Nahrungsergänzungsmittel: Bedeutung in der ärztlichen Praxis

2018 ◽  
Vol 143 (10) ◽  
pp. 722-729 ◽  
Author(s):  
Nadiya Bakhiya ◽  
Klaus Richter ◽  
Rainer Ziegenhagen ◽  
Karen Hirsch-Ernst ◽  
Alfonso Lampen

AbstractFood supplements in Europe are subject to food safety legislation. They should not be confused with pharmaceuticals. Rather, they are foods, whose purpose is to supplement the normal diet, and represent concentrated sources of nutrients (i. e. vitamins and minerals, including trace elements) or other substances with a nutritional or physiological effect. Nevertheless, it should be kept in mind that consumers may in some cases use food supplements for the purpose of self-medication. In the context of anamnesis, physicians should specifically question their patients about the use of food supplements. This can be of significant relevance for evaluation of possible undesirable or adverse effects, influences on laboratory parameters, or interactions with pharmaceuticals, which may be due to consumption of certain products that are marketed as food supplements. Furthermore, education of patients with respect to the possible benefits and risks related to the use of vitamins, minerals and other constituents of food supplements should be intensified.

Author(s):  
Martinus Løvik ◽  
Livar Frøyland ◽  
Margaretha Haugen ◽  
Sigrun Henjum ◽  
Kristin Holvik ◽  
...  

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements and energy drinks sold in Norway. VKM has assessed the risk of doses given by NFSA. These risk assessments will provide NFSA with the scientific basis while regulating "other substances" in food supplements. "Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional and/ or physiological e ffect. It is added mainly to food supplements, but also to energy drinks and other foods. In this series of risk assessments of "other substances" the VKM has not evaluated any claimed beneficial effects from these substances, only possible adverse effects. The present report is a risk assessment of specified doses of L-threonine in food supplements, and it is based on previous risk assessments and articles retrieved from literature searches. According to information from NFSA, L-threonine is an ingredient in food supplements sold in Norway. NSFA has requested a risk assessment of 1000, 1200, 1500, 2000 and 2400 mg/day of L-threonine from food supplements.  L-threonine is an essential amino acid not known to cause any adverse health effects. Previous reports do not indicate a tolerable upper intake level, apart from an approval of a dose of 1150 mg/day by the Scientific Committee of the Spanish Agency for Food Safety and Nutrition (AESAN). Long-term studies in humans were not found. The only available human studies were: a small uncontrolled one-year pilot study with doses ranging from 0.5 to 2.5 g/day, one eight-week randomised controlled trial (RCT) using a dose of 7.5 g/day, and two 2-week RCTs using doses of 6 and 4.5 g/day. No adverse effects (diary method of registration of adverse effects) were reported in the eight-week clinical trial, and the only adverse effects observed in the two-week trials were one case of indigestion and one case of diarrhoea. A four-week rodent toxicity study indicated a no observed adverse effect level (NOAEL) of 854.3 mg/kg bw per day (only dose tested, no adverse effects observed).  The value used for comparison with the estimated exposure in the risk characterisation is the NOAEL defined in an 8-week randomised placebo controlled study in humans, 7500 mg/day. For a 70-kg individual, this corresponds to 107 mg/kg bw per day. Two human two-week studies and a small one-year pilot study support the notion that this dose will be well tolerated. The overall mean threonine intake according to NHANES III (3 g/day) is slightly larger than the doses requested for evaluation in the present risk assessment. No studies in children (10 to <14 years) and adolescents (14 to <18 years) were identified. Based on the included literature there was no evidence indicating that age affects the tolerance for relevant doses of threonine. Therefore, in this risk characterisation a tolerance as for adults, based on body weight, was assumed for these age groups. VKM concludes that: In adults (≥18 years), the specified doses 1000, 1200, 1500, 2000 and 2400 mg/day L-threonine in food supplements are unlikely to cause adverse health effects. In adolescents (14 to <18 years), the specified doses 1000, 1200, 1500, 2000 and 2400 mg/day L-threonine in food supplements are unlikely to cause adverse health effects. In children (10 to <14 years), the specified doses 1000, 1200, 1500, 2000 and 2400 mg/day L-threonine in food supplements are unlikely to cause adverse health effects. Children younger than 10 years were not within the scope of the present risk assessment.


