As I travel the underground to work each morning I must survive a barrage of advertising. Everywhere you look in a modern city there is some kind of attempt to get you to buy the latest doodad or visit this or that place. One of the largest categories of advertising is that of the supplement industry.
Feel less tired. Improve your mood. Regrow your hair. Protect your heart. Stop that cold. Boost your immune system. Pass that exam. There is nothing, apparently, that the right mixture of vitamins and nutrients cannot do for you. The problem is that there isn’t a supplement in the world that can do any of these things; indeed, high doses of some vitamins can even be harmful.
Before we get into the meat of this I want to caveat it by saying that if you actually have a genuine vitamin deficiency of some kind, or if you think you do, then go see your doctor and follow their advice. This article is not about actual sick people with actual deficiencies, I’m talking about the typical person who wants to cheat the system by taking a pill. Let’s get to it.
A lot of people don’t seem to realise this but as the supplement market is entirely unregulated in the US and UK supplement suppliers have no burden of proof for either the safety or efficacy of their products. So when a supplement does claim to have scientific underpinning then it generally means one of two things. Either they have hired a company that conducts research for hire and has given them an end point to achieve by whatever means necessary; needless to say this is not science.
Or, secondly, they will highlight legitimate science that has been conducted by some third party. Normally this will be a small, basic research study that might not even actually be linked to the issue at question. Throw a toxic quantity of vitamin A onto some cancer cells, if it affects them adversely, which it may well do, then they can say that their supplement helps fight cancer. It doesn’t matter that that quantity would also be enough to kill an ox.
In both cases, scientific studies are just being used as a marketing ploy to give a thin veneer of legitimacy to an otherwise fictional health claim.
Many supplements are marketed as sticking it to Big Pharma. “Here’s the drug that The Man doesn’t want you to have because it’ll make you live forever, cures what ails ya and is available at a reasonable price from our online store!!” The thing is, nearly all the supplement companies are just offshoots of the Big Pharma companies we’re (supposedly) meant to be railing against. So if you’re trying to avoid filling the pockets of a billionaire CEO, you’re failing.
Think about this: In the proper drug industry with the full weight of multi-billion dollar drug companies behind them, with the best research that money can buy and the greatest minds in the field hammering away at it, only 8% of drugs make it from basic research to a shelf in your pharmacy. There is a huge failure rate because either the drug wasn’t as effective as was hoped or because the side effects were intolerable. It takes, on average, about $10 billion dollars of upfront investment and 15 years to get a drug to market; that’s why it is only the big companies that can afford to do it. This is also why that, when your doctor prescribes you a medicine, you can be pretty sure that it will do what it claims and that you can be warned ahead of time about unpleasant side effects. In the supplement industry: it’s a crap shoot. You can’t even know for sure if what is in the box even matches the packaging.
Here’s another aspect that seems counterintuitive, simply ingesting the pure vitamin doesn’t seem to provide any real benefit to the body. There is preliminary research suggesting that some of the thousands of other chemicals inside your fruit and vegetables are necessary to get the best out of the vitamins you consume. Basically there is no shortcut to healthy eating.
There is no shortcut to high quality scientific research either. Studies of tens and even hundreds of thousands of people, followed up over multiple years or even decades are what is required to genuinely know if a drug (make no mistake, vitamins are drugs) is efficacious and safe.
Lets look at some of these high quality studies, what do they show us?
Let’s start with the heart, we’re often told that this or that supplement will lower our cholesterol or somehow protect our heart, perhaps from free radicals or whatever the current buzz word is. Four years ago the United States Preventative Task Force conducted a thorough review of all the evidence for effects of supplements on cardiovascular disease (CVD) along with cancer and mortality. They looked at studies with hundreds of thousands of people in them that covered vitamins A, C, D, folic acid, selenium and calcium. They concluded that, “…studies showed no clear evidence of benefit. Neither vitamin E nor β-carotene prevented CVD or cancer, and β-carotene increased lung cancer risk in smokers.” That’s right, if you are a smoker then taking vitamin A actually increases your risk of getting lung cancer.
What about your brain? Want to feel more alert? Stave off dementia? Increase your intelligence? I’ve got the supplement for you! It’s called sleep; no supplement is going to help you. A study of 6000 dudes over 65 years of age taking a daily multivitamin found that after 12 years, “…there were no differences between the multivitamin and placebo groups in overall cognitive performance or verbal memory.” In another review, 12 good quality studies looking for cognitive improvements in patients with early stage dementia found that multivitamins, B vitamins, vitamins E and C, and omega-3 fatty acids were ineffective: “None of the supplements improved cognitive function.”
The powers of vitamin C are legendary. Obviously it will protect you from the flu and getting colds, it’s also well known to protect your heart. Except, the reality is that it doesn’t do any of these things. Linus Pauling is a scientific hero of mine. He won the first of his two Nobel Prizes at the age of thirty. When he initially submitted that paper for review the editor of the journal couldn’t find anyone qualified to go over it. When Einstein was asked what he made of Pauling’s work he shrugged and replied, “It was too complicated for me.”
Despite his indisputable genius Pauling, in his later years, became a quack when it came to the powers of vitamin C. He would routinely take hundreds of times the recommended daily dose and wrote a best selling book encouraging the American public to do likewise. And they did, in their millions. That legacy, sadly, lives on despite a mountain of evidence that extra vitamin C doesn’t bring any benefits. In a review last year of all the evidence to date, the authors concluded that, “the current literature provides little support for the widespread use of vitamin C supplementation.”
Given that there appear to be no benefits and, in some cases, there are actually increased risks to taking dietary supplements, another review from 2013 contained a stark warning: “The message is simple: Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided.” These are very strong words to be printed in a scientific journal, but this is where the evidence has led us.
The problem is that this is now a wordwide $100 billion industry, $30 billion per year in the US alone. Ironically, though the supplement industry sells us the idea of beating the system; of dodging Big Pharma; of living healthier, cleaner lives; it is actually they who are the Big Pharma companies and they who are doing us harm, financially if not physically.
I’m afraid it’s the same message as always, if you want to be healthy and feel good then this is what you do:
- Get plenty of sleep.
- Don’t smoke.
- Take regular moderate exercise.
- Drink alcohol only in moderation.
- Eat a wide and varied diet, mostly fruits and vegetables, not too much red meat.
It really is that mundane. It’s also unlikely to make anyone much money, but there it is.