Above image: Ocean Water Courtesy of Wikipedia
What is Pseudo Science ?
You might be surprised to know that vitamins are actually killing you. We were informed of this fact by new stories based on a 2007 JAMA publication by Goran Bjelakovic. (1A)(10)(12)(13)(1).
What's the problem with this JAMA article? It is an example of pseudoscience called selective sampling. Out of 748 vitamin studies, the researchers selected only 67 focusing on high dose synthetic vitamins, and excluded all the others showing benefit.(1B)(1C)(1D)(11)
Selective Sampling: There is No Water in the Ocean
To demonstrate this pseudoscience selective sampling technique in the above JAMA article, you can do this experiment on your own which proves there is no water in the ocean. Merely go down to the beach front, wade into the water up to your ankles and collect a sample from the ocean floor for later analysis.
Reach under the surface of the water, pick up a few pebbles from the ocean floor, and return to your laboratory. Place the sample into your analyzer machine for sophisticated chemical analysis with nuclear magnetic resonance.
Amazingly, the print out shows no water! You have thereby proven there is no water in the ocean, and can publish your report in a prestigious journal.
Fortunately nobody noticec the pebbles, were air dried on the table for two hours before analysis. This and other types of pseudoscience is sadly prevalent in the scientific literature, related to the conflict of interest involved in corporate funding. The media and the public can be easily deceived with pseudo science.
What is Pseudo Science?
Pseudoscience is the form of trickery or sleight of hand used to obtain a favorable result in a scientific publication. Pseudo science is used commonly by the pharmaceutical industry to either 1) show that ineffective drugs are actually effective 2) to minimize adverse effects of drugs that actually do have adverse effects 3) discredit competing natural substances as ineffective or dangerous (such as the above article in JAMA.)
The media is then used to amplify and trumpet the false information to the public. It's all econonics and business. It's all about corporate profit.
Proven Health Benefits of Vitamins
Negative articles on vitamins are seen in the mass media. Usually, these are funded directly or indirectly by drug companies, and the researchers are paid to come up with negative findings in order to discredit vitamins so people will take more drugs. It is a simple matter of follow the money trail.
When the studies are done by a neutral party such as the Chinese government, the results are closer to reality. A study from Linxian province in China showed a 9 per cent reduction in mortality from only three vitamins: E, A and selenium. They also showed a 13% reduction in cancer mortality, and a 21% reduction in gastric cancer mortality.(2)
Another study showed selenium supplementation prevented esophageal cancer, heart disease, stroke, and total death: (3) Folate supplementation in pregnant mothers prevents birth defects (Neural Tube defects) in the developing fetus.(4)(5) Vitamin C prevents coronary artery disease and a variety of other chronic diseases: (6)(7) Vitamin B-12 supplementation is recommended by the USDA for everyone over the age of 50. (US dept of Agriculture 2005 Food Guidelines)(14)(8) In fact there are volumes of research data showing benefits of vitamin supplementation.(9)
The Bottom Line, Be Skeptical of News Media
Bottom line is that you can't believe the newspapers or media when it comes to vitamin, mineral or nutritional supplements, because the media depends on advertising revenue from the drug companies. The media will therefore tend to run stories which are negative for vitamins and supplements, which in comparison makes the drug ads look good. The reality is that by and large, vitamins are safe, and drugs are dangerous. Adverse effects from drugs cause 140,000 deaths and 76 billion a year in health care annually.(15)(16)
So remember to be skeptical of news media stories which have a hidden agenda.
Direct-to-Consumer drug advertising is also largely deceptive and misleading, and should be banned here in the US as it has been banned in all other countries, with the exception of New Zealand.
Which Vitamins Require Caution?
The water soluble vitamins (C and B complex) are readily excreted in the urine and therefore can be taken at high doses with no ill effects. The fat soluble vitamins A and D, however, can accumulate and cause toxicity at high doses over prolonged periods, so these must be monitored. We routinely measure vitamin D blood levels, and supplement Vitamin D with serial monitoring of blood levels. Also, Vitamin E and fish oils have a blood thinning effect, which can cause bleeding tendencies. Most anesthesiologists will recommend avoiding Vitamin E and fish oils prior to elective surgery to avoid bleeding.
