Streams

Following Up: Supplements

Monday, June 11, 2012

Dr. David Agus, professor of medicine and engineering at University of Southern California Keck School of Medicine and author of The End of Illness, referred to the lack of proof of the need for vitamins and supplements in his appearance on the Brian Lehrer Show in February. Agus and Jeffrey Blumberg, professor at the Friedman School of Nutrition Science and Policy at Tufts University, debate the need for supplements.

 

Guests:

Jeffrey Blumberg

The Morning Brief

Enter your email address and we’ll send you our top 5 stories every day, plus breaking news and weather.

Comments [52]

Dave

Agus received a $20,000 speaking fee from statin maker Pfizer. Figure it out. Brian, don't you vet your guests or at least call them out for conflicts of interest? http://projects.propublica.org/docdollars/payments/3387121

Jun. 11 2012 01:53 PM
kevin from upper LS

NO! the only inconclusive "science", is that done by the hack, corporate paid research people, at pharmaceutical PR divisions. people who have underwriting money in PRN/WNYC, incidentally. so there is at the very least, an implied conflict of interest in reporting the efficacy of vitamins. you guys at WNYC,continue to bring in the same sort of people on this. i have zero respect for you on this topic. why don't you do a show, on the ineffective and dangerous drugs, that so many american zombies obediently take.

Jun. 11 2012 01:35 PM
Yvonne from Park Slope, Brooklyyn

It is no surprise to me that studies on the efficacy of nutritional supplements have no consistency or reproducibility as not all supplements are created equal ... literally.

To add to what the doctor said who called in with the comment about lack of quality control, the situation is a bit more complicated: there is evidence that the body may not use synthetic vitamins as well as natural, that the body may better utilize what it creates itself (for example, pre-formed vitamin A as in animal liver may not work as well as beta carotene as in either carrots or supplements ... I suspect this may be, also true of protein and amino acids)) and that some compounds (for example, calcium carbonate) are better assimilated than some others (for example, calcium oxide). Add to that the reality that, in this country where more is seen as better, may multivitamins contain high dosages of what is cheap or small and inadequate dosages of what is expensive or bulky without regard to how vitamins and minerals work with or against each other and in what proportions to each other.

Until we understand this better, this is factored into the studies done and consumers are better educated about this, the studies do not mean much.

Jun. 11 2012 12:44 PM

Going on the folksy "imitation is the highest form of flattery" saying...looks like dboy got his first fan!

Jun. 11 2012 12:04 PM

Oooop!

They're coming out of the woodwork!!

Jun. 11 2012 11:52 AM

In 1970 about 18% of personal income was spent on food and just under 10% was spent on health care.

Since then those numbers have flipped, and we spend less than 10% on food 'products' and almost 20% on health care.

Go figure!

(And that's not even mentioning things like the Gulf of Mexico dead zone largely caused by agricultural runoff of all those unnecessary nitrogen fertilizers).

Jun. 11 2012 11:46 AM
dboy2 from Manhattan

I am, in truth, an absolute idiot.....

but if I CAPITALIZE ALL MY WORDS, USE PUNCTUATION !!!! and make up, like, REALLY KOOL spellings.... I might actually fool people into thinking that I HAVE ANY IDEA AT ALL WHAT I AM TALKING ABOUT !!!!

Maybe I'll throw in a few faux OB*#*$CENE words, too. KOOL !!!!!

Jun. 11 2012 11:45 AM
Briank from Nj

So basically the doctors pulled data from various trials supporting their positions. I lean toward MD which says : until you have definitobe proof that putting this pill in my body is beneficial, than I am my taking it.

The MD caller Paul also made a great point- those supplement industries have virtually no regulation. As someone who works in pharma where every utterance, every ad, every piece of literature given to a doctor, must go in from of the FDA for approval. Yet the supplement industry can claim crazy data. Not right. And of course the ingredients in these supplements can also vary quite a bit due to limited regulation.

Jun. 11 2012 11:42 AM
BJK from Queens, NYC

I would be grateful if your guests might be able to comment on the efficacy and safety of DHEA (Dehydroepiandrosterone).
There are claims that the drug is a bioprecursor which is transformed to testerone (in the male body).
I have never been able to confirm what dosage is 'recommended', and if there have been any studies indicating that this compound might have any long-term dangers.

