China Works to Regulate the Difference between Food and Traditional Chinese Medicine

Traditional Chinese medicine (TCM) and Chinese food share a good deal in common. This includes not only ingredients, but also combinations of food used as therapies. For example, TCM espouses the consumption of certain specially prepared combinations of foods, considered to be cooling (yin)or heating (yang) foods, to balance forces within the body, maintain health, and treat illness.

TCM is backed by thousands of years of tradition and enjoys the trust of many in China. But it presents challenges for regulators that are seeking to strengthen a system that requires support for the safety and efficacy of drugs on the market and restricts the use of potentially harmful, untested additives in food. For example, Chinese authorities have recently banned poppy capsules because of their opium content, after a high profile story in which a chef was cooking with them in an effort to make his restaurants food addictive.

The latest draft of the Food Safety Law released for public comment in December of 2014 shows that China is increasingly concerned with the addition of drugs to food. Under that draft, those individuals who are directly responsible for a company impermissibly using pharmaceutical additives may be subject to 5-15 days of detention by the Ministry of Public Security.

It should be no surprise then that the National Health and Family Planning Commission (NHFPC), the primary agency for regulating food ingredients, recently issued proposed Administrative Measures on the Catalogue for Substances Traditionally Used in Both and Chinese Medicine (the Measures) to clarify the line between food and drugs. The Agency released the Measures in October 2014, with a deadline for comments ending shortly thereafter.

The Measures establish a catalogue of what substances may be used in both food and TCM. The Measures dictate the conditions for substances to be included in the Catalogue. For example, they must fulfill the requirements for food under the Food Safety Law, as well as be included in the national standards for TCM. They must also be recognized as edible in Chinas Drug Code, and normal use of the substance as a food must not have revealed short- or long-term harms to human health. The Measures also indicate what substances are not permitted to be included, e.g., those have a high rate of adverse events associated with them when used as a drug; those TCM substances that are, by law, protected wild animals or plants; and/or those for which the use might violate national law or not conform to food requirements.

The NHFPC will administer these criteria and amend the Catalogue, releasing proposed revisions for public comment. An amendment will take place when there is new information to consider, whether in the form of a new TCM standard, new adverse events reported, or other information that causes a reevaluation of a given substance or substances. As the NHFPC decides applications for new food ingredients (a separate process), it will consider adding those ingredients to the Catalogue.

While all of this sounds promising for resolving some of the stakeholder confusion that exists in this area, the proposed Catalogue itself (appended to the Measures) is fairly sparse on information. The user gets the Chinese and common English name of the substance, the name of the plant or animal from which it comes, its family or species, and some additional notes about it. But there is very little to indicate under what conditions it may be a food, a drug, or both. And there is little in the way of interpretations of the primary food and drug laws in China that would indicate if and when these categories can overlap. Whats more, while NHFPC primarily decides what can be added to food, the China Food and Drug Administration is in charge of drug ingredients. Yet, for some reason, the Measures do not appear to have been a joint effort between the two agencies.

It is important that Chinese regulators are thinking hard about these lines between overlapping product categories and their related safety issues. However, inclusion in this list, the way it is currently structured, will only answer so many questions, leaving many holes in the regulatory equation for these products.

Well-worded definitions of what constitutes a food and what constitutes a drug and guidance on hybrids would not only answer many of these questions, butthey would also make interpreting catalogues like the one that NHFPC is proposing much easier. Right now there does not seem to be guidance available to accomplish that task.

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China Works to Regulate the Difference between Food and Traditional Chinese Medicine

North Texas Family Medicine Plano Wonderful Five Star Review by Chowderbug W… – Video


North Texas Family Medicine Plano Wonderful Five Star Review by Chowderbug W...
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North Texas Family Medicine Plano Excellent 5 Star Review by Abbey S. – Video


North Texas Family Medicine Plano Excellent 5 Star Review by Abbey S.
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Annual Student Conference for Integrative Medicine (ASCIM 2015) – promo video – Video


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Integrative Medicine Conference: Early Registration Open Now! Interested in whole-person medicine? Come to Student for Integrative Medicine #39;s (SIM) Third Annual Student Conference for Integrativ...

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Why your doctor doesn't always tell you the truth

"Youve got a little bit of a problem down below" means "a grenades gone off in here".

"You may feel a bit of gentle prodding" means "I take a size 18 glove".

"Yes of course Ive done one of these before" means "Ive seen it on ER".

"Youve got a spot on the lung" means "youre going to die".

"Itll get a little worse before it gets a little better" means "youre going to die today".

"Its probably a virus" means "go away".

"Its probably a virus but wed better examine you anyway" means "you have fabulous breasts".

"Take this drug and your risk of death will be slashed by 40pc" means "if you swallow 1,825 of these over five years and at a prescription cost of 500, your risk of death would fall by 0.9pc. The recognised side effects are muscle damage, headache, abdominal pain, nausea, vomiting, hairloss, anaemia, dizziness, depression, nerve damage, hepatitis, jaundice, pancreatitis and hypersensitivity syndrome".

Doctors are human, so we make mistakes, act in our own best interests and give biased advice. One way to inoculate yourself against this is to seek out and understand the scientific evidence behind what we say, rather than taking it at face value. Senseaboutscience.org is a good place to start.

Five doctors often give five different opinions. Are four of them lying or just ill-informed? Remember also that disguising the truth is a two way street. Patients lie to doctors as much as we lie to you.

