这部名为《补充剂与安全》(Supplements and Safety) 的 FRONTLINE 纪录片，与《纽约时报》联合制作，探讨了美国保健品市场的乱象，主要揭露了保健品行业的缺乏监管，产品质量问题以及对消费者健康的潜在危害。

以下是纪录片中根据时间顺序或因果关系总结的关键事件和信息：

  1. 保健品市场现状 (The Current State of the Supplement Market): 美国保健品市场规模巨大，超过 300 亿美元，一半的美国人每天都服用保健品。该行业从大型制药公司到小型夫妻店都有，产品种类繁多，宣传五花八门。
  2. Purity First 事件 (The Purity First Incident): 保健品公司 Purity First 的产品导致多名消费者出现严重健康问题，例如背痛、性格改变、声音变化、皮肤病以及男性乳房发育 (gynecomastia)。经检测，产品中被发现含有两种类固醇：甲睾酮(Methyltestosterone) 和地塞米松(Dexamethasone)。公司老板 Candice Tripp 将产品污染归咎于生产商 Mira Health Products。
  3. FDA 监管不力 (FDA's Ineffective Regulation): FDA (美国食品药品监督管理局, Food and Drug Administration) 在保健品上市前不进行任何审查，也不强制要求厂商提供产品安全或有效的证据。FDA 只对厂商的生产规范进行检查，但由于资源和信息的限制，检查力度有限。在 Purity First 事件中，FDA 行动迟缓，花了近六个月才将问题产品下架，被 Kenneth Spaeth 博士批评为“极其缓慢(glacial)”。
  4. Mira Health Products 生产问题 (Manufacturing Problems at Mira Health Products): FDA 检查员曾多次发现 Mira Health Products 违反生产规范，但并未采取有效措施。
  5. 保健品掺假问题 (Adulteration of Supplements): 纽约植物园的 David Baker 博士对多种黑升麻 (Black Cohosh) 保健品进行 DNA 检测，发现 30% 的产品不含黑升麻，而是含有来自中国的观赏植物。其他研究也发现锯棕榈 (Saw Palmetto) 和魔鬼爪 (Devil's Claw) 等保健品存在掺假或污染问题。
  6. 保健品行业游说 (Lobbying by the Supplement Industry): 保健品行业在华盛顿拥有强大的游说力量，其中最大的游说团体是天然产品协会 (Natural Products Association, NPA)，其负责人 Daniel Fabricant 曾是 FDA 膳食补充剂部门的负责人。行业游说导致 1994 年《膳食补充剂健康与教育法案》(Dietary Supplement Health and Education Act, DSHEA) 的通过，该法案削弱了 FDA 对保健品的监管力度。
  7. 麻黄事件 (The Ephedra Incident): 麻黄 (Ephedra) 是一种被用于减肥的保健品成分，尽管 FDA 收到大量关于麻黄导致健康问题的投诉，但直到一名棒球运动员 Steve Bechler 因服用麻黄而死后，FDA 才禁止销售含有麻黄的保健品。
  8. 鱼油的氧化问题 (Oxidation Problems with Fish Oil): 研究发现，许多鱼油补充剂中含有高浓度的氧化脂质 (Oxidized Lipids)，这可能对健康有害。
  9. 保健品有效性问题 (The Effectiveness of Supplements): 许多研究表明，大多数保健品对健康并没有明显的益处，甚至可能对健康有害。例如，过量服用维生素 E 会增加患前列腺癌的风险。
  10. DNA 条形码技术 (DNA Barcoding Technology): Steven Newmaster 博士开发的 DNA 条形码技术可以用来鉴定保健品中的成分，帮助消费者识别假冒伪劣产品。纽约州总检察长 Eric Schneiderman 利用该技术对保健品进行检测，发现大量产品存在掺假问题。

This FRONTLINE documentary, Supplements and Safety, co-produced with The New York Times, explores the chaotic landscape of the dietary supplement market in the United States, primarily exposing the industry's lack of regulation, product quality issues, and potential health risks to consumers.

Here's a summary of the key events and information presented in the documentary, organized chronologically or by cause and effect:

  1. The Current State of the Supplement Market: The U.S. supplement market is enormous, exceeding $30 billion, with half of Americans taking supplements daily. The industry ranges from big pharma to mom-and-pop shops, offering a vast array of products with various marketing claims.
  2. The Purity First Incident: Purity First, a supplement company, had its products linked to serious health problems in multiple consumers, including back pain, personality changes, voice changes, skin disorders, and gynecomastia (development of male breasts). Testing revealed the presence of two steroids: Methyltestosterone and Dexamethasone. The company owner, Candice Tripp, blamed the contamination on the manufacturer, Mira Health Products.
  3. FDA's Ineffective Regulation: The FDA (Food and Drug Administration) does not review dietary supplements before they enter the market, nor does it require manufacturers to provide evidence of product safety or effectiveness. The FDA only inspects manufacturing practices, but these inspections are limited by resources and information. In the Purity First case, the FDA's response was slow, taking nearly six months to remove the problematic product from the market, a response criticized by Dr. Kenneth Spaeth as "glacial."
  4. Manufacturing Problems at Mira Health Products: FDA inspectors cited Mira Health Products multiple times for violating manufacturing codes, yet effective action was not taken.
  5. Adulteration of Supplements: Dr. David Baker at the New York Botanical Garden conducted DNA testing on various Black Cohosh supplements and found that 30% contained no Black Cohosh but instead contained ornamental plants from China. Other studies also found adulteration or contamination problems in supplements like Saw Palmetto and Devil's Claw.
  6. Lobbying by the Supplement Industry: The supplement industry wields significant lobbying power in Washington. The largest lobbying group, the Natural Products Association (NPA), is headed by Daniel Fabricant, the former head of the FDA's dietary supplements division. Industry lobbying led to the passage of the 1994 Dietary Supplement Health and Education Act (DSHEA), which weakened the FDA's regulatory authority over supplements.
  7. The Ephedra Incident: Ephedra, a supplement ingredient used for weight loss, was linked to numerous health complaints reported to the FDA. However, it wasn't until the death of a young baseball player, Steve Bechler, that the FDA banned the sale of supplements containing Ephedra.
  8. Oxidation Problems with Fish Oil: Studies have revealed that many fish oil supplements contain high levels of oxidized lipids, which can be harmful to health.
  9. The Effectiveness of Supplements: Numerous studies suggest that most supplements offer no clear health benefits and may even be harmful. For example, excessive vitamin E intake can increase the risk of prostate cancer.
  10. DNA Barcoding Technology: Dr. Steven Newmaster developed DNA barcoding technology that can be used to identify ingredients in supplements, helping consumers detect fake or adulterated products. New York Attorney General Eric Schneiderman utilized this technology to test supplements, uncovering widespread adulteration.