do that.
        Mr. Burton. OK. Our next panel is Allen Dobson, Ph.D.,
    senior vice president of the Lewin Group. Would you come
    forward, Mr. Dobson.
        Jeffrey Blumberg, Ph.D., professor at Friedman School of
    Nutrition Science and Policy at Tufts University; Barbara
    Levine, R.D., Ph.D., associate professor, nutrition in
    medicine, Weill College of Medicine, Cornell University;
    Elliott Balbert, president of the Dietary Supplement Education
    Alliance; and the ever popular Marilu Henner, TV and movie
    star, actress, author, and health advocate, and author of six
    books. I will have to read one of your books.
        Would you all please rise so we can have you sworn.
        [Witnesses sworn.]
        Mr. Burton. Dr. Dobson.

     STATEMENTS OF ALLEN DOBSON, Ph.D., SENIOR VICE PRESIDENT, THE
       LEWIN GROUP; JEFFREY BLUMBERG, Ph.D., PROFESSOR, FRIEDMAN
       SCHOOL OF NUTRITION SCIENCE AND POLICY, TUFTS UNIVERSITY;
    BARBARA LEVINE, R.D, Ph.D., ASSOCIATE PROFESSOR OF NUTRITION IN
         MEDICINE, WEILL COLLEGE OF MEDICINE; ELLIOTT BALBERT,
     PRESIDENT, DIETARY SUPPLEMENTS EDUCATION ALLIANCE; AND MARILU
               HENNER, ACTRESS, NUTRITION AND DIET EXPERT

        Mr. Dobson. Mr Chairman, my name is Allen Dobson. I'm am a
    senior vice president for the Lewin Group. Thank you for the
    opportunity to present key findings of a study that the Lewin
    Group has conducted for the Dietary Supplement Education
    Alliance.
        The purpose of the study was threefold: to critically
    review the research evidence for five specific dietary
    supplements, to estimate changes in health care utilization and
    the associated health care expenditure savings that could
    result from the daily use of two of these supplements, and then
    for the other three supplements to recommend research that
    might be done in the future.
        The five supplements that were covered in this study,
    calcium with vitamin D, folic acid, omega-3 fatty acids,
    glucosamine and saw palmetto, the Lewin Group developed
    estimates of potential cost savings that could result from the
    daily use of only two of these supplements for which the higher
    standard of evidence exists at this time. In effect, what we
    are doing is we were moving beyond the research and the
    literature, which speak to the efficacy of the supplements, and
    speaking to their cost-effectiveness in society. That is to
    say, if they are used appropriately, what savings might accrue
    to both the individuals and society? So in that sense the study
    results that we are presenting today are new.
        Cost estimates were developed for calcium with vitamin D
    and folic acid where in each case there is significant
    scientific agreement as to the improvement in health status.
    For these two supplements, conservative estimates for health
    care expenditure savings were developed for specific relevant
    outcomes.
        Dr. Devonso, my colleague, and I were very conservative in
    our approach to building the cost estimates. We only went to
    those supplements that had the most strong scientific evidence,
    and when we did our costing, we only looked at a few of the
    possible areas where cost savings might exist.
        As Dr. Coates has indicated, for instance, for calcium,
    there is many areas where it will be effective, but we only
    looked at a few specific areas where the evidence was
    strongest. That is to say for calcium, we estimated savings for
    avoided hip fractures for over age 65; and for folic acid, we
    looked at avoided incidences of babies being born with neural
    tube defects.
        In terms of our key findings for calcium, for a daily
    intake of 1,200 milligrams of calcium D, calcium with vitamin
    D, could result in 734,000 fewer hip fractures for the
    population aged 65 and over. We estimated that would save about
    $13.9 billion over a 5-year period. We used the CBO-type
    scoring procedures, which you are familiar with, because CBO
    scores all of our budgetary items for you. We tried to use
    their procedures because they are well known and fairly
    conservative in their approach, and subject to much scrutiny,
    and we feel that those kinds of procedures are the appropriate
    ones to use.
        We looked at net savings in hospital, nursing facility and
    physician expenditures. There again, we could have added more
    expenditures to the list, but we felt we would take the biggest
    ones and the least controversial with respect to hip fractures.
        Over one-third of adults over age 65 experience falls each
    year. Hip fractures caused the most severe health problems and
    the greatest number of deaths. So not only are we looking at
    cost savings here, we are looking at improved health and
    people's status in terms of feeling better. When you have a
    broken hip and you are over 65, it is not a good condition to
    be in. If we can avoid that, not only do we save money, but we
    improve people's health status enormously.
        In terms of folic acid, there are 64 million women of
    child-bearing years in the United States. Again, we were
    conservative, and we said if an additional 10.5 million, or 25
    percent of those not currently taking folic acid, begin to take
    400 micrograms of folic acid on a daily basis, we estimated
    that 600 babies would be born without neural tube defects. Our
    savings over 5 years, using the CBO estimates again, were about
    $1.3 billion. Again, these are conservative, because we only
    took 25 percent.
        The problem here is not so much the effects of the
    supplement itself, but getting people to take the supplements.
    And the recommendation here, of course, would be that we do a
    lot as a society, much more as a society, to get people to
    understand both the benefits of taking the supplement and the
    risk of not taking it, which are enormous.
        For omega-3 fatty acids, we found that there was a lot of
    evidence. As we heard from Dr. Coates, a lot of it is good. But
    the evidence wasn't quite strong enough to do our cost
    estimates. And as Dr. Coates indicated, the government is under
    way taking studies where perhaps we will have stronger evidence
    in the future.
        Similarly with glucosamine and saw palmetto, we found that
    the evidence was strong, it was encouraging, but it wasn't
    quite up to the rigor that we would like before we did our cost
    studies. So for those two studies, we note that the government
    is undertaking again, and already under way, very large double-
    blind, placebo controlled studies, which should provide us the
    evidence in the future with which we can proceed with cost
    studies.
        In closing, I would like to note that the typical American
    diet does not always provide a sufficient level of nutrients to
    support optimal health, very much as you said in your
    introductory comments, and then that would be the overall
    conclusion of this; that is, in certain instances, supplements
    are an inexpensive and safe way to improve health status and
    reduce health care expenditures, and in these cases the role of
    public policy to support their use is unambiguous.
        I would thank you for the opportunity to present these
    findings from the Lewin Group study. Thank you.
        Mr. Burton. Thank you, Doctor.
        [The prepared statement of Mr. Dobson follows:]

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        Mr. Burton. We didn't get into any other--they only asked
    you about those five products?
        Mr. Dobson. Yes.
        Mr. Burton. Didn't get into vitamin C or any of the others?
        Mr. Dobson. No. We took the five--we knew there was a great
    deal of literature out there, and we wanted to look at those
    cases where we thought we had the best case to move beyond the
    studies of efficacy and impact on health and move into cost
    savings. So we felt that we would look at those where the
    literature in come cases is 30 and 40 years in length.
        Mr. Burton. OK.
        Dr. Blumberg.