Jeffrey Dach, M.D.
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443
http://www.jeffreydach.com/
References:
(1) http://news.bbc.co.uk/1/hi/health/6399773.stm
Vitamins 'could shorten lifespan' Research has produced mixed results. Taking certain vitamin supplements may adversely affect people's lifespan, researchers have suggested. BBC News 28 February 2007,
(1A) http://jama.ama-assn.org/cgi/content/abstract/297/8/842
Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention. Systematic Review and Meta-analysis, by Goran Bjelakovic, MD, DrMedSci;Dimitrinka Nikolova, MA; Lise Lotte Gluud, MD, DrMedSci, Rosa G. Simonetti, JAMA 2007;297:842-857.
(1B) http://oregonstate.edu/dept/ncs/newsarch/2007/Feb07/vitaminstudy.html
02-27-07 Media Release Linus Pauling Institute:
Study Citing Antioxidant Vitamin Risks Based on Flawed Methodology
(1C) http://www.organicconsumers.org/articles/article_4399.cfm
Alliance for Natural Health Critiques JAMA Study Claiming Synthetic Vitamins Can Kill You JAMA - 'vitamins kill' - no they don't! Alliance for Natural Health (UK), Mar 5, 2007 Straight to the Source
(1D)http://www.alliance-natural-health.org/_docs/ANHwebsiteDoc_270.pdf
Poor methodology in meta-analysis of vitamins. Dr Steve Hickeyi,ii, Dr Len Noriegai and Dr Hilary Roberts iFaculty of Computing, Engineering and Technology, Staffordshire University; iiSchool of Biology, Chemistry and Health Science, Manchester Metropolitan University.
(2) http://www.ncbi.nlm.nih.gov/pubmed/8360931
J Natl Cancer Inst. 1993 Sep 15;85(18):1483-92.
Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population.Blot WJ, Li JY, Taylor PR, Guo W, Dawsey S, Wang GQ, Yang CS, Zheng SF, Gail M, Li GY, et al..
(3) http://www.ajcn.org/cgi/content/full/79/1/80
ORIGINAL RESEARCH COMMUNICATIONS
Prospective study of serum selenium concentrations and esophageal and gastric cardia cancer, heart disease, stroke, and total death1,2,3 Wen-Qiang Wei, Christian C Abnet, You-Lin Qiao, Sanford M Dawsey, Zhi-Wei Dong, Xiu-Di Sun, Jin-Hu Fan, Elaine W Gunter, Philip R Taylor and Steven D Mark
Results: We found significant inverse associations between baseline serum selenium and death from ESCC (RR: 0.83; 95% CI: 0.71, 0.98) and GCC (0.75; 0.59, 0.95).
(4) http://www.fda.gov/Fdac/features/796_fol.html
FDA web site: How Folate Can Help Prevent Birth Defects by Paula Kurtzweil
(5) http://www.ebmonline.org/cgi/content/full/226/4/243
Experimental Biology and Medicine 226:243-270 (2001)
Folate, Homocysteine and Neural Tube Defects: An Overview
Nathalie M.J. van der Put1,*, Henny W.M. van Straaten, Frans J.M. Trijbels* and
(6) http://www.internetwks.com/owen/Synopsis.pdf
Linus Pauling Protocol for Reversing Heart Disease
Owen Fonorow 2005
(7) http://lpi.oregonstate.edu/infocenter/vitamins/vitaminC/
Vitamin C Information Linus Pauling Institute Oregon State University
(8) http://www.drinkyourvitamins.com/rk_articles/art09-b12underapr.htm
B12 by Richard A. Kunin, M.D. 2000
(9) http://www4.dr-rath-foundation.org/NHC/researcharchive.html
list of Clinical Studies that document the importance of micronutrients and nutrition in maintaining optimum health.
