Natural Health Products in
a Global Marketplace:
Scientific and Regulatory
Perspectives
Joseph M. Betz, Ph.D.
Office of Dietary Supplements
U.S. National Institutes of Health
http://dietary-supplements.info.nih.gov
Overview
Dietary Supplement Overview
Introduction to Regulations
Introduction to National Institutes of Health
Overview of ODS Programs
Dietary Supplements in 2001:
$17.7 Billion
Minerals
Vitamins
$1.2
$5.8
Herbs /
Botanicals
$4.1
Other
Supplements
$3.8
Sports Nutrition
$1.5
Source: NBJ, derived from a variety of sources
Top 10 Dietary Supplements
for 2005
Multivitamins/minerals
Calcium
B vitamins
Vitamin C
Glucosamine/Chondroitin
Vitamin E
Fish oils
Coenzyme Q10
Noni juice
Probiotics
Nutrition Business Journal
Ten Most Common Reasons for Taking
Supplements
(The Slone Survey)
•
•
•
•
•
•
•
•
•
•
•
General health/good for you (16%)
Arthritis (7%)
Memory improvement (6%)
Energy (5%)
Immune booster (5%)
Joints (4%)
Supplement diet (4%)
Sleep aid (3%)
Prostate (3%)
No reason (2%)
All other reasons (45%)
JAMA, 2002
Traditional (Herbal) Medicine in the
U.S.
Practice of medicine and the licensing of
physicians are regulated by the 50
individual states
National laws deal mostly with products
• U.S. Food and Drug Administration (FDA)
FD&C Act
Products
Foods, dietary supplements, or drugs
based on “intended use”
• e.g Psillyium husk can be a food, dietary
supplement or drug
• Applicable regulations for the category apply
Intended use is ascertained by
accompanying labeling claims, advertising
materials, or oral or written statements
Botanical Drugs
Intended use to cure, treat, mitigate, etc.
Subject to current drug regulations
– Pre-market approval for GRASE
Unique qualities recognized by the FDA
– inherently more complex than synthetics
– more likely to be components in mixtures
– active constituents and activity not always well
defined
DSHEA
(Dietary Supplement Health and Education Act - 1994)
• Amended the FD & C Act
• Defined dietary supplements
• Established regulatory framework
• Food and Drug Administration (FDA)
• As foods, not as drugs
• Established rules for what a label should contain
• Gave FDA authority to write GMP
• Called for creation of the Office of Dietary
Supplements
– Placed it in the Office of the Director at the National
Institutes of Health
Dietary Supplement
• “...any product (other than tobacco) that
contains a vitamin, mineral, herb, or other
botanical or amino acid and is intended as
a supplement to the diet.”
• A concentrate, metabolite, constituent, or
combination of the above
– Prior to DSHEA, most botanicals treated as
food additives or as drugs
• Approved, unapproved
Dietary Supplement
 Foods, therefore safe by definition
• No premarket safety approval except “new dietary
ingredients” (75 day notification)
 Statements of Nutritional Support
(“Structure/Function”) claims permitted
• No premarket approval for efficacy required (30 day
notification)
 Disease claims prohibited
 Intended for ingestion
 NOT REPRESENTED AS CONVENTIONAL
FOOD
Guide to Dietary Supplements
http://vm.cfsan.fda.gov/~dms/dietsupp.html
New Dietary Ingredients
• Not marketed in U.S. prior to 10/15/94
• Not a new ingredient:
– If ingredient was “in the food supply… in a
form... not chemically altered”
• No list of “FDA approved” ingredients
• Mfr. Determines whether “new”
– notifies FDA 75 d pre-market
• Exempt from food additive provisions
Dietary Supplements
• 21 CFR Part 111
• Current Good Manufacturing Practice in
Manufacturing, Packaging, Labeling, or
Holding Operations for Dietary
Supplements; Final Rule
• Published June 25, 2007
• http://www.cfsan.fda.gov/~lrd/fr07625a.html
Dietary Supplements
• 21 CFR Part 111
– Requires manufacturers to set specifications
– Requires manufacturers to test to see if
specifications are met using “scientifically
valid” methods
General Provisions
• CGMP applies to activities associated with
–
–
–
–
manufacturing
packaging
holding
distributing
• Manufacturer needs to comply with
requirements applicable to operations performed
– contractor needs to comply with applicable
requirements and
– contracting firm responsible for contractor’s
performance
Proposed Requirement Highlights
•
•
•
•
Personnel
Physical plant internal environment
Equipment and utensils
Production and process controls
– quality control unit
– master manufacturing & batch production records
Public Law 109–462
• Dietary Supplement and Nonprescription
Drug Consumer Protection Act
– http://www.fda.gov/opacom/laws/pl109462.html
– 22 Dec 2006, took effect Dec 2007
• Mandatory Serious Adverse Event Reporting
for OTC drugs and Dietary Supplements
– Manufacturer must provide a mechanism for
reporting (reports to manufacturer)
– Manufacturer must report serious events to FDA
Public Health Security and Bioterrorism
Preparedness and Response Act of
2002
• Signed into law June 12, 2002
• Relevant Provision is Title 3: Protecting
Safety and Security of Food and Drug
Supply.
