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Research Study States that Supplements are Harmful.... Really?
Mainstream media has been sensationalizing the latest study published in the Archives of Internal Medicine on the use of dietary supplements by older women. (1) Most of the headlines about this 19-year long study involving about 39,000 women with an average age of 62 state things like, “Women taking multivitamins or other supplements have an increased risk of death.” Basically, they are all saying that vitamins will kill you.
Wow! That sure gets our attention!
Don't worry about eating junk food, not exercising, smoking, drinking, speeding or the misuse of pharmaceutical drugs. Vitamins are the newest health hazard.
Well, of course I'm going a bit overboard. But it really bothers me when mainstream media jumps to a conclusion without carefully considering the validity of the study. If you read the broad base of data coming out of this retrospective study, a fuller picture emerges:
- The Iowa Women's Health Study was observational, where participants were asked to fill out three surveys over 19 years, reporting what supplements they took and what foods they ate, and answering a few questions about their health.
- This particular study took only one element, that of supplements and minerals, of the overall Iowa Women's Health Study, which looked at numerous lifestyle factors that may affect mortality due to heart disease, cancer, and other causes.
- Lifestyle factors, which are known to have a far greater influence on survival outcome than typical vitamin and mineral supplementation, have been ‘adjusted out’. Before this "data massage process" had occurred, the findings are quite different, and appear to have been largely ignored by the mass media.
- That being said, the headlines didn’t report that for most vitamins and minerals in the study there was no increased risk of death. In fact, calcium use reduced the risk of death in this study by about 9%. Interestingly, other studies, supported by plausible mechanisms, suggest that very high intakes of simple calcium supplements, especially in the absence of vitamin D, may increase risk of heart attack and therefore death.
- The headlines also neglected to mention that, on average, supplement users also had lower rates of diabetes and high blood pressure, two very important risk factors for overall health and mortality.
- What the study did report was that the use of iron, vitamin B-6, folic acid, magnesium, zinc, and copper had, on average, a slight/2.4 percent increased risk of death over the course of the research. Iron had the highest associated risk in women over 61. Iron is rarely recommended for older adults anyway, and supplementation should always be monitored by a physician.
- Most importantly, the study itself didn't look at a possible direct cause-and-effect of these ingredients. The study was non-placebo controlled and retrospective, based on “dietary recall” or self-reported supplement use, which is notoriously flawed. And, the study authors admit, a range of factors aside from the use of supplements could have impacted the outcome. For example there were no health comparisons drawn between supplement users and nonusers at baseline.
I have to conclude that this study shows a strong and flawed bias against supplement use. The conclusion of the study’s authors that general supplementation is unjustified and that supplements only be used for a “strong medically based cause such as symptomatic nutrient deficiency disease” is a perfect example of that flawed logic. As the Council for Responsible Nutrition pointed out, if supplements should only be used when a nutrient deficiency has been diagnosed by a doctor and the supplement is prescribed by that same doctor, the nutrient with the highest associated risk of death in this study, iron, was most likely used exactly that way.
I have been reading the current research on supplementation for many years, and there is a wide base of excellent research that shows the benefit of high quality supplementation. Age-appropriate supplementation, along with a healthy diet and lifestyle, can have many positive benefits for young and old alike. References of 758 studies over the past 20 years have been compiled in a single pdf document by the scientists at USANA Health Sciences if you care to follow the link and look.
Personally, I will be following the advice of the Alliance for Natural Health-International as quoted from their Executive and Scientific Director, Robert Verkerk, PhD:
"Don’t let this study influence your decisions about supplementation. We have always upheld that high doses of particular synthetic vitamins, notably synthetic vitamin E (alpha-tocopherol), beta-carotene and folic acid (pteroylmonoglutamic acid) may pose some risk to health in some individuals. But to avoid these risks, simply make sure you supplement with the right forms, at least of these vitamins, such as mixed tocopherols (and tocotrienols) in the case of vitamin E, mixed natural carotenoids in the case of beta-carotene and natural folate (including the 5-methyltetrahydrofolate form) in the case of folic acid.
And remember to maintain that healthy lifestyle: don’t smoke, get plenty of sleep, manage your stress, eat lots of fruit and especially vegetables, drink plenty of clean, unadulterated water — and exercise regularly. Oh, and don’t forget to supplement, as contrary to what most health authorities try to tell us, it’s increasingly difficult to get enough nutrients from our food alone to keep us in optimum health."
