Science & the vitamin myth
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WHY BUY AND TAKE WHAT YOU DON’T NEED—IT MAY HARM MORE THAT YOUR PURSE,  The Lancet recently reported that , “9,000 in every million users of such vitamin supplements will die prematurely as a result of taking something they think is good for them.”



The Vitamin Pushers

Stepehn Barett, M.D. & Victor Herbert, M.D., J.D., forward by Gabe Mirkin, M.D.


Prometheus Books, Amherst, New York, 1994


Some Simple Truths about Nutrition

Most Americans who take vitamins don't need them. Could you be one of these people? Are you afraid that our food supply is lacking in nutrients?

Do you think that vitamin pills can give you extra energy? That extra vitamins should be taken in times of stress? That vitamin C can prevent colds? That vitamin E has been proven to prevent heart disease? That large doses of other nutrients can prevent or cure many other ailments? Or that methods labeled "alternative" offer something special?


Are you afraid there are "too many chemicals" in our food? Do you believe that foods labeled "natural" or "organic" are safer or more nutritious? Or that diet plays a major role in behavior? Or that most diseases are caused by improper eating?

Do you think that most nutrition advice in books, magazines, newsletters, and talk shows is reliable? Or that "alternative" health methods hold great promise? Or that the health marketplace is tightly regulated by government agencies?

If you have any of these fears or beliefs, you have plenty of company. But you have been misled!


America is in the midst of a vitamin craze. Health hustlers who spread false ideas have developed a huge public following. But nutrition is not a religion. It is a science—composed mainly of human biochemistry and physiology. What a nutrient can or cannot do in the body is determined by its specific chemical structure and the specific biochemical reactions in which that structure can become involved.


How can you tell what to believe? The answer to this question has two parts. First, you should know what is meant by "scientific truth." Then you must determine who is telling the truth.


How Do We Know What We "Know"?

How are medical facts determined? Humans have always been curious about disease and what causes it. The more we understand, of course, the better we can control illness. Down through the centuries, thousands of theories have been formulated to explain the reasons for both health and sickness. During the past century, however, speculation has been supplanted by reliable knowledge based on experimentation and sound clinical experience. Armed with this new knowledge, doctors have been able to prevent and cure many diseases in a way that seems almost miraculous.


As part of the process of scientific development, good methods have been developed to test whether theories are logical. The sum of these methods is known as the "experimental" or "scientific" method. This method is used to answer questions like: "If two things happen, one after the other, are they related?" For example, suppose you take a pill when you have a headache and the headache goes away one hour later. How can we tell whether the pill relieved you or whether the headache would have gone away by itself anyway? Throughout the world, hundreds of thousands of scientists are working continu­ously to determine the boundaries of scientific thought.


As mountains of information are collected, how can we tell which evidence is valid? "Valid" means honestly collected and properly interpreted— using valid techniques of analysis. One hallmark of a good experiment is that others can repeat it and get the same results.

This brings us to the question of who can best interpret experimental findings. Scientists are judging each other all the time. People with equal or superior training look for loopholes in each others' experimental techniques and design other experiments to test conclusions. Skilled reviewers also gather in groups whose levels of ability far exceed that of the average scientist. Such experts are not likely to be misled by poorly designed experiments. Among the reviewers are editors and editorial boards of scientific journals; these people carefully screen out invalid findings and enable significant ones to be published. (Most reliable journals that cover nutrition topics are listed in the Index Medicus of the National Library of Medicine.)


As good ideas are put to use, more reports are generated. When contro­versies arise, further research can be devised to settle them. Gradually a shared set of beliefs is developed that is felt to be scientifically accurate. Expert panels convened by government agencies, professional groups, voluntary health agencies, and other organizations also contribute to this effort. When we speak of the "scientific community," we refer to this overall process of separating what is truly fact from what is not.

Three basic questions are involved in evaluating whether a treatment method works:

1.  Is it more effective than doing nothing, or than a placebo?

2.  Is it as safe as doing nothing?

3.  If there is a question about safety, does the potential for benefit exceed the likelihood of harm?


One of the central premises of science is that no method should be regarded as proven until it is actually proven.


Quacks, of course, operate outside of the scientific community. They do not use the scientific method to evaluate what they see. In fact, they seldom bother to experiment at all and ignore the three questions listed above. When scientists point out that they are wrong, quacks try to cover up their inadequacies by pointing out that the scientific community has made mistakes in the past. This, of course, is true but irrelevant. In recent years, the odds of major error by the scientific community have decreased greatly. So if you find someone referred to as a "scientist ahead of his time," he is probably aquack. Quacks may boast of "thousands of cases" in their files. But they won't tell you that none of these cases separates cause and effect from coincidence, suggestibility, or misdiagnosis. Nor do they ever keep score and reveal how many failures they have had for each "success."