Jun. 11 2012 11:40 AM
Fred Pasternack

Paul gave an anecdotal comment of no real value. There's a difference between association and cause and effect. Right now, a hot topic is HDL...there is an association between elevated HDL and a lowered cardiovascular risk. But then there's an area in Italy with low HDLs and low cardiovascular disease. The point being that the issue may not be the "number" but the function of the HDL particle. Similar concerns may exist with respect to supplements. But what we like to do is "cheat"...to lead a non-prudent life-style and then pop a pill.

Jun. 11 2012 11:38 AM
Em

This was a great illustration of the basic problem with contemporary medicine and medical research. Studies are performed sporadically, inconsistently, haphazardly and more often than not there are vested interests involved. Medical reporting on disease processes and treatments are purely voluntary (apart from a few specific conditions mostly related to infectious disease) in this country. This results in skewed, misleading data.

Additionally, as we see here, MDs with books to sell often will make extreme statements, supported by cherry picked data, which help to publicize their books and improve sales. The reason it is very difficult to educate patients in what is a basic balanced diet, is that they are inundated by so many conflicting sources in the media, mostly from celebrity doctors who are ostensibly "objective" but who have connections with multiple companies that they are never required to reveal. If people do not believe doctors are just as susceptible to conflict of interest issues, or plain simple bias, just like any other professionals, they are sadly mistaken.

Jun. 11 2012 11:38 AM

Supplement™ kooks are as CRAZY as Pharma™ kooks which are all slightly less kooky than the restricted cult diet kooks...

... I did NOT say "vegan"!

Jun. 11 2012 11:37 AM
Susan from Upper West Side

OK - I do have the example of many clinical trials that showed a positive impact. These trials were done in vitamin A DEFICIENT populations however. Dr. Alfred Sommer won the Lasker prize for his work on vitamin A deficiency where he showed that the risk of mortality dropped by about 30% when vitamin A supplements were provided to preschool children. Now, it is important to note that studies that showed increases in consumption of vitamin A rich foods (namely in Bangladesh) ALSO showed a drop in vitamin A deficiency. So an effective program to increase consumption would have the same results.

Jun. 11 2012 11:37 AM
jonn k from Vermont

What are your thoughts on ginkgo biloba?
I've been taking for concentration, not necessarily memory
Is there any damage or side effects that could be caused by this?

Jun. 11 2012 11:36 AM
Elaine from Baltimore

Brian.... sounds like you need zinc lozenges!!! ;-)

Jun. 11 2012 11:36 AM
Craig from Manhattan

Conclusion: as argued by Dr. Agus, healthy adults who eat a healthy diet do not need supplements. Blumberg would have been more persuasive had he taken a nuanced approach. Instead, he seems to advocate any and all supplements mentioned. This raises a question about his connection to the supplements industry.

Jun. 11 2012 11:35 AM
GW from Manhattan

I was taking statins... but the damage that they did to my muscles was extensive. Pain, burning, aches, I still haven't recovered. So I stopped taking them and noticed immediate relief, so I have turned to nutritional supplements and herbs and tried to increase the transformation of cholesterol to sex harmones and melanin in the skin

Jun. 11 2012 11:35 AM
RAllen from NJ

What about super doses of C and D? My current doctor wants both my spouse and I to take 2-10K IU of D twice a day and 2000mg of C twice a day. Aren't there known side effects to high doses of C&D and at what levels?

Jun. 11 2012 11:33 AM
Amy from Manhattan

What about people w/restrictions on their diets, whether they result from a medical condition, like a food allergy or intolerance, or from a personal choice, like vegetarianism or veganism? Sometimes these can make it hard to get enough of certain nutrients in the diet--what do the guests think the role of supplements is in such cases?

Jun. 11 2012 11:32 AM
Judy from Manhattan

It doesn't make sense to randomly imbibe an expensive substance that has a only slight chance of being beneficial and is more likely to be useless or dangerous.

Jun. 11 2012 11:32 AM

CoQ10, fish oil, statins...can't the industry just wrap this all up into one convenient Solvent Green pill that the faithful that take this cr*p can scarf down?

Or people could just eat real food!

Jun. 11 2012 11:31 AM

Eat a varied diet of WHOLE foods!

Love your farmer!!

Jun. 11 2012 11:30 AM

FYI:

The U.S. dietary supplement industry is estimated to be worth $25 BILLION!!!