Live Well,
Robin
References and further reading:
1. Arch Intern Med. 2011 Oct 10;171(18):1625-33. Dietary Supplements and Mortality Rate in Older Women: The Iowa Women's Health Study.Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR Jr.Department of Health Sciences, Institute of Public Health and Clinical Nutrition,University of Eastern Finland, Kuopio Campus, PO Box 1627, 70211 Kuopio, Finland.
USANA Health Sciences: Health Benefits of Nutritional Supplementation
Orthomolecular Medicine News Service
Council for Responsible Nutrition
In appreciation to Russ Barton MS, CNS, CISSN, USANA Science Information Services
Robin started contributing to Lumigrate in August 2010. "Meet Robin Thomas", a topic in our biographies/vitae forum is at http://www.lumigrate.com/forum/meet-robin-thomas to read all about her journey, which was greatly influenced by the need to help solve her youngest son's significant health challenges. For those who want just the overview here: After working over 22 years in medical research at the University of North Carolina on chronic inflammatory diseases she switched her focus to preventive health in 2004 when she was introduced to USANA Health Sciences. Robin is passionate about helping others improve their health, have more energy, manage their weight, and improve their skin.
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"I dream of a world free from pain and suffering. I dream of a world free from disease. The USANA family will be the healthiest family on earth. Share my vision. Love life and live it to its fullest in happiness and health."
-Dr. Myron Wentz, Founder and Chairman, USANA Health Sciences
This forum is provided to allow members of Lumigrate to share information and ideas. Any recommendations made by forum members regarding medical treatments, medications, or procedures are not endorsed by Lumigrate or practitioners who serve as Lumigrate's medical experts.
Hi Robin, I'm glad what I suspected when I heard this covered on the news was what you found when you dug into it with your expertise and scrutinous abilities -- it sounded VERY suspicious to me. However, I'm only glad that my radar was right when it went off, I'm VERY frustrated and concerned that confusing information reaches and inundates people through the media!
Beyond this type of bogus and misleading 'research' going on, the bigger insult is the visibility it is given by the media! The reason for my emotion about this, is I see so many people who are really suffering with health issues that have been caused by poor information and reporting and education in the past! It's heartbreaking! Increasingly, their awareness is up but they've not yet learned how to discern what is valid and what is not, as I have to turn to someone who knows research more than I, and appreciate your being on the Lumigrate team to turn to.
I believe and forsee there's going to be a growing 'fight' over supplements; I know that the reason "Vitamin Cottage" changed their name to "Natural Grocers" had to do with their marketing/legal people seeing what was coming down the tracks in the business, a.k.a Codex, and I'd talked with them two years ago about that. The good news is, the public demand is leading them to expect this expertise from their providers to become more knowledgeable about supplements.
I am concerned that by the providers who have gotten into selling supplements, however, which has been increasingly the case as they can make more revenues, there is going to eventually be the same problems we had when the pharmaceutical industry got so 'close' to physicians and other prescribing providers financially. It clouds the judgment if a provider isn't really firm in their ethics. It makes the consumer or others who the consumer tells wonder about if they're just saying things to sell a supplement. I hear patient after consumer/patient tell me 'I didn't know if he/she was recommending that because they were going to make money off of what they were going to sell me." So that 'separation' and delineation is getting blurred. It would be like the doctor saying 'eat this and that' and then making money when you checked out because they sold this and that food. Ideally, have the providers sending the consumers to a resource online or with a roof and brick and mortar, so to speak, but then you don't have the expertise giving the guidance on what to buy so that's not so ideal either. People just have to find what resonates for them, ultimately.
I know that if a doctor says to me "I think you could benefit from taking this supplement, I think you can get it at the health food store", that seems 100% unbiased. If they said "... you can buy it from me", I'd have to be wondering about it.
And that was a real example from last week with me, my osteopath suggested two things for my seasonal allergies (quercitin and a nasal spray developed by a DO)(it worked wonderfully by the way!). (NOTE from later: All the while she had a product in a closet she sells and never tried to sell me until I said 'what do I do if my S.I. joint goes out like that again when I'm traveling and having to sit a lot?', and so it was in the way that I had to have a big need for something before I even was aware she sold anything to patients, and she didn't have much markup on it either. ... I was assured by the trust I have developed over time going to this provider.)