Author(s):  
Tor A. Strand ◽  
Livar Frøyland ◽  
Margaretha Haugen ◽  
Sigrun Henjum ◽  
Kristin Holvik ◽  
...  

"Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional and/or physiological effect, and may be added to food supplements or e.g. energy drinks. In the series of risk assessments of "other substances" the VKM has not evaluated any claimed beneficial effects from these substances, but merely possible adverse effects at specified doses used in Norway.  This statement regards the substance L-methionine per se, and no specific products. According to information from the Norwegian Food Safety Authority (NFSA), L-methionine is an ingredient in food supplements sold in Norway. NFSA has requested a risk assessment of the intake of 200, 300, 500, 600 and 700 mg L-methionine per day from food supplements. The total L-methionine exposure from other sources than food supplements is not included in the risk assessment. This statement is based on a previous risk assessment from VKM of L-methionine, as well as scientific papers retrieved from a systematic search in literature published from 2012 up till 19 February 2016. The literature search aimed at retrieving human studies on adverse effects caused by L-methionine. VKM concludes that: VKM maintains the guidance level from 2013 at 210 mg methione per day.


Author(s):  
Siamak Yazdankhah ◽  
Danica Grahek-Ogden ◽  
Karl Eckner ◽  
Georg Kapperud ◽  
Jørgen Lassen ◽  
...  

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements sold in Norway. These risk assessments will provide NFSA with the scientific basis for regulation of the addition of “other substances” to food supplements and other foods. "Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional and/or physiological effect. It is added mainly to food supplements, but also to other foods. VKM has not in this series of risk assessments of "other substances" evaluated any claimed beneficial effects from these substances, only possible adverse effects. The present report is a risk assessment of Bifidobacterium lactis Bi-07, Bifidobacterium bifidum W23, Bifidobacterium longum Rosell-175, Bifidobacterium breve Rosell-70, and Bifidobacterium animalis sub. lactis Bb12 based on previous risk assessments and also publications retrieved from literature search. The risk of the Bifidobacterium strains listed above was assessed for the general population. However, in previous assessments of probiotics published by VKM, concerns have been identified for specific groups. Therefore, the risk was assessed for the age group with immature gastro-intestinal microbiota (age group 0-36 months), population with mature gastro-intestinal microbiota (>3 years) and vulnerable groups with mature gastro-intestinal tract. VKM has also assessed the risk of Bifidobacterium spp. in food supplements and other foods independent of the dose and have assessed exposure in general terms. VKM concludes that it is unlikely that B. lactis Bi-07, B. bifidum W23, B. longum Rosell-175, B. breve Rosell-70, and B. animalis sub. lactis Bb12 would cause adverse health effects in the general healthy population with mature gastro-intestinal tract. However, no data on long-term adverse effects on infants and young children were identified. As evidence is accruing that the early microbial composition of the neonatal gut is important for the development of the gut microbiota and the immune system of the growing child, it is not possible to exclude that a daily supply of a single particular bacterial strain over a prolonged period of time to an immature gastro-intestinal tract may have long-term, although still unknown, adverse effects on that development.


Author(s):  
Livar Frøyland ◽  
Margaretha Haugen ◽  
Sigrun Henjum ◽  
Kristin Holvik ◽  
Martinus Løvik ◽  
...  

