Person:

Cohen, Pieter

The prevalence of schistosomiasis and strongyloidiasis among Brazilian immigrants in the United States is unknown. We performed a retrospective chart review of serologic screening of asymptomatic Brazilian immigrants during routine physicals. Of 208 eligible patients, 189 were screened: 27.7% (n = 52) had elevated Schistosoma antibodies and 5.8% (n = 11) had elevated Strongyloides stercoralis antibodies.

For centuries, people have consumed live bacteria in many foods, such as yogurt, cheese, kimchi, and sauerkraut. The mass-marketing of isolated live bacteria for their purported beneficial or “probiotic” properties, however, is a relatively recent phenomenon. The World Health Organization defines probiotics as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” Yet to be sold as a probiotic supplement in the United States, a live microorganism does not require evidence of efficacy or even safety.

Background: Higenamine is a stimulant with cardiovascular properties recently prohibited in sport by the World Anti-Doping Agency (WADA). Higenamine is also a natural constituent of several traditional botanical remedies and is listed as an ingredient in weight loss and sports supplements sold over-the- counter in the United States. Objectives: We analyzed dietary supplements available for sale in the United States prior to WADA’s prohibition of higenamine in sport for the presence and quantity of higenamine. Methods: All supplements labeled as containing higenamine or a synonym (i.e., norcoclaurine or demethylcoclaurine) available for sale in the United States were identified. For each brand, one sample was analyzed by NSF International (Ann Arbor, MI) and one sample by the Netherland’s National Institute for Public Health and the Environment (RIVM). NSF International carried out qualitative and quantitative analyses using ultra high performance liquid chromatography (UHPLC) with tandem mass spectrometry. RIVM carried out qualitative analysis using UHPLC quadrupole time of flight mass spec- trometry for an independent confirmation of identity. Results: Twenty-four products were analyzed. The majority of supplements were marketed as either weight loss (11/24; 46%) or sports/energy supplements (11/24; 46%); two brands did not list a labeled indication. The quantity of higenamine (±95% CI) ranged from trace amounts to 62±6.0mg per serv- ing. Consumers could be exposed to up to 110 ± 11 mg of higenamine per day when following recom- mended serving sizes provided on the label. Five products (5/24; 21%) listed an amount of higenamine, but none were accurately labeled; the quantity in these supplements ranged from <0.01% to 200% of the quantity listed on the label. Conclusion: Dosages of up to 62 ± 6.0 mg per serving of the stimulant higenamine were found in diet- ary supplements sold in the United States.