That's why I'd prefer to see providers setting their patients up with resources for purchasing supplements that have NO connection to them financially. I've been part of a start-up clinic; the costs are staggering, and a way to offset that and be able to have the doors open and lights on without charging each patient MORE per minute of time with the provider is to have them purchase their supplements there rather than elsewhere. Which is awesome if it's convenient AND the provider is being ethical in how and what they suggest to the patient.
It comes down to 'some are and some aren't' same as with anything in the medical industry -- some are qualified, some are not; some are ethical, some are not. Buyer beware, patient beware.
I would like to see more medical providers in the US (and beyond) getting to know you and the other supplement resources on Lumigrate (the co-president/pharmacists at ITC Pharmacy, for example and others will likely be added in the future), to refer people here and we can help direct them to the experts who can help them. We also have a link to a very well respected natural foods/supplement vendor who ships nation-wide, the afore-mentioned Vitamin Cottage, but if people need assistance with what to select, I'm not as comfortable with who answers the questions as I am if they call you or the guys at ITC. (NOTE from later: They have scaled back their online aspect of their business since this was written.)
I'm not 'immersed' in the supplement world like you are since I'm immersed in Lumigrate and covering ALL aspects of mind/body/soul 'integrative' medicine, but I like to think I know a fair amount about all topics being covered, and I do have a lot more information 'on hand' and 'in head' than what gets posted on Lumigrate.
One example that pertains to this discussion is the study that was done on publications that professional medical people subscribe to: There was an inverse relationship of # of advertisements from the pharmaceutical industry and # articles about nutrition supplementation.
So when I heard on the news about the study that you're referring to in your piece here now, as ALWAYS, I try to think 'who was behind the study, who was funding the study'. I hope everyone does this as they become savvier health care consumers! "Follow the money." But it's really hard to sort out if a person is totally unaware of how the medical industry that is known as 'modern medicine' with 'big pharma' being part of that system (which I jokingly call 'mangling medicine', others call it the 'sickness model' rather than a wellness model like we promote at Lumigrate).
In my research class in OT school I had buddied up to some of the top male students in the class, as we were doing EVERYTHING in group projects to make the grading easier on the instructors and allegedly to teach us in those two years how to work in teams. There were about 10 of us that were older and didn't have kids, about half guys and half gals. We hung out on weekends cooking and eating on Saturday evenings about once a month, and playing Pictionary. We had a blast together at those, and in school we'd had a great year of fun and learning as well.
So I got into a group for our research project final with three of the guys -- and they were some of the top students in the class in terms of grades and leadership, etc. The topic we decided upon to research was 'depression' and if running/exercise had an impact. One of the guys in the group had a history of depression and he was finding running was helpful.
Well, I had been into yoga for a while by then .. about five years. I'd actually stopped when I was having the onset of what turned out to be fibromyalgia just after I started into the OT program; I'd been unaware of a herniated disk in my neck, and was actually unknowingly antagonizing it with my yoga practice and gym workout (and had been riding my bike a LOT, even doing a tour of Alaska in 1995, I was 35 that summer). So I dug into research about yoga and depression/mental health/well-being and found a lot of evidence that indicated yoga was JUST as effective in affecting people's depression as doing something more aerobic, like running.
But that wasn't the answer one of the guys in the group had wanted to come up with, the three amigos banded together with the guy with the history of depression. It's one thing to have a preconceived notion of what is causing something, but when you go into researching it you really have to design things to find the truth. So I learned right then and there how it could be that some research from the start is so poorly designed.
And in our case, it was only EGO involved, there was no MONEY involved like in the real world of research! Since I'd worked for 8 years with some of the top air quality scientists in the United States from age 24 to 32, and was involved in producing and distributing the research once it came out of the brainiacs computers and printers, I knew that my little OT class research group was not doing things the right way. And these were my pals, my buddies outside of class, remember. Ultimately, I figured it would not be in their best interests complete our project and turn it in and get our grade back and let them go on to internships and starting their new careers without my version of the experience.