• Title 3 contains 15 sections with
relevant provisions to the DS industry.
Homeland Security
• SECTION 303: Administrative Detention
– FDA may order the detention of foods when credible
evidence exists that they present a threat of serious
adverse health consequences or death to humans or
animals
• SECTION 305: Registration of Facilities
– Requires that any facility engaged in manufacturing,
processing, packaging or holding food for consumption in
the U.S. register with the Secretary
Homeland Security
• SECTION 414: Maintenance/Inspection of Records
– Companies and individuals involved in any aspect of food
production must make and keep records
– If FDA suspects dangerous adulteration, records must be
made available
• SECTION 307: Prior Notice of Imported Food
Shipments
– Require submission of prior notice of arrival providing
each of the following:
• Identity of: article, manufacturer and shipper, grower,
country of origin, country from which article is shipped,
port of entry
– Articles failing to meet these requirements shall
be refused admission to the U.S
The National Institutes of Health
DSHEA and the NIH
• DSHEA called for creation of the Office of
Dietary Supplements
• Placed at the National Institutes of Health
in the Office of the Director
• Formally established in 1995
• Strategic planning process guided the first
few years of its activities
NIH is the Nation’s Medical Research Agency
• 27 Institutes and Centers
• Total NIH Budget for 2006: $28 billion
• Grants, Contracts, Cooperative Agreements
• Department of Health & Human Services
www.nih.gov
Research
• Intramural- “in-house” at Institutes
• Extramural
– Grants, Cooperative Agreements, Contracts
• http://grants.nih.gov/grants/funding/funding.htm
– More than 80% of the NIH budget
– Subject to competitive review
• Investigator-initiated
• Request for Application (RFA)
The Primary Function of NIH is to
Conduct and Support Medical Research
• 65% Basic Research
• 25% Translational
• 15% Clinical
NIH Funding for Dietary Supplement
Research Has Increased Significantly
$ Million
300
250
200
150
100
50
0
1999 2000 2001 2002 2003 2004 2005
THE OFFICE OF
DIETARY
SUPPLEMENTS
ODS Mission is to Strengthen Knowledge
and Understanding of Dietary Supplements
– Evaluate Scientific Information
– Stimulate and Support Research
– Disseminate Research Results
– Educate the Public to Foster
an Enhanced Quality of Life
and Health for U.S. Population
Echinacea
Echinacea purpurea
Office of Dietary Supplements
FY 2003 $23.0 M
2%
6%
29%
15%
5%
5%
12%
22%
4%
Centers Program
Grants
Databases
Administrative
NHANES
Evidence Program
Analytical Methods
Conferences
Training
ODS Has a Broad Array of Programs
• Co-funding with NIH Institutes
• Evidence-Based Reviews
• Botanical Research Centers
• Training
St. John’s Wort
Hypericum perforatum
• Analytical Methods and Reference
Materials
• Communications and Information
ODS Activities are Comprehensive and
Global
• Dietary Supplement Databases
• Surveys of Supplement Use
• International Collaborations
• Workshops, Conferences, Seminars
Ginkgo
Ginkgo biloba
RESEARCH
AGENDA:
Grants
Co-funded
with NIH ICs
ODS Grant “Portfolio”
 Growth of ODS co-funded grant portfolio:
• 1996: 6 grants initiated, $300,000
• 2002: 39 grants initiated, total of 59 (new and
continuing), $9.3 million
• 2003: total of 72 grants, $13.5 million
 Broad portfolio: basic, clinical, training
 Details available on the ODS website
RESEARCH
AGENDA:
EvidenceBased
Review
Evidence-Based Review Program
• Systematic review of the literature, with
meta-analysis as appropriate, on DS efficacy
and safety
• In collaboration with the Agency for
Healthcare Research and Quality (AHRQ)
Evidence-Based Practice Center Network
• Major reason for conducting these reviews is
to assist NIH in the development of research
agendas
ODS Evidence-Based Review Program
• Chromium and insulin sensitivity*
• Ephedra for weight management and athletic performance