        Mr. Blumberg. Good morning. I am a professor of nutrition
    at the Friedman School of Nutrition Science and Policy, and the
    associate director of the Jean Mayer USDA Human Nutrition
    Research Center on Aging at Tufts University in Boston. I also
    serve as a nonpaid member of the Scientific Advisory Board of
    the Dietary Supplement Education Alliance. I have been
    investigating the role of dietary supplements in the promotion
    of health and prevention of chronic disease for almost 25
    years.
        It is now indisputable that nutrition is a key component of
    any disease-prevention strategy, and optimal intakes of
    vitamins, minerals, and other nutrients are critical to
    maintaining wellness. Virtually every nutrition-monitoring
    survey reveals that most Americans fail to achieve these
    intakes through their usual diets. Fortunately, dietary
    supplements represent an affordable, effective and practical
    tool to help solve this problem, and thus ultimately reduce
    health care costs.
        This morning I will illustrate this principle with the
    example of folic acid. Folic acid is a B vitamin essential to
    the activity of more than a dozen enzymes, amino acid
    metabolism, and DNA formation. Inadequate intake of folic acid
    has been associated with anemia, some forms of cancer, heart
    disease, poor pregnancy outcomes, and birth defects, most
    notably neural tube defects, but also including cleft lip and
    palate, limb deficiencies and defects of the heart.
        The richest dietary sources of folic acid are liver,
    mushrooms, dried beans, green leafy vegetables, and, since
    1998, enriched grains fortified with this vitamin.
        The recommended dietary allowance for folic acid is 400
    micrograms daily. Usual intakes of folic acid before
    fortification were 200 micrograms, but are now estimated to be
    about 300 micrograms, with much lower intakes in people
    following low-carbohydrate diets and avoiding fortified breads
    and other cereals.
        However, it is important to understand that many people
    have a greater need for folic acid, including pregnant and
    lactating women, people who consume alcoholic beverages or take
    certain medications, patients with certain inflammatory
    conditions of the intestines, and the elderly.
        For the last 5 years, the Center for Disease Control and
    Prevention and the Institute of Medicine have recommended that
    all women capable of becoming pregnant should consume 400
    micrograms per day of synthetic folic acid from supplements or
    fortified foods, in addition to consuming food folate from a
    variety of dietary sources. Nonetheless, two-thirds of American
    women of child-bearing age do not follow this advice, and 1 of
    every 1,000 babies in the United States is born with a neural
    tube defect.
        The Lewin Group analysis which you just heard about
    calculated that over the next 5 years, $1.3 billion in health
    care costs could be saved if these women took a daily
    supplement containing 400 micrograms of folic acid, but folic
    acid supplements are not just for women. Observational studies
    consistently reveal that men and women taking supplements
    containing folic acid have the lowest blood levels of the amino
    acid homocysteine. Elevated levels of homocysteine are a
    significant independent risk factor for atherosclerotic
    vascular disease and for thromboembolism. Some evidence
    suggests that lowering homocysteine levels could reduce the
    risk of heart disease by 20 percent. Many studies reveal that
    elevated homocysteine may enhance the effect of other
    established vascular risk factors such as hypertension and
    smoking.
        Folate inadequacy also has a procarcinogenic effect by
    interfering with normal DNA synthesis and regulation. An
    increased risk for some forms of cancer has been associated
    with poor folate status in several epidemiological studies,
    with the strong evidence linked to colorectal cancer.
        Studies have also suggested that the increased risk of
    breast cancer associated with regular alcohol consumption may
    be reduced by an increased intake of folic acid from dietary
    supplements.
        While many different factors contribute to the risk of poor
    health and chronic disease, we know that diet and the intake of
    specific nutrients play a key role in the prevention of cancer,
    diabetes, heart disease, infectious diseases, macular
    degeneration, osteoporosis and other conditions.
        The power of nutrition to promote health is well
    established. We need now to find ways to encourage Americans to
    choose helpful dietary patterns and increase their intake of
    key nutrients with fortified foods and dietary supplements. If
    we succeed in doing so, both the personal burden of disease
    carried by Americans and the associated enormous expenditure
    for their health care will be substantially reduced. Thank you.
        Mr. Burton. Thank you, Dr. Blumberg.
        [The prepared statement of Mr. Blumberg follows:]

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        Mr. Burton. Dr. Levine.
        Ms. Levine. Good morning, Chairman Burton. I am Barbara
    Levine, associate professor of medicine at Weill Cornell
    Medical College, as well as the head of clinical nutrition at
    Strang, which is part of Cornell Medical College, as well as
    the Rockefeller University.
        It is a great honor to be able to address you about the
    importance of the nutritional health of Americans. More
    specifically, I will be discussing two nutrients I have studied
    for most of my career. The first nutrient is calcium, which is
    found in every cell of the body. Calcium is essential for bone
    development and growth, and in the protection of the human body
    through all stages of life.
        Prolonged low calcium intake has been linked to the
    development of several chronic diseases, including colon
    cancer, hypertension and osteoporosis, and we have to remember
    that we reach our peak bone mass really at around age 20, and
    then bone resorption will really exceed bone formation, so that
    it is very important for us to get enough calcium very early on
    in life, but continue to get the calcium we need throughout our
    life so that we don't lose more bone than we make.
        It is generally accepted that the ideal method for
    obtaining calcium is through regular dietary sources.
    Unfortunately, meeting the recommended daily intake of calcium
    has proven to be difficult for the average American, as
    evidenced by the low percentage of individuals actually meeting
    recommended calcium intake levels on a continuing daily basis.
        In the recent National Health and Nutrition Examination
    Survey, it was reported that the average intake of calcium for
    women, for example, age 40 and over, was only 698 milligrams
    per day. This is well blow the 1,200-milligrams-per-day calcium
    intake recommended for postmenopausal women, and illustrates
    the overall need to encourage calcium supplementation.
        And this is true for men as well, as we know that women
    generally experience fractures earlier on because of
    postmenopause, but men catch up in the sixth decade of life and
    will experience hip fractures as well.
        Not only can calcium supplements help to increase the
    intake of calcium among our population, but also the resultant
    disease prevention can help cut health care costs
    substantially.
        The second nutrient I will discuss today is actually part
    of a group of nutritional components, the much-heralded omega-3
    fatty acids. This group has a major role in the maintenance of
    cardiovascular health, development of the nervous system and
    other key functions. As was mentioned today, there is more
    evidence in the secondary prevention of the omega-3 fatty
    acids, which include DHA, docosahexaenoic acid, and
    eicosapentaenoic acid.
        But we just finished, and I will have the results at the
    Rockefeller University, a primary prevention study with DHA in
    patients that are overweight and have the syndrome called
    metabolic syndrome. So they are overweight, they have high
    triglycerides, they generally have insulin resistance, and we
    will get you that information as soon as possible.
        But the role of omega-3 fatty acids and cardiovascular
    function has been studied for the last 40 years. I would like
    to commend the American Heart Association for its recent
    Scientific Statement on Fish Consumption, Fish Oil, Omega-3
    Fatty Acids and Cardiovascular Disease. This statement confirms
    the importance of long-chain omega-3 fatty acids, both DHA and
    EPA, for their significant role in the reduction of cardiac
    death. DHA recommends that patients with coronary disease and
    hypertriglyceridemic patients, that is with the high
    triglycerides, consume DHA and EPA as part of their medical
    management.
