dr. alan gaby

As we discussed in our last post asking “Are Vitamins Bad For You?”, a number of studies on supplements are getting a great deal of attention in the press lately. As usual, it’s negative attention. For some reason, the medical and mainstream media seem to ignore studies that find health benefits as a result of nutritional supplements, but they sure make a ruckus when there’s even a whiff of bad news. The three most recent studies published in the Annals of Internal Medicine are being trumpeted all over the web and the airways as bad news for dietary supplements. Our post points out that that is a misguided conclusion, unsupported by the scientific evidence.

A couple of years ago there was a similar hoopla, and the same sources were making it sound like nutritional supplements are unscientific, a waste of money, and often bad for you. At that time, we interviewed one of the world’s foremost experts on nutritional medicine, Dr. Alan Gaby, to see if he agreed with the conclusions others were drawing about those studies. You can read his responses to see that, in fact, the studies were flawed, and the judgments delivered by the media were faulty. 

Now, the media is again telling us that a succession of studies have found that supplements have either no health benefit or possible negative health consequences. We decided to examine some of these recent studies, and we again solicited Dr. Gaby’s opinion. 

One of the oft-cited studies, from the November 2012 Issue of the Journal of the American Medical Association, followed nearly 15,000 American male physicians who were fifty or older when the study began, with an average age of 65. They were followed for a period of 14 years during which they took either Centrum Silver^® or placebo (sugar pill) daily. At the end of the study, the multivitamin had no effect on preventing heart disease or heart attack and stroke.

Of course, a study like this isn’t applicable to women, especially younger women. It does show that older men who begin taking a low potency multivitamin late in life shouldn’t expect too much benefit from it.

And, as Dr. Gaby points out, the product used in the study contains (according to the label) the non-nutritive additives crospovidone, butylated hydroxytoluene, FD&C Blue 2 Aluminum Lake, FD&C Red 40 Aluminum Lake, FD&C Yellow 6 Aluminum Lake, polyethylene glycol, polyvinyl alcohol, sodium aluminum silicate, sodium benzoate, talc, and titanium dioxide.

Dr. Gaby reminds us that

“It would be surprising if none of these chemicals were harmful with long-term use, and it is possible that one or more of them negated a beneficial effect of the nutrients.”

Even given the shortcomings of the product used in the study, among the men in this study who had already had cancer, those taking the multivitamin had a significant 27% reduction in new cancers. The men taking a multivitamin were also 6% less likely to die from any cause compared to those taking placebo, though this result could have been from chance, and would need to be more clearly demonstrated in another study. The men taking the multivitamin were 8% less likely to develop cancer during the study. Furthermore, a study using the same product was undertaken in China, where people are more likely to suffer from nutritional deficiency. In China, the multivitamin decreased heart disease deaths in men and in older people, but appeared to increase the risk of stroke deaths in women and in younger subjects.

All of these results merit further study, meaning they are not truly conclusive one way or another. Unfortunately, the editor of The Annals of Internal Medicine has twisted the facts, declaring that all of these equivocal results mean that "the case is closed", and that vitamins and supplements are a waste of money, and worthless. It is curious that, while championing the concept of science in medicine, and research advances, the overall medical establishment distorts research on dietary supplements. Stay tuned: this story will probably have many more chapters to follow.

Major media outlets like NPR, Fox News, the Wall Street Journal, and others are telling us that new studies published in the Annals of Internal Medicine have conclusively proven that vitamins and supplements are a waste of money at best, and possibly even bad for you.

This is a familiar refrain of these large media outlets and the medical commentariat. A couple of years ago, a very similar story prompted this same kind of hysteria from the same sources. In that case, we found that it was easy to poke holes in the conclusions that were being trumpeted as “airtight.” In that case, we enlisted the help of Nutritional Medicine Expert Dr. Alan R. Gaby to help us understand the merits of the 2011 studies, and their very obvious faults.

There are three new studies that have caused this new hue and cry. We’re going to examine them one by one, and see if they really do tell us that vitamins are worthless.

One of the studies looks at what happened when people took a multivitamin, or a placebo (sugar pill) after they’d had a heart attack. Although we’re not sure what multivitamin was used, most such studies use the equivalent of Centrum Silver^®. The average age in the study was 65; 18% were women; and the average time between the first heart attack, and beginning a multivitamin, was 4.5 years.

The results of this study don’t apply to people under the age of 65, or to women, or to people who’ve never had a heart attack, or to people who start taking a multivitamin shortly after a first heart attack! Unfortunately, you don’t get that impression from the media reports and from the medical doctors commenting on the study. You get the impression that this study concluded that for everyone, multivitamins are unhealthy and a waste of money. However, the authors themselves didn’t find any negative effects of taking a multivitamin in this group of older men, nor do they try to say that their results apply to younger people who haven’t had a heart attack.

The next study compared a multivitamin to placebo for its effect on cognitive decline, such as memory loss and Alzheimers. This study was conducted on close to 6000 male doctors aged 65 or older. Again, these results are meaningless for women; for people under the age of 65, and even for people with very different levels of wealth and education, compared to American male doctors.

The last study was not original research but rather a study of studies to examine whether vitamins and minerals could help prevent cancer or heart disease in those who had never had those conditions. This type of study allowed the researchers to look at existing scientific evidence for multivitamins as well as individual nutrients such as vitamin E, selenium, folic acid, and calcium. The value of this kind of study is that it includes very large numbers of study subjects, so the authors are less likely to be fooled by random occurrences. However, the conclusions they were able to reach were limited because in each study, different preparations of different nutrients were used. The authors concluded that two good quality studies on multivitamins showed a slightly reduced incidence of cancer in men but not women, and confirmed what many other studies have found: that isolated Vitamin E and beta-carotene raise risks of disease.

The authors actually give a conditional endorsement to the concept of using multivitamins in their article:

“One explanation for this result (that studies on individual nutrients often don’t find the benefit that some would expect) could be that the physiologic systems affected by vitamins and other antioxidant supplements are so complex that the effects of supplementing with only 1 or 2 components is generally ineffective or actually does harm.”

The editorial accompanying the three studies proclaimed “Enough is Enough: Stop Wasting Money on Supplements.” Do you think these studies proved that supplements are a waste of money, or bad for you? For women, for people under the age of 65, and for those who choose to take high quality multivitamins, these studies don’t prove much of anything. They certainly don’t justify the headlines we’ve been seeing.