So I opted to give them my feedback. (For starters, they liked to meet at 9 pm and Monday or something, which wasn't a good time for me, my significant other went to bed about that time as he got up early to go to work in the mornings. So there I was at our LAST meeting at 9 pm (yeah! we're on the home stretch of college and this class and this group project....) and they were saying how great we'd done. I said 'not from my perspective. You missed every deadline, I was the one putting the pieces together and I asked you to all learn APA format so you knew what that was and you didn't do it, I covered a lot of bases for this group and you didn't do your equal shares." They looked crushed. I hope it was to their benefit that I did that; I trust it was.)
That was ONE of MANY hidden treasures in my education in the mid 1990s at one of the top-rated OT programs in the country at the time, Colorado State University. However, today, I'm very concerned about the general quality of the providers the people in the United States are interacting with, overall, whether they're doing reseaarach or hands on. That is why I work so hard to sort out those who contribute at Lumigrate and why I VERY MUCH VALUE all our experts' backgrounds both in education in and work history. (Robin's being in medical in research until her youngest son had medical problems requiring her to work from home, which is covered at her website and in our 'About the Lumigrate experts' forum.
Again, THANK YOU for this piece, as I quite frankly am shocked when I see the poor quality of supplements that many people have been using; they're clearly not 'invested' in supplementing their nutrition by purchasing those brands in the first place, and I could envision people reading or hearing of this study that was widely publicized in the media due to it's WOW factor, and people throwing the whole concept out the window. And I can see how if people take poor quality or not the correct supplement for them, it would contribute to shortened lifespan. For instance, people thinking if they're tired they need more iron - for many people iron something to avoid or not go out of the way to consume more of. Others its absolutely needed. Finding qualified experts who can guide what to ask providers for in tests and what to take is the difficult part right now. We hope we've helped fill a void.
I clearly believe that supplementation is critical for ideal health and, more importantly, health of the whole body with longevity/advancing age. Doing it "correctly" is the key. At least there is now some evidence about how supplementing incorrectly is counterproductive -- this is a case in point! ~~ Mardy
Live and Learn. Learn and Live Better! is my motto. I'm Mardy Ross, and I founded Lumigrate in 2008 after a career as an occupational therapist with a background in health education and environmental research program administration. Today I function as the desk clerk for short questions people have, as well as 'concierge' services offered for those who want a thorough exploration of their health history and direction to resources likely to progress their health according to their goals. Contact Us comes to me, so please do if you have questions or comments. Lumigrate is "Lighting the Path to Health and Well-Being" for increasing numbers of people. Follow us on social networking sites such as: Twitter: http://twitter.com/lumigrate and Facebook. (There is my personal page and several Lumigrate pages. For those interested in "groovy" local education and networking for those uniquely talented LumiGRATE experts located in my own back yard, "LumiGRATE Groove of the Grand Valley" is a Facebook page to join. (Many who have joined are beyond our area but like to see the Groovy information! We not only have FUN, we are learning about other providers we can be referring patients to and 'wearing a groove' to each other's doors -- or websites/home offices!) By covering some of the things we do, including case examples, it reinforces the concepts at Lumigrate.com as well as making YOU feel that you're part of a community. Which you ARE at Lumigrate!
Someone on Facebook shared this video link in a thread that was created when he posted an article from a conventional medical journal's findings about heavy menstrual bleeding and iron supplementation -- with the comment added of 'duh', since they were studying and taking up journal space on something that was pretty common sense. It lead to a discussion where I referenced this topic at Lumigrate and someone else mentioned Geritol. I didn't know they even made that anymore, it's just not on the radar at all in the supplements or health circles that I am in.
So I watched the video for old times sake and thought about how I was 23 then, my health problems were completely baffling everyone and I had good insurance and was seeking out health advise. The Internet was something I would learn of a dozen years later and not start to use for research for many more years. THIS was what I was exposed to for 'education' about wellness. At this time, my mother was becoming more ill and it wasn't determined for a while that she had the most common genetic disorder, hemachromatosis. Despite her father having had it and her telling me as a young girl about how I might be a carrier and so if I have any boys in the future if I had children, I'd need to be aware of it, but women never get it.