        As just another example of the importance of omega-3 fatty
    acids, research has found that DHA is particularly vital for
    pregnant and lactating women because it plays a critical role
    in supporting brain and retinal development in infants. A
    recent workshop supported by NIH recommends 300 milligrams of
    DHA a day for pregnant and nursing women to promote optimum
    neurological development and visual acuity in their babies.
        As I mentioned in my discussion of calcium, despite our
    best intentions, the nutritional health of our Nation remains
    suboptimal. The principal dietary source of omega-3 fatty acids
    is coldwater fish like salmon and trout. However, both the
    United States Food and Drug Administration and the
    Environmental Protection Agency has recently scrutinized
    certain fish, such as shark, swordfish and fresh frozen tuna,
    for having potentially high levels of methyl mercury. And the
    Heart Association tempers its recommendations to increase DHA
    and EPA intake by stating that the availability of high-quality
    omega-3 fatty acid supplements, free of contaminants, is an
    important prerequisite to their extensive use. This is even
    more important for pregnant and lactating women who would
    benefit from DHA. These are a clear example of the benefits of
    supplementation which can provide high-quality omega-3 without
    contamination.
        I thank you for the opportunity to speak to you about these
    important nutrition issues. Thank you, Mr. Chairman.
        Mr. Burton. Thank you.
        [The prepared statement of Ms. Levine follows:]

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        Mr. Burton. You know, before we go to the next witness, I
    always find it very interesting that the EPA is talking about
    being very careful about how much fish we eat that might have
    mercury in it, because the environment has been contaminated
    with mercury, you know, and yet most of the adult shots that we
    get, where we get a vaccination, contain mercury. They have
    that in there as a preservative.
        I mean, they will tell you not to eat it, but when you go
    to get a tetanus shot or a flu shot, they are going to stick
    mercury in your body. They say it doesn't hurt anything. And we
    have a huge increase; we have gone from 1 in 10,000 children
    that are autistic to 1 in 166. We have an epidemic of
    Alzheimer's. And we know that mercury causes neurological
    problems, and yet our health agencies--I know the gentleman is
    here from a health agency. I don't know if he is going to carry
    this message back, but it just seems reasonable to me that
    maybe we ought to get mercury out of these shots. Just get it
    out of there. Hell, if we can't eat it, we sure don't want to
    have it stuck in our bodies.
        Anyhow, Mr. Balbert.
        Mr. Balbert. Chairman Burton and members of the committee,
    thank you for the opportunity to address you as a
    representative of the dietary supplement industry.
        I am Elliot Balbert, CEO of Natrol, Inc. Natrol is a
    diversified nutrition company and manufactures and markets
    premium-branded nutritional products for a wide range of
    consumer needs.
        While running Natrol is obviously an important and central
    role for me, I am here in another capacity, as chairman of a
    not-for-profit group, the Dietary Supplement Education Alliance
    [DSEA]. DSEA was created in 2001 as a way for my industry to
    help ensure that the intent of the Dietary Supplement Health
    and Education Act [DSHEA], is met by providing meaningful
    information about the health benefits and responsible use of
    dietary supplements to all Americans.
        As you well know, Mr. Chairman, an important aspect of the
    passage of this critical law was to ensure that all of us as
    potential consumers of dietary supplements were educated about
    them, the very reason for the E in DSHEA. For that reason,
    those of us involved in DSEA have worked over the past 3 years
    to educate the public, the media, and even Members of Congress
    and their staffs through our Web site, supplementinfo.org, and
    other educational activities and means.
        In fact, one of our ongoing educational efforts is a
    monthly mailing to Members of Congress, where we strive to
    provide those of you on the Hill with essential information on
    the benefits of supplements. This may be a familiar package
    that you have seen.
        Mr. Burton. Do those contain supplements?
        Mr. Balbert. Yes, they do. I can show you that if you would
    like to see those.
        Mr. Burton. No, just keep sending them.
        Mr. Balbert. Our pleasure.
        Mr. Burton. I don't want to interrupt your testimony, but
    something very humorous is I take so many supplements that I
    don't eat anymore. There is no more room for food. It is
    supplements and more supplements. I wish somebody would tell me
    what I really--I know I need vitamin C and E and all of this,
    but I wish somebody would say, Danny--that is me--this is what
    you ought to take every day. But everybody that I know that
    knows that I am very concerned and want to make sure that the
    supplement industry does very well, because I believe very
    strongly in it, as you know, as the chairman of the caucus, but
    there has to be a limit to how much of this stuff I can take. I
    know I am going to live to be 170, but I would like to know if
    I can cut down a little bit, because I am afraid if I stop
    taking this, I am making a mistake and so forth.
        So somebody needs to write me a letter and say, OK, this
    what you ought to take. Marilu, maybe it is you.
        Ms. Henner. I have it.
        Mr. Burton. I may read your book. I want you to keep me
    young. I am 29 now, but I want to stay there.
        Ms. Henner. You only look 27.
        Mr. Burton. I love you. I love you.
        Go ahead, Mr. Balbert.
        Mr. Balbert. Well, before I continue, Mr. Chairman, we want
    to thank you on behalf of the industry for single-handedly
    supporting the ongoing efforts to help educate folks.
        As a representative of DSHEA, I have three important points
    to make here, and I will be brief. First, as you have heard
    from Dr. Blumberg and Dr. Levine, dietary supplements have been
    shown to be safe and effective aids for maintaining health and
    supporting overall wellness.
        Just think about the implications of this on the human
    level. Dietary supplements can help prevent a life of
    disability due to neural tube defects. Dietary supplements can
    enable senior citizens to live fuller lives without the
    disability of a broken hip. Dietary supplements can help active
    adults have less discomfort from arthritic knees.
        The potential goes on and on. And how do you put a dollar
    and cents value on the quality of life? You simply cannot. This
    isn't a matter of statistics. It is the ability to lead
    healthy, happy lives.
        Second, these relatively inexpensive supplements can help
    our country with the critical issue of managing health care
    costs. One of the most pressing problems confronting the United
    States today is the spiraling cost of medical health care. That
    is no mystery, and as you heard from Dr. Dobson, just two
    dietary supplements examined in the study could provide--I
    don't know if we fully grasped his statement--just two, just
    two dietary supplements examined in this study could provide
    over $15 billion in savings over the next 5 years. That is two.
        We have a critical crisis going on in our health care
    system, and we are talking about food supplements that can help
    reduce health care costs, and we are not even talking about the
    value of the quality of life.
        Third, to take advantage of health-promoting and cost-
    savings potential of supplements, people need accurate,
    science-based information about dietary supplements and access
    to them. To ensure that dietary supplements get the research
    attention they deserve, ongoing support from the Office of
    Dietary Supplements [ODS], Mr. Coates's office, and the
    National Center for Complementary and Alternative Medicine
    [NCCAM], is essential.
        We would urge members of your committee to strive to find
    ways to increase funding to these government bodies. We are
    confident that more extensive research will only further
    support the benefits, safety, effectiveness, and cost savings
    we are hearing about in this panel today.
