Juice Plus+ is a branded line of dietary supplements containing concentrated fruit and vegetable juice extracts fortified with added vitamins and nutrients. Introduced in 1993 by its manufacturer, Natural Alternatives International of San Marcos, CA; the supplements are distributed by National Safety Associates (NSA; Collierville, TN) via direct or multi-level marketing. Marketing claims made about Juice Plus products suggest benefits such as reducing oxidative stress and promoting cardiovascular health. The supplements are advertised as "the next best thing to fruits and vegetables," a claim which some consumer watchdog organizations and governmental agencies consider to be misleading. Critics have argued that there is no scientific proof that Juice Plus offers significant health benefits, and that deceptive claims are used in the product's marketing information. Studies of Juice Plus' effects have generated conflicting and controversial results.