War on Integrative Medicine, Part Two: Eliminate Supplements

By Alliance for Natural Health

Why are the attacks on supplements becoming so loud?

By now anyone not living in a cave has heard the message loud and clear: don’t use supplements. Either they are a harmless waste of money, or they’re a harmful threat to your health (note that these points are contradictory). This message has been repeated over and over both in journals and in conventional media outlets. It is, with very few exceptions, junk science. Even in the few instances when it is right, it is wrong.

Here’s an example of what we mean by being right and wrong at the same time. Journals and the media keep insisting on calling alpha-tocopherol “vitamin E.” This is incorrect.

Vitamin E is comprised of mixed tocopherols and tocotrienols. Too much alpha-tocopherol can interfere with your body’s use of the arguably more important gamma form. Hence studies that supplement alpha alone and call it vitamin E are both inaccurate and doing something that does not occur in nature. In addition, in most instances the alpha-tocopherol being tested is dl-alpha-tocopherol, which is the fully synthetic form, also not something you will ever find in nature.

Similarly, studies suggesting there is a heart risk associated with supplementing calcium are both right and wrong. They are right because calcium needs some essential co-factors to move into the bones instead of the circulatory system. These include vitamin K2 in particular, along with vitamin D3 and other less important factors. This is one reason (among others) why the World Health Organization’s 2010 proposal to put calcium in the water supply was simply crazy.

Another way to be right and wrong simultaneously is to use a tiny bit of a supplement and say that it had no measurable effect. This is spending a great deal of money in order to state what should have been obvious. There is no point studying supplements if you don’t test meaningful doses. To do this, you have to do what researchers least want to do: actually consult with integrative doctors, the people with clinical experience using supplements.

Not understanding co-factors and proper dosages is perhaps excusable. The other tricks used to make supplements look dangerous are really dubious: the intentional cherry picking of studies, most of them with very questionable data, followed by all kinds of “clever” statistical manipulations, among other underhanded techniques.

For example, if you are allowed to see the underlying data (often not the case) and dig into it deeply enough, you find that people using supplements lived longer. But the researchers then “corrected” for lifestyle habits (e.g., diet), throwing in as many factors as they liked, until they could force the remaining data into a weak statistical result that now seemed to say the supplements actually hurt. Why does the researcher bother to go to all this trouble when he or she clearly had already decided on the answer?

Recently, more and more researchers have been going to more and more trouble to find evidence—any evidence, no matter how weak or falsified—to shore up conclusions they have already reached. Why? And why have reporters more or less done the opposite, going to no trouble at all, just parroting press releases? In the latter case, it can’t just be laziness.

This increasing phenomenon of underhanded attacks amplified mindlessly by the mass press suggests that the natural health idea, based on diet and lifestyle, not just supplements, must be reaching people. This seems to be a campaign of push-back, and it is getting bigger and bigger.

There is the old story about how new ideas emerge. First, they are scoffed at: “What a complete joke!” As the ideas advance, the entrenched interests who benefit from the old ideas lapse into a stony silence: “Shh! Don’t let any more people hear about this!” In phase three, there is a very vocal campaign of push-back from the entrenched interests.

Stage three seems to be where we are at now. Do you know how to tell we have reached the final, fourth stage, the stage in which the new ideas are finally accepted? It is when the former opponents of the new ideas say, “Oh, we knew that all along!”

During our current third stage of vocal attack on natural health, one of the oft-heard arguments against supplements is, “Hey, just eat well. You can get everything you need from food.” That seems reasonable. It at least nods in the direction of natural health ideas, because we do believe that diet is vital. But it is wrong, for a number of reasons.

Studies suggest that Americans are short of many essential nutrients. Dr. Bruce Ames, emeritus professor of biochemistry and molecular biology at the University of California at Berkeley, points out that 60% of Americans get too little magnesium, one of our most important nutrients. Magnesium alone is needed for over 300 biochemical reactions, according to the Life Extension Foundation. Dr. Ames estimates that not getting enough of the right nutrients in general is shortening the average lifespan by eight to ten years.

Partly this is because many of us don’t eat well. But there are  numerous other reasons why we might not get sufficient nutrients from food alone. One of them is conventional medical treatment, especially medical mistakes. One of the gravest mistakes of modern medicine appears to be blocking the acid in people’s stomachs in the mistaken belief that this will control acid reflux or stomach pain over the long run.

As we have often pointed out, the evidence has always existed that people lose stomach acid as they age and it is often the lack of acid that contributes both to reflux and stomach pain. Even the FDA has only authorized the use of acid blockers for short periods of time. Yet doctors routinely prescribe them for years.