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements and energy drinks sold in Norway. VKM has assessed the risk of doses given by NFSA. These risk assessments will provide NFSA with the scientific basis for regulating the addition of "other substances" to food supplements and other foods. "Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional or physiological effect. It is added mainly to food supplements, but also to energy drinks and other foods. VKM has not in this series of risk assessments of "other substances" evaluated any claimed beneficial effects from these substances, only possible adverse effects. The present report is limited to the use of L-tyrosine in food supplements. Risks related to tyrosine added to food and drinks, protein hydrolysates or high dietary protein intake are outside the scope of the opinion. The report is based on previous risk assessments of tyrosine and scientific papers retrieved from a comprehensive literature search. L-tyrosine, an aromatic amino acid, is considered a conditionally indispensable amino acid because it can be synthesised from L-phenylalanine in the liver. The magnitude of endogenous synthesis of L-tyrosine is not known, but is related to the intake of phenylalanine. L-tyrosine is a precursor of several biologically active substances, including catecholamine neurotransmitters, thyroid hormones and melanin skin pigments. L-tyrosine is available from all protein-containing foods such as meat, eggs, fish, dairy products, grains and pulses. According to information from the NFSA, L-tyrosine is an ingredient in food supplements sold in Norway. The NFSA has requested a risk assessment of the following doses of L-tyrosine food supplements: 1250 mg/day, 1500 mg/day, 1750 mg/day, and 2000 mg/day. Dietary intake of tyrosine in Norway is not known, but data from NHANES III (USA) suggest a mean dietary intake of about 2.8 g per day. In phase 1 seven previous reports that assessed the safety of L-tyrosine supplementation in humans were identified. For the present report, a literature search was performed to retrieve relevant human or animal studies on the safety of L-tyrosine. One relevant animal study assessing the toxicity of tyrosine by feeding rats different doses of tyrosine daily by oral gavage for 13 weeks was identified. No human studies have been identified. No major specific issues related to adverse effects from L-tyrosine used as food supplements were identified in previous reports. However, a lack of studies in healthy adult individuals as well as in children was pointed out, and in particular the absence of long-term studies in healthy individuals.  A lowest observed adverse effect level (LOAEL) and a no observed adverse effect level (NOAEL) of 2000 and 600 mg/kg bw per day, respectively, for tyrosine have been identified in a 90-day toxicological study in rats. At 2000 mg/kg bw per day, significant increases, were found in weights of livers and kidneys in addition to increased plasma lipids and hypertrophy of centrilobular hepatocytes in both sexes. The NOAEL at 600 mg/kg per day was used to calculate the margin of exposure (MOE), the ratio of the NOAEL to the specified doses of 1250, 1500, 1750 and 2000 mg/day of Ltyrosine in food supplements. The MOE-values range from 13 for the highest supplement dose in children to 34 for the lowest supplement dose in adults. Given the low MOE-values (range 13-34), and the severity of the adverse effects at the LOAEL (3.3 times the NOAEL), VKM concludes that all the specified doses may represent a risk of adverse effects. No evidence was found to assume specific tolerance levels for L-tyrosine for children or adolescents. Therefore, a similar tolerance as for adults relative to body weight was assumed for these age groups.  Based on these data, the Norwegian Scientific Committee for Food Safety (VKM) concludes that: In adults (≥18 years), the specified doses of 1250, 1500, 1750, and 2000 mg/day Ltyrosine in food supplements may represent a risk of adverse health effects. In adolescents (14 to <18 years), the specified doses of 1250, 1500, 1750, and 2000 mg/day L-tyrosine in food supplements may represent a risk of adverse health effects. In children (10 to <14 years), the specified doses of 1250, 1500, 1750, and 2000 mg/day L-tyrosine in food supplements may represent a risk of adverse health effects. Children below 10 years were not included in the terms of reference.


Author(s):  
Livar Frøyland ◽  
Margaretha Haugen ◽  
Kristin Holvik ◽  
Martinus Løvik ◽  
Tor A. Strand ◽  
...  

