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evidence-based medicine. The studies
must be ‘auditable,’ meaning they can be reconstructed from the raw data. The results must show that the product is good for the intended claim. Very few studies outside
of FDA studies for drugs can meet this evidence-based standard, including those for “nutraceuticals.”
Another dilemma exists when assessing results of any clinical trials – there may be a vested, conflict of interest of a nutraceutical company in funding a clinical trial on a product they develop and market. To remove subjective bias, masked studies are performed in independent labs where the study can be reconstructed from the data.
Most ‘nutraceutical’ claims are based
on purported information from human medicine and often are never substantiated with a clinical trial in people or in animals. The horse’s GI tract is destructive to many formulations; even in people there are questions as to product efficacy. In effect, many feed additive supplements simply increase costs to the horse owner, but don’t necessarily benefit a horse beyond providing calories. It is hard to extrapolate in vitro results to feeding a product to a live horse since a horse may be unable to absorb the product into the bloodstream or it may fail to reach the target tissue.
When evaluating a product, look
at the manufacturer as a whole, rather
than just producing a single product. An ethical manufacturer invests in third party research and development as part of their business model. This commercial culture of research, together with third party quality control audits can provide a high level of confidence to the consumer that the product likely does what the label says it does.
Such quality control audits include cGMP, hazard analysis and critical control points (HACCP), or ISO22000, all of which
deal with food safety measures – this information is written on the labels and/or marketing material.
The best way to determine whether a product and/or company is ethical is to a) ask for research supporting safety and/or efficacy; and b) ask for evidence for third party quality control audits.
WHAT’S ON THE LABELS?
So, what is a horse owner supposed to do when faced with such lack of regulation, oversight, or policing of label claims?
Be careful not to blindly follow the latest vogue, or only believe what you hear at the latest event, read on a blog or advertisement, or glean from the label about nutraceutical claims that extend beyond nutritional benefits.
Another problem develops when an owner over-supplements by using multiple supplements containing the same additive, such as vitamin D or dietary fats – this could create toxic
levels of intake. It is important to involve your veterinarian in deciding on nutraceutical products that are appropriate for your horse.
In addition, products do not always contain what is printed on the label. One study (2006) measured glucosamine levels in 23 commercially available equine oral joint supplements. When comparing the actual glucosamine levels to
the label claim, concentrations were found to range from 221 percent to zero percent. Nine products failed to meet the label claim. Another study (Pearson and Lindinger 2009) reviewed 15 clinical trials involving the joint nutraceutical glucosamine and concluded that the overall quality of evidence for these products was low.
For joint supplements, it is recommended that owners investigate a product via a seven- step ACCLAIM process: Evaluate the product based on:
Nutraceuticals are never a good substitute for good veterinary care.
IS THERE HARM?
We’ve all heard the saying “........... it won’t do any harm.” Yet, as long as many nutraceuticals escape the need to provide full safety and efficacy evidence, this remains a grey area. Trials using both canine and bovine cartilage have shown death of cartilage cells resulting from high doses of glucosamine. In real life such high doses are difficult to achieve, thus requiring further research to identify exactly what is an ideal dose. Also, glucosamine as a glucose-derived substance could exacerbate problems in
a horse with equine metabolic syndrome, pituitary dysfunction, or laminitis.
Nutraceuticals are never a good substitute for good veterinary care. Another potential harm arises when a caring owner spends a fortune on daily supplements and then is
less able to afford veterinary care, proven efficacious and safety-tested medicines, or preventive health care. For instance, an aged horse with severe osteoarthritis more likely benefits from veterinarian-prescribed anti- inflammatory drugs, regular foot trimming, and a warm blanket than from a joint supplement. All health issues should
be managed under the guidance of a veterinary professional.
Good quality feed and a balanced diet are the best things to feed a horse to optimize health. Buy quality hay, pay attention to a horse’s conditioning program and fitness, and implement sound management practices on the farm in consultation with your veterinarian.
A name you know; C linical experience; C ontents;
L abel claims;
A dministrative instructions;
I dentification of lot number; Manufacturer information.
The ACCLAIM process puts added responsibility on consumers to determine whether a product or company is good. That responsibility should be on the manufacturer – by demanding research evidence, the consumer places the responsibility back to the manufacturer where it belongs.
Find a trusted source of information to turn to with questions. Your vet is a great starting point and he or she has access to primary literature and research to help your decision.
VETERINARY VIEWS
A “nutraceutical,” as defined by the Dietary Supplement Health and Education Act of 1994, is a product taken by mouth that contains a ‘dietary ingredient’ intended to supplement the diet.
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