Supplements, Vitamin Pills, Anti-Oxidants
How an Entire Industry Seeks to Mislead

https://www.humantruth.info/supplements.html

By Vexen Crabtree 2024

Supplement and vitamin pills do not work₁_,₂_,₃_,₄ outside of a strictly medical context. In particular, we don't need to take anti-oxidants such as Vitamin C nor Vitamin E and we certainly don't need mega-doses of vitamins. They don't help ageing, they don't "boost our energy" and don't make us live longer. They don't help prevent colds₅. Our body maintains a careful balance of oxidants, free radicals and anti-oxidants; the trick is to eat them (in food) in a balanced way; supplements encourage imbalance - the stronger they are, the worse the risk.

A powerful and rich industry of supplement pills has intentionally misled many people into thinking that we need such supplementary pills and used many dirty tricks to avoid regulators' restrictions on what claims they can make₆, yet the evidence is clear that they do no good. Even some mild supplements can increase the damage of some diseases. In total, all studies by 2008 had included 230,000 people, with the results being that vitamin pills in general don't have a health benefit and conversely they increase risks₃_,₄_,₇ and cause earlier death₂. The boring truth is that only well-rounded diets are truly effective at long-term health sustenance and weight management. Only the very basic advice is effective: cut down on fats and salts, sugary and fizzy drinks, eat plenty of wholegrain food, fruit and vegetables, and drink ordinary water.₈_,₉

1. Misguided

#bad_science #diet #food #health #pseudoscience

There are two routes by which these industries harm people's health. They can do so directly, causing medical problems as do some 'megavitamins' and fad diets. Megavitamins are normal vitamins in massive doses; it's certainly not beneficial and sometimes harmful. Or they cause harm indirectly by making people feel that their diet is good enough due to the supplements, when in reality they still need to improve their diet, because supplements do not work.

“[U]ntrue claims that certain nutrients and nutraceuticals reduce cardiovascular risk and prevent cognitive decline or cancer steer patients away from safe, proven treatments that are often cheap and generic. For example, generic aspirin, ACE inhibitors, and stains have been unequivocally proven to decrease cardiovascular risk and death in selected populations. [...]
After spending hundreds of millions of dollars on scientific controlled trials, it is now clear that megavitamins do not work.”
Dr Spector
Skeptical Inquirer₁₀ (2009)

“There is a gold-standard systematic review from Cochrane which brings together the evidence from all twenty-nine different trials on this subject, covering 11,000 participants in total, and concluded that there is no evidence that vitamin C prevents colds.”
"Bad Science" by Ben Goldacre (2008)₆

The success of the industry is based purely on public relations to such an extent that several countries have considered banning bottled supplements altogether. Although the contents of supplements are often the right chemicals that our bodies need, in most cases we simply cannot metabolize or use the chemicals in concentrated pill form, making them effectively useless. This is why most supplements-adverts are very careful not to claim that they can improve health or diet, but, they merely list their ingredients or give the results of opinion-polls rather than provide scientific evidence.

2. Antioxidants (Vitamin C, Vitamin E)

#bad_science #diet #food #health #pseudoscience

Oxidants are chemical products of cellular metabolism. They are highly reactive and can cause damage to proteins and cells₁_,₂. They're also called free radicals, and reactive-oxygen-species (ROS). We tentatively thought that as their reactivity can damage proteins and cells, causing disease and ageing, we can reduce that damage by inflating our level of anti-oxidants, by taking Vitamin C and Vitamin E supplements, but that's not the case₁_,₂.

Supplements such as Vitamin C and Vitamin E are "have long been peddled as preventative pills that have the ability to slow ageing and protect against diseases such as cancer. But the research has shown that the proposed molecular mechanism behind how they are supposed to work is false" - they don't reduce damage from chemical free radicals. Research Dr David Gems says "trying to boost your antioxidant levels is very unlikely to have any effect on ageing" despite the claims being made by those promoting some specialist diets and creams. Research into the effect of vitamins C and E on cancer have also come back negative.₃. Not only are the claims false, but they're harmful.