enhancement* (with NCCAM)
• Omega-3 fatty acids for cardiovascular disease prevention*
(with NHLBI) and other health indications
• Health effects of soy (with NCCAM)
• Antioxidant phytochemicals/B vitamins and neurodegenerative
diseases*(with NCCAM)
• Multivitamins/multiminerals and chronic disease prevention
(with OMAR)
• Coagulation, diet, and dietary supplements
• Health effects of vitamin D (with multiple partners)
*Congressional mandate
Evidence
•
•
•
•
•
•
Pre-Clinical
Ecologic
Observational
Cohort
Intervention
RCT
Ephedra Efficacy and Safety
• Systematic review: weight management and
athletic performance enhancement
• All languages, both published and unpublished
• Conclusions:
– Modest effect on weight in short term and no evidence of
effect on athletic performance
– Some side effects seen in trials, some serious adverse
events filed with FDA and to a major ephedra
manufacturer
• Released by Secretary of DHHS, Feb 2003
– Shekelle P et al, JAMA 289:1537-1545, 2003
• ODS and NCCAM convened expert panel to
recommend research agenda based on review
Evidence-Based Review of Vitamin D
in Relation to Bone Health
Conducted by
University of Ottawa
Evidence-Based Practice Centre
Funded by
NIH Office of Dietary Supplements &
Agency for Health Care Research and Quality
Available at
http://www.ahrq.gov/clinic/tp/vitadtp.htm
&
the ODS website
Conference Objectives
 Evaluate available evidence on the efficacy and safety of
vitamin D, using the AHRQ evidence-based review titled,
Effectiveness and Safety of Vitamin D in Relation to
Bone Health as the framework.
 Identify gaps in knowledge on the efficacy and safety of
vitamin D in general and across the life cycle.
.
Findings from the Evidence Based
Review
• Strong evidence that Vitamin D supplementation
reduces falls, fractures and bone loss in men and
women 60+ y
• Not possible to separate the impact of vitamin D
from Ca supplementation— typical amounts used were
700-800 IU Vitamin D/d and 500-1,200 mg Ca/d
• Sparse data on other subgroups
• Difficult to identify a specific blood level of 25(OH) D
indicative of optimal bone health in all population
subgroups
2003 Conference: Vitamin D and Health
in the 21st Century; Bone and Beyond
(NICHD & ODS)
Evidence-based
Review
(AHRQ & ODS)
Standard
Reference
Materials
Vitamin D Status
25-OH D2 and D3
Serum 25-OH D
Measures in
NHANES
(NIST & ODS)
(NCHS, FDA, ODS)
Analytical
Methods
Development
D2 & D3 in Foods &
Dietary Supplements
(USDA & ODS)
Health Effects of Omega-3 Fatty
Acids
• Asthma
• Cancer
•
•
•
•
•
•
•
•
•
Cardiovascular Disease
Cardiovascular Disease Risk Factors
Arrhythmogenic Mechanisms
Child and Maternal Health
Cognitive Function
Eye Health
Type II Diabetes, Rheumatoid Arthritis, and Other Diseases
Mental Health
Organ Transplantation
Omega-3 Fatty Acids
• 11 reports; 3 EPCs
– 9 focused on human studies
– 2 focused on animal and in vitro models
– Collaborated on methodological elements
• Multiple NIH Institutes and Centers
• Multiple diseases and risk factors
Omega-3 Fatty Acids
Or
Photo of Menhaden - Courtesy of National Oceanic and Atmospheric
Administration (NOAA)
Omega-3 and Cancer
• RAND EPC (MacLean CH, JAMA 295:403,
2006)
– Tumor incidence: prospective cohort
studies
– Clinical outcomes: RCTs
– Tumor behavior: animal, cell culture
studies
Omega-3 and Tumor Incidence
• 19 prospective cohorts, 11 cancers
– Breast: 2 significant (1 positive, 1
negative), 5 not significant
– Lung: 2 significant (1 positive, 1 negative),
4 not significant
• Supported by another systematic
review (Hooper L, BMJ 332:752, 2006)
Health Effects of Omega-3 Fatty
Acids
• Secondary CVD Prevention
– Reduces all cause mortality and other
CVD outcomes (sudden death, cardiac
death, MI)
• Primary CVD Prevention
– Large, consistent beneficial effect found
for serum triglyceride levels
– Little or no effect found for other CV
risk factors and markers of CVD
Omega-3 Reports
• Heterogeneous data; challenging
to evaluate
