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127 Causality is difficult to prove, because herbal and dietary supplements are often dispensed without medical supervision, FDA oversight of product quality is minimal, multiple active ingredients contribute to product variability, and product contamination with hepatotoxic substances (toxic herbs or heavy metals) may occur.127, 128, 129 Drug interactions between herbal and dietary supplements and prescription medications may also occur, because medicinal plants can have effects on hepatic P450 enzyme systems

10.1016/j.neuro.2017.11.008 189 PajarilloE.JohnsonJ.RizorA.Nyarko-DanquahI.AdinewG.BornhorstJ.et al (2020a)

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18 Furthermore, a study by Hu & Malik containing 6,000 adult subjects showed a 39% increased risk for metabolic syndrome when subjects consumed one or more soft drinks per day over four years