“Free radicals are vital for your body to kill off bacteria in phagocytic immune cells.”
"Bad Science" by Ben Goldacre (2008)₂

“ROS actually serve a purpose in the body, for example, as signals to cells or as neurotransmitters (nitric oxide). In fact, the body has evolved a balanced and complex system to maintain homeostasis between ROS and antioxidants. Influencing that system by taking large amounts of exogenous antioxidants may not be such a good idea. In other words, if a balance between ROS and antioxidants has evolved, there is no reason to believe that there are any benefits to tipping the scales in one direction - towards antioxidants. In fact, doing so may cause harm.
What does the actual clinical evidence show? [...] Overall, the evidence is ambiguous and does not support a benefit for treatment [... and] actually suggests the potential for harm. A comprehensive review published in 2008 concluded: 'We found no evidence to support antioxidant supplements for primary or secondary prevention. Vitamin A, beta-carotene, and vitamin E may increase mortality' (Bjelakovic et al. 2008).”
Dr Novella (2011)₁

Research results in 2023 found that in particular, Vitamin C, Vitamin supplements are linked with an increase in lung cancer growth₇, and, it doesn't require mega-doses in order to cause the effect. This was presaged by two previous studies who found that human subjects suffer more from lung cancer if taking anti-oxidants, and then, by a flood of corroborating evidence₂. In total all studies by 2008 had involved 230,000 people₂.

“One was in Finland, where 30,000 participants at high risk of lung cancer were recruited, and randomised to receive either ẞ-carotene, vitamin E, or both, or neither. [...]
[Another, over a decade ago, ] was called the 'Carotene and Retinol Efficacy Trial', or 'CARET', in honour of the high ẞ-carotene content of carrots. [...] The people having the antioxidant tablets were 46 per cent more likely to die from lung cancer, and 17 per cent more likely to die of any cause, than the people taking placebo pills. [..]
The most up-to-date systematic review and meta-analysis on the use of antioxidants to reduce heart attacks and stroke looked at vitamin E, and separately ẞ-carotene, in fifteen trials, and found no benefit for either. For ẞ-carotene, there was a small but significant increase in death.”
"Bad Science" by Ben Goldacre (2008)₂

Note that Vitamin E and ẞ-carotene are necessary and healthy in normal doses. It's supplements and unbalanced specific diets that can cause excesses.

“[If] people who eat healthily [...] have some supplements, and then they may have a ginger shot and a smoothie - [...] if you do all that, you could end up with the levels of doses that we're talking about.”
New Scientist (2023)₇

3. Omega-3 Fish Oils

#bad_science #diet #food #health #pseudoscience

The fish oil craze ("brain food!") centers on omega-3 oils.

“Omega-3 oils are 'essential fatty acids'. They´re called 'essential' because they're not made by the body (unlike glucose or vitamin D, for example), so you have to eat them. This is true of a lot of things, like many vitamins, and it's one of the many reasons why it's a good idea to eat a varied diet.”
"Bad Science" by Ben Goldacre (2008)₆

Dr Goldacre reports with observant glee that the benefits of omega-3s must be false, because "we do not have an epidemic of thick vegetarians"₁₁. There have been only 6 trials on children [as of 2008]; three of them, only half, have shown a positive result, and the others were negative. More importantly, all of them were on children who have medical problems, and none have been done on the representative populace. Even on those few who might be more likely to need supplements, any effect must be considered as part of overall diet, and, the positive effect is small.

4. The Dirty Tricks of the Supplements Industry

#australia #bad_science #canada #diet #food #health #pseudoscience

The supplements industry is well-known amongst scientists and government-officials to be worthless and sometimes harmful₄, but, it has a positive reputation amongst the public. A powerful and rich industry of supplement pills has intentionally misled many people into thinking that we need such pills and has used many dirty tricks to restrict science and avoid regulators' restrictions on what claims they can make₆.