        To promote education about supplements, full implementation
    of the Dietary Supplement Education Act is important. Chairman
    Burton, we applaud your recognition of this critical aspect; on
    behalf of the industry, praise your efforts to achieve this
    goal by your introduction of H.R. 4760, which I wholeheartedly
    support.
        I believe there is more that can and should be done to
    ensure that consumers have access to balanced, science-based
    facts about dietary supplements so they may make informed
    decisions about achieving and maintaining optimum health. That
    is really what this is all about.
        To ensure even greater access to supplements, bills like
    your Tax Fairness Act are critical and represent legislation we
    endorse. The Tax Fairness Act would allow taxpayers to deduct
    amounts paid for foods for specialty dietary uses, dietary
    supplements or medical foods as medical expenses, thereby
    fairly putting supplements on par with other health benefits.
        Likewise, the ability of food stamp recipients to use their
    benefits to purchase dietary supplements. Food stamps can be
    used to buy Twinkies, but they can't be used to buy dietary
    supplements.
        As you and others have proposed in the past, Mr. Chairman,
    this is an idea we hope you and others will pursue.
        In closing, I would like to point out although many
    congressional hearings focus on what is wrong, hearings like
    this provide encouragement to continue doing what is not only
    right, but cost-effective, too. I want to thank the chairman
    and others on the subcommittee for taking the time address to
    the positive aspects of dietary supplements. Thank you, sir.
        Mr. Burton. Thank you.
        [The prepared statement of Mr. Balbert follows:]

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        Mr. Burton. And I do take a myriad of supplements, but,
    like I said, I think that might be one of the problems with a
    lot of people, because there are so many supplements that are
    available in the marketplace to take care of a myriad of
    problems that you sometimes wonder, you know, if you are--if
    you are taking too many, or if you are not taking enough.
        So I am going to read Ms. Henner's book, I have it right
    here. She looks awful nice. Does this tell me how to do that?
        Ms. Henner. Sure. If not, I will give you my e-mail
    address, and I can send you a lot of information.
        Mr. Burton. Gosh, that would be great. I would love just to
    converse with you. You are a lovely lady. OK.
        Ms. Henner. Well, thank you so much.
        Well, Chairman Burton, good morning, and members of the
    committee. I am Marilu Henner, actress, author, concerned
    mother, and health advocate. As a consumer who recognizes the
    value of dietary supplements, I thank you for the opportunity
    to speak here today.
        I would like to provide testimony on why I believe it is
    important for consumers to have information about dietary
    supplements and to have access to supplements through their
    government and private health plans. The information and access
    is important in order to help people make better decisions and
    lead healthier lives than is possible through a healthy diet
    alone. I mean, that is why I believe dietary supplements should
    be part of a campaign to improve our Nation's health.
        Now, I feel qualified to say that, because I am not only
    the author of six best-selling books promoting health and
    nutrition and a healthy lifestyle, but I am also one of the
    healthiest eaters in Hollywood; that is, according to a few
    magazines. Which isn't saying much, because everybody is on
    that crazy low-carb phase except me.
        Anyway, I believe that healthy food without dietary
    supplements is not enough, because it is not always possible to
    get everything we need from our food, no matter how carefully
    we plan our diet. We eat in restaurants, we eat on airplanes,
    we eat in school lunch programs, etc.
        But before I get into my personal story, I would like to
    talk first about the need for information. According to the
    Centers for Disease Control, approximately 400,000 Americans a
    year die as a result of an unhealthy diet and a sedentary
    lifestyle. While I personally think the estimate is low, it is
    high enough for us to recognize that something must be done to
    get people moving and eating better.
        As the waistline of the average American continues to
    expand, illnesses related to obesity, such as diabetes and
    heart disease, are reaching epidemic proportions. People are
    stuffing themselves with processed foods and fast foods and
    junk foods, while they are literally starving their bodies of
    the nutrients they need.
        The solution for too many people is fad diets that only
    perpetuate their unhealthy eating habits. As I have described
    in several of my books, I was raised on the standard American
    diet and spent many years dieting as I tried to control my
    weight. I actually weighed 54 pounds heavier than I do right
    now. Big change. The result, of course, was that I was
    consistently in bad health and never could control my weight
    eating that way. Both of my parents died in their fifties of
    diseases associated with poor diet. As I have since learned, my
    father's heart disease could have probably been mitigated using
    vitamin E and omega-3 fatty acids, and the severity of my
    mother's arthritis could have been alleviated using calcium
    and/or glucosamine.
        I have had my own experiences with calcium. I have not had
    a dairy product in 26 years. I take a calcium supplement. I had
    a bone density test recently. I am the 104th percentile for a
    woman my age. I am 52. I was in the 97th to 99th percentile for
    a woman 18 to 25, and this is--I had a mother who died of
    arthritis. So I know that a calcium supplement can definitely
    help, and, you know, coupled with a very healthy diet of leafy
    greens, etc., salmon.
        My parents' deaths were the impetus for my never-ending
    quest for better health for myself, my siblings, my children
    and anyone else who would listen. My journey to good health
    took many years. Mine was a story of trial and error, because
    it was so difficult in the 1970's and 1980's to find
    information about optimizing health through diet and
    supplements. There is more information now than ever before
    about health, but unfortunately the same chatter about fad
    diets and miracle drugs drowns out the sound information that
    people should be getting.
        I believe that people are ready to take the right steps
    toward becoming healthy, but without the proper guidance and
    the support of their insurance providers, health organizations
    and the Federal Government, they will continue to be led into
    to seeking false solutions. One of my goals as an author is to
    show people the way to optimize their health by encouraging
    them to disregard false solutions such as drastic weight loss
    with no sacrifice, or better health through miracle pills. I
    really do believe it is about changing the palate of America.
        Through my many personal appearances advocating good
    health, my books and my Web site at marilu.com, I come into
    contact with and mentor thousands or people who are on their
    own quest for good health. I hear many personal accounts of how
    people have turned their lives around from debilitating illness
    to vibrant health when they get information needed to make
    choices, to make good choices, and by good choices I mean
    specifically rejecting the manufactured foods of our society
    with their overreliance on sugar, meat and dairy, and the
    chemical, hormones and steroids that usually accompany these
    products. Instead we should be moving toward an organic, plant-
    based diet that produces a sense of physical well-being, and
    also a healthy diet that includes the use of appropriate
    dietary supplements.
        Finally, I would like to describe why I think it is
    important to have access to dietary supplements. Eleven years
    ago when I was pregnant with my first son, I began to take
    prenatal vitamins and supplements and found that I felt better
    than ever before. I continued to take dietary supplements after
    my pregnancy to benefit from the essential nutrients that I
    knew I couldn't get from food alone, even though I am very
    committed to a healthy way of eating. But I was lucky enough to
    have a doctor who not only understood the value of dietary
    supplements, he also encouraged me to use them to maintain my
    health. Not everyone is that lucky, however, and many doctors
    have no idea what supplements are best for their patient's
    individual needs.