(10) http://www.aidstruth.org/Mortality-with-antioxidants.pdf
Full pdf of JAMA article, Mortality with antioxidants
(11) http://en.epochtimes.com/news/8-4-22/69603.html
Dr. John Briffa is a London-based doctor and author with an interest in nutrition and natural medicine. My opinion is this review's weaknesses and limitations mean that it's hard to draw any conclusions from it. The selective approach to selecting studies, the very variable protocols of the studies, and the fact that the focus was on high doses of synthetic nutrients, means that this review has little or no relevance to individuals taking, say, a multivitamin and mineral each day as nutritional insurance.
(12) http://news.yahoo.com/s/nm/20080416/lf_nm_life/britain_vitamins_dc_1
Vitamin pills can "increase rate of mortality" Reuters News Service
Scientists reviewed 67 studies on 230,000 people to see whether so-called antioxidant vitamins prolonged life expectancy.
(13) http://www.foxnews.com/story/0,2933,351443,00.html
FOXNEWS.Mom, This Study Says I Don't Have to Take My Vitamins!
Wednesday, April 16, 2008. The Health Food Manufacturers' Association told Sky News online that the study was "in essence, systematically flawed." "The analysis focused on one broad category of study, then evaluated just 67 of the 748 studies that could be included in the review," according to the Association.
(14)
http://www.health.gov/dietaryguidelines/dga2005/document/html/executivesummary.htm
Dietary Guidelines for Americans 2005, USDA
Key Recommendations for Specific Population Groups
People over age 50. Consume vitamin B12 in its crystalline form (i.e., fortified foods or supplements). Women of childbearing age who may become pregnant. Eat foods high in heme-iron and/or consume iron-rich plant foods or iron-fortified foods with an enhancer of iron absorption, such as vitamin C-rich foods. Women of childbearing age who may become pregnant and those in the first trimester of pregnancy. Consume adequate synthetic folic acid daily (from fortified foods or supplements) in addition to food forms of folate from a varied diet. Older adults, people with dark skin, and people exposed to insufficient ultraviolet band radiation (i.e., sunlight). Consume extra vitamin D from vitamin D-fortified foods and/or supplements.
(15) http://archinte.ama-assn.org/cgi/content/abstract/155/18/1949
Arch Int Med Vol. 155 No. 18, October 9, 1995
Drug-related morbidity and mortality. A cost-of-illness model
J. A. Johnson and J. L. Bootman Center for Pharmaceutical Economics, College of Pharmacy, University of Arizona, Tucson, USA. Drug-related morbidity and mortality was estimated to cost $76.6 billion in the ambulatory setting in the United States.
(16) http://www.healthsentinel.com/briefs.php?id=010&title=Adverse+Drug+Events+and+Hospital+Acquired+Infections&event=briefs_print_list_item
Classen, David C. MD MS, Pestotnik, Stanley L. MS RPh, Evans R. Scott PhD, Lloyd James F., and Burke John P. MD, "Adverse Drug Events in Hospitalized Patients: Excess Length of Stay, Extra Costs, and Attributable Mortality", JAMA, January 22, 1997, Vol. 277, Num. 0, pp. 301-306. With 140,000 people dying each year from adverse drug events and another 88,000 dying from acquired infections makes it a total of 228,000 deaths a year from hospital related harms. This makes it the third leading cause of death in the United States, only behind heart disease and cancer according to the CDC's statistics (National Vital Statistics Report, July 24, 2000, Vol. 48, No. 11, p. 26).
Jeffrey Dach, M.D.
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443
www.jeffreydach.com
Copyright (c) 2007-2008 Jeffrey Dach MD All Rights Reserved
This article may be copied or reproduced on the internet providing credit to author and link to original: http://jeffreydach.com/2007/05/05/vitaminsjeffrey-dachdrdach.aspx
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Just Thinking...
Amy A
Jimmy Zuma
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Comments
Seriously, good topic. I think people forget that if they are eating right, they wouldn't need a daily vitamin.
Thumbed!
I try to spend time in the sun getting vitamin D the natural way. Not burning or tanning just ten or fifteen minutes at a time. Eating right helps in the other areas as well. monkey fingered.
Horlick, MD, PhD, New England Journal of Medicine, Vol 357: 266-281, July 19,2007.
