title: Melamine contamination in nutritional supplements--Is it an alarm bell for the general consumer, athletes, and 'Weekend Warriors'?
abstract: BACKGROUND
  Nutritional supplements are used or experimented with by consumers, notably these are; competitive and recreational athletes of all ages, and 'weekend warriors'. As a consequence the supplement industry has grown to meet the increasing demand. A Global Industry Analysts Inc. report indicates that the herbal supplement market has not declined during the worldwide recession, but in fact exhibited steady growth over the period 2008 to 2009. It is anticipated that the market will reach US$93.15 billion by the year 2015. These supplements may contain adulterated substances that may potentially have harmful short - and long-term health consequences to the consumer. "Scrap Melamine" is such an example, which has been implicated in the kidney failure and death of several cats, dogs and pigs. In China in 2008, reports described very severe health effects in infants and young children. At the time over 294,000 infants were screened and diagnosed with urinary tract stones and sand-like calculi associated with melamine in milk products, of which 50,000 infants were hospitalised, and at least six associated deaths, recorded. The extent that melamine contamination occurs in nutritional supplements is not known. Therefore, the aim of this study was to determine whether commercially available nutritional and traditional supplement products contain melamine, even though they are not declared by the manufacturer on the product label.
  
  
  METHODS
  A total of 138 nutritional supplements products were obtained from (i) direct purchases from shops, pharmacies and outlets, (ii) directly from consumers, and (iii) from suppliers, manufacturers and distributors. The products were laboratory analysed for melamine, using Tandem Liquid Chromatography Mass Spectrometry.
  
  
  RESULTS
  Forty-seven % of all the products (n = 138) tested positive for melamine. Eight-two % of the South African produced products (n = 27) tested positive and 58 % of the products imported into South Africa (n = 50) tested positive. The median concentration estimate for melamine in the products tested were, 6.0 μg/g for the 138 supplements tested, 8.9 μg/g for South African produced products, and 6.9 μg/g for products imported into South Africa.
  
  
  CONCLUSIONS
  The melamine (undeclared on product label) levels detected in the nutritional supplements products investigated were within the Tolerable Daily intake (TDI) limit guidelines of 200 μg/g as set by WHO and others. Melamine over exposure within the context of the nutritional supplements consumption in the products investigated should not be of concern to the consumer provided the recommended guidelines of daily product use are adhered to. Further investigation is warranted to determine, (i) the link of melamine as (part) substitute for the perceived total declared protein content on the product label, (ii) cyanuric and uric acid presence in the supplement products that could form chemical-complex formation with melamine and/or analogues that could cause adverse health effects.
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Faculty of Health Sciences, Observatory, Cape Town, 7925, South Africa. gary.gabriels@uct.ac.za.
authors.forename: Gary
authors.initials: G
authors.lastname: Gabriels
authors.affiliation: Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa. mike.lambert@uct.ac.za.
authors.forename: Mike
authors.initials: M
authors.lastname: Lambert
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Faculty of Health Sciences, Observatory, Cape Town, 7925, South Africa. peter.smith@uct.ac.za.
authors.forename: Pete
authors.initials: P
authors.lastname: Smith
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Faculty of Health Sciences, Observatory, Cape Town, 7925, South Africa. lubbe.wiesner@uct.ac.za.
authors.forename: Lubbe
authors.initials: L
authors.lastname: Wiesner
authors.affiliation: Department of Medical BioSciences, University of the Western Cape, Cape Town, South Africa. dhiss@uwc.ac.za.
authors.forename: Donavon
authors.initials: D
authors.lastname: Hiss
mesh_terms: D000821:Animal Feed / Q000032:analysis; D056352:Athletes; D002681:China; D003257:Consumer Product Safety / Q000592:standards*; D019587:Dietary Supplements / Q000592:standards*; D005506:Food Contamination / Q000032:analysis*; D006801:Humans; D019055:No-Observed-Adverse-Effect Level; D013019:South Africa; D014227:Triazines / Q000032:analysis* / Q000592:standards / Q000633:toxicity*; D014944:World Health Organization
chemical_list: D014227:Triazines; C011907:melamine