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Why your doctor doesn't always tell you the truth

Mauro Moscucci, M.D., Appointed Chief of Medicine at Sinai & Medical Director of LifeBridge Health Cardiovascular …

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Newswise Baltimore, MD Mauro Moscucci, M.D., M.B.A., a board-certified specialist in internal medicine, cardiovascular disease and interventional cardiology, has joined LifeBridge Health as chief of medicine for Sinai Hospital and medical director of the LifeBridge Health Cardiovascular Institute.

Dr. Moscuccis clinical expertise, business leadership and commitment to quality patient care make him the ideal person to lead our medical teams now and into the future, says Amy Perry, president of Sinai Hospital and executive vice president of LifeBridge Health.

Moscucci will be leading the advancement of the LifeBridge Health Cardiovascular Institute, a comprehensive center that provides advanced patient-centered care and conducts groundbreaking cardiovascular research at Sinai and Northwest hospitals. The institutes integrated centers and programs are dedicated to preventing, treating and improving outcomes for heart disease, vascular disease and stroke.

This is an exciting time for the LifeBridge Health Cardiovascular Institute. Advances in medicine and technology, as well as new discoveries in genetics, are changing our approach to heart disease. We are committed to building on our strengths to become a destination center for the prevention and treatment of heart disease and related conditions, says Dr. Moscucci.

The LifeBridge Health Cardiovascular Institute is comprised of several centers working in coordination to provide individualized care to patients, including personalized medicine, less invasive treatments and support services.

The Beverly & Jerome Fine Cardiac Valve Center offers a multidisciplinary, individualized approach for patients with heart valve disease. The services include state-of-the-art minimally invasive and traditional valve replacement or valve repair and medical management for patients.

Specialists at the Ben and Zelda Cohen Heart Rhythm Center at Sinai Hospital diagnose and treat heart rhythm conditions, such as arrhythmias. They offer treatments such as cryoablation, using extremely cold temperatures to freeze tiny portions of heart tissue that are not functioning properly.

The Benjamin and Margaret Schapiro Cardiac Diagnostic Center merges the latest in medical technology and patient comfort, and it features five state-of-the-art catheterization labs.

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Overly Conservative FDA Label Likely Prevents Use of Metformin in Many Type 2 Diabetics

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Newswise PHILADELPHIAMany patients with type 2 diabetes in the United States may be discouraged from taking metformina proven, oral diabetes medicinebecause the U.S. Food and Drug Administration inappropriately labels the drug unsafe for some patients also suffering from kidney problems, researchers from Penn Medicine and Weill Cornel Medical College report this week in a research letter published in JAMA Internal Medicine.

Amending the overly conservative FDA labelwhich differs from professional society recommendationscould extend the drugs use in nearly 1 million more diabetic patients with renal impairment, say the studys authors, Sean Hennessy, PharmD, PhD, associate professor of epidemiology in Penns Center for Clinical Epidemiology and Biostatistics, and James H. Flory, MD, MSCE, of the division of Endocrinology at Weill Cornell Medical College.

Certain patients with type 2 diabetes and renal impairment are discouraged from taking metformin to treat their diabetes because of the fear of lactic acidosis, which is too much acid in body that can case acute kidney injury, sepsis, liver failure and heart failure. To determine which patients can handle the drug, the FDA recommends measuring their serum creatinine levels to see if their kidneys are working properlyhigher levels of creatinine are associated with poorer function. If it exceeds 1.4 mg/dL in women or 1.5 mg/dL in men, the FDA recommends against metformin.

But professional societies, such as the American Diabetes Association, say thats not the best measure of renal function, and that the FDA number is too conservative. They recommend taking the estimated glomerular filtration rates (eGFRs), a more modern tool that describes the flow rate of filtered fluid through the kidney. If a patient is above 30 mL/min (which equates to a serum creatinine level of roughly 2 mg/dL), the drug is safe to use. In other words, their kidneys are functioning properly enough to take metformin.

Metformin is the first-line drug that helps control blood sugar levels and is the only drug shown to improve cardiovascular outcomes. There are over 25 million people with type 2 diabetes today in the U.S., nearly 10 million of whom are taking the drug.

For the study, the authors sought to determine if there was gap in care because of the inconsistency between the professional recommendations and the FDA label. They examined data from 2007 to 2012 of patients taking only oral medication from the National Health and Nutrition Survey to assess how much metformin nonuse may be attributable to concern about safety. Serum levels and eGFR were examined as predictors of metformin use.

For patients with eGFRs between 30 and 60 mL/min, at which metformin use is contraindicated by the FDA but supported by professional guidelines, the metformin rates were between 48 and 57 percent. If the FDA relaxed their recommendation, the number of these patients taking metformin might increase by an additional 560,000, the authors report. For patients with GFRs greater than 60 to 90 mL/min, at which renal function is mildly impaired but the serum level is below the FDA cutoff, the rate was 80.6 percent. That could represent 425,000 additional patients on the drug if the FDA amended the label. Such numbers highlight missed opportunities for type 2 diabetic patients, the authors say.

The FDA is overdue to revisit the contraindication to metformin use in patients with mild to moderate renal insufficiency, said Hennessy, which is worsening the care of almost 1 million patients with type 2 diabetes in the U.S.

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Overly Conservative FDA Label Likely Prevents Use of Metformin in Many Type 2 Diabetics