September 1, 2016 general

Hopefully, very few people take it seriously when some of the so-called “experts” imply that dietary supplements are just a frivolous fad based on old wives’ tales. Let me address that last part first. Grandma was an “old wife” and most of what she told us about health holds up under scientific scrutiny. And are they a fad? No, I don’t think so. According to a Gallup survey, cited in the current Consumer Reports magazine, 94 percent of physicians now recommend vitamins or minerals to some of their patients and 45 percent have recommended herbal supplements. Supplement benefits are backed by good science.

Benefits: Supplements could save untold suffering and billions of dollars in disease care costs. Any bottle could be quite an impressive gift of health for the right person at the right time. You certainly don’t need to take my word for it. Just take a peek at government-run websites like www.clinicaltrials.gov and https://www.ncbi.nlm.nih.gov/pubmed/ that show tens of thousands of research studies with positive results on supplements. Those benefits cover virtually any complaint we could have. However, except for just filling in nutrition basics, we may need a nutritionist’s help to figure out what supplements to take because the labels are not legally allowed to say much. (E.g. like the generically gift-wrapped bottles in the photo above.)

Negative results. A study wouldn’t be conducted in the first place if there was not some evidence of benefit. However, sometimes studies do end with a negative result. It would take more space than this whole blog to cover the reasons why. As a start, it could have been one of these flaws: the wrong form of the supplement; the wrong dose; too short a time frame; failure to account for confounding factors; the wrong target group; measuring the wrong outcome; or a silly averaging of dissimilar subjects. Occasionally studies are actually designed to fail. Our nurse friend, Carla, sent a link to a hilarious John Oliver program (Last Week Tonight) highlighting some of the foibles of science. I don’t agree with everything John says (e.g. he has “swallowed the Kool-Aid®” regarding a couple of issues) and the language is a bit rough because it is cable. However, the show is entertaining and insightful. LINK

Why the controversy? What possible motive would there be for actually rigging a study to fail? Sometimes one looks as though it might have been a subconscious effort to protect some researcher’s long held bias and reputation. But, more often, the core reason is money. As you can well imagine, it would not be good for the sales of pharmaceutical drugs if people started solving their problems with nutrients, herbs and homeopathics. The extremely lucrative drug industry exerts tremendous direct pressure and subtle indirect influence on research, regulation, medical journals, medical education, medical practice and the media. So, it is much easier for them to cast doubt on a supplement than to prove that their drugs are more effective and safer. (E.g. if all else fails big pharma can conduct a “trial by press release”.) In a rare moment of transparency on the issue, the Food and Drug Administration’s 1992 Task Force Report on Dietary Supplements it stated that dietary supplements represented a “disincentive for patented drug research.” So be it. If a supplement does the work, maybe they should work on a different drug?

Better supplements = better results. There is risk in buying from fly-by-night companies; in falling for excess marketing hype; and in thinking that cost is the key factor in achieving a good value. (A cheap supplement that is not absorbed and well utilized is actually an expensive choice.) It is safest and most productive to stick with great companies that have done their homework. For example, rather than jumping on every popular trend, Jarrow Formulas picks ingredients and ingredient forms that the research supports. Then they hope to educate consumers about their sophisticated formulas. That is properly getting the horse in front of the cart.

You are not average. RDA’s, DRV’s, etc. and other such guidelines come closer to being useful when listing minerals than they do recommending vitamins. Vitamins are safe in typical supplement quantities even when the amounts are multiples of the RDA number. Since one person may need as much as 100 times as much vitamin C as the next person, it usually pays to take more of a vitamin than the very minimum to make sure you are covered. (Vitamin D provides an excellent example of individual variations and I’ll cover that next week.) Even with minerals, the officially recommended dose might not be ideal. For example, some people need more of a mineral because they get less of it in their diet, or they need more due to life style issues or perhaps that mineral form is not well absorbed. Keeping minerals balanced with each other is very important. That is why, unless a person has had tests run, it is safest to consume minerals in a balanced blend formulated by a reputable company.