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements and energy drinks sold in Norway. VKM has assessed the risk of doses given by NFSA. These risk assessments will provide NFSA with the scientific basis while regulating the addition of "other substances" to food supplements.  "Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional and/or physiological effect. It is added mainly to food supplements, but also to energy drinks and other foods. VKM has not in this series of risk assessments of "other substances" evaluated any claimed beneficial effects from these substances, only possible adverse effects.  The present report is a risk assessment of L-phenylalanine and DL-phenylalanine and is based on previous risk assessments. According to information from the Norwegian Food Safety Authority, L- and DL-phenylalanine are ingredients in food supplements sold in Norway. NFSA has requested a risk assessment of the following doses of L-phenylalanine and DL-phenylalanine in food supplements: L-phenylalanine 100, 250, 500, 750 and 1000 mg/day and DL-phenylalanine 50 and 75 mg/day.  L-phenylalanine is an essential amino acid which means it has to be obtained from the diet. Amino acids are building blocks for proteins and present in protein rich food such as milk, meat, fish, eggs and cheese.  No data on adverse health effects after chronic ingestion of supplemental phenylalanine in apparently healthy subjects are available, thus no tolerable upper intake level (UL) can be established. Patients with phenylketonuria (PKU), a genetic disorder that impairs phenylalanine hydroxylase (PAH), an enzyme involved in the metabolism of phenylalanine, must keep plasma levels of phenylalanine low in order to maintain normal growth and brain development. In Norway, all newborns are routinely screened for PKU three days after birth.  The mean dietary intake of phenylalanine in the EU population range from 0.4-4.1 g/day corresponding to 79.0 mg/kg bw per day for adolescents (10-17 years) and 58.7 mg/kg bw per day for adults, respectively (EFSA, 2013). The sweetener aspartame contains phenylalanine. Taking the molecular weight of phenylalanine into account, the proportion of to phenylalanine exposure from aspartame is 56%. The ADI of 40 mg aspartame/day/kg bw (providing 22.4 mg phenylalanine/day/kg bw) JECFA (1981) was re-evaluated and maintained in 2013, based on the notion that elevated plasma levels of phenylalanine in pregnant women leads to developmental toxicity in their children (EFSA, 2013).  The literature search did not provide novel information on adverse health effects related to intake of L-phenylalanine and no information related to DL-phenylalanine.  VKM concludes that:  In adults (≥ 18 years), the specified doses 100, 250, 500, 750 and 1000 mg/day L-phenylalanine in food supplements are considered unlikely to cause adverse health effects. In adolescents (14 to < 18 years), the specified doses 100, 250, 500, 750 and 1000 mg/day L-phenylalanine in food supplements are considered unlikely to cause adverse health effects. In children (10 to < 14 years), the specified doses 100, 250, 500, 750 and 1000 mg/day L-phenylalanine in food supplements are considered unlikely to cause adverse health effects. Although the highest dose provides 23 mg/kg bw per day which slightly exceeds 22.4 mg/kg bw per day, it is considered unlikely to cause adverse health effects in healthy children 10 to < 14 years. None of the above conclusions are applicable for patients with phenylketonuria (PKU). No conclusion can be made regarding DL-phenylalanine.  Children below 10 years were not included in the terms of reference.


2016 ◽  
Vol 62 (4) ◽  
pp. 97-106 ◽  
Author(s):  
Justyna Baraniak ◽  
Radosław Kujawski ◽  
Marcin Ożarowski

Summary Food supplements are concentrated sources of nutrients and/or other substances with a nutritional or physiological effect. However, they often contain herbal substances or their preparations. Food supplements belong to category of food and for that reason are regulated by food legislation. European Union regulations and directives established general directions for dietary supplements, dietetic food, which due to their special composition or manufacturing process are prepared for specific groups of people with special nutritional needs, and novel food/novel food ingredients to ensure product safety, suitability and appropriate consumer information.


Author(s):  
Siamak Yazdankhah ◽  
Danica Grahek-Ogden ◽  
Karl Eckner ◽  
Georg Kapperud ◽  
Jørgen Lassen ◽  
...  

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements sold in Norway. These risk assessments will provide NFSA with the scientific basis for regulation of the addition of “other substances” to food supplements and other foods. "Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional and/or physiological effect. It is added mainly to food supplements, but also to other foods. VKM has not in this series of risk assessments of "other substances" evaluated any claimed beneficial effects from these substances, only possible adverse effects. The present report is a risk assessment of Lactobacillus rhamnosus Rosell-11 ND, Lactobacillus rhamnosus W71, Lactobacillus rhamnosus GG and Lactobacillus rhamnosus Lr-329 based on previous risk assessments and also publications retrieved from literature search. The risk of the Lactobacillus strains listed above was assessed for the general population. However, in previous assessments of probiotics published by VKM, concerns have been identified for specific groups. Therefore, the risk was assessed for the age group with immature gastro-intestinal microbiota (age group 0-36 months), population with mature gastro-intestinal microbiota (>3 years) and vulnerable groups with mature gastro-intestinal tract. VKM has also assessed the risk of L. rhamnosus Rosell-11 ND, L. rhamnosus W71, L. rhamnosus GG and L. rhamnosus Lr-329 in food supplements and other foods independent of the dose and have assessed exposure in general terms. VKM concludes that it is unlikely that L. rhamnosus Rosell-11 ND, L. rhamnosus W71, L. rhamnosus GG and L. rhamnosus Lr-329 would cause adverse health effects in the general healthy population with mature gastro-intestinal tract. However, no data on long-term adverse effects on infants and young children were identified. As evidence is accruing that the early microbial composition of the neonatal gut is important for the development of the gut microbiota and the immune system of the growing child, it is not possible to exclude that a daily supply of a single particular bacterial strain over a prolonged period of time to an immature gastro-intestinal tract may have long-term, although still unknown, adverse effects on that development.