And what does the lack of stomach acid lead to—in addition to steadily worsening stomach problems for millions of sufferers? Malnutrition, of course (one example of which is vitamin B12 deficiency). How can we properly digest protein and especially minerals without the acid that is supposed to be in our stomachs? And don’t forget pneumonia: lack of acid lets the bugs through and has been shown by creditable researchers to lead to more serious illness and even death. The culprit is often the class of gastric acid-suppressing drugs known as PPIs, or proton pump inhibitors, like Nexium and Prevacid, among the most widely prescribed drugs in the US, with nearly 110 million prescriptions and $13.9 billion in sales in 2010, in addition to over-the-counter sales. In other words, a huge number of Americans are malnourished from PPIs alone.

Think about a doctor who both prescribes acid blockers for years and tells his patient not to take supplements. He or she may be literally starving the patient to death, however many years it takes to play out. Other drugs may also interfere with nutrition in ways that are barely understood, and surgical trauma certainly requires extra nutrients to heal.

In our next article, we’ll cover some particularly egregious recent attacks on supplements coming both from a medical journal published by—who else—the American Medical Association and amplified by the mainstream media.

War on Integrative Medicine, Part Three: Get the Public to Believe Junk Science

AMA-helmed medical journals twist nutritional science and the mainstream media gobbles it up. Both are financially supported by Big Pharma.

On December 17, three studies on nutritional supplements were published in the same issue of the Annals of Internal Medicine. Practitioners, consumers, and scientists—both integrative and conventional—dismissed the studies as inconclusive, poorly interpreted, structurally questionable, and much too vague to truly analyze the benefits of supplementation.

It’s not surprising that “leading” medical journals and doctors continue to argue against natural alternatives to pharmaceutical drugs—they’re even more drug and drug money-dependent than even the average American. For example, doctors frequently rely on drug companies to pay for mandatory Continuing Medical Education (CME) classes, while journals like the Annals of Internal Medicine are utterly beholden to the advertising dollars of drug companies.

Unconvincing studies on dietary supplements are nothing new. However, these three had a unique advantage: in what appears to be an attempt to generate media buzz, they were accompanied by a scathing editorial that gleefully declared “case closed” on the effectiveness of dietary supplements.

The editorial, entitled “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” based its “decree” on those three flawed or inconclusive studies. Keep in mind that at this point, there are hundreds of thousands of scientific studies suggesting that supplements can be valuable.

As noted by ANH-USA board member Dr. Ron Hoffman, the compliance of patients to these particular “negative” studies’ supplementation regimen is unclear. “Recall” studies—where participants self-report whether or not they complied with the experiment’s protocols, sometimes years before—are notoriously unreliable.

We might add that one doesn’t really know for sure what the individuals took, what doses it contained, whether the right co-factors were taken, and of course whether the individuals were deficient in the substance to start with. In some cases, scientists devising studies do not even seem to know much about what they are studying.

As we point out in our companion article, so-called studies of vitamin E mostly use only alpha-tocopherols, even though it should be understood by now that tocopherols must be mixed, and that too much of the alpha form interferes with absorption of the arguably more vital gamma form. This is somewhat like the World Health Organization recommending putting calcium in the water supply without any realization that calcium without co-factor vitamin K2 in particular can create a heart risk rather than a bone benefit. The degree of ignorance about these basic points in many researchers is at this point inexcusable.

The Editorial Was Also Based on Flawed Assumptions

The editorial stated:

Most supplements do not prevent chronic disease or death, their use is not justified, they should be avoided. This message is especially true for the general population with no clear evidence of micronutrient deficiencies, who represent most supplement users in the United States.

This simply isn’t true. Most consumers don’t take vitamins to “prevent chronic disease or death,” as the editorial says. They’re just trying to bolster their overall health in combination with diet, exercise, and lifestyle choices. The integrative community knows there’s no “magic pill” for health, and therefore strives for holistic solutions. In this sense, the Annals editorial perfectly personified the Achilles’ Heel of modern medicine: its hyper-focus on piecemeal, “one-pill-per-symptom” approaches to health.

Implying that the general population has “no micronutrient deficiencies” perpetuates a common anti-supplement myth: that we can get all of the vitamins and minerals we need from the average American diet. Common sense and a growing body of scientific evidence heartily disagree!

Fully twenty percent of Americans eat fast food twice a week; fourteen percent eat fast food three or more times a week. We can’t get all the micronutrients we need from burgers and fries! But even if we were to eschew fast food and crafted healthy meals every day, we’d still be lacking critical micronutrients: according to the National Health and Nutrition Examination Survey (NHANES), up to 93% of Americans don’t get enough micronutrients in their diet due, in part, to soil depletion and our practice of breeding plants based solely on taste and aesthetics: in vegetables, for example, iron content has fallen 27% since 1940. As we have also pointed out, people vary greatly in their ability to digest and assimilate nutrients.