Interpretation of experimental findings is not always simple. Consider antioxidants, for example. Certain recent studies have found a lower incidence of death from heart disease among people who take vitamin E supplements than among similar people who do not. Does this prove that taking high doses of vitamin E will reduce the risk of a heart attack? Does this prove that taking high doses of vitamin E will do more good than harm? Does this mean that everyone should take a vitamin E supplement?


The answer to each of these questions is no. The reduction in death rate among the vitamin E group may have resulted from other lifestyle characteristics of the group such as eating a more healthful diet. Studies to answer the first question are underway and may be completed within a few years. Even if the results are promising, however, they may not indicate which people should take a supplement, what dose would be optimal, or whether long-term administration of vitamin E will turn out to have a detrimental effect.  [Subsequent research found a 5% greater risk of dying over a 4-year period—jk.]


Excess vitamin C may damage growing bone, produce diarrhea, produce "rebound scurvy" in adults and in newborn infants whose mothers took large dosages, caused adverse effects in pregnancy, produce kidney stones, and cause false urine tests for sugar in diabetics. Vitamin C in large doses can also produce false negative tests for blood in the stool and thereby prevent early detection of serious gastrointestinal diseases including cancer.


In 1980, the megavitamin world was rocked by a report of seven cases of unsteady gait and numbness of the feet and hands from taking 2,000 mg or more of vitamin B6 daily for several months. (The RDA is 2 mg/day.) Although all of them improved greatly within a few months after stopping B6, their recovery was not complete. Soon afterward, the scientists who made this report heard from at least forty persons with similar symptoms that had improved after stopping their B6 intake. Some had been misdiagnosed as suffering from multiple sclerosis! In 1987, a survey at a clinic specializing in the treatment of premenstrual syndrome (PMS) discovered that 107 patients had developed neurological symptoms as a result of taking vitamin B6. Ninety-two had taken less than 200 mg (one hundred times the RDA) daily for more than six months, and twenty had taken less than 50 mg/day. The lowest dosage on which anyone developed symptoms was 20 mg/day for two years; the shortest time was two months of 100 mg/day. Although all of their symptoms resolved when the B6 was stopped, it is clear that megadoses of B6 pose considerable risk.


Adverse effects such as those listed above are unlikely to occur with water-soluble vitamins at intake levels below ten times the RDAs, or with fat-soluble vitamins below five times the RDAs. But even if lesser dosages don't harm you physically, if you don't need them, they are a waste of money. The number of reported cases of toxicity is not large, but since there is no evidence that self-prescribed megadoses are helpful, taking them is senseless.


A recent study by the U.S. Centers for Disease Control and Prevention showed that Americans who took supplements had exactly the same mortality rate as those who did not. We interpret this to mean that supplements help some people, harm others, and are a waste of money for most.  { The Lancet recently reported that , “9,000 in every million users of such vitamin supplements will die prematurely as a result of taking something they think is good for them.”--jk}


About the Authors

Stephen Barrett, M.D., a retired psychiatrist who practiced in Allentown, Pennsylvania, for more than twenty-five years, is a nationally renowned author, editor, and consumer advocate. He edited Nutrition Forum Newsletter for nine years and has contributed frequently to Priorities Magazine, Healthline Newsletter, and Consumer Reports on Health. He is a board member of the National Council Against Health Fraud and chairs its Task Force on Victim Redress. He is a scientific and editorial advisor to the American Council on Science and Health. His 42 books include The Health Robbers: A Close Look at Quackery in America; Health Schemes, Scams, and Frauds; Vitamins and "Health" Foods: The Great American Hustle; Reader's Guide to "Alternative" Health Methods; and five editions of the college textbook Consumer Health: A Guide to Intelligent Decisions. In 1984, he won the FDA Commissioner's Special Citation Award for Public Service in fighting nutrition quackery. In 1986, he was awarded honorary life membership in the American Dietetic Association. In 1987, he began teaching health education at The Pennsylvania State University.

Victor Herbert, M.D., J.D., F.A.C.P., is professor of medicine at Mt. Sinai School of Medicine in New York City and chief of the Hematology and Nutrition Laboratory at the Sinai-affiliated Bronx V.A. Medical Center. He is a board member of the National Council Against Health Fraud and a member of the American Cancer Society's Committee on Questionable Methods. He has served on the Food and Nutrition Board of the National Academy of Sciences and its Recommended Dietary Allowances (RDA) Committee. He consults in nutrition to the World Health Organization (WHO), has been president of the American Society for Clinical Nutrition, and was chairman for five years of the American Bar Association's Committee on Life Sciences and the Law. He has received the FDA Commissioner's Special Citation Award for Public Service in fighting nutrition quackery and is an honorary life member of the American Dietetic Association. He has written more than seven hundred scientific articles and received seven national awards for his nutrition research. His books include The Megaloblastic Anemias; Nutrition Cultism: Facts and Fictions; Vitamins and "Health" Foods: the Great American Hustle; The Mount Sinai School of Medicine Complete Book of Nutrition; Genetic Nutrition: Designing a Diet Based on Your Family Medical History; and Total Nutrition: The Only Guide You'll Ever Need.