She was diagnosed in the mid '80s and died in early 1987 at the age of 62, with the hemachromatosis being just one contributing factor along with a high use of tobacco since age 12 and alcohol since college age. Why was it she took to those drugs like a fish to water? We'll maybe never know, but I believe today there are biochemical approaches to understanding addictions and have also provided that information at Lumigrate earlier this year. (Search on addiction, pyroluria to find the topics there are two, and also methylation is another word I'd suggest searching on here or in general to learn about some interesting things YOU might not already know.)
So obviously 'mama didn't know right' when she was educating me at age 4 about things in our family genetic tree. Women do get hemachromatosis if BOTH parents have he gene for it, so it's very rare that it occurs. What are the chances? We used to think it was amazing that they said that handedness was genetic and both of my parents were lefties/south paws, yet my sibling and I were both right handed. We just didn't know very much back in the 'good old days'.
I was then tested for the condition and gene well into the 1990s, but only because of my family history and my taking it to the attention of my physicians. I was going to a lot of physicians at that time due to what turned out to be fibromyalgia but again, was escaping their expertise to diagnose it. Even the heavy menstrual bleeding and clotting problems that had occurred whenever I had minor surgeries, such as wisdom tooth extraction or adenoidectomy in my teens or age 4, respectively, never had anyone looking into why that was. I was in my 40s before an MD knew of a less often performed test for clotting that measures what's in your tissues and not in your veins. Still a bafflement to put it all together and understand what's causing it, but at least I had the information that it was something to really be aware of and take into account relative to my overall safety and wellness. So we're onions that take time to get through the layers and figure out sometimes, likely always with more layers than time or expertise to get to the bottom of it.
Other physicians had known and not suggested testing, and luckily they moved or I moved or my insurance changed again and I'd have another brain in the game. My point in bringing this up is that it's such a common condition and makes your organs hoard iron which damages them (and other metals can be involved as well as I understand it). So even living in progressive communities along the Front Range of Colorado, I wasn't getting very good medical advise oftentimes. What about the people in Iowa? I'd suspect there are fewer physicians whose dream job is to work in Iowa compared to Colorado, though I'm sure there are good physicians everywhere. It's kind of like kissing a thousand frogs to find the prince.
But hopefully this little story helps people see why the research can end up being misleading when they study a batch of 'ordinary people'. The ordinary people were maybe doing their best to take what supplements they took and the supplements were simply, as Robin pointed out, harmful in some cases and had they had more education and made better choices, the research would have had different results.
I hope this topic is helping our YOUsers understand how the media game is being played relative to things that are good for you and bad for you, or frightening to you, or maddening to you. But mostly how the scientific studies that we used to be able to trust were well done if they were in esteemed journals are no longer to be necessarily trusted. And Robin hopefully pointed the way to how she detectives them. Others do as well, so Searching online for what others have to say and NOT just going with what comes up at the top of your search results that Google picks knowing what they know about you.
Enjoy the old commercial if you go .... Here's to how much better we have it now for information available to us, it's just a matter of getting in the habit of how to research and apply it for those who didn't grow up with the Internet as a tool, or who don't keep up with things about how the search results are filtered and customized to each Google user (if you use Google, many use other search engines, increasingly, but it's certainly our mainstay today).
www.dailymotion.com/video/xcht5x_1983-geritol-commercial_shortfilms
Live and Learn. Learn and Live Better! is my motto. I'm Mardy Ross, and I founded Lumigrate in 2008 after a career as an occupational therapist with a background in health education and environmental research program administration. Today I function as the desk clerk for short questions people have, as well as 'concierge' services offered for those who want a thorough exploration of their health history and direction to resources likely to progress their health according to their goals. Contact Us comes to me, so please do if you have questions or comments. Lumigrate is "Lighting the Path to Health and Well-Being" for increasing numbers of people. Follow us on social networking sites such as: Twitter: http://twitter.com/lumigrate and Facebook. (There is my personal page and several Lumigrate pages. For those interested in "groovy" local education and networking for those uniquely talented LumiGRATE experts located in my own back yard, "LumiGRATE Groove of the Grand Valley" is a Facebook page to join. (Many who have joined are beyond our area but like to see the Groovy information! We not only have FUN, we are learning about other providers we can be referring patients to and 'wearing a groove' to each other's doors -- or websites/home offices!) By covering some of the things we do, including case examples, it reinforces the concepts at Lumigrate.com as well as making YOU feel that you're part of a community. Which you ARE at Lumigrate!