The particular success of the dietary supplements industry compared with its particular ineffectualism was one of the reasons that prompted Dr Spector to report on the issue in the Skeptical Inquirer:

“It is worth noting that the nutraceutical (supplement) industry is a multi-billion-dollar enterprise. [...] Focusing on the lack of scientific rationale for so many nutritional claims, many people ask why and how this sad state of affairs developed.”
Dr Spector (2009)

“There is a more mundane reason why people may not be aware of these findings on antioxidants, or at least may not take them seriously, and that is the phenomenal lobbying power of a large, sometimes rather dirty industry, which sells a lifestyle product that many people feel passionately about. The food supplement industry has engineered itself a beneficent public image, but this is not borne out by the facts.”
"Bad Science" by Ben Goldacre (2008)₂

“The field of essential fatty acid research has seen research fraud, secrecy, court cases, negative findings that have been hushed up, media misreporting on a massive scale, and some very striking examples of people using the media to present research findings direct to the public in order to circumvent regulators. [...]
The [UK] Royal Pharmaceutical Society was expressing concern at these covert marketing strategies in the mainstream pharmaceutical industry as long ago as 1991: `Barred from labelling products with detailed medicinal claims unless they submit to the licensing procedure,´ it said, `manufacturers and marketing companies are resorting to methods such as celebrity endorsements, free pseudomedical product literature, and press campaigns that have resulted in uncritically promotional features in large-circulation newspapers and magazines.´ [...]
The vitamin pill magnate Patrick Holford, for example, makes sweeping and dramatic claims for all kinds of supplements in his 'Optimum Nutrition' books; yet these same claims are not to be found on the labels of his own-brand 'Optimum Nutrition' range of vitamin pills (which do feature, however, a photograph of his face).
Alternative health columnist Susan Clark - who had a column in the Sunday Times, Grazia and the Observer for several years. In the course of these columns she recommended one company's products, Victoria Health, with notable frequency: once a month, regular as clockwork, by my reckoning. [...] She had done paid work for the company in the past, and she has now left her newspaper jobs to take up a full-time position at Victoria Health, writing their in-house magazine.”
"Bad Science" by Ben Goldacre (2008)₆

As well as industry-wide successes in avoiding regulations to get advertising to replace science as its basis, the industry also engaged in a wholesale price-fixing scheme. The scale of this highlighted just how much money the industry makes.

“The vitamin industry is also - amusingly - legendary in the world of economics as the setting of the most outrageous price-fixing cartel ever documented. During the 1990s the main offenders were forced to pay the largest criminal fines ever levied in legal history - $1.5 billion in total - after entering guilty pleas with the US Department of Justice and regulators in Canada, Australia and the European Union.”
"Bad Science" by Ben Goldacre (2008)₁₂

5. Fad Diets and Pseudoscience: Let's Stop Falling for These Tricks

#bad_science #diet #diets #fads #food #health #pseudoscience

Diet has an impact on health and affects the risk of disease₁₃. Over the last few decades biochemical and other sciences, from neural to gastric, have made impressive contributions to our knowledge₁₄. Never before have scientists known so much about food and nutrition. Unfortunately much of this knowledge is not reported by the popular press and news outlets because it is technical, mundane and statistical in nature. The average consumer mostly hears only the sensational claims of pseudoscientific sham researchers and promoters, which are often paid for and orchestrated by the rich food industry itself. The two most misleading sources of information are reports based on single-studies and TV adverts. Most people are ill-informed about diet and health as a result of this.

There have been a long series of temporarily popular fad diets which limit food intake to a specific range of items, sometimes cutting out essential fats and proteins completely. They emphasize rapid short-term change at the expense of medium and long-term issues. Of the independent scientific studies on fad diets, supplements, mega-vitamins and similar highly-hyped abnormal sources of nutrition, all have found them to be useless and sometimes actually harmful. The National Health Service (UK) warns that "many fad diets are based on dodgy science or no research at all, prescribing eating practices that are unhealthy and can make you ill"₈.

Fads rely on testimonials and public-relations tricks to make themselves sound effective and claims are often based on (easily biased) single-studies rather than on independently verified and duplicated scientific trials. The mass media love reporting on these single-studies as their claims are often outlandish and celebrity endorsements boost a fad diet from time to time. Fad diets distract people from sensible eating habits. Rather than accept enthusiastic praise from soap stars, models and newspaper advertisements, it is doctors and the medical profession that we should trust to keep us informed. Let's stop falling for these tricks!

For more, see:

"Fad Diets and Pseudoscience: Let's Stop Falling for These Tricks" by Vexen Crabtree (2014).