Barely a year goes by without there being a supposedly independent survey, published by a supposedly reputable medical journal, to tell us that taking dietary supplements is a waste of money and they just don’t work.
Of course, it has to be said that barely a week goes by without there being claims made, quoting all manner of research, claiming the opposite-that they can and do work.
They can’t all be right…. or wrong, as the case may be. So what on earth are we supposed to make of it?
Here comes the latest, a study published this month from the Annals of Internal Medicine now making the rounds in the media and blogosphere broadly asserting that dietary supplements don’t work and won’t do you any good.
This survey reviewed data from hundreds of trials involving almost a million people. The researchers examined the relationship between diet and supplements and cardiovascular health, with the goal of determining which of these approaches, if any – can help prevent heart disease.
Their findings? In a nutshell:
• Very few supplements or diet choices showed any tangible benefit.
• Vitamins A, B, C, D, and E, as well as beta-carotene, calcium, iron, antioxidants, and multivitamins showed no benefit. Folate and fish oil showed some benefit, but with significant caveats (i.e., they only helped people that were deficient in folate and who didn’t eat much seafood, respectively).
• Neither low-fat nor Mediterranean diets had any impact on CVD risk prevention.
What are we to make of ‘metadata’ studies like this?
I have long maintained in these pages “most supplements don’t work, but some do’. It’s certainly true that many supplements including multivitamins not only fail to provide benefit-but can even be harmful.
I’ve mentioned the risks of excessive calcium supplementation. And this new study does find that those taking calcium and vitamin D together increased their risk of stroke due to increased arterial stiffness and blood clotting.
But so what? There’s a crucial point here that is too often missed in reporting these studies:
You cannot treat people as if they’re all the same and assume that what works (or doesn’t work) for one person will work (or not work) for another. You don’t need a medical or scientific background to know it just isn’t true. Yet that is still how most nutritional studies are designed. It invalidates the findings and is a colossal waste of money, to such an extent that one has to suspect there’s an ulterior motive at work.
A quick check on some of the 14 doctors involved in this particular piece of research shows links to major pharmaceutical companies in their published work. That does not necessarily invalidate the findings but it does leave them open to question. Why not be open and declare them? And, despite the statement that there was no ‘primary funding’ for this research, if you look hard enough you find a sponsor involved. Go figure the semantics of that….
To ask a straight question, does this study tell us, unequivocally, that no one should supplement with vitamins and minerals, or follow a low-fat or Mediterranean diet?
No, it doesn’t.
What it tells us that, on average, those interventions-at least how they were undertaken in this particular piece of research (and that is a whole other topic) were not effective. But what if someone goes to a Functional Medicine doctor, gets nutritional testing, and finds that they are low in B12 and iron? Should the doctor avoid prescribing B12 and iron to that patient because of this study? Hardly.
And what if someone is elderly and/or has a health condition that prevents them from obtaining adequate nutrition? Should they avoid taking a multivitamin too or a Mediterranean diet? I don’t think so.
In both instances, clearly not. It would be absurd, to the extent of malpractice to suggest otherwise. On the other hand it is all too often foolish and wasteful, evven harmful to self-diagnose and spend a fortune on supplements you not only don’t need but could harm you.
It is common sense to get a periodic nutritional benchmark from a functional medicine doctor and/or a clinical nutritionist, whom you trust and whose living does not depend on ‘churning’ product or multilevel marketing.
Studies like this don’t answer these questions or help us make a correct decision. Which is a shame, because these are important questions we need answered. We are not scientists (most of us), we cannot reasonably be expected to make a medically informed decision. We need reliable advice to help us do that. We are not bereft of common sense (most of us), we know there are plausible shysters in white coats out there.
Don’t be led up the garden path, seek out the honest professionals and work with them. By and large, but not necessarily, it is best to buy ‘practitioner only’ formulations having consulted a trusted professional.
If you are buying unguided, here’s the sort of thing to watch out for:
• What constitutes a therapeutic dose? You need to know or you’re probably wasting your money.
• Beware the 30-day assumption. 30 tabs in a bottle at 10mg p/tab is a month’s supply, right? Not necessarily. If the therapeutic doseage is 30mg p/day it’s not, it’s a 3-day supply.
• Bio-availability. If you need 10mg of a nutrient and take in a pill form of which only 1mg gets absorbed it’s not going to do you much good. You need to up the dose or find an alternative means of administration.
• Steer clear of multi-level marketing. While it may be possible to get a good product at a fair price, usually it isn’t. Average and over-priced on a good day is the best you can expect here.
• While there are indeed many outright fraudulent claims and products, most are within the law in what they say on the label.
• Most popular brands are cheap ingredients expensively marketed and packaged.
• Watch out for a tiny ineffective amount of an expensive ingredient used to hype the price of an otherwise average formulation.
• There are many different chemical forms of minerals, some are a lot more therapeutic than others. It matters – but how are you going to know which?
Weasel ways of marketing: caveat emptor… let me count the ways:
• Reseach shows… whatever the seller wants it to say in the sales lit.
• If the 6th Dalai Lama was said to have used it to improve his meditation and cognition – head for the hills. Same goes for a growth hormone formulation, which the annals tell us was prepared for Ghengis Khan.
I’m sure you get the picture….
We share much as human beings, but we have important differences. It is these differences that ultimately drive what will work and will not work for us.
At the end of the day, it’s sensible to remember supplements aren’t necessarily harmless, or effective and that good testing and guidance can go a long way toward avoiding problems and are what brings the maximum benefit from the real thing.
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