In France, nearly 20 years after implementation of the 2002 European Directive covering the use of food supplements, the quantities consumed and their diversity continue to increase. Community pharmacies are the main distributors, with increasing competition from internet marketing websites. A 2002 European Directive, implemented in France in 2006, defined three procedures to market food supplements, depending on whether or not the ingredients were already marketed in France or the European Union. Several thousands of requests per year involve ingredients which were marketed in the European Union but not in France. As of the end of 2020, apart from a European list of vitamins and minerals, most ingredients are authorised at the national level, particularly plantbased products and essential oils, with notable differences between member states. In France, the system for authorisation of food supplements, overseen by the French General Directorate for Competition Policy, Consumer Affairs and Fraud Control (DGCCRF), lacks rigour in terms of public protection, particularly with respect to new ingredients which are already marketed in another member state. The information available to consumers in France regarding food supplements is inadequate and difficult to find. It is spread across a range of ministerial decrees, which are updated on the basis of recommendations from the DGCCRF. As of early 2021, there is no French or European public database for use by consumers and healthcare professionals listing either authorised ingredients, with their conditions and possible restrictions on use, or prohibited and dangerous ingredients. The manufacturers of food supplements are subject to very few requirements regarding information. They are not routinely required to provide a contents information leaflet as defined by a responsible authority. Labelling has to conform to the requirements for foodstuffs but not health products. Marketing is not based on any evaluation providing official information. Health claims put forward by manufacturers for some food supplements make them appear to be medicinal products, whereas they are not subject to the safeguards which apply to medicines. Health claims are checked at the European level, but this requirement may be circumvented for plants if they have a recognised traditional use. Several factors can lead to major confusion between food supplements and drugs, including similarity of formulations and packaging, exaggerated health claims, suggestive brand names, and media publicity. There is a growing track record of adverse effects, sometimes involving serious disorders. A large number of safety signals increasingly indicate the need for more caution, whereas the benefit of taking food supplements remains uncertain. The food supplement market is growing, including on the internet. Healthcare professionals have a role to play in urging caution and, together with patients, raising questions as to their real benefit, their uncertain effects and their dangers. It is crucial to contribute to adverse effect reporting in order to better protect consumers.
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