2018 ◽  
Vol 12 (2) ◽  
pp. 13-17
Author(s):  
Przemysław Kardas ◽  
Jakub Dorożyński ◽  
Paula Zdanowicz ◽  
Dawid Tyrna ◽  
Paulina Lis ◽  
...  

Background: Dietary supplements (DSs) are concentrated sources of nutrients and/or other substances, whose purpose is to supplement the normal diet. Their consumption in Poland has been on the rise, leading to numerous concerns. However, current legislation does not provide any background for a relevant pharmacovigilance system. Therefore, little is known about their adverse effects (AEs) or patterns of use in Poland. To shed some light on this, we conducted a nationwide survey. Aim of the study: To assess the prevalence of, and the reasons for, the use of dietary supplements in Poland via national survey with a collection and an analyse of supposed adverse effects of dietary supplements. Material and methods: The study was conducted using an online survey based on the original questionnaire. In this report, we present the results of the analysis of the first 200 responses. Results: As many as 55.5% (111) of respondents were ‘definitely sure’ or ‘rather sure’ about DSs safety. However, 70.5% (141) believed that they could have negative effects. Over 3/4 (153) of respondents used DSs themselves, and 61.0% (122) used them within last 12 months. Of those using DSs, 11.1% (17) reported diverse AEs, with GI tract irritation and mental disturbances being the most common (experienced by 35.3% (6), and 17.6% (3) of those reporting AE s, respectively). Conclusions: Respondents had mixed feelings about DS safety. Despite that, they used these products frequently. Of a note is high incidence of adverse effects experienced by DS users. This undoubtedly points to the need for a relevant pharmacovigilance system.


Author(s):  
Siamak Yazdankhah ◽  
Danica Grahek-Ogden ◽  
Karl Eckner ◽  
Georg Kapperud ◽  
Jørgen Lassen ◽  
...  

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements sold in Norway. These risk assessments will provide NFSA with the scientific basis for regulation of the addition of “other substances” to food supplements and other foods. "Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional and/or physiological effect. It is added mainly to food supplements, but also to other foods. VKM has not in this series of risk assessments of "other substances" evaluated any claimed beneficial effects from these substances, only possible adverse effects. The present report is a risk assessment of Lactobacillus acidophilus W37, Lactobacillus acidophilus DDS-1, Lactobacillus acidophilus La-5 and Lactobacillus acidophilus La-14 based on previous risk assessments and also publications retrieved from literature search. The risk of the Lactobacillus strains listed above was assessed for the general population. However, in previous assessments of probiotics published by VKM, concerns have been identified for specific groups. Therefore, the risk was assessed for the age group with immature gastro-intestinal microbiota (age group 0-36 months), population with mature gastro-intestinal microbiota (>3 years) and vulnerable groups with mature gastro-intestinal tract. VKM has also assessed the risk of L. acidophilus W37, L. acidophilus DDS-1, L. acidophilus La-5 and L. acidophilus La-14 in food supplements and other foods independent of the dose and have assessed exposure in general terms. VKM concludes that it is unlikely that L. acidophilus W37, L. acidophilus DDS-1, L. acidophilus La-5 and L. acidophilus La-14 would cause adverse health effects in the general healthy population with mature gastro-intestinal tract. However, no data on long-term adverse effects on infants and young children were identified. As evidence is accruing that the early microbial composition of the neonatal gut is important for the development of the gut microbiota and the immune system of the growing child, it is not possible to exclude that a daily supply of a single particular bacterial strain over a prolonged period of time to an immature gastro-intestinal tract may have long-term, although still unknown, adverse effects on that development.


Author(s):  
Sigrun Henjum ◽  
Livar Frøyland ◽  
Margaretha Haugen ◽  
Kristin Holvik ◽  
Martinus Løvik ◽  
...  

The Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) has, at the request of the Norwegian Food Safety Authority (Mattilsynet; NFSA), assessed the risk of "other substances" in food supplements and energy drinks sold in Norway. VKM has assessed the risk of doses given by NFSA. These risk assessments will provide NFSA with the scientific basis while regulating "other substances" in food supplements. "Other substances" are described in the food supplement directive 2002/46/EC as substances other than vitamins or minerals that have a nutritional and/ or physiological effect. It is added mainly to food supplements, but also to energy drinks and other foods. In this series of risk assessments of "other substances" the VKM has not evaluated any claimed beneficial effects from these substances, only possible adverse effects. The present report is limited to the use of L-lysine in food supplements. Risks related to lysine added to food and drinks, protein hydrolysates or high dietary protein intake are outside the scope of the opinion. The report is based on previous risk assessments of lysine and scientific papers retrieved from a comprehensive literature search. According to information from the NFSA, L-lysine is an ingredient in food supplements sold in Norway. NSFA has requested a risk assessment of 1000, 2000, 2500, 2750 and 3000 mg/day of L-lysine from food supplements. Foods rich in L-lysine are generally protein rich foods such as meat, dairy products, eggs, legumes, and some fish. Based on NHANES III (19881994), the overall mean intake of L-lysine from food and food supplements in the United States was 5.3 g/day (IOM, 2005). L-Lysine, an indispensable amino acid, is present in all proteins in the human body. Its catabolisation takes place mainly in the liver. The two nitrogen groups are transferred to alpha-ketoglutarate to form glutamate. The remaining carbon skeleton is broken down to acetoacetyl-CoA. Lysine is exclusively ketogenic i.e. does not enter gluconeogenesis for the production of glucose. In the first phase of the present evaluation of L-lysine, previous reports evaluating the safety of L-lysine supplementation in humans were identified. In the second phase, two systematic literature searches have been performed to retrieve scientific papers published before 11 May 2016 (human studies literature search) and before 28 September 2016 (animal studies literature search). Based on these searches, we identified two human studies and one study in rats that could be used for risk assessment of L-lysine in food supplement. According to a report from the Institute of Medicine in the USA (IOM, 2005), several clinical trials of lysine with intakes ranging from 0.6 to 3.0 g/day for 3 to 6 months have not reported any adverse effects. The same was the case for the two human randomised controlled trials (RCTs) included in this report providing 6 g/day L-lysine orally for 8 weeks to schizophrenic patients. One 90-days subchronic toxicity study with rats was identified, showing a no observed adverse effect level (NOAEL) of 3357 mg/kg bw per day (the highest dose tested), with no functional, biochemical or histological changes in renal function. In the present report, the value of comparison is set to 86 mg/kg bw per day, corresponding to 6000 mg per day in a 70 kg adult; the daily dose provided in the two human RCTs. The calculated margins of exposures (MOE-values) range from 1.2 to 6.0 for the specified supplement doses with 1000-3000 mg/day of L-lysine. MOE-values below 10 (for interindividual differences in humans) is regarded as acceptable since L-lysine is a nutrient that does not cause any known adverse effects. In addition, the overall mean lysine intake according to NHANES III (5.3 g/day) is close to the the doses considered in the present risk assessment. The requirement for lysine, 30 mg/kg bw per day, corresponding to 2.1 g/day in a 70 kg adult, is close to the doses considered in the present risk assessment. The NOAEL suggested in the 90 days subchronic rat study supports the suggestion that these doses are well tolerated in humans even with somewhat low MOE-values. VKM concludes that: In adults (≥18 years), the specified doses 1000, 2000, 2500, 2750 and 3000 mg/day L-lysine in food supplements are unlikely to cause adverse health effects. In adolescents (14 to <18 years), the specified doses 1000, 2000, 2500, 2750 and 3000 mg/day L-lysine in food supplements are unlikely to cause adverse health effects. In children (10 to <14 years), the specified doses 1000, 2000, 2500, 2750 and 3000 mg/day L-lysine in food supplements are unlikely to cause adverse health effects. Children younger than 10 years were not within the scope of the present risk assessment.


Sign in / Sign up

Export Citation Format

Share Document