Study One: Multivitamins and Adults

This meta-analysis (which combines the results of selected independent studies, which itself introduces bias) showed “no clear evidence” of a beneficial effect of supplements on cancer prevention. Surprised by these results, ANH-USA’s sister organization, ANH-International, did a thorough analysis of the study’s design and found it to be a “perfect example of a study designed to fail”:

• The supplementation doses were below the Institute of Medicine’s Tolerable Upper Levels (ULs). ULs are intrinsically flawed and result in extremely low doses, as they focus on the single most sensitive adverse effect occurring in the most vulnerable sub-population. It’s likely that these doses were too low to have any real effect.
• The supplements used were synthetic, “bargain basement” multivitamins produced by Big Pharma.
• The study failed to address how supplementation works in tandem with a healthful, active lifestyle.

Additionally, the study claimed to analyze multivitamins—yet out of the twenty-seven studies considered, only three looked at multivitamins.

Study Two: Older Men, Multivitamins, and Cognitive Decline

According to the editorial’s summary, multivitamins do not prevent cognitive decline in men over 65. However, according to the study’s own declaration of limitations, the doses used may have been “too low” and the study participants “too well-nourished” to benefit from a multivitamin.

Participants in this study were considered “adherent” to their multivitamin regimen if they took it a mere two-thirds of the time—as LEF pointed out in its rebuttal, that means you could skip the multivitamin four months out of the year, and still be included in the study results!

There’s also the problem of taking a single multivitamin for something as serious as cognitive decline, when other supplements (such as some B vitamins and foods such as coconut oil) are far more appropriate.

Then there’s the problem of the study’s main sponsors—and the strong possibility of conflicts of interest: Pfizer (which has been trying and failing to market an Alzheimer’s drug) and the chemical company BASF. These companies have a vested interest in the failure of supplements to help cognitive decline.

Study Three: Multivitamins in the Prevention of a Second Heart Attack

The intent of this study was to learn more about chelation therapy, not determine the benefits of dietary supplements. But somehow, the editorial uses this study as hard evidence that multivitamins don’t work.

You wouldn’t be able to tell this from the headlines, but any conclusions that can safely be drawn from the study actually indicate the incredible benefit of dietary supplements: those who took multivitamins without statins experienced a 34% reduction of cardiovascular risk! This is enough to “reach a high level of statistical significance,” (meaning it’s unlikely that the benefit observed was due to chance).

How could the editorial’s authors claim otherwise? In their analysis, they misleadingly lumped patients with vital differences together in one group. For example, some of the study participants were taking statins, while some weren’t. Since past research has shown that dietary supplements for heart health should not be used in tandem with statins (just another reason why statins have more drawbacks than benefits!), the results of the statin and non-statin groups should have been analyzed separately. Instead, the editors assessed them together. This essentially compared “apples to oranges,” and skewed the overall results.

Furthermore, the authors failed to acknowledge that subjects in the group that received multivitamins had a higher rate of diabetes. The problem? Since people with diabetes are twice as likely to suffer heart disease, this may have also tainted the study’s “lump sum” results.

In any case, as both the study itself and the editorial are forced to state, no definitive conclusions can be safely drawn from this study, because it had a participant drop-out and non-adherence rate of 46%!

The Annals served up exactly what mainstream media loves: a reinforcement of the conventional medical narrative, “definitive” hyperbole, and a healthy dose of natural-health-bashing. The Wall Street Journal, Slate, Reuters, the New York Times, Fox News, and a number of local news outlets gobbled up the editorial word-for-word, leading with such headlines as “Study Finds Multivitamins Are a Complete Waste of Money, Why Do We Keep Taking Them?”

In their eagerness to bash supplements, the mainstream media seems to have lost their memory (we’d recommend niacinamide for that): less than two years ago, they touted the Journal of American Medical Association’s study, which found that low-dose multivitamins may help prevent cancer in men, cutting their risk by up to 8%. The difference? That study’s centerpiece was the multivitamin Centrum Silver, made by Big Pharma company and mainstream-media advertising giant Pfizer.

What this demonstrates is how utterly controlling Big Pharma is when it comes to these studies. When the drug companies want to show supplements in a bad light (because they might compete with their high-dollar pharmaceutical, as with statins), the results are negative. But once in a while, when they have their own product to sell (here, their own brand of multivitamin), the results are more positive. Pfizer doesn’t sell expensive pharmaceuticals that “prevent” cancer, so they’re content to make a few bucks off of the mainstream media promoting their junk, low-dose vitamin.

Read the full articles here: http://www.anh-usa.org/eliminate-supplements/ and here: http://www.anh-usa.org/public-junk-science/

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