– Methods of estimating fish or
omega-3 fatty acid intake
– Background diets
– Methods of reporting results
• Adverse events from clinical
studies appear to be minor
– However, AERs not reported in a
systematic way
From Concept to Research:
Chromium
Conference (1999)
Evidence-based Review (2000)
Initiative (2001)
Funding (2001-2004)
• Chromium and Insulin Action
• Chromium Enhancement of
Insulin Signaling
• Chromium Effects in Impaired
Glucose Tolerance
• Chromium Picolinate in the
Metabolic Syndrome
• Elucidating the Biochemistry of
Chromium III
• Novel Method for Chromium
Analysis in Biological Fluids
• Adjuvant Therapy for Vascular
Inflammation in Diabetes
Systematic Reviews for Nutrition
Topics
• Applications
–
–
–
–
Research Agenda (NIH)
Clinical Practice (ADA)
Nutrient Recommendations (IOM)
Public Health (Gov’ts)
• Challenges
– Heterogeneity
– Background Diet
– Misgivings
Systematic Reviews for Nutrition
Topics
• Questions Paramount
• Why Do an EBR?
– Vitamin E and Mortality
– Antioxidants and Mortality
• EBRs Inform, but Do Not Dictate
• Keep Them Current
RESEARCH
AGENDA:
Analytical
Methods and
Reference
Materials
Saldahna, LG, Betz, JM, Coates, PM (2004) JAOAC INT 87:162-165
Quality
 Correct plant Slifman et al., NEJM 339, 806-811, 1998
 Correct plant part
 Plant collected at proper time of year
 Pathogen free
 Not filthy or decomposed, not moldy
 Aflatoxin, pesticide, toxic elements within
acceptable range
 No extraneous material-prescription drugs, etc.
 “High quality” raw materials/finished product
• Standardization? Marker Compounds?
• Basic research into bioactive compounds needed
 Product consistency
“The Marketplace”
LA Times
August 31, 1998
“Remedy's U.S. Sales Zoom, but Quality Control Lags St. John's wort:
Regulatory vacuum leaves doubt about potency, effects of herb
used for depression.”
By TERENCE MONMANEY, Times Medical Writer
ConsumerLab.com
December 20, 2002
“1500% Variation Found in Strength of Garlic Supplements: Many
labels not helpful, misleading”
Can J Clin Pharmacol (2003) 10(3):114-118
“Only two products (of 54) were observed to have a total
naphthodianthrone concentrations within 10% of their label claim”
Draves AH, Walker SE
Analytical Methods and
Reference Materials
• Part of original ODS Strategic Plan
• U.S. Senate language for FY 2002, 03
Called for ODS to allocate sufficient
funds to speed up an ongoing
collaborative effort to develop and
disseminate validated analytical methods
and reference materials for the most
commonly used botanicals and other
dietary supplements.
Program Goals
•
Designed to provide opportunities for
public/private partnership
–
–
•
•
•
Establish priorities (botanicals and others)
Identify potential research partners
Develop, validate, share analytical methods
Produce, share reference materials
Applications
–
–
Research: characterization of test substances
Industry: implementation of GMPs/product
formulation
Recommendations
• Pay attention to basic quality issues
– Identity, contaminants
• Accept role of existing frameworks for
methods validation
• Accept recommendations of AOAC DS task
group for prioritization of ingredients
Recommendations
•
•
•
•
•
Consensus process: experts, stakeholders
Proposed a steering committee
Timely output
Program should reward innovation
Define appropriate phytochemical
markers (basic research)
• Emphasis on methods for raw materials
Needs
• New methods
• Validation of methods for reliability,
accuracy, precision
• Calibration standards (reference
chemicals) for methods
• Matrix reference materials for evaluation
of method performance
• All must be publicly available
Strategic Overview
1. Short-term: build the infrastructure to
support development of validated methods
and reference materials;
2. Medium-term: fund development of validated
methods and reference materials using
standard NIH mechanisms;
3. Long-term: make methods and reference
materials readily accessible to the user
community.