        Since then I have taken dietary supplements every day, and
    I would recommend them to my family and friends as well as in
    my books and classes. The general public needs more access to
    dietary supplements to maintain good health. Supplements are
    the result of American research and development, but for some
    reason they have been stigmatized by the American Medical
    Association and the drug companies, and, as a result, most
    Americans do not have access to those supplements because they
    are not covered by their health plans, nor recognized as
    effective by the Federal Government.
        I think this needs to be changed. People need to be able to
    find the supplements to target their specific needs. They need
    good information. They need to be able to find quality
    products, and the product needs to be cost-effective. They
    can't have any of these things without your help.
        I have the benefits of 26 years of research and
    experimentation, and I have never been afraid to think outside
    the box when it comes to my health, but I only wish I had that
    information when my parents were alive, because I know I could
    have helped them and saved their lives.
        In closing, I want to thank the committee for examining the
    issue and inviting me to speak here today. I would like to
    encourage you to make this information on dietary supplements
    available to all Americans so that the health of the American
    public can be improved. And I wish you the best of health.
        [The prepared statement of Ms. Henner follows:]

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        Mr. Burton. You know, I am going to use a different kind of
    metaphor to make this next statement. That is, you know, when
    we were attacked on September 11, we at that point didn't have
    the ability to arrest and hold a suspected terrorist before the
    act took place. There had to be probable cause, you know, all
    of the things that you do. And we ended up passing what was
    called the Patriot Act, so that if we saw a terrorist, we could
    get him and hold him until we checked him out to make sure that
    he didn't kill 10,000 or 12,000 people.
        And that brings me to the issue we are talking about here
    today, and that is health. My son-in-law is a doctor, and most
    doctors are taught to take care of people who become sick. But
    they don't move in advance to help them with preventive
    medicine, because they are not trained that way. They are not
    trained to say take these supplements, take these things, and
    you probably won't have the kind of maladies that you may be
    heading for.
        And it seems to me in our medical schools, in addition to
    what we have been talking about here today, and we talked about
    this at other hearings, that the medical colleges and
    universities around the country ought to be teaching diet,
    supplements, nutrition and everything right along with the
    medical studies so that they minimize the amount of people that
    have to come to them in the first place. And I think we would
    have a much healthier Nation.
        Unfortunately, that's not the case. We have the cart before
    the horse. You get sick, then you go to the doctor and he gives
    you prescription drugs, many of which help but don't solve the
    problem, because the problem started earlier. So I agree with
    what you said, and that's why we are sponsoring all of the
    legislation we are to try to give people the ability to get
    vitamins and minerals and supplements that will help them in a
    preventive way from getting these diseases.
        Dr. Dobson, you provided us with some very significant cost
    savings in the findings of your studies. Would you say that the
    cost savings for calcium and folic acid are conservative? And
    would you also agree that even more savings could be achieved
    by people using them?
        Mr. Dobson. Yes, they are very conservative estimates, for
    two reasons, No. 1, we assumed that most people wouldn't take
    either the calcium they should or the folic acid they should.
    If more people took each of those supplements, our estimates
    would rise.
        If we had public policies that encourage people, as Marilu
    has suggested, to get more people to take more folic acid, we
    would reduce more neural tubes defect than we estimated in our
    studies, which would increase the savings similarly with the
    calcium.
        Second, we only took the major healthcare savings
    associated with both calcium and folic acid. And as you have
    heard from your panel, there are many other potential savings
    that one might have. We didn't cost those, because the research
    isn't quite there yet, but it may very well be in the future.
    So I think for those two reasons at least, our estimates are
    very, very conservative.
        Mr. Burton. You also stated that omega 3 fatty acids,
    glucosamine and saw palmetto, that there's emerging evidence
    that suggests there's going to be significant cost savings for
    those as well. What types of research would have to be
    conducted to help determine if there would be economic benefits
    from those supplements?
        Mr. Dobson. I think that the research already in place, the
    clinical trials under way by FDA and others at other Federal
    agencies, may be powerful enough in the next couple of years to
    allow the cost estimates to be made. We won't know until we get
    the studies, of course, but it's these very carefully
    controlled studies that take time and money to put in place. We
    need more of those for our supplements.
        The government is, as we heard from Dr. Coates, is well on
    its way to providing those types of studies. We are focusing
    now in those areas where there's a long trail already of
    evidence that's out there, and a few additional studies may be
    what we need to take us over the top to be able to say, yes,
    these are supplements that we can now have confidence that they
    do improve health to the point where we can calculate cost
    benefits.
        Mr. Burton. Let's see, Dr. Blumberg, in your testimony, you
    state that all women capable of becoming pregnant need to
    consume folic acid on a daily basis. What would you recommend
    is the best method of obtaining folic acid besides eating
    liver, mushrooms, dried greens or green leafy vegetables. Would
    just taking a folic acid pill be sufficient?
        Mr. Blumberg. Well, I would point out--it's not nearly my
    view, but the view of the Institutes of Medicine and the CDC--
    that the most effective, reliable and practical way to insure
    that enough folic acid is consumed to reduce the risk for
    neural tube defects is to take a dietary supplement containing
    400 micrograms of folic acid.
        It's just, hands down, the most realistic way to do it. The
    reason that many women don't, indeed as I stated, two-thirds of
    American women in this group do not use supplements containing
    folic acid, is they are not getting the recommendations from
    their health care providers that this is an appropriate thing
    for them to do. It's really part of the preventive nutrition
    issue that you were raising. This advice, which is actually
    official government advice, is still not being picked up by
    health care providers by physicians, dieticians, pharmacists
    and others to encourage women to do this.
        Mr. Burton. Is folic acid one of the most practical ways to
    insure good health?
        Mr. Blumberg. Well, folic acid, I like to think, is a very
    important vitamin, but it's certainly not the only one. I would
    point out, for example, that folic acid works in conjunction
    with other B vitamins, like vitamin B6 and vitamin B12 to lower
    homocysteine, which I mentioned is an independent risk factor
    for cardiovascular disease.
        As Dr. Coates mentioned, there's some exciting new research
    that suggests that increasing our intake of folic acid may
    reduce the risk for age-related dementias like Alzheimer's
    disease. Recent research studies at Tufts University have shown
    that people with elevated homocysteine levels which can be
    lowered by folic acid supplements, have fourfold higher rates
    of Alzheimer's disease than people with low homocysteine
    levels. So I think the promise of folic acid, together with
    other essential vitamins and minerals, holds tremendous promise
    for promoting health and reducing our risk for many chronic
    diseases.
        Mr. Burton. Well, I would like for all of you, as I said
    before--I would like for all of you, if you would, to give me a
    list of the essential vitamins that people should take so that
    they--I personally would like to know.
        I have drawers of items. I can't possibly take them all. I
    think that's one of the shortcomings that people have when they
    start deciding what is best for them. Because every article
    that you read says this does this, this does this, and this
    does this. And clarity in your health, I think, providing for
    your health, I think is very important. So I would like some
    advice from you folks, and I have been taking these things for
    a long time.
        Dr. Levine, as part of your both written and oral
    testimony, you stated that Americans are not getting the
    recommended daily intake of calcium that they need on a daily
    basis, just through the foods they eat, that they are eating.
    Can you tell us the benefits that we are getting as a society,
    how it could reap more benefits if individuals supplemented
    their diets with calcium and what kind of calcium are we
    talking about, are you talking about CalMax or things like
    that?