Many physicians and naturopaths make money off the blood tests they order on their patients. The more tests, the more money. Be sure to ask your doctor how labs are billed. If you pay directly to the lab, especially cash, the savings can be phenomenal.
Unfortunately, because doctors are underreimbursed, especially by Medicare right now, particularly internal medicine doctors, ordering huge panels of blood testing is a way to keep the office open. And patients like it because they feel this is "individualized" medicine, instead of cost-effective.
As for direct advertising of pharmaceuticals to the public: if there's anything that proves lack of human intelligence, it's subscribing to the idea that pharmaceuticals will help. I frequently read the disclaimers, usually pages long, in drug ads, and what Americans subject themselves to in taking pharmaceuticals....well, all I can say is to echo what I read somewhere, that people doing stupid things that will kill them, is a way of "culling the population" and ridding it of nitwits!!
"Negative articles on vitamins are seen in the mass media. Usually, these are funded directly or indirectly by drug companies, and the researchers are paid to come up with negative findings in order to discredit vitamins so people will take more drugs. It is a simple matter of follow the money trail."
Nahhhhhhhhhhh! Big Pharmaceutical paying someone off to their benefit!!!! Surely you jest! :-D (heavy, heavy sarcasm.)
Good counter post to Dr. Whatshername
rated
For example, in your "cherry" post you begin by saying "If you own a cherry orchard, don't be surprised when heavily armed federal agents wearing bullet proof vests and riot gear raid your farmhouse."
http://open.salon.com/content.php?cid=67568
In fact all that happened is that certain companies marketing cherry products received warning letters from the FDA. This is because the product advertising made specific and sometimes unqualified health claims about the benefits of their products, thus, from a legal point of view, turning their products into drugs. It's not that cherries per se are drugs, but when a company makes certain health claims about cherries (or any other product for that matter) then that product falls under FDA regulations.
Rather than making such claims, the cherry marketers could have gone through the standard FDA process of getting approved "qualified health claims." Many product claims have in fact been approved by the FDA, and these include tomatoes, calcium, nuts, green tea, fish oil, corn oil, canola oil, and various other products. In fact it appears that the Cherry Marketing Institute is currently beginning that process now. http://www.choosecherries.com/
Perhaps you are not aware of this process; at least there is no discussion of it in your post. You claim that the FDA suppresses truthful information about such products even though the FDA has a well-defined process through which legitimate claims can be made.
In this post you also begin with an inaccurate statement: "You might be surprised to know that vitamins are actually killing you. We were informed of this fact by new stories based on a 2007 JAMA publication by Goran Bjelakovic."
In fact, the paper to which you refer makes a much more modest claim -- that large doses of beta carotene, vitamin A, and vitamin E may increase mortality. Note that the paper dealt only with specific vitamins not vitamins in general. In addition, the paper dealt only with large doses of these vitamins administered through supplements, not vitamins consumed as part of a normal diet.
In an editorial published in the Journal of the National Cancer Institute Goran Bjelakovic, one of the authors of the paper in question, said
An association between healthy diet and good health has been noted since Hippocrates (460–377 BC)—and in fact long before. Our diet provides numerous vitamins and trace elements that are essential to good health. Observational studies have shown that there is a positive association between a healthy diet, especially high intake of fruits and vegetables, and delayed aging, reduced risk of cancer, and reduced risk of cardiovascular diseases.
http://jnci.oxfordjournals.org/cgi/content/full/99/10/742
This is from the fellow whom you say asserts that vitamins will kill you.
Concerning the study you say "It is an example of pseudoscience called selective sampling. Out of 748 vitamin studies, the researchers selected only 67 focusing on high dose synthetic vitamins, and excluded all the others showing benefit."
Yes, that's what the study looked at -- high doses of synthetic vitamins. Also, the inclusion criteria had nothing to do with whether or not there was a benefit:
They identified 815 prevention trials and contacted authors to get any missing information. A total of 339 studies were excluded because they weren’t randomized trials or didn’t meet the inclusion criteria, which was straightforward. A total of 405 trials (on 40,000 people) reported no deaths at all, meaning no comparisons could be made between the vitamin and placebo groups to show an effect from the vitamins — the majority were small phase I or II trials of short duration — but the Cochrane reviewers contacted the authors to confirm they had no deaths.