Saldahna, Betz, Coates (2004) JOURNAL OF AOAC INTERNATIONAL
87:162-165
Tactical Approach
• Program with 4 major components
–
–
–
–
Methods development
Methods validation
Reference materials development
Outreach/dissemination
• Includes education and training
Accomplishments
• 8 supplement methods have been approved as
first action Official Methods-7 more expected by
March 2008
• Published collaborative studies:
–
–
–
–
–
Ephedrine alkaloids in botanicals/dietary supplements
Ephedrine alkaloids in plasma/urine
Glucosamine in raw materials and finished products
β-carotene in raw materials and finished products2
Flavonol glycosides in Ginkgo biloba raw materials and
finished products
– Campesterol, stigmasterol, and beta-sitosterol in Saw
Palmetto raw materials and finished products
Accomplishments
• 9 Published Single Laboratory Validation
Studies
• 7 single-laboratory validation studies in
progress
• 38 additional ingredients in various stages
of study
Reference Materials
• Reference Materials being developed by the
ODS program:
– Calibration Standards-Single chemical entities
• For construction of calibration curves for quantitative
analysis
• For confirming analyte identity
– Matrix Reference Materials-Systematically
characterized supplement raw materials & finished
products
• Evaluation of analytical methods performance in individual
laboratory settings
– No identity reference materials (for now)
Calibration Standards
• Mix of research and procurement
– National Research Council (NRC)-Panax ginsenoside RM
– Calibration standard production for methods
development
• Echimidine, lycopsamine, n-methyltyramine
– Calibration standards for AOACI validation work
• Hypericin, hyperforin, ginkgolides, etc.
– USP Reference Materials
• Berberine, hydrastine, β-sitosterol, 6-gingerol, shoagol,
eleutherosides B and E, actein, 23-epi-26-deoxyactein,
secoisolariciresinol diglucoside
Matrix Reference Materials
National Institute of Standards & Technology (NIST)
• 5-year project to produce SRMs for 6-8
botanicals-Interagency Agreement (IAG)
– NIST, CFSAN, CDER, ODS collaboration
– Obtain authentic Botanical Reference Materials (BRM)
– Develop and validate analytical methods for actives
and/or markers
– Assign values using the NIST certification approachMeasure with 2 or more methods/labs
– Assign values for heavy metals/pesticides
– Issue NIST Certificate of Analysis
National Institute of Standards &
Technology (NIST)
• Completed
•
•
–
•
•
•
Ephedra
Ω-3’s in cod liver oil RM
Ginkgo biloba
β-carotene (carrot oil)
Bitter orange
Multivitamin/mineral
• 2007
•
•
•
•
•
•
•
Saw palmetto
α-tocopherols
Green tea
Various Vaccinium berries
Ω-3’s in seed oils
Vitamin D in serum
Vitamins B6, B12 in serum
• Acquisitions in progress
(no date available)
• St. John’s wort
• Black cohosh
Future Directions
• Based in part on reviewer recommendations:
– Accelerate methods development/validation by:
• Supporting mechanism for selection, prioritization,
review of methods
• Devoting more resources to direct funding of
laboratory work
• De-emphasizing Official Methods of Analysis
• Concentrating on optimization/Single Laboratory
Validation studies
• Engaging ODS Botanical Centers Program with AMRM
Future Directions
• Provide more resources for development,
optimization, and validation of methods and
materials for nutrient determination in DS
– Systematic review of the state of nutrient
methods
Future Directions
• Provide increased resources for tools that
allow laboratories to demonstrate
proficiency
– Emphasis on evaluation tools for SLV methods
– Expand NIST SRM program
– NIST pilot laboratory proficiency program has
begun and is recruiting participants
• Provide increased resources for tools that
allow stakeholders to use methods
– Calibration standards
Conclusions
• Past 5 years have been a time to identify
stakeholders and build an analytical
community
– Researchers, QA personnel, Contract
Laboratories
– Progress is accelerating
• Supplement Methods published in J AOAC Int:
– 2000-2001-Zero
– 2002-2006-approximately 100
– Challenges remain
• Estimated number of unique products projected by
2010 = 40,000
RESEARCH
AGENDA:
Dietary
Supplement
Ingredient
Database
Database of DS Ingredients
• ODS held workshops with Federal and academic
researchers, and the private sector to explore the
feasibility of developing databases for dietary
supplements
• Considerable research funded by NIH and other
agencies on dietary supplement use
– Depends on accurate measures of intake
• Emerging opportunities for public-private partnership
in meeting research needs
• Published in J Nutrition 133: 573S – 634S, 2003
• Congressional language (’04)
Progress Toward Analytically Supported
Dietary Supplement Database
NHANES
Label-Based
Dietary Supplement
Database
DSID
Dietary Supplement
ingredient Database
at ARS
Goal: Analytically Supported
Dietary Supplement Database
RESEARCH
AGENDA:
Botanical
Research Centers
Congressional Mandate
Botanicals Initiative 1999
“Establish a botanical research initiative
with major research institutions in the
United States.”