        Ms. Levine. Well, they are. Well, first some people should
    get some calcium from their diet. Typically they get it from
    dairy foods, certain leafy vegetables like cal-fortified foods,
    such as fortified orange juice. They can get it from fortified
    cereals. But really most people are unwilling or unable to get
    the 1,200 milligrams they need, and that's for both men and
    women.
        That's if you translate it into dairy products, that's four
    glasses of milk a day--and most of us are saying low fat or
    skim milk a day--but most of us are unwilling or unable to do
    that. So you can get it from calcium carbonate, calcium
    citrate. You really do not want to go to bone meal or dolomite
    that are contaminated with things like lead or arsenic.
        And the coral calcium issue is one that I don't even want
    to go into.
        Mr. Burton. Why not? Wait a minute. I want you to go into
    the coral calcium issue.
        Ms. Levine. Because they were advertising that as having a
    high absorption rate of 69 percent. We know that most calcium,
    like carbonate or citrate, according to Dr. Heeney, who is a
    calcium expert, shows that most calcium is absorbed like milk
    at about 30 percent. So they did not do the calcium studies on
    coral calcium.
        Mr. Burton. Well, you are not saying coral calcium is not
    good, it is just----
        Ms. Levine. There is no way that it has an absorption rate
    of 69 percent.
        Mr. Burton. But it's not bad?
        Ms. Levine. I don't think we have the studies. We really
    need good double blind placebo-controlled studies. Most of the
    studies that I am involved in, either at Cornell or the
    Rockefeller or Strand, are in our clinical research center
    where we typically--I should say it this way--incarcerate our
    patients. They stay in the hospital. We control everything that
    they eat and drink.
        Mr. Burton. But you haven't studied coral calcium yet?
        Ms. Levine. We do. We just finished a study on calcium,
    using calcium carbonate in patients that were at high risk for
    colon cancer.
        Mr. Burton. Uh-huh.
        Ms. Levine. Those data are not quite complete yet, so we
    will have----
        Mr. Burton. What about the coral calcium?
        Ms. Levine. We didn't use coral calcium.
        Mr. Burton. You haven't studied it?
        Ms. Levine. No, we haven't studied it.
        Mr. Burton. All right. Could you further explain the
    benefits of omega 3 fatty acids for all Americans?
        Ms. Levine. Yes. As I mentioned with children, it starts at
    the very beginning. Mom gives DHA by the placenta in the third
    trimester of pregnancy to her baby, and then if she is nursing
    her baby, she will give DHA to her baby.
        However, as Americans, we have the lowest levels of DHA in
    our breast milk. That's because we do not eat fish, and we
    don't eat organ meats--and you mentioned you don't like liver.
    Typically, we used to eat more organ meats.
        It's in liver, it's in brain. Remember that brain is made
    up of 60 percent fatty acids and 30 percent of which is DHA or
    decosahexaenoic acid, and it's also very concentrated in the
    retina. So, babies that get DHA have better cognitive function
    and visual acuity. And it's also in the heart muscle. So that
    we really need to have it throughout all stages of life.
        And now, through the Framingham study, you mentioned that
    too, it's been shown that patients that have low DHA levels in
    their serum and then on autopsy in their brain have higher,
    higher incidence of Alzheimer's disease or dementia. So we need
    it throughout our life cycle. So it's very, very important. And
    I mentioned, we soon will have results in a primary--prevention
    trial with DHA. And that, again, is in a study that we gave
    everything that the patients had to eat and drink in our
    clinical research center.
        The only thing that was different is that they were either
    on placebo or on DHA supplementation while in the hospital for
    6 months. So it was a long-term study, and we will have the
    results shortly.
        Mr. Burton. Well, if I have to choose from eating a
    supplement that contains DHA or eating brains----
        Ms. Levine. I'm sorry.
        Mr. Burton. I said if I have to choose between eating a
    supplement that has DHA or eating brains, there's not going to
    be any question.
        Ms. Levine. Me too.
        Mr. Burton. Mr. Balbert, were you surprised by the $15
    billion in cost savings and healthcare expenditures that were
    derived from the results of the study conducted by the Lewin
    Group?
        Mr. Balbert. I was delighted with the cost savings.
        Mr. Burton. Were you surprised?
        Mr. Balbert. Not really. Just putting a number to something
    that we have, I think, intuitively understood in the industry,
    was a pleasure and a relief. The fact of the matter is that's
    just a quantification of a specific ailment, and I happened to
    put a great deal of value in the quality of life of dietary
    supplements.
        One other comment, chairman, you have expressed a number of
    times in your comments about the angst that you have with the
    volumes of dietary supplements that you take and the difficulty
    that you have in finding out what is right for you. The
    industry has a very simple guideline on that. We suggest that
    everybody should take one multivitamin and mineral formula as a
    base of any healthy nutritional program, and then based upon
    the additional body functions that you are looking for
    sufficient nutritional support from--whether it be eye health
    such as lutein or insulin balance, which is chromium--you would
    then build around your multivitamin formula.
        That, along with a good healthy life-style with plenty of
    sleep and rest, and you will live to that 170 that you were
    talking about.
        Ms. Levine. And laughter.
        Mr. Balbert. Oh, yes, and laughter.
        Mr. Burton. OK. All right.
        Your organization, the Dietary Suupplements Education
    Alliance, in your Web site and mailings to Capitol Hill have
    helped to educate Members of Congress on the benefits of taking
    dietary supplements.
        Do I then assume correctly that it is critical that the
    DSHEA be preserved and not amended?
        Mr. Balbert. Absolutely, Mr. Chairman. We don't believe
    that there needs to be any modification for DSHEA. The Federal
    Food and Drug Administration has all the authority that they
    need. What they need to do is to encourage and implement the
    DSHEA, all the grounds that are necessary at this time. DSHEA
    does not need to be modified.
        Mr. Burton. Our health agencies have the tools necessary to
    police that?
        Mr. Balbert. By their open admission and testimony----
        Mr. Burton. I think they have the tools today, yes. Well
    there are those in Congress and in health agencies that want to
    junk DSHEA, as you probably know. I just want to admonish those
    that are interested in the health care field and the supplement
    field, and that they stay vigilant in contacting their
    Congressmen and Senators, not just Representative Kucinich,
    myself and Hatch and others. But contacting them and telling
    them how important it is, we don't tinker with DSHEA.
        Ms. Henner, you stated in your testimony--you just stated
    that eating healthy is not enough and that you believe that
    dietary supplements need to be a part of your and everyone
    else's daily regimen.
        Tell us a little bit about what you take and why you think
    supplements are so important to you?
        Ms. Henner. I take a multivitamin called Comprehensive
    Formula that I actually helped develop. I take vitamin E, I
    take calcium. I do take coral calcium. And I do take a calcium
    called Bone-Up and I--because it's vegetarian.
        Mr. Burton. You are vegetarian?
        Ms. Henner. I am what is known as pesca vegetarian. Because
    I eat some fish, although I have been, I eat, you know, a
    little bit of fish, but I mainly eat whole grains, fruits,
    vegetables, legumes. So I have a very strong plant-based diet.