I'm no fan of BIG Pharma™ or the AMA® or the RDA™ but BIG Supplement™ does NOT seem to have much less in the "game"!!

..jus' sayin'!

Jun. 11 2012 11:28 AM
Susan from Upper West Side

Dr. Jeffrey Blumberg needs to understand that it is very easy to do a study with an inadequate sample size that doesn't pick up on risks. You need large studies to pick up on risks. I would not be convinced from a lack of effect in a small study that there is no risk. You can have infrequent risks that are very severe that are hidden in small studies. A more appropriate evaluation of the studies would be to identify and target JUDICIOUS use of supplements to select groups who may benefit from them without risk. Otherwise we should be spending our research dollars on better ways to improve the quality of food consumed. SOME nutritionists like supplements because they are easier to study.

Jun. 11 2012 11:27 AM
Debbie from nyc

I am pregnant and taking B6. I am currently taking 25mg, but at one time I was taking 50mg-100mg. Is this a problem?

Jun. 11 2012 11:27 AM
John A. from the Natural food store. Period.

There are pills and there are PILLS.
The ones that are mass marketed tend to shoot for 100% of the recommended levels. The ones in the Vitamin Stores are all up at seemingly crazy levels - 2,200% of the recommended limits and the like. Surely this practice has more drawbacks, how damaging could it be?

Jun. 11 2012 11:27 AM
DarkSymbolist from NYC!

Dr. Angus seems to have little or no facts to back up his arguments, and the other guy is running circles around him, quite frankly.

Maybe Dr.Angus is yet another cooky guy with arguments full of holes and declarative statements with no factual backing that this show likes to have on and take seriously like that ridiculous "End of War" guy....that's my impression so far.

Jun. 11 2012 11:27 AM
g in staten island from staten island

Please discuss ginger. Any good evidence that it is an antiflamitory, aids digestion? How much is too much? The bottle I have suggest 1 capsule 3 times/day.

Jun. 11 2012 11:26 AM

dboy...hit it on the head

We need whole foods that aren't laced with carcinogenic pesticides and grown with hormones [which help super-bugs evolve]; and we need it grown on soil that's not bombarded with petroleum industry nitrogen.

The argument against it is that that kind of food system is too expensive for the general public yet that is the food system that was in place in our grandma's time and our current system doesn't include the full costs in environmental and health side effects.

Jun. 11 2012 11:26 AM
Varun from Manhattan, NY

Are multi-vitamins federally regulated? Are they treated as foodstuffs or as drugs? What constitutes a 'multivitamin,' exactly? Is there any regulation on its composition (chemical contents, etc.) or is it self-regulated in that sense?

Jun. 11 2012 11:24 AM
Truth & Beauty from Brooklyn

I agree with Dr. Blumberg in that we should take supplements because we don't always eat properly and we want at least to have the minimum required vitamins. I believe problems arise when people feel that if a little bit is good, then more is better. For example, most people require 30-60 mgs per day of Vitamin C. The body will dispose of any more than that, through the kidneys, and enough of a build up can cause kidney stones, as well as other potential problems based on the quantity consumed.

Another issue is whether various supplements are FDA approved. With those that are not, dosages and potencies vary and one is never certain exactly how much or what the quality of the supplement might be.

Jun. 11 2012 11:24 AM
max

Excessive vitamin B6 causes peripheral neuropathy which I believe I got by taking too much vitamin B6, perhaps above 150 mg/day

Jun. 11 2012 11:23 AM
desdemona finch from Brooklyn

What do your guests think about Tommy Chong "curing" his prostate cancer with hemp oil (or something like that) and pot? Sounds like we should be expecting a "Tommy Chong Dead At 74" headline soon?

Jun. 11 2012 11:22 AM

I take iron b/c I can't afford an optimal source of iron -- grass-fed meat. How should those on a budget decide between a) getting sort of enough nutrients through non-organic foods vs. b) apparently insufficient supplementation through vitamins etc.?

Jun. 11 2012 11:22 AM
Janice Hall from NYC

Can you please ask the guests about the problems in labeling? For example, I have both dairy and soy allergies. My doctor and I believe that supplements' labeling is not necessarily accurate - I continued to have allergic reactions to supplements in spite of labeling to the contrary. The manufacturers/distributers will not provide independent analysis of their products to "prove" no such impurities are in their products, instead insisting "I can give you my word." What actually is the law and regulation on such matters and what assurances are there that there is independent oversight?