They ended up with 67 clinical trials that had been conducted all over the world on a total of 232,550 people.
http://junkfoodscience.blogspot.com/2008/04/jfs-special-results-of-largest-study-on.html
I don't have the time to review all of your citations, but I would like to comment on the China study (your footnote #2). You say "When the studies are done by a neutral party such as the Chinese government, the results are closer to reality."
One thing is that you are comparing two very different kinds of studies. The China study was a single primary study. The study done by Bjelakovic et al was a meta-analysis -- a study that integrates the results of many different studies. Also, I suspect that the China study was not included in the study published in JAMA because it included neither placebo nor control groups -- at least the abstract does not mention any.
Furthermore, the "reality" of this study is found in the conclusion: "The results on their own are not definitive, but the promising findings should stimulate further research to clarify the potential benefits of micronutrient supplements."
I will also note that people need to know that the media do not always accurately report the actual results of statistical studies, with "media" including posts in Open Salon.
In conclusion, it seems to me that your articles would benefit from less of a "straw man" approach and more attention to the details of the issues -- what the research article actually says, what the researcher actually says, what the FDA regulations actually are, and so on. Also, the mere inclusion of large numbers of footnoted articles may give your arguments the appearance of greater plausibility, but even these need to be looked at to see if they really make the case that you say they do.
Bacon!
Cream!
Lard!
First, thanks for the response.
The FDA does not suppress information in the scientific literature. Rather, they regulate the product claims that can be made using that literature. That is an important distinction.
Otherwise the marketer of a product could simply refer people to studies showing a benefit for the product while excluding other studies. (This is similar to what you accuse Bjelakovic et al of doing in their meta-analysis.) Furthermore, it is unrealistic to think that the general public can adequately evaluate the validity, scope, and conclusions of research studies. Even in your own writings here you frequently leave off critical qualifiers such as "may" and "might." The average person is simply not trained to evaluate scientific research. This is why it is important to have an agency that can evaluate the totality of research studies whether positive, negative, or neutral conclusions are involved.
Dr. Dach: "The other study from China showed that vitamins reduced mortality."
Once again we have the Case of the Missing Qualifiers. The study showed that vitamins "may" reduce mortality in the "subject population," and that "further study is needed."
But let's talk about the China study. Two years prior to the publication of the JAMA meta-analysis, the FDA had already considered the China study as part of a comprehensive look at Selenium and vitamin E: "The Level of Evidence for Permitting a Qualified Health Claim: FDA’s Review of the Evidence for Selenium and Cancer and Vitamin E and Heart Disease"
http://jn.nutrition.org/cgi/content/full/135/2/354#B7
Based on the China study and twenty-six other studies the FDA concluded that
although the limited number of intervention studies had significant flaws for evaluating a selenium/cancer relationship and the findings were not conclusive, there was some basis for a qualified health claim. Therefore a qualified health claim was permitted, provided that the necessary qualifying language accompanied the claim (i.e., "FDA has determined that this evidence is limited and not conclusive"). J. Nutr. 135:354-356, February 2005
In other words, the FDA is not hiding or withholding research information from the public. Instead they look at the totality of relevant studies and permit or prohibit health claims based on that review.
But it seems to me that you would prefer a "system" in which companies could simply market products, saying whatever they want to about the products, based on whatever studies they chose to select (or neglect), in the name of the First Amendment, as you suggest in your "cherry" post -- "Freedom of speech is a personal liberty protected by the First Amendment of the Constitution."
I suggest to you that such a "system" would lead to utter chaos and potentially dangerous misunderstandings among the public about what these products actually do or don't do.
By the way, I don't remember where I got the sunglasses, but I got them based on a single study showing that sunglasses prevent cancer. So far they work.
AMY
Just wanted to encourage you not to feed the monster...take the high road brother....she's poison.