    I have just a----
        Mr. Burton. You don't drink a lot of milk?
        Ms. Henner. No, I never drink milk. My children have never
    had milk. They are 8 and 10 years old. They are both in a
    gifted school. They have both skipped a grade. And they have
    strong bones. They are both athletes. They are incredible. My
    children have never had a dairy product in their life. And I
    haven't had one for 26 years. So----
        Mr. Burton. Why is that?
        Ms. Henner. Because the only thing dairy is supposed to do
    is turn a 50-pound calf into a 350-pound cow in 6 months. It's
    true. I always tell people if those are your aspirations, knock
    yourself out.
        I mean, we have a 27-foot long intestinal track in a very
    small stomach. A baby calf has four stomachs and 9 feet of
    intestines, and they have nothing to do with each other. So we
    are not even, you know, I think that dairy is one of the worst
    calcium carriers ever. Now, it doesn't even, you know, resemble
    the milk of old. It is really just a white bovine slime, as far
    as I am concerned.
        Mr. Burton. Wait a minute, I will get there. White bovine
    slime.
        Ms. Henner. Bovine slime, it's--you know, I read people's
    faces, I go up and I can always tell somebody who has an
    overconsumption of dairy products. Because that was my problem.
        I always ate a lot of dairy products, and when I gave them
    up, my digestion changed, my skin changed, my weight changed.
    Everything changed about my body.
        So I am a big advocate of people looking to alternatives to
    dairy products. Because two-thirds of the country doesn't even
    eat dairy.
        So, anyway, the other things that I take are I take
    pycnogenol, which is an antioxidant. And I also take--but I
    work with a nutritionist in Los Angeles, who tests me from time
    to time, and also note from, based on my schedule, and based on
    if I am traveling, etc., I need to make adjustments along the
    way.
        So, you know, I am lucky enough to have found someone to
    work with who puts me on different programs from time to time.
    Excuse me. Does that answer your question?
        Mr. Burton. I think so. Bovine slime.
        As an author of six books promoting a healthy lifestyle,
    what recommendations would you make to Americans so that they
    can make better healthy choices?
        Ms. Henner. You mean in terms of food or supplements or
    both?
        Mr. Burton. Both.
        Ms. Henner. Well, I think definitely think, you know, you
    are a real person, eat real food. They should start reading
    labels. That's always where I start with people. Because
    anything that takes a paragraph, you know, this big to
    describe, or says continued on the next can, you probably
    shouldn't be eating it.
        With my children, I always say if you can't read it, don't
    eat it. I always start there. And so I always have people start
    there. I also think that you should--the American public really
    needs to change their palate, because it's really not about
    counting, it's not about measuring, counting, you know, it's
    not about measuring, weighing, counting the points, grams,
    carbs, etc., of the same old food. That is not going to make
    somebody healthy or thin or fit.
        And the other thing is, I think that everyone needs a good
    daily multivitamin to start. And as Mr. Balbert said, you start
    there and then you build from there.
        And then depending on your genetic hand. I knew that my
    parents--having died of arthritis and heart attack, that I had
    to, I looked into those diseases thoroughly and started taking
    the calcium and vitamin E and, you know, Pro-EPA is the fish
    oil, the one that I take.
        Mr. Burton. Besides buying your book what other things can
    we do to educate the public?
        Ms. Henner. Well, that's an excellent start. You know what.
    I always say I educated myself. I started this in 1978 after my
    mother died, and I went to medical libraries and research
    departments and took human anatomy classes and went to health
    food stores. And there was not a lot of information.
        I think what we have to do is we have to get the
    information out there to people, because once you know, you
    can't choose not to know anymore. And this is why I am, you
    know, an actress who goes out talking as much as I do about
    health. Because I think people need to be educated.
        So I think what people also need to do is also get off
    their butts and stop stuffing their faces but starving their
    bodies with the same old junk over and over again. Because
    that's exactly what is happening. Their bodies can't even
    ignore the nutrients in the food, and there's no nutrients in
    the foods, they choose so they keep overeating and overeating
    and overeating.
        I always look at someone who has either a weight or skin
    problem, and I always say that's a natural healer. Because
    their body is telling them that they are doing something wrong.
    So I really think that what people have to do is rediscover the
    child in themselves, get out there and exercise, find a good
    doctor who can work you, know enough about your body so that
    you can help your doctor help you and educate yourself as much
    as possible. And eat lots of fruits and vegetables.
        Mr. Balbert. Mr. Chairman, the DSEA has created a very
    comprehensive Web site called supplementinfo.org, which is
    extremely exhaustive in providing information to the American
    public and access.
        Mr. Burton. Give me that again.
        Mr. Balbert. Supplementinfo.org contains over 2 million
    pages of information on the use of dietary supplements. It is
    ad nauseam in terms of--the information is there.
        Mr. Burton. I want a one-page, one pager.
        Mr. Balbert. We will have it prepared for you, Mr.
    Chairman. I can assure you.
        Mr. Burton. I want you to write down something for me
    saying Dan, you can do this, and you are going be all right.
    All right?
        Mr. Balbert. Mr. Chairman, consider it done.
        Ms. Levine. I think other responsibilities organizations,
    such as the Heart Association, American Diabetes Association,
    of course the NIH Web site, they are excellent Web sites to go
    to.
        Mr. Burton. Sure. Do you know how many pieces of paper.
    Representative Watson and I, how many documents we have to look
    at a day. Do you know how many pieces of documents we get each
    day and constituents asking us to pass to the White House and
    people asking us to get their kids appointed to the Air Force
    Academy or West Point or God only knows, Social Security,
    veterans problem, we really, I am not asking for sympathy. I
    asked for this darn job a long time ago, but we really don't
    have time to go into a million pages here.
        Mr. Balbert. Of course not.
        Mr. Burton. But I will say give me the KIS principle, keep
    it simple.
        Mr. Balbert. I will kiss you, Mr. Chairman.
        Mr. Burton. No, thank you. Maybe Marilu Henner.
        I just want to say first of all, your enthusiasm, Ms.
    Henner is very helpful, very nice.
        Ms. Henner. Thank you, this is my true passion, I was there
    yesterday at the dietary guidelines open public forum talking
    about--you know.
        Mr. Burton. Yes. I appreciate all of you panelists, I just
    want to tell you, we had a hearing about a week ago, was it, on
    obesity in America, and 31 percent of the people of this
    country are overweight. No. 65, 65 percent of the people of
    America are overweight and 31 percent, almost 1 out of 3
    people, are considered to be obese.
        I just got back from Guam and Saipan not too long ago, and
    they have an absolute epidemic of diabetes over there. I think
    we had a doctor before us at our last hearing and he said if we
    don't change our dietary habits in this country, one out of
    three children will develop diabetes in their life, newly born,
    one out of three.
        I mean, we are looking at an absolute epidemic if we don't
    educate the public about eating habits, junk food--and then
    they start saying that the average child in a year sees about
    10,000 commercials--and I started watching children's
    commercials and my God, Little Benny's chocolate wafers, you
    know, and all the stuff you see is nothing but junk food, junk
    food, junk food. And a bit of that is all right. But somehow,
    we have to educate the public, that they ought to create better
    food products and advertise them the way that make people want
    to eat them so that they get healthy. Otherwise, we are going
    to be paying so much money in health care cost, it's not even
    funny.