Office of Dietary Supplements
National Institutes of Health
National Center for Complementary
and Alternative Medicine
National Institutes of Health
What is a Botanical?
• Whole plants or plant parts (e.g., bark,
leaves, stems, roots, flowers, fruits,
seeds, berries, extracts)
• Medicinal Plants and Foods
Ginger
Zingiber officinale
• Algae and macroscopic fungi
Cranberry
Vaccinium macrocarpon
Flaxseed
Linum usitatissimum
Green Tea
Camellia sinensis
St. John’s Wort
Hypericum perforatum
BRC Program Objectives
• Build Collaborative Research Teams to
Advance Basic Science to Inform Clinical
Studies
– Characterize Chemical Composition and Study
Their Biological Effects
– Develop and Improve Preclinical Model
Systems
• Cultivate the Use of Contemporary
Technologies and Innovative Approaches
• Conduct Clinical Studies (optional)
Echinacea
Echinacea purpurea
Botanical Research Centers
2005 - 2010
• Multidisciplinary Teams
• Emphasis on Quality Assurance/Quality Control
• Studies of Basic Mechanisms
• Identify Active Constituent(s) and Explore
Mechanism(s) of Action
• Clinical Evaluation (optional)
• Thematic Focus With High Public Health Impact
EAC
Research Projects
Administrative
Core
Pilot Studies
Training
P1
P2
P3
Resource Cores
Botany
Plant Sciences
“Chemistry”
Clinical Studies
Biostatistics
Each NIH Botanical Research Center has
its Own Individual Focus
•
University of Illinois at Chicago
– Botanicals for Women’s Health
•
Purdue University/University of Alabama Birmingham/ Rutgers
– Botanicals for Age-Related Diseases
•
Iowa State University/University of Iowa
– Botanicals and Immune Function
Each NIH Botanical Research Center has
its Own Individual Focus
•
Pennington Biomedical Research Center/Rutgers
– Botanicals and Metabolic Syndrome
•
Memorial Sloan Kettering/Cornell/Chinese University Hong Kong
– Botanical Immunomodulators and Cancer
•
Wake Forest/Brigham and Women’s Hospital
– Botanical Lipids and Inflammatory Diseases
Sample Research Questions
• Do Soy Isoflavones Have Beneficial Skeletal Effects in
Postmenopausal Women?
• Can Black Cohosh Alleviate Menopausal Hot Flashes?
• Do Anthocyanins Improve Insulin Sensitivity?
• Does Echinacea have antiviral activity?
Two EB Articles
• Botanicals for age-related diseases: from field
to practice. CM Weaver, S Barnes, JM Wyss,
H Kim, DM Morre, DJ Morre, JE Simon, M Lila,
EM Janie, and MG Ferruzzi
• Technologies and experimental approaches at
the National Institutes of Health Botanical
Research Centers. S. Barnes, DF Birt,
BR Cassileth, WT Cefalu, FH Chilton,
NR Farnsworth, I Raskin, RB van Breemen,
and CM Weaver
Multidisciplinary Research
• Collaborative Effort
• Make Use of Unique Areas of Expertise
• Integrate Activities
• Develop Collegial Environment
• Recognize Individual Contributions
www.nih.gov
RESEARCH
TRANSLATION:
Information
Resources
Information Resources
• Conferences/Workshops
• Research Findings
• Fact Sheets
– Vitamins, minerals, botanicals
• Bibliographic Database
– World literature
– Consumer version
"The secret of being
tiresome is to tell
everything."
-Voltaire