Jun. 11 2012 11:21 AM
Amy from Manhattan

I'd like to hear the specific dosages or blood levels of the vitamins & minerals in the studies the guests mention. Sometimes it's a matter of finding the right dose. If some of the studies used megadoses or compared the people w/the highest levels to those w/the lowest, that might not tell us the effects of the supplements at moderate doses or levels.

Jun. 11 2012 11:21 AM

3% of Americans "eat properly?"

i'll bite -- but first, proof and definition please

Jun. 11 2012 11:21 AM
LANCE from bklyn

What are the benefits of fish oil supplements?

Jun. 11 2012 11:21 AM
seth from East Village

What about Glucosamine / Chondroitin Supplements to assist in the buildup of cartlidge? What's the current thinking on this?

Jun. 11 2012 11:21 AM
Tim from Ridgewood

The Vitamin E study that Dr. Angus cites that led to increase incidence of prostate cancer used a synthetic form of Vitamin E.

Jun. 11 2012 11:21 AM
Susan from Upper West Side

Vitamin C is so easy to find in FOOD. The Recommended Dietary Allowances are set high so that most of the population won't be deficient. In this regard, most people who don't meet the RDAs are not necessarily deficient since the recommendations are set high.

Jun. 11 2012 11:20 AM

If supplements aren't being *absorbed* effectively (which I assume is why detractors deem them ineffective), why aren't they? Is it because we don't know enough about which aid which in absorption (like vit. C helping with iron absorption)? How are we to assess brands' claims of better processing for better absorption?

Jun. 11 2012 11:19 AM
Elaine from Baltimore

Please comment on CoEnzyme Q10

Jun. 11 2012 11:18 AM
Tim from Ridgewood

What is the basis for the US RDA for various supplements? For example, the RDA for Vitamin C is 70-90mg. Less than 10mg would lead to scurvy. But what is the optimal level?

Jun. 11 2012 11:17 AM
Erica from BK

How many of the women in the study already had other health problems for which supplements were prescribed by their doctors as opposed to women in the study who might have taken them on their on volition?

Jun. 11 2012 11:17 AM
Susan from Upper West Side

Yes, but there are other really important risks that are exacerbated by the high levels of folic acid that are recommended. One of my professors from Cornell, who is EXCELLENT by the way, is really pissed off that they set the levels so high while ignoring evidence that it has negative effects on adult women. I'm not going to quote her name, but I will email her and read the original studies on this particular issue after this discussion.

Jun. 11 2012 11:15 AM

More and more, studies indicate that there is a synergetic relationship between nutrients and the foods they reside in.

You can't isolate the nutrients and expect them to be beneficial in any way.

You need to eat a quality diet of WHOLE foods.

It's really not too complicated.

Don't drink the AMA (nutrition is not important) OR the Supplement® Industry KoolAid™!!

Jun. 11 2012 11:13 AM
Edward from NJ

In his previous interview, Dr. Agus also seemed to advocate that people take aspirin regularly for it's anti-inflammatory qualities. In that context, his opposition to vitamin supplements came across as "don't take that magic pill! take this magic pill!"

Jun. 11 2012 11:13 AM

what about the soil quality, or lack of quality, in our industrial agriculture mega conglomerate corporate farming? The story is that our soil is devoid of minerals.

Jun. 11 2012 11:13 AM
George from ann arbor

I have hemochromatosis and before it was diagnosed I took a daily womens multi-vitamin with iron. I was diagnosed at 30 with a blood iron saturation of 90%. So, although I believe in taking vitamins, there are conditions that make some vitamins/minerals toxic.

Jun. 11 2012 11:12 AM
Susan from Upper West Side

All of the nutrients you just mentioned can be consumed from food. Is Jeffrey Blumberg an epidemiologist or a biochemical nutritionist. Linus Pauling may have won the Nobel Prize but his epidemiological research was deeply flawed.

Jun. 11 2012 11:10 AM
carolita from NYC

Big Pharma would LOVE for us all to stop taking vitamins and just buy their medicines. That's where all this discrediting of vitamins, minerals, and herbal supplements is coming from.

Jun. 11 2012 11:08 AM

Leave a Comment

Email addresses are required but never displayed.