        Ms. Watson is with us, she is my ranking democrat and a
    very fine lady who is really concerned about health foods.
    Would you like to make a comment?
        Ms. Watson. I thank you, Mr. Chairman. I am going to give
    my opening statement, because I think it frames my interest and
    concern. Natural foods and supplements are very important to a
    healthy population. If one understands what should go into the
    body, then it is possible to live a healthier and more
    productive life. Breast milk nurtures an infant and promotes
    accelerated learning.
        Vitamins and minerals give cells and organs the proper
    building block for optimal performance. There are some
    supplements that have been proven to be very effective, for
    example, pregnant women are advised to take folic acid to
    reduce the risk of certain birth defects. And calcium
    supplements have been demonstrated to reduce the risk of
    osteoporosis. Certain herbs and trace elements also have
    medicinal values and sickness-preventing properties.
        Mr. Chairman, I am encouraged with the aggressive outreach
    and research initiated by the natural food and supplemental
    industry.
        But there is room to do much more. The natural foods and
    supplement industry can help increasing numbers of Americans to
    take charge of their own health. They can assist our
    constituents in adopting healthier lifestyles that include a
    good diet, exercise, supplementation and becoming more educated
    about all of these.
        The Dietary Supplement Health and Education Act is a very
    important piece of legislation, and prior to its enactment, the
    FDA regulated dietary supplements as food. Because
    manufacturers claims are often promising and completely
    positive, Congress created guidelines to address supplement
    definition, safety concerns, ingredient and nutrition labels,
    supplement claims, good manufacturing practices and new dietary
    ingredients. In addition, the DSHEA created a supplement
    Commission and an office of dietary supplements at the National
    Institutes of Health. Over the past few years, there have been
    several media stories of supplements causing adverse effects.
        Natural nutrients are nothing to be scared of, but they
    should be respected, treated with care and used properly. Since
    the enactment of DSHEA, the FDA has issued alerts on several
    supplements to warn consumers of possible safety problems.
        In other examples, the FDA has issued alerts about a
    possible liver toxicity with kava-containing dietary
    supplements, dangerous interactions between Saint John's Wort
    and a number of prescription drugs and serious kidney disease
    and some cancers from herbal supplements containing aristolic
    acid.
        Until recently, the FDA has only invoked its authority to
    declare a supplement altered. In December 2003, the FDA
    declared that Efedra, a dietary supplement that was marketed
    for weight loss and was associated with serious adverse events,
    including heart attack, stroke and death, presented an
    unreasonable risk of injury. The courts are currently reviewing
    this action, and courts should not decide the risks and the
    efficacies of a dietary supplement at all.
        On the contrary, the scientific community should reach a
    well-founded conclusion.
        And, Mr. Chairman, you mentioned that several of the
    island, Guam and other areas of the north Pacific and South
    Pacific are now seeing the rapid development of being diabetic.
        Mr. Burton. Diabetes.
        Ms. Watson. I am thinking of so many other things. And I
    remember going to the Far East early--earlier on, and there
    wasn't a dentist around, and going back decades later, now
    there's a dentist on every corner. Why? Because they have
    started consuming western DSHEA style foods. And I think that
    is a sad commentary on how we are promoting our bad dietary
    habits around the world.
        And so I hope that we will have other hearings on this
    issue, because I do believe that of dietary supplements have an
    essential role to play in today's world. And I look forward to
    other hearings. I'm sorry I am late. I am sitting in another
    committee at the same time. So thank you very much, Mr.
    Chairman, for this opportunity.
        Mr. Burton. You are welcome. Before we adjourn, let me say
    we regret Ken Venturi wasn't here with us. Ken Venturi won the
    U.S. Open here at congressional under very stressful conditions
    years ago, he is one of my heroes, I have had a chance to get
    to know him and meet him a little bit. So I hope somebody will
    convey to Mr. Venturi our sorrow that he couldn't be with us.
    He has a book out, and I am hoping I get a copy of it. I would
    like to read it, not only on supplements but golf. I am a golf
    nut.
        We have had some other people who are very interested in
    health care issues and supplements. Arnold Schwarzenegger--I
    talked to him on the phone--we were going to have him testify
    at one time, shortly after he had open heart surgery, and I
    asked him, this might be interesting to a lot of people who are
    interested in the supplement field. I asked him if he thought
    that supplements benefited him in the course of his surgery and
    his recovery. He said that he recovered much more rapidly than
    anybody anticipated, and he was absolutely certain it was
    because of not only his physical conditioning, but because of
    the supplements that he had been taking for years that helped
    him heal quicker.
        Of course, we have Ms. Henner here, another celebrity, we
    appreciate you being here. You are very beautiful and useful.
        Ms. Henner. Thank you very much.
        Mr. Burton. Just like when I saw you on TV.
        Jane Seymour is a very good friend of mine. In fact I think
    I am going to have lunch with Jane and James Keach, her
    husband, tomorrow. I think you know both of them. But she is a
    very, very physical culturalist, if you will, and she is also
    big on supplements as well as her sister, who I think teaches
    supplements.
        And of course, we had one lady here, who I am sure would be
    recognized as a person of great physical stature, Raquel Welch,
    and just thought that you might like to know that she takes
    supplements as well. So this isn't just limited to the plain
    people like me. I mean, you have a lot of beautiful people who
    take that stuff as well.
        Ms. Watson. Mr. Chairman, would you yield just 1 second?
        Mr. Burton. What piqued your interest there, was it Raquel
    Welch or----
        Ms. Watson. This morning, on CNN, they were talking about
    the Greek diet, and I was in Greece for the Olympics, and I
    noted that every time you went into a restaurant, there was a
    Greek salad. And I also noticed that everyone smoked there.
        And I was asking, why is it that they don't develop the
    kinds of cancers related to smoking? Lung cancer and etc.? And
    they said because of olive oil. So there are some medicinal
    properties in olive oil that we all should be looking into.
        They also talked about couscous in place of white rice, and
    they talked about the fresh vegetables. They have the best
    tomatoes in the world. So I think there are a lot of natural
    products that we get through the supplements, and they tend
    to--they say they live longer because of the olive oil. So I
    think we ought to try that and, you know, stop using butter,
    dip our bread in olive oil. Thank you, I just had to get that
    in.
        Mr. Burton. Put that on my list, will you?
        Ms. Henner. I am half Greek, I just want you to know. My
    book has exactly what they were talking about today.
        Mr. Burton. A lot of olive oil.
        Ms. Henner. A lot of olive oil. I was raised on olive oil
    too.
        Mr. Burton. Send me your list, kid.
        Ms. Henner. I will.
        Mr. Burton. Thank you, this has been very, very
    interesting. We will have more panels on this, health and
    wellness and supplements. And you have been very helpful today.
        We will send some questions to you. If you wouldn't mind
    answering them and sending them back to us for our record.
    Thank you very much. We stand adjourned.
        [Whereupon, at 11:40 a.m., the subcommittee was adjourned.]